Case Reports in Otolaryngology The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Ossifying Parotid Carcinoma ex Pleomorphic Adenoma Sun, 17 May 2015 12:46:09 +0000 We present a unique case of an extensively ossified carcinoma ex pleomorphic adenoma (CXPA) in a 76-year-old man with a five-year history of a slowly growing parotid mass. Fine-needle aspiration of the mass was nondiagnostic. A computed tomography (CT) scan of the lesion revealed a well-circumscribed mass with peripheral calcification. Initial pathological analysis suggested a benign parotid mass, but rigorous decalcification revealed noninvasive CXPA. The patient underwent complete resection of the mass and remained disease-free nine months later. Extensive ossification of a seemingly benign parotid mass may mask areas of carcinoma that may progress if left untreated. Suresh Mohan, Sidharth V. Puram, Bharat Yarlagadda, Vania Nosé, and Daniel G. Deschler Copyright © 2015 Suresh Mohan et al. All rights reserved. Rare Head and Neck Benign Mesenchymoma in Close Proximity to Submandibular Gland in a Pediatric Patient: Case Report and Review of the Literature Tue, 12 May 2015 11:22:16 +0000 Pediatric head and neck masses are commonly congenital in origin or of infectious etiology. We present a rare case of benign mesenchymoma in close proximity to the submandibular gland in an otherwise asymptomatic child. Computerized tomography (CT) scan of the head and neck area revealed a benign lesion, which was later determined to be a benign mesenchymoma on histopathology. The child did well after surgery without any reported recurrence. We discuss the salient features of a benign mesenchymoma in a child and also discuss relevant imaging and management. Priyanka Jain and Shraddha Mukerji Copyright © 2015 Priyanka Jain and Shraddha Mukerji. All rights reserved. Rosai-Dorfman Disease Originating from Nasal Septal Mucosa Sun, 10 May 2015 14:34:29 +0000 Rosai-Dorfman disease is a rarely seen disease with unknown etiology. Extranodal involvement is most commonly seen in the head and neck region. Histopathologically, it is characterized by histiocytic cell proliferation. This paper presents a case of a 15-year-old male patient who presented with nasal obstruction and was surgically treated for a mass filling in the left nasal meatus that was diagnosed to be Rosai-Dorfman disease by histopathological examination. Abdulvahap Akyigit, Hadice Akyol, Oner Sakallioglu, Cahit Polat, Erol Keles, and Ozkan Alatas Copyright © 2015 Abdulvahap Akyigit et al. All rights reserved. Lingual Thyroid Excision with Transoral Robotic Surgery Thu, 07 May 2015 16:02:52 +0000 Ectopic thyroid gland may be detected at any place between foramen caecaum and normal thyroid localization due to inadequacy of the embryological migration of the thyroid gland. It has a prevalence varying between 1/10.000 and 1/100000 in the community. Usually follow-up without treatment is preferred except for obstructive symptoms, bleeding, and suspicion of malignity. Main symptoms are dysphagia, dysphonia, bleeding, dyspnea, and obstructive sleep apnea. In symptomatic cases, the first described method in surgical treatment is open approach since it is a region difficult to have access to. However, this approach has an increased risk of morbidity and postoperative complications. Transoral robotic surgery, which is a minimally invasive surgical procedure, has advantages such as larger three-dimensional point of view and ease of manipulation due to robotic instruments. In this report, a case at the age of 49 who presented to our clinic with obstructive symptoms increasing within the last year and was found to have lingual thyroid and underwent excision of ectopic thyroid tissue by da Vinci surgical system is presented. Elif Ersoy Callıoglu, Kazım Bozdemir, Bulent Ulusoy, Tolga Oguzhan, and M. Hakan Korkmaz Copyright © 2015 Elif Ersoy Callıoglu et al. All rights reserved. