Nasal Cavity (nasal + cavity)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Actinomycosis of the Nasal Cavity: Case Report and Literature Review

Sreekrishna K. Donepudi MD
No abstract is available for this article. [source]

The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder

L. F. Fontenelle
Objective: To describe a different type of self-injurious behavior that may be secondary to body dysmorphic disorder (BDD). Method: Single case report. Results: We reported a case of an individual who have developed the self-destructive habit of pulling and severely scraping hairs and debris out of the mucous membrane of his nasal cavities. We have proposed the term rhinotrichotillomania to emphasize the phenomenological overlapping between trichotillomania (TTM) and rhinotillexomania (RTM) exhibited by this case. The main motivation behind the patient's actions was a distressing preoccupation with an imaginary defect in his appearance, which constitutes the core characteristic of BDD. The patient was successfully treated with imipramine. Conclusion: The case suggests that certain features of TTM, RTM, and BDD may overlap and produce serious clinical consequences. Patients with this condition may benefit from a trial of tricyclics when other effective medications, such as serotonin reuptake inhibitors, are not available for use. [source]

Dehydroepiandrosterone regulates astroglia reaction to denervation of olfactory glomeruli

GLIA, Issue 3 2004
Zsófia Hoyk
Abstract Effects of dehydroepiandrosterone (DHEA) on glial reactions of the peripherally denervated olfactory bulb were studied in adult male rats. Denervation was achieved by destroying the olfactory mucosa with ZnSO4 (0.17 M) irrigation of the nasal cavities. In one series of experiments, chronic DHEA treatment was applied (daily injections for 7 days, i.p., 10 mg/kg b.w. and 25 mg/kg b.w.); in the other series of experiments, animals received a single injection of DHEA (i.p., 10 mg/kg b.w., 25 mg/kg b.w. and 50 mg/kg b.w.) 2 h following ZnSO4 treatment. To determine whether DHEA conversion to estradiol was involved in the mechanism of DHEA action on glia, a third series of experiments was carried out in which the aromatase inhibitor fadrozole (4.16 mg/ml) was administered using subcutaneously implanted osmotic minipumps. Rats were killed on day 7 after chemical denervation, and the reaction of glial cells was monitored within the olfactory bulb, using GFAP and vimentin immunohistochemistry. Qualitative changes in GFAP expression were analyzed by Western blot. Chronic DHEA treatment with both doses (10 mg/kg b.w. and 25 mg/kg b.w.) and acute DHEA treatment with the highest dose applied (50 mg/kg b.w.), inhibited the increase in GFAP expression induced by the denervation of the olfactory bulb. Furthermore, GFAP and vimentin immunostaining in the glomerular layer of the olfactory bulb were diminished in the denervated and DHEA treated groups. However, when DHEA treatment was combined with fadrozole administration, such a decrease in GFAP expression could not be detected in the chemically denervated olfactory bulb. These findings indicate that DHEA, depending on the dose applied and the mode of administration, attenuates glial reaction to denervation and may regulate glial plasticity in the olfactory glomeruli. These effects are likely to be mediated at least in part by the conversion of DHEA to estradiol. © 2004 Wiley-Liss, Inc. [source]

Host response to the chondracanthid copepod Chondracanthus goldsmidi, a gill parasite of the striped trumpeter, Latris lineata (Forster), in Tasmania

M Andrews
Abstract The chondracanthid copepod, Chondracanthus goldsmidi is an ectoparasite of gills, inner opercula and nasal cavities of cultured striped trumpeter, Latris lineata (Forster). Whilst often present in high numbers (up to 60 parasites per host), little is known about its effect on striped trumpeter. In this study C. goldsmidi was associated with extensive epithelial hyperplasia and necrosis. Pathological changes were most pronounced near the parasite's attachment site, with papilloma-like growths surrounding the entire parasite resulting in deformation of the filament. The number of mucous cells increased near the parasite attachment sites on both the opercula and gills. Mast cells were absent in healthy gills; in contrast numerous mast cells were identified in the papilloma-like growths. Immunostaining identified piscidin-positive mast cells in the papilloma-like growths, presenting the first evidence of piscidin in the family Latridae. [source]

Early Onset Childhood Cicatricial Pemphigoid: A Case Report and Review of the Literature

Monia Kharfi M.D.
We describe a new case in a 20-month-old boy, who is to our knowledge the youngest patient reported yet. The disorder had begun 10 months before he was referred to our department by mucosal crusted erosions of the oral and nasal cavities and conjunctivae. Cutaneous examination showed buccal erosions with limited mouth opening, entropion of the lower eyelids, trichiasis, cicatricial cornea, synechia of the nasal cavities and hypopigmented lesions of the abdomen. There were no anal or genital lesions. Cicatricial pemphigoid was confirmed by positive direct and indirect immunofluorescence on mucous biopsy. Systemic corticosteroids (2 mg/kg/day), maintained for 12 months, had led to complete healing of lesions. But due to cicatrization, synechia of the nasal cavities and corneal opacities, leading to a dramatic visual loss, have occurred. Dapsone 25 mg/day and topical ocular cyclosporine are now maintained to avoid relapse. Our review of the literature of all cases of CP showed that ocular and to a less degree, vulvar lesions are the most severe ones, due to the serious complications with scar formation. [source]

