ObjectiveTo present a number of cases with lobular capillary haemangioma (pyogenic granuloma) of the nose; and to discuss the clinical and histopathological diagnosis of this disorder.MethodsA clinicopathological study of patients diagnosed with nasal lobular capillary haemangioma who were treated at King Abdel Aziz University Hospital, Riyadh from 1986 to 1995.ResultsThe study group consisted of 12 patients (four males and eight females ranging in age from 17 to 65 years; mean 30.1 years). Clinically, most patients presented with epistaxis and a rapidly growing unilateral haemorrhagic mass. Most lesions were located on the septal mucosa. The clinical impression was misleading in some cases. The histological diagnosis was based on the lobular arrangement of capillaries. One case was initially misdiagnosed as angiofibroma. Excisional biopsy was the mainstay of treatment. One instance of recurrence was recorded.ConclusionThis uncommon lesion should be considered in the differential diagnosis of a rapidly growing haemorrhagic lesion within the nasal fossa. Clinical and histological diagnostic pitfalls occur frequently.

The pharmacokinetic and mean time tissue distribution parameters, after a single 50-mg/kg dose of quercetin administered as intravenous bolus, oral solution, and oral suspension, were determined using rat as an animal model. Following intravenous administration, the elimination rate constant and the elimination half-life were found to be 0.0062 min(-1) and 111 min, respectively. Examining the mean time tissue distribution parameters reflected a strong binding affinity of the drug molecules to both plasma and tissue proteins. In addition, the low permeability rate of drug molecules in the peripheral system was demonstrated. Following the oral administration of the drug, the extent of absorption was greater from solution than from suspension. Moreover, the solution showed a shorter Tmax and a higher Cmax than suspension. The absolute bioavailability for the solution was 0.275 and that for suspension was 0.162. The mean residence time (MRT) and the mean absorption time (MAT) were higher for suspension, reflecting the need for dissolving the drug in order to be absorbed. The mean (in-vivo) dissolution time (MDT(in-vivo)) was 34.5 min. Thus, an oral quercetin formulation that can readily form a drug solution in the gastrointestinal tract may enhance the absorption of the drug.

Primary ciliary dyskinesia is a hereditary defect in the ultrastructure of cilia, leading to poor ciliary motility. The sinonasal and the bronchial manifestations of the disease are well documented; whereas its otological aspects have received less attention. In this report, we describe the clinical profile of 16 patients with primary ciliary dyskinesia laying particular emphasis on the otological manifestations. All children (11 patients) had bilateral otitis media with effusion. Of the five adults, three had tympanosclerosis; one had bilateral cholesteatoma; and one patient had bilateral keratosis obturans in combination with tympanosclerosis. Hearing improvement and a dry ear was achieved in all the children treated by tympanostomy tube insertion. The study suggests that otitis media is a prominent feature of this disorder. Most subjects suffer from protracted bilateral otitis media with effusion throughout childhood.

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Acquired medial canal fibrosis is a discrete clinicopathological entity characterized by formation of fibrous tissue in the bony external auditory meatus.Over a seven-year period, a total of 14 operative procedures were performed on 12 ears involving 10 patients. Four cases had followed otitis externa, two were complications of suppurative otitis media, and three cases were iatrogenic. The cause could not be identified in three ears involving two patients.Treatment entails excision of all the fibrous tissue and involved skin, a wide canaloplasty, a meatoplasty, and then reconstruction by split skin graft. Two cases of canal cholesteatoma were encountered. Average follow-up of two years showed hearing improvement in all patients. The only complication was a recurrence of the stenosis in two ears. The paper discusses terminology, aetiology, pathophysiology, diagnosis, and principles of treatment of this condition.