Nasal Schneiderian papillomas are unique lesions involving the mucosa of the nasal cavity and paranasal sinuses. Most often epidermoid in histological appearance, they favour 2 sites: the septum and the lateral wall of the nasal cavity. The medical literature on these tumours contains a plethora of contradictions concerning the nomenclature and no less than 54 separate designations are used. The synonyms are discussed and the term Schneiderian papilloma is proposed as the most suitable alternative. This study includes 83 patients with Schneiderian papillomas in whom the history, clinical and radiological findings, treatment procedures, pathological sections, recurrences, and associated malignancies were analyzed. Histological and clinical features were not helpful in predicting recurrence, but the recurrence rate was related to the treatment modalities; with 17% recurrences using an extranasal approach (lateral rhinotomy) and 59% using intranasal approach with limited excision. Schneiderian papillomas were associated with squamous cell carcinoma in 7 patients. Simultaneous papilloma and carcinoma were demonstrated in 4 patients at presentation (5%) and subsequently developing carcinoma in 3 patients (4%). As recurrences are frequent after inadequate removal and as association with maligancies may occur in both septal and lateral wall papillomas, radical aggressive surgery, thorough histological examination of the entire specimen, and careful follow-up are advocated.
Following the reduction of nasal fractures, fixation was performed in 3 ways: 1 Packing for 72 h and plaster cast for 1 week. 2 Packing for 72 h and adhesive tape for 1 week. 3 Adhesive tape for 1 week. At follow-up 3 months after the reduction, these groups were compared with a group of patients with nasal fractures which had not needed treatment and with a group of normals. It was concluded that among the group fixed with packing and plaster cast, significantly fewer patients were dissatisfied than in the other groups, and fewer complained of deformity. The physical examination showed an appreciable number of minor deformities in all groups including the normal group. A significantly higher frequency of nasal obstruction was found in the group of patients operated upon compared to the non-operated group and the normal group by physical examination, but not by the questionnaire. The present study does not support the point of view that a high percentage of cases of nasal fracture have to be operated upon by open reduction. Radiology has no medical or legal value in patients with nasal fractures and should not be used.
Ultrasonographically guided percutaneous fine-needle aspiration biopsy is a safe and reliable method of establishing the cytologic diagnosis of intrathoracic tumors.
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