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Sommer F. Rare Diseases of the Nose, the Paranasal Sinuses, and the Anterior Skull Base. Laryngorhinootologie 2021; 100:S1-S44. [PMID: 34352902 PMCID: PMC8354577 DOI: 10.1055/a-1331-2469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Due to their low incidence and thus resulting limited diagnostic criteria as well as therapeutic options, rare diseases of the nose, the paranasal sinuses, and the anterior skull base are a significant challenge. The value as of which a disease has to be considered as rare amounts to a maximum of 5 patients per 10 000 people. Within these diseases, however, there are extreme differences. Some rare or orphan diseases like for example the inverted papilloma belong to regularly diagnosed and treated diseases of larger departments of oto-rhino-laryngology whereas other rare diseases and malformations have only been described in less than 100 case reports worldwide. This fact emphasizes the necessity of bundling the available experience of diagnostics and therapy. The present article gives an overview about rare diseases of the nose, the paranasal sinuses, and the anterior skull base from the field of diseases/syndromes of the olfactory system, malformations of the nose and paranasal sinuses, ventilation and functional disorders as well as benign and malignant tumors. The classification and data on diagnostic and therapeutic options were established based on the current literature.
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Affiliation(s)
- Fabian Sommer
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universitätsklinik Ulm
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2
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The surgical management of monostotic fibrous dysplasia of the inferior turbinate. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:457-459. [PMID: 31689546 DOI: 10.1016/j.jormas.2019.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 11/22/2022]
Abstract
Fibrous dysplasia is a non-neoplastic, sporadic, slowly progressing disease of the bone in which normal bone is replaced by abnormally overgrowing lesions. There are three different types of fibrous dysplasia: monostotic (affecting a single bone), poliostotic (affecting multiple bones) and syndromic, when it is associated with other diseases (such as McCune Albright syndrome). Fibrous dysplasia affects cranio-facial bones in 10% of the cases. However, its occurrence in the inferior turbinate is extremely rare. To the best of our knowledge, only four cases of monostotic form have been reported so far. Hereafter we describe a case of monostotic FD of the inferior turbinate surgically treated with a trans-nasal endoscopic partial maxillectomy type II.
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Abstract
Background Endoscopic resection of sinonasal fibro-osseous lesions remains a technical challenge because of the loss of anatomic landmarks and the frequent need to resect bone along the skull base. The purpose of this study was to evaluate the usefulness of image-guidance systems for the resection of these lesions. Methods Endoscopic surgery was performed in 10 patients with fibro-osseous lesions of the sinuses and skull base (six fibrous dysplasias and four osteomas). Indications for surgical intervention were recurrent infection (7), facial pain (3), mucocele (1), and compressive optic neuropathy (1). All surgeries were performed with an image-guidance system, which included an integrated high-speed drill system. Results Anatomic localization was accurate to within 1 mm when monitoring the depth of bone removal along the skull base. Complete resection of the fibro-osseous lesion was possible in six patients (60%) and partial removal was possible in four patients (40%). In the latter group, a margin of dysplastic bone was preserved along the ethmoid roof to prevent dural exposure. There were no intraoperative complications. Surgery resulted in resolution of infection and facial pain in nine patients (90%). Additional surgery was required in one patient (10%) who developed recurrent optic neuropathy because of continued dysplastic bone growth. Mean follow-up was 34 months (range, 13–67 months). Conclusion Image-guidance technology appears to be ideally suited for the treatment of patients with fibro-osseous lesions of the sinonasal cavity. Real-time monitoring of the depth of bone removal relative to the skull base may enhance the safety and efficacy of such surgery.
