Other ENT Topics

Infected sublingual hematoma: A rare complication of frenulectomy

July 21, 2013     Amal Isaiah, MD, DPhil; Kevin D. Pereira, MD, MS
article

Given the spectrum of potential poor outcomes, some consensus has emerged in favor of early surgical management of significant ankyloglossia.

Laryngeal plexiform neurofibroma in a child

June 11, 2013     Fikret Kasapoglu, MD; Talip Ozdemircan, MD; and Levent Erisen, MD
article

Abstract

Neurofibromatosis (NF) is a genetically inherited, autosomal dominant disease, characterized by multiple cafe au lait spots, cutaneous neurofibromas and “Lisch nodules.” Neurofibromatosis can develop from a neural source at any age. However, neurofibroma of the larynx is extremely rare and is usually manifested by obstructive airway symptoms. We encountered a 5-year-old child presenting with stridor and dyspnea, who had a diagnosis of laryngeal plexiform neurofibroma. The purpose of our report is the consideration of laryngeal NF in the differential diagnosis of dyspnea in infants and children.

Inferior vestibular neuritis in a fighter pilot: A case report

June 11, 2013     Xie Su Jiang, MD, PhD; Jia Hong Bo, PhD; Xu Po, MS; and Zheng Ying Juan, BSC
article

Abstract

Spatial disorientation in airplane pilots is a leading factor in many fatal flying accidents. Spatial orientation is the product of integrative inputs from the proprioceptive, vestibular, and visual systems. One condition that can lead to sudden pilot incapacitation in flight is vestibular neuritis. Vestibular neuritis is commonly diagnosed by a finding of unilateral vestibular failure, such as a loss of caloric response. However, because caloric response testing reflects the function of only the superior part of the vestibular nerve, it cannot detect cases of neuritis in only the inferior part of the nerve. We describe the case of a Chinese naval command fighter pilot who exhibited symptoms suggestive of vestibular neuritis but whose caloric response test results were normal. Further testing showed a unilateral loss of vestibular evoked myogenic potentials (VEMPs). We believe that this pilot had pure inferior nerve vestibular neuritis. VEMP testing plays a major role in the diagnosis of inferior nerve vestibular neuritis in pilots. We also discuss this issue in terms of aeromedical concerns.

Methicillin-resistant Staphylococcus aureus as a cause of neonatal suppurative parotitis: A report of two cases and review of the literature

June 11, 2013     Sean T. Donovan, MD; Grant T. Rohman, MD; John P. Selph, MD; Roy Rajan, MD; Rosemary M. Stocks, MD; and Jerome W. Thompson, MD, MBA
article

Abstract

Suppurative parotitis is an uncommon entity identified in newborns. While Staphylococcus aureus has been frequently identified as the causative pathogen among the few patients diagnosed with neonatal suppurative parotitis (NSP), there has only been one prior case described in the literature that was due to methicillin-resistant Staphylococcus aureus (MRSA). Because of its virulence, MRSA presents new and substantial challenges for the surgeon; we describe two cases of NSP caused by MRSA and the subsequent surgical intervention necessitated for cure. We also include a review of all cases of NSP described in the English-language literature.

Intrapharyngeal schwannoma in a pediatric patient

June 11, 2013     Nader Nassif, MD; Mariaelisabetta Cottelli, MD; Davide Farina, MD; and Marco Berlucchi, MD
article

Abstract

Schwannomas are benign peripheral nerve neoplasms that arise from Schwann cells. They usually occur in the adult population. The most common site in the head and neck region is the parapharyngeal space. Intrapharyngeal schwannomas are extremely rare, and those that have been reported all occurred in adults. We report what to the best of our knowledge is the first case of an intrapharyngeal schwannoma in a pediatric patient. The patient, a 15-year-old boy, was treated successfully with surgical excision.

Airway management in an infant with alobar holoprosencephaly and cebocephaly associated with maternal diabetes mellitus

April 17, 2013     Rajanya S. Petersson, MD; William A. Carey, MD; Dana M. Thompson, MD
article

Abstract

We report a case of alobar holoprosencephaly (HPE) and cebocephaly associated with uncontrolled maternal type 1 (insulin-dependent) diabetes mellitus. Alobar HPE is the most severe form of HPE. Patients with cebocephaly have ocular hypotelorism and a proboscis with a single, blind-ended nostril. Shortly after our patient was born, we were consulted for airway management, as the parents' goal was to bring their child home. A tracheostomy tube was placed, and choanal atresia repair was eventually performed. The infant was never decannulated, however, and she died at the age of 9 months of acute respiratory distress syndrome secondary to an upper respiratory infection. To the best of our knowledge, this case represents the longest reported survival of an infant with alobar HPE and cebocephaly. Decisions regarding the care of these infants should be made in a collaborative, multidisciplinary fashion, with special attention paid to the primary caregivers' goals of care.

Congenital cholesteatoma in a 3-year-old

April 17, 2013     Danielle M. Blake, BA; Senja Tomovic, MD; Robert W. Jyung, MD
article

 When a congenital cholesteatoma is diagnosed early as a localized circumscribed mass, it can be resected with a very low risk of recurrence.

Local anesthesia for nasal and sinus surgery

March 24, 2013     Jennifer R. Decker, MD; Jay M. Dutton, MD, FACS
article

Knowledge of nasal anatomy, use of decongestants, a combination of topical and injectable medications, and adequate time for anesthesia effect allow the otolaryngologist to comfortably perform a wide variety of nasal procedures using local anesthesia.

Bilateral mastoid subperiosteal abscesses in an infant

January 24, 2013     Hernan Goldsztien, MD; Kevin D. Pereira, MD
article

The finding of bilateral acute mastoiditis in an infant should prompt a search for underlying predisposing causes.

The extended dorsal-shield graft in augmentation rhinoplasty

December 31, 2012     Giancarlo F. Zuliani, MD; Kailash Narasimhan, MD
article

Rhinoplasty in ethnic populations often warrants a graft versatile enough to correct dorsal deficiency, underprojection, malrotation, and cartilage deficiency.

Intraorbital erosion of a malar implant resulting in mastication-induced vision changes

October 31, 2012     Kyle Hatten, MD; Robert E. Morales, MD; Jeffrey S. Wolf, MD, FACS
article

Abstract

Complications of cosmetic malar augmentation are uncommon. We describe the unusual case of a 60-year-old woman who experienced vision disturbances (flashing lights and diplopia) while masticating. Ten years earlier, she had undergone bilateral malar enhancement with silicone implants. Imaging studies revealed that the implant on the right side had become displaced. The prosthesis had entered the orbit in the retrobulbar area and eroded the lateral zygomaticomaxillary buttress and the orbital floor. Both implants were removed, and the patient's symptoms immediately resolved. To the best of our knowledge, no case of vision changes secondary to erosion of the posterior orbit by a silicone malar implant has been previously described in the literature.

Sphenoethmoid sinusitis in a child resulting in a disastrous intracranial sequela

October 31, 2012     Aye Jane Sow, MS(ORL-HNS); Jeevanan Jahendran, MS(ORL-HNS); Charng Jeng Toh, MS(Neurosurg); Thean Yean Kew, FRCR
article

Abstract

Localized sphenoethmoid sinusitis in children is a rare occurrence. It is usually overlooked because of the misconception that the sinuses are not developed. We describe a case of localized acute sphenoid and right posterior ethmoid sinusitis that presented as right frontobasal subdural empyema and multiple deep cerebral abscesses. Morbidity from subdural empyema in children is high. Early diagnosis and treatment based on recognition that the etiology might involve the paranasal sinuses affects the overall prognosis.

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