Case Reports in Otolaryngology https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . All rights reserved. Angioleiomyoma of the Auricle: An Unusual Tumor on a Rare Location Sun, 10 Dec 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/8289710/ Cutaneous angioleiomyomas (ALMs) (also known as vascular leiomyomas or angiomyomas) are unusual benign tumors of the skin deriving from the muscle layer of dermal blood vessels. They usually manifest as tender subcutaneous nodules, mostly encountered on the legs of adult women in their fifth or sixth life decade. ALMs rarely develop on the head/neck area, and even more rarely (<3% of all cases) on the auricle. Head/neck (including ear) ALMs differ from their more usual leg counterparts in that they are usually painless and do not show a female predominance. The diagnosis is clinically difficult, and most cases are diagnosed by histopathologic examination. A new case of an auricular ALM in a 40-year-old Caucasian man is reported herein, and a brief literature review on this unusual tumor is presented. Jean Kanitakis Copyright © 2017 Jean Kanitakis. All rights reserved. Relapsing Ipsilateral Vestibular Neuritis Mon, 04 Dec 2017 10:02:43 +0000 http://www.hindawi.com/journals/criot/2017/3628402/ In 2013, a 70-year-old male was admitted with an acute episode of vertigo, nausea, and vomiting with duration of one day. The patient’s background included prehypertension, vitiligo, left ventricular hypertrophy, and Sjögren's syndrome. He denied any previous episode of vertigo or migraine manifestations. Neither hearing loss nor tinnitus or otorrhea was detected at the time of evaluation. No neurological symptoms were found. There was a left-beating spontaneous nystagmus Grade 3. The patient could stand still and walk on his own with some help without falling. Day 1 vHIT showed a significant reduction in VOR gain and refixation saccades after head impulses were delivered in the planes of the right anterior and horizontal semicircular canals. MRI showed no significant findings. He was treated with steroids. A vHIT performed 14 days later showed recovery of gains and no refixation saccades. In 2015, the patient had a new episode of acute vertigo. The clinical examination was similar, and the vHIT revealed a new drop of right superior and lateral canal gains. Cervical and ocular VEMPs were performed, and no significant asymmetry was detected. Serum PCR for herpes viruses resulted negative. Contrast MRI was performed without relevant brain findings. Duilio Emiliano De Schutter and Nicolás Pérez Fernández Copyright © 2017 Duilio Emiliano De Schutter and Nicolás Pérez Fernández. All rights reserved. ANCA-Negative Granulomatosis with Polyangiitis Presenting with Hypertrophic Cranial Pachymeningitis, Abducens Nerve Palsy, and Stenosis of the Internal Carotid Artery Thu, 30 Nov 2017 09:41:31 +0000 http://www.hindawi.com/journals/criot/2017/9687383/ We report a rare case of granulomatosis with polyangiitis (GPA) presenting with hypertrophic cranial pachymeningitis (HCP), abducens nerve palsy, and stenosis of the internal carotid artery (ICA). A 59-year-old Japanese man presented with a year history of nasal obstruction and a 2-month history of slight headache. Histopathological examination of the granulomatous mucosa in the ethmoid sinuses resected by endoscopic sinus surgery revealed necrotizing vasculitis with multinucleated giant cells. The patient was diagnosed with the limited form of GPA as a result of the systemic examination. He declined immunosuppressive treatment. Eighteen months after the diagnosis of GPA, he presented with diplopia and severe headache. Though nasal findings indicating GPA were not observed in the nasal cavity, CT scan revealed a lesion of the right sphenoid sinus eroding the bone of the clivus. Gadolinium-enhanced MRI of the brain showed thickening of the dura mater around the right cavernous sinus and clivus. Magnetic resonance angiography and cerebral angiography revealed narrowing at the C5 portion of the ICA. Intravenous methylprednisolone pulse therapy followed by oral prednisolone and cyclophosphamide resolved headache and dramatically improved HCP and stenosis of the ICA. Shohei Harabuchi, Nobuyuki Bandoh, Rika Yasukawa, Michihisa Kono, Takashi Goto, Yasuaki Harabuchi, Hidetoshi Ikeda, Hajime Kamada, and Hiroshi Nishihara Copyright © 2017 Shohei Harabuchi et al. All rights reserved. Thyroid Carcinoma on the Side of the Absent Lobe in a Patient with Thyroid Hemiagenesis Mon, 27 Nov 2017 07:20:05 +0000 http://www.hindawi.com/journals/criot/2017/4592783/ Background. Thyroid carcinoma complicated by hemiagenesis is very rare, and previous reports have not described this cancer on the side of the absent lobe. Methods and Results. We report the case of a 64-year-old woman in whom left thyroid