Case Reports in Otolaryngology http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Pleomorphic Adenomas of the Parapharyngeal Space Tue, 22 Jul 2014 10:21:34 +0000 http://www.hindawi.com/journals/criot/2014/168401/ 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 http://www.hindawi.com/journals/criot/2014/897540/ 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 http://www.hindawi.com/journals/criot/2014/756280/ 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 http://www.hindawi.com/journals/criot/2014/282958/ 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 http://www.hindawi.com/journals/criot/2014/278640/ 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 http://www.hindawi.com/journals/criot/2014/715035/ 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. Informed Consent in Otolaryngologic Surgery: Case Scenario from a Nigerian Specialist Hospital Tue, 08 Jul 2014 13:05:50 +0000 http://www.hindawi.com/journals/criot/2014/120985/ Informed consent is a foundational concept necessary for ethical conduct of clinical research and practice. It is a technical tool that shifts the autonomy to decide whether a medical procedure should be performed—from the doctor to the patient. However there is an ongoing discussion in bioethical circles on the level of comprehension of the informed consent process by the patients and research participants. We present this case vignette and the discussion afterwards to explore the question of to what extent a patient comprehends the information given to him/her before a surgical procedure is carried out. In other words, the question being asked here is how informed is informed consent in the context of oto-laryngological practice. O. A. Afolabi, J. O. Fadare, and O. T. Ajiboye Copyright © 2014 O. A. Afolabi et al. All rights reserved. Congenital Intralabyrinthine Cholesteatoma Thu, 26 Jun 2014 08:38:56 +0000 http://www.hindawi.com/journals/criot/2014/172162/ A patient with a congenital intralabyrinthine cholesteatoma is presented. High-resolution computerized tomographic scans and intraoperative photomicrographs display features of intralabyrinthine extension. We discuss pathogenetic theories for the development of congenital intralabyrinthine cholesteatoma. The distinction of this condition from congenital cholesteatoma with labyrinthine erosion is discussed. Sanjay Prasad, Kiran Prasad, and Roya Azadarmaki Copyright © 2014 Sanjay Prasad et al. All rights reserved. Primary Atypical Carcinoid Tumour of the Sphenoid Sinus Rostrum Thu, 26 Jun 2014 00:00:00 +0000 http://www.hindawi.com/journals/criot/2014/753964/ Primary carcinoid tumors of the nasal cavity and sinuses are exceedingly rare. An accurate histopathological diagnosis is crucial to optimal investigation and management. We present a case of a primary atypical carcinoid tumor arising from the sphenoid rostrum without evidence of associated carcinoid syndrome. This rare but important differential diagnosis of a nasal tumor is discussed and important unique management issues are highlighted. Kate A. Stephenson and Darlene E. Lubbe Copyright © 2014 Kate A. Stephenson and Darlene E. Lubbe. All rights reserved. Squamous Cell Carcinoma Arising from Inverted Schneiderian Papilloma: A Case Report with Oral Involvement Wed, 25 Jun 2014 05:51:33 +0000 http://www.hindawi.com/journals/criot/2014/478092/ Inverted Schneiderian papilloma is an uncommon benign tumor that presents tendency to recur and propensity to be associated with malignancy in approximately 10% of the cases. Some of these lesions are isolated in the maxillary sinus, and predominantly affect white males with mean age of 50 years. We report a case of squamous cell carcinoma arising from inverted Schneiderian papilloma in the maxillary sinus extending to the mouth. The patient was submitted to extraction of a maxillary molar tooth four months before the exacerbation of the symptoms of nasal airway obstruction and facial enlargement. Computed tomography scan revealed a sinonasal mass causing opacification of the right maxillary sinus with destruction of the lateral nasal wall and maxillary sinus floor. The patient was referred to an oncology center for treatment and died from tumor progression one year after the cancer was diagnosed. The intention of this report is to alert dentists to include the inverted Schneiderian papilloma, either associated with squamous cell carcinoma, or not, in the differential diagnosis of maxillary sinus tumors with aggressive behavior, which may extend to the oral cavity or involve