Case Reports in Otolaryngology The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Chronologic Presentation of a Severe Case of Progressive Hemifacial Atrophy (Parry-Romberg Syndrome) with the Loss of an Eye Tue, 18 Nov 2014 08:23:18 +0000 Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is a slowly advancing degenerative disease that mostly affects the cutaneous, subcutaneous fatty tissue, muscle tissue, and bone structures on one side of the face. We describe the chronological progression of this very rare syndrome from early childhood until adulthood in a patient who developed severe atrophy and lost one eye. We also discuss the aetiology and pathophysiology of this syndrome. Mesut Kaya, Ceyda Sel Yilmaz, Hanifi Kurtaran, and Mehmet Gunduz Copyright © 2014 Mesut Kaya et al. All rights reserved. Myocardial Infarction as a Rare Cause of Otalgia Thu, 13 Nov 2014 09:56:20 +0000 Aim. To present a case referred to our clinic with severe right ear pain but without any abnormal finding during otological examination and diagnosed as myocardial infarction and also to draw attention to otalgia which can occur secondary to myocardial infarction. Case Report. An 87-year-old female admitted with right ear pain lasting for nearly 12 hours and sweating on the head and neck region. On otolaryngologic examination, any pathological finding was not encountered. Her electrocardiogram revealed findings consistent with myocardial infarction. Her troponin values were 0.175 ng/L at 1 hour, and 0.574 ng/L at 3 hours. The patient was diagnosed as non-ST MI, and her required initial therapies were performed. On cardiac angiography, very severe coronary artery stenosis was detected, and surgical treatment was recommended for the patient. The patient who rejected surgical treatment was discharged with prescription of medical treatment. Conclusion. Especially in elderly patients with complaints of ear pain but without any abnormal finding on otoscopic examination, cardiac pathologies should be conceived. Riza Dundar, Erkan Kulduk, Fatih Kemal Soy, Ersin Sengul, and Faruk Ertas Copyright © 2014 Riza Dundar et al. All rights reserved. Osteoma of the Medial Wall of the Maxillary Sinus: A Primary Cause of Nasolacrimal Duct Obstruction and Review of the Literature Tue, 11 Nov 2014 08:22:12 +0000 A 74-year-old male patient presented to the outpatient department with left-sided epiphora and chronic dacryocystitis, without any history of head trauma or previous nasal or paranasal sinuses surgery. No abnormalities were noted at the time with the use of nasal endoscopy. The computed tomography scan however revealed an osteoma of the medial wall of the left maxillary sinus. An endonasal endoscopic dacryocystorhinostomy (DCR) with osteoma removal by using a drill with temporary silicone stenting of the nasolacrimal duct system was performed. Due to a granuloma formation at the DCR-window site 2 months postoperatively a revision-DCR was performed and the new window remained patent at control 6 months after surgery. Athanasios Saratziotis and Enzo Emanuelli Copyright © 2014 Athanasios Saratziotis and Enzo Emanuelli. All rights reserved. Rising Methicillin-Resistant Staphylococcus aureus Infections in Ear, Nose, and Throat Diseases Thu, 06 Nov 2014 09:12:30 +0000 The increasing incidence of methicillin-resistant Staphylococcus aureus infections (MRSA) in ENT diseases is becoming a big clinical concern. Here two patients are described who developed MRSA infections presented with unusual post-FESS epistaxis and postmastoidectomy perichondrial abscess and failed treatment with broad spectrum intravenous antibiotics. Following treatment with oral linezolid combined with local mupirocin dressing both patients fully recovered. Sangeetha Thirumazhisi Sachithanandam Copyright © 2014 Sangeetha Thirumazhisi Sachithanandam. All rights reserved. Oncocytoma of Oral Cavity Mimicking as Jaw Tumor Sun, 02 Nov 2014 11:36:28 +0000 Oncocytoma of major salivary gland is a fairly common benign tumour encountered, but its occurrence in oral minor salivary gland is a rare entity. Here we report a case of a giant minor salivary gland oncocytoma mimicking a