hemiagenesis was discovered incidentally during investigations of abnormal sensation during swallowing. A tumorous 1.4 cm lesion was also found on the side of the absent lobe, left of the isthmus. Fine-needle aspiration biopsy revealed class V papillary carcinoma, but no lymph node metastases. Total thyroidectomy was performed for stage cT1bN0M0 carcinoma. Histopathology revealed normal thyroid tissues in the right lobe and isthmus, while the left lobe was absent. The mostly papillary carcinoma was adjacent to the truncated thyroid tissue, with a portion histologically consistent with poorly differentiated carcinoma. Conclusions. All previously reported cases of thyroid cancer complicated by hemiagenesis have represented carcinoma occurring within the present lobe. This case is extremely rare. Hiroki Sato, Kiyoaki Tsukahara, Ray Motohashi, Midori Wakiya, Hiromi Serizawa, and Atsushi Kurata Copyright © 2017 Hiroki Sato et al. All rights reserved. Adult-Type Rhabdomyoma of the Larynx: Clinicopathologic Study of an Uncommon Tumor in a Rare Location Sun, 26 Nov 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/7186768/ Rhabdomyoma is an uncommon benign mesenchymal tumor with skeletal muscle differentiation that may occur either in the heart or in extracardiac sites. Even though the head and neck region is the most common area of extracardiac rhabdomyoma, the larynx is rarely involved. We present the case of an 85-year-old woman who reported a 10-day history of breathing difficulties, dysphagia, and dysphonia. A computed tomography scan of the head and neck showed a contrast-enhanced, solid hypopharyngeal-laryngeal neoplasm with well-defined margins causing subtotal obliteration of the right pyriform sinus and a reduction in air lumen of the laryngeal vestibule. The patient underwent complete endoscopic removal of the lesion; histologic examination revealed an adult-type rhabdomyoma based on the histologic features and the immunoreactivity of the neoplastic cells for desmin, myoglobin, and muscle-specific actin but not for cytokeratin, S-100, CD68R, chromogranin-A, and synaptophysin. Since clinical and imaging features are not specific for rhabdomyoma, histologic examination and immunohistochemical analyses play a central role in the differential diagnosis of the adult-type rhabdomyoma from other laryngeal neoplasms. A correct diagnosis is mandatory to avoid inappropriate treatment. Giancarlo Altissimi, Massimo Ralli, Giulio Sementilli, Francesco Fiorentino, Andrea Ciofalo, Antonio Greco, Marco de Vincentiis, Alessandro Corsi, and Giancarlo Cianfrone Copyright © 2017 Giancarlo Altissimi et al. All rights reserved. Angiofibroma Localized in the Sphenoid Sinus Wed, 22 Nov 2017 06:11:07 +0000 http://www.hindawi.com/journals/criot/2017/4287293/ Juvenile nasopharyngeal angiofibroma is the most common benign tumor of the nasopharynx with complaints of unilateral nasal obstruction and recurrent nosebleeds in the young male population. Despite being a benign tumor, it can be aggressively destructive in surrounding tissues and bones by acting locally. The gold standard treatment method is the surgical excision of the tumor. This case report is a case of angiofibroma, a 32-year-old asymptomatic male patient with no evidence of clinical signs and endoscopic examination, which is recognized as a localized vascular mass lesion in the right sphenoid sinus on the cranial MR imaging. We prepared this case report that may represent an angiofibroma localized only within the sphenoid sinus which is very rare in the literature. Alper Yenigun, Fadlullah Aksoy, Omer Vural, and Orhan Ozturan Copyright © 2017 Alper Yenigun et al. All rights reserved. Pleomorphic Adenoma Originating from Heterotopic Salivary Tissue of the Upper Neck: A Diagnostic Pitfall Wed, 15 Nov 2017 05:59:56 +0000 http://www.hindawi.com/journals/criot/2017/5767396/ Pleomorphic adenoma directly arising in the neck is thought to originate from heterotopic salivary gland tissue. In this article, we present the case of a 55-year-old female patient with a histologically proven pleomorphic adenoma located at the left mandibular angle, anteriorly to the sternocleidomastoid muscle and posteroinferiorly to the submandibular gland. As the patient also had an ipsilateral thyroid nodule with coarse calcifications, clinical and radiological features suggested a possible level II metastatic lymph node. However, ultrasound-guided fine needle aspiration cytology and postsurgery histopathological examination revealed a pleomorphic adenoma arising from heterotopic salivary gland tissue unrelated to a benign thyroid nodule. In this article, we provide a review of the existing literature on heterotopic salivary gland tissue and related neoplasms and discuss their imaging presentation. Riccardo La Macchia, Salvatore