scholarly journals Acute Orbital Hemorrhage as a Presentation of a Lytic Bony Lesion

2011 ◽  
Vol 4 (4) ◽  
pp. 189-191 ◽  
Author(s):  
Radwan Almousa ◽  
Chao Shuen ◽  
Gangadhara Sundar
Keyword(s):  
Sinus Surgery ◽  
Acute Hemorrhage ◽  
Show Evidence ◽  
History Of ◽  
Bony Lesion ◽  
Bony Involvement ◽  
The Right ◽  
Orbital Hematoma ◽  
Isolated Cell ◽  
Orbital Hemorrhage

A 61-year-old Chinese man presented to the emergency department with a 1-day history of painful swelling of the right eyelid with loss of vision. He had been treated earlier for an isolated pathological fracture of the T7 vertebra from plasmacytoma. Computed tomography was suggestive of superior orbital hematoma with bony erosion of the inner and outer tables of an isolated frontal cell, and urgent drainage of the hematoma resulted in relief of the pain and improvement of the vision. A formal orbitotomy was performed to evacuate the hematoma, followed by combined endoscopic sinus surgery and external anterior frontal table trephine to connect the isolated cell to the frontal sinus. The histology did not show evidence of myeloma, and the orbital hematoma was probably a result of an acute hemorrhage into the mucocele of an isolated cell in the frontal bone. However, in patients with a history of multiple myeloma, it is important to consider lytic bony involvement as the cause of an orbital hemorrhage.

scholarly journals Pushing behavior and hemiparesis: which is critical for functional recovery in pusher patients ? Case report

2007 ◽  
Vol 65 (2b) ◽  
pp. 536-539 ◽  
Author(s):  
Taiza E.G. Santos-Pontelli ◽  
Octávio M. Pontes-Neto ◽  
José Fernando Colafêmina ◽  
Dráulio B. de Araújo ◽  
Antônio Carlos Santos ◽  
...  
Keyword(s):  
Case Report ◽  
Barthel Index ◽  
Functional Improvement ◽  
Chronic Hypertension ◽  
Acute Hemorrhage ◽  
Lateral Posterior ◽  
History Of ◽  
Lateral Posterior Nucleus ◽  
Neuroimaging Study ◽  
The Right

We report a sequential neuroimaging study in a 48-years-old man with a history of chronic hypertension and lacunar strokes involving the ventral lateral posterior nucleus of the thalamus. The patient developed mild hemiparesis and severe contraversive pushing behavior after an acute hemorrhage affecting the right thalamus. Following standard motor physiotherapy, the pusher behavior completely resolved 3 months after the onset and, at that time, he had a Barthel Index of 85, although mild left hemiparesis was still present. This case report illustrates that pushing behavior itself may be severely incapacitating, may occur with only mild hemiparesis and affected patients may have dramatic functional improvement (Barthel Index 0 to 85) after resolution pushing behavior without recovery of hemiparesis.

scholarly journals Orbital Emphysema after a Protracted Episode of Sneezing in a Patient with no History of Trauma or Sinus Surgery

2010 ◽  
Vol 89 (11) ◽  
pp. E12-E13 ◽  
Author(s):  
Qasim A. Khader ◽  
Khader J. Abdul-Baqi
Keyword(s):  
Signs And Symptoms ◽  
Sinus Surgery ◽  
Blowout Fracture ◽  
Orbital Emphysema ◽  
The Face ◽  
History Of ◽  
Limiting Condition ◽  
The Right ◽  
Systemic Antibiotics ◽  
Periorbital Swelling

Orbital emphysema is a benign self-limiting condition. It can occur directly (as a result of trauma to the face) or indirectly (secondary to a blowout fracture). We report a case of orbital emphysema in a 38-year-old man who presented with ecchymosis of the right eye, pressure within the right orbit, and periorbital swelling following a protracted episode of vigorous sneezing. The diagnosis was confirmed by computed tomography. Systemic antibiotics were given, and the patient was cautioned to avoid blowing his nose. His signs and symptoms resolved within 1 week.

scholarly journals Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of Literature

