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Journal Cover Otolaryngology Case Reports
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2468-5488
   Published by Elsevier Homepage  [3175 journals]
  • Acute airway obstruction management in scorpion envenomation to
           submandibular region: A case report

    • Authors: Winslo Idicula; Rahul Varman; Daniel Nguyen
      Pages: 1 - 2
      Abstract: Publication date: June 2018
      Source:Otolaryngology Case Reports, Volume 7
      Author(s): Winslo Idicula, Rahul Varman, Daniel Nguyen
      Acute airway obstruction following scorpion envenomation to the head and neck region can present a unique challenge to a clinical practitioner and will require expeditious management to appropriately secure the airway. We present the case of acute airway obstruction following a scorpion sting to submandibular region in a 56 year-old female, initially managed with emergent cricothyroidotomy with subsequent revision to tracheostomy. The primary aim of management of acute airway obstruction is to maintain and secure a patient's airway. Some cases of obstruction due to local envenomation to the airway area can complicate respiratory management and may necessitate emergent operative intervention to best secure the airway in a timely manner.

      PubDate: 2018-03-10T02:20:50Z
      DOI: 10.1016/j.xocr.2018.02.005
      Issue No: Vol. 7 (2018)
       
  • Chronic mastoiditis and petrositis with viscous otorrhea caused by
           Achromobacter xylosoxidans: Case report and literature review

    • Authors: Ema Ikari; Noritaka Komune; Takashi Nakagawa
      Pages: 3 - 6
      Abstract: Publication date: June 2018
      Source:Otolaryngology Case Reports, Volume 7
      Author(s): Ema Ikari, Noritaka Komune, Takashi Nakagawa
      Glue otorrhea, or viscous otorrhea, is usually caused by eosinophilic otitis media and otitis media with effusion. However, bacterial infection can also cause viscous otorrhea. In this report, we present a case of chronic mastoiditis and petrositis with viscous otorrhea caused by Achromobacter xylosoxidans infection, and review previous literature regarding temporal bone infections involving this pathogen. In this case, the patient was not immunocompromised, and had bilateral viscous, easily relapsing, and intractable otorrhea. She was treated with long-term medication and a mastoidectomy. Our literature review shows that otitis media, mastoiditis, and petrositis caused by A. xylosoxidans are extremely rare, although viscous or mucinous otorrhea are sometimes caused by this organism. Though it is rare for an ear infection caused by A. xylosoxidans to be identified, such an infection should be treated appropriately, without consideration of the contaminants.

      PubDate: 2018-03-21T11:28:22Z
      DOI: 10.1016/j.xocr.2018.03.003
      Issue No: Vol. 7 (2018)
       
  • Emergent parotidectomy after parotid lymphatic malformation hematoma

    • Authors: Neel K. Bhatt; Liang-I. Kang; Samir El-Mofty; Brian Nussenbaum; Patrik Pipkorn
      Pages: 16 - 18
      Abstract: Publication date: June 2018
      Source:Otolaryngology Case Reports, Volume 7
      Author(s): Neel K. Bhatt, Liang-I. Kang, Samir El-Mofty, Brian Nussenbaum, Patrik Pipkorn
      Introduction Lymphatic malformations (LM) are non-malignant, congenital masses that contain fluid-filled lymph channels. These lesions typically present in childhood, but they can rarely present as a new head and neck mass in adults, which may not be on the differential diagnoses of clinicians. We present a case of an intraparotid mass that expanded rapidly secondary to hematoma after a diagnostic fine needle aspiration was performed. Case details A 24 year-old male presented with a right parotid mass. CT imaging revealed a 3.2 × 1.8cm cystic lesion in the parotid gland. Ultrasound-guided fine needle aspiration was performed, resulting in a parotid hematoma and compression of the buccal branch of the right facial nerve. The patient was taken to the operating room urgently for evacuation of hematoma, and a superficial parotidectomy was performed. Pathology revealed an intraparotid lymphatic malformation with organized hematoma. Conclusions We present a case of hematoma following fine needle aspiration of a lymphatic malformation. While these lesions typically present in the pediatric population, they may be first diagnosed in adulthood. Hematoma following FNA is exceedingly rare and may increase the clinical suspicion for LM.

      PubDate: 2018-04-25T05:33:11Z
      DOI: 10.1016/j.xocr.2018.03.001
      Issue No: Vol. 7 (2018)
       
  • Mucous membrane pemphigoid affecting the epiglottis and response to
           intravenous immunoglobulin therapy

    • Authors: Anes Yang; Ronald Chin; Dedee F. Murrell
      Pages: 1 - 3
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Anes Yang, Ronald Chin, Dedee F. Murrell


      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.001
      Issue No: Vol. 6 (2018)
       
  • Dysphagia due to systemic light chain amyloidosis revealed by
           videoendoscopic and videofluorographic swallowing examinations

    • Authors: Masafumi Ohki; Shigeru Kikuchi
      Pages: 4 - 6
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Masafumi Ohki, Shigeru Kikuchi
      Purpose Pharyngeal symptoms related to amyloidosis are quite rare, and there are no reports demonstrating videoendoscopic (VE) or videofluorographic (VF) swallowing examinations. We report a case of systemic light chain amyloidosis with dysphagia at the pharyngeal phase of swallowing revealed by VE and VF, and discuss the causative mechanisms. Case A 77-year-old man presented with a 6-month history of dysphagia. An oral cavity examination revealed normal findings. Laryngofiberscopy did not show space-occupying lesions or laryngeal nerve palsy. VE revealed a crystal violet-pigmented bolus that flowed into the pharynx toward the glottis before laryngeal elevation, and then pooled in the piriform recess of the hypopharynx and was aspirated into the trachea. VF using barium sulfate showed delayed onset and poor laryngeal elevation, aspiration during swallowing, poor pharyngeal contraction, and bolus residue in the piriform recess of the hypopharynx. Opening of the upper esophageal sphincter was adequate. Flow in the esophagus was normal. The number of swallowings was increased to clear the bolus from the pharynx. VE and VF indicated impairment during the pharyngeal phase of swallowing. Histopathological analysis of the lower lip demonstrated degeneration of the minor salivary glands and hypertrophic basal membranes due to amyloid deposits; the acini and ducts had been replaced by amyloid deposits of λ light chain (AL) amyloidosis. Discussion The possible mechanisms of pharyngeal phase impairment are peripheral neuropathy of the swallowing-related nerves and amyloid myopathy. Conclusion Systemic amyloidosis may cause pharyngeal phase dysphagia.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.002
      Issue No: Vol. 6 (2018)
       
  • Mammary analogue secretory carcinoma of the parotid gland: A case report

    • Authors: Richard Tjahjono; Ronald Chin; Firoz Iqbal
      Pages: 7 - 9
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Richard Tjahjono, Ronald Chin, Firoz Iqbal
      Mammary analogue secretory carcinoma (MASC) is a recently described neoplasm characterized by the ETV6-NTRK gene translocation. It is named as such due to its morphologic, genetic and immunohistochemical similarity to secretory carcinoma of the breast. Prior to its description as a distinctive salivary gland neoplasm, MASC was classified as a ‘zymogen-poor’ acinic cell carcinoma (AciCC) given their overlapping histological features – therefore AciCC and adenoma not otherwise specified, among other primary salivary gland tumors, are the main differentials for MASC. Here we report a case of MASC in an 87-year old Caucasian lady who presented with a slow growing, painless right mandibular lump who underwent right parotidectomy and neck dissection. Upon pathological analysis of the tumor specimen, many of the classical histopathologic features of MASC are present in this case, emphasizing the importance of molecular screening of salivary gland tumors for ETV6-NTRK3 translocation. Over 100 cases of MASC have been described in the literature, and it is known to be a mostly non-aggressive tumor with good prognosis. MASC commonly occurs in the parotid gland, with a slight preponderance to males. While MASC has been extensively discussed in pathologic literature, clinical information in otolaryngology literature has been scarce. Future research should aim to elucidate its clinical behaviour, disease progression and prognosis to formulate guidelines for the appropriate treatment of this neoplasm.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.003
      Issue No: Vol. 6 (2018)
       