roots of teeth. Alexandre Simões Garcia, Diego Maurício Bravo-Calderón, Mariana Pisinato Ferreira, and Denise Tostes Oliveira Copyright © 2014 Alexandre Simões Garcia et al. All rights reserved. Middle Ear Adenoma: Case Report and Discussion Sun, 22 Jun 2014 13:03:05 +0000 http://www.hindawi.com/journals/criot/2014/342125/ Introduction. Despite modern radiological workup, surgeons can still be surprised by intraoperative findings or by the pathologist’s report. Materials & Methods. We describe the case of a 52-year-old male who was referred to our clinic with a single sided conductive hearing loss. He ultimately underwent middle ear exploration and excision of a middle ear tumour followed by second look and ossiculoplasty a year later. Results. Though preoperative CT and MRI scanning were suggestive of a congenital cholesteatoma, the pathologist’s report diagnosed a middle ear adenoma. Discussion. Middle ear glandular tumors are extremely rare and, despite numerous histological techniques, continue to defy satisfactory classification. Most surgeons advocate surgical excision though evidence of the tumour’s natural course and risk of recurrence is lacking. D. Isenring, T. F. Pezier, B. Vrugt, and A. M. Huber Copyright © 2014 D. Isenring et al. All rights reserved. Bilateral Congenital Absence of the Stapes Superstructure in Two Siblings Sun, 22 Jun 2014 07:14:08 +0000 http://www.hindawi.com/journals/criot/2014/901672/ Middle ear ossicle malformations are an uncommon event. Among them, the congenital absence of the stapes is a very rare condition that is seldom described in the literature. We report the cases of two women, aged 19 and 22 , who presented with a long history of conductive deafness. An exploratory tympanotomy was performed and the absence of the stapes superstructure and an abnormal position of the facial nerve could be observed. A bone anchored hearing aid (BAHA) was implanted in both patients with good results. It is believed that stapes agenesis is related to an abnormal development of the facial nerve, which by the 5th to 6th week of gestation would interpose between the otic capsule and the stapes blastema, preventing these structures from contacting. A long history of nonprogressive hearing loss from birth or early childhood is the key to reach a diagnosis. Several treatment options have been described. The authors opted for a hearing aid due to the high risk of facial nerve lesion, with good functional results. Jose Ignacio Undabeitia, José Undabeitia, Laura Cianci, Luis Padilla, Eduardo Petreñas, and Antonio Municio Copyright © 2014 Jose Ignacio Undabeitia et al. All rights reserved. Massive Multinodular Head and Neck Recurrence of Parotid Gland Pleomorphic Adenoma: A Case Report Sun, 22 Jun 2014 00:00:00 +0000 http://www.hindawi.com/journals/criot/2014/914021/ Introduction. The optimal initial management of parotid pleomorphic adenomas reduces the risk of recurrence and malignant transformation. Surgery of recurrence can be difficult in multinodular disseminated forms. Case Report. A 67-years-old patient was referred for management of a large multifocal recurrence of a pleomorphic adenoma operated on 23 years ago. The clinical and radiological assessment found parapharyngeal, infratemporal, and prestyloid invasion, with nodules in the sternocleidomastoid muscle. Excision by transmandibular approach was performed. The pathologist found a multinodular recurrent pleomorphic adenoma without criteria of malignancy. Postoperative radiotherapy was performed. Discussion. Multinodular forms and incomplete resections are the most important factors that are thought to predispose to recurrence. A precise analysis of the extension by preoperative MRI is essential. Adjuvant radiotherapy can be given in these recurrent multifocal forms. Pierre Philouze, Nicolas Sigaux, Anne Frédérique Manichon, Jean-Christian Pignat, and Marc Poupart Copyright © 2014 Pierre Philouze et al. All rights reserved. Carbon Ion Beam Radiotherapy for Sinonasal Malignant Tumors Invading Skull Base Mon, 09 Jun 2014 08:54:04 +0000 http://www.hindawi.com/journals/criot/2014/241856/ Objective. To evaluate the treatment outcome and prognostic factors in patients with sinonasal malignant tumors invading skull base. Study Design and Setting. A retrospective clinical study at the Yamagata University School of Medicine. Subjects and Methods. Three patients with sinonasal malignant tumors invading skull base were presented in present study. All patients were treated with carbon ion beam radiotherapy. The