Triamcinolone-impregnated nasal dressing following endoscopic sinus surgery: A randomized, double-blind, placebo-controlled study,,

David W. J. Côté MD
Abstract Objectives/Hypothesis: To evaluate the impact of steroid-impregnated absorbable nasal dressing on wound healing and surgical outcomes after endoscopic sinus surgery (ESS). Study Design: A prospective, randomized, double-blinded, placebo-controlled trial. Methods: Chronic rhinosinusitis patients with polyposis who were to undergo bilateral endoscopic sinus surgery were recruited and randomized to receive triamcinolone-impregnated bioresorbable dressing (Nasopore; Stryker Canada, Hamilton, Ontario, Canada) in one nasal cavity and saline-impregnated dressing contralaterally. Postoperative healing assessments of edema, crusting, secretions, and scarring were done at postoperative days 7, 14, 28 and at 3 and 6 months using validated Lund-Kennedy and Perioperative Sinus Endoscopy (POSE) scores. Results: Analysis of 19 enrolled patients having completed observation shows no significant difference between the cavity scores preoperatively using both the POSE and Lund-Kennedy scores. There was, however, a statistically significant difference at day 7 and 14 in both the Lund-Kennedy (P = .04 and P = .03, respectively) and POSE scores (P = .03 and P = .001, respectively) for the treatment and control groups, and a significant difference was also detected between the groups at 3- and 6-month observations (Lund-Kennedy, P = .007 and P = .02, respectively; POSE, P = .049 and P = .01, respectively). Conclusions: Data analysis suggests a significant improvement in early postoperative healing in nasal cavities receiving triamcinolone-impregnated absorbable nasal packing following ESS and is also associated with improved healing up to 6 months postoperatively. [source]

Developing a Rabbit Model of Rhinogenic Chronic Rhinosinusitis,

Kai-Li Liang MD
Abstract Objective: The purpose of this study was to develop a rabbit model of rhinogenic chronic rhinosinusitis (CRS). Methods: New Zealand white rabbits were used and divided into two groups. In group A rabbits, a piece of Merocel (Medtronic-Xomed, Jacksonville, FL) was inserted into one nasal cavity and the other was left undisturbed as control. In group B rabbits, 1 ,g phorbol 12-myristate 13-acetate (PMA) was injected into bilateral nasal lateral walls and then a piece of Merocel (Medtronic-Xomed) was inserted into one nasal cavity. At week 2, the Merocel (Medtronic-Xomed) was removed, and computed tomography (CT), nasoendoscopy, and cultures were performed. All examinations were repeated at week 12. Rabbits that had purulent discharge in nasal cavities and sinuses opacification shown in CT scans were diagnosed as having rhinosinusitis. Rabbits with CRS were randomly allocated to receive intravenous ceftriaxone (50 mg/kg/day) for 28 days or nothing. All rabbits with CRS received CT scans, nasoendoscopy, and cultures at week 16. Results: At week 12, CRS had developed in two controlled nasal cavities, six nasal cavities inserted with Merocel (Medtronic-Xomed), six nasal cavities injected with phorbol 12-myristate 13-acetate (PMA), and seven both PMA-injected and Merocel- (Medtronic-Xomed) inserted nasal cavities. Seven of nine treated CRS sides were clear of opacification after treatment. All non-treated CRS sides had persistent diseases at week 16. There was a significant difference in the CRS incidence (P = .00043) and culture rates (P = .027) between treated and non-treated CRS nasal cavities. Conclusions: Our study developed a rabbit model of rhinogenic CRS. This model is easily performed and is reversible by treatment. [source]

