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https://www.readbyqxmd.com/read/28636740/initial-experience-of-a-hereditary-hemorrhagic-telangiectasia-center-of-excellence
#1
Christopher F Thompson, Jeffrey D Suh, Justin McWilliams, Gary Duckwiler, Marilene B Wang
Our objectives in reviewing the initial experience of a hereditary hemorrhagic telangiectasia center of excellence (HHT COE) were to better understand the interventions being performed in the comprehensive care of these patients and to present the early data as a reference for other tertiary centers considering starting an HHT COE. We conducted a retrospective review of consecutive patients referred to our newly developed HHT COE for evaluation and treatment between May 2010 and June 2013. Clinical presentation, otolaryngologic treatments, and other operative interventions were analyzed...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28635991/the-papillomas-of-the-sinonasal-tract-a-comprehensive-review
#2
G Leoncini, L Zanetti
Papillomas are uncommon tumors of the sinonasal tract histologically derived from the Schneiderian membrane. Three distinctive variants are described, the exophytic, the inverting and the oncocytic types. On physical examination, their appearance varies from exophytic-fungiform seen in the exophytic variant, to polypoid-papillary in both the inverting and oncocytic variant. The presence of an asymptomatic mass or epistaxis and unilateral nasal obstruction are the typical presenting symptoms. Clinically they tend to recur and, although benign, they may erode the bone laminas by pressure, especially the inverting type, causing proptosis and other co-morbidities...
March 2017: Pathologica
https://www.readbyqxmd.com/read/28626375/intravenous-bevacizumab-therapy-in-a-patient-with-hereditary-hemorrhagic-telangiectasia-eng-e137k-alcoholic-cirrhosis-and-portal-hypertension
#3
Luigi F Bertoli, Pauline L Lee, Lauren Lallone, James C Barton
Intravenous bevacizumab decreased mucosal bleeding in some patients with hereditary hemorrhagic telangiectasia (HHT). We treated a 47-year-old male who had HHT, severe epistaxis, and gastrointestinal bleeding, alcoholic cirrhosis, and portal hypertension with intravenous bevacizumab 2.5 mg/kg every 2 weeks. We tabulated these measures weekly during weeks 1-33 (no bevacizumab); 34-57 (bevacizumab); and 58-97 (no bevacizumab): hemoglobin (Hb) levels; platelet counts; units of transfused packed erythrocytes (PRBC units); and quantities of iron infused as iron dextran to support erythropoiesis...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28621574/endovascular-plug-for-internal-carotid-artery-occlusion-in-the-management-of-a-cavernous-pseudoaneurysm-with-bifrontal-subdural-empyema-technical-note
#4
Sunil Manjila, Gagandeep Singh, Obinna Ndubuizu, Zoe Jones, Daniel P Hsu, Alan R Cohen
The authors demonstrate the use of an endovascular plug in securing a carotid artery pseudoaneurysm in an emergent setting requiring craniotomy for a concurrent subdural empyema. They describe the case of a 14-year-old boy with sinusitis and bifrontal subdural empyema who underwent transsphenoidal exploration at an outside hospital. An injury to the right cavernous segment of the ICA caused torrential epistaxis. Bleeding was successfully controlled by inflating a Foley balloon catheter within the sphenoid sinus, and the patient was transferred to the authors' institution...
June 16, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28619056/ophthalmic-artery-occlusion-following-neuro-embolization-of-the-external-carotid-artery-a-case-report
#5
Ng Wei Loon, Balwant Singh Gendeh, Rozman Zakaria, Jemaima Che Hamzah, Norshamsiah Md Din
BACKGROUND: Embozene® is a new neuroembolizing microsphere used to reduce intraoperative bleeding for head and neck tumours. We report a case of iatrogenic ophthalmic artery occlusion after Embozene® embolization of the external carotid artery (ECA). CASE PRESENTATION: A 22-year-old African gentleman presented with left nasal obstruction and epistaxis for 2 years and was diagnosed with nasopharyngeal carcinoma. He subsequently underwent embolization of the maxillary branch of the left ECA using Embozene® Microspheres - 250 μm in size before endoscopic tumour excision to reduce intra-operative bleeding...
