Dysphagia after strangulation

September 7, 2012     Jenna Briddell, MD; Andrew Mallon, DO; Rima A. DeFatta, MD; Farhad Chowdhury, DO; Matthew Nagorsky, MD, FACS

Patients with an isolated cornu fracture can be asymptomatic in the acute setting, only to develop symptoms of chronic odynophagia and globus sensation months after the inciting injury.

Temporary blindness and ophthalmoplegia due to local anesthetic infiltration of the nasal septum

June 4, 2012     Devrim Bektas, MD; Neslihan Kul, MD; Nurettin Akyol, MD; Ahmet Ural, MD; Refik Caylan, MD


We report the case of a 35-year-old man who developed blindness and ophthalmoplegia during local anesthetic infiltration of the nasal septum. The complications were temporary, and the patient had full recovery without treatment. The vascular anatomy of the area and possible pathogenic mechanisms are discussed, with some suggestions on the prevention of this complication.

Endoscopic orbital decompression of an isolated medial orbital wall fracture: A case report

December 15, 2011     Erdogan Gultekin, MD, Zafer Ciftci, MD, Omer N. Develioglu, MD, Oner Celik, MD, Murat Yener, MD, and Mehmet Kulekci, MD


Motor vehicle and bicycle accidents are the most common causes of blunt head trauma. Other common etiologies are falls, physical violence, and sports accidents. Blunt trauma toward the superior orbital rim, lateral orbital rim, frontal region, and cranium may lead to intraorbital hematoma. A fracture following the blunt head trauma may form a one-way valve, which leads to orbital emphysema and a more pronounced increase in orbital pressure. Increased tissue pressure in an enclosed space will eventually lead to an inevitable decrease in tissue perfusion. It is important to treat the patient within the first 48 hours following the trauma, which is accepted as the “critical period.” In this report we present a case involving a 42-year-old man who was admitted to our clinic with left periorbital pain, edema, proptosis, and blurred vision after experiencing physical violence. The medical history and physical examination findings, along with imaging studies and a description of the endoscopic orbital decompression procedure within the first 24 hours, are reported.

Submental intubation to facilitate the management of maxillofacial trauma

September 20, 2011     Robert T. Adelson, MD

Characteristics of nasal injuries incurred during sports activities: Analysis of 91 patients

August 15, 2011     C. Ron Cannon, MD, Rob Cannon, BS, Kevin Young, MD, William Replogle, PhD, Scott Stringer, MD, and Elizabeth Gasson, RN, MSN


Nasal injuries are among the most common sports injuries. We conducted a prospective, observational study of 91 patients, aged 7 to 60 years (mean: 18.3), who had sustained a nasal injury while engaging in a sport, exercise, or other recreational physical activity. We found that a substantial proportion of these injuries occurred in females (29.7% of cases). A high percentage of injuries (86.8%) occurred in those who had been participating in a noncontact sport; the sport most often implicated was basketball (26.4%). Also, injuries were more common during organized competition as opposed to recreational play (59.3 vs. 40.7%). Of the 91 nasal injuries, 59 (64.8%) were fractures, most of which were treated with a closed reduction. Almost all of the patients in this study (92.3%) were able to return to their sport. We conclude that most sports-related nasal fractures are not preventable.

An unusual presentation of an asymptomatic neck mass

August 15, 2011     Rapahel Nach, MD, Lorraine M. Smith, MD, MPH, and Hootan Zandifar, MD

Self-induced subcutaneous facial emphysema in a prisoner: Report of a case

June 13, 2011     Mahmoud Goudarzi, MD and Jafar Navabi, MD


Subcutaneous cervicofacial emphysema is a rare condition that results from various causes. Initially it might be misdiagnosed and managed as other clinical entities, such as angioedema. We report a case of self-induced subcutaneous facial emphysema in a prisoner who sought better living conditions by simulating an emergency.

Nasal septal abscess

March 31, 2011     Jordan Cain, MD and Soham Roy, MD, FACS, FAAP

Postaural inflammatory pseudotumor: An extremely unusual complication of trauma in a child

March 1, 2011     Ashwani Sethi, MS, Vikas Malhotra, MS, Deepika Sethi, MS, and Sonu Nigam, MD


We report the case of a 12-year-old boy who presented with a rapidly enlarging, painless mass behind the ear following trauma to the area. The mass was excised, and histopathologic and immunohistochemical evaluations revealed it to be an inflammatory pseudotumor. At 1 year postoperatively, the child exhibited no evidence of recurrence.

Traumatic hemorrhage and rapid expansion of a cervical lymphatic malformation

January 1, 2011     Nishant Bhatt, MD, Helen Perakis, MD, Tammara L. Watts, MD, PhD, and Jack C. Borders, MD

Aspiration of radiolucent dentures in facial trauma: Case report

December 17, 2010     Jon B. Chadwell, MD, Joshua R. Mitchell, MD, Michael Donnino, MD, Charles Peterson, MD, Paul Guentert, MD, Cliff Arnold, BA, and Mark Walsh, MD


Foreign body aspiration is a serious problem that may lead to complications or even death. People who sustain major maxillofacial trauma can often damage their teeth or oral prostheses, and aspiration can occur. Detection of this type of aspiration can be difficult, especially in elderly people wearing dental appliances, since many dental prostheses are not radiopaque and the aspiration is not always recognized at the time of injury. We report a specific case of extensive maxillofacial trauma from a self-inflicted gunshot wound leading to aspiration of large, radiolucent denture fragments, delayed diagnosis, and complications. The possibility of denture fragment aspiration must always be part of the differential diagnosis in an elderly trauma patient presenting with dyspnea, hypoxia or, eventually, pneumonia. This is especially so when radiologic evaluation does not reveal a foreign body, since much dental prosthesis material is radiolucent. Delayed complications of radiolucent dental prosthesis aspiration could be avoided by the inclusion of some radiopaque material within the acrylic material of the prosthesis.

Botulinum toxin-assisted endoscopic repair of traumatic vocal fold avulsion

August 31, 2010     Rima F. Abraham, MD, Stanley Shapshay, MD, and Lisa Galati, MD


Blunt traumatic laryngeal injury in children often leads to intralaryngeal soft-tissue damage, which can quickly compromise an already small airway. Injuries requiring operative intervention have historically been repaired via open approaches such as thyrotomy and laryngofissure. These approaches carry significant long-term sequelae that can compromise the airway, deglutition, and voice. We describe a safe and effective alternative to open repair that includes the use of a botulinum toxin chemical myotomy to ensure optimal healing. We used this procedure to treat a 13-year-old boy who had experienced a traumatic avulsion of the true vocal folds. Postoperatively, his voice outcome was satisfactory, as evidenced by a marked improvement in his pediatric Voice Handicap Index score. No complication or compromise of the airway or swallowing occurred, and resolution of the botulinum effect was observed by 6 months postoperatively. The endoscopic approach supplemented by botulinum toxin injection avoids scarring and allows for safe postoperative extubation. Compared with open repair, it is associated with a shorter hospital stay and a lower risk of stenosis and fibrosis.

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