http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Thu, 23 May 2013 18:49:56 +0000 http://www.hindawi.com/crim/otolaryngology/2013/851270/ Introduction. In case of thrombopenia and/or thrombopathy, epistaxes are very difficult to manage. Case Series. Two patients, one with a thrombocytopenia, the other with a thrombopathy, were hospitalized because of repeated active epistaxes after failure of packing. Both patients were successfully treated with an application of Surgiflo without side effects and left the hospital without recurrence of epistaxis. Discussion. Being a subject of many studies dealing with epistaxis, Surgiflo is a simple treatment that seems to be very effective and without side effects to treat acute epistaxis in fragile patients with coagulation disorders. Prospective studies of tolerance and efficiency in such situations should be performed. G. Buiret, M. Pavic, J. C. Pignat, and F. Pasquet Copyright © 2013 G. Buiret et al. All rights reserved. Thu, 23 May 2013 18:49:14 +0000 http://www.hindawi.com/crim/otolaryngology/2013/541679/ Tumors originating from ceruminous glands are rare lesions of the external auditory canal. The lack of specific clinical and radiological signs makes their diagnosis challenging. We report the case of an exceptionally rare benign tumor, a syringocystadenoma papilliferum (SCAP), in an atypical location in the bony segment of the external auditory canal with uncommon clinical signs. The special traits of the case included the following: the most lateral component of the tumor was macroscopically cystic and a granular myringitis with an obstructing keratin mass plug was observed behind the mass. The clinical, audiological, radiological, and histological characteristics of the neoplasm are consequently presented. Intraoperative diagnosis of the epidermal cyst was proposed. The final diagnosis of SCAP was determined only by histological analysis after the surgical excision. The educational aspects of the case are critically discussed. Anastasija Arechvo, Svajunas Balseris, Laura Neverauskiene, and Irina Arechvo Copyright © 2013 Anastasija Arechvo et al. All rights reserved. Thu, 23 May 2013 18:34:12 +0000 http://www.hindawi.com/crim/otolaryngology/2013/259726/ Objective. To present a case of otic Langerhans' cell histiocytosis in an adult. Also included the diagnosis and management of the condition and a review of the relevant literature. Case Report. We report a case of a 41-year-old man with a history of persistent unilateral ear discharge associated with an aural polyp. Radiological imaging showed bony lesions of the skull and a soft-tissue mass within the middle ear. Histological analysis of the polyp demonstrated Langerhans' cell histiocytosis. His otological symptoms were completely resolved with the systemic therapy. Conclusions. Otic Langerhans' cell histiocytosis can present in adults. Persistent ear symptoms along with evidence of soft-tissue masses within the ear and bony lesions of the skull or elsewhere should prompt the otolaryngologists to include Langerhans' cell histiocytosis in their differential diagnosis. Management should be with systemic therapy rather than local surgical treatment. Anil Gungadeen, Peter Kullar, and Philip Yates Copyright © 2013 Anil Gungadeen et al. All rights reserved. Wed, 22 May 2013 15:57:36 +0000 http://www.hindawi.com/crim/otolaryngology/2013/937840/ This case report highlights an unusual case of sudden sensorineural hearing loss related to superficial siderosis (SS). Our patient had a craniotomy for medulloblastoma 23 years earlier, and this may represent a delayed complication related to this procedure. Magnetic resonance imaging (MRI) remains the key diagnostic investigation to illustrate the imaging features of superficial siderosis and exclude other pathologies. Increased awareness of progressive and sudden hearing complications caused by SS is important in the otolaryngologic community to expedite management and better counsel patients during the consent process. Kirsti S. V. Lee, Niranjan Sritharan, and Allan Forrest Copyright © 2013 Kirsti S. V. Lee et al. All rights