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Subcutaneous nasal angioleiomyoma: Case of a rare tumor and review of the literature

October 25, 2016  |  Robert Saadi, MD; Benjamin S. Oberman, MD; Henry Crist, MD; Jessyka Lighthall, MD

Abstract

We describe the case of a 46-year-old woman with a rare presentation of angioleiomyoma of the subcutaneous nasal tissue. The patient presented with pain and severe nasal obstruction. Her nasal deformity was sufficient to indicate an external rhinoplasty for both extirpation of the tumor and reconstruction of the defect with cartilage grafts. The procedure resulted in successful removal of the tumor and a satisfactory cosmetic outcome.

A novel approach to excision of distal tracheal granulation tissue in tracheostomy patients with difficult anatomy

October 25, 2016  |  Allison Rasband-Lindquist, MD; Keith Sale, MD

Abstract

Tracheostomy predisposes patients to various complications. The most common late complication is granuloma formation; others include tracheal stenosis, bleeding, infection, and fistula development. Small granulomas may not require treatment, but large ones necessitate removal to prevent bleeding, obstruction, respiratory distress and, in rare cases, death. Various treatment options have been described, but no single modality has proved to be superior. We describe a novel approach to treating substomal tracheal granulation by using trans-stomal Coblation for patients whose granulation is difficult to visualize. This procedure offers several advantages over other means, including better hemostasis, less risk of distal tissue loss, ease of use, and potentially less operative time.

Unusual case of dyspnea in a child

October 25, 2016  |  Stephanie Warrington, MD; Anita Jeyakumar, MD, FACS

Is the location of a septal deviation associated with the degree of postoperative pain after septoplasty?

October 25, 2016  |  Gül Soylu Özler, MD

Abstract

The author conducted a prospective study of patients who underwent septoplasty for nasal obstruction secondary to a septal deviation to determine if the location of the deviation had any association with the degree of postoperative pain. Patients with an anteroposterior deviation were not included in this study, nor were patients with vasomotor rhinitis, allergic rhinitis, nasal polyposis, turbinate pathologies, or a systemic disease; also excluded were patients who were taking any medication and those who had undergone any previous nasal surgery. The final study population included 140 patients, who were divided into two groups on the basis of the location of their deviation. A total of 64 patients (35 men and 29 women; mean age: 29.8 yr) had an anterior deviation, and 76 patients (35 men and 41 women; mean age: 30.3 yr) had a posterior deviation; there were no statistically significant differences between the two groups in terms of sex (p = 0.309) or age (p = 0.848). During the postoperative period, pain intensity in both groups was self-evaluated on a visual analog scale on days 1, 3, and 7 and again at 3 and 6 months. The mean postoperative pain scores on days 1, 3, and 7 were significantly higher in the posterior deviation group than in the anterior group; scores in the two groups were similar at 3 and 6 months.

Breast cancer metastasis to the thyroid gland

October 25, 2016  |  Michael Goldenberg, MA; Joshua Warrick, MD; Mariano Russo, BS; Darrin V. Bann, MD, PhD

It is important to distinguish between metastatic disease and a second primary thyroid malignancy, which is more common than thyroid gland metastasis.

Myeloid sarcomas of the head and neck in pediatric patients with myeloid leukemia

September 19, 2016  |  David W. Cuthbertson, MD; Jyotinder Nain Punia, MD; Vicki L. Owczarzak, MD

Abstract

Myeloid sarcoma is a rare extramedullary tumor composed of malignant myeloid cells that occur in the presence of myeloid leukemia. We report a case series of pediatric head and neck myeloid sarcomas representative of the epidemiology, symptomatology, laboratorial correlations, prognoses, and treatment of extramedullary leukemia. Presented are 3 cases involving patients ranging from 17 months to 11 years of age. Two patients were successfully treated with chemotherapy, and in the third patient, a large lytic lesion was treated palliatively with proton beam therapy. Knowledge and recognition of myeloid sarcomas is important as they can be locally invasive, and they may also be used as a diagnostic tool or a prognostic indicator for leukemia.

Endoscopic view of a polyp in a concha bullosa

September 19, 2016  |  Nurdoğan Ata, MD; Fatih Güzelkara, MD

Polyps originating within a concha bullosa are uncommon, with only 5 cases reported in the English literature.

An unusual cause of tinnitus

September 19, 2016  |  Po-Jun Chen, MD; Hsin-Chien Chen, MD, PhD

Live insects found in the outer ear canal should be immobilized or killed before removal.

Reverse omega technique for single-stage ear lobule reconstruction

September 19, 2016  |  Mofiyinfolu Sokoya, MD; Andrew A. Winkler, MD

The design of the reverse omega flaps leads to a lack of visible scars, and no major complications have been encountered.

Hailey-Hailey disease

September 19, 2016  |  Lester D. Thompson, MD

Careful correlation of clinical findings with histologic and immunofluorescence findings usually assists in reaching the diagnosis.

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