Spontaneous Abscess of the Posterior Nasal Septum: An Unusual Cause of Nasal Obstruction in Children

2021 ◽  
pp. 000348942098797
Author(s):  
Marco Berlucchi ◽  
Michele Tomasoni ◽  
Roberta Bosio ◽  
Vittorio Rampinelli
Keyword(s):  
Medical History ◽  
Nasal Obstruction ◽  
Sinus Thrombosis ◽  
Nasal Endoscopy ◽  
Purulent Discharge ◽  
Delay In Diagnosis ◽  
Anterior Rhinoscopy ◽  
Local Trauma ◽  
Septal Abscess ◽  
Rule Out

Introduction: Nasal septal abscess is a rare disorder in pediatric patients and is mostly diagnosed as a complication of trauma or secondary to dental or sinonasal infection. Case Presentation: A 10-year-old girl presented with acute nasal obstruction, otalgia, and headache. Medical history was negative; physical examination and anterior rhinoscopy did not reveal signs of acute rhinosinusitis or septal abscess. Management and Outcome: A thorough nasal endoscopy was performed to rule out a posterior nasal infection, revealing a bilateral posterior septal bulging, in the absence of purulent discharge. CT scan and contrast-enhanced MRI were performed, confirming the diagnosis of a spontaneous posterior septal abscess. Trans-nasal endoscopic-assisted drainage was conducted under general anesthesia. Haemophilus influenzae was detected on culture. Discussion: Although rare, nasal septal abscess in the pediatric age is typically anterior and secondary to local trauma or infection. Accurate medical history and anterior rhinoscopy are usually sufficient to make the diagnosis. In cases where the clinical presentation is consistent with a nasal septal abscess, with no history of recent local trauma or infection, or signs of anterior septal bulging, nasal endoscopy should be performed to rule out spontaneous posterior septal abscess. Delay in diagnosis and treatment could potentially cause the rapid onset of life-threatening complications, including intracranial abscess, meningitis, and cavernous sinus thrombosis.

scholarly journals Profil Pasien Rinosinusitis Kronik di Poliklinik THT-KL RSUP DR.M.Djamil Padang

2015 ◽  
Vol 4 (3) ◽  
Author(s):  
Hesty Trihastuti ◽  
Bestari Jaka Budiman ◽  
Edison Edison
Keyword(s):  
General Hospital ◽  
Clinical Symptom ◽  
Chronic Rhinosinusitis ◽  
Nasal Obstruction ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Septal Deviation ◽  
Nasal Endoscopy ◽  
Nasal Discharge ◽  
Anterior Rhinoscopy

Abstrak Rinosinusitis kronik adalah inflamasi kronik pada mukosa hidung dan sinus paranasal yang sering terjadi, tetapi belum ada data mengenai profil pasien rinosinusitis kronik di RSUP Dr.M.Djamil Padang. Penelitian ini merupakan penelitian deskriptif dengan mengambil data rekam medis THT-KL RSUP Dr.M.Djamil periode 1 Januari – 31 Desember 2012 dengan metode total sampling. Terdapat 63 kasus rinosinusitis kronik di poliklinik THT-KL RSUP Dr.M.Djamil Padang periode 1 Januari – 31 Desember 2012. Kasus rinosinusitis kronik paling banyak terjadi pada kelompok usia 46 – 55 tahun (22,22%) dan banyak terjadi pada perempuan (60,32%). Berdasarkan tanda dan gejala yang ditemukan paling banyak adalah deviasi septum (41,27%). Gejala klinik paling banyak adalah hidung tersumbat (88,89%). Berdasarkan pemeriksaan rinoskopi anterior dan nasoendoskopi ditemukan kelainan pada kavum nasi, konka inferior, konka media, dan sekret. Disimpulkan bahwa rinosinusitis kronik banyak terjadi pada usia dewasa, jenis kelamin perempuan, tanda dan gejala yang ditemukan deviasi septum, gejala berupa hidung tersumbat, sertaditemukan kelainan berdasarkan pemeriksaan rinoskopi anterior dan nasoendoskopi.Kata kunci: rinosinusitis kronik, pemeriksaan rinoskopi anterior, pemeriksaan nasoendoskopi AbstractChronic rhinosinusitis is a common chronic inflammation of the nose and paranasal sinuses mucosa, but there  is no data about profile of chronic rhinosinusitis patients at ENT clinic Dr.M.Djamil general hospital Padang. This research uses descriptive method by taking the data from the medical records at ENT clinic of Dr.M.Djamil general hospital during 1 January – 31 December 2012 with the method is total sampling. There are 63 chronic rhinosinusitis cases at ENT clinic Dr.M.Djamil Padang general hospital during 1 January – 31 December 2012. Most cases of chronic rhinosinusitis occurred in the age group 46 – 55 years old (22.22%) and higher in female (60.32%). The most sign and symptom finding is septal deviation (41.27%). The most clinical symptom is nasal obstruction (88.89%). Fromanterior rhinoscopy and nasoendoscopy examination, there are founded abnormalility of nasal cavity, inferior turbinate, middle turbinate, and nasal discharge. The conclusion is chronic rhinosinusitis often happened at adult ages, female, septal deviation as the most sign and symptom finding, nasal obstruction as the clinical symptom, and abnormal findings from anterior rhinoscopy and nasal endoscopy examination.Keywords: chronic rhinosinusitis, anterior rhinoscopy examination, nasal endoscopy examination

