Case Reports in Otolaryngology The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Filariasis of Stensen’s Duct: An Index Case Thu, 27 Oct 2016 13:46:30 +0000 Filariasis, a neglected tropical disease, is a global health problem and is endemic to 73 countries including India. It is caused by nematodes of Filariodidea family, namely, W. bancrofti and B. malayi in India, which have a predilection for the lower limbs and testis. We report a never before reported case of filariasis of the main parotid duct in a 25-year-old male that resolved on medical management, exemplifying the importance of maintaining a high index of suspicion and careful examination of cytological smears in endemic countries, allowing for an early diagnosis and treatment, decreasing the morbidity of this debilitating disease. Eishaan K. Bhargava, Nikhil Arora, Varun Rai, Ravi Meher, Prerna Arora, and Ruchika Juneja Copyright © 2016 Eishaan K. Bhargava et al. All rights reserved. A Case of Reactive Cervical Lymphadenopathy with Fat Necrosis Impinging on Adjacent Vascular Structures Thu, 20 Oct 2016 10:20:51 +0000 A tender neck mass in adults can be a diagnostic challenge due to a wide differential diagnosis, which ranges from reactive lymphadenopathy to malignancy. In this report, we describe a case of a young female with an unusually large and tender reactive lymph node with fat necrosis. The diagnostic imaging findings alone mimicked that of scrofula and malignancy, which prompted a complete workup. Additionally, the enlarged lymph node was compressing the internal jugular vein in the setting of oral contraceptive use by the patient, raising concern for Lemierre’s syndrome or internal jugular vein thrombosis. This report shows how, in the appropriate clinical context, and especially with the involvement of adjacent respiratory or neurovascular structures, aggressive diagnostic testing can be indicated. Albert Y. Han, Jacob F. Lentz, Edward C. Kuan, Hiwot H. Araya, and Mohammad Kamgar Copyright © 2016 Albert Y. Han et al. All rights reserved. Nonodontogenic Cervical Necrotizing Fasciitis Caused by Sialadenitis Sun, 16 Oct 2016 06:46:29 +0000 Necrotizing fasciitis is a rapidly progressive infectious disease of the soft tissue with high mortality and morbidity rates. Necrotizing fasciitis is occasionally located in the head and neck region and develops after odontogenic infections. Factors affecting treatment success rates are early diagnosis, appropriate antibiotic treatment, and surgical debridement. We present a necrotizing fasciitis case located in the neck region that developed after sialoadenitis. It is important to emphasize that necrotizing fasciitis to be seen in the neck region is very rare. Nonodontogenic necrotizing fasciitis is even more rare. Alper Yenigun, Bayram Veyseller, Omer Vural, and Orhan Ozturan Copyright © 2016 Alper Yenigun et al. All rights reserved. Tortuous Common Carotid Artery: A Report of Four Cases Observed in Cadaveric Dissections Thu, 13 Oct 2016 12:49:28 +0000 A tortuous common carotid artery poses a high risk of injury during tracheotomy. Preoperative diagnosis is therefore important to avoid serious complications. We found four cases of tortuous common carotid artery during an anatomical dissection course for students. The first case was a 91-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case was a 78-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case was an 86-year-old woman who died from bladder cancer and who also had a right tortuous common carotid artery without arteriosclerosis. Case was an 89-year-old woman who had bilateral tortuous common carotid arteries and a tortuous brachiocephalic artery with severe arteriosclerosis. Case was also examined using computed tomography to evaluate the arteriosclerosis. Computed tomography revealed severe calcification of the vascular wall, which was confirmed in the aortic arch and origins of its branches. In all four cases, the tortuosity was located below the level of the thyroid gland. Based on prior study results indicating that fusion between the carotid sheath and visceral fascia was often evident at the level of the thyroid gland, we speculated that the major region in which tortuosity occurs is at the same level or inferior to the level of the thyroid gland. Joe Iwanaga, Koichi Watanabe, Saga Tsuyoshi, Yoko Tabira, and Koh-ichi Yamaki Copyright © 2016 Joe Iwanaga et al. All rights reserved. Lipoma of Piriform Sinus: A Case Report and Review of the Literature Tue, 04 Oct 2016 07:00:46 +0000 The lipomas of oropharynx, hypopharynx, and larynx are so rare that up