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Malignant tumors of the nose and paranasal sinuses
Malignant diseases of this localization - cancer and isarcoma, as a rule, are primary. They are relatively rare, more often in middle-aged and elderly men. Most often, the primary malignant process affects the maxillary, then ethmoid, frontal and sphenoid sinuses. Rarely, the source of the malignant tumor is the nasal septum.
The malignancy of tumors of the paranasal sinuses is determined by their relatively rapid germination in neighboring organs and tissues: in the base of the skull, pterygopalatine fossa, orbit, and oral cavity. Metastasis usually occurs late, first in the occipital and submandibular lymph nodes, inaccessible for clinical research, and then in the cervical, well defined by palpation.
Given that the malignancy of a tumor largely depends on its location, the maxillary sinus is divided into more or less malignant sectors. This plane passes through the sinus from its lower outer corner to the inner corner of the eye, separating the more benign and treatable tumors of the anterior lower sector from the more malignant and less accessible tumors of the maxillary sinus.
Depending on the prevalence of the malignant process in the nasal cavity, 4 stages of tumor development are distinguished: stage I includes neoplasms that do not go beyond the limits of the nasal cavity in the absence of metastases, type II - tumors that grow on the walls of the nasal cavity or have single moving regional metastases, and type III - tumors that germinate to the base of the skull with metastases to regional nodes, to IV - tumors with distant metastases and sprouting into the cavity of the skull.
K l and n and with to and to kartin and. Tumors of the nose appear early, but their symptoms are not initially severe. Patients are concerned about the gradually increasing difficulty in breathing through one half of the nose, the mucous membrane that is separated, and then with an admixture of blood. Later, there may be nosebleeds, stuffy ear, otalgia. Externally, the tumor is often lumpy, however, it can also be polypoid. In this case, the neoplasm is often mistaken for polyps, especially in the elderly. Removal of such polyps is accompanied by bleeding, which should alert the surgeon; histological examination will help establish an accurate diagnosis. In a later stage, nasal tumors grow through the ethmoid labyrinth into the orbit, causing exophthalmos, into the frontal sinus, into the base of the skull, which is accompanied by the corresponding symptoms.
The primary localization of the tumor in the maxillary sinus is characterized by a prolonged absence of clinical symptoms. The first signs are often neuralgic pain, secondary damage to the teeth, deformation of the facial relief, secondary inflammatory process in the sinus, exophthalmos.
From the maxillary sinus, a tumor can grow through the anastomosis to the nasal cavity and ethmoid bone, and then to the base of the skull. According to the degree of prevalence of the tumor and metastases, four stages of its development are also distinguished.
Primary lesion of the frontal and especially sphenoid sinuses with a malignant tumor is rare; the resulting symptomatology corresponds to the localization of the tumor. Here, neurological, cerebral manifestations may come to the fore.
In the early period of growth of malignant tumors of the nose and paranasal sinuses it is quite difficult to diagnose cancer; therefore, with oncological alertness, it is necessary to evaluate any painful process in the upper respiratory tract from the point of view of the possibility of developing a malignant process. Tumors of this localization are very often manifested by symptoms of ordinary, non-tumor, diseases, so only a meticulous determination of the exact and complete causes of the appearance of a particular symptom will help to suspect a tumor and not miss the beginning of its development. If a tumor is suspected, using existing diagnostic techniques it is not difficult to recognize it.
In addition to endoscopic methods, for diagnosis, puncture and probing of the paranasal sinuses, aspiration of the contents and the introduction of a contrast agent, x-ray in various projections, computed tomography are used, and if a tumor or suspicious tissue is detected, a biopsy with histological examination is used.
Treatment in the early stage of the disease is combined - removal of the tumor with the use of diathermocoagulation, then radiation therapy in the path of lymph outflow. Some surgeons prefer preoperative radiation to suppress tumor growth activity, and radium preparations are placed in the postoperative wound. In the presence or suspicion of metastases in regional lymph nodes, their wide excision along with fiber is indicated. Germination of the tumor at the base of the skull, deep into the pterygopalatine fossa excludes the possibility of radical excision of the tumor, such patients undergo radiation treatment and general or regional chemotherapy. Involvement in the tumor process of the tissues of the orbit or the hard palate and the alveolar process of the upper jaw allows for the possibility of wide surgical intervention with resection of the upper jaw and with exentration of the orbit. The operation is performed under intubation anesthesia. Cosmetic defects of the face are then eliminated with the help of plastic surgeries and individual prostheses.
