جستجوی مقالات مرتبط با کلیدواژه "epistaxis" در نشریات گروه "پزشکی"

Malignant melanoma of the sinonasal area is a rare tumor that arises from melanocytes in the nasal mucosa and is more aggressive than the cutaneous type with a poor prognosis.We report a 60-year-old female with the initial chief complaint of nasal cavity fullness, continuous epistaxis, and nasal bone deformity in the past two months.In a primary examination, a black mass was found, and in an excisional biopsy, the pathologist reported sinonasal malignant melanoma, which was confirmed after IHC staining.In spindle cell tumors of the head and neck area, we should be aware of mucosal malignant melanoma as a differential diagnosis.

Leeches are rare cause of foreign body in airways. A 23-year-old male, experiencing epistaxis and difficulty in swallowing is presented. During nasopharyngoscopy, a moving leech was observed on the nasopharynx posterior wall in midline location, and removal of the leech was decided under general anaesthesia. The flexible nasopharyngoscopy was inserted, but removal was unsuccessful due to the leech’s movements. Leeches are blood-sucking parasites, so neuromuscular blocking agent was given to prevent the movement. After administration, motion of the leech was lost and easily removed undamaged. In patients presenting with unexplained epistaxis, hemoptysis, dyspnea, and foreign body sensation in the airway, leech infestation should be included as the differential diagnosis and history of contact with stream water should be questioned. We concluded that use of low dose neuromuscular blocking agents facilitates the gentle removal, and could be necessary for successful management of removal of leech under general anaesthesia.

 About 1% of psychiatric consultations are concerned with a factitious disorder. Unlike malingering, factitious disorder is a special psychiatric disorder that should be taken into consideration by the medical staff.

 This case reports a woman with fever and epistaxis as a primary clinical manifestation of a factitious disorder which was diagnosed and treated after further investigation and psychiatric consultation.

 Procrastination of diagnosis usually leads to an increase in the length of stay for unnecessary clinical and paraclinical investigations. The purpose of this case presentation was to raise the issue of psychiatric problems and their importance alongside physical problems.

It has been reported that inflammation may be a potential risk factor for the progression of epistaxis. Due to the major roles played by Th17 in the induction of inflammation, the present study aimed to assess the serum levels of Interleukin 17A (IL-17A) and IL-23, as the most important cytokines in the Th17 pathway, as well as IFN-g, IL-4, and IL-10 serum levels, as regulatory cytokines for Th17 cells in patients with idiopathic epistaxis.  

The serum levels of IL-4, IL-10, IL-17A, IL-23, and IFN-g were evaluated in 90 patients with idiopathic epistaxis and 90 healthy controls using enzyme-linked immunosorbent assay (ELISA) technique. 

The obtained results pointed out that the serum levels of IL-17A and IL-10, but not IL-4 and IL-23, were significantly up-regulated, and IFN-g serum levels were significantly down-regulated in patients with idiopathic epistaxis. Furthermore, female patients with epistaxis had higher IL-10 serum levels. 

As evidenced by the results of the present study, IL-17A is the main cytokine which participates in the pathogenesis of idiopathic epistaxis; moreover, in association with IL-10, it can be regarded as the suppressor of IFN-g in patients.

Systemic lupus erythematosus(SLE) is an autoimmune disease in which organs and cells are damaged by autoantibodies and immune complexes.This disease often affects the body organs, one of which is the vascular system that manifests itself as vasculitis. Rarely, this vasculitis can cause perforation and epistaxis in the nasal septum.Most people who present this manifestation in lupus are people who have a known lupus case and develop septal perforation over time.

In this article, a patient with epistaxis and septal perforation was referred and, finally, she was diagnosed with lupus.

This study shows that other than granulomatous and eosinophilic angiitis (Wegner & Churg-Strauss), systemic lupus erythematous should be in mind in diagnosis of septal perforation.

Epistaxis is one of the most prevalent complaints in the emergency department (ED), especiallyin patients who take antiplatelet agents. This study aimed to compare the effect of topical use of tranexamicacid (TXA) with phenylephrine-lidocaine anterior nasal packing (PANP) in controlling epistaxis of patients whotake aspirin or clopidogrel.

This prospective, double-blind, parallel-group, randomized clinical trialwas conducted to compare the effect of topical use of intravenous (IV ) TXA compared with PANP on controllinganterior epistaxis in patients who take aspirin or clopidogrel.