to now approximately there have been 100 cases reported. The lipomas are slow-growing lesions that are capable of reaching considerable dimensions and are often detected at a late stage. The symptoms can vary both in dimension and in location, semiobstructing the aerodigestive tract or exerting compression on adjacent structure. In this case, the lesion, which originated from the piriform sinus, was removed endoscopically urgently due to obvious signs of tissue suffering caused by stretching of the pedicle as a result of displacement of the mass. The two aims of this case report are to expose an interesting and rare case study mainly for an Emergency Room Specialist and an ENT (Ear, Nose, and Throat) Specialist involved in solving the problem and to demonstrate that the choice of an endoscopic approach is useful in order to have an optimal visualization of the lesion and to perform a total eradication. The use of endoscopic devices also allows a rapid postoperative recovery, compared to external access and optimum locoregional control in the follow-up procedures to prevent possible relapses. Gilberto Acquaviva, Theodoros Varakliotis, Stefano Badia, Francesco Casorati, Alberto Eibenstein, and Gianluca Bellocchi Copyright © 2016 Gilberto Acquaviva et al. All rights reserved. Juvenile Nasopharyngeal Angiofibroma Presenting with Acute Airway Obstruction Mon, 26 Sep 2016 13:29:19 +0000 We describe a case of a 24-year-old male presenting urgently with a juvenile nasopharyngeal angiofibroma (JNA) with difficulty breathing, inability to swallow, and respiratory distress following throat swelling. The swelling was reduced with administration of dexamethasone and the JNA was surgically resected within 48 hours. This presentation was atypical given the acuity of presentation and the patient’s older age. Chikoti Wheat, Ryan J. Bickley, Erik Cohen, Danya Wenzler, Nancy Hunter, and Donna Astiz Copyright © 2016 Chikoti Wheat et al. All rights reserved. Contralateral Cochlear Labyrinthine Concussion without Temporal Bone Fracture: Unusual Posttraumatic Consequence Wed, 21 Sep 2016 11:33:20 +0000 Introduction. Labyrinthine concussion is a term used to describe a rare cause of sensorineural hearing loss with or without vestibular symptoms occurring after head trauma. Isolated damage to the inner ear without involving the vestibular organ would be designated as a cochlear labyrinthine concussion. Hearing loss is not a rare finding in head trauma that involves petrous bone fractures. Nevertheless it generally occurs ipsilateral to the side of the head injury and extraordinarily in the contralateral side and moreover without the presence of a fracture. Case Report. The present case describes a 37-year-old patient with sensorineural hearing loss and tinnitus in his right ear after a blunt head trauma of the left-sided temporal bone (contralateral). Otoscopy and radiological images showed no fractures or any abnormalities. A severe sensorineural hearing loss was found in his right ear with a normal hearing of the left side. Conclusion. The temporal bone trauma requires a complete diagnostic battery which includes a neurotologic examination and a high resolution computed tomography scan in the first place. Hearing loss after a head injury extraordinarily occurs in the contralateral side of the trauma as what happened in our case. In addition, the absence of fractures makes this phenomenon even more unusual. I. M. Villarreal, D. Méndez, J. M. Duque Silva, and P. Ortega del Álamo Copyright © 2016 I. M. Villarreal et al. All rights reserved. Oncocytoma of the Submandibular Gland: Diagnosis and Treatment Based on Clinicopathology Mon, 19 Sep 2016 06:07:44 +0000 Background. Submandibular oncocytomas are rare benign salivary gland neoplasms. They are typically found in Caucasian patients aged 50–70 years with no gender preference. Due to the overlapping histological and clinical features of head and neck tumors, they are often misdiagnosed. Methods. We report a case of unilateral submandibular gland oncocytoma in a 63-year-old Caucasian man. Results. The patient underwent unilateral submandibular gland resection and histopathologic analysis of the tumor specimen. On follow-up at 2 weeks and 1 year, no recurrence was identified. Conclusion. Submandibular oncocytomas are best diagnosed with preoperative FNA and CT imaging and have distinctive findings on cytology and histology. CT followed by fine-needle aspiration cytology would be the preferred diagnostic modalities. Due to its low rate of malignant transformation and recurrence, the best treatment is local