jaw tumour which was successfully excised along with a review of literature. Aloke Bose Majumdar, Shib Shankar Paul, Gautam Sarker, and Souradeep Ray Copyright © 2014 Aloke Bose Majumdar et al. All rights reserved. Vallecular Cyst in Neonates: Case Series—A Clinicosurgical Insight Tue, 28 Oct 2014 06:17:55 +0000 The objective of the case series is to understand the clinical and surgical aspects of new minimally invasive technique of coblation in cases of vallecular cysts in neonates. Method of Study. Four neonates underwent surgery for vallecular cyst by using Arthrocare ENT coblator system. Results Obtained. All the four cases presented in stridor and difficult intubation was also a concern which necessitated a swift, high precision instrument with almost immediate results. Coblation excision includes direct contact with vallecular cyst, improved targeting of the cyst, and preservation of normal tissue. All the four cases had an uneventful postoperative period and smooth recovery and had an early discharge from the hospital. Conclusions. Early diagnosis and intervention hold the key for an early recovery and for minimizing nutritional disturbances secondary to poor feeding in cases of neonatal vallecular cysts. Shweta Gogia, Sangeet Kumar Agarwal, and Alok Agarwal Copyright © 2014 Shweta Gogia et al. All rights reserved. A Case of Pyriform Sinus Fistula Infection with Double Tracts Mon, 27 Oct 2014 12:47:47 +0000 Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid. Masato Shino, Yoshihito Yasuoka, Kyoko Nakajima, and Kazuaki Chikamatsu Copyright © 2014 Masato Shino et al. All rights reserved. A Method of Transoral Finger Dissection for a Giant Epiglottic Lipoma Mon, 27 Oct 2014 00:00:00 +0000 Background. Subcutaneous lipomas that occur in the trunk and proximal extremities are commonly dissected by low-invasive method. However, a standard surgical method for lipomas of the epiglottis has been absent. Microscopic laryngeal surgery is appropriate to extirpate small epiglottic lipomas. However, microscopic laryngeal surgery may be insufficient for giant epiglottic lipomas because there is restricted visualization of the operating field of the tumor under the microscope. Furthermore, microscopic surgical instruments are very small to manipulate giant lipomas, and it would be excessive to approach these lipomas via external cervical incisions. Case Presentation. A 57-year-old female presented with a giant lipoma on the lingual surface of the epiglottis. Following a tracheotomy, microscopic surgery was inadequate to manipulate the epiglottic lipoma. Instead, we performed macroscopic surgery in which the epiglottic lipoma was pulled into the oral cavity with forceps and then separated from the surrounding tissues using the surgeon’s finger to dissect the tumor en bloc. Conclusion. The low-invasive method of transoral finger dissection enabled the giant lipoma to be extirpated without leaving any remnants or causing excessive epiglottic damage. Toshizo Koizumi, Katsunari Yane, Toshiaki Yamanaka, and Tadashi Kitahara Copyright © 2014 Toshizo Koizumi et al. All rights reserved. Cutaneous Carcinosarcoma with Metastasis to the Parotid Gland Thu, 25 Sep 2014 07:59:25 +0000 Cutaneous carcinosarcoma is a rare malignancy that exhibits both mesenchymal and epithelial components. It is similar to nonmelanoma skin cancers in terms of risk and prognostic factors. However, these malignancies are known to have a propensity for local recurrence and metastasis, even with adequate resection margins. Here we report a case of metastatic cutaneous carcinosarcoma to the parotid gland and review the relevant literature. Tze Ling Loh, Jeanne Tomlinson, Ronald Chin, and Guy D. Eslick Copyright © 2014 Tze Ling Loh et al. All rights reserved. Adult Dermatomyositis with Bleeding Ulcer in the Pharynx Mon, 22 Sep 2014 09:07:55 +0000 Dermatomyositis (DM) is one of the idiopathic inflammatory myopathies caused by complement-mediated vasculopathy or vasculitis in the muscle. Although the gastrointestinal (GI) mucosa has been reported to be involved as a result of vasculitis or vasculopathy, ulceration in the pharynx is a rare manifestation