prescribed dose to the center of the clinical target volume was 64.0 GyE/16 fractions over 4 weeks at 4.0 GyE/fraction per day. Results. All patients completed carbon ion beam radiotherapy without an interval. The mean observation period was 39.6 months (range: 11–54 months). There were no local or regional recurrences in all cases; however, one patient had a metastasis in distant organs. Regarding the complications, visual loss was observed in one eye of one patient whose optic nerve was entirely involved by the tumor and field of carbon ion beam radiotherapy. Radiation induced brain injury was observed in two patients; however, these patients do not complain about neurological abnormality and had no treatment for radiation induced brain necrosis. Conclusions. Carbon ion beam radiotherapy for sinonasal malignant tumors invading the skull base showed therapeutic effectiveness. Nobuo Ohta, Yusuke Suzuki, Azusa Hasegawa, Masaru Aoyagi, and Seiji Kakehata Copyright © 2014 Nobuo Ohta et al. All rights reserved. Diagnostic Challenge of a Deep Minor Salivary Gland Neoplasm Mon, 09 Jun 2014 00:00:00 +0000 http://www.hindawi.com/journals/criot/2014/608267/ Core needle biopsy represents a safe and cheap alternative diagnostic method to open biopsy and fine-needle aspiration cytology in head and neck tumors. There is little evidence in the literature about the use of core needle biopsy in minor salivary gland lesions. This single case report presents a 60-year-old woman with a painless swelling in the soft palate, breathing and swallowing difficulties, and a feeling of suffocation. Two open biopsies had inconclusive diagnosis and the lesion could only be assessed and diagnosed as pleomorphic adenoma through core needle biopsy. Recognizing the correct indication of core needle biopsy can benefit both health professionals and patients; thus, it is important to consider the possibility of performing this method to diagnose minor salivary gland tumors. Vivian P. Wagner, Manoela D. Martins, Bruna Genari, Fernando B. do Amaral, Antônio C. Maciel, Marco A. T. Martins, and Maria C. Munerato Copyright © 2014 Vivian P. Wagner et al. All rights reserved. Facial Pain Associated with CPAP Use: Intra-Sinusal Third Molar Thu, 05 Jun 2014 12:28:56 +0000 http://www.hindawi.com/journals/criot/2014/837252/ Objective. This paper describes a patient with left hemifacial pain elicited by the use of a CPAP mask. Case Report. A 74-year-old man was referred with a history of pain in the left maxillary sinus related to the use of his CPAP interface, thereby prohibiting the use of the latter. Computed tomography revealed an intra-sinusal ectopic third molar in the left maxillary sinus floor corresponding to the painful area. After removal of the ectopic tooth under local anesthesia by a Caldwell-Luc approach, the patient was relieved of his symptoms. Conclusion. Although an ectopic tooth in the maxillary sinus is rare, this case points out the importance of actively looking for a regional problem if patients cannot tolerate the CPAP interface since this can lead to issues of incompliance and medical complications due to the untreated obstructive sleep apnoea syndrome. Maxime Mermod, Martin Broome, Remy Hoarau, and Daniel Zweifel Copyright © 2014 Maxime Mermod et al. All rights reserved. A Rare Case of Endolymphatic Sac Tumour: Clinicopathologic Study and Surgical Management Wed, 04 Jun 2014 10:22:07 +0000 http://www.hindawi.com/journals/criot/2014/376761/ Objective. Endolymphatic sac tumor (ELST) is a rare neoplasm arising from the intrapetrous portion of the endolymphatic sac, either isolated or in association with the von Hippel-Lindau disease. We report a sporadic case of ELST with an overview of the literature and a discussion of clinic-radiological, histopathologic, and surgical findings. Case Report. A young woman presented with a progressive hearing loss in the left ear. Otoscopy showed a reddish, bleeding hypotympanic mass. CT demonstrated an expansile lytic mastoid lesion extending to the middle ear, with bone erosion. MRI confirmed a lesion of increased signal on T1-weighted sequences. The patient underwent a canal wall-down tympanoplasty with complete removal of the tumor. Histopathology was consistent with a papillary ELST. Immunohistochemistry was positive for cytokeratin and chromogranin A. Conclusion. This paper highlights the rarity of ELST, the need for an accurate neuroradiological and immunohistochemical study at the early stages, and the timeliness of surgical treatment. Emanuele Ferri, Maurizio