2019 ◽  
Vol 12 ◽  
pp. 117955061985860
Author(s):  
Mingyang L Gray ◽  
Catharine Kappauf ◽  
Satish Govindaraj
Keyword(s):  
Foreign Body ◽  
Skull Base ◽  
Foreign Bodies ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Intracranial Involvement ◽  
History Of ◽  
Initial Imaging ◽  
The Right

A 35-year-old man with history of schizophrenia presented 3 weeks after placing a screw in his right nostril. Initial imaging showed a screw in the right ethmoid sinus with the tip penetrating the right cribriform plate. On exam, the patient was hemodynamically stable with purulent drainage in the right nasal cavity but no visible foreign body. While most nasal foreign bodies occur in children and are generally removed at the bedside, intranasal foreign bodies in adults tend to require further assessment. The foreign body in this case was concerning for skull base involvement and the patient was brought to the operating room (OR) with neurosurgery for endoscopic sinus surgery (ESS) and removal of foreign body. The screw was removed and the patient recovered with no signs of cerebrospinal fluid (CSF) leak postoperatively. Any concern for skull base or intracranial involvement should call for a full evaluation of the mechanism of injury and intervention in a controlled environment.

scholarly journals Monophasic Epithelial Synovial Sarcoma Accompanied by an Inverted Papilloma in the Sphenoid Sinus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Xiaohua Jiang ◽  
Qi Huang ◽  
Jianguo Tang ◽  
Matthew R. Hoffman
Keyword(s):  
Synovial Sarcoma ◽  
Sphenoid Sinus ◽  
Inverted Papilloma ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Olfactory Sensation ◽  
History Of ◽  
The Right ◽  
Sphenoid Sinuses

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.

scholarly journals Modified Lothrop (Draf III) procedure for the treatment of a recurrent orbitofrontal cholesterol granuloma: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2090780
Author(s):  
Hidenori Yokoi ◽  
Hidetaka Yamanaka ◽  
Yuma Matsumoto ◽  
Michitsugu Kawada ◽  
Masachika Fujiwara ◽  
...  
Keyword(s):  
Nasal Congestion ◽  
Sinus Surgery ◽  
Resected Specimen ◽  
Histopathological Analysis ◽  
Cholesterol Granuloma ◽  
Chief Complaints ◽  
History Of ◽  
The Right ◽  
Ethmoid Sinuses ◽  
Draf Iii

Orbitofrontal cholesterol granuloma is a rare occurrence. Here, we present a case involving a 64-year-old man with a recurrent orbitofrontal cholesterol granuloma treated by the Modified Lothrop (Draf III) procedure. The patient, who had a history of trauma and previous sinus surgery, presented with chief complaints of nasal congestion, olfactory impairment, and diplopia. We suspected chronic sinusitis; computed tomography showed a soft-tissue shadow extending from the bilateral frontal sinuses to the ethmoid sinuses, with a cyst in the right orbitofrontal region. We performed endoscopic surgery for removal of the mass, and histopathological analysis of the resected specimen confirmed a diagnosis of cholesterol granuloma. The lesion recurred 2 months later, and we performed revision surgery using the Modified Lothrop or Draf III procedure. The patient showed no relapse at the 5-year follow-up. These findings suggest that the Draf III procedure is an effective surgical treatment for cholesterol granulomas.

scholarly journals Blindness from Fungal Rhinosinusitis of the Paranasal Sinuses: A Case Report

2020 ◽  
Vol 35 (2) ◽  
pp. 41
Author(s):  
Daniel Rico De Jesus ◽  
Patrick Joseph Estolano
Keyword(s):  
Nasal Congestion ◽  
Fungal Growth ◽  
Pregnant Patient ◽  
Sinus Surgery ◽  
Fungal Rhinosinusitis ◽  
History Of ◽  
Left Maxillary Sinus ◽  
The Right ◽  
High Index Of Suspicion ◽  
Ethmoid Sinuses

ABSTRACT Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient. Methods:Design: Case ReportSetting: Tertiary Government Training HospitalPatient: One Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of  binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted. Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.

scholarly journals Prolonged Implantation of Sinus Devices and Implications for Chronic Rhinosinusitis: A Case Report and Review of the Literature