reserved. Mon, 20 May 2013 15:47:22 +0000 http://www.hindawi.com/crim/otolaryngology/2013/967536/ We report the case of a 51-year-old male smoker with diabetes mellitus and hyperlipidaemia and a long history of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) infection treated with various antiretroviral regimes, who was referred to the otolaryngology department with progressive dysphonia. Fibre-optic laryngoscopy showed a solitary, yellowish-white pedunculated polyp on the anterior third of the left cord, with no other abnormality. Pathological analysis revealed a polypoid laryngeal xanthoma that was immunoreactive against CD68, perilipin, and adipophilin. This unusual laryngeal lesion in the clinical context of our patient suggests a possible role of antiretroviral treatment in the pathogenesis of these xanthomas. Francisco Vera-Sempere, Diego Collado-Martín, and Beatriz Vera-Sirera Copyright © 2013 Francisco Vera-Sempere et al. All rights reserved. Wed, 15 May 2013 14:41:56 +0000 http://www.hindawi.com/crim/otolaryngology/2013/940187/ Carbon monoxide poisoning is one of the rare causes of hearing loss which may cause reversible or irreversible, unilateral or bilateral hearing loss after acute or chronic exposure. In this report, we present a case of bilateral sensorineural hearing loss in a secondary smelting workshop worker after an acute exposure to carbon monoxide. This complication was diagnosed by pure-tone audiometry and confirmed by transient evoked otoacoustic emissions. Hearing loss has not improved after 3 months of followup. Amir Houshang Mehrparvar, Mohammad Hossein Davari, Abolfazl Mollasadeghi, Mohammad Reza Vahidi, Mehrdad Mostaghaci, Maryam Bahaloo, and Pedram Shokouh Copyright © 2013 Amir Houshang Mehrparvar et al. All rights reserved. Mon, 13 May 2013 18:52:19 +0000 http://www.hindawi.com/crim/otolaryngology/2013/827902/ Severe laryngeal trauma is rare in the civilian environment and requires appropriate and timely surgical intervention. We report a case from Sydney, Australia, which was managed with open reduction and internal fixation of the larynx with resorbable plates. The use of resorbable plates for operative fixation of the larynx has rarely been reported in literature but may be a viable alternative. Sang Hwang, Samuel McGinness, Sim Choroomi, and Ian Jacobson Copyright © 2013 Sang Hwang et al. All rights reserved. Thu, 02 May 2013 12:25:45 +0000 http://www.hindawi.com/crim/otolaryngology/2013/796713/ Objectives. Hemangiopericytoma is a rare tumor entity deriving from pericytes. Less than 5% of hemangiopericytoma occur in the nasal cavity and are characterised by a rather benign nature with low tendency of metastasis. However, as the recurrence rate in the literature ranges from 9.5% to 50%—depending on the length of followup—a radical surgical resection is considered as the gold-standard treatment. Only a few years ago, a wide external approach, usually via lateral rhinotomy or Caldwell-Luc, was performed. Endoscopic techniques were regarded as appropriate for small low-vascularised tumors only. Methods. We present the case of a 64-year-old patient with an extended sinonasal hemangiopericytoma, who was successfully treated by an endoscopic controlled endonasal tumor resection after embolisation with Onyx. Further, to support the new treatment option, we review the literature concerning all features of sinonasal hemangiopericytomas and their therapeutical management. Results/Conclusion. Onyx, which has not been described in the context of hemangiopericytoma yet, is a very effective embolic agent for a preoperative embolisation of sinonasal hemangiopericytoma allowing a safe endoscopic surgery. Georg J. Ledderose, Donata Gellrich, Markus Holtmannspötter, and Andreas Leunig Copyright © 2013 Georg J. Ledderose et al. All rights reserved. Tue, 30 Apr 2013 15:28:53 +0000 http://www.hindawi.com/crim/otolaryngology/2013/712873/ Salivary gland tumors are rare. The majority of these tumors are benign and about 70% are pleomorphic adenomas (PA). Nasopharynx is an unusual site for the PA tumor. Only six cases are presented in the literature from 