Case Reports in Otolaryngology http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Pediatric Masked Mastoiditis Associated with Multiple Intracranial Complications Sun, 28 Jun 2015 14:15:09 +0000 http://www.hindawi.com/journals/criot/2015/897239/ Masked mastoiditis is a distinct form of mastoiditis with little or no symptomatology, characterized by its potential to generate severe otogenic complications. Therefore, suspected masked mastoiditis should be diagnosed and treated without delay. This study reports a rare case of masked mastoiditis, manifested by multiple intracranial complications in an immunocompetent girl. The child exhibited headache and neurological symptomatology. Imaging studies revealed an epidural and a large cerebellar abscess and the patient was immediately treated with a triple antibiotic therapy. Mastoid surgery and drainage of the epidural abscess took place after the stabilization of the patient’s neurologic status, on the 3rd hospitalization day. The cerebellar abscess was treated by craniectomy and ultrasound-guided needle aspiration in the 3rd week of hospitalization. The girl was finally discharged in excellent condition. Two years later, she is still in good health, without otological or neurological sequelae. Masked mastoiditis is an insidious disease which requires increased clinical awareness and adequate imaging. Should clinical and/or radiological findings be positive, mastoidectomy must follow in order to prevent severe otogenic complications that can be triggered by masked mastoiditis. Charalampos Voudouris, Ioannis Psarommatis, Ioannis Nikas, Dimitrios Kafouris, and Konstantina Chrysouli Copyright © 2015 Charalampos Voudouris et al. All rights reserved. Operative Management of OSAS in a Complex Case of Proteus Syndrome Tue, 23 Jun 2015 10:00:11 +0000 http://www.hindawi.com/journals/criot/2015/137589/ Obstructive sleep apnea syndrome (OSAS) is a common disorder in childhood with high prevalence in syndromic subjects with craniofacial malformations. Proteus Syndrome (PS) is a rare hamartoneoplastic disorder associated with disproportionate and asymmetric overgrowth of body parts and hypertrophy or malformation of lymphatic tissues, such as palatine tonsils. We report a case of a 12-year-old boy diagnosed with Proteus Syndrome (PS) and suffering from OSAS due to asymmetric palatine tonsillar hypertrophy, treated with partial resection of left tonsil. To avoid the risk of a general anesthesia and remove only the obstructive portion of the palatine tonsil bipolar radiofrequency-induced thermotherapy (RFITT) under local anesthesia was performed. Recovery of the obstructive respiratory disease was obtained. To our knowledge, this is the first case reported in the literature of partial tonsillar resection performed in a patient with PS suffering from OSAS under local anesthesia. Elena Cantone, Michele Cavaliere, Giovanni Castagna, Anna Marino, Luigi Del Vecchio, and Maurizio Iengo Copyright © 2015 Elena Cantone et al. All rights reserved. An Unusual Case of Bony Styloid Processes That Extend to the Hyoid Bone Mon, 22 Jun 2015 10:56:00 +0000 http://www.hindawi.com/journals/criot/2015/780870/ The embryological origin of the hyoid bone is a point of uncertainty, with controversy surrounding the relative contribution of the second pharyngeal arch to hyoid development. We encountered a 52-year-old male with bilateral bony styloid extension to the lesser cornu of the hyoid bone during the workup of a patient with laryngeal cancer. This embryological malformation clearly supports the hypothesis that the second pharyngeal arch gives rise to the lesser cornu and demonstrates an unusual clinical finding that may be encountered by otolaryngologists. We demonstrate the imaging findings and surgical management of this unusual anatomical variant and review the embryological basis for this rare malformation. Shekhar K. Gadkaree, Christopher G. Hyppolite, Aisha Harun, Ryan H. Sobel, and Young Kim Copyright © 2015 Shekhar K. Gadkaree et al. All rights reserved. Thyroid Hemiagenesis Associated with Hyperthyroidism Mon, 22 Jun 2015 06:07:11 +0000 http://www.hindawi.com/journals/criot/2015/829712/ Thyroid hemiagenesis (TH), very rare congenital anomaly, is generally asymptomatic. We report two cases of TH with hyperthyroidism. Case One. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goitre at right lobe. Biochemical analysis revealed the diagnosis of hyperthyroidism. Ultrasound showed multinodular hypertrophy in the right lobe and absence of the left lobe. Nuclear scan, confirming absence of the left lobe, showed hot nodules in the right one. The diagnosis was toxic multinodular goitre. Case Two. The thyroid was not palpable in this patient presented with signs and symptoms of thyrotoxicosis. Biochemical analysis revealed the diagnosis of autoimmune thyrotoxicosis. Ultrasound showed mild diffuse hyperplasia of the right lobe and agenesis of the left lobe. Nuclear scan, confirming absence of the left lobe, showed increasing diffuse uptake of radiotracer in the right one. The diagnosis was Graves’ disease in this patient. After antithyroid medication, the patients were surgically treated with total excision of the thyroid tissue. TH is sometimes associated with disorders of the thyroid. Hyperthyroidism makes TH cases symptomatic. During evaluation of patients, ultrasound and nuclear scan usually report agenesis of one lobe and establish the diagnosis of TH. The surgical treatment is total removal of hyperactive tissue and total excision of the remaining lobe. Gunay Gurleyik and Emin Gurleyik Copyright © 2015 Gunay Gurleyik and Emin Gurleyik. All rights reserved. An Inflammatory Pseudotumor Arising from Pterygopalatine Fossa with Invasion to the Maxillary Sinus and Orbital Cavity Thu, 18 Jun 2015 12:35:59 +0000 http://www.hindawi.com/journals/criot/2015/950823/ We report a patient who had an inflammatory pseudotumor (IPT) that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site; this is a very rare case. The patient was an 83-year-old woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects. To obtain a definitive diagnosis from histopathological analysis, the lesion was biopsied, and she was diagnosed as the inflammatory pseudotumor with the immunohistochemical study and multiplex polymerase chain reaction-based clonality assays. The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective. It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery. Hidenori Yokoi, Takuya Yazawa, Yuma Matsumoto, Tetsuya Ikeda, Masachika Fujiwara, Yasuo Ohkura, and Naoyuki Kohno Copyright © 2015 Hidenori Yokoi et al. All rights reserved. A Puzzle of Vestibular Physiology in a Meniere’s Disease Acute Attack Thu, 18 Jun 2015 09:23:21 +0000 http://www.hindawi.com/journals/criot/2015/460757/ The aim of this paper is to present for the first time the functional evaluation of each of the vestibular receptors in the six semicircular canals in a patient diagnosed with Meniere’s disease during an acute attack. A 54-year-old lady was diagnosed with left Meniere’s disease who during her regular clinic review suffers an acute attack of vertigo, with fullness and an increase of tinnitus in her left ear. Spontaneous nystagmus and the results in the video head-impulse test (vHIT) are shown before, during, and after the attack. Nystagmus was initially left beating and a few minutes later an upbeat component was added. No skew deviation was observed. A decrease in the gain of the vestibuloocular reflex (VOR) and the presence of overt saccades were observed when the stimuli were in the plane of the left superior semicircular canal. At the end of the crisis nystagmus decreased and vestibuloocular reflex returned to almost normal. A review of the different possibilities to explain these findings points to a hypothetical utricular damage. Marta Martinez-Lopez, Raquel Manrique-Huarte, and Nicolas Perez-Fernandez Copyright © 2015 Marta Martinez-Lopez et al. All rights reserved. Isolated Sensorineural Hearing Loss as a Sequela after Lightning Strike Tue, 16 Jun 2015 12:15:39 +0000 http://www.hindawi.com/journals/criot/2015/738416/ In most of the surviving patients after a lightning strike, audiovestibular abnormalities have been reported. The most frequently reported type of abnormalities is a tympanic membrane perforation with hearing loss and external ear canal burn. However a sensor neural hearing loss and mixed type hearing loss can also occur, but these occur rarely. A nineteen-year-old female patient had, after a lightning strike, serious burns on the left ear, behind the ear, and on the chest and neck. She also had in her left ear 108 dB hearing loss with irregular central perforation and in her right ear 52 dB sensorineural hearing loss. There was no hearing loss before the strike. A hearing aid was recommended for the right ear and good care and follow-up were recommended for the left ear. A lightning strike can cause serious audiological damage. Therefore, it is necessary to make a careful audiovestibular evaluation of the patients. Although there exist rarely healed cases from sensorineural hearing loss after lightning strike in literature, in our case hearing loss occurred bilaterally and then it healed unilaterally. This condition is quite rare in literature. Mahfuz Turan, Ferhat Kalkan, Nazım Bozan, İsa Özçalimli, Mehmet Zeki Erdem, Abdülaziz Yalınkılıç, and Mehmet Fatih Garca Copyright © 2015 Mahfuz Turan et al. All rights reserved. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review Sun, 14 Jun 2015 09:57:16 +0000 http://www.hindawi.com/journals/criot/2015/306950/ Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB) facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT) examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis. Sultan Şevik Eliçora, Aykut Erdem Dinç, Sultan Bişkin, Murat Damar, and Ergin Bilgin Copyright © 2015 Sultan Şevik Eliçora et al. All rights reserved. Isolated Nasal Tip Metastasis from Esophageal Squamous Cell Carcinoma: Case Report and Literature Review Sun, 14 Jun 2015 08:35:43 +0000 http://www.hindawi.com/journals/criot/2015/246094/ Objectives. Cutaneous metastases can be the first sign of a malignant disease and have an unfavorable prognostic significance. The external nose is rarely affected. The uncommon clinical presentation of these cutaneous metastases may lead to the wrong diagnosis and treatment. Methods. We present the case of a 59-year-old patient with a small indolent tumor on the tip of the nose that turned out to be the first sign of an extended esophageal cancer. Conclusion. The differential diagnosis of tumors of the facial skin and the nasal tip includes metastases from an unknown primary tumor. In rare cases, squamous cell carcinoma of the esophagus needs to be considered. Georg J. Ledderose and Anna S. Englhard Copyright © 2015 Georg J. Ledderose and Anna S. Englhard. All rights reserved. Primary Small Cell Carcinoma of the Hypopharynx: A Case Report of a Rare Tumor Sun, 07 Jun 2015 06:28:57 +0000 http://www.hindawi.com/journals/criot/2015/934926/ Introduction. Primary hypopharynx involvement of small cell carcinoma is very rare and very few cases have been reported in the literature. Here, we report a case of primary small cell carcinoma of the hypopharynx in a male patient. Case Report. A 50-year-old man presented with a 6-month history of sore throat and swellings in the right side of the neck. Direct laryngoscopy and biopsy revealed small cell carcinoma of the hypopharynx located in the right pyriform sinus. Discussion. Small cell carcinoma of the hypopharynx has no clear treatment modality due to the rarity of the disease. Systemic chemotherapy and radiotherapy should have priority among the therapy regimens because of the high metastatic potential of the tumor. Ali Bayram, Ebru Akay, Sema S. Göksu, and İbrahim Özcan Copyright © 2015 Ali Bayram et al. All rights reserved. Extramedullary Plasmacytoma of the Larynx Treated by a Surgical Endoscopic Approach and Radiotherapy Thu, 04 Jun 2015 09:18:46 +0000 http://www.hindawi.com/journals/criot/2015/951583/ Extramedullary plasmacytoma (EMP) is a rare variant of plasma cell myeloma that affects soft tissues. The head and neck region are the most affected sites, although others have also been described. Herein we report an uncommon case of EMP of the larynx in a 65-year-old male who presented with a history of progressive dysphonia and hoarseness. Laryngeal fiberscopy evidenced a reddish pedicled voluminous mass in the left false cords and ventricle. Microscopic suspension laryngoscopy was performed under general anaesthesia and a 4 W Acublade CO2 Laser was used for transoral resection of the lesion. This was followed by adjuvant radiotherapy, with the widely recommended doses on the supraglottic region, to achieve better local control. Diagnosis of EMP is based on immunohistochemistry and the exclusion of systemic plasma cell proliferative disorders. Diagnosis of solitary EMP can be made only if studies for disseminated disease and X-ray and/or magnetic resonance imaging of the spine, pelvis, femurs, and humerus and bone marrow biopsy are negative. As there are no internationally established guidelines, treatment of EMP is mainly based on consensus of expert opinion. Massimiliano Pino, Filippo Farri, Pietro Garofalo, Fausto Taranto, Andrea Toso, and Paolo Aluffi Copyright © 2015 Massimiliano Pino et al. All rights reserved. Endoscopic Modified Medial Maxillectomy for Resection of an Inverted Papilloma Originating from the Entire Circumference of the Maxillary Sinus Wed, 03 Jun 2015 06:09:16 +0000 http://www.hindawi.com/journals/criot/2015/952923/ For treatment of a sinonasal inverted papilloma (IP), it is essential to have a definite diagnosis, to identify its origin by computed tomography (CT) and magnetic resonance imaging (MRI), and to select the appropriate surgical approach based on the staging system proposed by Krouse. Recently, a new surgical approach named endoscopic modified medial maxillectomy (EMMM) was proposed. This approach can preserve the inferior turbinate and nasolacrimal duct. We successfully treated sinonasal IP with EMMM in a 71-year-old female patient. In this patient, the sinonasal IP originated from the entire circumference of the maxillary sinus. EMMM is not a difficult procedure and provides good visibility of the operative field. Lacrimation and empty nose syndrome do not occur postoperatively as the nasolacrimal duct and inferior turbinate are preserved. EMMM is considered to be a very favorable approach for treatment of sinonasal IP. Kota Wada, Takashi