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Otolaryngology Case Reports
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ISSN (Print) 2468-5488
Published by Elsevier Homepage  [3159 journals]
  • Hemangiopericytoma of the skull base masquerading as a middle ear mass:
           Case report and literature review

    • Abstract: Publication date: September 2018Source: Otolaryngology Case Reports, Volume 8Author(s): Alexandra M. Arambula, Matthew M. Dedmon, Brendan P. O'Connell, Robert J. Yawn, Scott L. Parker, Reid C. Thompson, Alejandro Rivas ObjectiveReview the clinical presentation and management of meningeal hemangiopericytomas of the lateral skull base and cerebellopontine angle (CPA), and describe a case of anaplastic hemangiopericytoma of the CPA presenting as a middle ear mass.Study designCase report and literature review.Case descriptionA 51-year-old male presented with a one year history of hearing loss, pulsatile tinnitus, and disequilibrium. Physical examination demonstrated a mass in the left middle ear. Magnetic resonance imaging revealed a 4 cm, T1-/T2-isointense, contrast-enhancing mass in the middle cranial fossa. The erosive mass extended into the middle ear and surrounding temporal lobe. A trans-zygomatic approach with a pterional craniotomy exposed a well-encapsulated, highly vascular mass. Manipulation of the tumor resulted in significant hemorrhage. Following removal from the temporal lobe and middle ear, an anterior petrosectomy was performed to remove tumor from the internal auditory canal (IAC) and carotid artery. The facial nerve near the IAC was encased in tumor, and all but a small amount of tumor adherent to the nerve was successfully removed. The final pathologic diagnosis was anaplastic hemangiopericytoma (WHO Grade III). Metastatic workup revealed no extracranial disease, and the patient underwent adjuvant radiation therapy. He continues to do well with only mild disequilibrium at one year follow-up.ConclusionsHemangiopericytomas are rare, malignant neoplasms that are aggressive and highly vascular. Current management recommendations include excision followed by radiotherapy. Close surveillance is required for patients with anaplastic hemangiopericytoma due to the aggressive nature of this tumor and its propensity for recurrence or metastasis.
       
  • Frontal sinus fibrous dysplasia with atypical radiological features: A
           case report and review of the literature

    • Abstract: Publication date: September 2018Source: Otolaryngology Case Reports, Volume 8Author(s): Ghassan Alokby, Scott M. Graham, Aristides A. Capizzano ObjectivesTo present a case of frontal sinus fibrous dysplasia with atypical radiological features and to perform a literature review.Case reportA 63 year old gentleman presented to clinic with a one year history of right eye proptosis. CT and MRI were performed and identified a mass filling the frontal sinus and eroding the orbital wall. The patient had a combined endoscopic and open approach to the right frontal sinus with the final diagnosis being fibrous dysplasia.Study designCase report and literature review.MethodsSystematic literature review was conducted with the review focusing on the radiological features of fibrous dysplasia in the head and neck.ResultsFibrous dysplasia can present in a variety of ways in the head and neck. There are certain features in its radiological appearance that can aid in early identification of the disease, thereby leading to the development of better management plans. In CT scan, the ground glass appearance is the most persistent presentation. While in MRI, the degree of mineralization of the lesion dictates its signal intensity.
       
  • Management of high pressure water jet oropharyngeal injury

    • Abstract: Publication date: Available online 5 July 2018Source: Otolaryngology Case ReportsAuthor(s): Justin Morse, Jacqueline Harris, Bridget Hopewell, Alexander Gelbard High-pressure water jets are used widely across various industries, and work-related injuries to the extremities commonly occur. However, high-pressure water injuries to the oropharynx are uncommon and can result in significant injury and aerodigestive compromise. These injuries are characterized by severe internal injuries far exceeding the minimal observable external damage. Here we review the case of a 37-year-old male with an oropharyngeal injury secondary to a power washer, the associated management, and provide a review of the literature of similar injuries.
       
  • Pediatric floor of mouth teratoid cysts: A case series

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Anisha Noble, Neha A. Patel, Ryan Mitchell, Henry Ou, Kaalan Johnson
       
  • Granulomatosis with polyangiitis presenting with facial nerve paralysis
           and strawberry gingivitis in a child

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Michael Coulter, Daniel Hershey, Wen Jiang Granulomatosis with Polyangiitis (GPA), formally termed Wegener's Granulomatosis, is characterized by necrotizing granulomatous inflammation affecting the upper and lower respiratory tract and the kidneys. We report a case of a 10-year-old female who presented with a complete right facial paralysis preceded by a 6-week history of intermittent fever, headaches, and a right-sided otorrhea. She was admitted for urgent placement of bilateral tympanostomy tubes and intravenous antibiotics. Despite maximal medical management, she had recurrent fever and was noted to have intermittent epistaxis and gum bleeding with erythematous gingival lesions resembling strawberries in appearance. Gingival biopsy combined with other clinical features confirmed the diagnosis of GPA. Strawberry gingivitis, a reddish-purple exophytic gingival swelling, is a rare presenting feature of GPA; however, when present, it is almost pathognomonic. Early recognition of this clinical feature is critical in establishing a timely diagnosis.
       
