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Cavernous hemangioma of rhinopharynx: our experience and review of literature

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Testa D., Motta S., Massimilla E. A., Tafuri D., Tafuri D., Russo D., Russo A., Landolfo P. G., Mesolella M., Motta G.

Open Medicine

2014

vol. 10

issue 1

Hemangiomas are benign tumors originating in the vascular tissues of skin, mucosa, muscles, glands, and bones. Although these tumors are common lesions of the head and neck, they rarely occur in the nasal cavity and paranasal sinuses. Cavernous haemangioma of the lateral wall of the nasopharynx has not previously been reported. We examined the clinical, radiological and therapeutic management of cavernous haemangioma of nasopharynx starting from a clinical case of a 26-year-old woman with a history of recurrent and conspicuous epistaxis and leftsided nasal associated severe obstruction. Nasopharynx examination, by flexible endoscopy, showed a cystic mass borne by the left side wall of the nasopharynx, in contact with the soft palate, covered by intact and regular mucosa. Contrast-enhanced computed tomography (CT) scan, confirmed these findings and showed contextual lamellar calcifications and inhomogeneous enhancement. The nasal endoscopic approach (FESS), under general anesthesia, allowed removal of the mass, without complications, after careful hemostasis of arterial branches. It was possible to establish the precise site of origin of the tumor only during the surgical procedure. Histopathological study showed mucosa with extensive vascular proliferation, with framework of lacunar/cavernous haemangioma, also present at lamellar bone tissue level. An unusual site and an unspecific clinical appearance can make diagnosis and treatment of a cavernous hemangioma of the nasopharynx difficult. The nasal endoscopic technique proved to be reliable in terms of adequate exposure and visualization of the lesion, control of bleeding, and complete removal of the mass.

Analysis of etiology and treatment methods of epistaxis in adult patients visiting

100%

Syniec M., Prygiel J., Dubielska A., Taradaj K., Deja M. D., Balcerzak J.

2015

vol. 4(4)

21-26

Introduction: Epistaxis is not only the most commonly seen type of bleeding in laryngological emergency department, but also a frequent reason of visiting this department. It may be a symptom of trivial disorder or serious systemic either chronic disease.Aim of study: The primary objective of this study was to analyze the etiology and treatment methods of epistaxis in adult patients. Material and methods: This was the retrospective study of 574 adult patients who visited the Emergency Department of Otolaryngology in Public Central Teaching Hospital between 1st January and 30th December 2014 because of epistaxis. There were 274 females and 300 males with the mean age of 64,6 years (woman), and 60,3 years (men). Results: 228 patients (39,7%) were chronically treated for hypertension. Blood pressure measurement was performed in 335 patients (58,4%) and elevation over 160 mmHg systolic, or over 95mmHg diastolic took place in 132 cases (22,99%). Other significant factor observed in the study was anticoagulant and antithrombotic drug usage. In 134 cases (22,3%) patients were treated with medicine from this group (the most frequently- acetylsalicylic acid). Other accompanying disorders were: heart failure, atrial fibrillation, diabetes mellitus, other cardio-/cerebro-vascular diseases, COPD, respiratory track infection. The most common intervention in case of epistaxis was nasal packing (Rapid Rhino – 248 patients, Spongostan sponge – 129 patients). Captoprilum was administered in 79 cases (13,8%) to normalize elevated blood pressure. 90 patients (15,6%) required an additional internal medicine consultation. Conclusion: The impaired control of hypertension and treatment with oral anticoagulant (acenocumarol) or antithrombotic drugs (acetylsalicylic acid) were the most common reasons of epistaxis in examined group of patients. The most frequent symptomatic management were packing with Spongostan sponge and Rapid Rhino balloon tampon. Typical anterior nasal tamponade with gauze was much less frequent. The treatment according to the etiology was added if needed.

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1 Open Medicine

1 Polski Przegląd Otorynolaryngologiczny

2 2015

1 Balcerzak J.

1 Deja M. D.

1 Dubielska A.

1 Landolfo P. G.

1 Massimilla E. A.

1 Mesolella M.

1 Motta G.

1 Motta S.

1 Prygiel J.

1 Russo A.

1 Russo D.

1 Syniec M.

1 Tafuri D.

1 Taradaj K.

1 Testa D.

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Cavernous hemangioma of rhinopharynx: our experience and review of literature

Analysis of etiology and treatment methods of epistaxis in adult patients visiting