How to refer to patients

April 2, 2014     Linda Zinn, Managing Editor, Ear, Nose & Throat Journal
We receive many manuscripts in which the authors refer to patients as “cases.” Patients are not cases. A case is simply a description of something that happens to a patient, a person. He is not a number. She is not a statistic. They are not cases. Please do not refer to them as such.

Endoscopic modified Lothrop approach for the excision of bilateral frontal sinus tumors

March 18, 2014     Jiun Fong Thong, MRCS; Deyali Chatterjee, MD; Siew Yoong Hwang, FRCS


We describe the use of an endoscopic modified Lothrop approach for clearance of an extensive sinonasal-type hemangiopericytoma of the nasal cavity and paranasal sinuses with bilateral frontal sinus involvement in a 44-year-old woman. The modified Lothrop approach is conventionally used to treat sinusitis, but with some slight modifications to the technique, it can also be used for tumor excision.

Cervical sympathetic chain paraganglioma: A report of 2 cases and a literature review

March 18, 2014     Rahul Seth, MD; Manzoor Ahmed, MD; Aaron P. Hoschar, MD; Benjamin G. Wood, MD; Joseph Scharpf, MD


We review 2 cases of surgically and pathologically confirmed paraganglioma of the cervical sympathetic chain. Both patients-a 46-year-old man and a 33-year-old woman-were treated surgically. Intraoperatively, both tumors were found to be hypervascular and arising from the cervical sympathetic chain. Histopathologic analysis confirmed both as paragangliomas. Paragangliomas arising from the cervical sympathetic chain are exceptionally rare, but they must be considered in the differential diagnosis of parapharyngeal masses. They often present with ipsilateral Horner syndrome and oropharyngeal fullness, and they may be associated with a higher rate of catecholamine secretion. Typical imaging characteristics include anterolateral or lateral displacement of both the carotid and jugular vessels.

Introduction Paragangliomas are rare, slowly growing, neuroendocrine tumors that develop at autonomic ganglia located in either blood vessel chemoreceptors or nerves. They are also referred to as glomus tumors, nonchromaffin paragangliomas, and chemodectomas, but paragangliomas is the preferred term.

Bilateral external auditory canal cholesteatomas

March 18, 2014     Danielle M. Blake, BA; Alejandro Vazquez, MD; Robert W. Jyung, MD

External auditory canal cholesteatomas may be classified as idiopathic or secondarily acquired, most commonly occurring in postoperative or post-traumatic settings.

Laryngeal schwannoma presenting as a pedunculated mass in the glottis

March 18, 2014     Hideki Nakagawa, MD; Naoyuki Kohno, MD; Toshiyuki Kusuyama, MD; Hiroyuki Fukuda, MD

This is the first case of laryngeal schwannoma that presented as a pedunculated tumor arising from the true vocal fold.

A 23-year-old man presented with a 2-year history of progressive hoarseness and an occasional choking sensation. Laryngofiberscopy revealed a large, yellowish-white, pedunculated, round mass in the glottis that moved with respiration (figure 1). Computed tomography (CT) with contrast enhancement indicated a homogeneously enhanced, pedunculated...

Y-V alar base reduction

March 18, 2014     Grant S. Hamilton III

For alar modification, removing tissue from inside the nostril to decrease width or from the lateral aspect of the ala to decrease flare works well in many patients, but these techniques may produce an unnatural result.

Madelung disease: Multiple symmetric lipomatosis

March 18, 2014     Enrique Palacios, MD, FACR; Harold R. Neitzschman, MD, FACR; Jeremy Nguyen, MD

Patients with multiple symmetric lipomatosis commonly also suffer from various neuropathies, especially paresthesias and autonomic neuropathy.

A 56-year-old African-American man presented to the emergency department with dyspnea and dysphagia with drooling. On his initial evaluation, disproportionate obesity of the face, neck and shoulders was noted. The patient's history was significant for obstructive sleep apnea, end-stage renal disease, alcoholic liver disease, pulmonary...

Endoscopic view of an inferior meatal polyp

March 18, 2014     Jae Hoon Lee, MD

Most polyps in the nasal cavity develop from the mucosa of the anterior ethmoid sinus, the contact areas of the uncinate process, and the middle turbinate so that they are observed in the middle meatus.

A 17-year-old man with a 2-year history of slowly progressive, left-sided nasal obstruction and intermittent mucopurulent rhinorrhea in both nasal cavities was referred to our hospital. He denied any history of underlying systemic disease, trauma, or nasal surgery. Nasal endoscopy showed a polypoid nasal mass obstructing the left inferior meatus...

Schwannoma of the nasal septum: An unusual finding

March 18, 2014     Shruti Dhingra, MS, DNB; Jaimanti Bakshi, MS, DNB; Satyawati Mohindra, MS, DNB


Schwannomas of the nasal cavity are rare benign tumors, and those that arise from the nasal septum are even rarer. When they do occur, they usually become symptomatic early because of the close confines of the nasal cavity. We describe a case of nasal septal schwannoma that was noteworthy in that the patient-a 28-year-old woman-waited 8 months after the onset of symptoms to seek medical care. Her symptoms included complete right-sided nasal obstruction, occasional epistaxis, and hemifacial pain. The tumor was completely removed via an endoscopic approach. We discuss the clinical presentation, differential diagnosis, and treatment of this rarely encountered neoplasm.

Introduction Schwannomas are rare benign tumors that can arise from the nerve sheath of any myelinated nerve. About 25% of all schwannomas are seen in the head and neck; of these, less than 4% are located in the sinonasal tract.1 In this location, they have been reported in patients between the ages of 6 and 78 years; there is no predilection for...

Descending necrotizing mediastinitis: A conservative approach

March 18, 2014     Sriram Iyer, MRCP; Joseph Collum, MRCP; Marta Babores, FRCP


Descending necrotizing mediastinitis (DNM) is a now-rare complication of dental and pharyngeal infections. Reports in the literature have emphasized the need for early, aggressive surgical intervention. We present a case of DNM with bilateral empyemas that arose secondary to a perforated pharyngeal abscess. The patient was successfully managed conservatively with intravenous antibiotics and intercostal drainage. We conclude that conservative management with antibiotics and image-guided percutaneous pleural drainage may be initially appropriate for the stable patient.

Introduction Descending necrotizing mediastinitis (DNM) is a rare complication of oral and pharyngeal infections in the postantibiotic era. When it does occur, the prognosis is poor, with a reported mortality rate of about 40%.1-4