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome Thu, 07 May 2015 11:07:28 +0000 Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1 mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic. Cuneyt Kucur, Isa Ozbay, Fatih Oghan, Nadir Yildirim, Zuhal Zeybek Sivas, and Sibel Canbaz Kabay Copyright © 2015 Cuneyt Kucur et al. All rights reserved. Congenital Cholesteatoma Localized to the Mastoid Cavity and Presenting as a Mastoid Abscess Wed, 15 Apr 2015 13:15:27 +0000 Introduction. Congenital cholesteatoma is a pearly white mass that rarely originates from the mastoid process. Case Report. A 21-year-old male patient presented to our department with severe right mastoid pain and postauricular fluctuant swelling for 23 days. There was no preceding history of ear complaints and examination showed a normal right ear drum. Emergency exploration of the mastoid process was done on the same day and revealed localized cholesteatoma limited only to the mastoid cavity. Conclusion. Despite a rarity, the mastoid process should be always put in mind as a site of origin for congenital cholesteatoma. Salim M. Sloma Tabook, Hazem M. Abdel Tawab, and Naveen Kumar Gopal Copyright © 2015 Salim M. Sloma Tabook et al. All rights reserved. Polymorphous Low-Grade Adenocarcinoma of the Tongue Base Treated by Transoral Robotic Surgery Tue, 14 Apr 2015 15:38:18 +0000 Polymorphous low-grade adenocarcinoma is a rare malignancy arising from the minor salivary glands in the aerodigestive system, most frequently the hard palate. The treatment of choice is wide surgical resection, and the efficacy of radiotherapy has not been confirmed. A 54-year-old male presenting with a mass at the base of the tongue performed transoral laser microsurgery. The pathologic diagnosis was polymorphous low-grade adenocarcinoma. Complete surgical excision was performed via transoral robotic surgery without a flap reconstruction of the surgical defect. Without complications of bleeding or injury to the hypoglossal nerve, proper surgical margins were obtained, and no recurrence was found after 6 months after surgery. The patient did not complain of dysphagia or aspiration. We conclude that, in surgery for tongue base tumors with unknown malignant potential, transoral robotic surgery can be considered for achieving a definite resection avoiding a mandibulotomy without complications of dysphagia or aspiration after confirmation of malignancy with a frozen biopsy. Jeong Hong Kim, Chang Lim Hyun, and Gil Chai Lim Copyright © 2015 Jeong Hong Kim et al. All rights reserved. Mature Teratoma of the Temporal Bone in 3.5-Month-Old Baby Girl Mon, 06 Apr 2015 06:24:10 +0000 Mature teratoma is a benign germ cell tumor rarely located in the temporal bone. We are reporting a case of a mature teratoma of the temporal bone in a healthy borne 3.5-month-old baby girl with a 2-day suggestive history of otitis media and polypoidal mass expulsing from the external auditory canal of the left ear. A definitive diagnosis is made after complete excision and histological examination of the tissue. Total surgical excision of the tumor is the treatment of choice. Alshema Alqurashi, Essa Bakry, Marta Straube, Christian H. Rickert, and Parwis Mir-Salim Copyright © 2015 Alshema Alqurashi et al. All rights reserved. Late Pneumolabyrinth May Be Induced by Old Penetrating Injury: Possibility of Undiagnosed Posttraumatic Perilymphatic Fistula Thu, 26 Mar 2015 12:37:18 +0000 Traumatic pneumolabyrinth is a relatively rare entity. We report the case of a unilaterally deaf woman with pneumolabyrinth who had suffered penetrating injury 15 years ago. This past history indicated that the case was late pneumolabyrinth occurring from undiagnosed old posttraumatic perilymphatic fistula. In Japan, most cases of traumatic pneumolabyrinth are caused by penetrating injury with an ear pick. Dizziness often improves within several months. Immediate surgical intervention is recommended for hearing loss, but the hearing outcome is not satisfactory. An appropriate strategy should be selected based on the interval to surgery, bone conduction hearing level at disease