February 1, 2008 Lt. Matthew T. Brigger, MD, Maj. Ian K. McLeod, MD, and Cdr. Martin P. Sorensen, MD
article
Abstract
Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis. This case illustrates the varied multisystem presentation of sarcoidosis and the diagnostic considerations that are merited.
February 1, 2008 Eiji Yanagisawa, MD, FACS, Joseph P. Mirante, MD, FACS, and Dewey A. Christmas, MD
January 1, 2008 Lisa Chirch, MD, Patricia Roche, DO, and Jack Fuhrer, MD
article
Abstract
Chronic invasive Aspergillus sinusitis is a rare and potentially devastating infection. Management typically requires extensive surgical debridement followed by long-term antifungal therapy, primarily with intravenous amphotericin B. We describe the case of an elderly woman who had been diagnosed with extensive Aspergillus sinusitis that had invaded critical structures. The extensiveness of the infection and the patient's frailty and unwillingness to undergo a disfiguring procedure precluded surgery, and her medical condition was too fragile to withstand amphotericin B therapy. Therefore, we decided to treat her with a combination of caspofungin and voriconazole, two relatively nontoxic antifungal agents that have different mechanisms of action. After administration of this novel regimen, the infection resolved rapidly.
January 1, 2008 Lisa Skultety Ayers, DO, Jacqueline Oxenberg, DO, Seth Zwillenberg, MD, and Mahmoud Ghaderi, DO
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Abstract
The diagnosis of low-grade B-cell lymphoma consistent with marginal-zone lymphoma has proven to be challenging when the disease involves the hard palate. The diagnosis is complicated by the nonspecific nature of the presenting symptoms and a difficult-to-differentiate histologic picture. We describe a case of low-grade B-cell lymphoma of the hard palate with a delayed presentation. We also compare the features of this case with the features of the small number of other such cases that have been reported in the literature. Finally, we review the etiology of low-grade B-cell lymphoma, we discuss its radiologic and pathologic features, and we briefly describe the treatment options.
December 1, 2007 David Mullin, MD, Fred W. Lindsay, DO, and Michael A. Keefe, MD
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Abstract
Nodular fasciitis is an uncommon tumor-like fibroblastic proliferation of the head and neck that is difficult to differentiate from its more malignant counterparts. Despite modern advances, making this distinction is challenging because the clinical presentation is nonspecific and the histologic and radiologic features are variable. Once nodular fasciitis is diagnosed, the primary treatment is conservative resection and observation. We describe a case of nodular fasciitis of the nasal cavity in a 43-year-old woman. To the best of our knowledge, this is only the second reported case of nodular fasciitis arising in the nasal cavity, and the first such case in an adult.
July 31, 2007 Dewey A. Christmas Jr., MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
February 1, 2007 Joseph P. Mirante, MD; Dewey A. Christmas, Jr., MD; Eiji Yanagisawa, MD
March 1, 2006 Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
March 1, 2006 Robert L. Pincus, MD; Harold H. Kim, MD; Stacy Silvers, MD; Scott Gold, MD
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Abstract
Much discussion is taking place regarding the role of gastric reflux disease in the development and maintenance of chronic sinus disease. We studied 31 patients in a large urban private practice who had recalcitrant chronic sinusitis despite aggressive medical and surgical therapy. After we obtained information on the severity of each patient's sinus disease, we performed either double- or triple-catheter probe pH testing to assess the presence of reflux disease. Of the 30 patients who were successfully tested (1 patient did not tolerate probe testing), 25 demonstrated reflux disease, including 2 whose reflux reached the level of the nasopharynx. These 25 patients were placed on a proton-pump inhibitor (PPI) regimen and reassessed at least 1 month later. At follow-up, 14 of 15 evaluable patients demonstrated at least some improvement in their sinus symptoms, including 7 who experienced either a complete or almost-complete resolution of symptoms. The improvements in sinus symptoms corresponded with improvements in reflux symptoms. These findings suggest that antireflux therapy might play a role in the treatment of recalcitrant chronic sinus disease.
September 30, 2005 Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
June 30, 2005 Daniel H. Coelho, MD; Eiji Yanagisawa, MD, FACS
May 31, 2005 Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