resection with follow-up as necessary. Betty Chen, Joshua I. Hentzelman, Ronald J. Walker, and Jin-Ping Lai Copyright © 2016 Betty Chen et al. All rights reserved. Lymphoepithelial Cyst in the Palatine Tonsil Sun, 18 Sep 2016 16:16:54 +0000 Lymphoepithelial cyst (LEC) is the most commonly encountered congenital neck pathology in the lateral part of the neck. A 66-year-old woman presented to the ENT clinic due to difficulty in swallowing persisting for approximately 1 year. Magnetic resonance imaging revealed a cystic mass at right tonsil. Surgery was performed due to this unilateral tonsillar mass, which was excised together with the right tonsil. LEC was diagnosed at histopathological examination. LEC in the palatine tonsil is rare, and only a few cases have been reported in the literature. We report a rare case of LEC in the palatine tonsil. Fatih Bingöl, Hilal Balta, Buket Özel Bingöl, Recai Muhammet Mazlumoğlu, and Korhan Kılıç Copyright © 2016 Fatih Bingöl et al. All rights reserved. Chronic Invasive Nongranulomatous Fungal Rhinosinusitis in Immunocompetent Individuals Thu, 15 Sep 2016 13:36:33 +0000 Chronic invasive nongranulomatous fungal rhinosinusitis is a well-described but uncommon type of fungal rhinosinusitis (FRS). While the prevalence of chronic FRS is 0.11% in healthy individuals, only 1.3% of them are in nongranulomatous invasive nature. The majority of the cases in the literature have been reported from developing countries mostly located in the tropical regions, as typically occurring in the background of diabetes mellitus or corticosteroid treatment. The current paper reports four consecutive cases, who were diagnosed within a short period of six months at a single center of a country located outside the tropical climate zone. None of the patients had a comorbid disease that may cause immune suppression or a history of drug use. The only risk factor that may have a role in development of chronic invasive nongranulomatous FRS was that all of our patients were people working in greenhouse farming. Three cases underwent endoscopic sinus surgery, and one case underwent surgery with both endoscopic and external approaches. Systemic antifungal therapy was initiated in all cases in the postoperative period with voriconazole 200 mg orally twice a day. All patients achieved a complete clinical remission. Chronic invasive nongranulomatous FRS should be kept in mind in the presence of long-standing nonspecific sinonasal symptoms in immunocompetent individuals, particularly with a history of working in greenhouse farming. Ozge Turhan, Asli Bostanci, Irem Hicran Ozbudak, and Murat Turhan Copyright © 2016 Ozge Turhan et al. All rights reserved. Oral Neurothekeoma of the Right Buccal Mucosa Thu, 08 Sep 2016 17:45:57 +0000 Oral neurothekeoma or nerve sheath myxoma is a rare benign oral tumour of nerve sheath origin. Historically, this tumour has been subclassified as myxoid (classic), mixed, or the cellular type, depending on the amount of myxoid stroma and cellularity. We present a case of oral neurothekeoma (mixed type) of the buccal mucosa. The tumour was completely excised. No recurrence was detected in the last 3 years after local excision. Alex C. Tham, Nandini L. Chilagondanahalli, Manish M. Bundele, and Jeevendra Kanagalingam Copyright © 2016 Alex C. Tham et al. All rights reserved. Leiomyosarcoma Ex Pleomorphic Adenoma of the Parotid Gland: A Case Report and Literature Review Thu, 08 Sep 2016 17:33:02 +0000 There is only one previously reported incident in the English literature of sarcoma ex pleomorphic adenoma of the parotid and there are only 8 cases of primary parotid leiomyosarcoma. In our case, a 79-year-old female patient presented to our care with left preauricular pain, swelling, and facial weakness. After CT imaging, she underwent left total parotidectomy. A spindle cell lesion was identified intraoperatively and the facial nerve was sacrificed. Subsequent analysis of the lesion yielded a diagnosis of leiomyosarcoma ex pleomorphic adenoma. After 30 fractions of radiation therapy, scans were negative for tumor. However, 18 months after first experiencing symptoms, she was found to have metastases to the brainstem and lung. When diagnosing sarcoma ex pleomorphic adenoma of the parotid gland, it is important to perform thorough immunohistochemical staining and exclude a previous history of sarcoma or other sources of metastases. Complete resection is critical due to the tumor’s local aggressiveness and metastatic potential. Although these tumors are not very responsive to chemotherapy or radiation, adjuvant