Ishigaki, Yutaro Ida, Yuki Yamada, Sachiko Hosono, and Hideo Edamatsu Copyright © 2015 Kota Wada et al. All rights reserved. Internal Carotid Artery Aneurysm Mimicking Peritonsillar Abscess Mon, 01 Jun 2015 12:10:04 +0000 http://www.hindawi.com/journals/criot/2015/389298/ The extracranial internal carotid artery aneurysm (EICAA) is an uncommon arterial lesion. Patients typically present with neurologic symptoms resulting from impaired cerebral perfusion and compression symptoms of cranial nerves. Often EICAA presents as a pulsatile neck mass, which is otherwise asymptomatic. We present a case of an 84-year-old female, who was initially referred to the Emergency Department for Otolaryngology with suspected peritonsillar abscess. The patient had a history of recent upper airway infection and cardiovascular comorbidities, including hypertension and ischaemic stroke complicated by extensive neurologic deficits. Physical examination revealed a compact, nonpulsatile mass in the lateral parapharyngeal space and local erythema of the mucosa. Duplex Doppler Ultrasonography and Computed Tomography revealed an atherosclerotic aneurysm of the right internal carotid artery, measuring  mm, stretching from the skull base to the angle of the mandible. Jacek Brzost, Anna M. Cyran, Martyna Waniewska, and Miroslaw J. Szczepanski Copyright © 2015 Jacek Brzost et al. All rights reserved. A New Variant of Posterior Canal Benign Paroxysmal Positional Vertigo: A Nonampullary or Common Crus Canalolithiasis Sun, 31 May 2015 14:04:48 +0000 http://www.hindawi.com/journals/criot/2015/816081/ Clockwise or counterclockwise, rotational, upbeating nystagmus is seen in patients with posterior canal benign paroxysmal positional vertigo during left or right head-hanging test, respectively. Rotating of nystagmus in opposite direction to the ear tested or even reversal of initial positioning rotational nystagmus is not usual and has never been reported before. We propose a new variant of posterior canal benign paroxysmal positional vertigo due to unusual behavior and location of the otoliths inside the membranous labyrinth. Unexpected rotational direction may lead to confusion about the site. The examiner should be aware of this abnormal or atypical variant of posterior canal benign paroxysmal positional vertigo. Sertac Yetiser Copyright © 2015 Sertac Yetiser. All rights reserved. Pleomorphic Adenoma of the External Auditory Canal: A Rare Presentation Wed, 27 May 2015 14:12:52 +0000 http://www.hindawi.com/journals/criot/2015/696531/ A 55-year-old male presented with a nine-month history of gradually enlarging, painless mass in the right external auditory canal associated with hearing loss and occasional bleeding. Examination demonstrated complete obstruction of the outer 1/3 of the external auditory canal by a firm, pink, rubbery mass. CT scan of the temporal bone showed tumor mass with no evidence of bone destruction. The tumor was excised and histopathology confirmed a diagnosis of ceruminous pleomorphic adenoma of the external auditory canal. Six months following the surgery, patient is free of any recurrent disease. Samir Jaber, Milan Rudic, and Ivan James Keogh Copyright © 2015 Samir Jaber et al. All rights reserved. Ossifying Parotid Carcinoma ex Pleomorphic Adenoma Sun, 17 May 2015 12:46:09 +0000 http://www.hindawi.com/journals/criot/2015/395358/ 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 http://www.hindawi.com/journals/criot/2015/131469/ 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 http://www.hindawi.com/journals/criot/2015/232898/ 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 http://www.hindawi.com/journals/criot/2015/548582/ 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 http://www.hindawi.com/journals/criot/2015/570520/ 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 http://www.hindawi.com/journals/criot/2015/305494/ 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 http://www.hindawi.com/journals/criot/2015/981436/ 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 http://www.hindawi.com/journals/criot/2015/372089/ 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 http://www.hindawi.com/journals/criot/2015/506484/ 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 http://www.hindawi.com/journals/criot/2015/460208/ 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 http://www.hindawi.com/journals/criot/2015/159647/ 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 http://www.hindawi.com/journals/criot/2015/813240/ 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 http://www.hindawi.com/journals/criot/2015/404586/ 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 http://www.hindawi.com/journals/criot/2015/872038/ 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 http://www.hindawi.com/journals/criot/2015/739630/ 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.