Changes in Nasal Cavity Dimensions in Children and Adults by Gender and Age,

Boles, aw K. Samoli, ski MD
Abstract Objective: The aim of the study was to establish the dynamics of changes in the intranasal spaces of children and adults by gender and age. Materials and methods: Each side of the nasal cavity was evaluated separately in 366 healthy subjects 9 to 74 years old. The following acoustic rhinometry parameters were analyzed: 1) I-C, distance between the isthmus nasi (I) and the head of the inferior turbinate (C); 2) CA-I, cross-sectional area at the isthmus nasi; 3) CA-C, at the head of the inferior turbinate; and 4) CA-F, the highest point on the rhinometric curve between points I and C. Results: Before age 11 years, the intranasal spaces were slightly larger in girls than in boys. After age 11 years the nasal parameters were larger in boys than in girls. The growth rates before age 17 years were as follows: I-C: 0.073 cm/yr, 0.135 cm/yr, CA-F: 0.055 cm2/yr, 0.133 cm2/yr (P < .00001), and CA-C: 0.010 cm2/yr, 0.034 cm2/yr (P < .02) in girls and boys, respectively. In subjects older than 16 years, the mean values of I-C were 1.707 cm, 1.934 cm (P < .0001), and of CA-C, 0.493 cm2, 0.611 cm2 (P < .0001) in women and men, respectively, and changed slightly over the year. Conclusions: The parameters of intranasal spaces depend on age and gender. The dynamics of the changes is greater in boys than in girls and usually the growth is completed by the age of 16. After this age, nasal cavities are bigger in men than in women. [source]

Nasal Nitric Oxide in Children: A Novel Measurement Technique and Normal Values,,

Hamid Daya FRCS (ORL)
Abstract Objectives To develop and standardize a technique for measuring nasal nitric oxide (NO) output in children and to determine normal values in this population. Study Design Prospective study evaluating a new technique for measuring nasal nitric oxide in a cohort of normal patients and a cohort of patients with nasal disease. Methods Nasal NO was measured using an aspiration technique, aspirating room air through the nasal cavities by means of a Teflon nozzle placed in one nasal vestibule while maintaining velopharyngeal closure using a party "blow-out" toy Results Nasal NO measurements were performed in 45 children (mean age, 11.0 y; age range, 3.2,17.6 y) There were 20 girls and 25 boys. All children were able to perform the maneuvers necessary for measurement of nasal NO output. Among the subgroup of normal healthy children (30), there was considerable variation in NO output between subjects, with a mean NO output of 481 nL/min and an SD of 283 nL/min. Conclusions Nasal NO can be readily measured in children using the presented technique. There is considerable variability in the values for nasal NO output in normal children. [source]

Hypoxia Depresses Nitric Oxide Output in the Human Nasal Airways

James S. J. Haight MD
Abstract Objectives The role of oxygen in the nasal air on nasal nitric oxide (NO) output was studied in 13 adult volunteers. Methods Nasal NO was measured while air containing oxygen (0%,100% in nitrogen) was aspirated through the nasal airway before and after the topical application of xylometazoline. Results The mean nasal NO output of the untreated nose was 507.8 ± 161.9 nL/min (mean ± SD) when 21% oxygen was aspirated through the nasal cavities in series and remained unaltered by 100% O2 (P = .79). Below 10% oxygen the reduction in nasal NO output correlated positively and significantly with the decrease in oxygen concentration (r2 = 0.14). NO output was 245.2 ± 153.4 nL/min at 0% oxygen, a significant decline from 21% oxygen (P < .0001). Nasal vasoconstriction induced by xylometazoline and alterations in the blood oxygen content by a maximal breath-holding or breathing 100% oxygen did not alter nasal NO in hypoxia (P = .41). Conclusions Nasal NO output is markedly depressed in hypoxia and is oxygen dependent at concentrations of less than 10%. Approximately 50% of nasally generated NO is produced from oxygen in nasal air or regulated by it. [source]

Role of Vascular Reflex in Nasal Mucosal Swelling in Nasal Allergy

Tsutomu Numata MD
Abstract Objective: In patients with nasal allergy, antigen challenge on the unilateral nasal mucosa results in nasal secretion not only in the ipsilateral but also in the contralateral nasal cavities that can be inhibited almost completely by premedication with atropine sulfate. The present study was performed to elucidate if centrally mediated vascular reflex induced by antigen challenge plays a role in nasal mucosal swelling in subjects with nasal allergy. Methods: Variations of mucosal swelling and mucosal blood flow in the ipsilateral and the contralateral nasal cavities after unilateral antigen challenge were evaluated by acoustic rhinometry and laser Doppler flowmetry in 20 patients with perennial nasal allergy. Results: Unilateral antigen challenge caused ipsilateral and contralateral nasal mucosal swelling in 17 and 13 patients, respectively. Incidence of contralateral nasal mucosal swelling after unilateral antigen challenge was significantly higher compared with that after control disc challenge (P < .001). In 10 patients in whom unilateral antigen challenge caused bilateral nasal mucosal swelling, significant swelling of the nasal mucosa lasted for more than 30 minutes in the ipsilateral nasal cavity after antigen challenge compared with only 15 minutes in the contralateral nasal cavity. Peak values of contralateral mucosal swelling were 45.3% of those of ipsilateral nasal mucosa. Conclusions: Centrally mediated vascular reflex is partially involved in the onset of nasal mucosal swelling observed after antigen challenge in subjects with nasal allergy. However, nasal mucosal swelling that persists and proceeds even 20 minutes after antigen challenge is caused by the direct effects of chemical mediators on the nasal vasculature. [source]

