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BIBLIOGRAPHY Keen, Monte. The Avitene Pack: A New Method to Control Epistaxis In a Patient with Poor Platelet Function. Laryngoscope 96:141 !- Brook, Itzhak. Bacteriology of Chronic Maxillary 1412, 1986. Sinusitis in Adults. Ann Otol Rhinol Laryngol 98:426-428, 1989 Schaitkin, B., Strauss, M., Houk, J.R. EpistaJtis: Medical Versus Surgical Therapy: A Comparison Derkay, Craig S., et al. Posterior Nasal Packing. Arch of Efficacy, Complications, and Economic Otolaryngol Head Neck Surg 115:439-441, Considerations. Laryngoscope 97:t392- 1989 1396, 1987. Guyuran, Bahman. Is Packing After Septorhinoplasty Seigel, Sydney. Non-parametric Statistics for the Necessary Plast Reconst Surg 71:196-198, Behavioral Sciences. New York: McGraw 1983 Hill Book Company, Inc., 1956, pp.61-63. Jackson, J.A. and E.M. Kaswom. Toxic Shock Syn- Slavin, S.A., et al. An Investigation of Bacteremia dromeAfterNasalSurgery. Arch Otolaryn- During Rhinoplasty. Plast Reconst Surg gol Head Surg 112:329-332, 1986 71:196-198, 1983. 95
EAST AVENUE MEDICAL CENTER DEPARTMENT OF OTOLARYNGOLOGY TITLE • CollisionTumor of the Nasopharynx(Liposarcoma, UndifferentiatedCa) Reportof a Case AUTHORS:GeraldS. Chua,M.D. AngelV. Veloria,M.D. Mamerto(3.Almelor, M.D. Milagros S. Lopez,M.D. .. INTRODUCTION health center which provided temporary relief. The patient consulted at EAMC because of the persistence We report a case of a rare, highly malignant collision of epistaxis and was subsequently admitted, He has tumor. A liposarcoma of the nasal cavity with extension a 35 pack year smoking history and has been taking to the ethmoid and orbit and an undifferentiated Ca alcoholic drinks for 30 years, In the past three months of the nasopharynx. Biopsy was done three times from he lost 35 pounds. the nasal mass and nasopharynx. Radical maxillectomy with orbital exenteration, radical neck dissection On admission, the significant findings were: and post-op radiation was contemplated. Unfortunately, retracted TM, AD, a grayish-reddish gelatinous friable the patient deteriorated until his untimely demise before mass about .5 cm at the area of the middle (R) turbinate, the proposed management was instituted, a 1 cm fleshy mass at the area of the posterior choanae, bilateral infra-auricular neck nodes both measuring 2 x 3 cm. PNS x-ray reveals bilateral maxillary sinusitis. OBJECTIVES Except for minimal PTB other laboratory work-ups were unremarkable. The admitting impression was 1, To report a rare collision tumor involving NPCA, stage III. liposarcoma of the nasal cavity, paranasal sinuses and orbit and an undifferentiated Ca The first biopsy of the nasal mass revealed of the nasopharynx, liposarcoma. However, a repeat biopsy of the nasopharynx was suggested. The repeat biopsy was 2. To review the literature regarding liposarcoma undifferentiate Ca. After a week, a third biopsy was of the head and neck. done as per suggestion of the pathologist. The previous ' diagnosis was confirmed - Liposarcoma, myxoid type 3. To present a local retrospective study on with some degree ofdifferentiadon at the nasal cavity liposarcoma of the head and neck. with an undifferentiated Ca of the nasopharynx, a collision tumor. CASE REPORT He was scheduled for radical maxillectomy (R) with possible orbital exenteration and RND (R) pend- A 49-year old taxi driver was admitted for the first ing C-T scan results, However, he developed proptime at the East Avenue Medical Center for recurrent tosis, lid edema, lateral and medial rectus palsy, OD epistaxis from the right nose, The patient had cough and hypoesthesia of the right half of the face. C-T scan and colds with yellowish, mucoid, blood-tinged spu- showed a mass in the right half of the nasal cavity turn, 7 months VIA which were temporarily relieved displacing the nasal septum to the left, with lyric changes by self-prescribed medications. One month PTA, he in the medial wall of the right maxillary sinus with noted decrease in hearing acuity (R) and (R) nasa] extension of the mass to the sella, ethmoid and spheobstruction. The epistaxis increased in frequency and noid sinuses. There is also involvement of the (R) amount. He was given hematinics IM at the local medial rectus muscle and the orbital roof. Two days 96
