Isolated sphenoid inflammatory diseases associated with visual impairment: 15-year experience at a single institution.

We present a retrospective series of 11 patients treated for isolated sphenoid inflammatory disease (ISID) with visual impairment in the period between 1994 and 2008. The series included 7 females and 4 males. All patients, preoperatively assessed by CT or MR, underwent endoscopic sinus surgery and broad-spectrum antibiotic therapy.

Limitations and complications of endoscopic surgery for treatment for sinonasal inverted papilloma: a reassessment after 212 cases.

Background: The purpose of this study was to define the optimal surgical strategy for sinonasal inverted papilloma in relation to the site of origin and tumor extent.

Methods: Retrospective analysis of patients affected by inverted papilloma treated by purely endoscopic or combined approaches at the Department of Otorhinolaryngology of the University of Brescia and Pavia-Varese from November 1991 to December 2007.

Results: Two hundred twelve patients were considered eligible for this study.

Nasopharyngeal endoscopic resection in the management of selected malignancies: ten-year experience.

Objective: To evaluate the feasibility of endoscopic surgery in the management of selected nasopharyngeal cancers. Three different types of nasopharyngeal endoscopic resections (NER) are described.

Method Of Study: From January 1997 to October 2008, 17 consecutive patients (mean age: 50 years) with previously untreated (5) or recurrent nasopharyngeal tumours (12) were treated with curative intent by pure endoscopic resection.

Fungus ball of the paranasal sinuses: experience in 160 patients treated with endoscopic surgery.

Objectives/hypothesis: Herein we present our experience in the management of fungus ball (FB) of the paranasal sinuses. Preoperative imaging strategy and findings, surgical technique, and pathologic and microbiologic results are discussed.

Study Design: Retrospective chart review of patients with FB of the paranasal sinuses who underwent endoscopic surgery at the Department of Otorhinolaryngology of the University of Brescia, Italy.

[Intranasal steroid therapy in inflammatory nasal-sinus pathology in pediatric age].

Nasal obstruction is the symptom par excellence signalling the onset of nasal-sinus inflammatory pathologies (allergic rhinitis, acute or intermittent rhinosinusitis without nasal polyps, persistent rhinosinusitis without nasal polyps, chronic or intermittent rhinosinusitis associated with nasal-sinus polyposis). This symptom is due, in particular, to the host's response to the etiological factor for which, where there is no accompanying infectious process, the therapy should be aimed at resolving the inflammatory response. The anti-inflammatory properties of steroid drugs have been used systemically with excellent results.

Role of endoscopic surgery in the management of selected malignant epithelial neoplasms of the naso-ethmoidal complex.

Background: This study reviews the outcome of patients with adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the naso-ethmoidal complex treated by endoscopic surgery.

Methods: Sixteen patients underwent a purely endoscopic excision of AC (n = 12) or SCC (n = 4) at 2 university hospitals. All patients were prospectively followed by endoscopic and MRI evaluations.

[Sino-nasal inverted papillomas and occupational etiology].

The sino-nasal inverted papilloma is a rare benign tumour with certain aggressive features because of frequent relapses and the high probability of malignant degeneration. For these reasons, several studies have been made to evaluate the efficacy of the different courses of treatment, but only afew studies have been carried out to establish the etiology of this tumour, which is still uncertain. Although it is believed that viral infection, chronic inflammation and cigarette smoking can play an important etiological role, it has recently been suggested that occupational risk factors, such as those involved in malignant epithelial sino-nasal cancer (SNC), can also be involved in causing sino-nasal inverted papilloma.

Magnetic resonance imaging findings of inverted papilloma: differential diagnosis with malignant sinonasal tumors.

Background: Computed tomography and magnetic resonance imaging (MRI) are the techniques of choice for pretreatment staging in neoplasms of the sinonasal tract. In inverted papilloma (IP), the information provided by computed tomography regarding characterization of the lesion is rather nonspecific. The present retrospective study was performed in the attempt to identify distinguishing features of IP on MRI.

Different endoscopic surgical strategies in the management of inverted papilloma of the sinonasal tract: experience with 47 patients.

Objective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract.

Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.

Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection.

Transnasal endoscopic dacryocystorhinostomy for the treatment of lacrimal pathway stenoses in pediatric patients.

Lacrimal pathway stenoses in pediatric patients are uncommon after the age of 1 year. Various conservative treatments (massages, hot compresses, topical antibiotics, probing and intubation of the lacrimal pathways) are generally used to resolve these disorders. When non-invasive procedures fail, dacryocystorhinostomy (DCR) is indicated.

Pneumosinus dilatans of the maxillary sinus: a case report and review of the literature.

