Case Reports in Otolaryngology https://www.hindawi.com The latest articles from Hindawi © 2017 , Hindawi Limited . 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. Tubercular Ulcer of Tongue in an Elderly Patient Masquerading as a Traumatic Ulcer Wed, 28 Jun 2017 09:01:36 +0000 http://www.hindawi.com/journals/criot/2017/8416963/ Tuberculosis is still one of the most prevalent diseases in developing countries like Nepal. However, due to the effectiveness of DOTS therapy, vaccination, and education, the prevalence of tuberculosis has fallen in recent years. Although the pulmonary and extrapulmonary tuberculosis, especially the tubercular lymphadenitis, is still very common in our country, the tuberculosis of oral cavity is an uncommon condition. We present a case of an elderly male who presented with the complaint of nonhealing ulcer of lateral border of tongue for 2-month duration which was masquerading as a traumatic ulcer due to sharp teeth adjacent to the lesion. Deep biopsy was taken under local anesthesia. Histopathological examination revealed that it was tuberculosis. Antitubercular therapy was then started which cured the lesion. Ramesh Parajuli and Sushna Maharjan Copyright © 2017 Ramesh Parajuli and Sushna Maharjan. All rights reserved. Large Cholesterol Granuloma of the Middle Ear Eroding into the Middle Cranial Fossa Thu, 22 Jun 2017 06:31:19 +0000 http://www.hindawi.com/journals/criot/2017/4793786/ Background. Cholesterol granuloma of the middle ear is extremely rare in comparison to cholesterol granuloma of the petrous apex but sometimes shows an aggressive course. Case Report. We report herein a case involving a large, aggressive cholesterol granuloma of the middle ear that eroded the middle cranial fossa. A 64-year-old woman presented with pain in the left ear and hearing loss. Cholesterol granuloma was finally diagnosed from diffusion-weighted imaging, and cortical mastoidectomy was performed with canal wall down tympanoplasty type III. Recovery was uneventful recovery and the patient well at the 3-year follow-up. Conclusion. This case demonstrates the rare but clinically important pathology of aggressive cholesterol granuloma of the middle ear. Tessei Kuruma, Tohru Tanigawa, Yasue Uchida, Ogawa Tetsuya, and Hiromi Ueda Copyright © 2017 Tessei Kuruma et al. All rights reserved. Vagal Paraganglioma Presenting as a Neck Mass Associated with Cough on Palpation Thu, 22 Jun 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/7603814/ A 70-year-old female presented with a neck mass and sporadic dry cough, often leading to fits of coughing severe enough to cause vomiting. The patient reported that touching the mass triggered the cough. On examination, a 2.5 cm right-sided level two neck mass deep to the sternocleidomastoid was present. Palpation of the mass immediately triggered coughing. Cross-sectional imaging proposed vagal paraganglioma as the chief differential, which was confirmed following surgical excision. The patient reported complete resolution of her severe dry cough after surgery. Vagal paragangliomas are rare neuroendocrine tumors arising from the neural crest-derived paraganglionic tissue surrounding the vagus nerve, typically presenting as a neck mass associated with hoarseness or pulsatile tinnitus. To the best of our knowledge this is a unique description in the English literature. This case is presented to aid physicians should they encounter a neck mass associated with cough. Vagal paraganglioma, although rare, should be part of the differential in such a presentation. Richard Heyes, Nizar Taki, and Miriam A. O’Leary Copyright © 2017 Richard Heyes et al. All rights reserved. The Relationship between Werner Syndrome and Sinonasal Malignant Melanoma: Two Sibling Cases of Werner Syndrome with Malignant Melanoma Thu, 22 Jun 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/9361612/ Werner syndrome (WS) is an autosomal recessive disease characterized by premature aging. Malignant tumors such as thyroid carcinoma and malignant melanoma occur frequently in WS patients. We describe 2 siblings with WS who suffered from sinonasal malignant melanoma (MM). Both patients initially experienced nasal obstruction and recurrent nasal bleeding and died within 2 years of the diagnosis of MM. Otolaryngologists should recognize that WS patients have a high