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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Isolated sphenoid sinus disease (ISSD) is a relatively uncommon disease. The present study is a retrospective review of 122 patients with ISSD who were treated at the Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital at Shanghai Medical University over a 25-year period. The diagnosis of ISSD was made on the basis of history and physical examination, signs and symptoms, nasal endoscopy, and computed tomography (CT) and magnetic resonance imaging (MRI). The final diagnosis of ISSD was confirmed by histopathologic and microbiological examinations of the surgical specimens. The pathological findings in this study included sphenoid cyst (47 cases), sphenoid sinusitis (31 cases), fungal disease (19 cases), inverted papilloma (4 cases), sphenochoanal polyp (1 case), foreign body (8 cases), malignant tumors (8 cases), and others (4 cases). The most common initial symptom was headache, followed in decreasing order by visual changes, cranial nerve palsies, and nasal symptoms. The more frequent use of routine CT and MRI scanning, as well as endoscopy, in the diagnosis of sinus disease has led to an increase in the early diagnosis of ISSD. The recent advances in endoscopic sphenoidotomy has allowed for relatively safe and immediate treatment of ISSD, preventing late extension into adjacent vital structures, which is commonly fatal. Endoscopic surgery also enables the surgeon to make a precise pathological diagnosis.
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PMID:Isolated sphenoid sinus disease: an analysis of 122 cases. 1199 83

The purpose of this article is to describe a chronic variant of invasive fungal sinusitis (IFS) and discuss its management. This is a retrospective review of two cases of IFS that were characterized by atypical clinical courses. Patient 1 was a 75-year-old man with noninsulin-dependent diabetes mellitus who came to us with a 5-month history of headache. Computed tomography detected an opacified left sphenoid sinus. After the man failed to respond to medical therapy, he underwent a left endoscopic sphenoidotomy. Pathologic examination revealed that septate, branching fungal hyphae had invaded the soft tissues. The patient was started on oral itraconazole, but later switched to intravenous amphotericin B in response to intracranial extension. The man's disease stabilized, but he died a little more than 1 year later of unrelated causes. Patient 2 was an otherwise healthy 41-year-old woman who came to us with nasal congestion and unilateral nasal polyps. She underwent endoscopic sinus surgery. Pathologic examination identified granulomatous sinusitis and septate, branching fungal hyphae that had invaded the soft tissue of the middle turbinate. The patient was not treated with systemic antifungal medications because of the localized nature of the fungal invasion and the lack of bone invasion or erosion. She has now been symptom-free for 5 years. These two cases demonstrate that IFS can appear in a chronic variant form that is characterized by an indolent course and histologic evidence of tissue invasion by fungal hyphae. The type of treatment is dependent on the extent of the disease on initial examination and the rapidity of its progression.
Ear Nose Throat J 2002 Jul
PMID:Chronic invasive fungal sinusitis: a report of two atypical cases. 1214 43

A study undertaken to assess the olfactory acuity in allergic (group I) and non-allergic rhinitis (group II) patients in comparison with age and sex matched controls (group III). Patients presenting with atleast three of the five cardinal symptoms of rhinitis i.e. rhinorrhoea, sneezing, itching, headache and nasal obstruction were grouped as non-infective rhinitis and further divided into allergic rhinitis (group I, n = 20) and non-allergic rhinitis (group II, n = 20) based on nasal smear cytology positivity or negativity for eosinophils respectively. Detailed Ear, Nose and Throat examination was carried out in both the groups and peripheral blood samples were analysed for total, differential leukocyte and absolute eosinophil counts using standard techniques. In all the three groups the olfactory thresholds for 5 odorants i.e. musk (M), formalin (F), camphor (C), asafoetida (A, 10% aqueous solution) and oil of peppermint (P, 20%) were evaluated for testing musky, pungent, camphorous, putrid and minty odours respectively by the method described by Elsberg and Levy for quantitative olfactometry. The results indicated elevation of olfactory thresholds (delta %, calculated taking control values as 100%) for 4 or 5 odorants in group I and group II patients respectively as compared with controls (group I: delta % for P--89.6%; M--116.4%; A--55.8%; P < 0.001; C--73.1%; P < 0.02; F--26.6% N.S.; group II: P--96.9%; M--99.3%, P < 0.01 for both; A--66.8%; C--102.7%, P < 0.001; F--42%, P < 0.05). In the non allergic rhinitis group the magnitude of the olfactory loss was more severe except for the odorant musk. Further interpretations as per gender based specificities revealed more severe olfactory loss in males of both the groups for the odorants peppermint and musk and moderately severe olfactory loss for formalin and camphor as compared to females. However, for the odorant asafoetida females showed greater olfactory loss than males in both the groups (delta % 73.38% versus 52% in group I and 81.29% versus 69.7% in group II).
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PMID:Assessment of olfactory status in allergic and non-allergic rhinitis patients. 1250 Apr 93