1990 to 2011. The diagnosis of this disease is linked to the sum of imaging tests, clinical and histological study of the mass of the above. The radiologic features of noninvasion of surrounding structures give the first clue to the benign lesion. From the review of the literature and our experience is identified as the gold standard in surgical treatment for this condition. Thanks to the endoscopic surgery, we can perform a complete resection of the lesion without damaging adjacent structures. We presented a case of pleomorphic adenoma of nasopharynx with literature review. S. Berrettini, S. Fortunato, A. De Vito, and L. Bruschini Copyright © 2013 S. Berrettini et al. All rights reserved. Tue, 30 Apr 2013 13:34:05 +0000 http://www.hindawi.com/crim/otolaryngology/2013/712365/ Schwannomas are indolent benign lesions arising from schwann cells in the nerve. They are especially rare in the paediatric population. We report an interesting case of a swelling in the upper neck, which highlights an atypical presentation of this tumour, as well as the complex details of its clinical, radiological, and surgical management. E. Keane, E. C. Francis, and Sri Paran Thambipillai Copyright © 2013 E. Keane et al. All rights reserved. Sun, 21 Apr 2013 15:37:45 +0000 http://www.hindawi.com/crim/otolaryngology/2013/913157/ Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm that mainly arises from the lymphoid tissues of the immune system. Although this neoplasm typically occurs anywhere along the lymph nodes, it can also be found at extranodal sites, especially in the head and neck. We experienced a rare case of extranodal IDCS in the nasal cavity, a location that has not been previously reported. A 73-year-old woman presented with a polyp-like mass in the nasal cavity and underwent endoscopic sinus surgery. A histologic study confirmed the mass as IDCS by immunohistochemistry with S-100 antibody, and postoperative adjuvant radiotherapy was administered. Although the incidence is extremely rare, this case suggests that extranodal IDCS should be considered in the differential diagnosis of nasal cavity masses. Eun Jung Lee, Dong Woo Hyun, Hyung-Ju Cho, and Jeung-Gweon Lee Copyright © 2013 Eun Jung Lee et al. All rights reserved. Thu, 11 Apr 2013 09:12:09 +0000 http://www.hindawi.com/crim/otolaryngology/2013/934386/ Symptomatic palatal tremor is potentially the result of a lesion in the triangle of Guillain-Mollaret (1931) and is associated with hypertrophic olivary degeneration (HOD) which has characteristic MR findings. The triangle is defined by dentate efferents ascending through the superior cerebellar peduncle and crossing in the decussation of the brachium conjunctivum inferior to the red nucleus, to finaliy reach the inferior olivary nucleus (ION) via the central tegmental tract. The triangle is completed by ION decussating efferents terminating on the original dentate nucleus via the inferior cerebellar peduncle. We can demonstrate the anatomy of this anatomical triangle using a clinical case of palatal tremor presenting with bilateral subjective pulsatile tinnitus along with the pathognomonic MR findings previously described. The hyperintense T2 signal in these patients may be permanent, but the hypertrophied olive normally regresses after 4 years. The temporal relationship between the evolution of the histopathology and the development of the palatal tremor remains unknown as does the natural history of the tremor. Botox injection at the level of tensor and levator veli palatini insertion have been used to treat patients with disabling tremor synchronous tinnitus. A lesion involving the triangle can have a quite varied clinical expression. Fadil Khoyratty and Thomas Wilson Copyright © 2013 Fadil Khoyratty and Thomas Wilson. All rights reserved. Thu, 04 Apr 2013 11:32:04 +0000 http://www.hindawi.com/crim/otolaryngology/2013/935435/ Cellular neurothekeoma is known as a cutaneous tumor with uncertain histogenesis. Very little involvement of mucosal membrane has been reported in the literature so far. This is a case report of an intraoral lesion in a 15-years-old girl. Histopathologic