onset, stapes lesions, and location of air. Takahiro Nakashima, Keiji Matsuda, Takumi Okuda, Tetsuya Tono, Minoru Takaki, Tamon Hayashi, and Yutaka Hanamure Copyright © 2015 Takahiro Nakashima et al. All rights reserved. Meningitis and Brain Abscess Presenting with Epistaxis in a Woman with Prior Head and Neck Cancer Thu, 26 Mar 2015 09:08:43 +0000 It is estimated that more than 60% of people have epistaxis in their lifetimes, and as such it is a common complaint encountered in emergency medicine. Although epistaxis is usually self-limited and benign, it can occasionally be a sign of serious underlying pathology. We report a case of epistaxis secondary to invasive squamous cell cancer, ultimately leading to pneumocephalus and brain abscess. We recommend a low threshold for neuroimaging in patients with known prior head and neck cancers presenting with epistaxis, as even resolved epistaxis may be related to serious pathology. Danielle Cross and Rebecca Jeanmonod Copyright © 2015 Danielle Cross and Rebecca Jeanmonod. All rights reserved. Management of Congenital Midline Nasofrontal Masses: Case Report and Review of Literature Wed, 25 Mar 2015 14:23:11 +0000 Epidermoid cysts, dermoids, gliomas, and meningo-/encephaloceles are the most important differential diagnoses in congenital nasofrontal masses. Since they arise from an abnormal fusion during fetal development, intracranial extension of the lesion has to be ruled out radiologically before therapy. Dermoids are the most common entity. We report about a congenital epidermoid cyst of the glabella and nasion that had been growing over the last two years before presentation in a 24-year-old patient. We discuss radiological imaging and the different surgical approaches described in literature. A. C. Volck, G. A. Suárez, and A. J. Tasman Copyright © 2015 A. C. Volck et al. All rights reserved. Spindle Cell Lipoma of the Soft Palate Tue, 24 Mar 2015 09:51:23 +0000 Intraoral spindle cell lipomas (SCL) are very rare and comprise ranging between 1.4%–9.8% of all intraoral lipomas. To our knowledge, no case of a SCL located on the soft palate has been reported in the English-language literature. A 31-year-old female was admitted with a swelling in her soft palate. On examination, a 3 cm sessile, nontender swelling was observed on her soft palate. After surgical excision, it was diagnosed as a SCL. Ahmet Hançer, Can Özbay, Serap Karaarslan, and Muzaffer Balaban Copyright © 2015 Ahmet Hançer et al. All rights reserved. Laryngeal Preservation in Managing Advanced Tracheal Adenoid Cystic Carcinoma Tue, 24 Mar 2015 08:30:23 +0000 A 37-year-old male athlete was diagnosed with primary tracheal adenoid cystic carcinoma following investigation for dyspnea, wheeze, and eventual stridor. Preoperative bronchoscopy revealed a highly vascular tumor 4 cm distal to the cricoid with no gross disease extending to the carina. Imaging revealed circumferential tracheal irregularity immediately inferior to the cricoid, with no definite cricoid invasion. Locoregional extension of disease was noted invading the thyroid and abutment of the carotid approximately 180°. Intraoperative findings identified tracheal mucosal disease extending distal to the carina and proximally at the cricothyroid joints where bilateral functional recurrent nerves were preserved. A decision made to preserve the larynx given the inability to fully resect distal tracheal disease. A 5 cm sleeve resection of the trachea was made with a cricotracheal anastomosis following suprahyoidal muscle release and laryngeal drop-down. The patient was treated with adjuvant radiotherapy including platinum based chemotherapy in an effort to maximise local control. PET scanning three months after therapy revealed no FDG uptake locally or distally. Thavakumar Subramaniam, Paul Lennon, John Kinsella, and James Paul O’Neill Copyright © 2015 Thavakumar Subramaniam et al. All rights reserved. Giant Orbitoethmoidal Osteoma: When an Open Surgical Approach Is Required Mon, 23 Mar 2015 13:50:55 +0000 