Recurrent Rhinorrhea Research Articles

Primary Ciliary Dyskinesia Associated with Rheumatoid Lung at The Koulikoro Reference Health Center, Mali

Primary ciliary dyskinesia is a cause of bronchial dilatation, associated with rheumatoid lung is rare. This is why we report a case with the aim of discussing the clinical, diagnostic characteristics and therapeutic possibilities of ciliary pathology and showing the link between it and rheumatoid arthritis. Observation: This is a 40-year-old African patient, married without children, from a consanguineous couple, with a family history of a brother who died in adulthood in a picture of respiratory failure and productive cough. She presented with recurrent rhinorrhea since childhood and bronchorrhea in a picture of progressively worsening dyspnea and clubbing. During the evolution of the disease, inflammatory polyarthralgia was associated. The ultrastructural ciliary study by electron microscopy and the measurement of nasal nitrogen oxide are the confirmatory examinations of primary ciliary dyskinesia. They are not achievable in our practice. However, based on the history and clinical findings, the patient presented several elements in favor of this pathology. additional investigations, notably the rheumatoid factor and the chest CT scan, allowed us to suggest rheumatoid lung. Our therapeutic conduct was the administration of antibiotic therapy, oxygen therapy, immunosuppressant, anti-inflammatory and the practice of respiratory physiotherapy. Conclusion: Primary ciliary dyskinesia associated with pulmonary involvement in rheumatoid arthritis increases the risk of developing respiratory failure.

Inverted supernumerary nasal tooth

The eruption of a tooth into the nasal cavity is a rare and incidental finding during routine clinical or radiological examination. Since the 1960s there were more than 60 reported cases of nasal teeth. To the best of our knowledge, this is only the sixth case report of a supernumerary intranasal canine in the selected period. A 22-year-old male presented with a history of recurrent rhinorrhea, nasal congestion, tension headaches, and insomnia but without previous epistaxis or facial trauma episodes, and with no history of congenital craniofacial malformations. Following a computed tomography examination, a diagnosis of a supernumerary inverted ectopic canine eruption into the left nasal cavity was established. To identify such rarities and prevent possible complications, it is essential to acquire detailed patient history, be familiar with both normal and variant maxillofacial structures, and conduct systematic radiological image analysis

Allergic Fungal Sinusitis with Bilateral Optic Neuropathy

Introduction Allergic Fungal Rhinosinusitis (AFRS) is characterized by an inflammatory response to a non-invasive fungus which leads to sinus obstruction. Ophthalmic manifestations of AFRS are rare but can be of grave consequence. Case Report A 22-year-old female patient presented with a 5-day history of headache and decreased vision in both eyes (right- perception of light; left-6/18), along with a past history of nasal blockage and recurrent rhinorrhoea. She had thick viscid mucous secretion with polyposis in bilateral nasal cavities. Computed tomography showed pansinusitis with heterogenous opacification and polypoidal mucosal hypertrophy. Bony erosion was seen in bilateral orbital apices with oedematous optic nerves. MRI was suggestive of bilateral optic neuritis. Patient underwent emergency surgical debridement via endoscopic sinus surgery. Histopathological examination of the specimen showed cellular debris, eosinophilic prominence and numerous Charcot-Leyden crystals, with presence of branched septate fungal hyphae. Fungal culture grew Aspergillus flavus. Patient was treated with steroids (injectable followed by oral in gradually tapering doses). Over a period of 3 months vision returned to normal. Conclusion Vision loss is a rare complication of AFRS and constitutes an emergency. Prompt treatment with surgical debridement and corticosteroids is essential for reversal of visual complications.

A Case of Schwannoma in Subfrontal Area and Nasal Cavity

Schwannoma is a benign solitary neoplasm emerging from the Schwann cells of the peripheral, cranial and autonomic nerves. Approximately 25 to 45% of schwannomas occur in the head and neck region. However, schwannoma in the subfrontal area, nasal cavity or paranasal sinus is very rare and accounts for only 4% of these neoplasms. We experienced a case of schwannoma in the subfrontal area and left nasal cavity in a 74-year-old man who complained of recurrent rhinorrhea. We report this unusual case of schwannoma with a review of the literature.

Palatal ulcerations and midfacial swelling

A 50-year-old woman of Japanese descendant was referred to the Stomatology Department, Cancer Hospital A. C. Camargo, São Paulo, Brazil, for evaluation of nonhealing oral ulcers and swelling of 2 months duration involving the left maxilla. The patient reported that the lesions had increased rapidly in size over the course of the 4 preceding days. The patient reported a previous history of chronic nasal obstruction and recurrent rhinorrhea treated by surgery and antibiotics in another institution 6 months before the current visit.

Transethmoidal Meningoencephalocele Involving the Olfactory Bulb With Enlarged Foramina of the Lamina Cribrosa -Case Report-

A 3-year-old girl presented with a transethmoidal meningoencephalocele manifesting as recurrent rhinorrhea. Initially, she developed meningitis, but after treatment she experienced rhinorrhea. Two months later, she again presented with rhinorrhea. Neuroimaging studies revealed a small protrusion (15 mm x 10 mm) at the roof of the ethmoidal sinus. Nasal endoscopy confirmed the diagnosis of meningoencephalocele. The operative findings revealed a small hole in the left olfactory bulb, which had descended into an enlarged foramen along with the arachnoid membrane. The left olfactory bulb was removed, and the enlarged foramina of the lamina cribrosa were covered with a frontal pericranial flap. The defect in the bone was very small, but contributed to the development of meningitis and leakage of the cerebrospinal fluid. Basal cephalocele should be considered in a patient with recurrent rhinorrhea and intracranial infections, even in the absence of any apparent anomaly.

