Maxillary sinus hypoplasia is a relatively uncommon clinical condition that may be misdiagnosed as chronic sinusitis or neoplasm by otolaryngologist. We report an unilateral clinical case of this entity confirmed by CT and a short literature review is performed at this respect.
Mucosal melanomas of the nasal cavity and paranasal sinuses are rare and agresive neoplasms and carries a bad prognosis. The diagnosis may require confirmatory immunohistochemical stains (S-100 protein, HMB-45, vimentin and cytokeratine). The clinical records of 6 patients with the diagnosis of sinonasal melanomas between 1991 and 2005 were retrospectively reviewed. The mean age was 70 years (range 51 to 83 years), there were 2 men and 4 women. Surgery was performed in four patients, adjuvant radiation therapy was used in one patient after local recurrence and chemotherapy in three patients. Three of four patients (75%) had a recurrence after previous treatment (surgery). The actuarial disease-free survival for this group of 6 is 33.3% (2 of 6). Mucosal melanoma of the head and neck remains a difficult disease to treat, with high locoregional recurrence rates and poor prognosis.
Maxillary sinus hypoplasia is a common condition that may be misdiagnosed as chronic sinusitis. Although hypoplasia can usually be seen on conventional sinus films, computed tomography may be necessary, as in the cases described by the authors in this article.
We denominate otohematoma to the blood stock in the pinna. It occurs by the broke of pinna drilling vessels. Its origin is traumatic. It is usual after soft but continuous hits, less often after hard and unique ones, and more less often bilateral forms like the case we present.
Paragangliomas are tumours derived from cells in the neural crest that are normally benign, and have low incidence and slow growth rates. We report the clinical case of a 61 year-old female studied at the ENT's surgery suffering from a left side tinnitus with four years of evolution. Complementary explorations were carried out such as an audiogram, computerised axial tomography scans and angioresonance. In spite of the high diagnosis suspection, it is late confirmed, because it was not visible in the radiographic studies. We revised the literature referring this pathology.
The arterioveinous dural malformation (MAVD) is a rare entity between the vascular craneal anomalies with a not well nown ethiology and variability in treatments. We present eleven cases of MAVDs, between them five presented tinnitus as symptom of aparition. The importance of this pathology makes necessary to discard it before a patient consulting because of pulsaltil tinnitus with normal otoscopy.
Basosquamous carcinoma is a rare epithelial malignant neoplasm with clinical and biological features of both basal and squamous cell carcinoma. This neoplasm has been characterized for years as a variant of basal cell carcinoma, although now it is widely accepted as a clinical entity. We report a 59-year-old male patient, homeless, who presented an ulcerated tumoral lesion from four years ago, located in left malar region, orbit and nasal pyramid. It caused an important destruction of these anatomic structures and spred out the skull base through optic nerve. The most important features of basosquamous carcinoma are its great local aggressiveness, high frequency of recurrences and its metastatic potential. Because of that, the most effective therapeutic measure is the early detection and complete removement of these tumours; although, as the case we report, it is not always possible.
Acoustic neurinoma is the most frequent benign tumour at the cerebellopontile angle. It causes compressive type lesions in adjacent cerebral structures. Its usual symptoms are sensorineural hearing loss and tinnitus with or without unilateral vertigo, which is why we have to know the wide variety of clinical signs it can present from its beginning, including facial palsy. We present the case of a vestibular schwannoma in a pregnant lady diagnosed by a peripheral facial palsy.
We present a retrospective study of 200 consecutive children explored in our hospital between november 2005 and april 2006, as a part of the protocole or program of early identification hearing loss stablished several years ago in our Comunity. In case of suspected hypoacusia after performing otoacoustic emissions, children must be sent to PEATC 3 months later.
We present the case of a 56 years old female controlled in our ENT Department because of right sudden hearing loss, tinnitus and vertigo. The endoscopic exam was normal. Audiogram showed a severe neurosensorial hypoacusia and PEATC confirmed the so called hypoacusia suggesting a retrocochlear origin of it. As imaging tests an otic-craneal CT and IRM were asked for, which informed of the presence of a cystic lesion versus polyp in sphenoidal sinus of 15 x 10 mm without other alterations or significant pathology.