evaluation showed a tumor-consists of spindle to epitheloid cells forming micronodules in a concentric whorled shape pattern. Tumor cells were positive for CD63, vimentin, and NKI-C3. Total excision was performed and no recurrence happened after 16-month followup. Nader Emami, Faisal Zawawi, Rania Ywakim, Ayoub Nahal, and Sam J. Daniel Copyright © 2013 Nader Emami et al. All rights reserved. Thu, 04 Apr 2013 10:56:16 +0000 http://www.hindawi.com/crim/otolaryngology/2013/385405/ Introduction. The nonsquamous carcinomas of the larynx are considered rare with the majority of malignant tumors in this area, reaching the rate of 95%, to be squamous cell neoplasms. Case Report. The case refers to a 53-year-old man that presented with symptomatology of motor nerve disease. During the evaluation of the neurologic disease, a subglottic mass of the larynx was revealed accidentally in the imaging examination. Under general anesthesia, we performed direct laryngoscopy and biopsy of the mass. The histopathologic examination revealed a hybrid carcinoma coexistence of two different carcinomas, an adenoid cystic carcinoma and an adenocarcinoma, not otherwise specified with poor differentiation. Regarding the therapeutic plan, the mass was considered inoperable due to its expansion to trachea and the patient received radiotherapy. Conclusions. Both the adenocarcinoma and adenoid cystic carcinoma are extremely rare types of malignant tumors in the larynx. The special interest of the present case is the coexistence of these two rare tumors in the same region of the larynx, being a hybrid tumor of the salivary glands in the larynx, which is the second reported case, based on our systematic literature review. Ilias Karasmanis, John K. Goudakos, Iosif Vital, Thomas Zarampoukas, Victor Vital, and Konstantinos Markou Copyright © 2013 Ilias Karasmanis et al. All rights reserved. Wed, 03 Apr 2013 08:57:26 +0000 http://www.hindawi.com/crim/otolaryngology/2013/921365/ Tracheotomy is often successfully used to manage tracheal stenosis, as a temporizing measure prior to definitive treatment or a long-term remedy. In some patients, where a sizeable portion trachea is stenotic, the fixed arm of an ordinary tracheotomy tube may not be of sufficient length to satisfactorily maintain the distal tracheal lumen, and commercially available adjustable tubes may not be at hand in certain clinical settings. Herein, we describe a simple method of constructing a temporary tracheotomy tube with an adjustable distal arm, allowing custom fit at the patient bedside. Doh Young Lee, Jungirl Seok, Wonjae Cha, Won Yong Lee, J. Hun. Hah, Tack-Kyun Kwon, Kwang Hyun Kim, and Myung-Whun Sung Copyright © 2013 Doh Young Lee et al. All rights reserved. Tue, 02 Apr 2013 11:42:54 +0000 http://www.hindawi.com/crim/otolaryngology/2013/743021/ Aberrant internal carotid artery (ICA) is a rare but a very important vascular anomaly of temporal bone. Misdiagnosis of the anomaly may lead to massive hemorrhage and severe complications during otologic procedures. It is essential to keep this anomaly in mind for any otologic surgeon to prevent catastrophic complications. We present a case of aberrant ICA appeared as a nonpulsatile middle ear mass. The patient had a complaint of hearing loss, and the otoscopic examination of the patient revealed a tympanic membrane perforation and a blue-reddish retrotympanic mass. Multidetector computed tomography (MDCT) is a useful tool that may provide excellent visualization of temporal bone for the diagnosis of aberrant ICA. Otolaryngologists should be aware of the possibility of a vascular anomaly of temporal bone when a patient presents with a blue-reddish mass in the middle ear. Togay Muderris, Sami Bercin, Ergun Sevil, Huseyin Cetin, and Muzaffer Kiris Copyright © 2013 Togay Muderris et al. All rights reserved. Sun, 31 Mar 2013 11:27:53 +0000 http://www.hindawi.com/crim/otolaryngology/2013/938787/ A patient is described with a right-sided tortuous siphon-like extracranial internal carotid artery leading to highly distressing ipsilateral heart beat synchronous pulsatile tinnitus, scoring 9/10 