  • Rare presentation of an arteriovenous malformation within the internal
           auditory canal

    • Authors: Noor Sulieman; Gregory Basura
      Pages: 10 - 13
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Noor Sulieman, Gregory Basura
      While cerebral arteriovenous malformations (AVM) are common, a presentation of this vascular lesion involving the internal auditory canal (IAC) is rare. We describe a case of an un-ruptured AVM within the right IAC of a 55-year-old male who presented following a whiplash injury and left-ear (contralateral to the lesion) unilateral non-pulsatile tinnitus. On magnetic resonance imaging (MRI), an incidental atypical linear enhancement suspicious for a vascular lesion within the right IAC was identified and investigated further using magnetic resonance angiography and venography (MRA/MRV), which illustrated serpentine flow voids that confirmed the presence of an AVM. Given the patient's intact hearing and rare location of the AVM, treatment options including watchful waiting, stereotactic radiosurgery, embolization, and microsurgery were discussed, of which observation was chosen.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.009
      Issue No: Vol. 6 (2018)
       
  • Management of laryngotracheal complications of inherited epidermolysis
           bullosa in the adult: A case series

    • Authors: A.E. Wall; A. Gelbard; D. Vinh; J.C. Simmons; D.T. Donovan; E. Grogan; J. Ongkasuwan
      Pages: 14 - 15
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): A.E. Wall, A. Gelbard, D. Vinh, J.C. Simmons, D.T. Donovan, E. Grogan, J. Ongkasuwan


      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.004
      Issue No: Vol. 6 (2018)
       
  • An unusual presentation of a branchial cleft cyst in a 70-year-old

    • Authors: J. Howlett; P. Horwich; M.J. Bullock; S.M. Taylor; R. Hart; J. Trites; M.H. Rigby
      Pages: 16 - 18
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): J. Howlett, P. Horwich, M.J. Bullock, S.M. Taylor, R. Hart, J. Trites, M.H. Rigby
      Background Branchial cleft cysts are common congenital head and neck masses predominantly presenting in a pediatric setting. Most branchial cleft cysts do not provide a diagnostic challenge as they have consistent physical locations and clinical presentation. This paper describes a rare case of branchial cleft cyst isolated in the parapharyngeal space. To our knowledge, this is the oldest presentation of a parapharyngeal space branchial cleft cyst in the literature. Case A 70-year-old non-smoking gentleman presented with a subacute presentation of dysphagia and odynophagia. Physical examination revealed a right posterior oropharyngeal swelling. On imaging he was found to have a 4.6cm cystic, right parapharyngeal mass abutting the prevertebral fascia. Fine needle aspirate suggested benign pathology. Surgical resection was pursued and final pathology was consistent with a branchial cleft cyst. Discussion Benign congenital branchial cleft cysts should be considered in the differential diagnosis for parapharyngeal masses, regardless of age.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.005
      Issue No: Vol. 6 (2018)
       
  • Pediatric sarcoidosis presenting as bilateral parotid swelling

    • Authors: Jason R. Brown; Prasad John Thottam; Janet Poulik; Michael Haupert
      Pages: 19 - 21
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Jason R. Brown, Prasad John Thottam, Janet Poulik, Michael Haupert
      Pediatric sarcoidosis is a rare granulomatous disorder that affects numerous organ systems. Manifestations in the head and neck are not uncommon, but typically present in conjunction with other systemic signs and symptoms. The differential diagnosis of neck and facial masses in children is vast with infectious and even neoplastic pathology far outpacing inflammatory conditions, such as sarcoidosis, in incidence. We present the unusual case of a 5-year-old male with histologically confirmed sarcoidosis presenting solely with bilateral parotid gland enlargement. We review the pertinent clinical features, necessary laboratory and radiological studies, and treatment options of this disease in children.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.008
      Issue No: Vol. 6 (2018)
       
  • Pyoderma gangrenosum after stapedotomy - First report in otolaryngology
           literature

    • Authors: Luiz C.A. Sousa; Aldo J. Bellodi; Daiane O. Braga; Henrique F. Pauna
      Pages: 22 - 24
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Luiz C.A. Sousa, Aldo J. Bellodi, Daiane O. Braga, Henrique F. Pauna
      Introduction Pyoderma gangrenosum is an inflammatory disease of unknown etiology characterized by a rapidly progressive necrotizing fasciitis. Our objective is to report a case of pyoderma gangrenosum after stapedotomy. Case report A 46 years-old female, presented an ulcerated skin lesion above the left pinna after stapedotomy, diagnosed as pyoderma gangrenosum. Clinical treatments failed, and surgical removal of the prosthesis lead to completed healing of the lesion. Discussion Pyoderma gangrenosum has been associated as a complication of many surgical procedures. However, to the best of our knowledge, this is the first study to describe this disease as complication of a stapedotomy. Conclusion The healing of pyoderma gangrenosum after the prosthesis removal suggests its participation on the genesis of the disease. This fact had not yet been reported in the literature.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.12.001
      Issue No: Vol. 6 (2018)
       
  • Pericardial metastasis from p16 positive oropharyngeal squamous cell
           carcinoma

    • Authors: Victoria Kuta; Matthew Rigby; Robert Hart; Jonathan Trites; S. Mark Taylor
      Pages: 25 - 26
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Victoria Kuta, Matthew Rigby, Robert Hart, Jonathan Trites, S. Mark Taylor
      Distant metastasis from head and neck cancers is a rare occurrence, especially in the case of HPV positive primaries, which are statistically less aggressive than HPV negative tumors. Our patient presented with a p16 positive oropharyngeal cancer, a surrogate marker for HPV. He underwent a laser pharyngectomy and radical neck dissection with adjuvant post-op radiation therapy. Approximately two years later our patient presented to hospital with an atypical presentation of cardiac tamponade. Pathology from tissue obtained at the time of a pericardial window was consistent with malignant squamous cell carcinoma of the pericardium. No local disease recurrence was found. Despite his low risk profile and the effective loco-regional control of his disease, he eventually succumbed to complications from distant metastasis. This is the first report of an HPV positive oropharyngeal primary with distant cardiac metastasis, to our knowledge. Considering the rarity of this outcome and the atypical presentation seen in our patient, we hope to use this report to raise awareness on the possibility of cardiac metastasis in head and neck cancer survivors presenting with non-specific or new cardiac signs/symptoms with unknown etiology.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.007
      Issue No: Vol. 6 (2018)
       
  • Infraglottic lobular capillary hemangioma: A case report

    • Authors: Vinh Ly Pham Hoang; Nguyen Pham Dinh; Hoang Nguyen; Joseph P. Kitzmiller; Linh Bui Doan Hai; Huy Nguyen
      Pages: 27 - 30
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Vinh Ly Pham Hoang, Nguyen Pham Dinh, Hoang Nguyen, Joseph P. Kitzmiller, Linh Bui Doan Hai, Huy Nguyen
      Lobular capillary hemangioma (LCH) is a benign proliferation of capillary blood vessels adopting a lobular configuration. A laryngeal origin of LCH is exceedingly rare. Here, we describe a case of an 11-year-old boy presenting with a subglottic lesion, leading to a subglottic stenosis. Histopathologic findings of the lesion implicated an LCH, which was removed successfully by a coblator. This is the first report of a subglottic LCH. Physicians should be aware of this unique lesion and laryngeal LCH should be considered in diagnosing the cause of a subglottic stenosis. Additionally, coblation should be an effective treatment for laryngeal LCH.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.12.002
      Issue No: Vol. 6 (2018)
       
