Case Reports in Otolaryngology

BACKGROUND: Thyroglossal duct cysts (TDC) represent approximately 70% of all congenital neck masses, and up to 1% of them contain thyroid tissue malignancies. Clinical presentation of TDC carcinomas is usually indistinguishable from benign tumors preoperatively, and differential diagnosis can be challenging. We present a rare case of TDC carcinoma concurrent with thyroid cancer in an adolescent. Case Presentation . A 16-year-old Caucasian female, otherwise healthy, was referred with a painless, gradually expanding lump on the neck...

BACKGROUND: Tension pneumocephalus is a neurosurgical emergency caused by progressive accumulation of air in the intracranial spaces mediated by a valve mechanism. Tension pneumocephalus usually presents with headaches, reduced consciousness, and even death. One of the most common causes is an ethmoidal defect resulted by nasal surgery or facial traumas. METHODS: A literature review about tension pneumocephalus resulting from ethmoidal damages was performed. Surgery strategies included decompression by frontal burr holes and multilayer repair of the ethmoidal defect...

Seromucinous hamartoma is a rare benign glandular proliferation arising from the respiratory epithelium of the sinonasal tract and nasopharynx. It was described for the first time in 1974 by Baillie and Batsakis. Since then, few cases have been reported in the literature with most of them occurring in the posterior nasal septum. We report the case of a 52-year-old woman that presented to our department with left periorbital edema, pain, and dacryorrhea due to seromucinous hamartoma arising from the left inferior turbinate and extending through the lateral nasal wall into the maxilla, the nasolacrimal duct, and the orbit...

BACKGROUND: Hemotympanum may occur due to otic barotrauma secondary to Valsalva maneuver during the second phase of labor. A pressure differential across the tympanic membrane (TM) of about five psi can cause rupture. The increased intrathoracic and intraabdominal pressure spikes repeatedly manifested by "pushing" during second-stage labor easily approach (and may exceed) this level. Clinical Presentation . This case report describes a healthy thirty-seven-year-old multipara patient admitted for the 40-weeks' gestational age routine follow-up that proceeded to active labor followed by an aural fullness and bloody otorrhea...

Spontaneous cerebrospinal fluid (CSF) rhinorrhea develops in patients without any history of trauma. Multiple factors have been theoretically debated. Also, localizing the defect may result in a challenge for the rhinologist. The common locations are the cribriform plate and the lateral recess of the sphenoid. Clival CSF rhinorrhea is rare, and only few cases have been reported so far. A 52-year-old female presented to the otolaryngology clinic with 7 years of history of left-side clear fluid rhinorrhea as a drop, which progressed to be runnier after she had pneumonia with severe cough secondary to COVID-19 infection...

BACKGROUND: Sinonasal lymphoepithelial carcinoma (SNLEC) is a rare neoplasm, representing less than 1% of all types of carcinomas and approximately 3% of head and neck tumors. It can affect the nasopharynx due to the rich lymphoid tissue present in this region. Clinical SNLEC presentation varies, ranging from asymptomatic to nonspecific sinonasal symptoms. We report a case of SNLEC and review the literature for SNLEC presentation, diagnosis, management options, and outcomes. Case Presentation ...

BACKGROUND: Juvenile nasopharyngeal angiofibroma (JNA) is a rare tumor that mainly affects young boys. Its intervention may be complex due to its high vascularity, location, and extension. Preoperative embolization is used to prevent intrasurgical and postsurgical bleeding. Two main kinds of embolization are described in literature: intratumoral and transarterial, and numerous embolic materials are used. Case Presentation . We want to present a case of presurgical embolization of a stage IV JNA, performed using a single stop-flow balloon assisted technique with the balloon cuffed exclusively in the external carotid artery and using Onyx 18 as an embolic agent...

Laryngeal cryptococcosis is a rare condition. While there is no reliable evidence regarding the treatment of laryngeal cryptococcosis, oral fluconazole was successful in most previous cases. We experienced a case where we could not continue fluconazole because of adverse drug effects. An 88-year-old female was referred to our department with a 5-month history of sore throat and cough. She had used oral steroids and a corticosteroid inhaler for poorly controlled asthma. Flexible laryngoscopy showed leukoplakia of the vocal cords and subglottic mucosa, and biopsy revealed cryptococcal infection...

BACKGROUND: Vascular endothelial growth factor/receptor (VEGF/R) inhibitors are used in chemotherapy protocols to limit tumor angiogenesis. Recent evidence shows they are associated with hoarseness, but their impact on vocal cord function has not been fully identified. OBJECTIVES: To describe the preliminary laryngeal findings in patients undergoing chemotherapy with VEGF/R inhibitors, and to describe possible mechanisms of their effect on vocal fold function. METHODS: A retrospective case series was conducted in a tertiary medical center between July 2008 and August 2022...

Introduction . Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo among adults. The etiology of BPPV is unknown in approximately 50 percent of cases. This condition is also termed primary BPPV, if the etiology is unknown, and secondary BPPV if patients have identified predisposing factors. A few studies suggest that there is a correlation between the development of BPPV and specific sports. Case Report . A 19-year-old male presented with recurrent episodes of vertigo during soccer play...