Non-Hodgkin's lymphoma of the sinonasal tract is an uncommon lesion, representing 1.5 to 15% of all lymphomas. Most cases of primary non-Hodgkin's lymphoma of the sinonasal tract occur in the maxillary sinus, ethmoid sinus, and nasal cavity; its occurrence in the frontal sinus is extremely rare. We report a case of primary type B non-Hodgkin's lymphoma of the frontal sinus in a 43-year-old man. The patient complained of frontal headaches that had not improved with analgesic drugs, and he presented with a frontal bulge that involved the left upper eyelid; the bulge had progressively enlarged over a 3-month period A biopsy of the mass identified the type B non-Hodgkin's lymphoma. Immunohistochemical study not only confirmed the histologic type of the tumor, it also provided some important information about the primary tumor site. Advances in immunohistochemistry have shown that type B non-Hodgkin's lymphoma is more common in North American and European patients, whereas subtype T is more common in Asians and in some Latin Americans. The treatment of this condition is still controversial, but the combination of radiotherapy and chemotherapy has yielded the best results in all stages of the disease.
Ear Nose Throat J 2005 Jan
PMID:Primary non-Hodgkin's lymphoma of the frontal sinus: case report and review of the literature. 1574 75

Most translabyrinthine temporal bone defects are reconstructed with free abdominal fat grafts, with or without the use of hydroxyapatite cement. However, these procedures are associated with considerable morbidity at the graft donor site, with a 6 to 15% incidence of cerebrospinal fluid (CSF) leaks, and with postoperative headaches. We have developed a new technique for reconstructive cranioplasty that involves the use of hydroxyapatite cement and a pericranial/deep temporal fascia graft. This technique obviates the need for an abdominal fat graft and therefore circumvents the morbidity associated with it; it may also significantly reduce the incidence of CSF leaks and postoperative headaches. We describe the results of our use of this technique in a series of 10 patients. Based on our early findings, we believe that this technique holds great promise for reconstructive cranioplasty following translabyrinthine craniectomy.
Ear Nose Throat J 2005 Feb
PMID:The use of hydroxyapatite cement and a pericranial/deep temporal fascia graft for cranioplastic reconstruction of translabyrinthine craniectomy defects. 1579 44

We describe a case of bilateral massive conchae bullosa in a 76-year-old woman. She presented with a 2-year history of nasal obstruction and frontal headache. In light of these and other findings on anterior rhinoscopic and endoscopic examinations, we initially suspected nasal tumors. However, after a prebiopsy evaluation by computed tomography, we diagnosed bilateral massive conchae bullosa that did not impair sinus ventilation. Endoscopic surgery was performed, and the patient's symptoms abated.
Ear Nose Throat J 2005 Aug
PMID:Bilateral massive conchae bullosa mimicking intranasal tumors. 1622 Aug 56