Epistaxis is one of the more frequent entities in the otolaryngological practice. The term is attributed to CULLEN (1785). Since them, multiple theories concerning etiology, clinical manifestacions, diagnosis and management have been reported in the medical literature. Nevertheless, an impressive improvement of awareness about these questions have emerged in the last half of past century. The objective of this work is to revise the history of epistaxis since the ancient times to the first half of the 20th century.
The presence of two or more different histologic types of neoplasms in patients treated for head and neck cancer is well known. It is provided the clinical case of a woman of 48 years old who developed two primary tumors, a squamous carcinoma of larynx and a clear cell carcinoma of kidney (hypernephroma). The diagnosis of second primary tumor was a casual find when an abdominal TC was being carried out. The more frequent association of a head and neck cancer is with a malignant tumors of lung, being unusual the malignant tumors of kidney association.
Cholesterol granulomas and cysts located on the petrous apex can course of a silent way during years. We describe one case assisted in our consulting rooms which was discovered after performing CT and MRI (with and without paramagnetic contrast) in a patient with vertigo associated to conscience loss without other symptoms. In the discussion is exposed which must be the differential diagnosis of this pathology.
The dynamic posturography (PD) is an amply diffused method for the study of balance. Its principal utility is the design of therapeutic strategies based on the vestibular rehabilitation. In determined patients and with the help of other elements of rehabilitation the PD favour the compensation of the degradation ofthe secondary balance to determinated pathologic entities that affect the vestibular peripheric or central system. Normally individualized strategies for each patient are employed and although this is the more correct, we consider necessary to propose global mesures that facilitate the rehabilitation program and the comparison of the results of different authors.
Stapedial surgery is able to obtain excellent hearing results in the long-term in most otosclerotic patients. Nevertheless, some cases have vertigo and/or tinnitus after surgery, that may lead them to revision surgery. Out of a consecutive series on 115 patients, we present three cases (2,6%) with persistent vertigo after stapedotomy. These patients had residual unsteadiness despite good hearing after surgery, with a minimum follow-up of 12 months. Videonystagmography showed spontaneous nystagmus towards the contralateral ear in one case, whereas the other two had a canalicular paresis in the operated side, signs of vestibular hypofunction. After vestibular rehabilitation, unsteadiness resolved in all cases, with good spontaneous compensation, without any further surgery.
Vegetal or animal food can produce hipersensibility reactions IgE mediated of diverse intensity. We report the case of a 54 years old woman without previous allergic antecedents who after eating frozen fish had to go to Emergencies due to angioedema especially in face and oropharynx. The ENT exploration by fibroscopia descarted laryngeal edema but the patient showed initially respiratory symptoms so she was treated with SC adrenalina and then steroids during her admission. The diagnosis of alimentary alergia would be confirmed after by Allergology with cutaneous test prick type.
The complexity of the embriologic development of the neck and the possible abnomarlies in this process, with the consequent posterior manifestations make necessary the knowledge of the embriologic anatomy of the neck. In the possible manifestations that can be of the anomalies of the development of the branchial archs are the abnomarlies of the first branchial archs. They are, in the anomalies of the development of the branchial archs infrequent and are intimately related with the facial nerve. We present a clinic case of a seven years old boy affected by this pathology and revise its more important aspects.
INTRODUCTION:Mechanical stapling devices have long been used in the operating room and have been extensively discussed in the literature of laparoscopic surgery, abdominal surgery and gynecologic surgery. However, this technique has not been commonly used in Oral and Maxillofacial surgery.OBJECTIVE:To explain the application of stapling devices in head and neck surgery. Their use may help to reduce total operative time and reduce postoperative morbidity. We present the use of staplers in some patients.
We report the case of a 52 years old patient with clinic of food regurgitation and some dysphagia without other added symptoms who was sent to our ENT consulting rooms. It was performed a cervicothoracic CT which informed as a paratracheal cystic lesion with differential diagnosis between esophageal or tracheal diverticulum. The possibility of that last one was discarted by a normal bronchoscopy.
Schwanomas in extracranial head and neck region are an uncommon tumour, but when refered to its origin in the parasympathetic nerve fibers are extremely rare. We describe a case of schwanoma of the right submandibular gland originating from the parasympathetic branch of the lingual nerve, and we discuss about the clinical, diagnostic and therapeutic aspects of this rare tumour and a literature review of the recent cases.