Stefanelli, Vincent Lenoir, Nicolas Dulguerov, Jean-Claude Pache, and Minerva Becker Copyright © 2017 Riccardo La Macchia et al. All rights reserved. Nodular Lymphocyte-Predominant Hodgkin Lymphoma in Progressive Transformation of Germinal Centers Tue, 14 Nov 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/5982168/ Nodular lymphocyte-predominant Hodgkin lymphoma is an uncommon variant of Hodgkin lymphoma. Progressive transformation of germinal centers has been associated with and can develop prior to, concurrent with, or after the diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma. We present a patient with a history of progressive transformation of germinal centers of the right parotid who presented 4 years later with ipsilateral parotid mass and cervical adenopathy. Knowledge of her previous diagnosis raised our concern for lymphoma, influenced our surgical management, and spared the patient additional surgery with risk of facial nerve injury inherent in revision parotidectomy. C. Eric Bailey, Francesca Jung, Benjamin Addicks, Olukemi A. Esan, and Brian Kellermeyer Copyright © 2017 C. Eric Bailey et al. All rights reserved. Intranodal Palisaded Myofibroblastoma in a Submandibular Lymph Node Thu, 26 Oct 2017 09:55:43 +0000 http://www.hindawi.com/journals/criot/2017/7121485/ Intranodal palisaded myofibroblastoma (IPM), also known as “intranodal hemorrhagic spindle cell tumor with amianthoid fibers,” is a rare benign mesenchymal tumor originating from smooth muscle cells and myofibroblasts, often with the presence of amianthoid fibers. Usually IPM affects inguinal lymph nodes, but three cases have been described in the submandibular and cervical lymph nodes. We report a new case of a 44-year-old women with submandibular mass. Cervical ultrasound showed a suspect right submandibular adenomegaly. The patient underwent an excision of the submandibular mass. Histological features of the tumor include an encapsulated fusocellular proliferation, with nuclear palisading, amianthoid fibers, hemosiderin pigment, and extravasated erythrocytes. In the light of these results, we made the diagnosis of IPM. No recurrence was found 5 years after surgery. Leila Bouhajja, Raja Jouini, Olfa Khayat, Wafa Koubâa, Chiraz Mbarek, Ehsen Ben Brahim, and Achraf Chedly-Debbiche Copyright © 2017 Leila Bouhajja et al. All rights reserved. Maxillary Sinus Kaposi Sarcoma: Case Report in an HIV-Negative Patient with Thymoma Tue, 24 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/3263728/ Introduction. Kaposi sarcoma is an angioproliferative disorder that requires infection with human herpesvirus 8 (HHV-8) for its development. The majority of cases are associated with HIV infection or other immunocompromising conditions. Thymomas are occasionally associated to cytopenia, which may alter the patients’ immune responses. Methods. Case report using clinical records. Results. Case report of a 46-year-old male patient diagnosed with thymoma and myasthenia gravis. The patient was referred to an otolaryngology consultation with complaints of facial pain in the right malar region, interpreted as an acute sinusitis. Following examination, an expansive maxillary sinus mass was found, and endoscopic surgery was undertaken. After careful investigation, it was diagnosed as a Kaposi sarcoma. Conclusions. It is thought to be the first described case of a maxillary sinus Kaposi sarcoma in an HIV-negative patient. Thus, this entity has to be considered in the differential diagnosis of sinus masses, even in non-HIV patients. Bernardo Carvalho Araújo, Sara Viana Baptista, Luís Mascarenhas, and Ezequiel Barros Copyright © 2017 Bernardo Carvalho Araújo et al. All rights reserved. Historical Case of Cervical Penetrating Wound: From First Aid to Surgical Intervention Sun, 22 Oct 2017 08:44:26 +0000 http://www.hindawi.com/journals/criot/2017/2415679/ Objective. We report a case of cervical penetrating wound by posing the problem of its support and by analyzing the chain of survival of a patient to human sacrifice. Case Report. It was an 11-year-old boy admitted to the hosting service of cervical penetrating wound emergency occurring in a context of human sacrifice by weapon (knife). On admission, the conscious patient had a left cervical hematoma at the level of the cervical zone II and severe signs of acute anemia. The exploratory cervicotomy, carried out 12 hours after the trauma under transfusion, allowed us to highlight a section of the front edge of the sternocleidomastoid and previous jugular muscles under hyoid. We noted the presence of a linear wound of 1 cm at the level of the left internal jugular vein. The wound of the internal jugular vein has been repaired with the Prolene 4.O. The outcome was good, allowing the exit 10 days after cervicotomy. Conclusion. The causal circumstances