Sinusitis

There are four air-filled facial sinuses in the human body. Of these are: frontal, ethmoidal, sphenoidal, and maxillary. When excess fluid and bacteria is built up into these sinuses, inflammation and swelling may occur. This is known as sinusitis.

Sinusitis may be caused by cilia that do not work properly in disposing of mucus, colds and allergies which block of the openings of the sinuses, deviated nasal septum, nasal bone spurs, or nasal polyps. There are three stages: acute, sub-acute, and chronic. Acute sinusitis is less than 4 weeks and is usually caused by a bacterial infection. Sub-acute is between 4 and 12 weeks long. And chronic is any symptoms lasting longer than three months.

Hay fever, cystic fibrosis, smoking, large adenoids, change in altitude, day care, tooth infection, and a weakened immune system from HIV or chemotherapy may put one at an increased risk for sinutsitis

Symptoms may include: bad breath, loss of smell, cough, fatigue, fever, headaches, nasal congestion and discharge, sore throat and constant runny nose.

CT is the best way to visualize sinusitis. MRI may be used if the cause is a suspected tumor or fungal infection. Nasal endoscopy may also help determine the diagnosis.

Treatment of sinusitis may include but are not limited to:an increase in fluids, use of a humidifier, nasal saline sprays, inhale steam, acetaminophen, ibuprofen, allergy shot, or surgery (typically for chronic sinusitis).

Complications of sinusitis are abscesses, bone infections, meningitis, and skin infections around the eye.

Optic Nerve Glioma

Optic nerve glioma is a slow-growing benign tumor. It may affect one or both optic nerves as well as the optic chiasm. The cause seems to be unknown. It usually occurs in children under the age of 20.

Symptoms include, but are not limited to: involuntary eyeball movement, vision loss, squinting, and one or both eyes bulging out. If not treated, optic nerve glioma may cause permanent loss of vision which may be limited to peripheral.

Different ways to diagnose optic nerve gliomas are with a cerebral angiography, CT or MRI. The tissue may be removed during surgery or a biopsy of the tissue may be taken to determing the type of tumor. Visual field tests are also used to determine the location and how invasive the tumor may be. An MRI  with contrast (gadolinium), T1 weighted with fat saturation is the best diagnostic test for visualizing optic nerve gliomas.

Treatment may include a complete removal of the tissue. Partial removal may also be utilized to reduce the size of the tumor and the pressure it's causing. Radiation therapy or chemotherapy may also be an effective mode of tretment. Corticosteroids may be prescribed to reduce swelling and inflammation while radiation therapy is being used.

Pubmedhealth (March 2010) Optic nerve glioma. Retrieved from http://www.ncbi.nih.gov/pubmedhealth/PMH0002019/

Woodcock, Richard (June 2009). Optic nerve glioma imaging. Retrieved from http://emedicine.medscape.com/article/383533-overview

Cushing's Disease

Cushing's Disease is a condition where the pituitary gland releases too much adrenocortitropic hormone (ADCH). This excessive production is caused by a tumor or growth. ATCH stimulates the production and the release of corticol, which is released in the body when it is exposed to stress. Cortisol helps maintain blood pressure, decreases the body's immune system inflammatory response, balances insulin, and regulates carbohydrates, fats, and protein. The body is then exposed to corisol for too long which may cause the symptoms. Another reason that the body may be exposed to cortisol for an excessive amount of time is for people that may be taking glucocorticoids, which is a steroid hormone. It is most common in adults between the ages of 20 and 50. People who are obese with type II diabetes are at high risk for this disease.

Symptoms of Cushing's Disease is upper obesity and thin arms and legs, collection of fat between the shoulders, thinning of bone density, round and red face, slow growth rate in children, weak muscles, excessive fatigue, mental changes, acne or skin infection, purple marks on the abdomen, thigh, and breasts, thin skin that may bruise easily, bone pain or tenderness, increase in thirst and urination, and increased blood pressure.

Cushing's disease is easiest seen with MRI. Other tests that help to diagnose this disease are a 24 hour urinary free cortisol level, LDDST, and a CRH test.

Cushing's disease can be treated several ways. Surgery is the most common. It consists of removing the tumor and may be put on a medication that replaces the cortisol production. Radiation and other medications are also alternative modes of treatment.

National Endocrine and Metabolic Disease Information Service (n.d.) Cushing's disease. Retrieved from http://niddk.nih.gov/pubs/cushings/cushings.htm 

Public Med Health (Nov, 2009) Cushing's disease. Retrieved from http://ncbi.nih.gov/pubmedhealth/PMH0001388 

Vestibular Schwannoma

Vestibular Schwannoma is a benign tumor of the inner ear. It grows very slowly and develops from the nerves that contribute to hearing and balance. There are estimated between 13 and 20 annual cases per million. This tumor is a result of an overproduction of Schwann cells that wrap around nerve fibers. While these cells grow, it pushes and adds pressure to these nerves. It may cause unilateral or bilateral hearing loss or ringing in one's ears, dizziness, or a loss of balance. Some symptoms of Vestibular Schwannoma are facial drooping on one side, unsteady walk, or a dilated pupil on one side. If the tumor goes untreated, it may grow large enough to put pressure on the facial nerve and cause numbness in one side or both of the face. It is a tumor that connects the ear to the brain. If it continues to grow even more, the tumor may press against the brain and could potentially become life threatening.

Early detection of Vestibular Schwannoma may be difficult due to subtle symptoms that the person may not realize. MRI with contrast is the best way to visualize this pathology but CT may also be used.

Unilateral Vestibular Schwannoma accounts for about 8% of all skull tumors. Symptoms may occur at any age but they usually appear anywhere from 30 to 60 years old. Bilateral Vestibular Schwannoma affects both hearing nerves and may be associated with a genetic disorder called Neurobibromatosis Type 2. Some scientists believe that unilateral and bilateral Vestibular Schwannoma comes from a loss of function of the gene on chromosome 22. This has an affect on the production of Schwann cells.

Treatment may be, but not limited to, surgical removal, radiation, and monitoring. The majority of cases where patients have Vestibular Schwannoma, the tumor is surgically removed. Sometimes, the growth is growing over the nerve and the nerve will have to be removed as well. This can make symptoms worse and a patient will not be able to recover from this. Radiation may be used to reduce the size and growth if the tumor to prevent it from getting bigger and causing further complications. The last is monitoring. Sometimes the growth is not worth removing if it is not causing harmful symptoms to the patient. At this point, they monitor the growth to see if it is progressively getting worse.

National Institute on Deafness and Other Communication Disorders (June, 2010) Vestibular schwannoma (acoustic neuroma) & neurofibromatosis. Retrieved from http://nidcd.nih.gov/health/hearing/acoustic_neuroma.html