One hundred patients with the mean ageof 59.24±7.75 (45 – 75) years were studied (52% male). Two groups were similar in terms of age (p=0.81) and sex(p=0.23) distribution, diabetes mellitus (p=0.54), and hypertension (p = 0.037). The mean time to stop bleed-ing was 6.70±2.35 minutes in the TXA group and 11.50±3.64 minutes in the PANP group (p=0.002). Bleedingrecurrence occurred in 3 (6%) cases of the TXA group and 10 (20%) cases of the PANP group (p =0.03). Timeto discharge from ED in the TXA group was significantly lower than the PANP group (p<0.001). The absoluterisk reduction (ARR), relative risk reduction, and number needed to harm of treatment with TXA for anteriornasal bleeding were 14.00% (95%CI: 1.11 – 26.89), 17.50% (95%CI: 0.60 - 37.27), and 7.14 (95%CI: 3.71 -90.43),respectively.

Topical TXA is an appropriate treatment option in bleeding cessation, and reducingre-bleeding and duration of hospital stay in patients with epistaxis who take antiplatelet agents.

Organized hematoma of the maxillary sinus (OHMS) is a rare benign disease that can be locally aggressive. The diagnosis of this condition is challenging.  

We report two cases of OHMS presented with recurrent nasal bleeding, nasal obstruction and anosmia. Radiological findings were suggestive of a vascularised lesion in the first case and a malignant tumor of the maxillary sinus in the second case. Both patients underwent an endonasal endoscopic surgery, There was no recurrence at 19 months’ and six months’ follow-up respectively.  

OHMS should be included in the differential diagnosis if a patient presents with history of recurrent epistaxis and nasal obstruction and radiological findings reveal an expansible maxillary mass with or without bone erosion. Correct preoperative diagnosis is important to avoid unnecessary extensive surgery. The prognosis is very good and minimally invasive surgery such as endonasal endoscopic surgery can cure it completely.

Chondrosarcoma is a rare tumor of the head and neck with a prevalence of 5-12% of all chondrosarcomas reported. The most common affected site in the head and neck is the larynx. Other sites include the craniofacial, maxilla, and mandible, nasal cavity, and paranasal sinuses. Clinical symptoms usually include a painless mass with bony swelling and one of the symptoms that thepatient presents with is epistaxis nasal obstruction. The most appropriate treatment is radical surgery. This article introduces a 72-year-old man with a complaint of left nasal congestion, epistaxis, and swelling of middle canthus area of the left eye.

Various studies are being conducted because of the value of finding an appropriate medication tocontrol bleeding in patients with epistaxis faster and more conveniently. This study aimed to compare the effectof Traumastem powder with routine tampons in treatment of non-traumatic epistaxis.

This random-ized clinical trial enrolled patients with epistaxis presenting to the emergency departments of two hospitalsaffiliated to Tabriz University of Medical sciences. Patients were divided into two groups using randomizationsoftware (intervention group: 107 patients, control group: 96 patients). Primary outcome variables includedbleeding control time and patient satisfaction. Secondary outcome variable was recurrence of bleeding withinthe first 24 hours after treatment. Visual assessment scoring system was used to assess patient satisfaction.Re-sults:Epistaxis was controlled in less than 5 minutes in 85 (79.4%) patients in the intervention group and 85(88.5%) patients in the control group (P=0.058). Patient satisfaction in the intervention group was higher thanthat of the control group (P<0.05). In the intervention group, 10 patients experienced recurrence of epistaxiswithin 24 hours of treatment, while 9 patients in the control group experienced recurrence (P= 0.591).Conclu-sion:Based on the findings, bleeding control time was similar in the two groups, but patient satisfaction washigher in Traumastem group. It is concluded that Traumastem can conveniently control anterior epistaxis, butit is not successful in cases with severe bleeding

Ewing sarcoma (ES), which is described as diffuse endothelioma of the bone, is divided into osseous and extraosseous Ewing sarcoma (EES) mostly affecting children and adolescents. It is a rare, aggressive, and poorly differentiated small blue round cell tumor that seldom affects the head and neck regions.

Herein, we reported a 46-year-old man presenting with right nasal block, epistaxis,  and epiphora from the right eye for one month. The nasal endoscopy revealed a friable mass  arising from the anterior half of the right nasal cavity. Histological findings were suggestive of  Ewing sarcoma. A contrast-enhanced computed tomography (CT) scan of the paranasal sinuses showed a soft tissue mass in the right anterior nasal cavity with mucosal thickening in the right maxillary sinus, without any bony erosion or distant metastasis. The patient underwent endoscopic medial maxillectomy with modified Denker’s procedure, followed by a 6-cycle course of chemotherapy. He was clinically well after chemotherapy; however, the recent bone scans were suggestive of bone involvement with the tumor.  

TheEES of paranasal sinus in the head and neck regions is extremely rare and requires exceptional attention due to their adjacent vital structures. The ES diagnosis-related dilemma  arises from the numerous differential diagnoses of small round blue cell tumors. In this regard, accurate diagnosis is important, since ES requires a multi-modality approach. Furthermore, early diagnosis and aggressive intervention are crucial to obtain good prognosis and function.