of DM. A 54-year-old woman complaining of muscle weakness in the extremities, low-grade fever, and dysphagia was diagnosed as having DM. Despite medical treatment with corticosteroids and immunosuppressive agents, her DM progressed rapidly, leading to exacerbation of the dysphagia. About 3 weeks after undergoing tracheostomy as a preventive measure against aspiration, the patient developed intractable respiratory tract hemorrhage. Repeated laryngoendoscopy revealed a bleeding ulceration in the pharynx that required hemostasis with electric cautery under general anesthesia. No bleeding recurred thereafter. Histopathologically, the pharynx exhibited nonspecific inflammatory cell infiltration in the muscle tissue. This rare manifestation may be considered in cases of DM with unexplainable airway bleeding. Junko Kusano, Yuka Takahashi, Yoshikata Misaki, and Norihiko Murai Copyright © 2014 Junko Kusano et al. All rights reserved. Repair of Temporal Bone Encephalocele following Canal Wall Down Mastoidectomy Mon, 22 Sep 2014 00:00:00 +0000 We report a rare case of a temporal bone encephalocele after a canal wall down mastoidectomy performed to treat chronic otitis media with cholesteatoma. The patient was treated successfully via an intracranial approach. An enhanced layer-by-layer repair of the encephalocele and skull base deficit was achieved from intradurally to extradurally, using temporalis fascia, nasal septum cartilage, and artificial dural graft. After a 22-month follow-up period the patient remains symptom free and no recurrence is noted. Sarantis Blioskas, Ioannis Magras, Stavros Polyzoidis, Konstantinos Kouskouras, Georgios Psillas, Stamatia Dova, and Konstantinos Markou Copyright © 2014 Sarantis Blioskas et al. All rights reserved. Periorbital Necrotising Fasciitis after Minor Skin Trauma Sun, 21 Sep 2014 07:05:34 +0000 Necrotizing fasciitis (NF) is a fatal and rare disease, mainly located in extremity and body. Due to the good blood supply, the occurrence of this infective disease of skin and subcutaneous tissue/fascia is much rarer in the head and neck region. In this study, we represent periorbital necrotizing fasciitis case in a patient with normal immune system. The patient applied the emergency clinic with the complaints of swelling and redness on the left eye. It was found out that a skin incision occurred at 2 cm below the left eye with razor blade 2 days ago. After taking swab culture sample, patient was started on parenteral Vancomycin + Ampicillin-Sulbactam treatment. It was observed that necrosis spread within hours and an emergent deep surgical debridement was performed. Following the debridement, it was observed that periorbital edema began to regress prominently on the 1st day of the treatment. Treatment was carried on with daily wound care and parenteral antibiotherapy. The patient was discharged from the hospital with slightly cosmetic defect. Ceren Günel, Aylin Eryılmaz, Yeşim Başal, and Ali Toka Copyright © 2014 Ceren Günel et al. All rights reserved. Temporal Bone Fracture Causing Superior Semicircular Canal Dehiscence Wed, 10 Sep 2014 13:11:10 +0000 Importance. Superior semicircular canal dehiscence (SCD) is a third window lesion of the inner ear causing symptoms of vertigo, autophony, tinnitus, and hearing loss. A “two-hit” hypothesis has traditionally been proposed, whereby thinly developed bone overlying the superior canal is disrupted by a sudden change in intracranial pressure. Although the symptoms of SCD may be precipitated by head injury, no previous reports have described a temporal bone fracture directly causing SCD. Observations. Two patients sustained temporal bone fractures after closed head trauma, and developed unilateral otologic symptoms consistent with SCD. In each instance, computed tomography imaging revealed fractures extending through the bony roof of the superior semicircular canal. Conclusions and Relevance. Temporal bone fractures, which are largely treated nonoperatively, have not previously been reported to cause SCD. As it is a potentially treatable entity, SCD resulting from temporal bone fracture must be recognized as a possibility and