Acquired immune deficiency syndrome presenting as oral pharyngeal and cutaneous kaposi's sarcoma

A 25-year-old black male homosexual with AIDS presented with Kaposi's sarcoma of the tongue, palate and skin. The definition, epidemiology, diagnosis, treatment and prognosis of AIDS are discussed. The role of the otolaryngologist-head and neck surgeon in diagnosing this disease is outlined.     

Endoscopic repair of a nasal septal perforation

The repair of septal perforations represents a challenging problem, with numerous techniques existing to address the defect. The use of sinonasal endoscopy represents a novel approach to solving this problem. By using the endoscope, excellent visualization and exposure can be achieved without excessive dissection. In addition, the use of the camera and monitor allows for excellent teaching capabilities.     

Nasal septal perforation and antiphospholipid syndrome (Hughes syndrome)

We present the case of a 19-year-old woman who developed a nasal septal perforation and atrophic rhinitis following septal surgery. During the subsequent five years, she also experienced intermittent episodes of swelling and ischaemia of the left foot, as well as livedo reticularis. Ultimately, haematological investigations revealed the presence of lupus anticoagulant and elevated antiphospholipid immunoglobulin M levels. A diagnosis of antiphospholipid syndrome (Hughes syndrome) was made.A search of the literature revealed that nasal septal perforation has been described in up to 0.8 per cent of patients with antiphospholipid syndrome. However, it is undescribed in the otorhinolaryngological literature. The impact of this syndrome on otorhinolaryngology practice is examined.     

Ultrastructure of Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS)

We used electron microscopy to examine the ultrastructural morphology of Kaposi's sarcoma (KS) of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS). The tumors manifested endothelial vascular proliferation and neoplastic spindle cell formations. The endothelial tumor cells contained several multivesicular bodies and a large number of tubuloreticular structures within the endoplasmic reticulum. Ultrastructural changes in the other cytoplasmic organelles included defective cell junctions that seemed to facilitate the migration and extravasation of erythrocytes through endothelial gaps, after which erythrophagocytosis occurred. Tumor cells contained viral particles which were 100-120 nm in diameter and contained dense cylindrical cores. We believe that this is the first time these particles have been identified in KS cells of the oral mucosa in patients with AIDS. These viral particles are also ultrastructurally identical to the human T-cell lymphotropic retroviruses subgroup HTLV-III. Our observations are discussed in the light of recent immunological findings.     

Retroviruses in Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS)

The ultrastructure of Kaposi's sarcoma (KS) of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS) was examined electron microscopically. The tumour consisted of pleomorphic vascular endothelial structures and spindle cell formations. The KS cells contained characteristically numerous multivesicular bodies, a large number of tubuloreticular structures and abundant Weibel-Palade bodies in their cytoplasm. Virus particles, 100-120 nm in diameter, were observed budding from the plasma membrane or as free particles already separated from the plasma membrane. Many mature virions manifested a dense cylindrical-shaped core. These virus particles and the human T-cell lymphotropic retroviruses subgroup HTLV-III are ultrastructurally identical. This report is based on recent immunological research.     

Ultrastructure of Kaposi's sarcoma in acquired immune deficiency syndrome (AIDS)

Summary We used electron microscopy to examine the ultrastructural morphology of Kaposi's sarcoma (KS) of the oral mucosa in patients with acquired immune deficiency syndrome (AIDS). The tumors manifested endothelial vascular proliferation and neoplastic spindle cell formations. The endothelial tumor cells contained several multivesicular bodies and a large number of tubuloreticular structures within the endoplasmic reticulum. Ultrastructural changes in the other cytoplasmic organelles included defective cell junctions that seemed to facilitate the migration and extravasation of erythrocytes through endothelial gaps, after which erythrophagocytosis occurred. Tumor cells contained viral particles which were 100–120 nm in diameter and contained dense cylindrical cores. We believe that this is the first time these particles have been identified in KS cells of the oral mucosa in patients with AIDS. These viral particles are also ultrastructurally identical to the human T-cell lymphotropic retroviruses subgroup HTLV-III. Our observations are discussed in the light of recent immunological findings.This work was supported by the Austrian Foundation for Cancer Research (Fonds Österreichische Krebsforschungsinstitute) and by the Tumor Board of the Medical Faculty of the University of Vienna (Krebsausschuß der Medizinischen Fakultät der Universität Wien)     

Repair of nasal septal perforation with a silicone button

A symptomatic nasal septal perforation is an annoyance to both the patient and the treating physician. Patients complain of a whistling sound on respiration, persistent nasal crusting, occasional odor, and recurrent bouts of epistaxis. Most of the described surgical methods to attempt to close them, are not very successful; they may require more than one surgical procedure, entailing the associated hospitalization, morbidity, etc., and, at best, dubious outcome. The technique I have used for the past few years was first proposed to me by Vernon Gray M.D.;¹ it offers a simple atraumatic office procedure which, has proven to be successful in eliminating the symptoms resulting from a nasal septal perforation. Naturally, the physician should try to determine the underlying cause of the perforation and when practical, treat it. Most cases, however, are due to previous septal surgery or trauma     