measuring loudness. Dilating the balloon during the occlusion test in or distal to the siphon-like anomaly reduces the arterial pulsations. Subsequently, surgery is performed using Teflon as an external construct to straighten the siphon-like anomaly. Postoperatively, the pulsations improve to 5/10 in a standing position and disappear during a reclined position. By adding a hearing aid, the pulsations are almost completely gone during a standing position (1/10) and remain absent in a reclined position. Dirk De Ridder, Sven Vanneste, and Tomas Menovsky Copyright © 2013 Dirk De Ridder et al. All rights reserved. Wed, 27 Mar 2013 10:21:27 +0000 http://www.hindawi.com/crim/otolaryngology/2013/787824/ Inflammatory myofibroblastic tumor is composed of myofibroblast and inflammatory cell infiltration of the tissue. Malign transformation and recurrence rate of this tumor is rare and accepted as benign fibroinflammatory disease. The main etiology is unclear, but infection, trauma, and immunologic event are accused. In this study, we presented a 75-year-old man with a mass on his tongue, which was diagnosed as “inflammatory myofibroblastic tumor.” This type of tumor is rarely seen in the tongue and might be difficult to diagnose. Complete mass excision was provided for an adaquete treatment. Nur Yucel Ekici, Tuba Bayindir, Ahmet Kizilay, and Nasuhi Engin Aydin Copyright © 2013 Nur Yucel Ekici et al. All rights reserved. Wed, 27 Mar 2013 08:52:31 +0000 http://www.hindawi.com/crim/otolaryngology/2013/690194/ Giant cell reparative granuloma (GCRG) is an uncommon and nonneoplastic reactive tumor that involves the maxilla and mandible in the region of the head and neck. It is rare in the nasal cavity, and it might be misdiagnosed. We reported a very aggressive GCRG with intracranial invasion, which was treated surgically via a combined approach of a lateral rhinotomy with a craniotomy by bilateral coronal incision. The pathology was consistent with GCRG. A short literature review about diagnosis, clinical behavior, and treatment of this tumor entity is given. Hajime Ishinaga, Kazuya Otsu, Genshin Mouri, and Kazuhiko Takeuchi Copyright © 2013 Hajime Ishinaga et al. All rights reserved. Sun, 24 Mar 2013 18:58:53 +0000 http://www.hindawi.com/crim/otolaryngology/2013/267285/ Background. Eosinophilic angiocentric fibrosis (EAF) is a rare benign condition of unknown aetiology that causes stenosis of the upper respiratory tract. It is most commonly found at the nasal septum and sinus mucosa causing mucosal thickening and nasal obstructive symptoms. The diagnosis is mainly based on characteristic histologic findings. Case Report. A 27-year-old young woman presented with a slow growing mass at her anterior nasal septum for over eight years. She complained of persistent nasal obstruction, epistaxis, sometimes diffused facial pain, and chronic headache. 3 years ago, the tumor was partially resected for ventilation and a nasal septum perforation was left. Imaging findings indicated soft-tissue thickening of the anterior part of septum and adjacent lateral nasal walls. Pathological examination showed numerous inflammatory cells infiltrates containing eosinophils, fibroinflammatory lesion with a whorled appearance fibrosis which typically surrounded vessels. A diagnosis of eosinophilic angiocentric fibrosis was made. All laboratory tests were unremarkable. Skin prick test was positive. The tumor-like lesion was totally resected. Conclusions. EAF is a rare benign and progressive disorder causing destruction. Combined with radiological imaging of EAF historical findings contribute to the diagnosis. It is important to prevent tumor from recurrence by total resection of the lesion. Yunchuan Li, Honggang Liu, Demin Han, Hongrui Zang, Tong Wang, and Bin Hu Copyright © 2013 Yunchuan Li et al. All rights reserved. Sun, 24 Mar 2013 11:48:42 +0000 http://www.hindawi.com/crim/otolaryngology/2013/987504/ The presence of an esophageal foreign body (EFB) is a medical emergency requiring urgent evaluation and treatment. Swallowing of foreign bodies is most common in children aged between 6 months and 6 years, in