treatment is commonly used when margins are unclear. Michael Coulter, Jingxuan Liu, and Mark Marzouk Copyright © 2016 Michael Coulter et al. All rights reserved. Persistent Down-Beating Torsional Positional Nystagmus: Posterior Semicircular Canal Light Cupula? Wed, 07 Sep 2016 14:37:06 +0000 A 16-year-old boy with rotatory positional vertigo and nausea, particularly when lying down, visited our clinic. Initially, we observed vertical/torsional (downward/leftward) nystagmus in the supine position, and it did not diminish. In the sitting position, nystagmus was not provoked. Neurological examinations were normal. We speculated that persistent torsional down-beating nystagmus was caused by the light cupula of the posterior semicircular canal. This case provides novel insights into the light cupula pathophysiology. Akihide Ichimura and Koji Otsuka Copyright © 2016 Akihide Ichimura and Koji Otsuka. All rights reserved. Case of Chronic Otitis Media with Intracranial Complication and Contralateral Extracranial Presentation Wed, 07 Sep 2016 12:26:08 +0000 Intracranial complications of chronic otitis media have been on the decline with advent of antibiotics. Septic thrombosis of the sigmoid sinus is rarer compared to commoner complications such as otogenic brain abscesses and meningitis. This patient presented with recurrent infection after left mastoidectomy secondary to cholesteatoma and a contralateral internal jugular vein thrombosis with parapharyngeal abscess, which was drained. He recovered well postoperatively with antibiotics. X. Y. Yeoh, P. S. Lim, and K. C. Pua Copyright © 2016 X. Y. Yeoh et al. All rights reserved. Bilateral Vocal Cord Paralysis and Cervicolumbar Radiculopathy as the Presenting Paraneoplastic Manifestations of Small Cell Lung Cancer: A Case Report and Literature Review Wed, 07 Sep 2016 09:21:20 +0000 Introduction. Bilateral vocal cord paralysis (BVCP) is a potential medical emergency. The Otolaryngologist plays a crucial role in the diagnosis and management of BVCP and must consider a broad differential diagnosis. We present a rare case of BVCP secondary to anti-Hu paraneoplastic syndrome. Case Presentation. A 58-year-old female presented to an Otolaryngology clinic with a history of progressive hoarseness and dysphagia. Flexible nasolaryngoscopy demonstrated BVCP. Cross-sectional imaging of the brain and vagus nerves was negative. An antiparaneoplastic antibody panel was positive for anti-Hu antibodies. This led to an endobronchial biopsy of a paratracheal lymph node, which confirmed the diagnosis of small cell lung cancer. Conclusion. Paraneoplastic neuropathy is a rare cause of BVCP and should be considered when more common pathologies are ruled out. This is the second reported case of BVCP as a presenting symptom of paraneoplastic syndrome secondary to small cell lung cancer. Jeffrey C. Yeung, C. Elizabeth Pringle, Harmanjatinder S. Sekhon, Shaun J. Kilty, and Kristian Macdonald Copyright © 2016 Jeffrey C. Yeung et al. All rights reserved. Pleomorphic Rhabdomyosarcoma Arising from True Vocal Fold of Larynx: Report of a Rare Case and Literature Review Tue, 06 Sep 2016 14:21:31 +0000 We present an extremely rare case of a pleomorphic rhabdomyosarcoma of the true vocal fold. The histopathological diagnosis was confirmed by immunohistochemistry. The patient was treated with radical surgery including total laryngectomy and radical neck dissection followed by postoperative radiotherapy. The clinicopathologic features of this rare malignancy are discussed together with a review of the literature. This case report and literature review highlights the more favorable prognosis of pleomorphic rhabdomyosarcoma in the larynx than in other locations. Sevdegül Mungan, Selçuk Arslan, Eda Küçüktülü, Şafak Ersöz, and Bengü Çobanoğlu Copyright © 2016 Sevdegül Mungan et al. All rights reserved. Tympanosclerosis Presenting as Mass: Workup and Differential Tue, 30 Aug 2016 15:54:57 +0000 Introduction. Tympanosclerosis is a commonly encountered entity within ENT clinics and primary care settings. Recognizing ear pathology is essential for correct management. Oftentimes the diagnosis is clear; however in certain cases further workup to rule out other more insidious disease processes is warranted. Case Report. We present a case of tympanosclerosis which presented as an ear mass without classic appearance of tympanosclerosis. Through imaging and biopsy the diagnosis of tympanosclerosis was made. The patient was treated surgically with good outcome. Discussion. Various ear pathologies, with different treatment algorithms, may present