  • Unusual presentation of medullary thyroid carcinoma: Regional and distant
           metastases in the background of benign non-neoplastic Multi-Nodular Goiter
           

    • Authors: Samiah S. Al-Angari; Mohammed AlEssa; Tariq Al-Johani
      Pages: 31 - 33
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Samiah S. Al-Angari, Mohammed AlEssa, Tariq Al-Johani
      Background Medullary Thyroid Carcinoma (MTC) is a malignancy that primarily arises from the C-cells of the thyroid gland with a tendency to regional and distant metastases. Methods We report a case of a 34-year-old female with MTC where there was no evidence of primary foci of the disease within the thyroid gland, while there was a widespread metastasis in the cervical lymph nodes, lungs, abdomen, and vertebrae. Results The patient was diagnosed with metastatic sporadic MTC based on the pre-operative work up. She underwent completion thyroidectomy with bilateral neck dissection levels II-VI. The post-operative histopathology report confirmed the diagnosis. Conclusion The case report shows an unusual presentation of MTC. It demonstrates that there is an entity of metastatic sporadic MTC, confirmed by an abnormal calcitonin level, with unknown primary.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.12.003
      Issue No: Vol. 6 (2018)
       
  • A rare case of primary Ewing's sarcoma presenting in the posterior nasal
           cavity with extension into the sphenoid sinus and a review of the
           literature

    • Authors: Koorosh Rahmani; Shokouh Taghipour zahir; Mohammad Baghi Yazdi; Mohammad-hossein Vahedian-Ardakani; Maryam Vajihinejad
      Pages: 34 - 37
      Abstract: Publication date: Available online 10 January 2018
      Source:Otolaryngology Case Reports
      Author(s): Koorosh Rahmani, Shokouh Taghipour zahir, Mohammad Baghi Yazdi, Mohammad-hossein Vahedian-Ardakani, Maryam Vajihinejad
      Ewing's sarcomas/primitive neuroectodermal tumors (PNET) are a group of tumors characterized by small round cells that rarely affect the bone and soft tissues of the nasal cavities. Herein, we describe the case of a 38-year-old man who presented with a one-year history of epistaxis, headache, hyposmia, anosmia, night sweats, weight loss, hearing loss, dysphagia, and nasal blockage. A computed tomography (CT) scan and magnetic resonance imaging (MRI) studies revealed a lesion in the posterior nasal cavities with extension into the sphenoid and ethmoid sinuses. Histological examination of a biopsied specimen obtained via flexible fiberoptic endoscopy showed small dark round cells with scanty cytoplasm arranged in solid nests and pseudorosette formations. The diagnosis of Ewing's sarcoma was confirmed by the positive reactive pattern of the neoplastic cells for CD99 by immunohistochemistry studies and also identification of a chromosomal translocation of FLI1 in PCR studies. Cervical lymph nodes and bone marrow involvement were also observed. The patient was treated by adjuvant chemotherapy including vincristine, endoxan, and adriamycin for 6 cycles followed by radiotherapy (eleven courses). Unfortunately, before completion of treatment, the patient died due to disease progression and brain metastasis.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2018.01.003
      Issue No: Vol. 6 (2018)
       
  • Irreversible laryngeal palsy: An induced complication of carboplatin
           450mg/m2 and paclitaxel 250mg/m2 - Case report

    • Authors: Rawish Kumar; Sanjay K. Munjal; Naresh K. Panda
      Pages: 38 - 39
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Rawish Kumar, Sanjay K. Munjal, Naresh K. Panda
      Introduction Unilateral vocal cord paralysis is common than bilateral palsy and is mostly idiopathic in origin. Other causes may include malignancy, secondary to neck or recurrent laryngeal nerve trauma, intubation or secondary to surgery however, taxanes induces paresis which can lead to paralysis following paresis of larynx. Case summary: A female patient presented with cancer of cervix (Endometrium) and developed vocal cord paralysis after completion of five cycles of treatment with injections paclitaxel 250mg/m2 and carboplatin 450mg/m2. Patient's stroboscopic examination, electromyography (EMG) confined that one vocal cord lateralized in paramedian position. Voice analysis revealed low pitch and loudness and with breathy quality. Discussion: The vocal cord paralysis was believed to have occurred due to neurotoxic effect of carboplatin and paclitaxel, as an added complication of these drugs. Carboplatin and paclitaxel above than cumulative dose can induce bilateral or unilateral vocal cord paresis or sometimes paralysis also. The concurrent amount of dose used of carboplatin and paclitaxel might have contributed to this illness in patient.

      PubDate: 2018-02-10T05:31:38Z
      DOI: 10.1016/j.xocr.2018.01.004
      Issue No: Vol. 6 (2018)
       
  • Twofold spontaneous otogenic pneumocephalus - Case report

    • Authors: Lennart Weitgasser; Sebastian Roesch; Gernot Schulz; Gerd Rasp
      Pages: 40 - 42
      Abstract: Publication date: March 2018
      Source:Otolaryngology Case Reports, Volume 6
      Author(s): Lennart Weitgasser, Sebastian Roesch, Gernot Schulz, Gerd Rasp
      Introduction Occurrence of spontaneous pneumocephalus, without any determined cause like trauma, infection or surgery, is rare. Case report A 67-year old female patient was admitted to the outpatient clinic due to acute change in personality and occurrence of expressive aphasia. Imaging showed an intracranial pneumocephalus located in the left temporal lobe. High-resolution CT scan of the temporal bone demonstrated an osteo-dural defect of the floor of the middle cranial fossa. The defect was sealed with a duraplasty via a transmastoid approach following a quick postoperative recovery. Discharge was 10 days after surgery. Six weeks later the patient presented with acute emesis, reported clear rhinorrhea and confusion. CT scan showed recurrence of the pneumocephalus on the left side. MRI scan demonstrated another defect in the left lateral temporal bone. A second surgery was performed in which a new osteo-dural leakage was found. The former duraplasty was unremarkable with no sign of liquorrhea. Another duraplasty was carried out. After operation the patient's clinical condition improved again rapidly. She was discharged on the 7th postoperative day. There has been no recurrence ever since. Discussion Etiology of these two consecutive osteo-dural defects remains unclear. An arachnoidal cyst as possible cause is under debate. However, a review of the radiological images could not confirm this theory. Conclusion Occurrence of spontaneous pneumocephalus is a rare event and should be considered in case of acute unspecific neurological symptoms. A diverse range of symptoms is described. Mostly surgical intervention is needed.

      PubDate: 2018-02-21T01:06:38Z
      DOI: 10.1016/j.xocr.2018.01.005
      Issue No: Vol. 6 (2018)
       
  • A rare case of peritonsillar abscess resulting in cervical necrotizing
           fasciitis

    • Authors: Carmen E. Flores; Marc R. Matthews; Daniel M. Caruso; Kevin N. Foster; Mariel Stroschein
      Pages: 1 - 5
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Carmen E. Flores, Marc R. Matthews, Daniel M. Caruso, Kevin N. Foster, Mariel Stroschein
      Objectives Necrotizing fasciitis of the head and neck region is a rare but lethal complication of any head and neck infection. We present a case of cervical necrotizing fasciitis secondary to peritonsillar abscess requiring a large neck debridement and bilateral mastectomies that was treated in our institution. Case report A 38-year-old male presented with a history of sore throat which progressed to right neck swelling and bilateral chest pain. Blood work was only significant for a white blood cell count of 22.0 × 103/μL. Computed tomographic imaging of the neck and chest demonstrated a right peritonsillar abscess involving the right masticator space and carotid space which had dissected laterally and superficially to involve the right sternocleidomastoid and bilateral pectoralis muscles. The patient was taken emergently to the operating room for wide excision resulting in a neck debridement, right total mastectomy, and left partial mastectomy. After multiple debridements, intravenous antibiotics, and dressing changes the patient underwent split thickness skin grafting to his neck and chest wounds and was subsequently discharged from the hospital 45 days after initial presentation. Conclusions Necrotizing fasciitis of the head and neck demands a high index of suspicion involving a multidisciplinary team, rapid diagnostic measures and aggressive surgical and antibiotic management as the mainstay of treatment in reversing this potentially fulminant and lethal disease process. In this rare case of peritonsillar abscess resulting in cervical necrotizing fasciitis, the infection spread across cervical fascial planes onto the anterior chest wall rather than dissecting as usual to the parapharyngeal, retropharyngeal spaces or mediastinum. Extensive and potentially disfiguring debridements may be necessary to obtain negative margins with frequent reoperations until the patient is ready for reconstruction.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.08.005
      Issue No: Vol. 5 (2018)
       
