May 31, 2009 Nadia Mohyuddin, MD, Cecillie Sulman, MD, and Melissa Wheeler, MD
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Abstract
The airway exchange catheter can be used both to ventilate the lungs and to act as a guide for reintubation in patients of all ages who have a tenuous airway. We report the case of a 2-year-old boy with an anatomically challenging airway in whom both an airway exchange catheter and a rigid bronchoscope were used to visualize and maintain a secure airway. We also review the literature as it pertains to the management of the difficult pediatric airway.
March 1, 2009 Jeremy C. Roebuck, MD and Kevin D. Pereira, MD, MS (ORL)
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Abstract
We report a case of idiopathic rupture of an internal carotid artery (ICA) aneurysm in an infant, a finding that we believe has not been previously reported in the literature. The more common causes of isolated injury to the ICA are deep neck space infections and penetrating intraoral trauma. Pseudoaneurysms of the artery are well known to result in delayed hemorrhage. In most cases, the outcome is unfavorable because of the large amount of blood loss. Our case involved a previously healthy 11-month-old girl who presented with massive epistaxis secondary to a ruptured left ICA aneurysm. The patient had no history of any antecedent trauma or infection. She was successfully managed by ligation of the involved ICA in the neck.
January 1, 2009 Kevin D. Pereira, MD, MS
January 1, 2009 Rahul K. Shah, MD, Adarsh Vasanth, MD, and Collin S. Karmody, MD, FRCSE
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Abstract
The authors report a case of asymmetric development of the mastoid antrum in a neonate. The lack of mastoid development most likely represents a congenital mal-development. Agenesis of the mastoid antrum has surgical implications, as failure to recognize its absence can result in disorientation during surgery, with potential to injure adjacent structures.
December 1, 2008 Charles S. Ebert Jr., MD, MPH, Carlton Zdanski, MD, Farhad Ardeshirpour, MD, Mihir Patel, MD, Craig F. Hart, MD, and Amelia F. Drake, MD
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Abstract
Infantile myofibromatosis is a rare proliferative mesenchymal disorder that has a potential for rapid growth and recurrence. Approximately 30% of infantile myofibromatosis lesions present in the head and neck, and some of these can cause significant morbidity. We report a case of recurrent infantile myofibromatosis that persisted after surgery and chemotherapy and was managed conservatively. Treatment of infantile myofibromatosis varies according to the size, location, and extent of disease. Solitary lesions may be simply observed in view of their potential for regression, but surgical excision, radiotherapy, and/or chemotherapy should be considered on a case-by-case basis, especially for nonresectable, rapidly progressive, or symptomatic lesions.
September 25, 2008 Kevin D. Pereira, MD and Stacey L. Smith, MD
August 31, 2008 Kadambari Batra, DLO, DNB, Anil Safaya, MS, and Kiran Aggarwal, MS
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Abstract
Lipoid proteinosis (Urbach-Wiethe disease) is a rare autosomal-recessive anomaly that primarily affects the skin and the mucosa of the upper aerodigestive tract in children. It is caused by hyaline deposits in tissues. Hoarseness secondary to laryngeal involvement is frequently the first presenting feature. It is important to consider this disease in the differential diagnosis of hoarseness because it might lead to life-threatening airway compromise. We report a case of lipoid proteinosis in a 12-year-old girl who presented with hoarseness and skin lesions.
August 31, 2008 Patrick M. Spielmann, MRCSEd, Richard Adamson, FRCS, Kenneth Cheng, MRCS, and Robert J. Sanderson, FRCS†
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Abstract
Juvenile nasopharyngeal angiofibroma is a rare, benign tumor that occurs most often in adolescent males. Common practice is to excise the tumor with open or endoscopic surgery. We report the case of a 17-year-old male who presented in 1995 with a mass filling the left posterior nasal cavity. A diagnosis of juvenile nasopharyngeal angiofibroma was obtained with computed tomography and magnetic resonance imaging. The patient elected to have no treatment. On annual scans, the lesion changed little until 1998, when it began to gradually decrease in size. Although it is not well proven, the natural history of these tumors seems to be regression over time. This case supports the argument that a policy of watchful waiting with regular imaging studies may postpone or eliminate the need for surgery and its attendant risks.
June 30, 2008 Melissa L. Somers, MD and Dana L. Suskind, MD
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Abstract
Long-segment near-complete tracheal ring deformity is a rare condition with few documented cases. We present the case of a 7-week-old male with total anomalous pulmonary venous return and long-segment near-complete tracheal rings. We discuss the presentation, evaluation, and management of near-complete and complete tracheal rings.
May 31, 2008 Steven P. Chase, MD, Jerry W. Templer, MD, Ronald Miick, MD, and Alberto A. Diaz-Arias, MD
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Abstract
While most cases of cervical lymphadenopathy resolve with conservative management, persistent adenopathy can lead to costly investigations and invasive treatments. One cause of persistent adenopathy, as well as a variety of other associated systemic symptoms, is Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis). This rare entity can be diagnosed only by excisional biopsy on the basis of its characteristic histologic appearance. We describe a case of persistent cervical lymphadenopathy secondary to Kikuchi-Fujimoto disease in an 11-year-old girl.
April 30, 2008 Robert Wilson, MD, Tarika Bhuta, MD, and Richard Haydon, MD
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Abstract
While the prevalence of acute otitis media complications in pediatric patients has decreased over the past 30 years because of effective antibiotic therapy, the incidence has begun to rise again recently, possibly because of increased antibiotic resistance. Patients who simultaneously manifest multiple complications may require a more thorough evaluation, including an immunologic work-up. The presented case should encourage physicians to investigate the possibility of an underlying immunodeficiency when treating patients with multiple simultaneous complications of acute otitis media.
March 31, 2008 Dary J. Costa, MD, Ron B. Mitchell, MD, and David S. Brink, MD