risk for head and neck malignant disease, particularly sinonasal MM, even if they are aged below the expected age range and undergo periodic examinations. Furthermore, it is important that WS patients are aware that a prompt nasal examination is indicated if they experience continuous nasal obstruction or recurrent nasal bleeding. Yoshinori Kadowaki, Satoru Kodama, Munehito Moriyama, and Masashi Suzuki Copyright © 2017 Yoshinori Kadowaki et al. All rights reserved. A Rare Cause of Upper Airway Obstruction in a Child Tue, 13 Jun 2017 08:07:51 +0000 http://www.hindawi.com/journals/criot/2017/2017265/ Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postoperative prophylaxis tracheotomy was done. The postoperative course was uneventful with improvement of clinical and endoscopic signs. H. Ahmed, C. Ndiaye, M. W. Barry, Aliou Thiongane, A. Mbaye, Y. Zemene, and I. C. Ndiaye Copyright © 2017 H. Ahmed et al. All rights reserved. Mechanisms Underlying Improvement in Obstructive Sleep Apnea Syndrome by Uvulopalatopharyngoplasty Tue, 06 Jun 2017 09:28:04 +0000 http://www.hindawi.com/journals/criot/2017/2120165/ In a previous case report, we determined for the first time that uvulopalatopharyngoplasty (UPPP) does not change the volume of the upper airway but causes morphological changes in the entire upper airway. The objective of this study is to elucidate the mechanisms underlying the improvement in obstructive sleep apnea syndrome (OSAS) by UPPP. We present an additional case involving a patient with OSAS treated using UPPP. Morphological and numerical parameter changes after surgery were compared with the corresponding preoperative values. Anatomically accurate upper airway computational models were reconstructed from computed tomographic imaging data. In addition, computed fluid dynamics analysis was performed to reveal inhalation flow characteristics before and after UPPP and clearly assess the effect of UPPP on airflow patterns in the patient’s upper airway. An important benefit of UPPP is the morphological changes in the entire upper airway, in addition to widening the restricted area. These morphological changes induce laminarization of the pharyngeal jet. To obtain sufficient efficacy of UPPP in OSAS, the morphological changes in the upper airway and the airflow pattern after the surgery must be controlled. Takahisa Yamamoto, Naoko Fujii, Yoichi Nishimura, Noboru Iwata, and Seiichi Nakata Copyright © 2017 Takahisa Yamamoto et al. All rights reserved. Aspiration of Aluminum Beverage Can Tab: Case Report and Literature Review Sun, 28 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/1010975/ We describe the case of a 16-year-old male who aspirated a beverage can tab resulting in significant functional impairment. Since the introduction of beverage can opening tabs (“pop-tops” or “pull-tabs”) nearly 50 years ago, five cases of their aspiration have been reported in the literature and this is the first case to report tracheal lodgment. We describe the clinical course for this patient including the inadequacy of radiographic evaluation and a significant delay in diagnosis. We highlight unique features of small aluminum foreign bodies that require consideration and mention a potential change in epidemiology associated with evolving product design. Our primary objective is increased awareness among otolaryngologists that radiography is unreliable for diagnosis or localization of small aluminum foreign bodies. The patient history must therefore be incorporated with other imaging modalities and/or endoscopic evaluation. Also, given the marked prevalence of aluminum beverage cans, we suspect that the inadvertent aspiration of can tabs is more common than indicated by the paucity of published reports. Alhasan N. Elghouche, Brian C. Lobo, and Jonathan Y. Ting Copyright © 2017 Alhasan N. Elghouche et al. All rights reserved. Sudden Onset, Rapidly Expansile, Cervical Cystic Hygroma in an Adult: A Rare Case with Unusual Presentation and Extensive Review of the Literature Wed, 24 May 2017 09:18:59 +0000 http://www.hindawi.com/journals/criot/2017/1061958/ Cystic hygroma (CH) is a benign infiltrative malformation of the lymphatic channels. We report a case of a 28-year-old Indian female who presented with rapidly enlarging right sided neck swelling over the posterior triangle since 5 