of cervical penetrating wounds are diverse. Their importance or their severity depends on the causative circumstances dominated by aggression and attempts to autolysis. Human sacrifice, with use of the weapon, is an exceptional circumstance. Koné Fatogoma Issa, Keïta Mohamed Amadou, Soumahoro Siaka, Konaté N’faly, Diarra Kassim, and Timbo Samba Karim Copyright © 2017 Koné Fatogoma Issa et al. All rights reserved. Lingual Osseous Choristoma of the Tongue Base: Unusual Presentation of a Rare Entity Sun, 22 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/3234086/ Osseous lesions of the tongue, also referred to as osseous choristomas, are benign growths of bony tissue. These lesions are not true neoplasms but rather represent growth of normal tissue at an abnormal location. Clinically, they appear as exophytic masses of the tongue, and they are treated by surgical excision. Lingual osseous choristomas are rare entities, with only 71 reported cases in the literature. We present the case of a lingual osseous choristoma of the tongue base in a 21-year-old female. Of the cases of lingual osseous choristoma reported in the literature, ours is only the fifth case to involve this location. Matthew J. Heinz, Scott M. Peters, Salvatore M. Caruana, and Angela J. Yoon Copyright © 2017 Matthew J. Heinz et al. All rights reserved. Lymphangiomatous Polyp Presenting as Tonsillar Mass Sun, 15 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/9506260/ A 19-year-old female presented to ENT OPD of Dhulikhel Hospital, Kathmandu University Hospital, with history of foreign body sensation in throat for 2 weeks and mass in left tonsil for 1 week. There is no history of difficulty swallowing or recurrent throat infection. Physical examination revealed a pedunculated mass arising from upper pole of left tonsil. Bilateral tonsillectomy was done under general anaesthesia. Grossly, 2.5 × 1.5 × 1 cm polypoidal mass, soft in consistency, was found to be attached to left tonsil. Histopathology report was consistent with lymphangiomatous polyp of tonsil. Postoperative period was uneventful and she was normal during her follow-up at 1 month with bilateral healthy tonsillar fossa. Ashish Dhakal, Sameer Karmacharya, and Sandhya Shrestha Copyright © 2017 Ashish Dhakal et al. All rights reserved. Synchronous HPV-Related Cancer of Bilateral Tonsils Detected Using Transoral Endoscopic Examination with Narrow-Band Imaging Thu, 12 Oct 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/9647010/ Background. The incidence of human papillomavirus- (HPV-) related oropharyngeal squamous cell carcinoma (OPSCC) has been rapidly increasing worldwide. HPV is reported in approximately 50% cases of OPSCC in Japan. However, there are few reports of synchronous bilateral HPV-positive tonsillar carcinoma, and, in almost all those cases, carcinoma was detected using positron emission tomography/computed tomography and/or bilateral tonsillectomy. Methods and Results. We report the case of a 63-year-old male with bilateral tonsillar carcinoma detected using transoral endoscopic examination with narrow-band imaging (NBI). A biopsy of the bilateral tonsils revealed squamous cell carcinoma, which was demonstrated to be HPV-related using in situ hybridization and p16 immunohistochemistry. The patient was diagnosed as synchronous bilateral tonsillar carcinoma: T1 (2) N2b M0. He was treated with induction chemotherapy, bilateral radical tonsillectomy with neck dissection, and radiotherapy. Conclusion. To our knowledge, this is the first report of a synchronous bilateral tonsillar carcinoma detected using transoral NBI in the outpatient setting. Early diagnosis without the inspection under general anesthesia is beneficial for the patients with lymph node metastasis from unknown primary lesion. Fukuko Shimizu, Kenji Okami, Koji Ebisumoto, Daisuke Maki, Akihiro Sakai, Go Ogura, Naoya Nakamura, and Masahiro Iida Copyright © 2017 Fukuko Shimizu et al. All rights reserved. Cochlear Implantation in Patients with Keratitis-Ichthyosis-Deafness Syndrome: A Report of Two Cases Mon, 02 Oct 2017 08:32:13 +0000 http://www.hindawi.com/journals/criot/2017/3913187/ Background. Keratitis-ichthyosis-deafness (KID) syndrome is a syndrome which presents with hearing loss and visual and keratinization disorders. In such patients, hearing aids cannot be effectively used in the rehabilitation of hearing loss because of the frequent blockage of the external ear canal with epithelial debris and due to dry and tense skin of the external ear canal. Moreover, severe or profound hearing loss also limits the benefits gained from the conventional hearing aids. On the other hand, cochlear implantation is a method that has been used in limited cases in the literature. Case Report. This study presents the results of cochlear implantation