scholarly journals Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

2021 ◽  
Author(s):  
Lars Aksel Pedersen ◽  
S. Dölvik ◽  
K. Holmberg ◽  
C. Ahlström Emanuelsson ◽  
H. Johansson ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Nasal Obstruction ◽  
General Health ◽  
Surgical Skills ◽  
Nasal Endoscopy ◽  
Experienced Surgeon ◽  
Senior Surgeon ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

scholarly journals Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Hesam Jahandideh ◽  
Mojtaba Maleki Delarestaghi ◽  
Delaram Jan ◽  
Ayda Sanaei
Keyword(s):  
Ct Scan ◽  
Evaluation Method ◽  
Controlled Trial ◽  
Preoperative Evaluation ◽  
Functional Results ◽  
Outcome Evaluation ◽  
Nasal Endoscopy ◽  
Control Group ◽  
Clinical Value ◽  
Anterior Rhinoscopy

Introduction. The endonasal mucosal or anatomic pathologies could lead to poor functional results and dissatisfaction after rhinoplasty. Although computed tomography (CT) scan has become an integral part of the diagnostic paradigm for patients with pathologies of the paranasal sinuses, the use of CT scan for preoperative evaluation of patients seeking rhinoplasty is up for debate. Our aim in this study was to compare the efficacy of CT scan in diagnosing nasal pathologies with other evaluating tools in patients undergoing rhinoplasty. Design. In this randomized controlled trial study, 74 consecutive patients seeking cosmetic rhinoplasty referred to otorhinolaryngology clinic were randomly assigned into three groups based on the perioperative evaluation method: the CT group, the nasal endoscopy group, and the control group (anterior rhinoscopy only). Surgical planning was made according to perioperative findings, and the identified endonasal pathologies were corrected during the surgery. The functional and aesthetic outcomes of the rhinoplasty were assessed by Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and the Visual Analogue Scale (VAS) tools before surgery and at 12-month follow-up. Results. All outcome measures improved significantly in either group toward one year after rhinoplasty (all with p value <0.05). Subjects in the CT group demonstrated greater improvement in the NOSE, VAS, and ROE compared to other two groups (NOSE: p value = 0.17; VAS: p value = 0.024; ROE: p value = 0.042). Conclusions. According to our study, perioperative CT is associated with greater patients’ satisfaction and quality of life after rhinoplasty compared to either nasal endoscopy or anterior rhinoscopy. A preoperative CT scan may improve the outcomes of rhinoplasty.

The ancient practice of sutra neti leading to velopharyngeal stenosis: case report

2019 ◽  
Vol 133 (8) ◽  
pp. 730-732
Author(s):  
H Tiwana ◽  
R S Virk ◽  
V Gautam
Keyword(s):  
Case Report ◽  
Nasal Obstruction ◽  
Male Patient ◽  
Mouth Breathing ◽  
Nasal Endoscopy ◽  
Zero Degree

AbstractBackgroundAn ancient yoga technique called sutra neti, which is extensively used in India to keep the sinuses healthy, led to complete velopharyngeal stenosis in a 67-year-old male patient who presented with bilateral nasal obstruction, mouth breathing, anosmia and a change in voice.MethodThe patient was diagnosed by nasal endoscopy using a zero-degree Hopkins rod endoscope, and adhesions were released using coblation.ResultsThe patient had post-operative alleviation of symptoms and a patent velopharyngeal inlet on examination.ConclusionVigorous sutra neti can lead to velopharyngeal stenosis. Release of the stenosis is then required to cure the nasal blockade.

Nasal Endoscopy: Its Role in Office Diagnosis

1997 ◽  
Vol 11 (2) ◽  
pp. 177-180 ◽  
Author(s):  
Michael S. Benninger
Keyword(s):  
Treatment Plan ◽  
Septal Deviation ◽  
Diagnosis And Treatment ◽  
Nasal Endoscopy ◽  
Nasal Sinus ◽  
Anterior Rhinoscopy ◽  
Choanal Polyp ◽  
Before And After ◽  
Treatment Plans

To clarify the role of nasal endoscopy in the diagnosis and treatment planning for patients with nasal or sinus complaints, 100 consecutive new patients were evaluated. Patients were excluded if their only complaint was obstruction and they had a septal deviation as the only clinical finding. Each patient underwent a thorough history and head and neck examination, including anterior rhinoscopy before and after decongestion, and the diagnosis and treatment plans were documented. Each then underwent nasal endoscopy, and the diagnosis and treatments were compared. The most common diagnoses after anterior rhinoscopy were allergic rhinitis (21), nonallergic rhinitis (12), chronic sinusitis with polyps (19) or without polyps (9), and nonsinus pain (13). Nasal endoscopy played a role in 11% of patients, although in no case did endoscopy change the diagnosis or treatment plan. Endoscopy allowed visualization past an enlarged turbinate or septal deviation in six patients, confirmed a suspected diagnosis in three by visualization of the middle meatus, and detected the site of a large choanal polyp in one. In one case, endoscopy identified a paradoxical turbinate on the side opposite the symptoms and radiological findings. Routine nasal endoscopy need not be part of the evaluation of all patients with nasal sinus disorders but is particularly valuable in confirming diagnoses, particularly in patients where anterior rhinoscopy is limited by anatomic vobstruction.