diagnosed promptly if present. Kevin A. Peng, Sameer Ahmed, Isaac Yang, and Quinton Gopen Copyright © 2014 Kevin A. Peng et al. All rights reserved. Unusual Postrhinoplasty Complication: Nasal Dorsum Cyst Tue, 09 Sep 2014 00:00:00 +0000 Among all the possible complications of aesthetic rhinoplasty, a rare one is the development of cystic masses on the nasal dorsum: several theories suggest that cysts develop commonly by entrapment of nasal mucosa in the subcutaneous space, but they can also originate from foreign body reactions. This report deals with two cases of nasal dorsum cysts with different pathogenesis: both patients had undergone aesthetic rhinoplasty in the past (26 years ago and 14 years ago, resp.). Both cystic masses were removed via a direct open approach and nasal reconstruction was performed successfully with autologous vomer bone. The pathologic investigations showed a foreign body inclusion cyst associated with latex rubber in the first case and a sequestration of a mucosal-lined nasal bone was not removed at the time of primary rhinoplasty in the second case. A brief review of the literature focuses on the pathophysiology and treatment options for nasal dorsal cysts following aesthetic rhinoplasty. Pier Giorgio Giacomini, Davide Topazio, Roberta Di Mauro, Stelio Mocella, Matteo Chimenti, and Stefano Di Girolamo Copyright © 2014 Pier Giorgio Giacomini et al. All rights reserved. Case Study of a Parotid Gland Adenocarcinoma Dedifferentiated from Epithelial-Myoepithelial Carcinoma Tue, 09 Sep 2014 00:00:00 +0000 Dedifferentiation is defined as high-grade malignant tumor development out of a low-grade malignant tumor. We present an adenocarcinoma tumor of the parotid gland that was dedifferentiated from a low-grade epithelial-myoepithelial carcinoma and was followed up for 3 years. Our patient, a 46-year-old female, presented with a left parotid mass of 20-year duration. Histopathologic results showed that there was only one area of typical epithelial-myoepithelial carcinoma, with foci of poorly differentiated adenocarcinoma (not otherwise specified; NOS) and clear cytoplasm in the parotid gland. Immunohistochemical staining results showed SMA (+), P63 (+), CK8 (+), and S100 (+) on epithelial cells. A review of the literature revealed 22 previously reported cases of dedifferentiated epithelial-myoepithelial carcinoma. In these cases, the malignant tumors that dedifferentiated from epithelial-myoepithelial carcinoma were adenoid cystic carcinoma, actinic cell carcinoma, polymorphous low-grade adenocarcinoma, mucoepidermoid carcinoma, and intraductal carcinoma. In our case, the malignant tumor that dedifferentiated from the epithelial-myoepithelial carcinoma was a poorly differentiated adenocarcinoma. Histopathological results showed that metastases were not seen in the neck-dissection material. As a result, our case will make a contribution to the literature in terms of prognosis, because there are very few reported cases of dedifferentiated adenocarcinoma development arising from epithelial-myoepithelial carcinoma. Salih Aydın, Umit Taskin, Kadir Ozdamar, Kadir Yücebas, Mehmet Sar, Mehmet Faruk Oktay, and Ümit Seza Tetikkurt Copyright © 2014 Salih Aydın et al. All rights reserved. A Solitary Malignant Schwannoma in the Choana and Nasal Septum Tue, 09 Sep 2014 00:00:00 +0000 Malignant schwannoma is an extremely rare tumor and the risk of malignant schwannoma increases in patients with von Recklinghausen’s disease. Recently, we encountered a case of solitary malignant schwannoma in the choana and posterior nasal septum. Malignant schwannoma has not been previously reported in these locations. A 53-year-old man, who was immunologically healthy and showed no abnormal dermatological lesions, presented with a polypoid mass in the right nasal cavity and underwent endoscopic mass excision. The mass originated from the choana and the posterior portion of the right nasal septum. This mass was confirmed as a malignant schwannoma on histological examination and immunohistochemical staining. After endoscopic excision, postoperative adjuvant radiotherapy was administered, and there was no recurrence at 