带蒂鼻腔黏骨膜瓣联合鼻中隔减张皮瓣修补鼻中隔穿孔(附3例报告)

目的探讨鼻中隔穿孔修补术的方法。方法3例鼻中隔穿孔病人采用鼻内镜联合显微镜下,应用带蒂鼻腔黏骨膜瓣翻转联合鼻中隔减张皮瓣修补术,并用保湿物鼻腔填塞方式。结果随访1~2年,3例鼻中隔穿孔手术修补成功。结论鼻内镜联合显微镜下,应用带蒂鼻黏骨膜瓣翻转联合鼻中隔减张皮瓣修补术是修补鼻中隔穿孔行之有效的治疗方法。     

Acquired immune deficiency syndrome--related lymphadenopathies presenting in the salivary gland lymph nodes

Homosexual males at risk for acquired immune deficiency syndrome (AIDS) frequently present with peripheral lymphadenopathies that precede the opportunistic infections and neoplasias of this disease. Two homosexual males had enlarged salivary glands due to lymphadenopathies initially affecting intraparotid and perisubmaxillary gland lymph nodes. Both the hyperplastic and the atrophic histologic patterns of AIDS-related lymphadenopathies were observed in the lymph nodes. Subsequently, the two patients developed lymphoma and opportunistic infections, respectively. The AIDS-related lymphadenopathy developing in salivary gland lymph nodes is an entity that should be considered in the differential diagnosis of salivary gland tumors.     

Schwannoma presenting as a nasal polyp.

An unusual presentation and treatment of an intranasal Schwannoma are discussed. The clinical and pathological features are also reviewed.     

A nasal tooth associated with septal perforation: a rare occurrence

Supernumerary teeth occur in a wide variety of sites, including the palate, mandibular condyle, coronoid process, orbit, maxillary antrum, and nasal cavity. Supernumerary teeth manifest in different ways depending on the site. Reported symptoms and signs associated with supernumerary teeth in the nasal cavity (nasal teeth) include facial pain, external nasal deformities, foul-smelling rhinorrhea, recurrent epistaxis, and oronasal fistula. Very rarely, septal perforation has been reported. We present a case in which eruption of a tooth into the nasal cavity was associated with nasal septal perforation. The tooth was extracted endoscopically.     

Chondroid hamartoma presenting as a neonatal nasal mass.

We present a case of a 3-month-old female with a right nasal mass. Upon evaluation with computed tomography, magnetic resonance imaging and angiography, a large right intranasal mass extending through the cribiform plate, displacing the dura, was noted. The patient underwent a combined midfacial degloving and bifrontal craniotomy for complete resection of the tumor mass. Pathologic evaluation demonstrated a mesenchymal tumor with spindle and stellate cells from which islands of immature cartilage emerged. The spectrum of histologic features closely resembled a mesenchymal chondroid hamartoma typically located in the chest wall. It is the first reported case of a chondroid hamartoma of the head and neck in the literature to date. We examine the characteristics and treatment of this unusual tumor.     

The nasal airflow in noses with septal perforation: a model study

BACKGROUND: Septal perforation is a common clinical problem in rhinology. Affected patients suffer from a dry nose, crusts as well as recurrent epistaxis and sometimes an inspiratory whistle. The aim of this study was to investigate the underlying flow dynamic mechanisms. METHODS: The physical flow effects of such pathologies were examined in functional nose models (box models) and anatomically exact models of the nose. Therefore, septal perforations of different sizes and localisations were studied in straight and deviated nasal septa. RESULTS AND CONCLUSIONS: It could be seen that the localisation of the perforation has no impact on the flow pattern. In large septal perforations, the air jet collides with the posterior edge of the perforation and disintegrates turbulently. Since airflow is physiologically turbulent in the posterior part of the nose, posterior perforations do not cause clinical complaints. The inspiratory whistling sound during respiration is based on the principle of a lip whistle. Large perforations do not cause a whistling sound. The necessary high flow velocity needed in large perforations is usually not achievable.     

Pediatric nasal septal perforation secondary to magnet misuse: a case report

We describe the case of a 7-year-old girl who had placed magnetic earrings bilaterally on her nasal ala. However, the two backing magnets that had been placed inside the nasal cavity became attached to each other rather than to the outer jewelry, compressing the nasal septum. Several weeks later, the septum became perforated. The patient was treated conservatively with mupirocin ointment, oral amoxicillin, and nasal saline. Subsequent examinations revealed no enlargement of the perforation, and the patient was followed conservatively with saline nasal spray.     

A new method of nasal dermoplasty (MW grafting method) in patients with large septal perforation

Nasal dermoplasty is effective in controlling epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). Skin graft take failure occurs mostly in cases of large septal perforation. The MW method was developed as a modification of nasal dermoplasty designed for patients with HHT having a large septal perforation. It seems to be a safe and effective approach and should be tried for recurrent bleeders with septal perforation.     

Extracranial meningioma presenting as a nasal polyp

The extracranial occurrence of meningiomas is summarized. A patient suffering from repeated episodes of epistaxis presented with a lobulated nasal polyp which was found to be a meningioma. At subsequent radical removal, the extracranial location in the nose, ethmoidal region and cribriform area was verified.