June 15, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28615135/combined-therapy-for-epistaxis-by-hereditary-hemorrhagic-teleangiectasia-a-3-year-follow-up-study-on-45-patients
#6
Giorgos Papaspyrou, Dietmar Hecker, Maximilian Linxweiler, Bernhard Schick, Basel Al Kadah
Hereditary hemorrhagic telangiectasia (HHT) is a mutilating disease associated with the majority of patients with recurrent epistaxis episodes. The aim of this study was to present a single institution experience with patients treated for nasal epistaxis using a combination of Nd:YAG laser and argon plasma coagulation (APC) vs Nd:YAG laser alone, with a minimum follow-up of 3 years. 45 patients (21 men, 24 women) aged from 15 to 84 years with the diagnosis of HHT were treated in the Department of Otolaryngology, Head and Neck Surgery in Homburg/Saar between 10/2002 and 10/2012 because of epistaxis, using a combination of Nd:YAG laser and APC or Nd:YAG laser alone...
May 24, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28603431/hereditary-hemorrhagic-telangiectasia-and-pregnancy-potential-adverse-events-and-pregnancy-outcomes
#7
REVIEW
Omar Bari, Philip R Cohen
Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant condition with a prevalence of ~1 in 5,000 individuals. The pathophysiology of this condition centers on the lack of capillary beds between arterioles and venules, leading to direct contact between these vessels. This results in telangiectases on characteristic locations such as the face, fingers, mouth, and nasal mucosa. Visceral arteriovenous malformations (AVMs) are also observed in many patients, and these are most commonly seen in the brain, gastrointestinal tract, and lungs...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28598460/hypercalcemia-due-to-nasopharyngeal-carcinoma
#8
S Chaudhary, J P Sah
Hypercalcemia is a rare metabolic disorder associated with hyperparathyroidism, malignancy and various other causes. Although common in adult malignancies, hypercalcemia is rare in pediatrics and purports poor prognosis. Nasopharyngeal carcinoma is rare with no reported hypercalcemic presentation. We present here a case of hypercalcemia in a child of nasopharyngeal carcinoma. A 10 year girl presented with backache for 1 month, epistaxis, cough, chest-pain for 1 week alongwith anorexia and weight loss. Investigations revealed anemia and hypercalcemia (23mg/dl; normal range 9-11 mg/dl) with hyperphosphatemia, normal parathyroid levels...
January 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28596822/ethmoid-malformation-associated-with-pediatric-nasal-polyposis-and-allergic-fungal-sinusitis
#9
Cameron G Hanson, Todd B Proctor
A 17-year-old female with allergic fungal sinusitis and nasal polyposis presented with epistaxis in the emergency room. On examination, right-sided proptosis and irregular nasal obstruction were observed in the right nasal cavity. CT imaging revealed massive right-sided polyposis and significant ipsilateral malformation with boney architecture preservation of the ethmoidal labyrinth and lamina papyracea. The patient was treated surgically with symptomatic improvement. These findings indicate a unique malformation of the ethmoid while the patient was in development...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28583229/landmarks-for-rapid-localization-of-the-sphenopalatine-foramen-a-radiographic-morphometric-analysis
#10
Anne K Maxwell, Henry P Barham, Anne E Getz, Todd T Kingdom, Vijay R Ramakrishnan
BACKGROUND: Transnasal endoscopic sphenopalatine artery ligation is becoming the procedure of choice for surgical management of intractable posterior epistaxis. Landmarks for localization of the sphenopalatine foramen can assist in rapid surgical exposure of the sphenopalatine artery. OBJECTIVE: This study examined distances from easily identified endoscopic surgical landmarks to the sphenopalatine foramen. METHODS: By using computed tomography of the sinus to study radiologic anatomy in 50 adults, distances were measured between five simple endoscopic landmarks and the sphenopalatine foramen...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28579581/a-nasal-osteoma-with-an-acute-course-in-a-japanese-black-heifer
#11
Reiichiro Sato, Yumi Une, Hiroo Madarame, Hyougo Hanami, Eiichi Kanai, Hironobu Murakami, Atsushi Tsukamoto, Takehito Suzuki, Hideharu Ochiai, Masato Kikuchi, Hidekazu Tanaka, Ken Onda
A 14-month-old Japanese Black heifer presented with unilateral epistaxis and mild swelling of the right face. Radiography revealed a mass with increased radiopacity on the right side of the nasal bridge, extending to the left side. Intranasal endoscopy confirmed a large tumor-like structure protruding into the nasal cavity. Following euthanasia, cranial computed tomography (CT) was performed, revealing a tumor 24.3 × 17.5 × 14.8 cm in size. The tumor occupied the entire right nasal cavity and the frontal and sphenoid sinuses...