Giant orbitoethmoidal osteoma in children is considered to be rare. This type of pathology can be associated with significant disfiguring proptosis and limitation of eye movement. Here, we report on a child who presented with a giant orbitoethmoidal osteoma that was removed through an orbitofrontal approach. The cosmetic result was excellent and evident immediately after surgery. A review of the literature complements this report. Hussam Abou Al-Shaar, Turki El Arjani, Michael S. Timms, and Faisal Al-Otaibi Copyright © 2015 Hussam Abou Al-Shaar et al. All rights reserved. Carotid Sheath Abscess Caused by a Tooth Decay Infection on the Opposite Side Mon, 23 Mar 2015 08:24:07 +0000 Deep neck infections are mortal diseases that need emergency treatment. It can occur at any age but usually in pediatric ages. In this report, a left cervical carotid space abscess of a pediatric patient was discussed. It was interesting that the only origin of the left carotid sheath abscess was right inferior first molar tooth decay. Right neck spaces were all clean. Patient had no immunosupression and also there were no congenital masses such as branchial cleft cysts, foreign bodies, or masses suspicious for malignancies in cervical ultrasound and MRI. We discussed this rare condition under the light of the literature. F. Ruya Tuncturk, Lokman Uzun, M. Tayyar Kalcioglu, Oguz Kadir Egilmez, Emine Timurlenk, and Muferet Erguven Copyright © 2015 F. Ruya Tuncturk et al. All rights reserved. Endoscopic Endonasal Approach of Congenital Meningoencephalocele Surgery: First Reported Case in Lithuania Thu, 19 Mar 2015 13:51:59 +0000 Meningoencephalocele is a rare condition that usually occurs in children and is treated by neurosurgeons with occasional help from ENT doctors. The symptoms of meningoencephalocele might not develop until adulthood, but usually they are apparent immediately after birth. The case of small anterior basal transethmoidal meningoencephalocele in a 24-year-old patient who had headaches and runny nose since childhood is presented. Endonasal endoscopic approach for meningoencephalocele removal and skull base defect reconstruction was used. It was concluded that endoscopic endonasal approach is less invasive and provides an acceptable operative outcome with short recovery time and less postoperative complications in comparison with other external microsurgical approaches. Svajūnas Balseris, Giedrius Strazdas, Saulius Ročka, and Tomas Jakštas Copyright © 2015 Svajūnas Balseris et al. All rights reserved. Management of Dysphagia Pre- and Postoperatively in a Case of Eagle’s Syndrome Tue, 17 Mar 2015 07:12:23 +0000 Eagle’s syndrome (ES) is rare condition, most frequently described within the context of case study presentation. ES results from elongation of the styloid process, contributing to symptoms such as globus sensation in the throat, as well as pain localized to the ear, neck, face, or tongue. Additional symptoms can include hypersalivation, change in vocal quality, submandibular swelling, and dysphagia. This report discusses evaluation, diagnosis, and surgical intervention with respect to Eagle’s Syndrome in a patient presenting with moderate-severe dysphagia. Vicki Lewis, Bari Hoffman Ruddy, Jeffrey Lehman, Erin Silverman, and Brian Spector Copyright © 2015 Vicki Lewis et al. All rights reserved. Extravasation Mucocele Arising from a Lingual Thyroglossal Duct Remnant Thu, 12 Mar 2015 11:24:01 +0000 Although a thyroglossal duct cyst is a congenital anomaly, it can also appear in adults. Despite the presence of embryological remnants, it is still unclear why the cyst should suddenly develop later in life. We report a case of a 46-year-old male with an extravasation mucocele arising from a long-standing lingual thyroglossal duct remnant. MRI demonstrated a lingual cystic lesion near the hyoid bone associated with a suprahyoid tract-like structure masquerading as a thyroglossal duct cyst. However, histopathological examination demonstrated a mucocele secondary to a rupture of a