Nasal septal teratoma in a child

BackgroundTeratoma is a rare developmental neoplasm that arises from totipotential tumor stem cells. Head and neck teratomas constitute about 10% of all cases. Only two cases of mature teratoma of the nasal septum have previously been documented in the world literature.Case presentationWe present a case of histologically confirmed mature teratoma arising from the nasal septum in an eighteen month old Nigerian female who presented with a history of noisy breathing associated with recurrent rhinorrhea since birth. Physical examination revealed obstruction of the right nasal cavity by a pale fleshy mass. She underwent a total surgical excision and to date, after thirty one months follow-up, she is free from recurrence.ConclusionThe prognosis for benign teratoma of the nasal septum is good following total surgical excision.

Macroprolactinomas presenting with spontaneous cerebrospinal fluid rhinorrhea

Medical therapy with dopamine agonists is today's first-line treatment for prolactinomas. Surgery becomes necessary only in few cases where DA therapy is non-responsive or not tolerated. However, there are rare clinical settings that require primary surgical therapy, such as the occurrence of spontaneous CSF rhinorrhea. We present two cases of patients harboring invasive prolactinomas that caused destruction of the skull base. Both cases required urgent surgical repair of the leak using a transsphenoidal approach to prevent life-threatening meningitis. The leak was sealed with fascia lata. One case necessitated a second operation due to recurrent rhinorrhea under postoperative DA therapy of the residual tumor. The treatment of invasive macroprolactinomas remains a challenge to guarantee a favourable clinical outcome for the patient. All patients with invasive prolactinomas should be alerted concerning the symptoms and risks of CSF rhinorrhea.

Spontaneous Cerebrospinal Fluid Rhinorrhea in Untreated Macroprolactinoma - an Indication for Primary Surgical Therapy

Medical therapy is usually indicated as first-line treatment for prolactinomas. Surgery is generally reserved as second-line therapy if prolactinomas are non-responsive to dopamine agonists (DA) or DA therapy is not tolerated. Herein, we draw attention to the rare occurrence of spontaneous CSF rhinorrhea in prolactinomas requiring primary surgical therapy. Only 8 cases of confirmed prolactinomas with spontaneous rhinorrhea have been reported in the literature so far. Two out of 267 surgical cases with pituitary adenomas presented with spontaneous rhinorrhea. Both patients harbored invasive prolactinomas. In both cases, the defect was exposed using a transsphenoidal procedure and was sealed with fascia lata. Urgent surgical repair of the leak prevented meningitis. In one case, a second operation was required due to recurrent rhinorrhea under postoperative dopamine-agonist therapy of the residual tumor. The clinical course was otherwise uncomplicated. Certain clinical settings still require primary surgical therapy of prolactinomas. Spontaneous rhinorrhea caused by invasive macroprolactinomas represents a mandatory indication for initial surgery. Early detection and surgical repair of a CSF leak is crucial for a favorable clinical outcome.

COW'S MILK ALLERGY: PREVALENCE AND MANIFESTATIONS IN AN UNSELECTED SERIES OF NEWBORNS

Summary1. A consecutive series of 787 babies born at the University Hospital were followed for 12–36 months in order to determine the prevalence of cow's milk allergy (CMA).2. Fifty‐nine babies (7.5%) were shown by repeated challenge to have evidence of CMA.3. The main manifestations of CMA were eczema in 27, recurrent diarrhea in 24, recurrent rhinorrhea in 18, repeated vomiting in 12, recurrent bronchitis in 10, and asthma in 7.4. Thirty‐four babies had two or more allergic problems, e.g., had recurrent rhinorrhea and eczema, or recurrent bronchitis and recur‐rent diarrhea, 25 babies had only one.5. Babies allergic to cow's milk were often allergic to other foods, 20% for example were allergic to soya.6. Twenty‐five babies developed their first symptoms within 7 days of being given their cow's milk formula.7. Seventeen of the babies lost their sensitivity to cow's milk, 10 of these babies were less than 12 months old. Thirty‐eight babies over 12 months of age when last reviewed were still allergic to cow's milk.8. Babies with CMA, as well as those with other allergic problems, attended their doctors on account of illness more frequently than did the non‐allergic babies.9. Allergic disorders were commonest in the parents and siblings of babies with CMA, and least common in the parents and siblings of the non‐allergic children.

Familial Recurrent Rhinorrhea and Bronchitis Due to Cow's Milk

The child with recurrent rhinorrhea and bronchitis presents a common and sometimes perplexing problem. This disorder was seen in four children. Each child had one parent who was similarly affected. Four of the 11 siblings also had this syndrome. The four children together with their affected parents and siblings were all relieved of their symptoms when cow's milk and its products were eliminated from their diets.

Familial recurrent rhinorrhea and bronchitis due to cow's milk

Familial recurrent rhinorrhea and bronchitis due to cow's milk