June 2, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28579349/electromagnetic-guided-placement-of-nasoduodenal-feeding-tubes-versus-endoscopic-placement-a-randomized-multicenter-trial
#12
Wouter F W Kappelle, Daisy Walter, Paul Stadhouders, Hendrik J A Jebbink, Frank P Vleggaar, Peter van der Schaar, Jan Willem Kappelle, Ingeborg van der Tweel, Medard F M Van den Broek, Frank J Wessels, Peter D Siersema, Jan F Monkelbaan
BACKGROUND AND AIMS: Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to esophagogastroduodenoscopy guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. METHODS: In 3 centers with no prior experience in EMP, patients were randomized to placement of a single lumen nasoduodenal feeding tube either with EGDP or EMP...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28576526/assessment-of-red-blood-cell-distribution-width-and-mean-platelet-volume-in-children-with-epistaxis
#13
Selin Üstün Bezgin, Taliye Çakabay, Işık Odaman Al
OBJECTIVE: This study aimed to investigate whether there is a relationship between red blood cell distribution width, mean platelet volume and epistaxis in children. METHODS: Between January 2015 and July 2016, 105 children who were referred to our clinic with epistaxis and 100 sex- and age-matched controls were retrospectively analyzed. Red blood cell distribution width (RDW) and mean platelet volume (MPV) values were determined in both groups. RESULTS: RDW values were found significantly (P < 0...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28571176/juvenile-nasopharyngeal-angiofibroma-a-case-report
#14
Soubhagini Acharya, Choubarga Naik, Siddharth Panditray, Subha Soumya Dany
Juvenile nasopharyngeal angiofibroma is tumour almost exclusively seen in adolescent males, constituting less than 1% of all neoplasms in head and neck. They are benign and locally spreading and are highly vascular in nature and thus prove to be a surgical challenge because of its complex anatomical location. Here, we present a case report of a 18-year-old male presenting with a mass in his left nasal cavity, with recurrent epistaxis and nasal obstruction. Computed tomography imaging revealed a non-encapsulated lobulated heterogeneous mass lesion in the naso-pharynx and left posterior choana of the nasal cavity, extending to pterygopalatine and infratemporal fossa, masseter space of left side...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28559097/von-willebrand-disease-type-2-in-pregnancy-a-critical-clinical-association
#15
REVIEW
Anca A Simionescu, Natalia F Buinoiu, Nicoleta Berbec
Von Willebrand disease (vWD) is the most common inherited bleeding disorder. Its association with pregnancy is infrequent. Here we report three cases of vWD associated with pregnancy. The clinical features of this combination are very suggestive. However, difficulties are still encountered during the diagnosis process. The first case was diagnosed for the first time during the patient's second pregnancy despite several episodes of vaginal bleeding and suggestive clinical symptomatology. The second case was diagnosed during childhood and the patient was properly managed during this pregnancy...