Intranasal absorption of sumatriptan and naratriptan: no evidence of local transfer from the nasal cavities to the brain arterial blood in male rats

Niels Einer-Jensen
Abstract Nasal administration to rats of small molecules (tritiated water, tyrosine, and propanol) results in a higher concentration in the brain arterial blood than in other arteries. The preferential distribution is based on a counter current transfer, which takes place between nasal vein blood and brain arterial blood in the cavernous sinus-carotid artery complex. This model was used to investigate whether the antimigraine 5HT1B/1D receptor agonists sumatriptan and naratriptan may also be transferred by the system. The ratio of ,head':,heart' plasma concentrations obtained from two carotid catheters after intranasal administration was not different from 1.00 for either compound, and thus, there was no experimental evidence of a preferential local transfer of drug from the nose to the carotid artery circulation. However, plasma concentrations increased from the first minute after intranasal dosing suggesting that sumatriptan and naratriptan are absorbed into the general systemic circulation from the nasal cavity in rats in a first-order fashion with no lag time. This is consistent with the clinical onset of efficacy of sumatriptan after an intranasal dose which occurs as early as 15 min post dose. Copyright © 2001 John Wiley & Sons, Ltd. [source]

The effect of inferior turbinate hypertrophy on nasal spray distribution to the middle meatus,

A.C. Dowley
The effect of inferior turbinate hypertrophy on nasal spray distribution to the middle meatus The distribution of topical nasal sprays is suboptimal, the main obstruction to adequate delivery in normal volunteers being the nasal valve. We aimed to test the hypothesis that, in patients with rhino-sinusitis, hypertrophy of the inferior turbinate also limits the distribution of administered drug to the middle meatus. We modelled the effect of inferior turbinate hypertrophy and reduction by effecting congestion (by ipsilateral isometric exercise) and decongestion (topical oxymetazoline) in normal volunteers. The method chosen to estimate drug delivery to the middle meatus used endoscopic photography after the administration of dyed aqueous spray. A randomized cross-over study design was used and 20 nasal cavities were studied. The congestion/decongestion manoeuvres significantly altered nasal airflow, as measured by peak inspiratory nasal flow (P < 0.001). Congestion diminished significantly drug delivery to the middle meatus, as compared with decongestion (P = 0.026). This may support a clinical role for inferior turbinate reduction to improve the efficacy of topical nasal therapy, as well as improving nasal airflow. [source]

Does stimulation of nasal mucosa cause referred pain to the face?

M. Abu-Bakra
Ten healthy volunteers (five men and five women, mean age 30 years 3 months), with no nasal contact points, had pressure, adrenaline (1 : 1000), substance P (10 and 80 nmol/mL) and placebo topically applied to their nasal mucosa. Areas stimulated were the nasal floor, septum and lateral wall as well as the inferior and middle turbinates in both nasal cavities. The application of stimuli was randomized and single-blinded. A numerical score of the subjective severity of pain was used to assess outcome. Pressure caused variable local nasal discomfort limited by the duration of application and the site of pressure. Substance P caused variable nasal itching and sneezing. None of the stimuli caused referred pain to the face. The results question the role of mucosal contact points in facial pain. [source]

Severe periodontal damage by an ultrasonic endodontic device: a case report

John D. Walters
Abstract,,, Heat produced within a root canal during use of an ultrasonic instrument can be conducted through the dentin into periodontal ligament, bone and soft tissue. If severe in intensity or long in duration, it can induce damage to these tissues. This report describes a case in which an ultrasonic endodontic instrument apparently induced severe damage to alveolar bone, gingiva and nasal mucosa in a 42-year-old female. Overheating of a maxillary central incisor caused necrosis of soft tissue and bone on the facial and mesial aspects and triggered a protracted inflammatory response in the adjacent nasal cavity. To relieve the severe discomfort associated with this damage, the patient chose to have her maxillary incisors extracted and replaced by a removable partial denture. A defect in the soft tissue and bone was present at a follow-up visit 10 months after the extractions. While morbidity of this nature is rare, this case reinforces the need to maintain adequate cooling of ultrasonic instruments. [source]

Cytologic diagnosis of hemangiopericytoma of nasal cavity

Article first published online: 24 JUL 200
No abstract is available for this article. [source]

Treatment of an osteoblastic osteosarcoma in an aged gelding

T. Springer
Summary A 27-year-old Thoroughbred gelding was examined for a right nasal mass visible inside the right nares. Airflow through the right nostril was absent. Endoscopy and radiography revealed the mass to occupy the entire right nasal passage. Nasal biopsies were inconclusive, so en bloc resection was performed. A diagnosis of an incompletely resected osteoblastic osteosarcoma was made. Endoscopic biopsies performed 4 weeks post surgery revealed osteosarcoma cells present in the caudal right nasal cavity. Metastatic disease was not present in mandibular lymph node aspirates or on thoracic radiographs. The right nasal passage was irradiated with 12 treatments over the course of 4 weeks. Comfort and quality of life were excellent during treatment and no adverse side effects were noted. Endoscopy and follow-up biopsies at 1, 2, 4, 12 and 14 months post radiation therapy have not found any evidence of regrowth of the osteosarcoma. [source]

Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and in the nasal cavity of the mouse

Forugh Vaziri Sani
Vaziri Sani F, Kaartinen V, El Shahawy M, Linde A, Gritli-Linde A. Developmental changes in cellular and extracellular structural macromolecules in the secondary palate and nasal cavity of the mouse. Eur J Oral Sci 2010; 118: 221,236. © 2010 The Authors. Journal compilation© 2010 Eur J Oral Sci The aim of this study was to analyse the hitherto largely unknown expression patterns of some specific cellular and extracellular molecules during palate and nasal cavity development. We showed that epithelia of the developing palate and the vomerine epithelium express similar sets of structural proteins. With the exception of keratin 15, which becomes barely detectable in the elevated palatal shelves, nearly all of these proteins become upregulated at the presumptive areas of fusion and in the adhering epithelia of the palate and nasal septum. In vivo and in vitro analyses indicated that reduction in the amount of keratin 15 protein is independent of Tgf,,Alk5 signalling. Foxa1 expression also highlighted the regionalization of the palatal and nasal epithelia. Owing to the lack of reliable markers of the palatal periderm, the fate of peridermal cells has been controversial. We identified LewisX/stage-specific embryonic antigen-1 as a specific peridermal marker, and showed that numerous peridermal cells remain trapped in the medial epithelial seam (MES). The fate of these cells is probably apoptosis together with the rest of the MES cells, as we provided strong evidence for this event. Heparan sulphate, chondroitin-6-sulphate, and versican displayed dynamically changing distribution patterns. The hitherto-unknown innervation pattern of the developing palate was revealed. These findings may be of value for unravelling the pathogenesis of palatal clefting. [source]

Holes in the head: Evolutionary interpretations of the paranasal sinuses in catarrhines

Todd C. Rae
Everyone who has ever experienced a head cold is familiar with the paranasal sinuses, the bony hollows above and beside the nasal cavity that contribute, sometimes painfully, to upper respiratory tract disorders. These internal cranial structures have a wide distribution among eutherian mammals and archosaurs.1, 2 Sinuses have languished somewhat in the shadow of their better known and more accessible morphological cousins (dentition, postcrania), but new imaging techniques, growth studies, and explicit phylogenetic evaluation3 are beginning to fill in the gaps in our knowledge of the evolution of these enigmatic spaces in primates and promise to yield insights into the evolution of the facial skeleton. [source]

Long-term retention of coded wire tags in juvenile Arctic charr Salvelinus alpinus

Abstract, A hatchery experiment was organised to find out if the high loss rate of coded wire tags, noticed in connection with an Arctic charr Salvelinus alpinus (L.) restocking programme, was size-dependent and also to test head moulds for future taggings. Six moulds made by Northwest Marine Technology Inc. and five moulds made at the Finnish Game and Fisheries Research Institute were used. A total of 100 charr were tagged with standard-length coded wire tags using each mould. One-summer old charr at tagging were held for 534 days and two-summer old charr for 320 days. The tag loss rate varied between 0% and 54% and was negatively related to the size of the charr at tagging. The high loss rate was connected with the poor alignment of some moulds, such that a large proportion of the tags were located in the nasal cavity instead of the nasal cartilage. Testing of the moulds and careful grading of the fish for tagging is emphasised, especially if Arctic charr smaller than 20 g in weight are to be tagged. [source]

Comparative gene expression profiling of olfactory ensheathing glia and Schwann cells indicates distinct tissue repair characteristics of olfactory ensheathing glia

GLIA, Issue 12 2008
Elske H.P. Franssen
Abstract Olfactory ensheathing glia (OEG) are a specialized type of glia that support the growth of primary olfactory axons from the neuroepithelium in the nasal cavity to the brain. Transplantation of OEG in the injured spinal cord promotes sprouting of injured axons and results in reduced cavity formation, enhanced axonal and tissue sparing, remyelination, and angiogenesis. Gene expression analysis may help to identify the molecular mechanisms underlying the ability of OEG to recreate an environment that supports regeneration in the central nervous system. Here, we compared the transcriptome of cultured OEG (cOEG) with the transcriptomes of cultured Schwann cells (cSCs) and of OEG directly obtained from their natural environment (nOEG), the olfactory nerve layer of adult rats. Functional data mining by Gene Ontology (GO)-analysis revealed a number of overrepresented GO-classes associated with tissue repair. These classes include "response to wounding," "blood vessel development," "cell adhesion," and GO-classes related to the extracellular matrix and were overrepresented in the set of differentially expressed genes between both comparisons. The current screening approach combined with GO-analysis has identified distinct molecular properties of OEG that may underlie their efficacy and interaction with host tissue after implantation in the injured spinal cord. These observations can form the basis for studies on the function of novel target molecules for therapeutic intervention after neurotrauma. © 2008 Wiley-Liss, Inc. [source]