We report the rare occurrence of a temporal glioblastoma multiforme (GBM) showing transdural tumor extension into adjacent mastoid cells. As the dura mater provides a barrier to intraaxial tumors, GBM seldom penetrates into the skull base, even though it is a high-grade astrocytoma with a tendency to spread. Yet, some mechanisms of GBM-induced skull invasion have been identified, making this entity a very rare but nonetheless relevant differential diagnosis in otherwise ambiguous cases of an intracerebral tumor extending into the skull base...

A 69-year-old male patient presented to the hospital with a chief complaint of nasal obstruction. Physical examination revealed swelling of the anterior nasal septum and nasal dorsum and tender indurated oedema of the dorsum of both hands. Blood tests showed an elevated inflammatory response, and contrast-enhanced computed tomography (CT) showed a polycystic abscess in the nasal septum. Emergency surgery and histopathology were performed on the day of the initial visit for incisional drainage. Intraoperative findings showed white necrosis between the nasal septal cartilage and nasal septal mucosa, as well as white necrosis and pus accumulation in the periosteum and soft tissue of the piriform aperture and the nasal bone...

Lingual leiomyomatous hamartomas are rare lesions of the tongue with largely unknown mechanisms of formation. These lesions are often asymptomatic, though they may present with symptoms, particularly relating to swallow function. Workup should include imaging of the head and neck, and diagnosis should be made histologically. Treatment is surgical excision. This case is a report of a 4-week-old female who presented for evaluation of an asymptomatic 1 × 1 cm dorsal midline tongue mass discovered at birth...

Background: To explore spotted temporal lobe necrosis (TLN) and changes in brain magnetic resonance imaging (MRI) after image-guided radiotherapy (IGRT) in a patient with nasopharyngeal carcinoma (NPC). Case presentation: a 57-year-old male was diagnosed with stage III NPC, cT1N2M0, in 2017. He underwent concurrent chemoradiation therapy (CCRT) with cisplatin (30 mg/m2 ) and 5- fluorouracil (5-FU, 500 mg/m2 ) plus IGRT with 70 Gy in 35 fractions for 7 weeks. The following MRI showed a complete response in the NPC...

Clinical evaluation, differential diagnosis, and management of a neck mass constitute commonly encountered problems for the head and neck surgeon. An asymptomatic neck mass in adults may be the only clinical sign of head and neck cancer. A 50-year-old female patient presented with a painless, slowly enlarging, left lateral neck lump. Ultrasonography described a possible lymph node with cystic degeneration, and fine needle aspiration biopsy only detected atypical cells of squamous epithelium. An open biopsy under general anesthesia was performed...

Epistaxis in children can be caused by different systemic and local pathologies. Respiratory infections, nasal mucosa dryness, and foreign bodies are some local causes of bleeding from the nose. In developing countries, infestations still contribute a significant proportion of anemia in children. But it is very unusual for leech-causing persistent epistaxis with a consequence of severe anemia. We herein report a rare cause of severe anemia in a 5-year-old child presented to our clinic for persistent epistaxis...

Disturbed pitch perception is a rare but well-known side effect of the antiepileptic drug carbamazepine and its derivates. A patient is presented who used three antidepressants because of depression. After recovering, the medication was continued, but as a violinist, the patient was told that his intonation was too low with the consequence that he was not allowed to participate in the orchestra where he had been for years. After phasing out the medications, his pitch perception returned to normal. This observation is unique as no other examples of this side effect are found in the literature in relation to antidepressants...

A 14-year-old adolescent was referred to a regional paediatric outpatient clinic with anosmia by her family doctor in Western Australia. The patient has no recollection of her previous ability to smell, suggesting the possibility of congenital anosmia. She was assessed in the paediatric outpatient clinic. A "noncontrast high-resolution MRI-brain scan with Anosmia-Protocol" was requested as the first-line investigation of choice by the treating paediatrician. The MRI was reported as "absence of olfactory tracts with preserved olfactory bulb volume...

The COVID-19 pandemic has shown with certainty that SARS-CoV-2 can cause a variety of clinical findings, with some of the most notable being lasting chemosensory changes. Severe infections with SARS-CoV-2 can also lead to a variety of complications. For example, vocal cord paralysis can be caused by trauma sustained during intubation, which is a necessary procedure for many severe cases. Rarely, SARS-CoV-2 related vocal cord paralysis has occurred outside the context of intubation. These cases contribute to an emerging assortment of evidence supporting the neuropathic capacity of SARS-CoV-2...

Intraneural lipomas in peripheral nerves of cervical lesions are extremely rare and have not been previously reported. We present a 48-year-old male with a gradually increasing right cervical mass since 5 years. He visited our department because of pain and difficulty in raising the right upper limb. A tumor about 80 mm in size was palpable in the right neck along the cervical nerve. The tumor was suspected to involve fatty degeneration in schwannoma of cervical nerve origin, for which intercapsular resection was performed under general anesthesia...