applied in our clinic to two children who had been diagnosed with KID. Audiological assessments before and after the cochlear implant operation were performed using pure-tone audiometry, immittance audiometry, and auditory brainstem response (ABR), and the postoperative follow-up was conducted using pure-tone audiometry. Conclusion. Skin problems, visual disturbances, and other additional problems complicate the short-term and long-term rehabilitation after implantation in individuals with KID syndrome. Close monitoring should be exercised due to possible skin complications that may develop during the postoperative period. The families and rehabilitation teams should be warned about the possible visual disturbances and skin complications. Birgul Gumus, Armagan Incesulu, and Mehmet Ozgur Pinarbasli Copyright © 2017 Birgul Gumus et al. All rights reserved. Pneumocephalus Following Self-Inflicted Penetrating Brain Injury Tue, 26 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/7878646/ Objective. Pneumocephalus is a rare complication that often occurs after traumatic skull base injury, leading to morbidity and mortality. Material and Method. We present the case of a 42-year-old healthy man who injured himself when he stuck a metal stick into his left nasal cavity to relieve prolonged nasal obstruction. Immediate cerebrospinal fluid rhinorrhea and subsequent meningitis and pneumocephalus occurred later. He was presented at our hospital with fever and meningeal signs. Result. Computed tomography scans revealed left rhinosinusitis and air collection in the subarachnoid space. The patient received the conservative treatment of bed rest, intravenous hydration, head elevation, and broad-spectrum intravenous antibiotics. Pneumocephalus and meningitis resolved without any surgery, and he experienced no other sequela or complication. Conclusion. Pneumocephalus is a rare incidence and can lead to high morbidity and mortality. Prompt diagnosis and adequate treatment of pneumocephalus and meningitis proved beneficial for our patient who recovered without any complication or surgery. Che-Fang Ho, Yuan-Yun Tam, and Chia-Chen Wu Copyright © 2017 Che-Fang Ho et al. All rights reserved. Synchronous Ganglioneuroma and Schwannoma Mistaken for Carotid Body Tumor Sun, 24 Sep 2017 10:51:58 +0000 http://www.hindawi.com/journals/criot/2017/7973034/ Ganglioneuromas are a very rare benign neural tumor, commonly derived from the ganglia of the sympathetic system, and are composed of mature Schwann cells, ganglion cells, and nerve fibres. They may arise anywhere from the base of the skull to the pelvis along the paravertebral sympathetic plexus. We report a rare case of synchronous ganglioneuroma and schwannoma, mistaken for carotid body tumor. The coexistence of these two entities in head and neck region is very rare. Konstantinos Paraskevopoulos, Angeliki Cheva, Styliani Papaemmanuil, Konstantinos Vahtsevanos, and Konstantinos Antoniades Copyright © 2017 Konstantinos Paraskevopoulos et al. All rights reserved. Epithelial-Myoepithelial Carcinoma of the Base of Tongue with Possible Lung Metastases Wed, 20 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/4973573/ Background. Epithelial-myoepithelial carcinomas are rare neoplasms usually arising from the salivary glands. There is limited evidence in the literature on their prognosis in the base of the tongue but other cases have resolved without recurrence. Methods. The patient underwent biopsies demonstrating the diagnosis of epithelial-myoepithelial carcinoma of the base of tongue and a PET scan showed multiple bilateral rounded pulmonary nodules. Results. The patient declined chemotherapy and radiotherapy to maximise his quality of life and passed away under management from palliative care several months later. Discussion. This is the only case in the literature of this type of carcinoma in the base of the tongue resulting in metastases and a poor prognosis. The case highlights the importance of checking for metastases in such lesions and their potentially serious outcomes if left untreated. Michael Y. Chen, Vipul Vyas, and Ryan Sommerville Copyright © 2017 Michael Y. Chen et al. All rights reserved. A Neonatal Case of Glial Choristoma of the Tongue Causing Airway Obstruction Wed, 20 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/2413035/ Glial choristoma is considered to be a type of brain heterotopia consisting of ectopic central nervous tissue. We herein report a neonate with glial choristoma of the tongue who developed respiratory distress due to airway obstruction. A male neonate presented with respiratory distress due to a soft mass on the midline region of the dorsal tongue base at birth. He was intubated using a flexible fiberoptic nasopharyngoscope. MRI showed a well-circumscribed mass measuring 