American journal of otolaryngology
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Mucormycosis is a fatal infection of the immunocompromised individuals. Apophysomyces elegans is an unusual pathogen causing mucormycosis. It is unusual to affect the healthy individuals. We report 5 such cases of infection caused by A elegans in immunocompetent individuals. ⋯ Mucormycosis must be considered in the differential diagnosis of any severe acute headache, sinusitis, or orbital cellulites not only in the immunocompromised patients but also in the absence of any underlying disease. Successful treatment requires early debridement and systemic antifungal treatment with injection of amphotericin B.
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Lipomas of the cerebellopontine angle (CPA) are unusual tumors that typically present with hearing loss, tinnitus, dizziness, and occasionally facial neuropathies. We describe the case of a healthy 42-year-old woman who presented with left-sided hearing loss and facial synkinesis. T1-weighted magnetic resonance imaging revealed an enhancing lesion of the left CPA with no signal on fat suppression sequences. ⋯ Cerebellopontine angle lipomas are rare lesions of the skull base and are reliably diagnosed with T1-weighted and fat suppression magnetic resonance sequences, which we recommend in the routine radiologic workup of CPA tumors. Accurate preoperative diagnosis is crucial because most CPA lipomas should be managed conservatively. Partial surgical resection is indicated only to alleviate intractable cranial neuropathies or relieve brainstem compression.
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The purpose of this study is to explore the factors related to the occurrence of middle ear effusion (MEE) in prolonged endotracheal intubation patients in the intensive care unit (ICU). ⋯ Prolonged endotracheal intubation (>7 days) in adult ICU patients contributed to the high incidence of MEE (50%). Moreover, conscious disturbance and endotracheal intubation for 14 days were also significant contributing factors of MEE.
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Combined platinum-based chemoradiation therapy is frequently being used as therapy for head and neck cancer at multiple sites. These therapies are individually ototoxic, but little has been reported on their combined toxicity. ⋯ We conclude that patients undergoing combined modality therapy for head and neck cancer experience hearing loss. We recommend that hearing assessment, including pretreatment and posttreatment audiometry, be performed in all patients undergoing combined platinum-based chemotherapy and radiation for the treatment of head and neck cancer.
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Infestation of ear, nose, and throat by maggots, the larvae of the fly (genus Chrysomyia) [J Laryngol Otol 1976:393-399], is termed "myiasis." Prevalent in tropical countries, atrophic rhinitis is the most common predisposing factor for this condition. The maggots burrow into delicate membranes and feed on underlying structures, causing considerable destruction of tissues, resulting in complications such as extensive erosion of the nose, face, and orbit, with rarely meningitis and death as a result of intracranial involvement [J Laryngol Otol 1989;103:489-491]. We report a rare complication of pneumocephalus after atrophic rhinitis with nasal myiasis.