2020 ◽  
pp. 1-4
Author(s):  
Charles S. Ebert Jr. ◽  
Adam J. Kimple ◽  
Adam M. Zanation ◽  
Brian D. Thorp ◽  
Charles S. Ebert Jr. ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Medical Management ◽  
Endoscopic Sinus Surgery ◽  
Foreign Bodies ◽  
Scar Tissue ◽  
Sinus Surgery ◽  
Prior Surgery ◽  
History Of ◽  
Routine Observation ◽  
The Right

Background: Implantation of sinus stents and spacers can be used as adjuvant management to maintain patency of sinuses after endoscopic sinus surgery for chronic rhinosinusitis. These implants are typically removed several weeks after surgery. We present two cases of different patients who were initially treated by different physicians and were found to have retained sinus spacers in their paranasal sinuses 6-10 years after implantation. Case Presentation: Case 1: A 40-year-old male with chronic rhinosinusitis and history of balloon sinuplasty six years prior presented with worsening symptoms of chronic rhinosinusitis refractory to medical management. He underwent revision functional endoscopic sinus surgery and was found to have retained sinus implants in the left and right frontal sinus recesses. Case 2: A 48-year-old female with long-standing chronic rhinosinusitis refractory to medical management presented after two prior sinus surgeries most recently 10 years ago. She underwent revision functional endoscopic surgery and was found to have a retained sinus implant from prior surgery in the right frontal recess outflow tract embedded within scar tissue and reactive hyperostosis. Foreign bodies from both patients were removed without complication and patients were healing appropriately in the post-operative period. Conclusions: While sinus stents and spacers can help with post-operative scarring, leaving then unmonitored and in place will eventually result in them becoming a nidus for scarring and infection. It is critical that patients are aware of any foreign bodies we place, if they need scheduled removal or routine observation, and what symptoms may indicate that they are causing a problem.

scholarly journals Endoscopic Findings of Fungal Ball in the Mucocele After Endonasal Transsphenoidal Surgery

2019 ◽  
pp. 014556131986766
Author(s):  
Jong Seung Kim ◽  
Eun Jung Lee
Keyword(s):  
Transsphenoidal Surgery ◽  
Sphenoid Sinus ◽  
Pituitary Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Fungal Ball ◽  
Endoscopic Findings ◽  
Transseptal Approach ◽  
History Of ◽  
The Right

A 51-year-old woman with headache was referred to our hospital. She had a history of endonasal pituitary surgery 22 years prior and hypertension 10 years prior. The endonasal transsphenoidal pituitary approach was performed via microscopic transseptal approach. Nasal endoscopy revealed whitish cystic wall protruded from the right sphenoid sinus. Functional endoscopic sinus surgery was performed under general anesthesia. After incision of the right sphenoid ostium, yellowish mucoid discharge in the right sphenoid sinus was pushed out from the sphenoid sinus. Histopathology confirmed fungal ball in the sphenoid sinus, which is consistent with aspergillosis sinus. The presence of fungal ball and mucocele are rarely reported, but mucocele and fungal ball found after pituitary surgery are the first and therefore unique in this case.

Spontaneous unilateral exophthalmos after a vaginal delivery

2020 ◽  
pp. 112067212091453
Author(s):  
Anna Różańska-Walędziak ◽  
Oksana Szewczuk ◽  
Maciej Walędziak ◽  
Krzysztof Czajkowski
Keyword(s):  
Vaginal Delivery ◽  
Complete Resolution ◽  
Clinical Symptoms ◽  
Spontaneous Resolution ◽  
Abdominal Pressure ◽  
Case Description ◽  
Superior Ophthalmic Vein ◽  
The Right ◽  
Orbital Hematoma ◽  
Orbital Hemorrhage

Introduction: Spontaneous orbital exophthalmos is an extremely rare incident during a vaginal delivery. In most cases, it is associated with venous malformations and presents spontaneous resolution. Case description: We report a case of orbital hematoma after vaginal delivery due to a superior ophthalmic vein rupture. The patient presented proptosis of the right eye and diplopia immediately after the delivery and was diagnosed with unilateral orbital hematoma. The patient was given conservative treatment with complete resolution of clinical symptoms 4 weeks after the delivery. Conclusion: Increased abdominal pressure during a vaginal delivery may lead to a spontaneous orbital hemorrhage.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

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