1 year after treatment. This case suggests that a solitary malignant schwannoma should be considered in the differential diagnosis of a mass in the posterior nasal cavity. Eun Jung Lee, Kee Jae Song, Yeon Suk Seo, and Kyung-Su Kim Copyright © 2014 Eun Jung Lee et al. All rights reserved. A Pediatric Case of Ramsay Hunt Syndrome Mon, 08 Sep 2014 06:20:50 +0000 Ramsay Hunt syndrome (RHS) is characterized by facial paralysis, inner ear dysfunction, periauricular pain, and herpetiform vesicles. The reported incidence in children is 2.7/100,000. The pathogenesis involves the reactivation of latent varicella zoster virus (VZV) in the geniculate ganglion of the facial nerve. The recovery rate is better in children than in adults. This paper discusses a 12-year-old girl with a rare case of peripheral facial paralysis caused by RHS and reviews the literature. Serhan Derin, Hatice Derin, Murat Sahan, and Hüseyin Çaksen Copyright © 2014 Serhan Derin et al. All rights reserved. Agenesis of Submandibular Glands: A Report of Two Cases with Review of Literature Mon, 01 Sep 2014 13:05:26 +0000 Background. Congenital absence of the submandibular gland (SMG) is a rare condition. Although complaints such as dry mouth, dental problems, or difficulty in swallowing may be seen, the subjects may also be asymptomatic. The absence of the SMG may be associated with hypertrophy of the contralateral SMG. Case Report. We report the case of a 44-year-old woman with incidentally detected left SMG aplasia, with contralateral SMG hypertrophy mimicking a mass, and the case of a 46-year-old woman with incidentally detected bilateral SMG aplasia, demonstrated by computerized tomography (CT) and magnetic resonance imaging (MRI). Conclusion. It is important for the clinician to know that this very rare abnormality may exist. When such a case is encountered, symptoms and findings should be reevaluated and, if necessary, conservative therapy should be initiated. The possibility of observing additional deformities should be kept in mind and an evaluation should be done for other cases in the family. Medine Kara, Oğuz Güçlü, Fevzi Sefa Dereköy, Mustafa Resorlu, and Gürhan Adam Copyright © 2014 Medine Kara et al. All rights reserved. Von-Willebrand Disease Presenting as Intractable Epistaxis after Nasal Polypectomy Mon, 25 Aug 2014 08:51:04 +0000 Von-Willebrand disease (VWD) is one of the platelet dysfunction disorders that results from a deficiency of Von-Willebrand factor, which is essential for hemostasis. VWD patients typically have normal laboratory results on screening for bleeding disorders. To suspect and diagnose VWD, a careful review of past medical history and laboratory tests is critical. A 59-year-old male patient presented with intractable nasal bleeding after nasal polypectomy. The bleeding was controlled by platelet transfusion, and he was later diagnosed with VWD. Jeong Jin Park, Chang-Hoon Kim, Jeung-Gweon Lee, and Hyung-Ju Cho Copyright © 2014 Jeong Jin Park et al. All rights reserved. Intracranial Complication of Rhinosinusitis from Actinomycosis of the Paranasal Sinuses: A Rare Case of Abducens Nerve Palsy Thu, 21 Aug 2014 08:28:51 +0000 Sinonasal actinomycosis should be suspected when a patient with chronic sinusitis does not respond to medical therapy or has a history of facial trauma, dental disease, cancer, immunodeficiency, long-term steroid therapy, diabetes, or malnutrition. Radiological evaluation with computed tomography and magnetic resonance imaging are important in differential diagnosis, evaluating the extent of disease, and understanding clinical symptoms. Endoscopic sinus surgery associated with long-term intravenous antibiotic therapy is the gold standard for treatment of sinonasal actinomycosis. We report an unusual case of abducens nerve palsy resulting from invasive sinonasal actinomycosis in a patient with an abnormally enlarged sphenoid sinus. A review of the current literature highlighting clinical presentation, radiological findings, and treatment of this uncommon complication is also presented. G. L. Fadda, M. Gisolo, E. Crosetti, A. Fulcheri, and G. Succo Copyright © 2014 G. L. Fadda et al. All