  • First prospectively identified case of Candida auris in the United States

    • Authors: Anthony Yang; Daniel A. Carlton; Camille Hamula; Gopi Patel; Alfred Marc C. Iloreta
      Pages: 6 - 7
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Anthony Yang, Daniel A. Carlton, Camille Hamula, Gopi Patel, Alfred Marc C. Iloreta
      Candida auris is an emerging multidrug-resistant fungus associated with high mortality rates. With a predilection for immunocompromised patients, C. auris has been reported to be the cause of several nosocomial outbreaks. Conventional biochemical methods are inaccurate in identifying this species of Candida. We report the first prospectively identified case in the United States of a patient presenting with a colonization of C. auris in the ear. Due to the limited nature of clinical data and treatment results, our experience may provide insight for otolaryngologists in the identification, treatment and proper precautions with regards to C. auris.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.08.004
      Issue No: Vol. 5 (2018)
       
  • Supratip excision in rhinoplasty

    • Authors: M. Bhatt; M. Brandstetter; W. Gubisch; S. Haack
      Pages: 8 - 12
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): M. Bhatt, M. Brandstetter, W. Gubisch, S. Haack
      Rhinoplasty is a plastic surgery procedure for reconstructing the nose by correcting any structural deformity and improving its function. Special attention should be given to the type and nature of the skin covering the nose. Nasal skin thickness varies with age, ethnic and racial characteristics, and sebaceous activity. The sebaceous area is usually limited to the anterior and lower portion of the nose. A standard rhinoplasty will not be successful in all cases and may tend to result in an amorphous, unshapely nose or an even less aesthetic supratip deformity. Polly beak deformity is a complication of rhinoplasty defined by the typical appearance of a dorsal nasal convexity resembling a parrot's beak. This dosal hump is located in the supratip region of the nose which then “pushes” the tip downward causing underrotation. In our study, a total of 31 patients underwent rhinoplasty with supratip excision with good aesthetic outcome and minimal scar. Of these, 24 were primary and 7 were secondary cases. In patients with thick, inelastic skin and long nose with a drooping tip, elliptical skin excision just proximal to the cartilages of the nasal tip in such patients can improve the aesthetic outcome. We do not recommend the free use of external excision; indeed it should be; avoided whenever possible. However, it is important to be aware that in selected cases such a procedure; may achieve results impossible to get by any other means.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.08.002
      Issue No: Vol. 5 (2018)
       
  • Endoscopic endonasal resection of cavernous hemangioma of the palate

    • Authors: Kristina Piastro; Tiffany Chen; Roshni V. Khatiwala; Carlos D. Pinheiro-Neto
      Pages: 13 - 15
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Kristina Piastro, Tiffany Chen, Roshni V. Khatiwala, Carlos D. Pinheiro-Neto
      Hemangiomas are a common presentation in the head and neck, but intraosseous hemangiomas are exceedingly rare and account for only 1% of bone tumors. The hard palate is a unique anatomic structure consisting of mucosa rich in minor salivary glands, and is firmly attached to the palatine process of the maxilla and the horizontal plate of the palatine bone. Neoplasms of the hard palate are extremely rare and may display unique characteristics and histologic findings. Whether benign or malignant, the therapy of choice for such tumors is surgical excision performed through a transoral approach, which carries a significant risk of oronasal and oroantral fistula formation. This paper describes the use of an endoscopic endonasal technique for resection of a rare case of a cavernous hemangioma of the hard palate. Resection of favorable benign lesions like palatal hemangiomas are more likely to be successful via this endoscopic endonasal technique which avoids the traditional transoral palatal approach and thus reduces the risk of oronasal and oroantral fistulae. No complications in the immediate postoperative nor within a 1-year follow-up period were observed.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.08.001
      Issue No: Vol. 5 (2018)
       
  • Erosion of the incus by the chorda tympani nerve in a normally ventilated
           middle ear and its implications during stapedotomy

    • Authors: Frédéric Lemieux-Martel; Margaret Aron
      Pages: 16 - 17
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Frédéric Lemieux-Martel, Margaret Aron
      A case is reported showing partial erosion of the incus long process by the chorda tympani nerve in a normally ventilated middle ear: type A tympanogram, no tympanic membrane retraction, normal middle ear mucosa. A patient with no history of middle ear disease was diagnosed with left otosclerosis. After failed attempt with conservative treatment, she underwent elective stapedotomy. Intraoperatively, a deep groove in the incus long process was found upon mobilization of the chorda tympani without any sign of middle ear inflammation or other ossicular erosion. The tympanic membrane was also normal. Review of the current literature shows cases of incus erosion by the chorda tympani nerve associated with eustachian tube dysfunction resulting in middle ear disease and tympanic membrane retraction. Our findings are unique because unlike previously reported cases, our patient had no history or signs of chronic middle ear disease. Implications of this abnormality on stapedotomy completion are discussed.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.10.001
      Issue No: Vol. 5 (2018)
       
  • Osteoma of the superior petrous portion of the temporal bone

    • Authors: Cynthia Tsay; Apoorva Tewari Ramaswamy; Ajay Malhotra; Elias Michaelides
      Pages: 18 - 20
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Cynthia Tsay, Apoorva Tewari Ramaswamy, Ajay Malhotra, Elias Michaelides
      Background Osteomas are benign, often asymptomatic, bony osteoblastic lesions of mesenchymal origin, often presenting in the head and neck with an estimated prevalence of 0.42%. Osteomas can be found in the sinuses, mandible, and rarely in the temporal bone and are often found incidentally in imaging studies. Common symptoms for osteomas in the temporal bone include hearing loss, tinnitus, vestibular dysfunction, and external swelling. Methods We present a rare case and analysis of the clinical and radiographic presentation of an osteoma located in the petrous part of the temporal bone. Discussion Osteomas of the temporal bone, while rare, most commonly occur in the external auditory canal. A few cases of osteomas presenting on the petrous part of the temporal bone have been described. Knowledge of the existence of osteomas in this location can assist in the appropriate diagnosis, management, and care of patients presenting with sensorineural hearing loss and abnormal radiological findings. Conclusion In patients with auditory symptoms such as tinnitus or hearing loss with abnormal osseous findings on MRI, CT can assist in diagnosis. The differential diagnosis of such lesions includes osteomas, pneumoceles, pneumocephalus, parosteal osteosarcoma and osteoblastoma. Thorough radiological assessment can be valuable in reaching the correct diagnosis, and can prevent unnecessarily aggressive management and treatment for benign osseous lesions.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.09.001
      Issue No: Vol. 5 (2018)
       
  • Epidural abscess and paraplegia: Delayed sequela of tracheoesophageal
           puncture