Bacteria and PAMPs activate nuclear factor ,B and Gro production in a subset of olfactory ensheathing cells and astrocytes but not in Schwann cells

GLIA, Issue 9 2007
Adele J. Vincent
Abstract The primary olfactory nerves provide uninterrupted conduits for neurotropic pathogens to access the brain from the nasal cavity, yet infection via this route is uncommon. It is conceivable that olfactory ensheathing cells (OECs), which envelope the olfactory nerves along their entire length, provide a degree of immunological protection against such infections. We hypothesized that cultured OECs would be able to mount a biologically significant response to bacteria and pathogen-associated molecular patterns (PAMPs). The response of OECs to Escherichia coli (E. coli) and various PAMPs was compared to that of Schwann cells (SCs), astrocytes (ACs), and microglia (MG). A subset of OECs displayed nuclear localization of nuclear factor ,B), an inflammatory transcription factor, after treatment with E. coli (20% ± 5%), lipopolysacchride (33% ± 9%), and Poly I:C (25% ± 5%), but not with peptidoglycan or CpG oligonucleotides. ACs displayed a similar level of activation to these treatments, and in addition responded to peptidoglycan. The activation of OECs and ACs was enhanced by coculture with MG (56% ± 16% and 85% ± 13%, respectively). In contrast, SCs did not respond to any treatment or to costimulation by MG. Immunostaining for the chemokine Gro demonstrated a functional response that was consistent with NF,B activation. OECs expressed mRNA for Toll-like receptors (TLRs) 2 and 4, but only TLR4 protein was detected by Western blotting and immunohistochemistry. The results demonstrate that OECs possess the cellular machinery that permits them to respond to certain bacterial ligands, and may have an innate immune function in protecting the CNS against infection. © 2007 Wiley-Liss, Inc. [source]

Outcome of sinonasal melanoma: Clinical experience and review of the literature,

Thomas N. Roth MD
Abstract Background. Primary sinonasal malignant melanoma (SNMM) is a rare clinical entity. There is neither a classification nor a staging system nor an evidence-based treatment concept established. Our objective was to find potential risk factors predicting the outcome. Methods. Twenty-five patients with histologically confirmed SNMM were consecutively included and retrospectively analyzed. Staging methods were nasal endoscopy, CT, MRI, and positron emission tomography (PET) scan. Patients were selected for a curative or palliative concept. All patients had postoperative follow-up with control-MRI at 3 and 6 months. Restaging was performed when local recurrence occurred. Results. Nineteen patients underwent primary surgery with curative intention; in 16 cases with tumor free margins. Thirteen patients (68%) had transnasal endoscopic surgery, 4 lateral rhinotomy, and 2 transfacial approach with orbital exenteration. Six patients (32%) had palliative therapy and 7 patients (37%) had adjuvant radiotherapy. Despite radical operations, 6 patients (37%) showed local recurrence and 8 patients (50%) developed distant metastasis. In 2 patients with incomplete surgery, regional metastasis was noted. The median disease-free interval was 18 months, and the median overall survival rate was 23 months. Conclusion. SNMMs of the ethmoid and maxillary sinuses have a worse prognosis than other localizations in the nasal cavity; infiltration into the skull base, orbit, or facial soft tissue correlates with a very poor outcome corresponding to the palliative situations. Furthermore, local recurrence insinuates aggressive disease with short survival rate. A main difference from its cutaneous counterpart seems to be a primary tendency to hematogenic spread. Further research is needed to confirm these findings. © 2010 Wiley Periodicals, Inc. Head Neck, 2010 [source]

Malignant fibrous histiocytoma of the sinonasal tract

Cheng-Ping Wang MD
Abstract Background Sinonasal malignant fibrous histiocytoma (MFH) is rare. Methods Twenty-five patients were registered with a diagnosis of sinonasal MFH at our hospital in the past 30 years. Clinical data were retrospectively reviewed. Results Eight tumors were primary MFH and 17 tumors were post-irradiated MFH, located within the radiation field for previous nasopharyngeal carcinoma. Twenty-one tumors originated from the maxillary sinus, 3 from the nasopharynx, and 1 from the nasal cavity. Twenty-three patients underwent surgery but only 12 tumors were removed completely. The 5-year overall and disease-free survival rates were 25.1% and 21.5%, respectively. Multivariate analyses showed that previous radiation was the only adverse prognostic factor for disease-free survival (p = .045). The 5-year disease-free survival rates of primary MFH and post-irradiated MFH were 72.9% and 0%. Conclusion In this series, post-irradiated MFH was more common than primary MFH. The prognosis of post-irradiated MFH is poor, whereas primary MFH is fair. © 2008 Wiley Periodicals, Inc. Head Neck, 2009 [source]