Pneumosinus dilatans (PSD) is an abnormal dilatation of one or more of the paranasal sinuses and must be included in the differential diagnosis of expansile lesions of the sinonasal tract. The frontal and sphenoid sinuses are the most frequently involved sites. Herein, we present the case of a 30-year-old woman with a 6-year history of right nasal obstruction and pain in the right maxillary region, elicited by rapid changes in atmospheric pressure.

Endoscopic surgery for juvenile angiofibroma: when and how.

Objectives/hypothesis: In recent years, the indications for endoscopic surgery of the sinonasal tract, originally introduced for the treatment of inflammatory diseases, have been expanded to include selected cases of benign and malignant neoplastic lesions. The aim of the present study was to establish the efficacy of endoscopic surgery in the management of small and intermediate-sized juvenile angiofibromas.

Study Design: Retrospective study.

The distribution of lymph node metastases in supraglottic squamous cell carcinoma: therapeutic implications.

Background: The treatment of the neck in cancer of the upper aerodigestive tract is still a matter of controversy, even though nowadays there is a trend in the literature toward elective surgery in the N0 neck when the probability of occult lymph node metastasis is greater than 20%. In the elective setup, every effort is made for preservation of uninvolved nonlymphatic structures in positive neck. The aim of this study is to analyze in a large cohort of patients treated for supraglottic carcinoma the prevalence of lymph node metastases and their distribution through various neck levels to redefine our policy of neck treatment.

Adenotonsillectomy in children with von Willebrand's disease: how and when. A case report with review of the literature.

The presence of coagulation pathology in children who are candidates for adenotonsillectomy (AT) is a challenge to the otolaryngologist. von Willebrand's disease (vWD) is the most common hereditary coagulopathy and is due to a quantitative and/or qualitative deficiency of von Willebrand's factor (vWF). In recent years, the administration of 1-deamino-8-D-arginine vasopressin (DDAVP) has been recommended as coadjuvant therapy for surgical procedure.

[Dacryocystocele in the adult: etiology, diagnosis and treatment].

Dacryocystocele (DCC) is a pathologic condition frequently found in newborns as a consequence of congenital lacrimal system stenosis. Its occurrence in adult age is an exceedingly rare event and is secondary to inflammation, a neoplasm, facial trauma, or nasal surgery. Diagnosis is based on clinical examination, dacryocystography and computed tomography.

Postlaryngectomy pharyngocutaneous fistula: incidence, predisposing factors, and therapy.

Background: Pharyngocutaneous fistula is the most common complication following total laryngectomy. The present study was designed to determine the incidence and predisposing factors and to describe the management of the complication.

Methods: The records of 246 consecutive patients who underwent total laryngectomy for squamous cell carcinoma were reviewed.

[Endoscopic treatment of sphenoid aspergilloma].

In recent years there has been an increase in fungal infections of the nose and paranasal sinuses, even though it is difficult to ascertain the incidence and prevalence of such disorders. The only information which can be drawn from the literature is that such infections are diagnosed in 6% to 13% of surgically treated chronic sinusitis. Aspergillus is the etiologic agent in approximately 80% of cases.

Prognostic determinants in supraglottic carcinoma: univariate and Cox regression analysis.

Background: A series of 281 consecutive patients affected by supraglottic cancer and treated with surgery alone or with surgery followed by radiotherapy between 1983 and 1989 was reviewed to identify significant prognostic determinants.

Methods: Fifty-one variables (related to host, tumor, and treatment) were tested by univariate and multivariate analysis performed on absolute and determinate survival.

Results: The final model of the multivariate analysis for absolute survival included the following covariates listed in order of higher relative risk of death: extracapsular spread, involvement of the medial wall of the pyriform sinus, thyroid cartilage invasion, metachronous tumor, anesthesiologic risk according to the American Society of Anesthesiologists classification (chi 2 = 71.

[Incidence and distribution of lymph node metastases in supraglottic squamous cell carcinoma: therapeutic implications].

This retrospective study was designed to establish some guidelines for the treatment of the neck in the case of supraglottic cancer. The patient population included a series of 264 patients, from 39 to 76 years old (mean age 58.3), who had undergone monolateral (76) or bilateral (188) neck dissection for a total of 452 neck dissections.

Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma.

We present a case of sphenoid mucocele with large invasion of the middle cranial fossa, secondary to a nasopharyngeal acinic cell carcinoma, occurring in a 52-year-old man. To the best of our knowledge, this association has not been reported so far. We discuss the importance of imaging techniques in delineating the relationship between the two lesions, as long as the clinical and therapeutic problems related both to sphenoid mucocele and acinic cell carcinoma.

[Laryngocele: analysis of 18 cases and review of the literature].

18 cases of laryngocele (8 combined, 6 external, 4 internal) treated at the E.N.T.