    • Authors: Yohan Song; Krista Kiyosaki; Edward J. Damrose
      Pages: 21 - 23
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Yohan Song, Krista Kiyosaki, Edward J. Damrose
      We report the case of a patient who developed an epidural abscess several months following primary TEP. Tracheoesophageal puncture (TEP) is a common procedure used for speech rehabilitation in total laryngectomy (TL) patients. Epidural abscess after TEP placement is a rare complication but there are several cases reported in the literature. Patients typically present with neck pain and/or dysphagia, in addition to signs and symptoms of infection. Her case was unusual in that she presented initially with paraplegia without neck pain or dysphagia. Surgical evacuation of the abscess was performed urgently, however the patient developed osteomyelitis of the cervical spine with persistent cord compression and irreversible paraplegia. She subsequently expired from sepsis. Epidural abscess after TEP placement is a serious but rare complication. Early detection and treatment are imperative to avoid poor long-term outcomes.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.10.002
      Issue No: Vol. 5 (2018)
       
  • Solitary fibrous tumor/hemangiopericytoma arising from the posterior neck
           in the perivertebral space and treated with surgery and preoperative
           embolization

    • Authors: Christelle Miot; Alfred A. Simental; Mia C. Perez; Johnny Suh; Pedro A. Andrade Filho
      Pages: 24 - 27
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Christelle Miot, Alfred A. Simental, Mia C. Perez, Johnny Suh, Pedro A. Andrade Filho
      Solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) is a rare, slow growing vascular tumor. In the head and neck region, it is usually seen in the nasal or oral cavity, orbit, jaw, and parotid region. It has equal male to female distribution and affects mainly younger adults with median age of 45 years. According the World Health Organization, sometimes it is impossible to distinguish HPC from SFT and consequently, they are now classified as the same entity. The first line of treatment for this tumor is complete surgical removal with wide margins. In the head and neck area, wide margins can be very challenging and incomplete resection is associated with high rate of recurrence and malignant transformation. Embolization is a considerable option prior to excision, which helps reducing the tumor size and the risk of intraoperative hemorrhage. We describe a case of posterior neck solitary fibrous tumor/hemangiopericytoma that was completely resected following particle embolization of the feeding artery.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.10.004
      Issue No: Vol. 5 (2018)
       
  • Thyroid mass from a malignant glomus tumor: Case report and literature
           review

    • Authors: Amanda E. Dilger; John Cramer; Jose Dutra
      Pages: 28 - 30
      Abstract: Publication date: November 2017
      Source:Otolaryngology Case Reports, Volume 5
      Author(s): Amanda E. Dilger, John Cramer, Jose Dutra
      Objectives Glomus tumors arise in the dermal glomus body and are most commonly found in the subungual region of the digits, the dermis or the subcutis of the palm, wrist, forearm or foot. They are typically benign and localized but rare cases of malignant glomus tumor have been described. Here, we describe the first reported case of glomus tumor metastasizing to the thyroid gland. Study design Case report and literature review. Methods A 40-year old male with a history of glomus tumor of the dorsal aspect of his left foot status-post wide local excision with metastatic disease that was well controlled for four years with chemotherapy and radiation presents with a slowly enlarging left thyroid mass. The mass was first identified on surveillance CT and enlarged from 1.3 cm to 2.4 cm over the course of six months. Fine-needle aspiration of the mass demonstrated atypical epitheliod cells with conspicuous nuclei and scatter mitosis with immunostains positive for SMA, focally positive for calponin and negative for PAX-8 consistent with metastatic malignant glomus tumor. Results The patient underwent total thyroidectomy and final pathology was consistent with metastatic glomus tumor. Conclusion This is the first reported case of a glomus tumor metastasizing to the thyroid gland. This case illustrates several important points for otolaryngologists and highlights the differences between glomus tumors and paragangliomas, which were formerly also called glomus tumors. Although rare, malignant glomus tumors are an additional entity to consider when assessing a patient with an unusual appearing thyroid mass.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.10.005
      Issue No: Vol. 5 (2018)
       
  • Case report: Ductal eccrine adenocarcinoma with fibromyxoid stroma

    • Authors: Kyle Mitts; Adan Fuentes; Ambujakshan Dildeep
      Pages: 1 - 3
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Kyle Mitts, Adan Fuentes, Ambujakshan Dildeep


      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.05.002
      Issue No: Vol. 4 (2018)
       
  • Leiomyosarcoma of the inferior turbinate

    • Authors: Christopher W. Harper; Marc A. Polacco; John R. Newman
      Pages: 4 - 5
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Christopher W. Harper, Marc A. Polacco, John R. Newman
      We report a case of leiomyosarcoma of the inferior nasal turbinate. The patient, a 68-year-old Caucasian male, presented with 4–6 weeks of epistaxis that was resistant to nasal packing and septal cautery. Upon inspection in the operating room, a small mass was excised from the inferior turbinate. High-power H&E-stained microscopy demonstrated bundles of malignant smooth muscle cells, and immunohistochemical stains were strongly positive for desmin, smooth muscle actin and vimentin, while negative for pankeratin EA1/EA3 and CaM 5.2, suggesting leiomyosarcoma as the diagnosis. Clear margins were obtained at a second surgery. At the time of this writing it is 8 months since his last surgery and he has remained symptom free.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.06.001
      Issue No: Vol. 4 (2018)
       
  • Thyroid abscess following traumatic intubation

    • Authors: Marc A. Polacco; Isabelle L. Magro; Shawn X. Li; Mark C. Smith
      Pages: 6 - 8
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Marc A. Polacco, Isabelle L. Magro, Shawn X. Li, Mark C. Smith
      Thyroid abscess is a rare condition, and consequently diagnosis is often delayed. Causes include 3rd and 4th branchial cleft anomalies, hematogenous spread of infection, trauma from esophageal foreign body, and fine needle aspiration. Thyroid abscesses carry potential morbidity with thyroid and parathyroid gland destruction, tracheal compression, tracheal or esophageal fistula, internal jugular vein thrombophlebitis, and sepsis. The authors report a case of a 33-year old woman with a thyroid abscess following traumatic intubation. Thyroid abscess should be considered in patients presenting with anterior neck pain and swelling with a recent history of traumatic intubation, ultrasound or CT with contrast being the ideal diagnostic modalities.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.06.002
      Issue No: Vol. 4 (2018)
       
  • Ectopic thyroid presenting as a submental mass: A case report

    • Authors: Christopher Perdoni; Marcia E. Eustaquio
      Pages: 9 - 11
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Christopher Perdoni, Marcia E. Eustaquio
      Thyroid ectopia affects roughly 1/100,000 people, with the majority of patients having hypofunctional thyroid tissue and an absent orthotopic gland. If not recognized early, thyroid ectopia may cause diagnostic dilemmas and result in unnecessary workup. Through the use of basic radiographic and histologic analyses, these lesions can be properly identified while also ruling out more common clinical entities. Conservative management remains a legitimate option for many patients, with surgical intervention reserved for severe symptoms or malignancy. We describe the case of a woman with an impressive sublingual ectopic thyroid gland who was managed successfully with conservative strategies.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.07.001
      Issue No: Vol. 4 (2018)
       
  • Cartilage framework reconstruction after resection of thyroid cartilage
           chondrosarcoma: A case report

    • Authors: Valeria Navach; Francesco Chu; Augusto Cattaneo; Stefano Zorzi; Daniele Scelsi; Mohssen Ansarin
      Pages: 12 - 14
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Valeria Navach, Francesco Chu, Augusto Cattaneo, Stefano Zorzi, Daniele Scelsi, Mohssen Ansarin
      Background surgical treatment of laryngeal chondrosarcoma is extremely broad and varies according to the affected subsite. Cricoid cartilage is the most commonly affected subsite. Thyroid cartilage localization is less frequent and is considered more favourable but there is no general consensus about current best practice for treatment of this rare tumor. Case report we discuss the successful case of a young patient with thyroid cartilage chondrosarcoma, treated with radical surgery and cartilaginous graft reconstruction taken from costal synchondrosis in order to preserve laryngeal function and structure. Results and conclusion in our experience this procedure was perfectly adapted to laryngeal reconstruction, providing easy graft harvesting and fast revascularization, laryngeal function preservation, avoiding postoperative rehabilitation arising from surgical damage of the donor site.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.07.002
      Issue No: Vol. 4 (2018)
       