Lemierre's syndrome, a rare and almost forgotten cause of internal jugular vein thrombosis, is usually caused by an anaerobic head and neck infection. Left untreated, it can result in the release of septic emboli. We describe the case of a 42-year-old man who presented with fever and a tender, swollen neck mass. Computed tomography revealed an edematous parapharyngeal area and a compressed internal jugular vein. Despite antibiotic treatment, the patient's condition worsened, and a parapharyngeal fluid collection was drained 4 days later. Six weeks later, the patient returned to the outpatient department complaining of headaches, and he was found to have a tender, firm neck. He was readmitted, and magnetic resonance venography revealed a right internal jugular vein thrombosis that extended intracranially to the sigmoid sinus. He was anticoagulated for 6 months, and he remained well during outpatient follow-up. We examine the controversial roles that anticoagulation and thrombolysis play in Lemierre's syndrome and sigmoid sinus thrombosis, and we review the diagnostic options.
Ear Nose Throat J 2006 Feb
PMID:Sigmoid sinus thrombosis secondary to Lemierre's syndrome. 1657 97

Fibrous dysplasia typically occurs in patients between the ages of 5 and 15 years. We report the case of a middle-aged woman with longstanding monostotic fibrous dysplasia who responded well to conservative treatment. She had presented with a very long (15 yr) history of frontal headache and pressure over the frontal sinus. On examination, a protuberance was noted in the region of the right frontal sinus. No other symptoms were evident, and findings on the ENT examination were normal. Computed tomography (CT) detected a widening of the frontal bone with osteolytic changes of the cancellous bone of the diploe. Partial multiphase skeletal scintigraphy and single-photon emission CT of the cranium showed increased bone metabolism in the area of the right frontal bone. No other hot spots were seen. In view of the absence of any complications, no tissue biopsy was performed. The patient was prescribed bisphosphonates for symptom relief. Follow-up CT 1 year later revealed no progression of the lesion. Overtreatment of fibrous dysplasia should be avoided because most patients respond to conservative management. In those cases that are refractory to medical treatment, surgery--in experienced hands--can result in a good functional and cosmetic outcome.
Ear Nose Throat J 2006 Oct
PMID:Fibrous dysplasia of the frontal bone. 1712 36

Patients with an endolymphatic sac tumor (ELST) typically present with palsy of cranial nerves VII and/or VIII; other presenting symptoms include hearing loss, otalgia, occipital headaches, cranial nerve palsies, vertigo, gait ataxia, tinnitus, and otorrhea. ELSTs are extremely vascular, and they can invade and destroy temporal bone. Because of these characteristics, they are often mistaken for glomus tumors of the skull base. We describe the clinical presentation, evaluation, and management of ELSTs based on our review of the limited literature and our experience with 3 adults who presented to our tertiary care referral center with large ELSTs. Although these patients presented late in the course of their disease, their symptoms were relatively minor. Preoperative tumor embolization was performed, anda near-complete resection was achieved via an extended transotic approach in all 3 patients. The facial nerve was preserved without transposition in the first patient, the second patient underwent a primary nerve anastomosis, and the third required a cable graft of the facial nerve. Postoperative radiation therapy was administered to 2 of these patients. Follow-up by MRI detected no evidence of recurrence in any of the 3 patients.
Ear Nose Throat J 2007 Jan
PMID:Endolymphatic sac tumor: a report of 3 cases and discussion of management. 1731 32

Tornwaldt's cyst is an uncommon type of nasopharyngeal cyst that may cause clinically significant symptoms. We reviewed reports of 31,855 computed tomography (CT) scans and 21,158 magnetic resonance imaging (MRI) scans to ascertain how many Tornwaldt's cysts were discovered incidentally. These images had been obtained between Jan. 1, 1994, and Dec. 31, 1999, at the University of Virginia Health Sciences Center. We found that 32 Tornwaldt's cysts had been incidentally detected in 20 women and 12 men. Four of these cysts had been found on CT (0.013%; mean size: 0.66 cm3) and 28 on MRI (0.13%; mean size: 0.58 cm3). The overall rate was 0.06% (32/53,013). The most common indications for imaging in these patients were headache, seizures, dizziness/vertigo, and pharyngeal symptoms. We also report the case of a patient with a symptomatic Tornwaldt's cyst whose symptoms resolved after treatment with endoscopic marsupialization. Tornwaldt's cyst should be remembered as an uncommon but potentially treatable cause of many symptoms seen in a typical otolaryngology practice.
Ear Nose Throat J 2007 Jan
PMID:Tornwaldt's cyst: incidence and a case report. 1731 35


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