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Anomaly

A persistent left superior vena cava, with the accessory nerve passing through a duplicate segment of the left internal jugular vein: A unique presentation

October 18, 2014  |  Omar Ayoub, MSc, FRCSEd(ORL-HNS); Jamie Benton, MRCS; Shaun Jackson, FRCSEd

Abstract

The internal jugular vein and the spinal accessory nerve are important landmarks during neck dissection; unexpected variations in their positions can result in inadvertent iatrogenic damage to adjacent structures. We report the case of a 79-year-old man who was found during...

Congenital airway anomaly of double aortic arch in a 2-day-old infant

October 18, 2014  |  Seo Moon, MD; Jessica Mayor, MD; Ramzi Younis, MD

Double aortic vascular ring is a complete vascular ring that is formed when the distal portion of the right dorsal aorta fails to regress and the ascending aorta bifurcates to surround and compress both trachea and esophagus and rejoins to form the descending aorta.

Complete second branchial cleft anomaly presenting as a fistula and a tonsillar cyst: An interesting congenital anomaly

October 18, 2014  |  Prasad John Thottam, DO; Samba S. Bathula, MD; Janet M. Poulik, MD; David N. Madgy, DO

Abstract

Branchial cleft anomalies make up 30% of all pediatric neck masses, but complete second branchial cleft anomalies are extremely rare. We report an unusual case of a complete second branchial cleft anomaly that presented as a draining neck fistula and a tonsillar cyst in an...

Management of soft palate agenesis in Nager syndrome with an elongated, superiorly based pharyngeal flap

October 18, 2014  |  Oneida A. Arosarena, MD; Troy Hemme, DO

Abstract

Nager syndrome, or preaxial acrofacial dysostosis, is associated with aberrant development of the first and second branchial arch structures, as well as abnormal development of the limb buds. It is a rare disorder, and its clinical manifestations have not been completely...

Second branchial cleft anomaly with an ectopic tooth: A case report

September 18, 2014  |  Jennifer C. Alyono, MD; Paul Hong, MD; Nathan C. Page, MD; Denise Malicki, MD, PhD; Marcella R. Bothwell, MD

Abstract

Branchial cleft cysts, sinuses, and fistulas are the most common congenital lateral neck lesions in children. They arise as a result of an abnormal development of the branchial arches and their corresponding ectoderm-lined branchial clefts. Of these diverse anomalies, second...

Petrosquamosal sinus discovered during mastoidectomy, and its radiologic appearance on temporal bone CT: Case report and brief review

July 14, 2014  |  Hyun Joon Shim, MD; Seong Jun Song, MD; Ki Woong Chung, MD; Sang Won Yoon, MD

Abstract

We report the case of a 47-year-old woman who underwent a mastoidectomy. Preoperative computed tomography demonstrated an unusually distended bony canal that passed through the superolateral portion of the right petrous bone. Intraoperatively, we identified the anomaly as a...

An abnormal sigmoid sinus with a dire clinical implication

June 9, 2014  |  Perianan Puraviappan, MS(ORL); Naryanan Prepageran, FRCS Ed; Cheng Ai Ong, MS(ORL); Raffique Abd Karim, MS(ORL); Omkara Rubini Lingham, MS(ORL); Rajagopalan Raman, MS(ORL)

In reviewing CT scans before surgery, the location of the sigmoid sinus should always be noted.

The significance of magnetic resonance imaging and computed tomography findings in sphenoid sinus agenesis

February 12, 2014  |  Lokman Uzun, MD; Omer Faik Sagun, MD; Bulent Seferoglu, MD; Omer Etlik, MD; and Kamran Mahmutyazicioglu, MD

Abstract

Agenesis of the sphenoid sinuses is a very rarely encountered anatomic variation. Findings on magnetic resonance imaging can mislead the radiologist and clinician. Therefore, the gold standard for diagnosis is computed tomography (CT) of the paranasal sinuses. We present the...

Pseudo third cranial nerve palsy secondary to orbital ectopic lacrimal gland cyst: Management with functional endoscopic sinus surgery

February 12, 2014  |  Puneet S. Braich, BSc; Jonathan E. Silbert, MD; Andrew J. Levada, MD; and Neil R. Schiff, MD

Abstract

An otherwise healthy 13-month-old girl was noted by her pediatrician to have developed a left head turn. The patient was referred to a pediatric ophthalmologist, who noticed signs of incomplete third cranial nerve palsy. Magnetic resonance imaging revealed the presence of an...

When is a neck lump not a neck lump? Initial presentation of a solitary sternocleidomastoid muscle in an adult

January 21, 2014  |  Sonia Kumar, MRCS; Suzie Jervis, MRCS; Harpreet Uppal, FRCS(ORL-HNS)

Abstract

A 70-year-old woman was referred to us for evaluation of a presumed left-sided neck mass. The referral was based on the visual appearance of subtle neck asymmetry. The patient reported no ENT symptoms. Clinical examination and ultrasonography identified no pathology, but...

Progressive blindness caused by an unusual sphenoid sinus dehiscence

September 19, 2013  |  Mariana Marquez, MD; Enrique Palacios, MD, FACR; Jeremy Nguyen, MD; Harold R. Neitzschman, MD, FACR, FACNM, FAAP

The optic nerve and other important structures in the anterior skull base can be involved in chronic sphenoidal sinus disease.

Coexisting first and bilateral second branchial fistulas in a child with nonfamilial branchio-otic syndrome

July 22, 2013  |  Jose Florencio F. Lapena Jr., MA, MD; Genilou Liv M. Jimena, MD

Abstract

We describe what we believe is only the third reported case of coexisting first and bilateral second branchial fistulas associated with nonfamilial branchio-otic syndrome. The patient was a 6-year-old girl who presented with bilaterally draining anterior neck puncta, a...

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