whom it usually occurs during games. In adults, foreign bodies tend to be ingested accidentally together with food. The authors report an unusual case of EFB (a table fork) in an adult and briefly report the clinical presentation and the therapeutic procedures adopted in this case and similar cases. Emilio Mevio and Niccolò Mevio Copyright © 2013 Emilio Mevio and Niccolò Mevio. All rights reserved. Thu, 21 Mar 2013 15:08:55 +0000 http://www.hindawi.com/crim/otolaryngology/2013/284275/ Leiomyosarcoma arising in the head and neck region is a rare entity. Auricular involvement by the disease is further rarer with few cases reported in the literature. Usually auricular leiomyosarcoma is a disease of middle-old age. We report a case of leiomyosarcoma of the postauricular region in a young adolescent female. Surgery along with adjuvant radiotherapy was used for complete cure. Patient is disease-free for the last eight years and is on regular yearly followup. The aim of reporting this case is to add to the scarce existing literature regarding auricular leiomyosarcoma and its long-term outcome. Also, this is the first case report in young adolescent and second only of the post auricular region. Dillip Samal, Rajeev Kumar, Saumyaranjan Mallick, and Alok Thakar Copyright © 2013 Dillip Samal et al. All rights reserved. Thu, 21 Mar 2013 10:27:01 +0000 http://www.hindawi.com/crim/otolaryngology/2013/361986/ Laryngeal carcinoma and laryngeal papilloma are the most commonly encountered tumorous lesions in the larynx. Herein, we report a case of the mass arising from the left vocal cord in a 49-year-old Japanese man. Endoscopic examination suggested that the mass is a tumor such as carcinoma and papilloma. Pathological examination showed that the specimen demonstrated actinomycosis in the left vocal cord. Although vocal cord actinomycosis is extremely rare, the otolaryngologist should recognize this condition during the inspection of the larynx. Keisuke Yoshihama, Yasumasa Kato, and Yuh Baba Copyright © 2013 Keisuke Yoshihama et al. All rights reserved. Tue, 19 Mar 2013 11:14:00 +0000 http://www.hindawi.com/crim/otolaryngology/2013/103646/ Inflammatory myofibroblastic tumors (IMTs) are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT) was indicated at a low dose; 20 Gy in 10 fractions of 2 Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well. Jean-Philippe Maire, Sandrine Eimer, François San Galli, Valérie Franco-Vidal, Sigolène Galland-Girodet, Aymeri Huchet, and Vincent Darrouzet Copyright © 2013 Jean-Philippe Maire et al. All rights reserved. Tue, 12 Mar 2013 10:23:16 +0000 http://www.hindawi.com/crim/otolaryngology/2013/549564/ Skeletal tuberculosis is a well-known disease entity. We report the first case involving hyoid bone and the use of polymerase chain reaction-based test in detection and management. A 62-year-old male presented with neck swelling of a 20-day duration along with change of voice and dysphagia. Examination revealed a cystic, osteolytic lesion of the hyoid bone which histopathologically demonstrated features of granulomatous infection. A polymerase chain reaction test confirmed the diagnosis of tuberculosis. Paul Emerson, Ajay Philip, George M. Varghese, and Regi Thomas Copyright © 2013 Paul Emerson et al. All rights reserved. Mon, 04 Mar 2013 12:22:30 +0000 http://www.hindawi.com/crim/otolaryngology/2013/323210/ Actinomycosis is a chronic, suppurative, and granulomatous process caused by Actinomycetes, saprophytic bacteria normally residing in the oral cavity. It can involve any organ, but the cervicofacial disease is the most frequent. Pharyngolayngeal involvement is rare and usually occurs secondary to the oral or cervical disease. There are few cases of primary pharyngolaringeal actinomycosis described in the literature. A rare case of pharyngeal actinomycosis mimicking an ulcerative malignancy in a 63-year-old man is reported. The patient was treated successfully with long-term antibiotic therapy. The clinical and pathological features and the aspects of diagnosis and treatment of cervicofacial actinomycosis are discussed. Luca Volpi, Fabio