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Malignant tumors of the nose and paranasal sinuses
- TUMORS OF THE NOSE AND NANOPINASUS SINAS
In the nasal cavity and paranasal sinuses, as in other ENT organs, there are benign and malignant neoplasms, very diverse in morphological structure and clinical manifestation. A distinct border is often impossible to draw with many benign and malignant tumors. Modern classifications of tumors, including the nose and paranasal sinuses, are bulky and
- METHODS FOR STUDYING THE NOSE AND NANOSAXIS
The study of the nose and paranasal sinuses, after identifying the needles and clarifying the anamnesis, begins with an external examination and palpation. On examination, pay attention to the condition of the skin and soft tissues, the absence or presence of defects, the symmetry of both halves of the face, as well as the shape of the external nose. Palpation should be done carefully. With soft hand movements, the presence or
- Clinical physiology of the nose and paranasal sinuses
Distinguish between upper and lower respiratory tract. The nose and paranasal sinuses, pharynx with the oral cavity and larynx belong to the upper respiratory tract, the trachea, bronchi with bronchioles of the alveoli - to the lower. Normal for a person is breathing through the nose. The nose performs, in addition to the respiratory, protective, resonant and olfactory functions, and also participates in the regulation of the depth of breathing and lacrimation,
- CLINICAL PHYSIOLOGY OF THE NOSE AND NANOSAXIS
The nose and its paranasal sinuses, being the upper section of the respiratory tract, play an important role in the interaction of the body with the external environment, while performing a number of interrelated physiological functions. The following nasal functions are distinguished: 1) respiratory, 2) protective, 3) resonator (speech) and 4) olfactory. In addition, the nose, as an important element in the formation of a single ensemble of the face, is endowed with and
- Research methods for the nose and paranasal sinuses
They produce an external nose, places of projection of the paranasal sinuses of the nose on the face. Patch of the outer nose: the index fingers of both hands are located along the back of the nose, with light massaging movements they feel the areas of the root, slopes, back and tip of the nose. Palpate the front and lower walls of the frontal sinuses, figuring out the patient's sensations. Thumbs of both hands
- Surgery for diseases of the nose and paranasal sinuses
The most common operations for diseases of the nose and paranasal sinuses include polypectomy, endoscopic interventions in the paranasal sinuses, opening the maxillary sinus (Caldwell-Luc operation), rhinoplasty, septoplasty. Preoperative period Patients often have marked nasal breathing disorders due to polyps, nasal curvature
- Foreign bodies of the nose and paranasal sinuses
Most often, foreign bodies are found in children who have the habit of putting various objects (beads, buttons, stones, coins, berry bones, seeds and other small objects) in the nose of themselves or their gullible peers. In adults, foreign bodies get into the nose under random circumstances (for example, during sleep on the hayloft, a piece of straw may be drawn into the nose when breathing). More
- Fracture of the bones of the nose and paranasal sinuses
Case: Face asymmetry is determined in the form of deformation of the external nose, sinus front wall sagging, damage to the skin, palpation pain (sometimes with a crunch, crepitation of bone fragments and air in the subcutaneous tissues), edema, eyelid hematoma and usually bleeding from the nose. Depending on the depth of damage, fractures can be isolated or combined with a head injury
- Microendoscopic methods of surgical intervention in the nasal cavity and paranasal sinuses
There are a number of options for endonasal endoscopic microoperations, however, all the techniques can be combined into two main varieties - these are classic methods according to Messerklinger and Wiegand, they are designed to restore the natural ventilation and drainage paths, with minimal changes in the anatomical structures and maximum gentleness of the mucous membrane. Most widely
- DISEASES OF THE NOSE AND NEXTILOUS SINAS, THROATS, Larynx and Ear
The upper respiratory tract (nose, paranasal sinuses, pharynx and larynx) perform the most important life-supporting functions, a detailed description of which is given in Part I. The next part is devoted to diseases of these organs. Based on the functional significance in the clinic of each of the organs - reflex, humoral and other connections of these organs with the body as a whole, we can conclude
- DISEASES OF THE NOSE AND SINUS NANOSIS
DISEASES OF THE NOSE AND NEXTLINE
- CLINICAL ANATOMY OF THE NOSE AND NANOSAXIS
CLINICAL ANATOMY OF THE NOSE AND NANOSIS
- Treatment of injuries of the nose and paranasal sinuses at the stages of evacuation
Self-help and mutual assistance. It is carried out in the manner of self-help, mutual assistance by a nurse or medical examiner. In case of bruises accompanied by nosebleeds, you should try to stop the bleeding by pressing the wings of the nose to the nasal septum. Snow, ice, or cloth moistened with cold water is applied to the outer nose. With abrasions on the skin or superficial wounds
- CLINICAL ANATOMY AND PHYSIOLOGY OF THE NOSE AND NANOSAXIS
CLINICAL ANATOMY AND PHYSIOLOGY OF THE NOSE AND PALIPNOSIS
- TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATED MESENCHIMES
TUMOR GROWTH. TUMOR PROGRESSION. TUMOR MORPHOGENESIS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR TUMORS MARKERS. ANTITUMOR IMMUNITY. PARANEOPLASTIC SYNDROMES. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITELIUM AND TUMORS FROM TISSUES - DERIVATIVES
- Anatomy of the paranasal sinuses
The paranasal sinuses, sinus paranasalis, are located in the bones of the facial and brain skulls and communicate with the nasal cavity. They are formed as a result of the ingrowth of the mucous membrane of the middle nasal passage into the spongy bone tissue. In fig. 2.1.4 presents a diagram of the development of the paranasal sinuses in the age aspect. Phylogenetically, the paranasal sinuses are derivatives of the ethmoid labyrinth