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Iq4LIPl:qut=S TABLE OF CONTENTS NEC
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HEAD AND NECK SURGERY - TO ADD OR N
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PRESIDENT'S PAGE The years 1989-90
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RIZAL MEDICAL CENTER DEPARTMENT OF
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muscles. Again it is likely possibl
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area measuring 4.8 x 3.7 cm extendi
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tend to recur locally, even after p
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UNIVERSITY OF THE PHILIPPINES PHILI
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The majority of patients with hyper
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mass wa uttrasonograImy. Neck explo
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Figure 2 : Parathyroid Adcnoma vs.
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E.wa_ileMassonLe_Maxilla "salt& pep
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of some clinical features as well a
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MCU HOSPITAL DEPARTMENT OF OTOLARYN
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JOSE REYES MEMORIAL MEDICAL CENTER
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nonetheless stated: "We have the im
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to the diagnostic know-how of the c
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PATIENTS & METHODS: These signs and
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Most patients in group 1 complained
Page 47 and 48: DISCUSSION: and septal deviation mi
Page 49 and 50: OSPITAL NG MAYNILA DEPARTMENT OF OT
Page 51 and 52: ..temporary relief. According to Ha
Page 53 and 54: CASE REPORT phonuclear cells. The r
Page 55 and 56: TITLE:Cleft Lip Surgeryfor Rural Fi
Page 57 and 58: After intubation and the endoctrach
Page 59 and 60: BIBLIOGRAPHY Converse, J.M., Recons
Page 61 and 62: UNIVERSITY PHILIPPINE DEPARTMENT OF
Page 63 and 64: Table 3. Distribution of Organism b
Page 65 and 66: J BIBLIOGRAPHY Y MACKOWIAK, P.A., J
Page 67 and 68: Figure 3. SENSITIVITY PATTERN OF Pr
Page 69 and 70: Figure 3. Percent SENSITIVITY PATTE
Page 71 and 72: loradatine 10 mg/tabletgiven once a
Page 73 and 74: 1. Severity of Symptoms 3. Comparis
Page 75 and 76: -J;r,ceiving 40 mg of loratadine da
Page 79 and 80: : ' : _ : ::::::: : : i : ::
Page 81 and 82: These patients are new patients see
Page 83 and 84: - Table Vl Baseline Signs and Sympt
Page 85 and 86: The following Table VII will show t
Page 87 and 88: • 14.Drowsiness: None 30 2 4 10 2
Page 89 and 90: Actifed's side effect of drowsiness
Page 91 and 92: " to be packed with one type of pac
Page 93 and 94: With regard to microbiology of nasa
Page 95 and 96: TABLE 6: MANNER OF CONTROL OF REBLE
Page 97: APPENDIX C MICROBIALGROWTH POTENTIA
Page 101 and 102: type (20%-30% of cases) varies from
Page 103 and 104: TABLE Ii HistologicalClassification
Page 105 and 106: THE LATERAL NASAL WALL IN FILIPINOS
Page 107 and 108: MIDDLE MEATUS: Diameter of ostium:
Page 109 and 110: .;4".,..:'.-" ............. '---.",
Page 111 and 112: Figure 4. Variation in the location
Page 113 and 114: This study presents variations with
Page 115: ACKNOWLEDGMENT The authors would li
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