Amadori, Enrico Armato, and Ida Pavon Copyright © 2014 Emanuele Ferri et al. All rights reserved. Extensive Frontoparietal Abscess: Complication of Frontal Sinusitis (Pott’s Puffy Tumor) Sun, 25 May 2014 11:02:11 +0000 http://www.hindawi.com/journals/criot/2014/632464/ First described in 1768, the Pott’s puffy tumor is a subperiosteal abscess associated with frontal bone osteomyelitis, resulting from trauma or frontal sinusitis. The classic clinical presentation consists of purulent rhinorrhea, fever, headache, and frontal swelling. The diagnosis is confirmed by CT scan and treatment requires intravenous antibiotics, analgesia, and surgical intervention. Early diagnosis and aggressive medical and surgical approach are essential for a good outcome. It rare and the early diagnosis is important; we describe the case of a 14-year-old adolescent with Pott’s puffy tumor who was initially treated inadequately, evolving with extensive frontoparietal abscess. The patient underwent surgical treatment with endoscopic endonasal and external approaches combined. Intravenous antibiotics were prescribed for a prolonged time, with good outcome and remission of the complaints. Raquel Andrade Lauria, Fernando Laffitte Fernandes, Thiago Pires Brito, Pablo Soares Gomes Pereira, and Carlos Takahiro Chone Copyright © 2014 Raquel Andrade Lauria et al. All rights reserved. Laryngeal Giant Cell Tumor: A Case Report and Review of the Literature Thu, 15 May 2014 00:00:00 +0000 http://www.hindawi.com/journals/criot/2014/503497/ Giant cell tumor (GCT) is a benign neoplasm arising most commonly in the long bones. GCTs of the larynx (GCTL) are relatively rare, and only individual case reports are documented in the literature. Patients with such tumors may present with hoarseness and anterior neck swelling. We present a 59-year-old man with hoarseness and enlarging anterior neck mass for 3 months. A fiberscopy revealed a submucosal swelling of the left subglottic trachea. Computed tomography and magnetic resonance imaging of the larynx demonstrated a large, well-defined, inhomogeneous enhancing mass at the left thyroid cartilage, which was obstructed entirely. The anterior neck mass was biopsied for histopathological analysis, which showed multinodularity with intervening vascularized connective tissues. The mass was made up of mononuclear cells and distributed multinucleated giant cells. The mitotic activity of the mononuclear cells was as high as 6 per 10 high-power fields. Pathologic consultation resulted in a diagnosis of giant cell tumor. The patient underwent total laryngectomy and, postoperatively, he did well without recurrence or metastasis for two and a half years. Jumpei Nota, Yoshihisa Okochi, Futoshi Watanabe, and Tadahiko Saiki Copyright © 2014 Jumpei Nota et al. All rights reserved. Kimura’s Disease in a Caucasian Female: A Very Rare Cause of Lymphadenopathy Wed, 14 May 2014 08:44:05 +0000 http://www.hindawi.com/journals/criot/2014/415865/ Introduction. Kimura’s disease is a rare chronic inflammatory disorder characterized by the head and neck lymphadenopathy often accompanied by eosinophilia and elevated serum IgE. It is benign condition with unknown etiology usually affecting young men of Asian race. Affected Caucasians are very rare. Case Presentation. We report a clinically and histopathologically typical case of this disease in a 40-year-old Caucasian female. In differential diagnosis particular attention has been paid to angiolymphoid hyperplasia with eosinophilia and neoplasms. Conclusion. The diagnosis of Kimura’s disease can be very difficult and misleading; it is important not to ignore histopathological features. The presented patient has been under follow-up with no more symptoms of the disease for the last 1.5 years. Ewa Osuch-Wójcikiewicz, Antoni Bruzgielewicz, Magdalena Lachowska, Agata Wasilewska, and Kazimierz Niemczyk Copyright © 2014 Ewa Osuch-Wójcikiewicz et al. All rights reserved. Joint Use of Skull Base Surgery in a Case of Pediatric Parotid Gland Carcinoma Sun, 11 May 2014 07:12:38 +0000 http://www.hindawi.com/journals/criot/2014/158451/ Parotid gland carcinoma is extremely rare in children. We report a case of pediatric parotid gland carcinoma with extensive infiltration into surrounding tissues including the skin and temporomandibular joint capsule at initial examination. Total resection of the parotid gland was conducted together with skull base surgery and mandibular dissection. The patient was a 14-year-old girl. In addition to the skin and temporomandibular