thyroglossal duct remnant with numerous intramural heterotopic salivary glands. We propose a new mechanism of an acquired cystic formation of this congenital disease that excessive production of mucus from heterotopic salivary glands and a physical trauma such as swallowing may lead to extravasation of mucus from the thyroglossal duct. Mitsuhiko Nakahira and Hiroaki Nakatani Copyright © 2015 Mitsuhiko Nakahira and Hiroaki Nakatani. All rights reserved. Adult-Onset Woakes’ Syndrome: Report of a Rare Case Tue, 10 Mar 2015 11:53:19 +0000 Introduction. Woakes’ syndrome, commonly defined as severe recurrent nasal polyps with consecutive destruction of the nasal pyramid, is rare with only a few reports in the literature documenting surgical treatment of the external nose. Case Presentation. We describe the case of an adult patient with Samter’s triad who had been surgically treated from nasal polyposis since 2002. By 2014 a conspicuous deformity of the nasal pyramid had progressively occurred due to a recurrence. The patient underwent revision endoscopic sinus surgery and narrowing of the bony nasal vault by digital compression without osteotomies. Discussion. Having been described over 130 years ago, the etiology of Woakes’ syndrome remains poorly understood. Treatment includes endoscopic sinus surgery and topical treatment. Surgical treatment of the external nose deformity by rhinoplasty is rarely addressed. Conclusion. This case illustrates that the widening of the bony nasal vault may be successfully corrected by digital compression, if the nasal bones are substantially thinned, in combination with surgical treatment of nasal polyps. U. Schoenenberger and A. J. Tasman Copyright © 2015 U. Schoenenberger and A. J. Tasman. All rights reserved. Massive Temporal Lobe Cholesteatoma Wed, 04 Mar 2015 07:39:42 +0000 Introduction. Intracranial extension of cholesteatoma is rare. This may occur de novo or recur some time later either contiguous with or separate to the site of the original cholesteatoma. Presentation of Case. A 63-year-old female presented to a tertiary referral hospital with a fluctuating level of consciousness, fever, headache, and right-sided otorrhoea, progressing over several days. Her past medical history included surgery for right ear cholesteatoma and drainage of intracranial abscess 23 years priorly. There had been no relevant symptoms in the interim until 6 weeks prior to this presentation. Imaging demonstrated a large right temporal lobe mass contiguous with the middle ear and mastoid cavity with features consistent with cholesteatoma. The patient underwent a combined transmastoid/middle fossa approach for removal of the cholesteatoma and repair of the tegmen dehiscence. The patient made an uneventful recovery and remains well over 12 months later. Conclusion. This case presentation details a large intracranial cholesteatoma which had extended through a tegmen tympani dehiscence from recurrent right ear cholesteatoma treated by modified radical mastoidectomy over two decades priorly. There was a completely asymptomatic progression of disease until several weeks prior to this presentation. Pasan Waidyasekara, Samuel A. Dowthwaite, Ellison Stephenson, Sandeep Bhuta, and Brent McMonagle Copyright © 2015 Pasan Waidyasekara et al. All rights reserved. Acute Traumatic Injury of the Larynx Tue, 03 Mar 2015 11:56:05 +0000 Laryngeal trauma is rare but serious and potentially deadly injury. The prompt diagnosis and management of acute laryngeal trauma is necessary because the clinical presentation is variable depending on the location, severity, and mechanism of injury. Two case histories are presented: (1) case history A: a 53-year-old male, after motor vehicle accident, fractured the mid anterior thyroid cartilage and both aspects of the cricoid cartilage; however, this patient was asymptomatic from the above fractures; and (2) case history B: a 41-year-old male who sustained trauma to the chest, neck, and left arm after being struck by a large lead pipe which