as clinically similar to one another. Differential diagnosis for this case included tympanosclerosis, cholesteatoma, or other middle ear masses. We review these entities and discuss their pathophysiology and implications on management. Jonnae Y. Barry, Saranya Reghunathan, and Abraham Jacob Copyright © 2016 Jonnae Y. Barry et al. All rights reserved. Varicella Infection Complicated by Group A Beta-Hemolytic Streptococcal Retropharyngeal Abscess Mon, 29 Aug 2016 14:16:35 +0000 An unimmunized 19-month-old child presented with a retropharyngeal abscess and coincident varicella infection. The abscess resolved with operative drainage. This is the first published report of this connection, although varicella is known to be associated with abscesses in general. Practitioners should be aware that cervical abscesses may complicate varicella infections. Christine M. Clark, Colin Huntley, and Michele M. Carr Copyright © 2016 Christine M. Clark et al. All rights reserved. Abnormal Congenital Location of Stapes’ Superstructure: Clinical and Embryological Implications Sun, 28 Aug 2016 16:47:10 +0000 Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes’ superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window. A stapes prosthesis was inserted and resulted in closure of the air-bone gap by 25 dB. A review of the literature was also performed using MEDLINE. Two theories diverge on the embryologic origin of the stapes. Our findings seem to be in favour of the theory that defines two different embryologic origins to the stapes. Vânia Henriques, Rafaela Teles, Ana Sousa, Roberto Estevão, Jorge Rodrigues, Alexandra Gomes, Francisco Silva, Ângelo Fernandes, and Fausto Fernandes Copyright © 2016 Vânia Henriques et al. All rights reserved. Intramuscular Hemangioma of Thyrohyoid Muscle Sun, 28 Aug 2016 13:26:36 +0000 Intramuscular hemangiomas are rare benign vascular neoplasms. IMH accounts for less than 1% of all hemangiomas. These neoplasms commonly occur in trunk and extremities but are rare in head and neck region. The present case is a 17-year-old female patient, who presented with a painless, slowly enlarging mass in left sided upper neck for 4 years. Investigations were suggestive of vascular neoplasm. She underwent excision of the mass in toto under general anesthesia. Postoperative period was uneventful. Histopathological examination of the mass revealed it as mixed type of intramuscular hemangioma. She did not have any signs of recurrences on her last follow-up at 6 months postoperatively. This case report discusses the rare IMH arising from thyrohyoid strap muscle. Ramesh Parajuli, Suman Thapa, and Sushna Maharjan Copyright © 2016 Ramesh Parajuli et al. All rights reserved. Maxillary Osteomyelitis: A Rare Entity Thu, 25 Aug 2016 13:45:45 +0000 Osteomyelitis of the maxilla is now a rare event with the advent of antibiotics. The two predominant causes are odontogenic infections and sinusitis. Immunocompromised states such as diabetes, HIV, and malnutrition increase the risk of osteomyelitis. It is important to recognize this early as it is a difficult entity to treat with potentially serious consequences. We report an unusual case of right sided maxillary osteomyelitis in a lady with poorly controlled diabetes in rural Lincolnshire. Biopsy of the right maxillary bone showed features of acute osteomyelitis. This responded well to a prolonged course of oral antibiotics. Ayaaz Habib, Nagaraj Sivaji, and Tauseef Ashraf Copyright © 2016 Ayaaz Habib et al. All rights reserved. Primary Neuroendocrine Tumor of the Parotid Gland: A Case Report and a Comprehensive Review of a Rare Entity Tue, 16 Aug 2016 16:16:14 +0000 Neuroendocrine tumors (NETs) comprise a heterogeneous group of malignancies from cells derived from the neural crest with neuroendocrine differentiation. Despite the differences in the site of origin, nomenclature, biological behavior, and functional status, NETs share certain ultrastructural and immunohistochemical features. NETs are relative rare tumors with an annual incidence of 5.76 new cases per 100.000 inhabitants and they usually appear in the gastrointestinal tract or in the pulmonary system. Head and neck NETs are uncommon with limited information regarding frequency, most of them showing small cell carcinoma features. NETs that arise from the salivary glands are exceedingly rare. Regardless of their low frequency, it is imperative to accurately differentiate these tumors from the much more common squamous cell carcinomas and from metastasis from another primary tumor due to the completely different therapeutic approaches