  • Primary malignant melanoma of the larynx—A case report

    • Authors: Shivangi Lohia; Isabel Boersma; Eric Lentsch
      Pages: 15 - 17
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Shivangi Lohia, Isabel Boersma, Eric Lentsch
      Primary malignant melanoma of the larynx is extremely rare with fewer than 70 reported cases in the literature. Here we present the case of an 80-year-old gentleman who was referred to our institution for the treatment of a laryngeal mass. Initial immunostains were positive for SOX10 and S-100 and negative for HMB-45 and preoperative tissue biopsies were thought to be consistent with a malignant peripheral nerve sheath tumor. The endolaryngeal tumor was completely resected with negative margins and final surgical pathology with immunostaining was positive for primary malignant melanoma. Post-operative imaging via PET/CT demonstrated hypermetabolic lesions in the lungs and spine consistent with metastatic disease and the patient was referred for chemoradiation. Here, we review the literature and discuss diagnostic and therapeutic challenges associated with mucosal melanoma owing to its rarity and propensity for distant spread.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.07.003
      Issue No: Vol. 4 (2018)
       
  • Dermoid tumor of the middle ear: A case report and review of the
           literature

    • Authors: Benjamin R. Campbell; Robert J. Yawn; Brendan P. O'Connell; Alejandro Rivas
      Pages: 18 - 20
      Abstract: Publication date: September 2017
      Source:Otolaryngology Case Reports, Volume 4
      Author(s): Benjamin R. Campbell, Robert J. Yawn, Brendan P. O'Connell, Alejandro Rivas
      Dermoid tumors are benign inclusion cysts that are uncommon in the pediatric population. Dermoid tumors of the middle ear are exceedingly rare. A 17-month old female presented with 4-month history of recurrent left otitis media with chronic drainage, speech delay, and worsening episodes of stumbling while walking. A temporal bone CT scan showed complete left middle ear and mastoid air cell opacification. The patient underwent left tympanomastoidectomy for removal of the middle ear mass with pathologic confirmation of a dermoid tumor. The patient continues to do well post-operatively without evidence of disease recurrence. To our knowledge, only thirteen cases of middle ear dermoid tumors have been reported. The clinical and radiographic presentation of dermoid tumors can be similar to congenital cholesteatoma, but they are histopathologically distinct lesions. Surgical removal of the dermoid tumor is an effective treatment strategy as recurrence rates are low.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.08.003
      Issue No: Vol. 4 (2018)
       
  • Metastatic malignant melanoma of parotid gland: A case report and review
           of literature

    • Authors: Gunjan Agrawal; Ashutosh Gupta; Vivek Chaudhary; Fiza Qureshi
      Pages: 1 - 3
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Gunjan Agrawal, Ashutosh Gupta, Vivek Chaudhary, Fiza Qureshi
      Melanoma of the head and neck region metastasizes to cervical lymph nodes but parotid gland is a rare location for metastasis. We report a case of a cutaneous malignant melanoma of the face which metastasized to parotid gland. Metastatic infiltrations were also observed in intraparotid lymph nodes. The pattern of spread of melanoma in the head and neck region and its significance to treatment of salivary gland is reviewed in our report.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.03.002
      Issue No: Vol. 3 (2018)
       
  • Simultaneous and spontaneous reversal of positional nystagmus; an unusual
           peripheral sign of benign paroxysmal positional vertigo

    • Authors: Sertac Yetiser
      Pages: 4 - 6
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Sertac Yetiser
      Direction-changing positional nystagmus is generally thought to be of central origin. Reversal of initial positional nystagmus during maintaining the head position in patients with benign paroxysmal positional vertigo (BPPV) is quite unusual and could be a sign of peripheral pathology. Vestibular reflex adaptation, simultaneous co-existence of canalolithiasis and cupulolithiasis in the same or both ears and changing in direction of debris movement have been proposed for the mechanism of this phenomenon. This can be a sign of simultaneous ampullopedal and ampulofugal flows during single head movement. This double-phase pattern of flow causing reversal of positional nystagmus could be related with the amount, location and dispersal of otolithic debris inside the membranous labyrinth. Four patients (3 lateral canal canalolithiasis and 1 posterior canal) with reversing spontaneous nystagmus among 530 patients with BPPV have been identified in our clinic. They have been cured with standard re-positioning maneuvers. Endolymphatic reflux theory has been proposed as the underlying mechanism for unusual behavior of otolithic debris.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.04.001
      Issue No: Vol. 3 (2018)
       
  • Surgical management of a hemorrhagic pediatric brainstem cavernous
           malformation – A case report

    • Authors: Deborah X. Xie; Matthew M. Dedmon; Brendan P. O'Connell; Le Lucy He; John C. Wellons; Alejandro Rivas
      Pages: 7 - 9
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Deborah X. Xie, Matthew M. Dedmon, Brendan P. O'Connell, Le Lucy He, John C. Wellons, Alejandro Rivas
      Vascular malformations of the central nervous system such as cavernous malformations and arteriovenous malformations are rare lesions with controversial management recommendations in the pediatric population. We report a case of a 3-year-old male who presented with multiple discrete episodes of focal neurological deficits including ataxia and an abducens nerve palsy. Imaging revealed a 1.5 cm hemorrhagic mass located in the pons that was concerning for a cavernous malformation. This lesion was completely excised via a combined transpetrosal approach, and the patient had complete resolution of neurologic symptoms at three-month follow-up.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.03.001
      Issue No: Vol. 3 (2018)
       
  • Huge nasal mass: Unusual presentation of a giant concha bullosa

    • Authors: Saud Alromaih; Eman Hajr
      Pages: 10 - 11
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Saud Alromaih, Eman Hajr


      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.04.002
      Issue No: Vol. 3 (2018)
       
  • Facial nerve stimulation outcomes after cochlear implantation with
           cochlear-facial dehiscence

    • Authors: Christina H. Fang; Sei Y. Chung; Leila J. Mady; Nicole Raia; Huey-Jen Lee; Yu-Lan Mary Ying; Robert W. Jyung
      Pages: 12 - 14
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Christina H. Fang, Sei Y. Chung, Leila J. Mady, Nicole Raia, Huey-Jen Lee, Yu-Lan Mary Ying, Robert W. Jyung
      Objectives To examine the occurrence of facial nerve stimulation (FNS) and outcomes in patients with cochlear-facial dehiscence (CFD) who underwent cochlear implantation (CI). Methods The medical charts and imaging of three patients with bilateral sensorineural hearing loss (SNHL) who presented for CI evaluation were reviewed. Results Patient 1 (P1) had a history of Meniere's disease. Patient 2 (P2) had a history of medulloblastoma treated with surgery and chemoradiation. Patient 3 (P3) had a history of progressive SNHL. Audiometry showed moderate-to-severe SNHL in P1, severe-to-profound SNHL in P2, and profound SNHL in P3. All had poor speech discrimination ability. Temporal bone computed tomography (CT) coronal cuts were suspicious for bilateral dehiscence between the superior basal turn of the cochlea and labyrinthine segment of the facial nerve in P2 and P3, with maximum dehiscence lengths of 2.0 mm on the left in P2, and 1.8 mm on the right in P3. A thin bony partition was visualized bilaterally in P1. The left ear of P1, left ear of P2, and right ear of P3 were implanted. Facial nerve stimulation occurred immediately upon activation in P1 and P2, which resolved by decreasing the dynamic range of the offending electrodes. No FNS was observed in P3. Conclusion Cochlear-facial dehiscence can predispose patients to post-implant FNS. Prior temporal bone irradiation may carry a higher risk of FNS. We recommend scrutiny for CFD in CTs of CI candidates and appropriate risk counseling for FNS if CFD is discovered and more frequent monitoring for FNS by audiology.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.04.003
      Issue No: Vol. 3 (2018)
       