fractured the left aspect of the cricoid cartilage was symptomatic. The type rather than the severity of acute laryngeal injury and the mechanism of injury may be related to symptomatology. Acute laryngeal trauma should be recognized by trauma radiologists and emergency room physicians. Early diagnosis and management of acute laryngeal trauma may prevent unnecessary specialty consults and long-term complications. K. O. Kragha Copyright © 2015 K. O. Kragha. All rights reserved. A Surprising Finding after External Ear Polypectomy in a Deaf Mute Patient Sat, 28 Feb 2015 07:56:56 +0000 Introduction. External auditory canal polyps usually reflect an inflammatory process. Rarely, they may reflect a serious condition that warrants urgent intervention. Case Report. A 19-year-old deaf mute female presented to our department with persistent left ear discharge and a reddish mass in the ear. After surgery, the cause was identified as a neglected foreign body. Tympanic membrane was intact. Conclusion. Aural polyp that is resistant to medical treatment should raise the suspicion of an inflammatory polyp with underlying chronic suppurative otitis media or foreign body. Rarer neoplastic and immunological causes should also be considered. Hazem M. Abdel Tawab, Ravi Kumar V, and Salim M. Sloma Tabook Copyright © 2015 Hazem M. Abdel Tawab et al. All rights reserved. Thoracocervicofacial Emphysema after Heimlich’s Maneuvre Thu, 26 Feb 2015 08:34:40 +0000 We report an extremely rare example of a thoracocervicofacial subcutaneous emphysema after Heimlich maneuver case. Salim Bouayed, Kishore Sandu, Pedro S. Teiga, and Bassel Hallak Copyright © 2015 Salim Bouayed et al. All rights reserved. Enteric Duplication Cyst Located at the Posterior Tongue: A Rare Case Report and Review of the Literature Mon, 23 Feb 2015 11:52:03 +0000 The lingual localization of an enteric duplication is extremely rare but may present with respiratory and feeding problems that require emergency intervention. A 7-month-old boy was brought to our clinic with feeding difficulties and tongue swelling. Physical examination showed a cystic lesion located near the left side of the tongue base that caused tongue protrusion to the contralateral side. During surgery, a 3-cm diameter opaque thick-walled cyst was found to be very closely adherent to the base of tongue, which was excised in its entirety. Following surgery, the patient fed during the early postoperative period and no complications were observed other than hypersalivation. On histological examination, a cystic lesion lined with intestinal mucosa and goblet cells was found. We present the rare case of a duplication cyst of the posterior tongue, with a literature review. Bircan Savran, Cuneyt Kucur, Cengiz Kocak, Isa Ozbay, Mehmet Huseyin Metineren, and Yasin Tugrul Karakus Copyright © 2015 Bircan Savran et al. All rights reserved. Conservative Management for Lingual Thyroid Ectopic Sun, 15 Feb 2015 08:38:06 +0000 Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years. Eder Alberto Sigua-Rodriguez, Douglas Rangel Goulart, Luciana Asprino, and Afonso Celso de Moraes Manzano Copyright © 2015 Eder Alberto Sigua-Rodriguez et al. All rights reserved. IgG4-Related Nasal Pseudotumor Thu, 12 Feb 2015 09:58:05 +0000 IgG4-related disease is recognized as one form of autoimmune pancreatitis. During the last ten years, it has also been described in several other organs. We present two patients with lesions showing a histological picture of fibrosis and lymphoplasmacytic infiltrations with abundant IgG4 positive plasma cells at hitherto unreported symmetrical nasal locations. The symmetrical complex consisted of one central lesion in the anterior nasal septum and the two others in each of the lateral nasal walls. The lesions extended from the anterior part of the inferior concha into the vestibulum and caused severe nasal obstruction. L. K. Døsen, P. Jebsen, B. Dingsør, and R. Haye Copyright © 2015 L. K. Døsen et al. All rights reserved. Osteoma Presenting as a Painless