days. Complete resection of CH is sometimes not amenable because of its infiltrative nature and involvement of surrounding vital structures. However, in our patient successful complete surgical resection was undertaken. The MRI findings of our patient were consistent with brachial cleft cyst; this posed a challenge in the diagnosis of CH. The histopathological analysis of the resected mass confirmed CH. CH is rare in adults and such an acute presentation is exceptionally atypical. History of prior trauma and infection are known etiological factors for adult CH; these were conspicuously absent in our patient. CH should be considered in the differentials of rapidly enlarging cystic swelling of posterior region of neck in adults. Optimal and timely management is necessary to achieve a favorable prognosis. Therefore, we report a case of rapidly enlarging cervical CH in an adult along with extensive literature review to have a better understanding regarding epidemiology, etiopathogenesis, clinical presentation, optimal management, and prognosis of such a rare entity in adults. Vivek Dokania, Anagha Rajguru, Harmanjot Kaur, Ketan Agarwal, Sujata Kanetkar, Prajakta Thakur, Femina Patel, and Dhirajkumar Shukla Copyright © 2017 Vivek Dokania et al. All rights reserved. Vestibular Derangement and Motion Intolerance in VATER Association Mon, 22 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/4507323/ VATER association is a nonrandom occurrence of congenital malformations: vertebral defects, anal atresia, tracheoesophageal fistula, renal defects, and radial bone anomalies. We report the case of a 19-year-old man with a childhood diagnosis of VATER association, who presented to the motion sickness clinic with severe seasickness. We discuss the clinical and laboratory diagnosis of vestibular pathophysiology, which was confirmed by MRI of lateral semicircular canal and vestibule dysplasia. We suggest the possibility of vestibular involvement as part of the developmental field defect associated with VATER syndrome, which hitherto has rarely been reported. Orit Samuel, Avi Shupak, Ayelet Eran, and Dror Tal Copyright © 2017 Orit Samuel et al. All rights reserved. Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops Thu, 18 May 2017 00:00:00 +0000 http://www.hindawi.com/journals/criot/2017/6195317/ Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH. Massimo Ralli, Giuseppe Nola, Luca Sparvoli, and Giovanni Ralli Copyright © 2017 Massimo Ralli et al. All rights reserved. High-Grade Transformation (Dedifferentiation) of Acinic Cell Carcinoma of the Parotid Gland: Report of an Unusual Variant Sun, 14 May 2017 06:10:46 +0000 http://www.hindawi.com/journals/criot/2017/7296467/ Acinic cell carcinoma with high-grade transformation of the salivary gland is an unusual variant with less than fifty cases being reported in the literature. It is characterized by a low- and high-grade component juxtaposed with one another and tends to take on a more aggressive clinical course than its low-grade counterpart, suggesting a poor clinical outcome. We, hereby, report a case of acinic cell carcinoma in a 48-year-old woman with a 6-month history of a right parotid facial swelling rapidly increasing in size. The tumor was initially resected; however, residual focal tissue subsequently revealed areas typical of low-grade acinic cell carcinoma as well as high-grade transformation/dedifferentiation via histopathology. Sarah S. Al-Otaibi, Faiza Alotaibi, Yaseer Al Zaher, Nabil Al Zaher, and M. A. Dababo Copyright © 2017 Sarah S. Al-Otaibi et al. All rights reserved. Temporary Frontal Paralysis Secondary to Blunt Trauma Frontal Sinus Fracture Wed, 10 May 2017 07:34:38 +0000 http://www.hindawi.com/journals/criot/2017/4268259/ Frontal sinus fractures (FSF) are relatively uncommon and can be challenging for trauma surgeons to manage. Patients with FSF typically present with facial swelling, pain, and nasofrontal ecchymosis. Here we present a rare case of a patient with FSF and anterior table fracture where the main presenting symptom was bilateral frontal paralysis. We outline our management strategy and review the current literature in regard to management of FSF. Mark Bastianelli, Stefan Hamilton, Matthew Hearn, Safeena Kherani, and Kristian I. Macdonald Copyright © 2017 Mark Bastianelli et al. All rights reserved.