  • Case report: Unilateral mydriasis, palpebral ptosis and ophthalmoplegia
           following repairing of cerebrospinal fluid rhinorrhea

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Shuangshuang Li, Wenhui Huang, Xu Zhang Ophthalmic complications, including mydriasis, palpebral ptosis, and ophthalmoplegia following surgery in the vicinity of paranasal sinuses might indicate serious complications. We here report the case of a patient who exhibited a transient unilateral mydriasis, palpebral ptosis and ophthalmoplegia following a trans-nasal endoscopic surgery for the repair of a cerebrospinal fluid rhinorrhea. These symptoms completely resolved approximately three hours after the surgeon had removed the intranasal packed fat and fascia. Insofar as ocular complications may indicate life-threatening neurological injury, anesthesiologists and surgeons should be aware of possible aetiologies in order to timely identify the underlying cause and cure adequately.
       
  • Emergent parotidectomy after parotid lymphatic malformation hematoma

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Neel K. Bhatt, Liang-I. Kang, Samir El-Mofty, Brian Nussenbaum, Patrik Pipkorn IntroductionLymphatic 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 detailsA 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.ConclusionsWe 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.
       
  • Low grade spindle cell sarcoma of the true vocal folds

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(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.
       
  • Airway management for symptomatic benign thyroid goiters with
           retropharyngeal involvement: Need for a surgical airway with report of 2
           cases

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Fred M. Baik, Vivian Zhu, Anup Patel, Mark L. Urken BackgroundIntubation 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.MethodsTwo 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.ResultsBoth 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.ConclusionsRetropharyngeal 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.
       
  • Radiation-induced laryngeal angiosarcoma: Case report

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(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.
       
  • Chronic mastoiditis and petrositis with viscous otorrhea caused by
           Achromobacter xylosoxidans: Case report and literature review

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(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.
       
  • Acute airway obstruction management in scorpion envenomation to
           submandibular region: A case report

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(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.
       
  • Osteomyelitis of the odontoid process with associated retropharyngeal
           abscess: A case report

    • Abstract: Publication date: June 2018Source: Otolaryngology Case Reports, Volume 7Author(s): Alisa Timashpolsky, Daniel Ballard, Krishnamurthi Sundaram ObjectiveTo report an interesting and informative case of a unique clinical entity.MethodsIndividual case report.ResultsWe report a case of a 58-year-old female who presented with ten days of intractable neck pain and acutely worsening mental status. Her past medical history included type 2 diabetes mellitus, hypertension, hyperlipidemia and hypothyroidism. Initial laboratory workup revealed leukocytosis, and elevated CRP and ESR. CT scan of the cervical spine showed prominence of the retropharyngeal soft tissues. A subsequent MRI showed enhancing, lytic changes of the odontoid process with surrounding edema and soft tissue inflammatory changes, as well as a discrete fluid collection in the left anterior prevertebral space. Due to worsening airway compromise, the patient was intubated and taken to the operating room for evacuation of the retropharyngeal fluid collection. Intraoperatively, there was noted to be a small defect in the posterior nasopharyngeal mucosa, with active purulent drainage. Following decompression of the retropharyngeal abscess, the patient slowly improved, and remained on an extended course of IV antibiotics before being discharged to a rehab facility.ConclusionPyogenic vertebral osteomyelitis rarely occurs in the cervical spine, and only a handful of reports have described involvement of the odontoid process. Diagnosis of this rare entity is often delayed due to the vague presenting symptoms and location deep within the soft tissues of the neck. Although retropharyngeal abscess most commonly occurs as a complication of an upper respiratory tract infection, this case demonstrates the possibility of an underlying vertebral infection.
       
  • Discovery of de novo concurrent vocal fold dysplasia in a nonagenarian man
           and his octogenarian wife

    • Abstract: Publication date: Available online 24 April 2018Source: Otolaryngology Case ReportsAuthor(s): Laura Bomze, Priya Krishna IntroductionThis 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.MethodsRetrospective review of 2 cases.ResultsFlexible 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.ConclusionAn 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.
       
  • Methotrexate-induced cutaneous B-cell lymphoma masquerading as facial
           cellulitis

    • Abstract: Publication date: Available online 13 February 2018Source: Otolaryngology Case ReportsAuthor(s): Stephanie Warrington, Celeste C. Gary, Erin Thibault, Laura T. Hetzler ObjectiveTo 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.MethodCase Report and Literature Review.Case reportWe 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 reviewOver 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.ConclusionMethotrexate-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.
       
  • Rare case of pan-neck space infection from a peritonsillar abscess

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