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Affiliation(s)
- Mark Samaha
- From the Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, and Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts
| | - Ralph Metson
- From the Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, and Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts
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Sciarretta V, Pasquini E, Frank G, Modugno GC, Cantaroni C, Mazzatenta D, Farneti G. Endoscopic Treatment of Benign Tumors of the Nose and Paranasal Sinuses: A Report of 33 Cases. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/194589240602000112] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background The endoscopic approach can be used successfully for the treatment of benign tumors such as fibroosseous and vascular lesions, pleomorphic adenoma, glioma, meningioma, and schwannoma. Methods Thirty-three patients diagnosed with benign tumors of the nasal cavity and paranasal sinuses and treated using an endoscopic approach were reviewed retrospectively. The endoscopic approach was simple in 28 cases and associated with an external approach in 5 cases (because of an intracranial extension of the tumor in four patients and its location at the level of the anterior wall of the frontal sinus in the last case). Results The resection of the lesions was complete in 32 patients and subtotal in one case. The mean follow-up was 28 months and only two recurrences (6%) were observed in the juvenile angiofibroma group and in the case of the fibrous dysplasia associated to aneurysmal bone cyst, respectively, 20 and 24 months postoperatively. Conclusion In selected cases, endoscopic surgery can be considered an effective treatment for the resection of benign tumors involving the sinonasal tract.
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Affiliation(s)
- Vittorio Sciarretta
- Ear, Nose, and Throat Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Ernesto Pasquini
- Ear, Nose, and Throat Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Giorgio Frank
- Department of Neurosurgery, “Bellaria” Hospital, Bologna, Italy
| | - Giovanni Carlo Modugno
- Ear, Nose, and Throat Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Cosetta Cantaroni
- Ear, Nose, and Throat Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Giovanni Farneti
- Ear, Nose, and Throat Unit, Azienda Unità Sanitaria Locale Bologna Nord, Budrio-Bologna, Italy
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Benign Primary Neoplasms. CURRENT OTORHINOLARYNGOLOGY REPORTS 2016. [DOI: 10.1007/s40136-016-0138-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Headache Attributed to Fibrous Dysplasia of the Ethmoid Bone Mimicking Menstrual Migraine Without Aura. J Craniofac Surg 2016; 27:e417-9. [DOI: 10.1097/scs.0000000000002685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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DeKlotz TR, Kim HJ, Kelly M, Collins MT. Sinonasal disease in polyostotic fibrous dysplasia and McCune-Albright Syndrome. Laryngoscope 2013; 123:823-8. [PMID: 23444264 PMCID: PMC3609909 DOI: 10.1002/lary.23758] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 08/19/2012] [Accepted: 09/03/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVES/HYPOTHESIS To characterize the spectrum, symptoms, progression, and effects of endocrine dysfunction on sinonasal disease in polyostotic fibrous dysplasia (PFD) and McCune-Albright Syndrome (MAS). STUDY DESIGN Retrospective review. METHODS A prospectively followed cohort of subjects with PFD/MAS underwent a comprehensive evaluation that included otolaryngologic and endocrine evaluation, and imaging studies. Head and facial computed tomography scans were analyzed, and the degree of fibrous dysplasia (FD) was graded using a modified Lund-MacKay scale. Those followed for >4 years were analyzed for progression. RESULTS A total of 106 patients meeting inclusion criteria were identified with craniofacial FD. A majority (92%) demonstrated sinonasal involvement. There were significant positive correlations between the sinonasal FD scale score and chronic congestion, hyposmia, growth hormone excess, and hyperthyroidism (P < .05 for all). Significant correlations were not found for headache/facial pain or recurrent/chronic sinusitis. Thirty-one subjects met the criteria for longitudinal analysis (follow-up mean, 6.3 years; range, 4.4-9 years). Those who demonstrated disease progression were significantly younger than those who did not (mean age, 11 vs. 25 years). Progression after age of 13 years was uncommon (n = 3) and minimal. Concomitant endocrinopathy or bisphosphonate use did not have any significant effect on progression of disease. CONCLUSIONS Sinonasal involvement of fibrous dysplasia in PFD/MAS is common. Symptoms are usually few and mild, and disease progression occurs primarily in young subjects. Concomitant endocrinopathy is associated with disease severity, but not progression.