25 × 23 × 27 mm in size in the same region. A histologic examination confirmed a pathological diagnosis of glial choristoma. He underwent tracheotomy at 22 days of age, and a subtotal resection of the tumor was performed at five months of age. The clinical behavior of oral glial choristoma varies depending on the age at onset as well as the location and size of the mass. The small size of the organ and the narrow operating field hamper the surgical approach in neonates. The optimal therapeutic strategy for neonatal cases of glial choristoma should thus be determined based on the condition of each individual patient. Hajime Machi, Hiroki Karata, Yusuke Yamane, Junya Fukuoka, Yasutomo Funakoshi, and Hiroyuki Moriuchi Copyright © 2017 Hajime Machi et al. All rights reserved. Persistent Acute Onset Macroglossia Treated with Compression Therapy Mon, 11 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/6402413/ Acute macroglossia, while rare and often limited in duration, can present significant management challenges. The anatomic position of the tongue, which can result in airway compromise in cases of enlargement, contributes significantly to difficulty with management. We review several management options for persistent acute onset lingual macroglossia and present a novel noninvasive management technique in a case which was refractory to several strategies. Sean M. Johnson, C. Scott Brown, and Liana Puscas Copyright © 2017 Sean M. Johnson et al. All rights reserved. Recovery from Repeated Sudden Hearing Loss in a Patient with Takayasu’s Arteritis Treated with Hyperbaric Oxygen Therapy: The First Report in the Literature Sun, 10 Sep 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/3281984/ Hearing loss has been rarely reported in Takayasu’s arteritis, may present as Sudden Sensorineural Hearing Loss, and usually responds well to corticosteroid therapy. Hyperbaric Oxygen Therapy is commonly used as a supplementary treatment to corticosteroids for Sudden Sensorineural Hearing Loss. We present the case of a 36-year-old woman with Takayasu’s arteritis who had two episodes of sudden hearing loss involving one ear at a time with an 11-month delay between each episode. During the first episode, the patient was treated with high-dose intramuscular corticosteroids with a temporary improvement of auditory threshold that deteriorated 14 days after cessation of therapy. In the second episode, Hyperbaric Oxygen Therapy was associated with corticosteroids, with improvements in both ears, including the one that was unresponsive in the long term to previous pharmacologic therapy. In this case, Hyperbaric Oxygen Therapy could have acted synergically with corticosteroids playing a role in hearing restoration. Massimo Ralli, Antonio Greco, Vincenzo Falasca, Giancarlo Altissimi, Mario Tombolini, Rosaria Turchetta, Sara de Fazio, Marco de Vincentiis, and Giancarlo Cianfrone Copyright © 2017 Massimo Ralli et al. All rights reserved. Bilateral Peritonsillar Abscess in an Infant: An Unusual Presentation of Sore Throat Mon, 21 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/4670152/ Introduction. Peritonsillar abscess is considered a suppurative complication of acute tonsillitis. It is usually unilateral and clinically evident bilateral presentation is uncommon. The condition affects mainly children older than 10 years and young adults. Herein we present a rare case of bilateral peritonsillar abscess in an infant. Presentation of Case. A 1-year-old boy presented with a two-day history of worsening sore throat, loss of appetite, vomiting, and fever. Examination of the oral cavity and oropharynx revealed enlarged and inflamed tonsils and a bilaterally congested and bulging soft palate. CT scan confirmed the hypothesis of bilateral peritonsillar abscess. Antibiotic therapy was instituted and after 5 days only slight regression of swelling of the soft palate was observed. He underwent a surgical procedure for draining the abscesses. After the procedure, he presented good clinical and laboratory evolution and was discharged home. Discussion. Although peritonsillar abscesses are considered common complications of acute tonsillitis bilateral cases are extremely rare, especially in early childhood. The diagnosis is based on history and physical examination and the treatment remains controversial among otolaryngologists. Conclusion. Bilateral peritonsillar abscess should be diagnosed and treated promptly and adequately to prevent respiratory obstruction and to avoid dissemination into the deep neck spaces. Mariana Manzoni Seerig, Letícia Chueiri, Janaina Jacques, Maria Fernanda Piccoli Cardoso de Mello, Martin Batista Coutinho da Silva, Daniel Buffon Zatt, Rosana Cristine Otero Cunha, and Andre Souza de Albuquerque Maranhão Copyright © 2017 Mariana Manzoni Seerig et al. All