May 18, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28555879/impact-of-liver-disease-on-outcomes-of-patients-hospitalized-for-epistaxis
#16
Omar M Mohamed, Aparna Govindan, Andrey Filimonov, Michael J Sylvester, Michael Zaki, Soly Baredes, Jean Anderson Eloy
OBJECTIVES: Liver disease (LD) often results in coagulation abnormalities that may predispose to more severe epistaxis. The purpose of this analysis was to examine characteristics of patients hospitalized for epistaxis with LD and explore the impact of LD on patient outcomes. METHODS: The 2002 to 2013 National Inpatient Sample was queried for cases with a primary diagnosis of epistaxis. Cases with additional codes meeting the Agency for Healthcare Research and Quality's definition of LD were identified and compared to the non-LD cohort...
May 29, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28536685/small-cell-neuroendocrine-carcinoma-of-the-nasopharynx-a-rare-case-report
#17
Daniela Azevedo, Elisabete Rios, Lurdes Vendeira, Cristina Sarmento
Small cell neuroendocrine carcinoma rarely appears primarily in the head and neck and exhibits aggressive behavior with a poor prognosis. The pathologist has a significant role in the diagnosis, and a consensual treatment still does not exist. The authors report the case of a middle-aged male patient who presented repeated episodes of massive epistaxis. The diagnostic work-up disclosed the diagnosis of small cell neuroendocrine carcinoma of the nasopharynx. The patient was treated with chemotherapy followed by radiotherapy...
January 2017: Autopsy & case reports
https://www.readbyqxmd.com/read/28510336/epistaxis-in-anticoagulated-patients-fewer-hospital-admissions-and-shorter-hospital-stays-on-rivaroxaban-compared-to-phenprocoumon
#18
T C Sauter, K Hegazy, W E Hautz, G Krummrey, M E Ricklin, M Nagler, U Borner, A K Exadaktylos
OBJECTIVES: Treatment of epistaxis in patients on anticoagulants is challenging and associated with higher admission rates and longer hospital stays compared with patients without anticoagulation. However, there is little information about epistaxis in patients taking new direct oral anticoagulants such as rivaroxaban compared with patients on traditional vitamin K antagonists such as phenprocoumon. DESIGN: Retrospective cohort study. SETTING: The study was conducted at the emergency department of the University Hospital Inselspital, Bern, Switzerland...
May 16, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28508924/intractable-epistaxis-which-arteries-are-responsible-an-angiographic-study
#19
Guillaume de Bonnecaze, Y Gallois, P Chaynes, F Bonneville, A Dupret-Bories, E Chantalat, E Serrano
PURPOSE: Epistaxis constitutes a significant proportion of the Otolaryngologist's emergency workload. Optimal management differs in relation to the anatomic origin of the bleeding. The outcome of our study was to determine which artery(ies) could be considered as the cause of severe bleeding in the context of severe epistaxis. METHODS: Fifty-five procedures of embolization preceded by angiography were reviewed. Medical records of interventionally treated patients were analysed for demographics, medical history, risk factors and clinical data...
May 16, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28503128/a-confounding-case-of-inherited-factor-v-deficiency-complicated-by-inhibitors-at-first-presentation
#20
Hema Subramanian, Rakhee Kar, Deepak Charles, Hitha Babu, Pagadalu Ambika, Tarun Kumar Dutta
INTRODUCTION: Inherited factor V deficiency / Owren's disease has varied clinical manifestations ranging from asymptomatic laboratory abnormalities to massive hemorrhage. The acquired form due to inhibitors following antibiotic therapy, infection, or surgery is less common, and spontaneous development of inhibitors is not known. CASE REPORT: An 18-year-old boy presented with bleeding axillary and groin ulcers. At the age of 15, due to recurrent epistaxis and gum bleed, he was diagnosed with acquired factor V deficiency with positive inhibitor screen and treated with fresh frozen plasma (FFP) transfusion and temporary azathioprine...
April 2017: Transfusion Medicine and Hemotherapy
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