rights reserved. Transoral Robotic Surgery in Retrostyloid Parapharyngeal Space Schwannomas Mon, 18 Aug 2014 07:06:20 +0000 Parapharyngeal space (PPS) tumors are very rare, representing about 0.5% of head and neck neoplasms. An external surgical approach is mainly used. Several recent papers show how transoral robotic surgery (TORS) excision could be a prospective tool to remove mainly benign lesions in PPS; no cases of neurogenic tumors from the retrostyloid space treated with TORS have been reported. We present two cases which underwent TORS for schwannomas from the retrostyloid compartment of the parapharyngeal space. Clinical diagnosis of schwannoma was performed by magnetic resonance imaging (MRI). In the first case a 6 cm neurogenic tumor arose from the vagus nerve and in the second case a 5 cm mass from the sympathetic chain was observed. Both cases were treated successfully by the TORS approach using a new “J”-shaped incision through the mucosa and superior pharyngeal constrictor muscle. Left vocal cord palsy and the Claude Bernard Horner syndrome, respectively, were observed as expected postsurgical sequelae. In case 1 the first bite syndrome developed after three months, while no complications were observed in case 2. Both patients regained a normal swallowing function. TORS seems to be a feasible mini-invasive procedure for benign PPS masses including masses in the poststyloid space. Mohssen Ansarin, Marta Tagliabue, Francesco Chu, Stefano Zorzi, Michele Proh, and Lorenzo Preda Copyright © 2014 Mohssen Ansarin et al. All rights reserved. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis Wed, 13 Aug 2014 13:30:18 +0000 Laryngeal chondrosarcoma (CS) is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature. Kerem Kökoğlu, Özlem Canöz, Serap Doğan, Emrah Gülmez, İmdat Yüce, and Sedat Çağlı Copyright © 2014 Kerem Kökoğlu et al. All rights reserved. Intraosseous Hemangioma of the Middle Turbinate Misdiagnosed As a Nasal Polyp Wed, 06 Aug 2014 07:20:12 +0000 Intraosseous hemangiomas account for 1% of all bone tumors and primarily originate from the vertebral column and skull bones. However, intraosseous hemangiomas of the nasal cavity are extremely rare. Here, we report a case of intraosseous hemangioma with a cavernous pattern arising from the middle turbinate that was preoperatively misdiagnosed as chronic rhinosinusitis with polyps. Except for nasal obstruction, there were no specific rhinologic symptoms. The tumor was excised en bloc by the endoscopic endonasal approach without preoperative embolization. Tae Hoon Kim, Eun Jung Lim, Jun-Ki Lee, Jin Gul Lee, and Man-Hoon Han Copyright © 2014 Tae Hoon Kim et al. All rights reserved. T-Cell Lymphoblastic Lymphoma in a Child Presenting as Rapid Thyroid Enlargement Thu, 24 Jul 2014 07:23:38 +0000 The majority of lymphomas of the head and neck in children present as an enlarged cervical lymph node; however, malignant lymphoma arising from the thyroid gland is extremely rare. We report a case of a 12-year-old child who was admitted to our hospital because of a history of rapidly progressive anterior neck swelling. Histopathological studies revealed this case to be T-cell lymphoblastic lymphoma. We performed chemotherapy and the patient has kept recurrence-free survival for 18 months after the beginning of the treatment. This is the 2nd case of T-cell lymphoblastic lymphoma in the thyroid gland in a child. Shintaro Yoshihara, Muneo Nakaya, and Tomoya Ichikawa Copyright © 2014 Shintaro Yoshihara et al. All rights reserved. Pleomorphic Adenomas of the Parapharyngeal Space Tue, 22 Jul 2014 10:21:34 +0000 Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases. İstemihan Akın, Tuğba Karagöz, Murad Mutlu, Mehmet Şahan, and Evrim Önder Copyright © 2014 İstemihan Akın et al. All rights reserved. A Case of Conservatively Managed Invasive Ceruminoma and a Review of the Literature Tue, 22 Jul 2014 09:43:36 +0000 Ceruminomas are rare tumours arising from the apocrine sweat glands of the ear canal. We present a case of a malignant ceruminoma, which was managed with local surgical excision only rather than the wider clearance more commonly undertaken with