Ferreli, Maurizio Bignami, Andrea Pistochini, Francesco Meloni, Apostolos Karligkiotis, and Paolo Castelnuovo Copyright © 2013 Luca Volpi et al. All rights reserved. Sun, 03 Mar 2013 19:19:37 +0000 http://www.hindawi.com/crim/otolaryngology/2013/251629/ A 32-year-old lady presented to our ENT service with worsening tonsillitis. This was one of multiple attacks; all of which had all followed periods of self-induced vomiting due to the patient suffering with bulimia nervosa. Here we present the first ever case report of such a case of tonsillitis and a review of the literature of otolaryngology manifestations and complications of bulimia nervosa. Miles Bannister Copyright © 2013 Miles Bannister. All rights reserved. Thu, 28 Feb 2013 10:19:14 +0000 http://www.hindawi.com/crim/otolaryngology/2013/735147/ Headache is a common symptom, with a lifetime prevalence of over 90% of the general population in the United Kingdom (UK). It accounts for 4.4% of consultations in primary care and 30% of neurology outpatient consultations. Neuroimaging is indicated in patients with red flag features for secondary headaches. The guidelines recommend CT or MRI scan to identify any intracranial pathology. We present a unique case where the initial noncontrast CT scan failed to identify a potential treatable cause for headache. A middle aged man presented with headache and underwent a CT scan without contrast enhancement. The scan was reported as normal. The headache persisted for years and the patient underwent a staging CT scan to investigate an oropharyngeal cancer. This repeat CT scan utilized contrast enhancement and revealed a meningioma. Along with other symptoms, headache is an established presenting complaint in patients with meningioma. The contrast enhanced CT brain proved superior to a nonenhanced CT scan in identifying the meningioma. In a patient with persistent headache where other causes are excluded and a scan is to be requested, perhaps contrast enhanced CT is a better option than a plain CT scan of brain. V. Vallamkondu, M. Shakeel, A. Hussain, and D. McAteer Copyright © 2013 V. Vallamkondu et al. All rights reserved. Wed, 27 Feb 2013 16:27:56 +0000 http://www.hindawi.com/crim/otolaryngology/2013/579527/ Papillary thyroid carcinomas (PTCs) usually extend to lymph nodes in the neck and mediastinum. Rarely, they invade the neighboring upper airway anatomical structures. We report a 56-year-old woman who presented with symptoms of upper airway obstruction. Imaging studies revealed a lesion derived from the thyroid which invaded and obstructed the trachea, which appeared to be a highly differentiated PTC. Total thyroidectomy was performed, with removal of the endotracheal part of the mass along with the corresponding anterior tracheal rings. Two months later, a whole body I131 scan after recombinant human thyroid-stimulating hormone (rh-TSH) administration was performed and revealed a residual mass in upper left thyroid lobe. Subsequently, 150 mCi I131 were given following rh-TSH administration. Nine months later, there was no sign of residual tumor. This case is the first one reported in the literature regarding rh-TSH administration prior to RAI ablation in a PTC obstructing the trachea. Nickolaos Pontikides, Spyridon Karras, Antonios Papagiannis, Athina Kaprara, Panagiotis Anagnostis, George Noussios, Argyrios Doumas, Apostolos Goropoulos, Ioannis Iakovou, Georgios Kotronis, Konstantinos Bantis, and Gerasimos Krassas Copyright © 2013 Nickolaos Pontikides et al. All rights reserved. Tue, 26 Feb 2013 11:37:53 +0000 http://www.hindawi.com/crim/otolaryngology/2013/363049/ Schwannomas are usually single, encapsulated, and benign tumors of the nerve sheath that arise from the perineural Schwann cells. Schwannomas are mostly seen in the fourth decade. Despite its location in the head and neck region is 25–45%, lip location of schwannoma are very rare. We present a case of a upper lip schwannoma in the pediatric age and review the literature. Tuba Bayindir, M. Tayyar Kalcioglu, Mehmet T. Cicek, Nese Karadag, and Abdurrahman Karaman Copyright © 2013 Tuba Bayindir et al. All rights reserved.