  • Bilateral oncocytic-type Schneiderian papilloma in a pediatric patient

    • Authors: Erkan Ozturk; Bora Basaran; Dilek Yilmazbayhan; Nesil Keles
      Pages: 15 - 17
      Abstract: Publication date: June 2017
      Source:Otolaryngology Case Reports, Volume 3
      Author(s): Erkan Ozturk, Bora Basaran, Dilek Yilmazbayhan, Nesil Keles
      Oncocytic-type papilloma is the rarest histologic type of all sinonasal papillomas, and usually present with a unilateral mass in adults. Histologically, oncocytic Schneiderian papilloma (OSP) has an exophytic and endophytic growth pattern with oncocytic features. As in inverted papillomas, the potential of malignant transformation and the rate of recurrence are high in cases of oncocytic papilloma. In this report, we present a 16 year old girl with OSP that originated from both maxillary sinuses, who underwent endoscopic transnasal bilateral medial maxillectomy.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.04.004
      Issue No: Vol. 3 (2018)
       
  • Discovery of de novo concurrent vocal fold dysplasia in a nonagenarian man
           and his octogenarian wife

    • Authors: Laura Bomze; Priya Krishna
      Abstract: Publication date: Available online 24 April 2018
      Source:Otolaryngology Case Reports
      Author(s): Laura Bomze, Priya Krishna
      Introduction This case report describes an unusual case of a 92-year-old man with chronic dysphonia with more recent worsening and his 88-year-old wife who developed new-onset hoarseness within 6 months of her husband's surgical treatment. Methods Retrospective review of 2 cases. Results Flexible laryngovideostroboscopy showed very similar exophytic hemorrhagic-appearing lesions. The pathology reports for both husband and wife were nearly identical: inflamed polypoid granulation tissue with high-grade dysplastic epithelium. No organisms were found on Periodic acid-Schiff (PAS) stain. The patients did not recall any environmental exposure in the home, dietary changes, or illnesses requiring antibiotics. Neither had prior history of vocal fold dysplasia or other vocal fold pathology. Conclusion An elderly couple presented with nearly identical vocal fold pathology – containing polypoid granulation tissue with high-grade dysplasia. The coincidence may be related to age as a risk factor; although, shared environmental or dietary factors should be taken into consideration.

      PubDate: 2018-04-25T05:33:11Z
      DOI: 10.1016/j.xocr.2018.04.001
       
  • Radiation-induced laryngeal angiosarcoma: Case report

    • Authors: Hiroyuki Hanakawa; Nobuya Monden; Kaori Hashimoto; Aiko Oka; Isao Nozaki; Norihiro Teramoto; Susumu Kawamura
      Abstract: Publication date: Available online 13 March 2018
      Source:Otolaryngology Case Reports
      Author(s): Hiroyuki Hanakawa, Nobuya Monden, Kaori Hashimoto, Aiko Oka, Isao Nozaki, Norihiro Teramoto, Susumu Kawamura
      Head and neck angiosarcoma (AS) is extremely rare. We report the fourth case report of radiation-induced laryngeal AS. The patient is a 73-year-old man with a past medical history of radiation treatment for hypopharyngeal cancer. Laryngoscopy revealed a huge mass with a necrotic lesion in the larynx and pharynx. Biopsy showed AS. We performed radical resection. The pathological diagnosis was AS. 32 months after surgery, the patient died by local relapse. The patient spent over 2 years without relapse. We consider radical surgery as the first-line treatment for radiation-induced laryngeal AS.

      PubDate: 2018-03-21T11:28:22Z
      DOI: 10.1016/j.xocr.2018.03.002
       
  • Isolated tubercular parapharyngeal abscess masquerading as peritonsillar
           abscess: A case report

    • Authors: Shikharani Patel; Rajiv Kumar; Prem Sagar; Rakesh Kumar
      Abstract: Publication date: Available online 19 February 2018
      Source:Otolaryngology Case Reports
      Author(s): Shikharani Patel, Rajiv Kumar, Prem Sagar, Rakesh Kumar
      Introduction Tubercular abscess of parapharyngeal space without caries spine is a rare entity. This case report presents a immunocompetent adult female with parapharyngeal tuberculosis masquerading as peritonsillar abscess and could only be diagnosed by gene xpert. Case presentation We report a rare case of an isolated parapharyngeal space tubercular abscess in a 22 years immunocompetent female who was evaluated for throat pain and swallowing difficulties for 2 months. In clinical examination there was a bulge in left tonsillar fossa with congested tonsil pushed medially. Computed tomography scan showed localized abscess in left parapharyngeal space. USG guided aspiration was done and sent for bacterial and tubercular cause to be ruled out. All other reports were inconclusive except gene Xpert for TB was positive. Management and outcome Based on this we started ATT and patient was completely symptoms free in 3 months. Repeat scans done which did not show any residual abscess. Discussion Although tuberculosis is one of the most common infectious disease in India, tubercular abscess only localized to parapharyngeal space is not a common entity.

      PubDate: 2018-02-21T01:06:38Z
      DOI: 10.1016/j.xocr.2018.02.003
       
  • Primary calcitonin-secreting neuroendocrine carcinoma of the larynx - Case
           report and update on current terminology

    • Authors: Miriam Smetak; Samir S. Khariwala; Zuzan Cayci; Bevan Yueh; Emilian Racila
      Abstract: Publication date: Available online 16 February 2018
      Source:Otolaryngology Case Reports
      Author(s): Miriam Smetak, Samir S. Khariwala, Zuzan Cayci, Bevan Yueh, Emilian Racila
      Primary calcitonin-secreting neuroendocrine carcinoma of the larynx is a rare neuroectodermal neoplasm currently classified as moderately differentiated (atypical carcinoid/WHO classification) neuroendocrine carcinoma of the larynx. Due to the rarity of these tumors at this location as well as their distinctive histologic and immunophenotypic features, they often raise significant diagnostic difficulties in biopsy specimens. We present a 57-year-old woman with persistent and gradually worsening pharyngeal pain for approximately one year duration, who was found to have a lesion limited to the right aryepiglottic fold. Final pathology showed moderately differentiated neuroendocrine carcinoma. Due to calcitonin positivity and coexistence of a thyroid nodule, the tumor raised the differential diagnosis of medullary thyroid carcinoma. A practical approach to pathologic diagnosis of laryngeal neuroendocrine tumors and discussion of clinical management is provided.

      PubDate: 2018-02-21T01:06:38Z
      DOI: 10.1016/j.xocr.2018.02.004
       
  • Methotrexate-induced cutaneous B-cell lymphoma masquerading as facial
           cellulitis

    • Authors: Stephanie Warrington; Celeste C. Gary; Erin Thibault; Laura T. Hetzler
      Abstract: Publication date: Available online 13 February 2018
      Source:Otolaryngology Case Reports
      Author(s): Stephanie Warrington, Celeste C. Gary, Erin Thibault, Laura T. Hetzler
      Objective To describe a case of methotrexate-induced cutaneous B-cell lymphoma presenting as facial cellulitis to focus on the importance of considering a wide differential and expediting biopsy. Method Case Report and Literature Review. Case report We report a case of an 89 year old gentleman who presented with central facial skin involvement of what appeared to be an extensive cellulitis of infectious etiology which was not responsive to treatment. After much investigation, a link was made between his long-term methotrexate use and the risk for cutaneous lymphomas. A cutaneous biopsy was able to confirm thdis diagnosis. Literature review Over the past 20 years, a rising trend has been noted in the incidence of lymphoma, including cutaneous forms, in patients who have rheumatoid arthritis treated with long-term methotrexate. This rare but serious complication has been hypothesized to be secondary to both increased immunosuppression with genetic predisposition and increased frequency of latent infections such as Epstein-Barr Virus (EBV). Most of the reported cases describe complete regression of these malignancies with cessation of methotrexate use. However, the diagnosis can be difficult to ascertain due to the rarity and infectious appearing nature of the disease. Conclusion Methotrexate-associated cutaneous B-cell lymphoma is an entity that should be considered in patients who present with the appearance of facial cellulitis and are on long-term methotrexate therapy.