joint, infiltration into the anterior wall of the external auditory meatus and masseter muscle was also seen, and T4N0M0 stage IV parotid carcinoma was diagnosed. Skin was resected together with the pinna, and temporal craniotomy and skull base surgery were performed to resect the temporomandibular joint capsule and external auditory meatus en bloc, and mandible dissection was conducted. Facial nerves were resected at the same time. Level I to level IV neck dissection was also conducted. A latissimus dorsi myocutaneous flap was used for reconstruction. The postoperative permanent pathology diagnosis was high-grade mucoepidermoid carcinoma with a low-grade component. Postoperatively, radiotherapy at 50 Gy alone has been conducted, with no recurrence or metastasis observed for over 4 years. Yuri Ueda, Kiyoaki Tsukahara, Kazuhiro Nakamura, Ray Motohashi, Minoru Endo, Hiroki Sato, Yasuaki Katsube, and Mamoru Suzuki Copyright © 2014 Yuri Ueda et al. All rights reserved. Cervicofacial Surgical Emphysema following Tonsillectomy Thu, 08 May 2014 10:09:09 +0000 http://www.hindawi.com/journals/criot/2014/746152/ We report the case of a patient who developed cervicofacial subcutaneous emphysema following a routine tonsillectomy. An 18-year-old male with swallowing difficulties underwent a tonsillectomy and developed swelling of the right side of his neck and face 36 hours after surgery. A neck X-ray revealed subcutaneous emphysema. Unlike similar previously published cases, there were no postoperative issues of coughing, straining, or use of positive pressure ventilation. The complication also occurred after a considerable length of time. Further complications may include pneumothorax and pneumomediastinum and these should be excluded. Samir Yelnoorkar and Wolfgang Issing Copyright © 2014 Samir Yelnoorkar and Wolfgang Issing. All rights reserved. The Development of Dorsal Nasal Cyst Formation after Rhinoplasty and Its Reconstruction with Conchal Cartilage Tue, 06 May 2014 16:00:33 +0000 http://www.hindawi.com/journals/criot/2014/928715/ The dorsal nasal cyst formation is a rare and late complication of rhinoplasty. It has been rarely reported in the literature and it is usually mucous cysts. Migration and planting to the subcutaneous space during the surgical procedure has been recognized as the formation mechanism. This case report has presented 42-year-old male patient with a destructing dorsal nasal mucous cyst that developed 10 years after the rhinoplasty operation. There was no complication in the primary rhinoplasty and the patient was satisfied with his appearance. There was a swelling of the nasal dorsum over the past year and surgical excision of the cyst was performed. During the surgery, the defect was reconstructed with conchal cartilage. There was no recurrence during follow-up. Tolgar Lütfi Kumral, Yavuz Uyar, Güven Yıldırım, Güler Berkiten, Yavuz Atar, and Enes Ataç Copyright © 2014 Tolgar Lütfi Kumral et al. All rights reserved. Isolated Enteric Cyst in the Neck Thu, 24 Apr 2014 16:49:27 +0000 http://www.hindawi.com/journals/criot/2014/597813/ We report an extremely rare case of isolated enteric cyst in the neck region which was diagnosed on the histopathological examination. It was suspected to be duplication cyst on radiology. We have also evaluated the differential diagnosis and management issues. Amit Mahore, Raghvendra Ramdasi, Palak Popat, Shilpa Sankhe, and Vishakha Tikeykar Copyright © 2014 Amit Mahore et al. All rights reserved. Multiple Congenital Epulis in Alveolar Ridges of Maxilla and Mandible in a Newborn: A Rare Case Report Tue, 08 Apr 2014 00:00:00 +0000 http://www.hindawi.com/journals/criot/2014/606985/ Congenital granular cell lesion (CGCL) or congenital epulis is an uncommon benign of the oral cavity tumor appearing at birth with typical clinical and pathologic features. It predominately affects females, mainly on the anterior maxillary alveolar ridge, and occurs usually as a single mass, although sometimes as multiple. The left side incisor area is the most common site. The etiology and histogenesis of the lesion remain obscure. Though it is a benign lesion, the tumor may cause feeding and respiratory problems if there are too large or multiple tumors. We report a case of a three-day-old, female newborn, who was referred to our hospital with multiple congenital oral swellings arising from the maxilla and mandible. The tumors caused a feeding problem and, hence, they were resected by surgical excision under general anesthesia. Nader Saki and Somayeh Araghi