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An inverted papilloma is a type of tumor in which surface epithelial cells grow downward into the underlying supportive tissue. It may occur in the nose and/or sinuses or in the urinary tract (bladder, renal pelvis, ureter, urethra). When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion. When it occurs in the urinary tract, it may cause blood in the urine.
The exact cause of nasal polyps is unclear. They are, however, commonly associated with conditions that cause long term inflammation of the sinuses. This includes chronic rhinosinusitis, asthma, aspirin sensitivity, and cystic fibrosis.
Various additional diseases associated with polyp formation include:
Chronic rhinosinusitis is a common medical condition characterized by symptoms of sinus inflammation lasting at least 12 weeks. The cause is unknown and the role of microorganisms remains unclear. It can be classified as either with or without nasal polyposis.
Cystic fibrosis (CF) is the most common cause of nasal polyps in children. Therefore, any child under 12 to 20 years old with nasal polyps should be tested for CF. Half of people with CF will experience extensive polyps leading to nasal obstruction and requiring aggressive management.
In a Meta-analysis study to conglomerate findings regarding 28 published papers including 158 patients presenting SNUC following up with patients for an average of 14 months showed that at the time of last follow up 25% of patients were alive with no evidence of the disease, 22.4% were alive with presence of the disease, and 52.6% were deceased due to the disease.
A salivary gland fistula (plural "fistulae") is a fistula (i.e. an abnormal, epithelial-lined tract) involving a salivary gland or duct.
Salivary gland fistulae are almost always related to the parotid gland or duct, although the submandibular gland is rarely the origin.
The fistula can communicate with the mouth (usually causing no symptoms), the paranasal sinuses (giving rhinorrhea) or the facial skin (causing saliva to drain onto the skin).
The usual cause is trauma, however salivary fistula can occur as a complication of surgery, or if the duct becomes obstructed with a calculus.
Most parotid fistulae heal by themselves within a few weeks.
Nasal polyps resulting from chronic rhinosinusitis affect approximately 4.3% of the population. Nasal polyps occur more frequently in men than women and are more common as people get older, increasing drastically after the age of 40.
Of people with chronic rhinosinusitis, 10% to 54% also have allergies. An estimated 40% to 80% of people with sensitivity to aspirin will develop nasal polyposis. In people with cystic fibrosis, nasal polyps are noted in 37% to 48%.
A papilloma (plural papillomas or papillomata) ("" + "") is a benign epithelial tumor growing exophytically (outwardly projecting) in nipple-like and often finger-like fronds. In this context refers to the projection created by the tumor, not a tumor on an already existing papilla (such as the nipple).
When used without context, it frequently refers to infections (squamous cell papilloma) caused by human papillomavirus (HPV), such as warts. Human papillomavirus infection is a major cause of cervical cancer, although most HPV infections do not cause cancer. There are, however, a number of other conditions that cause papilloma, as well as many cases in which there is no known cause.
OAF is a complication of oroantral communication. Other complications may arise if left untreated. For example:
- Candidal infection
- Chronic maxillary sinus infection of bacterial origin
- Osteomyelitis
- Rhinosinusitis
- Sinus pathology
Therefore, OAF should be dealt with first, before treating the complications.
Internationally tumors of the choroid plexus are rare, accounting for 0.4-0.6% of all intracranial neoplasms. It most commonly affects young children under the age of 5 with a mean patient age of 5.2 years.
Choroid plexus papillomas are benign tumors that are usually cured by surgery; malignant progression has been rarely reported.
Immunoperoxidase stains have identified antigens of the human papillomavirus (HPV) types 6 and 11 in approximately 50% of cases of squamous cell papilloma.
Heck's disease (also known as focal or multifocal epithelial hyperplasia) is an asymptomatic, benign neoplastic condition characterized by multiple white to pinkish papules that occur diffusely in the oral cavity. Can present with slightly pale, smooth or roughened surface morphology. It is caused by the human papilloma virus types 13 and 32. It exhibits surface cells with vacuolated cytoplasm around irregular, pyknotic nuclei and occasional cells with mitosis-like changes within otherwise mature and well-differentiated epithelium. A distinguishing histologic feature is elongated rete ridges resembling Bronze Age axe with mitosoid bodies present. It was first identified in the Aboriginal population.
Over time, they will spontaneously regress without treatment. Possible treatment may be excisional biopsy for lesions of functional or aesthetic concern.
Inverted papillomas are definitively diagnosed by histologic examination. However, Magnetic Resonanace Imaging (MRI) may show a characteristic feature described as a Convoluted Cerebriform Pattern (CCP). A retrospective study published in the American Journal of Neuroradiology concluded that identification of CCP by MRI in a patient with a nasal tumor made the diagnosis of Inverted papilloma quite likely. The study reported the sensitivity and specificity to be 100% and 87% respectively. CCP can be associated with other malignant tumors as well.
About 60 percent of initial attacks of dacryocystitis will recur. Individuals with a poorly functioning immune system (immunocompromised) may develop orbital cellulitis, which may lead to optic neuritis, proptosis, motility abnormalities, or blindness.