      PubDate: 2018-02-21T01:06:38Z
      DOI: 10.1016/j.xocr.2018.02.002
       
  • Rare case of pan-neck space infection from a peritonsillar abscess

    • Authors: Lisa Brown; Kevin Shi; Jeffery Yu; Katherine Nickley
      Abstract: Publication date: Available online 12 February 2018
      Source:Otolaryngology Case Reports
      Author(s): Lisa Brown, Kevin Shi, Jeffery Yu, Katherine Nickley


      PubDate: 2018-02-21T01:06:38Z
      DOI: 10.1016/j.xocr.2018.01.006
       
  • A review and report of a rare clinical entity: Intratonsillar abscess

    • Authors: Aaron Esmaili; Zubair Hasan; Peter Friedland
      Abstract: Publication date: Available online 9 February 2018
      Source:Otolaryngology Case Reports
      Author(s): Aaron Esmaili, Zubair Hasan, Peter Friedland
      Background Intratonsillar abscess is a rare complication of tonsillitis. The number of reported cases in the literature is scarce. The clinical features can resemble tonsillitis or peritonsillar abscess. Recognition of this as a possible cause is important as management differs. Often imaging is required to make this distinction. The aim of this report is to help provide a comprehensive review of the literature on patients with intratonsillar abscess. In doing so a case is also presented. Method Literature review and case review. Case review We report the case of a previously well 40 year old man with an intratonsillar abscess. Imaging was required to make the diagnosis and patient was managed with incision and drainage together with empirical intravenous antibiotics. Conclusion Intratonsillar abscess is rare. Although the distinction between tonsilitis, intratonsillar abscess and peritonsillar abscess is difficult there are symptoms and signs that may help the clinician make the differentiation. Imaging is often utilised to localise the abscess. To achieve a more rapid recovery procedural management seems to be necessary.

      PubDate: 2018-02-10T05:31:38Z
      DOI: 10.1016/j.xocr.2018.02.001
       
  • Interdigitating dendritic cell sarcoma of the supraglottic larynx

    • Authors: Shivani Sud; Jordan Holmes; Trevor Hackman; Juneko E. Grilley-Olson; Bhisham Chera
      Abstract: Publication date: Available online 17 January 2018
      Source:Otolaryngology Case Reports
      Author(s): Shivani Sud, Jordan Holmes, Trevor Hackman, Juneko E. Grilley-Olson, Bhisham Chera
      Background Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm with sparse published literature, limited to case reports. This neoplasm arises from dendritic cells mainly within lymph nodes, however extranodal localization has been noted in the head and neck. Methods Herein we present the first report of IDCS of the supraglottic larynx. A 35-year-old woman presented with odynophagia and dysphagia and was found to have an epiglottic primary lesion with bilateral regional lymphadenopathy. She was treated with transoral laser supraglottic laryngectomy, bilateral neck dissections, and postoperative radiation therapy. Results Patient has no evidence of disease with 4 years of follow-up. Conclusion Surgical resection with postoperative radiation therapy is a reasonable approach for management of loco-regionally advanced extranodal IDCS of the head and neck.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2018.01.002
       
  • Comparison of standard modified shrobingers Incision versus transverse
           cervical Incision for neck dissection – Our experience

    • Authors: Gunjan Agrawal; Ashutosh Gupta; Amit Choraria; Santanu Tiwari; Vivek Chaudhary
      Abstract: Publication date: Available online 12 January 2018
      Source:Otolaryngology Case Reports
      Author(s): Gunjan Agrawal, Ashutosh Gupta, Amit Choraria, Santanu Tiwari, Vivek Chaudhary
      Aim To compare the feasibility and outcomes of Transverse Cervical incision and Modified Schobinger's incision for neck dissection. Materials and Methods Patients having oral cavity cancer with positive metastatic nodal disease in the neck requiring ablative surgery were included. Patients requiring a lip split incision for tumor ablation were excluded from the study. A total of forty patients were selected and were randomized in two groups. Transverse Cervical incision was placed in group A for neck dissection and a standard Modified Schobinger's incision in group B. These two groups were then compared on the basis of criteria's like adequacy of surgical access, flap dehiscence or necrosis, number of lymph nodes retrieved, length of incision, wound contracture, length of hospital stay and cosmetic result. Results Result of our study show that Transverse Cervical incision had adequate surgical access, adequate lymph node retrieval, and better cosmetic result, less postoperative complications with early discharge of patient as compared to Modified Schobinger's incision for neck dissection. Conclusion According to our experience, we believe that this transverse cervical incision in oral cancer patients can be very useful which fulfills all the requirements for neck dissection in terms of required surgical access, adequate lymph nodes retrieval, good healing of skin flaps and better cosmetic result without any postoperative complications.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2018.01.001
       
  • Low grade spindle cell sarcoma of the true vocal folds

    • Authors: Samuel R. Barber; Pavel Kopach; Elizabeth M. Genega; Thomas L. Carroll
      Abstract: Publication date: Available online 28 November 2017
      Source:Otolaryngology Case Reports
      Author(s): Samuel R. Barber, Pavel Kopach, Elizabeth M. Genega, Thomas L. Carroll
      Laryngeal tumors of non-epithelial origin are uncommon. Spindle cell sarcoma specifically of the true vocal fold is exceedingly rare. A comprehensive morphological and immunohistochemical analysis is necessary for diagnosis. Two cases of true vocal fold spindle cell sarcoma are presented.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.11.006
       
  • Airway management for symptomatic benign thyroid goiters with
           retropharyngeal involvement: Need for a surgical airway with report of 2
           cases

    • Authors: Fred M. Baik; Vivian Zhu; Anup Patel; Mark L. Urken
      Abstract: Publication date: Available online 21 October 2017
      Source:Otolaryngology Case Reports
      Author(s): Fred M. Baik, Vivian Zhu, Anup Patel, Mark L. Urken
      Background Intubation prior to surgical intervention for thyroid goiters is typically straightforward and uneventful. However, retropharyngeal extension of thyroid goiters is a unique entity which is characterized by displacement of the hypopharynx and laryngeal deviation. Methods Two patients presented with progressive compressive symptoms due to enlarging thyroid goiters. Imaging revealed thyroid goiters with significant retropharyngeal involvement causing anterior displacement of the larynx and hypopharynx. Results Both patients were unsuccessfully intubated by direct laryngoscopy, GlideScope laryngoscopy and flexible fiberoptic laryngoscopy. Tracheostomy was performed to safely establish the airway, and thyroidectomy was subsequently performed uneventfully. Formalization of the tracheal stoma was performed on both patients to prevent soilage of the thyroid bed with tracheal secretions. Conclusions Retropharyngeal involvement of thyroid goiters can pose significant difficulty with intubation. Airway compromise can be avoided by directly proceeding with a surgical airway. Management of the tracheal stoma is an important step in preventing postoperative infection.

      PubDate: 2018-01-30T15:18:51Z
      DOI: 10.1016/j.xocr.2017.10.003
       
 
 
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