these invasive neoplasms. We present the clinical case, histological analysis, and clinical progression for this patient and review the literature on this uncommon pathology. T. F. C. Saunders and P. Monksfield Copyright © 2014 T. F. C. Saunders and P. Monksfield. All rights reserved. Tegmen Tympani Defect and Brain Herniation Secondary to Mastoid Surgery: Case Presentation Mon, 21 Jul 2014 11:29:06 +0000 Brain herniation into the middle ear is very rarely seen. In addition to reasons like congenital factors, trauma, and infection, tegmen defect may develop as a result of iatrogenic events secondary to chronic otitis media surgery with or without cholesteatoma. Since it may cause life-threatening complications, patients must be evaluated and monitored for tegmen defect. In this paper, diagnosis and treatment of a brain herniation case due to iatrogenic tegmen defect were described along with relevant literature. Oguz Kadir Egilmez, Fatih Mehmet Hanege, M. Tayyar Kalcioglu, Tuncay Kaner, and Numan Kokten Copyright © 2014 Oguz Kadir Egilmez et al. All rights reserved. A Rare Tumor of Nasal Cavity: Glomangiopericytoma Sun, 20 Jul 2014 09:05:11 +0000 Glomangiopericytoma is a rare vascular neoplasm characterized by a pattern of prominent perivascular growth. A 72-year-old woman was admitted to our clinic complaining of nasal obstruction, frequent epistaxis, and facial pain. A reddish tumor filling the left nasal cavity was observed on endoscopy and treated with endoscopic excision. Microscopically, closely packed cells interspersed with numerous thin-walled, branching staghorn vessels were seen. Glomangiopericytoma is categorized as a borderline low malignancy tumor by WHO classification. Long-term follow-up with systemic examination is necessary due to high risk of recurrence. Aysegul Verim, Cigdem Kalaycik Ertugay, Cigdem Tepe Karaca, Pembegul Gunes, Shahrouz Sheidaei, and Cagatay Oysu Copyright © 2014 Aysegul Verim et al. All rights reserved. Endoscopic CO(2) Laser Horizontal Partial Laryngectomy in Larynx Carcinosarcoma Mon, 14 Jul 2014 12:02:54 +0000 Background. Carcinosarcoma is an extremely rare malignant neoplasm, with both a malignant epithelial and mesenchymal component, that rarely affects the larynx. Aim. Aim of this paper is to describe the case of a patient affected by a larynx carcinosarcoma treated by endoscopic horizontal partial laryngectomy with CO(2) laser and particularly discuss the histogenetic hypothesis as well as the possible treatment modalities of this rare lesion. Methods. Case report and literature review. Discussion and Conclusion. Still little is known about the biology of carcinosarcoma and there is still no consensus in the literature on the treatment of these tumors. Endoscopic horizontal partial laryngectomy could represent another treatment option in selected cases. Andrea Ciorba, Chiara Bianchini, Valeria Iannini, Antonio Faita, Enzo Bianchini, Francesco Stomeo, Stefano Pelucchi, and Antonio Pastore Copyright © 2014 Andrea Ciorba et al. All rights reserved. A Rare Presentation of Retiform Hemangioendothelioma in the External Auditory Canal Sun, 13 Jul 2014 11:54:56 +0000 Retiform hemangioendothelioma is a rare intermediate or borderline neoplasm of the blood vessels that mostly occurs in extremities. Here we report a unique case of retiform hemangioendothelioma presented in the external auditory canal. 58-year-old male patient presented with the complaint of right ear swelling for 4 years. On examination, a spherical swelling in the right ear was found occluding the view of external auditory canal. The tumor was removed surgically. Intraoperatively, the mass was found attached to the outer part of the right external auditory canal near the root of helix. Histopathology of the resected tumor showed typical features of retiform hemangioendothelioma. In addition, immunohistochemical analysis revealed that tumor was positive for endothelial cell marker CD34 and occasionally positive for cell proliferative marker Ki-67. Ezhil Arasan Jothi, Muthuchitra Sundaram, Jeyalakshmidevi Namasivayam, and Mathivanan Jothi Copyright © 2014 Ezhil Arasan Jothi et al. All rights reserved.