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Affiliation(s)
- Timothy R DeKlotz
- Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, Washington, DC 20007, USA
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Lee JS, FitzGibbon EJ, Chen YR, Kim HJ, Lustig LR, Akintoye SO, Collins MT, Kaban LB. Clinical guidelines for the management of craniofacial fibrous dysplasia. Orphanet J Rare Dis 2012; 7 Suppl 1:S2. [PMID: 22640797 PMCID: PMC3359960 DOI: 10.1186/1750-1172-7-s1-s2] [Citation(s) in RCA: 150] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Fibrous dysplasia (FD) is a non-malignant condition caused by post-zygotic, activating mutations of the GNAS gene that results in inhibition of the differentiation and proliferation of bone-forming stromal cells and leads to the replacement of normal bone and marrow by fibrous tissue and woven bone. The phenotype is variable and may be isolated to a single skeletal site or multiple sites and sometimes is associated with extraskeletal manifestations in the skin and/or endocrine organs (McCune-Albright syndrome). The clinical behavior and progression of FD may also vary, thereby making the management of this condition difficult with few established clinical guidelines. This paper provides a clinically-focused comprehensive description of craniofacial FD, its natural progression, the components of the diagnostic evaluation and the multi-disciplinary management, and considerations for future research.
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Affiliation(s)
- J S Lee
- Department of Oral & Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
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Karligkiotis A, Terranova P, Dallan I, Castelnuovo P. Monostotic fibrous dysplasia of the inferior turbinate. Otolaryngol Head Neck Surg 2011; 146:1035-6. [PMID: 22157265 DOI: 10.1177/0194599811431059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Apostolos Karligkiotis
- Department of Otorhinolaryngology, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.
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Amit M, Fliss DM, Gil Z. Fibrous Dysplasia of the Sphenoid and Skull Base. Otolaryngol Clin North Am 2011; 44:891-902, vii-viii. [DOI: 10.1016/j.otc.2011.06.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Zodpe P, Chung SW, Kang HJ, Lee SH, Lee HM. Endoscopic treatment of nasolacrimal sac obstruction secondary to fibrous dysplasia of paranasal sinuses. Eur Arch Otorhinolaryngol 2007; 264:495-8. [PMID: 17203310 DOI: 10.1007/s00405-006-0219-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 11/17/2006] [Indexed: 10/23/2022]
Abstract
Fibrous dysplasia involving paranasal sinuses mostly has asymptomatic features, but sometimes may cause signs and symptoms which relate to the location and extent of bony abnormalities. The use of endoscopic nasal surgery for debulking ethmoidal fibrous dysplasia, blocking the left nasolacrimal sac and simultaneous intranasal endoscopic dacryocystorhinostomy with silicone intubation is presented. The procedure and advantages of endoscopic approach over the external approach are outlined in this paper.
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Affiliation(s)
- Prakash Zodpe
- Department of Otorhinolaryngology, Korea University College of Medicine, Seoul, South Korea.
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Pasquini E, Sciarretta V, Frank G, Cantaroni C, Modugno GC, Mazzatenta D, Farneti G. Endoscopic treatment of benign tumors of the nose and paranasal sinuses. Otolaryngol Head Neck Surg 2004; 131:180-6. [PMID: 15365533 DOI: 10.1016/j.otohns.2003.05.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The endoscopic approach can be successfully employed for the treatment of benign tumors such as fibroosseus and vascular lesions, pleomorphic adenomas, gliomas, and schwannomas. STUDY DESIGN AND SETTING Nineteen patients diagnosed with benign tumors of the nasal cavity and paranasal sinuses and treated using an endoscopic approach were retrospectively reviewed. The endoscopic approach was used exclusively in 15 cases and was associated with an external approach in 4 cases (due to an intracranial extension of the tumor in 3 patients and its location at the level of the anterior wall of the frontal sinus in the last case). RESULTS The resection of the lesions was radical in 18 patients and subtotal in 1 case. The mean follow-up was 27 months and only 1 recurrence (5%) was observed in the juvenile angiofibroma group 20 months postoperatively. CONCLUSION and significance In selected cases, endoscopic surgery can be considered an effective treatment for the resection of benign tumors involving the sinonasal tract.
