Auris, nasus, larynx
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Auris, nasus, larynx · Feb 2014
Case ReportsSynchronous bilateral tonsillar carcinomas associated with human papillomavirus.
Although the incidence of human papillomavirus (HPV)-positive oropharyngeal carcinoma is increasing, only a limited number of synchronous bilateral HPV-positive tonsillar carcinomas have been reported to date. Here, we describe an additional case of 61-year-old female. Pathological analysis proved squamous cell carcinoma in biopsy specimens from bilateral tonsillar lesions and a fine needle aspirate from an enlarged cervical node. ⋯ We administered concurrent chemoradiotherapy to treat these synchronous lesions, and the restaging workup resulted in overall complete response. No recurrent and/or metastatic disease has been evident 20 months after the restaging. It seems reasonable to include bilateral tonsils as a therapeutic target in the treatment of HPV-positive unknown primary carcinoma.
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Auris, nasus, larynx · Feb 2014
Case ReportsIsolated vagus nerve paralysis associated with internal carotid artery dissection.
Dysphagia and hoarseness caused by laryngopharyngeal paralysis associated with internal carotid artery (ICA) dissection is rare. We reported a case which recovered spontaneously. A 57-year old man visited our hospital complaining of dysphagia and hoarseness lasting for two weeks. ⋯ Magnetic resonance imaging was performed under diagnosis of isolated right vagus nerve paralysis, and dissection of the right ICA was revealed. He was treated conservatively, and both of laryngopharyngeal movement and the ICA dissection were improved completely. There is a possibility that laryngeal paralysis caused by ICA dissection has been misdiagnosed as an idiopathic paralysis.
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Desmoplastic small round cell tumor (DSRCT) is a rare malignancy with poor prognosis that generally involves the peritoneum. Only rare cases occur outside the abdomen. ⋯ The DSRCT diagnosis was confirmed by the presence of a polyphenotypic immunoprofile (positive for cytokeratin, desmin, and neuronspecific enolase) and the characteristic EWS-WT1 gene fusion resulting from the t(11;22)(p13;q12) reciprocal translocation. This reported case of DSRCT draws attention to the importance of including DSRCT in the differential diagnosis of sinonasal tumors.
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Cochlear implantation has become an effective treatment for many profoundly deaf patients. As with any surgical procedure, a proportion of patients suffer postoperative complications. The aim of this study was to analyze long-term postoperative complications in patients with cochlear implants with a view to improve clinical interventions and propose a consensus for reporting complications. ⋯ Many cases of major complications, including electrode problems and facial paralysis, excluding traumatic device failure were considered avoidable by strict operative and postoperative procedures. Some cases of flap infection and traumatic device failure may not be able to be avoided completely, and every possible care should be taken by implant patients and others involved.
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Auris, nasus, larynx · Oct 2013
Review Case ReportsBlindness caused by septic superior ophthalmic vein thrombosis in a Lemierre Syndrome variant.
A 65-year-old man presented with right facial cellulitis and right blindness. Enhanced CT and MRI showed right facial cellulitis involved with pterigopalatine fossa. Additionally, orbital cellulitis, superior ophthalmic vein thrombosis, and pulmonary multiple nodules were observed. (18)F-FDG PET/CT supported these findings. ⋯ Since septic superior ophthalmic vein thrombosis and Lemierre Syndrome both have life-threatening potential, early diagnosis and appropriate treatment are important and may contribute to reduce the incidence of severe complications. Septic superior ophthalmic vein thrombosis accompanied with Lemierre Syndrome is exceeding rare, and this case is the first report of blindness in Lemierre Syndrome. A literature review and discussion of septic superior ophthalmic vein thrombosis and Lemierre Syndrome are included.