Postoperative intensity-modulated radiation therapy for cancers of the paranasal sinuses, nasal cavity, and lacrimal glands: Technique, early outcomes, and toxicity,

Bradford S. Hoppe MD
Abstract Background Our aim was to review Memorial Sloan-Kettering Cancer Center's experience with postoperative intensity-modulated radiotherapy (IMRT) for paranasal sinus, nasal cavity, and lacrimal gland cancer and report dosimetric measures, toxicity, and outcomes. Methods Between September 2000 and June 2006, 37 patients with paranasal sinus, nasal cavity, or lacrimal gland cancer underwent postoperative IMRT. Median values were as follows: prescription dose, 60 Gy (range, 50,70); PTVD95, 99% (range, 79,101%); optic nerve Dmax, 53 Gy (range, 2,54); optic chiasm Dmax, 51Gy (range, 2,55). Acute and late toxicities were scored by Radiation Therapy Oncology Group morbidity criteria. Results Median follow-up was 28 months. Two-year local progression,free and overall survivals were 75% and 80%. No early- or late-grade 3/4 radiation-induced ophthalmologic toxicity occurred. Conclusions Preliminary results show that adjuvant IMRT in these patients is feasible, allowed for excellent planning target volume (PTV) coverage, and minimized dose delivered to optic structures. Longer follow-up is warranted to assess the extent of late effects and outcomes. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [source]

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: A 25-year experience

David J. Howard FRCS, FRCS(Ed)
Abstract Background. Craniofacial resection is the established "gold standard" for surgical treatment of tumors affecting the anterior skull base. Methods. This study analyzed 308 patients (220 males, 88 females) who had undergone craniofacial resection for sinonasal neoplasia with up to 25-year follow-up. Results. An overall actuarial survival of 65% at 5 years and 47% at 10 years was found for the cohort as a whole. For patients with malignant tumors, the 5-year actuarial survival was 59%, falling to 40% at 10 years. For patients with benign pathology, the actuarial survival was 92% at 5 years falling to 82% at 10 years. Statistical analysis again identified brain involvement, type of malignancy, and orbital involvement as the 3 most significant prognostic factors. Conclusion. Analysis of one of the largest single institution cohorts over a 25-year period provides a baseline against which other approaches such as an entirely endoscopic skull base resection must be judged. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source]

Kaposiform hemangioendothelioma arising in the ethmoid sinus of an 8-year-old girl with severe epistaxis

Manfred T. Birchler MD
Abstract Background. Epistaxis is very common during childhood. It occurs primarily in boys and is usually self-limiting. Trauma and nose picking are among the most common causes. In general, epistaxis can be easily treated with anterior nasal packing or electrocoagulation. Methods. We report a case of an 8-year-old girl with severe unilateral epistaxis. Results. The bleeding originated from a kaposiform hemangioendothelioma arising in the left nasal cavity and ethmoid sinus. The feeding vessels originating from the maxillary artery were first embolized. The tumor was then surgically removed through a combined external ethmoidectomy and endonasal approach. The postoperative course was uneventful. MRI at 6 months after surgery showed no tumor recurrence. Conclusions. We report a previously undescribed cause of epistaxis in children, namely, a kaposiform hemangioendothelioma. To our knowledge, this is the first such case in the English-language literature. The differential diagnosis of severe unilateral nasal bleeding among the pediatric population should include the possibility of a kaposiform hemangioendothelioma. © 2006 Wiley Periodicals, Inc. Head Neck, 2006 [source]

Clinical relevance of three subtypes of primary sinonasal lymphoma characterized by immunophenotypic analysis