scholarly journals Vertigo in Cerebrovascular Diseases

2012 ◽  
Vol 4 (1) ◽  
pp. 46-53
Author(s):  
Rahul T Chakor ◽  
Nishikant Eklare
Keyword(s):  
Cerebrovascular Disease ◽  
Sinus Thrombosis ◽  
Cerebrovascular Disorders ◽  
Posterior Inferior Cerebellar Artery ◽  
Cerebrovascular Diseases ◽  
Superior Cerebellar Artery ◽  
Anterior Inferior Cerebellar Artery ◽  
Vestibular Cortex ◽  
Delay In Diagnosis ◽  
Cerebellar Artery

ABSTRACT Background Vertigo as a symptom of cerebrovascular disease is relatively uncommon. All types of cerebrovascular diseases namely ischemia, infarction, hemorrhage can produce vertigo. Since, cerebrovascular disease is an emergency prompt recognition and treatment is necessary to prevent neurologic deficit and death. Among cerebrovascular diseases vertebrobasilar territory strokes commonly present with vertigo. Since, the term vertigo is used nonspecifically by patients this may lead to delay in diagnosis of these strokes. This article reviews the epidemiology of vertigo in cerebrovascular diseases and the various stroke syndromes associated with vertigo. Summary Cerebrovascular diseases in the vertebrobasilar territory have vertigo, imbalance, dizziness in addition to other symptoms and signs. Posterior inferior cerebellar artery, anterior inferior cerebellar artery, superior cerebellar artery and basilar artery territory strokes can present with true vertigo. A high index of suspicion of stroke in patients with vertigo and risk factors for stroke is essential. Other vascular causes of vertigo are small cerebellar hemorrhage, vestibular cortex stroke, rotational vertebral artery syndrome, transverse/sigmoid sinus thrombosis and vestibular paroxysmia. Conclusion Cerebrovascular disorders are estimated to account for 3 to 4% of patients with vertigo or dizziness. Early detection and treatment is necessary to prevent disability and death in these cases of vascular vertigo. How to cite this article Chakor RT, Eklare N. Vertigo in Cerebrovascular diseases. Int J Otorhinolaryngol Clin 2012;4(1):46-53.

scholarly journals Delayed Diagnosis of Hidradenitis Suppurativa and Its Effect on Patients and Healthcare System

Dermatology ◽  
2020 ◽  
Vol 236 (5) ◽  
pp. 421-430 ◽  
Author(s):  
Georgios Kokolakis ◽  
Kerstin Wolk ◽  
Sylke Schneider-Burrus ◽  
Stefanie Kalus ◽  
Sebastian Barbus ◽  
...  
Keyword(s):  
Healthcare System ◽  
Inflammatory Disease ◽  
Hidradenitis Suppurativa ◽  
Severe Disease ◽  
Delayed Diagnosis ◽  
Chronic Inflammatory Disease ◽  
Purulent Discharge ◽  
Diagnosis Delay ◽  
Cross Sectional ◽  
Delay In Diagnosis

Background: Hidradenitis suppurativa (HS) is a neglected chronic inflammatory disease with long delay in diagnosis. Besides pain, purulent discharge, and destruction of skin architecture, HS patients experience metabolic, musculoskeletal, and psychological disorders. Objectives: To determine the delay in HS diagnosis and its consequences for patients and the healthcare system. Methods: This was a prospective, multicenter, epidemiologic, non-interventional cross-sectional trial carried out in Germany and based on self-reported questionnaires and medical examinations performed by dermatologists. In total, data of 394 adult HS patients were evaluated. Results: The average duration from manifestation of first symptoms until HS diagnosis was 10.0 ± 9.6 (mean ± SD) years. During this time, HS patients consulted on average more than 3 different physicians – most frequently general practitioners, dermatologists, surgeons, gynecologists – and faced more than 3 misdiagnoses. Diagnosis delay was longer in younger and non-smoking patients. In most cases, HS was correctly diagnosed by dermatologists. The longer the delay of diagnosis, the greater the disease severity at diagnosis. Delayed HS diagnosis was also associated with an increased number of surgically treated sites, concomitant diseases, and days of work missed. Conclusion: This study demonstrates an enormous delay in the diagnosis of HS, which results in more severe disease. It also shows for the first time that a delay in diagnosis of a chronic inflammatory disease leads to a higher number of concomitant systemic disorders. In addition to the impaired health status, delayed diagnosis of HS was associated with impairment of the professional life of affected people.

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