rights reserved. Myoepithelioma of the Parotid Gland: A Case Report with Review of the Literature and Classic Histopathology Wed, 16 Aug 2017 06:59:19 +0000 http://www.hindawi.com/journals/criot/2017/6036179/ Myoepithelioma is a rare salivary gland neoplasm. They most commonly affect the major and minor salivary glands with the parotid gland being the most common, approximately 40%. Only 1% of all salivary gland neoplasms are myoepitheliomas. Myoepithelioma is usually a benign tumor arising from neoplastic myoepithelial or basket cells which are found between the basement membrane and the basal plasma membrane of acinar cells. They also contain multiple cellular elements. We present a case of a 73-year-old female with myoepithelioma of the parotid gland, an extremely rare neoplasm. There have been approximately 42 cases reported through 1985 and fewer than 100 cases through 1993. We will discuss the clinical presentation, pathophysiology, diagnosis, and treatment of such neoplasms. Mark Weitzel, Jason E. Cohn, and Harvey Spector Copyright © 2017 Mark Weitzel et al. All rights reserved. Ganglioneuroma of the External Auditory Canal and Middle Ear Thu, 10 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/4736895/ Objective. We report an extremely rare case of ganglioneuroma involving the external auditory canal and middle ear. Case Report. Ganglioneuromas are rare benign mature tumors thought to originate from sympathetic ganglions, with the highest incidence in the retroperitoneum, adrenal medulla, and posterior mediastinum. We present a case of ganglioneuroma of the external auditory canal and middle ear. At the age of 12 months, the patient was diagnosed with neuroblastoma stage IV with metastasis to the squamous temporal bone, bone marrow, and skull base. He received a high-risk protocol regimen resulting in complete remission. The patient later presented with recurrent right ear discharge at the age of six years and was diagnosed with ganglioneuroma of external auditory canal and middle ear after appropriate investigations. We report in this article the clinical presentation, investigations, surgical intervention, and follow-up. Conclusion. After the literature review and to our knowledge, this is the first reported case of its kind. Ganglioneuroma maturing from neuroblastoma is one of the theories describing pathophysiology of the disease. Ganglioneuroma should be considered in the differential diagnosis of patients presenting with recurrent ear discharge and decreased hearing in treated cases of neuroblastoma with metastases to temporal bone. Hesham Saleh Almofada, Michael Steven Timms, and M. Anas Dababo Copyright © 2017 Hesham Saleh Almofada et al. All rights reserved. Endoscopic Treatment of Sphenoid Sinus Mucocele: Case Report and Surgical Considerations Mon, 07 Aug 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/7567838/ Introduction. The paranasal sinuses mucoceles are benign expansive cystic lesions that occur rarely in the sphenoid sinus and contain mucous material enclosed by cylindrical pseudostratified epithelium. Objective. To report one case of sphenoid sinus mucocele that occurred with headache and was submitted to surgical treatment through endonasal endoscopy approach. Case Report. 59-year-old male patient with history of increasing frontoorbital, bilateral, fluctuating headache and exophthalmos. There was no other associated clinical abnormality. Computed Tomography (CT) and Magnetic Resonance Image (MRI) scans confirmed an expansive mass of sphenoid sinus, suggesting mucocele. The patient was submitted to endonasal endoscopic surgery with posterior ethmoidotomy, large sphenoidotomy, and marsupialization of the lesion. Conclusion. Mucoceles of the sphenoid sinus are a very rare condition with variable clinical and radiological presentation. Surgical treatment is absolutely indicated and early treatment avoids visual damage that can be permanent. Endonasal endoscopic approach with drainage and marsupialization of sphenoid sinus, using a transnasal corridor, is a safe and effective treatment modality. Joel Caballero García, Adolfo Michel Giol Álvarez, Iosmill Morales Pérez, Nélido Gonzales Gonzales, Adolfo Hidalgo Gonzáles, and Peggys Oleidis Cruz Perez Copyright © 2017 Joel Caballero García et al. All rights reserved. Cryosurgery as an Option for the Treatment of Vascular Lesions of the Oral Cavity Wed, 02 Aug 2017 08:10:40 +0000 http://www.hindawi.com/journals/criot/2017/8529016/ Cryosurgery is a treatment modality consisting in the destruction of tissue by the application of extremely low temperatures. This causes irreversible damage to cellular metabolism, leading to tissue destruction within minutes, a mechanism that may be beneficial when used in diseased tissues. Because cryosurgery is effective, simple, and