Gwi Eon Kim MD
Abstract Background. The purpose of this study was to investigate the clinical relevance of subtypes categorized by immunophenotypic analysis in primary sinonasal lymphomas. Methods. Eighty patients with localized non-Hodgkin's lymphoma involving the nasal cavity and/or paranasal sinuses were divided into three subtypes on the basis of their immunohistochemical findings: (A) B-cell lymphoma (n = 19), (B) T-cell lymphoma (n = 27), and (C) natural killer (NK)/T-cell lymphoma (n = 34). The clinicopathologic profiles, immunophenotypic data, patterns of treatment failure, and survival data among the three patient groups were retrospectively compared. Results. The nasal cavity was the predominant site of involvement in T-cell and NK/T-cell lymphoma, whereas sinus involvement without nasal disease was common in B-cell lymphoma. Systemic B symptoms were frequently observed in NK/T-cell lymphoma. Almost all patients with NK/T-cell lymphoma showed a strong association with the Epstein-Barr virus by in situ hybridization studies. Sixty-five patients (81%) patients achieved complete remission after initial treatment, but 36 (55%) of these subsequently experienced treatment failure. Although there were no significant differences in locoregional failure rates among the patients of the three groups, distant failure was far more common in B-cell or NK/T-cell lymphoma than in T-cell lymphoma (p = .005). Most B-cell lymphoma cases showed a predilection for sites of systemic failure in the nodal and extranodal sites below the diaphragm, such as the paraaortic lymph nodes or the gastrointestinal (GI) tract, whereas patients with NK/T-cell lymphoma showed an increased risk of systemic dissemination to the skin, testes, or GI tract, including the development of hemophagocytic syndrome. The 5-year actuarial and disease-free survival rates for all patients were 57% and 51%, respectively. Of the three subtypes of primary sinonasal lymphomas, T-cell lymphoma seemed to carry the most favorable prognosis and NK/T-cell lymphoma the worst. (The 5-year actuarial survival rate was 57% for B-cell lymphoma, 80% for T-cell lymphoma, 37% for NK/T-cell lymphoma; p = .02, log-rank.) By univariate and multivariate analyses, immunophenotype was identified as the most important prognostic factor. Conclusions. Our data indicate that the three subtypes of primary sinonasal lymphomas classified by immunohistochemical studies exhibit different clinical profiles, different patterns of failure, and different treatment outcomes. Given these observations, it is concluded that the recognition of these distinct subsets, diagnosed on the basis of immunophenotypic study, is very important and clinically relevant in predicting their potential behavior and prognosis. © 2004 Wiley Periodicals, Inc. Head Neck26: 584,593, 2004 [source]

Odontogenic ghost cell carcinoma

David Goldenberg MD
Abstract Background. Odontogenic ghost cell carcinoma (OGCC), a malignant counterpart of the calcifying odontogenic cyst (COC), is exceedingly rare. Previous descriptions of this tumor were based on identification of malignant histologic characteristics such as infiltration, cellular pleomorphism, numerous mitoses, and necrosis concurrent with classical benign COC or its solid benign variant, the odontogenic ghost cell tumor. Methods. We present a case of a young Asian man who underwent multiple local excisions of a recurring maxillary COC. After one such excision, a rapid onset of painful swelling ensued, and the patient was referred to our institution for definitive surgery. Results. The patient underwent a right subtotal maxillectomy. Intraoperatively, a 5-cm tumor was found to be extending into the right maxillary sinus and nasal cavity. The excised tumor was diagnosed as an OGCC. The tumor was excised with clear margins, and no adjunctive radiotherapy was given. The patient was free of residual or recurrent disease 18 months after surgery. Conclusions. On the basis of this case and prior cases found in the literature, OGCCs show a spectrum of growth from slow growing locally invasive tumors to highly aggressive, rapidly growing, infiltrative tumors. Wide local excision with histologically clean margins is the recommended mode of treatment. We recommend close long-term surveillance of recurrent or long-standing benign COCs and OGCC. © 2003 Wiley Periodicals, Inc. Head Neck26: 378,381, 2004 [source]

Radiation therapy for esthesioneuroblastoma: Rationale for elective neck irradiation,

Alan T. Monroe MD
Abstract Purpose. Esthesioneuroblastoma is an uncommon malignancy of neural crest origin arising in the upper nasal cavity. We describe the University of Florida experience using radiation therapy (RT) in the treatment of this neoplasm, particularly the use of elective nodal irradiation. Materials and Methods. Between May 1972 and August 1998, 22 patients received RT for esthesioneuroblastoma. Two additional patients were treated with palliative intent and were excluded from analysis. Equal numbers of male and female patients were treated, with a median age of 54 years (range, 3,82). The modified Kadish stage was A in 1 patient, B in 4 patients, C in 15 patients, and D in 2 patients. Treatment modalities included primary RT in 6 patients, preoperative RT in 1 patient, postoperative RT after craniofacial resection in 12 patients, and salvage RT in 3 patients treated for recurrence after surgery. Elective neck RT was performed in 11 of 20 patients; 2 patients had cervical metastases at presentation for RT. Results. Rates of local control, cause-specific survival, and absolute survival at 5 years were 59%, 54%, and 48%, respectively. The cause-specific survival rate at 5 years was lower after primary RT (17%) than after craniofacial resection and postoperative RT (56%). Cervical metastases occurred in 6 of 22 patients (27%). No neck recurrences occurred in 11 patients treated with elective neck RT compared with 4 neck recurrences in 9 patients (44%) not receiving elective neck RT (p = .02). Conclusions. Combined modality therapy is preferred over RT alone in advanced-stage esthesioneuroblastoma. Our data and review of the current literature suggest a higher cervical failure rate than previously recognized. Elective neck RT seems to correlate with improved nodal control and should be considered in the treatment of esthesioneuroblastoma. © 2003 Wiley Periodicals, Inc. Head Neck 25: 529,534, 2003 [source]