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Affiliation(s)
- Ernesto Pasquini
- ENT Department, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
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Ikeda K, Oshima T, Suzuki H, Kikuchi T, Suzuki M, Kobayashi T. Surgical treatment of subperiosteal abscess of the orbit: Sendai's ten-year experience. Auris Nasus Larynx 2003; 30:259-62. [PMID: 12927288 DOI: 10.1016/s0385-8146(03)00060-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE One of the common complications of acute infection of the paranasal sinus is cellulitis of the orbit. This is secondary to the spread of infection through the very thin bony wall between the ethmoid sinuses and the orbit, the roof of the orbit in frontal sinusitis, and the floor of the orbit in maxillary sinusitis. When the infection does not penetrate the periorbita, it dissects under the periosteum and forms subperiosteal abscess. METHODS We experienced 10 patients with subperiosteal abscess for 10 years from 1992 to 2002 that required surgical drainage. The age of the patients ranged from 4 to 76 years including five males and five females. RESULTS Successful and safe drainage of the abscess with endoscopic sinus surgery was obtained in four patients while six patients required external surgery. The selection of the surgical approach depended upon the localization of abscess in the orbit. Five of the seven patients with visual disturbance resulted in a complete recovery of vision after surgery. However, there was no improvement of visual acuity in the other two patients who had already shown severe damage of vision prior to treatment. CONCLUSION Ocular symptoms such as exophthalmos, double vision, and ptosis subsided completely in all patients. It is suggested that prompt diagnosis and surgical drainage before severe loss of visual acuity rescue or recover the vision.
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Affiliation(s)
- Katsuhisa Ikeda
- Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan.
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Pasquini E, Ceroni Compadretti G, Sciarretta V, Ippolito A. Transnasal endoscopic surgery for the treatment of fibrous dysplasia of maxillary sinus associated to aneurysmal bone cyst in a 5-year-old child. Int J Pediatr Otorhinolaryngol 2002; 62:59-62. [PMID: 11738696 DOI: 10.1016/s0165-5876(01)00593-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fibrous dysplasia (FD) and aneurysmal bone cyst involving the facial skeleton are rare but their synchronous association in other parts of the body is well-known. The most common treatment for these lesions has been based on surgical resection using an external approach. Only recently has the endonasal endoscopic approach been utilized for the partial or complete removal of these lesions. In this report, we attempt to outline the effectiveness of the endonasal endoscopic approach for the treatment of a 5-year-old child affected by a fibrous dysplasia associated with an aneurysmal bone cyst of the right maxillary.
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Transnasal endoscopic surgery for benign neoplasms of the nose and sinuses. Curr Opin Otolaryngol Head Neck Surg 2001. [DOI: 10.1097/00020840-200102000-00008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Fibrous dysplasia (FD) in the paranasal sinuses is uncommon, and its management may be difficult. We report the case of a 25-year-old female with FD exhibiting a cystic appearance in the maxillary sinus. The patient had been complaining of facial swelling for few years. Imagery study showed a cystic lesion and dense bone changes in the maxillary bone. Inferior meatal antrostomy with a nasal endoscope failed to confirm a histological diagnosis. After a 3-year follow-up, the degree of facial swelling was unchanged, and the patient underwent middle meatal antrostomy and was diagnosed with FD.
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Affiliation(s)
- H Muraoka
- Department of Otolaryngology, Kawaguchi-Kogyo General Hospital, 1-18-15 Aoki, Saitama, 332-0031, Kawaguchi City, Japan
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Ikeda K, Takahashi C, Oshima T, Suzuki H, Satake M, Hidaka H, Takasaka T. Endonasal endoscopic marsupialization of paranasal sinus mucoceles. AMERICAN JOURNAL OF RHINOLOGY 2000; 14:107-11. [PMID: 10793914 DOI: 10.2500/105065800781692886] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Paranasal sinus mucoceles are relatively common in Japan, especially after prior Caldwell-Luc surgery. Recently developed endonasal endoscopic approaches were used for the drainage and marsupialization of mucoceles. We present the surgical treatment of 97 patients with mucoceles, including 68 maxillary, 13 ethmoid, nine frontal, seven sphenoid, eight frontoethmoid, and one sphenoethmoid sinuses. Six patients with maxillary mucoceles were operated via a sublabial incision. For frontal mucoceles, four patients were treated by a combined external and endonasal endoscopic approach. The other mucoceles underwent complete marsupialization under endonasal endoscopic control. There were no intraoperative or postoperative complications. No evidence of recurrence was observed in any patients during follow-up periods ranging from 36 to 84 months.
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Affiliation(s)
- K Ikeda
- Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University School of Medicine, Sendai, Japan
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