and prognosis. The diagnosis is based on the recognition of the typical neuroendocrine architecture and immunohistochemical staining and on an exhaustive work-up. Hereby, we report a case of a moderately differentiated NET of the parotid gland that was treated with a complete parotidectomy. We summarize the clues that led to the final diagnosis and major strategies that were employed to manage the patient. We also perform a comprehensive review of the scarce available literature on this topic. Olga Martínez-Sáez, Javier Molina-Cerrillo, Carmen Moreno García del Real, Rafael Barberá Durban, Juan J. Díez, Teresa Alonso-Gordoa, and Enrique Grande Pulido Copyright © 2016 Olga Martínez-Sáez et al. All rights reserved. A Case of Skull Base Osteomyelitis with Multiple Cerebral Infarction Thu, 11 Aug 2016 10:54:13 +0000 Skull base osteomyelitis is classically documented as an extension of malignant otitis externa. Initial presentation commonly includes aural symptoms and cranial nerve dysfunctions. Here we present a case that emerged with multiple infarctions in the right cerebrum. A male in his 70s with diabetes mellitus and chronic renal failure presented with left hemiparesis. Imaging studies showed that blood flow in the carotid artery remained at the day of onset but was totally occluded 7 days later. However, collateral blood supply prevented severe infarction. These findings suggest that artery-to-artery embolization from the petrous and/or cavernous portion of the carotid artery caused the multiple infarctions observed on initial presentation. Osteomyelitis of the central skull base was diagnosed on the basis of the following findings taken together: laboratory results showing high levels of inflammation, presence of Pseudomonas aeruginosa in the otorrhea and blood culture, multiple cranial nerve palsies that appeared later, the bony erosion observed on CT, and the mass lesion on MRI. Osteomyelitis was treated successfully by long-term antibiotic therapy; however, the patient experienced cefepime-induced neurotoxicity during therapy. The potential involvement of the internal carotid artery in this rare and life-threatening disease is of particular interest in this case. Haruka Miyabe, Atsuhiko Uno, Takahiro Nakajima, Natsue Morizane, Keisuke Enomoto, Masayuki Hirose, Toshinori Hazama, and Yukinori Takenaka Copyright © 2016 Haruka Miyabe et al. All rights reserved. Massive Cerebrospinal Fluid Leak of the Temporal Bone Thu, 11 Aug 2016 10:48:57 +0000 Cerebrospinal fluid (CSF) leakage of the temporal bone region is defined as abnormal communications between the subarachnoidal space and the air-containing spaces of the temporal bone. CSF leak remains one of the most frequent complications after VS surgery. Radiotherapy is considered a predisposing factor for development of temporal bone CSF leak because it may impair dural repair mechanisms, thus causing inadequate dural sealing. The authors describe the case of a 47-year-old man with a massive effusion of CSF which extended from the posterior and lateral skull base to the first cervical vertebrae; this complication appeared after a partial enucleation of a vestibular schwannoma (VS) with subsequent radiation treatment and second operation with total VS resection. Giannicola Iannella, Alessandra Manno, Emanuela Pasqualitto, Andrea Ciofalo, Diletta Angeletti, Benedetta Pasquariello, and Giuseppe Magliulo Copyright © 2016 Giannicola Iannella et al. All rights reserved. Orbital Metastasis of Breast Cancer Mimicking Invasive Fungal Rhinosinusitis Mon, 01 Aug 2016 12:46:25 +0000 Introduction. A range of traumatic, vascular, inflammatory, infectious, and neoplastic processes can affect the orbit and its structures. In the area of otolaryngology, the rhino-orbital-cerebral involvement of invasive fungal rhinosinusitis can affect the orbit, which may look like initially a rhinosinusitis or even mimic malignancy. Case Presentation. Female patient, 32 years old, with headache and ocular proptosis. She was using prednisone in immunosuppressive doses for a year and had breast cancer treated three years earlier. The initial CT scan showed opacification of the sphenoid and ethmoid sinuses, left intraorbital involvement and contrast impregnation in the cavernous sinus. The biopsy resulted positive for invasive ductal carcinoma of the breast. Discussion. The initial CT scan of our patient showed both signs of early changes of invasive fungal rhinosinusitis (IFR) and possible metastatic involvement. The intracranial extension and ocular involvement are usually the most common signs of IFR (first