Septum

Chondrosarcoma of the nasal septum

January 1, 2009     Akram Rahal, MD, FRCSC, Joseph R. Durio, PA-C, and Michael L. Hinni, MD
article

Abstract

Chondrosarcoma of the nasal septum is a rarely encountered malignancy. When it does occur, early diagnosis is difficult because patients generally present with common, nonspecific sinonasal complaints. We describe a case of chondrosarcoma of the nasal septum in a 38-year-old Hispanic man. The lesion was discovered on computed tomography during a workup for symptoms of chronic sinus disease. The tumor was removed in its entirety and identified as a low-grade lesion that required no further treatment. The patient remained disease-free 4 years postoperatively. We review the diagnosis of this neoplasm and its treatment and follow-up.

Nasoseptal chondrosarcoma resection requiring anterior fossa floor repair: A case report

December 1, 2008     Samuel Spear, MD, John Iskandar, MD, Derek Seaquist, MD, and Douglas Sorensen, MD
article

Abstract

We present a case in which a 23-year-old male patient diagnosed with nasoseptal chondrosarcoma with anterior cranial fossa extension underwent combined surgical approaches to optimize complete resection of the tumor. Surgery was followed by a 6-month course of proton-beam radiation therapy. Extensive tumors of this type with significant intracranial extension require surgical repair of the anterior fossa floor. We employed a repair technique not previously associated with the resection of these tumors, using a split-calvaria osteoplastic rotational flap. This method provided structural integrity while avoiding the risks associated with the use of free bone grafts and metallic meshes.

Nasal packing after septoplasty: A randomized comparison of packing versus no packing in 88 patients

October 31, 2008     Mohammad Sohail Awan, FCPS and Moghira Iqbal, MBBS
article

Abstract

The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation. However, it was since found that not only is nasal packing ineffective in this regard, it can actually cause these complications. Although the consensus in the world literature is that packing should be avoided, to the best of our knowledge, no truly randomized study has been undertaken in Southwest Asia upon which to justify this recommendation here. Therefore, we conducted a prospective randomized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients, 15 years of age and older, who did (n = 44) and did not (n = 44) undergo nasal packing following septoplasty. We found that the patients who underwent packing experienced significantly more postoperative pain, headache, epiphora, dysphagia, and sleep disturbance on the night of surgery. Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding, septal hematoma, adhesion formation, and local infection. Finally, the packing group reported a moderate to high level of pain during removal of the packing. Our findings confirm that nasal packing after septoplasty is not only unnecessary, it is actually a source of patient discomfort and other signs and symptoms.

Rhinolithiasis with a nasal polyp: A case report

March 1, 2008     Ibrahim Ozcan, MD, K. Murat Ozcan, MD, Serdar Ensari, MD, and Huseyin Dere, MD
article

Abstract

Rhinoliths are uncommon mineralized masses that form as a result of calcification of an endogenous or exogenous nidus. The most common manifestations of rhinolithiasis are unilateral nasal discharge, nasal obstruction, and facial pain. The diagnosis is made by nasal endoscopy and computed tomography. The differential diagnosis includes chronic inflammation, osteomyelitis, benign tumors (e.g., calcified nasal polyps, ossifying fibromas, osteomas, and chondromas), and malignant tumors (e.g., osteosarcomas, chondrosarcomas, and squamous cell carcinomas). Rhinoliths may cause rhinosinusitis, erosion of the nasal septum and medial wall of the maxillary sinus, and perforations of the palate. To the best of our knowledge, the occurrence of a nasal polyp associated with rhinolithiasis has not been previously reported in the English-language literature. In this article, we describe such a case.

Neurosarcoidosis presenting as complicated sinusitis: A case report and review

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.

Pediatric nasal septal perforation secondary to magnet misuse: A case report

October 31, 2007     Carl Shermetaro, DO, FAOCO and Melissa Charnesky, DO
article

Abstract

We describe the case of a 7-year-old girl who had placed magnetic earrings bilaterally on her nasal ala. However, the two backing magnets that had been placed inside the nasal cavity became attached to each other rather than to the outer jewelry, compressing the nasal septum. Several weeks later, the septum became perforated. The patient was treated conservatively with mupirocin ointment, oral amoxicillin, and nasal saline. Subsequent examinations revealed no enlargement of the perforation, and the patient was followed conservatively with saline nasal spray.

Correction of caudal deflections of the nasal septum with a modified Goldman septoplasty technique: How we do it

September 30, 2007     William Lawson, MD, DDS; Richard Westreich, MD
article
Abstract

Correcting deviations of the caudal septum can be challenging because of cartilage memory, the need to provide adequate nasal tip and dorsal septal support, and the long-term effects of healing. The authors describe a minimally invasive, endonasal approach to the correction of caudal septal deviations. The procedure involves a hemitransfixion incision, unilateral flap elevation, and cartilage repositioning by limited dissection and excision.

Nasal cavernous hemangioma

May 31, 2007     Enrique Palacios, MD, FACR; Philip J. Daroca Jr., MD

A new method for closure of small to medium-size nasoseptal perforations

March 31, 2007     Ward S. De Witt, MD, FACS
article
 

Correction of caudal septal deviation: Use of a caudal septal extension graft

March 1, 2007     Annette M. Pham, MD; Travis T. Tollefson, MD, FACS

Nasal septal perforation secondary to rhinitis medicamentosa

May 31, 2006     Harold F. Keyserling, MD; John D. Grimme, MD; Daniel L.A. Camacho, MD; Mauricio Castillo, MD
article
Abstract
Nasal septal perforation is a rarely reported complication of rhinitis medicamentosa. We describe such a complication in a 54-year-old man, and we discuss the clinical, pathologic, and imaging aspects of this case.

Endoscopic view of a nasal septal polyp

April 30, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
PreviousPage
of 4Next