Oral mucocele (also termed mucous retention cyst, mucous extravasation cyst, mucous cyst of the oral mucosa, and mucous retention and extravasation phenomena) is a clinical term that refers to two related phenomena:
- Mucus extravasation phenomenon
- Mucus retention cyst
The former is a swelling of connective tissue consisting of a collection of fluid called mucin. This occurs because of a ruptured salivary gland duct usually caused by local trauma (damage), in the case of mucus extravasation phenomenon, and an obstructed or ruptured salivary duct (parotid duct) in the case of a mucus retention cyst. The mucocele has a bluish translucent color, and is more commonly found in children and young adults.
Although the term cyst is often used to refer to these lesions, mucoceles are not strictly speaking true cysts because there is no epithelial lining. Rather, it would be more accurate to classify mucoceles as polyps (i.e. a lump).
The most common causes of nipple inversion include:
- Born with condition
- Trauma which can be caused by conditions such as fat necrosis, scars or it may be a result of surgery
- Breast sagging, drooping or ptosis
- Breast cancer
- breast carcinoma
- Paget's disease
- Inflammatory Breast Cancer (IBC)
- Breast infections or inflammations
- mammary duct ectasia
- breast abscess
- mastitis
- Genetic variant of nipple shape such as
- Weaver syndrome
- congenital disorder of glycosylation type 1A & 1 L
- Kennerknecht-Sorgo-Oberhoffer syndrome
- Gynecomastia
- Holoprosencephaly, recurrent infections and monocytosis
- Tuberculosis
Around 10–20% of all women are born with this condition. Most common nipple variations that women are born with are caused by short ducts or a wide areola muscle sphincter.
Inverted nipples can also occur after sudden and major weight loss.
Sinonasal Undifferentiated Carcinoma (SNUC) is a rare and aggressive type of cancer originating in the epithelial layer of the nasal cavity or paranasal sinuses. It was first diagnosed in 1987. The aggressive nature of the cancer coupled with the advanced stage of disease upon presentation lead to a poor survival rate. Although the molecular nature of the mutation that causes SNUC is still poorly understood clinical treatment has shown that multimodality treatment has been the most successful option.
Normally found in children or young adults, a common cause of conjunctival squamous cell papilloma is during childbirth, when the mother passes the virus to her child.
A variety of causes may lead to dacrocystitis. Most notably, obstruction of the nasolacrimal duct leads to stasis of the nasolacrimal fluid, which predisposes to infection. Staphylococcus aureus is a common bacterial pathogen causing infectious dacrocystitis. Sometimes, especially in women, stones may develop in the lacrimal gland, causing recurrent bouts of dacrocystitis; this condition is called "acute dacryocystic retention syndrome."
Also due to pneumococcus, infection due to surrounding structure such as paranasal sinuses.
Little is known about the total incidence of salivary gland tumours as most benign tumours go unrecorded in national cancer registries. The majority of salivary tumours are benign (65-70%). Within the parotid gland 75 - 80% of tumours are benign. Around 50% of the tumours found in the submandibular glands are benign. Sublingual gland tumours are very rare but if present, they are most likely to be malignant.
In the United States, salivary gland cancers are uncommon with an incidence rate of 1.7 in 100000 between 2009 and 2013.
This is a very rare tumor, since only about 1 in 35,000 to 40,000 people have VHL, of whom about 10% have endolymphatic sac tumors. Patients usually present in the 4th to 5th decades without an gender predilection. The tumor involves the endolymphatic sac, a portion of the intraosseous inner ear of the posterior petrous bone.
Both mucous retention and extravasation phenomena are classified as salivary gland disorders.
Studies have shown that sinusitis is found in about 60% of the cases on the fourth day after the manifestation of sinus. Moreover, patient may be afflicted with an acute sinus disease if OAC is not treated promptly upon detecting clear signs of sinusitis. So, early diagnosis of OAC must be conducted in order to prevent OAF from setting in.
Spontaneous healing of small perforation is expected to begin about 48 hours after tooth extraction and it remains possible during the following two weeks. Patient must consult the dentist as early as possible should a large defect of more than 7mm in diameter or a dogged opening that requires closure is discovered so that appropriate and suitable treatment can be swiftly arranged or referral to Oral Maxillofacial Surgery (OMFS) be made at the local hospital, if required.
A comprehensive preoperative radiographic evaluation is a must as the risk of OAC can increase due to one or more of the following situations :-
- Close relationship between the roots of the maxillary posterior teeth and the sinus floor
- Increased divergence or dilaceration of the roots of the tooth
- Marked pneumatization of the sinus leading to a larger size
- Peri-radicular lesions involving teeth or roots in close association with the sinus floor
Hence, in such cases:
- Avoid using too much of apical pressure during tooth extraction
- Perform surgical extraction with roots sectioning
- Consider referral to OMFS at local hospital
Pneumosinus dilatans is a condition consisting of abnormal expansion or dilatation of one or more paranasal sinuses. It most often affects the frontal sinus, and can cause damage to vision due to pressure on the nearby optic nerve. The preferred treatment is endoscopic surgery to deflate the sinus.
Prognosis for this condition varies according to extent of the hematoma, but is normally fairly good. Smaller hematomae carry a 99% chance of full recovery, with larger ones carrying a recovery rate ranging from 80 to 90%. Occasional epistaxis may follow the surgery, but this is temporary and should subside within 2 to 3 weeks after surgery.
A squamous cell papilloma is a generally benign papilloma that arises from the stratified squamous epithelium of the skin, lip, oral cavity, tongue, pharynx, larynx, esophagus, cervix, vagina or anal canal. Squamous cell papillomas are a result of infection with human papillomavirus (HPV).