Copyright © 2014 Nader Saki and Somayeh Araghi. All rights reserved. Primary Pleomorphic Adenoma of the External Auditory Canal: A Case Report and Review of the Literature Mon, 07 Apr 2014 06:33:56 +0000 http://www.hindawi.com/journals/criot/2014/975151/ Background. Pleomorphic adenoma (PA) is a benign tumour that mainly arises from salivary glands, and PA of the external auditory canal (EAC) is very rare. The objective of this study was to clarify the clinical presentation and treatment of PA of the EAC. Method. The authors present a case of PA arising from the EAC together with a literature review. Results. A 40-year-old man complained of hearing loss and foreign-body sensation of the right ear. Clinical and radiological examinations revealed a well-defined tumour limited to the EAC, with no connection to the parotid gland. Preoperative fine-needle aspiration cytology findings were characteristic of PA. The tumour was removed en bloc with the overlying skin. Conclusion. PA of the EAC is very rare, and methods to rule out malignancy before treatment are lacking. Thus, long-term follow-up is necessary, because malignant tumours are common in the EAC and PA has malignant potential. Chizu Saito, Takeharu Kanazawa, Takehiko Yamaguchi, Ken-ichi Nakamura, and Keiichi Ichimura Copyright © 2014 Chizu Saito et al. All rights reserved. Transoral Robotic Surgery: Step-by-Step Radical Tonsillectomy Sun, 06 Apr 2014 12:22:50 +0000 http://www.hindawi.com/journals/criot/2014/497528/ Introduction. Transoral robotic surgery (TORS) radical tonsillectomy is an emerging minimally invasive surgical procedure for the treatment of cancer of the tonsil. The detailed surgical technique and claims for its reproducibility have been previously published. Case Presentation. We present a patient with a T2N2bM0 epidermoid carcinoma of the tonsil to illustrate step by step the surgical procedure for TORS radical tonsillectomy. Neck dissection and TORS were staged. No surgical reconstruction of the defect was required. No tracheostomy was necessary. The patient could eat without any feeding tube and was on full oral diet on the fifth postoperative day. Discussion. The transoral approach offers the benefits of minimally invasive surgery to patients with cancer of the tonsil. The excellent exposure and high precision provided by robotic instrumentation allow the surgeon to closely follow and accomplish the surgical steps, which is the best warranty for safety and effectiveness. Jose Granell, Ivan Mendez-Benegassi, Teresa Millas, Laura Garrido, and Raimundo Gutierrez-Fonseca Copyright © 2014 Jose Granell et al. All rights reserved. Impending Carotid Blowout Stabilization Using an LT-D Tube Tue, 01 Apr 2014 09:14:59 +0000 http://www.hindawi.com/journals/criot/2014/531561/ Adequate stabilization of a patient presenting with a carotid blowout is one of the most challenging issues an on-call ENT surgeon can be confronted with. Reducing the bleeding and securing the airway are essential before more definitive management. We present the case of a 72-year-old patient with head and neck cancer who arrived at the emergency room with a carotid blowout and who was successfully stabilized using a King LT-D ventilation tube. G. Desuter, A. Gregoire, Q. Gardiner, and P. M. Francois Copyright © 2014 G. Desuter et al. All rights reserved. Multiple Cranial Nerve Palsies as the First Presentation of Sarcoidosis Wed, 26 Mar 2014 11:18:06 +0000 http://www.hindawi.com/journals/criot/2014/592510/ Sarcoidosis is a disease process which predominantly affects the lungs but can involve virtually any organ in the human body. Neurosarcoidosis is a rare manifestation which can present in a variety of ways. There is no single diagnostic test for sarcoidosis; hence, the diagnosis is based on combined clinical, laboratorial, and radiological grounds. We describe a rare case where a patient presented with dysphagia, hoarseness, hearing loss, and unsteadiness. Oliver Rose, Zahoor Ahmad, and Barry Snow Copyright © 2014 Oliver Rose et al. All rights reserved. Grisel’s Syndrome: A Rare Complication following Adenotonsillectomy Mon, 24 Mar 2014 09:37:53 +0000 http://www.hindawi.com/journals/criot/2014/703021/ Grisel’s syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel’s syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel’s syndrome after adenotonsillectomy is discussed with review of the literature. Abdulkadir Bucak, Sahin Ulu, Abdullah Aycicek, Emre Kacar, and Murat Cem Miman Copyright © 2014 Abdulkadir Bucak et al. All rights reserved.