Endoscopic view of a nasal septal polyp

April 30, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD

Maxillary sinusitis caused by nasoseptal obstruction

March 1, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD

Extramedullary plasmacytoma arising from the nasal septum

November 1, 2005     Byoung J. Baek, MD; Seong W. Kim, MD; Hoon Park, MD; Jin K. Park, MD; Kyung Y. Han, MD; Cheon H. Oh, MD
We report a rare case of extramedullary plasmacytoma of the nasal septum in a 65-year-old woman. She presented with a 2-month history of left-sided nasal obstruction and intermittent blood-tinged nasal crusting. Nasal endoscopy revealed that a dark-red mass had arisen from the nasal septum; no evidence of invasion to adjacent tissues was seen. A biopsy specimen was diagnosed as a plasmacytoma (kappa light chain'type). Serum and urine electrophoresis failed to detect any myeloma component or Bence Jones protein. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. The mass was completely removed via an endoscopic approach. No recurrence was noted at the 2-year follow-up.

Total necrosis of the intranasal structures and soft palate as a result of nasal inhalation of crushed OxyContin

July 31, 2005     David Greene, MD, FACS
Nasal inhalation of substances such as cocaine has long been linked to septal necrosis and more recently to palatal perforation. This report describes the case of a 37-year-old man who was addicted to crushed OxyContin (sustained-release oxycodone HCl) tablets and who presented with total necrosis of the septum, sinuses, and soft palate. To the best of the author's knowledge, this is the first reported case of nasal and palatal necrosis linked to nasal inhalation of crushed OxyContin, which is a relatively new form of drug abuse. The pathophysiology of drug-induced sinonasal disease and a review of the literature are also presented.

The vomeronasal (Jacobson's) organ

June 30, 2005     Daniel H. Coelho, MD; Eiji Yanagisawa, MD, FACS

Septal perforation caused by nasal magnetic foreign bodies

April 30, 2005     David A. Lehman, MD; Soham Roy, MD

Primary columellar angiosarcoma: A case report

January 1, 2005     Pedro Oliveira, MD; Ricardo Correia, MD; Eugénia Castro, MD; Rosete Almeida, MD; Agostinho Silva, MD
Angiosarcoma of the head and neck, a rare malignancy, is associated with a high degree of invasiveness and poor survival. A high level of suspicion followed by histopathologic and immunohistochemical studies is warranted in order to arrive at a well-timed and accurate diagnosis. We report the case of a 56-year-old man who developed an unusually small neoplasm in the nasal columella. Rapid diagnosis allowed for simple treatment with surgical excision, a rare circumstance because most of these tumors require extensive surgery. Close long-term follow-up of patients with angiosarcoma of the head and neck is vitally important.

A rare case of rapidly progressive craniofacial chondrosarcoma

January 1, 2005     Jason S. Hamilton, MD; Ryan F. Osborne, MD; Jimmy J. Brown, MD

The effect of silver nitrate on nasal septal cartilage

January 1, 2005     Simon Lloyd, BSc (Hons), MRCS; John Almeyda, FRCS (ORL); Riccardo Di Cuffa, MRCS; Ketan Shah, FRCPath
Epistaxis from the anterior septum is frequently treated with a topical application of silver nitrate, which cauterizes the bleeding vessel. However, this treatment causes a septal perforation in a small percentage of patients. We report our study of the histologic effect of topical silver nitrate on samples of septal tissue obtained from 11 patients. We found that 30 seconds of exposure allowed silver nitrate to penetrate to a depth of approximately 1 mm. Longer exposure (45 and 60 sec) resulted in no significant additional penetration. Similarly, the amount of silver nitrate deposition into the chondrocytic lacunae did not vary significantly with the length of exposure. On the other hand, the depth of deposition into the extracellular matrix was positively associated with the duration of exposure. We found no direct evidence that silver nitrate exerted any damaging effect on septal cartilage. Instead, the development of septal perforations in patients who receive topical silver nitrate may be attributable to necrosis of the septal cartilage following damage to the overlying perichondrium, from which it derives its blood supply.
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