December 17, 2010 Kang-Chao Wu, MD, Min-Tsan Shu, MD, and Cheng-Chien Yang, MD
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Abstract
Almost all aural cholesterol granulomas develop in the mucosa of the middle ear. We describe the case of a 14-year-old girl who presented with an asymptomatic, nontender, dark-blue, cystic lesion in the posteroinferior portion of the left ear canal. The mass was excised via a postauricular approach. Postoperatively, the mass was identified as a cholesterol granuloma on pathologic examination. To the best of our knowledge, this is the first reported case of a human cholesterol granuloma limited to the external ear canal.
June 30, 2010 S. Todd Hamilton, MD, Swarupa A. Gadre, MD, and Arun K. Gadre, MD, FACS
June 30, 2010 Dare V. Ajibade, BA, Iwao K. Tanaka, MD, Kapila V. Paghdal, PharmD, MD, Neena Mirani, MD, Huey-Jen Lee, MD, and Robert W. Jyung, MD
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Abstract
We report the case of a 41-year-old man who presented with progressive right-sided ear pressure, otalgia, hearing loss, tinnitus, and intermittent otorrhea. Computed tomography and magnetic resonance imaging detected a soft-tissue mass in the right mastoid with intracranial invasion and erosion through the tegmen tympani and mastoid cortex. Histopathologic examination was consistent with an inflammatory pseudotumor (plasma cell granuloma). These lesions rarely occur in the temporal bone. When they do, they are locally destructive and can erode bone and soft tissues. Aggressive surgery is recommended as a first-line treatment, with adjunctive steroid or radiotherapy reserved for residual or refractory disease. Our patient subsequently experienced multiple recurrences, and his treatment required all of these modalities. At the most recent follow-up, he was disease-free and doing well.
December 1, 2009 Heitham Gheriani, FRCSI, FRCSC, Mohammad Habibulla Khan, MRCSI, and John D. Russell, MCh, FRCSI
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Abstract
Vocal fold granuloma induced by polytef (Teflon) injection is rare. This condition requires surgical intervention in order to restore the voice. In this report, we discuss the use of an endoscopic laryngeal microdebrider blade in successfully treating this condition. To the best of our knowledge, this procedure has not been previously described in the literature.
August 31, 2009 Jaimanti Bakshi, MS, DNB, Ramandeep Singh Virk, MS, FIMSA, and Mayuresh Verma, MS
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Abstract
We describe the case of a 35-year-old man who presented with a 4 x 4-cm ulcerated swelling over the hard palate that had progressed over 6 months. The lesion was associated with recurrent bleeding and occasional pain. Based on the lesion's clinical appearance and other characteristics (i.e., the slow progression, ulceration, and lack of regional lymphadenopathy), a provisional diagnosis of pyogenic granuloma was made, even though pyogenic granulomas of such size are rare. The mass was excised via a transoral route with a 0.5-cm margin of healthy mucosa, and the base was curetted. Histopathologic examination of the excised specimen confirmed the diagnosis. We discuss the etiopathogenesis of this entity and the various treatment options, and we review the relevant literature.
March 1, 2009 Jason Roberts, MD, Carol Shores, MD, and Austin S. Rose, MD
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Abstract
Central giant cell granuloma (CGCG) is a benign but locally destructive lesion of the mandible or maxilla that presents most often in the second and third decades of life. Reports of treatment include curettage or complete en bloc resection and nonsurgical approaches such as intralesional steroid injections, interferon alfa-2a, and calcitonin. We describe the cases of 2 young adults with CGCG of the maxilla involving the palate. The first patient, an 18-year-old man, was initially treated with a partial maxillectomy via a facial degloving approach and a postoperative series of transoral intralesional steroid injections to the site of the residual hard palate disease. The partial maxillectomy achieved a near-total debulking of the mass and immediate cosmetic improvement, and the steroid injections resulted in initial regression of the residual disease. However, the patient experienced a recurrence 8 months postoperatively, so a bilateral total inferior maxillectomy via a facial degloving approach was performed with subsequent placement of an obturator. No recurrence was seen 15 months following revision surgery. In view of the incomplete resolution of disease with the use of steroid injections in the first patient, we treated the second patient, a 22-year-old woman, with a subtotal maxillectomy without steroid injection. No recurrence of disease was noted 12 months postoperatively. We conclude that a combination of partial surgical resection and intralesional steroid injection may not be sufficient for the treatment of large CGCGs of the maxilla. Complete surgical resection should be considered for the initial treatment of CGCG, particularly in aggressive cases.
January 1, 2009 Nitin A. Pagedar, MD, Catherine M. Listinsky, MD, and Harvey M. Tucker, MD, FACS
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Abstract
For more than 25 years, Teflon was the most commonly used material for injection laryngoplasty. However, the incidence of Teflon granuloma and the consequent deterioration of glottic function ultimately led to the development of other injectable materials, and as a result, Teflon granulomas are no longer frequently encountered. We present a case of Teflon granuloma that was unusual in that (1) a long period of time had elapsed between the injection and the granuloma formation and (2) there was no change in the patient's glottic function.
April 30, 2008 Enrique Palacios, MD, FACR, Andrew Smith, MD, and Neel Gupta, MD
February 1, 2008 Lt. Matthew T. Brigger, MD, Maj. Ian K. McLeod, MD, and Cdr. Martin P. Sorensen, MD
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Abstract
Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis. This case illustrates the varied multisystem presentation of sarcoidosis and the diagnostic considerations that are merited.
May 31, 2007 Chester P. Barton III, MD; Drew Horlbeck, MD
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Abstract
Eosinophilic granuloma is an uncommon condition that is characterized by unifocal or multifocal osteolytic lesions that often affect the skull. Unilateral lesions of the temporal bone are not uncommon, but bilateral temporal bone lesions are rare. In fact, to the best of our knowledge, fewer than 20 such cases have been reported during the past 40 years. We report a new case of bilateral temporal bone eosinophilic granuloma, and we review the disease process and its treatment.
April 30, 2007 M. Panduranga Kamath, MS; Kiran M. Bhojwani, MS; Shivananda Prabhu, MS; Ramdas Naik, MD; Geo P. Ninan, MBBS; Yeshwanth Chakravarthy, MBBS
March 31, 2007 Robert Eller, MD; Linda Marks, RN; Mary Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA
