Это, знаете ли, начало той болезни, закономерное окончание которой вы наблюдаете в своей эпохе. Человечество пытается спрятаться, оно страшится того, что лежит там, в пространстве, и скоро оно накрепко запрет все двери, которые еще ведут во Вселенную. -- Но ведь я только что видел в небе над Диаспаром космические корабли,-- возразил Джизирак.
-- Больше вы их не увидите. Мы уже потеряли контакт со звездами, а очень скоро мы уйдем и с планет Солнечной системы.
Drainage tube through the frontal recess The histopathologic examination confirmed the diagnosis of left frontal sinus osteoma. The postoperative evolution was favorable. The patient received i.
Source: Romanian Medical Journal. Inverted papilloma is a rare epithelial benign neoplasm malignant inverting papilloma presents a number of significant therapeutic problems due to a high rate of postoperative recurrence and a significant percentage of malignancy. This article represents a review of the literature on this topic and a synthesis of Colțea ENT Clinic experience in inverted papilloma associated with scuamos cell carcinoma SCC.
Daily dressing change was performed, as well as aspiration through and around the drainage tube. The postoperative Malignant inverting papilloma reevaluation was performed after 14 days Figure 6at one month, at three months, and at six months.
Figure 6. ENT reevaluation at 14 days after surgery Discussion Osteoma is the most common tumor of paranasal sinuses, often with a slow and silent evolution.
Inverting Papilloma or Squamous Cell Carcinoma?
The most frequently involved site is frontal sinus, followed by ethmoid and maxilar sinuses. The sphenoid sinus is rarely involved 1,2.
The procedure implies surgical excision of the lateral nasal wall and ethmoid malignant inverting papilloma. This technique is aided by the usage of adequate instruments, such as 0° and 70° scopes and angulated surgical instruments, which allow the complete visualization and access to the maxillary sinus. The authors present, as an endoscopic surgical atlas, step by step, the surgical procedure for endoscopic approach of inverted papilloma, in order to reach a complete tumor removal without any leftovers.
In general, the dimension of osteomas may vary between 2 and 30 mm. Osteomas bigger than 30 mm or the ones weighing more than g are considered to be giant 4. The etiology of osteomas is still unknown.
V-ar putea interesa
Several hypotheses have been taken into consideration: traumatic or infectious triggers, calcium metabolism disorders, or embryonic malformations 5. Frontal sinus osteoma grading system 6 Grade I. The base of attachment is posterior-inferior along the frontal recess.
The tumor is medial to a virtual sagittal plane through the lamina papyracea. Grade II. Grade III. Grade IV. Tumor fills the entire frontal malignant inverting papilloma the current case.
Frontal sinus osteoma – case report
Osteomas are white, hard, well circumscribed, round or oval, sesile rarely pediculatedbosselated tumors. Histologically, osteoma is composed of lamellar, mature bone with haversian-like systems, surrounded by fibrous, paucicellular stroma 7. The diagnosis of osteoma is established by clinical and paraclinical exams. The patients may complain of persistent frontal pain unresponsive to analgesic or antiinflammatory medication, hemifacial pain, rhinoreea and nasal obstruction.
Computed tomography of the head and paranasal sinuses is the gold standard for the diagnosis of osteoma and is also necessary for malignant inverting papilloma management. MRI is useful when intracranial extensions are suspected 8.
The management of the frontal sinus osteoma depends on the severity of the symptoms malignant inverting papilloma the extension of the tumor.
If chronic sinusitis unresponsive to treatmentpersistent headaches when all other causes have been excluded or mucocele occur, malignant inverting papilloma therapeutic approach is surgical.
It can be external, endoscopic or combined: external for the removal of the tumor, and endoscopic to provide the appropriate drainage from the frontal sinus. The approach depends mostly on the site and dimension of the osteoma.
Sometimes, there are cases of small frontal recess osteomas which can be approached only by endoscopic approach.
Endoscopic medial maxillectomy for inverted papilloma
The definitive diagnosis of osteomas can be established only after the histological examination of the tumor. If osteoma is big, extending through the sinus wall anemie manifestari the intracranial space, a multidisciplinary surgical approach will be malignant inverting papilloma otorhinolaryngologist and neurosurgeon.
The postoperative complications which may occur are: subcutaneous emphysema, persistent suppurative sinusitis, fistulization, malignant inverting papilloma osteomyelitis, supraorbitar nerve branches damage, supraorbitar neuralgia, ecchymosis, palpebral edema, dyplopia, epiphora, frontal recess stenosis, recurrence of frontal sinusitis, and tumoral recurrence.
The current case had a classic, slow onset and progression, affecting a middle aged female patient.