Solitary Mastoid Swelling Thu, 12 Feb 2015 06:45:12 +0000 Introduction. Osteoma of the temporal bone is a very uncommon benign tumor of bone. Osteomas may occur in the external auditory canals but are reported to be very rare in the mastoid bone. Case Report. A 36-year-old male presented to our department with a hard swelling behind the right ear diagnosed as osteoma. Complete excision was done through a postauricular approach. Histopathology confirmed the diagnosis of osteoma. Conclusion. Osteomas, although rare, should be considered when dealing with any hard mastoid swelling. Complete removal can be ensured by drilling till the normal cortical bone is reached to avoid recurrence. A cortical mastoidectomy should be done if the mastoid air cell system is involved. Hazem M. Abdel Tawab, Ravi Kumar V, and Salim M. Sloma Tabook Copyright © 2015 Hazem M. Abdel Tawab et al. All rights reserved. Recurrent Laryngeal Edema Imitating Angioedema Caused by Dislocated Screw after Anterior Spine Surgery Tue, 10 Feb 2015 12:38:13 +0000 The anterior cervical spine surgery is a common procedure to stabilize vertebrae damaged by various diseases. The plates and screws are usually used in the spine fixation. This kind of instrumentation may detach from the bones which is a rare but well-known complication. A 77-year-old male presented to the otorhinolaryngology department with throat pain, choking, and dysphagia. At first the angioedema was diagnosed and he was treated conservatively. The endoscopy revealed laryngeal edema, being more defined on the right side with right vocal fold paresis. CT scans showed the stabilizing plate with two screws attached tightly and the back-out of the third screw toward soft tissue of the neck. In the meantime, his condition deteriorated and he needed tracheotomy. In few days the surgical removal of the dislocated screw was performed successfully. Although two-month follow-up reported no obstruction of the larynx, the vocal folds paresis with gradual functional improvement was observed. Long-term complication of anterior spine surgery sometimes may suggest laryngeal angioedema at first. If the conservative treatment is ineffective and there is a history of anterior spine surgery, the clinicians should consider the displacement of the plate or screws in differential diagnosis. Piotr Wójtowicz, Tomasz Szafarowski, Ewa Migacz, and Antoni Krzeski Copyright © 2015 Piotr Wójtowicz et al. All rights reserved. Isolated Kaposi Sarcoma of the Tonsil: A Case Report and Review of the Scientific Literature Tue, 10 Feb 2015 10:25:40 +0000 Kaposi sarcoma is a tumour caused by human herpes virus 8, also known as Kaposi sarcoma-associated herpes virus. It usually affects the skin and oral mucosa; however, it can also sometimes affect the lungs, the liver, the stomach, the bowel, and lymph nodes. Several body sites may be affected simultaneously. The involvement of the tonsils is rare. We described an isolated localization of Kaposi’s sarcoma of the right tonsil in a HIV-positive patient. Barbara Pittore, Carlo Loris Pelagatti, Francesco Deiana, Francesco Ortu, Elena Maricosu, Sergio Cossu, and Giovanni Sotgiu Copyright © 2015 Barbara Pittore et al. All rights reserved. Hybrid Tumor of the Parotid Gland: A Case Report and Review of the Literature Mon, 09 Feb 2015 08:32:07 +0000 The parotid gland is the most common location of benign neoplasms affecting major salivary glands. Hybrid tumors are very rare tumor entities which are composed of two different tumor types, each of which conforms to an exactly defined tumor category. The tumor entities of a hybrid tumor are not separated but have an identical origin within the same topographical area. This report describes a 51-year-old male with three neoplasms occurring within a single parotid gland tumor. The clinical, radiological, and histologic features are described in addition to a review of the literature. Alain Sabri, Ibrahim Bawab, Ibrahim Khalifeh, and Elie Alam Copyright © 2015 Alain Sabri et al. All rights reserved.