easy to perform, it has been used in the treatment of lesions in both medical and dental fields. This technique provides many advantages, such as easy operation, absence of intraoperative bleeding, and low infection rate. We report the case of a patient with a hemangiomatous lesion of the oral cavity who was treated with liquid nitrogen spray cryosurgery, with successful results at 18-month follow-up. Pedro Thalles Bernardo de Carvalho Nogueira, Mariana Maria Castro Jatobá Remigio, Andreza Maria Correia de Queiroz, Andréia Aparecida da Silva, and José Rodrigues Laureano Filho Copyright © 2017 Pedro Thalles Bernardo de Carvalho Nogueira et al. All rights reserved. Lymphoepithelial Cyst of Parotid in an Immunocompetent Patient with Chronic Otitis Media Sun, 30 Jul 2017 06:33:15 +0000 http://www.hindawi.com/journals/criot/2017/5169364/ Lymphoepithelial cysts of parotid are known to occur in HIV patients. In the present report, lymphoepithelial cyst of parotid was diagnosed in a middle aged immunocompetent patient, along with chronic otitis media. The source of infection and treatment options are summarized. Meera Niranjan Khadilkar, Vishnu Prasad, Vijendra Shenoy Santhoor, M. P. Kamath, and Haneesh Domah Copyright © 2017 Meera Niranjan Khadilkar et al. All rights reserved. Primary Small Cell Carcinoma of the Hypopharynx: A Report of Two Cases and Review of Nine Additional Cases Wed, 19 Jul 2017 08:20:17 +0000 http://www.hindawi.com/journals/criot/2017/8143145/ Objective. Two patients with primary small cell carcinoma (SmCC) of the hypopharynx, an extremely rare site for the occurrence of SmCC, are reported and nine additional well-documented cases are reviewed. Methods. Case report and review of the literature concerning primary SmCC of the hypopharynx. Results. On the final analysis, we reviewed eleven cases of primary SmCC of the hypopharynx. The tumors contained mixed elements of SmCC and squamous cell carcinoma (SCC) in six (55%) of eleven patients. Out of eleven patients, two patients had distant metastasis at the initial presentation. Even though nine patients presented with locoregional disease, development of distant metastasis after treatment was seen in five patients (56%), whereas there was no report of treatment failure on the primary site. To achieve more than two-year survival, patients should have received more than 4 cycles of chemotherapy. Conclusion. We report two cases of primary SmCC of the hypopharynx with a review of the literature. In more than half of the cases, combined carcinomas with SCC are seen. Because this tumor has a strong propensity for distant metastasis even in patients with clinically localized tumor, new powerful systemic agents should be explored. Mitsuhiko Nakahira, Kiyomi Kuba, Satoko Matsumura, and Masashi Sugasawa Copyright © 2017 Mitsuhiko Nakahira et al. All rights reserved. The Youngest Reported and Successfully Treated Patient with a Dermoid Cyst of the Parotid Gland: A Rare Pediatric Case Sun, 16 Jul 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/4187030/ Dermoid cysts (DCs) are rare benign, epithelial-lined lesions. Up to 7% of them are found in the head and neck region and 80% of those predominantly occur in the orbit, in the nose, and in the floor of the mouth. The average age of presentation is around the age of six. Dermoid cysts located in the parotid gland have only been published in 19 cases so far. Interestingly, the mean age of occurrence in the parotid gland was much higher (31 years). We report on a four-year-old girl being the youngest patient who had ever been diagnosed with this disease. Marcel Fabian Glaas, Jörg Schipper, Nelofar Kajasi, and Angelika Albrecht Copyright © 2017 Marcel Fabian Glaas et al. All rights reserved. Repetitive Sinus-Related Symptoms May Accelerate the Progression of Chronic Maxillary Atelectasis Mon, 03 Jul 2017 07:01:55 +0000 http://www.hindawi.com/journals/criot/2017/4296195/ Chronic maxillary atelectasis (CMA) is characterized by a progressive decrease in maxillary sinus volume. The factors that promote the stage progression of CMA remain poorly understood. Here, we describe the time course of anatomical changes in a 40-year-old woman with stage II CMA that progressed to stage III disease. She did not show stage progression until she started to develop repetitive sinus-related symptoms. The stage progression was characterized by ocular symptoms. The repetitive inflammatory episodes may have increased the negative pressure in the affected sinus and weakened the bone walls, thereby promoting stage progression. Thus, a history of repetitive sinus-related symptoms may be a risk factor for stage progression in CMA. Shu Kikuta, Kyohei Horikiri, Kaori Kanaya, Ryoji Kagoya, Kenji Kondo, and Tatsuya Yamasoba Copyright © 2017 Shu Kikuta et al. All rights reserved.