hypothesis). Among metastases at the orbit and the eye, breast and lung carcinomas are the most frequent. Conclusion. Although several studies on the differential diagnosis of orbital lesions exist, especially when it concerns the involvement of the nasal cavity, the diagnosis by imaging is still a challenge. Mayara Tabai, Igor Moreira Hazboun, Emerson Taro Inoue Sakuma, Marcelo Hamilton Sampaio, and Eulalia Sakano Copyright © 2016 Mayara Tabai et al. All rights reserved. Use of a Rigid Curved Laryngoscope for Removal of a Fish Bone in the Hypopharynx Wed, 27 Jul 2016 05:51:05 +0000 Foreign body ingestion is a commonly encountered clinical problem. In particular, sharp foreign bodies lodged in the esophagus or hypopharynx can cause complications and require urgent removal. Removal by flexible esophagogastroduodenoscopy or rigid esophagoscopy is the treatment of choice and has high success rates, but cases in which these methods are unsuccessful must be treated with an external incision. A 62-year-old man was referred for a fish bone lodged in the hypopharynx that could not be removed by flexible esophagogastroduodenoscopy. We removed the bone transorally using a specially designed rigid curved laryngoscope. Based on our experience, this method may have clear practical value due to advantages of a wide field of view and use of multiple rigid forceps. Indications may be limited, but this novel method may reduce the limitations of noninvasive removal of foreign bodies. Hiroshi Sakaida, Kazuki Chiyonobu, Hajime Ishinaga, and Kazuhiko Takeuchi Copyright © 2016 Hiroshi Sakaida et al. All rights reserved. Comment on “Original Solution for Middle Ear Implant and Anesthetic/Surgical Management in a Child with Severe Craniofacial Dysmorphism” Mon, 25 Jul 2016 12:37:09 +0000 Ivo Joachim Kruyt, Ann-Louise Mc Dermott, and Myrthe Karianne Sophie Hol Copyright © 2016 Ivo Joachim Kruyt et al. All rights reserved. Granulomatosis with Polyangiitis with Bilateral Facial Palsy and Severe Mixed Hearing Loss Thu, 14 Jul 2016 06:21:31 +0000 Granulomatosis with polyangiitis is autoimmune and rare disease. It affects many organs, but the most often affected organs are the nose, lungs, and kidneys. It is part of vasculitis and causes an autoimmune attack by an abnormal type of circulating antibody termed ANCAs against small blood vessels. Disease concerns both men and women with a peak age of presentation in the sixth and seven decades. Typically upper and lower respiratory tract and kidneys are involved. Otitis externa, otitis media, or mastoiditis rarely occurs in granulomatosis with polyangiitis. Deafness is the most dangerous aural complication. Histological examination of biopsy is often not specific. A case of GPA with bilateral otitis media, bilateral deafness, and bilateral facial palsy with fatal course is presented. Agnieszka Wawrzecka, Anna Szymańska, Radosław Jeleniewicz, and Marcin Szymański Copyright © 2016 Agnieszka Wawrzecka et al. All rights reserved. Metastatic Malignant Melanoma of Parotid Gland with a Regressed Primary Tumor Tue, 05 Jul 2016 07:47:19 +0000 Malignant melanoma of the parotid gland is often metastatic and mainly originates from malignant melanomas in the head and neck. Nevertheless, some malignant melanomas may metastasize and subsequently regress. Therefore, it may not be possible to observe a metastatic malignant melanoma and its primary melanoma simultaneously. The investigation of a patient’s old photographs may help in the detection of preexisting and regressed pigmented lesions in the facial and neck regions. M. Mustafa Kılıçkaya, Giray Aynali, Ali Murat Ceyhan, and Metin Çiriş Copyright © 2016 M. Mustafa Kılıçkaya et al. All rights reserved. Neuroendocrine Adenoma of the Middle Ear: A Rare Histopathological Diagnosis Mon, 27 Jun 2016 07:42:16 +0000 Neuroendocrine tumours occur throughout the body but are rare in the head and neck region and particularly rare in the middle ear. Clinical findings are often nonspecific and therefore pose a diagnostic challenge. Furthermore, the nomenclature of neuroendocrine tumours of the middle ear is historically controversial. Herein a case is presented of a middle ear adenoma in a 33-year-old patient who presented with otalgia, hearing loss, and facial nerve palsy. A brief discussion is included regarding the histopathological features of middle ear adenomas and seeks to clarify the correct nomenclature for these tumours. Zubair Hasan, Sam McGinness, Dakshika A. Gunaratne, Hedley Coleman, Winny Varikatt, and Melville da Cruz Copyright © 2016 Zubair Hasan et al. All rights reserved.