Case Reports in Otolaryngology最新文献

Introduction: Ectopic salivary gland is rarely found in the vocal cords; only two cases have been reported in the English literature. To the best of our knowledge, this is the third reported case of this anomaly. Case Presentation. A 78-year-old man with hoarseness two years ago visited our department. There were no other symptoms such as cough or sore throat. He had no history of smoking. Laryngeal endoscopic examination revealed a smooth mass in the anterior right vocal cord. We performed surgery under general anesthesia to remove the polyps and improve hoarseness. The histopathological specimen was reported to be salivary gland tissue. We diagnosed ectopic salivary glands of the vocal cord.

Conclusion: It is necessary to consider the possibility of ectopic salivary glands as mass lesions of the vocal cords. Surgical resection is required and long-term follow-up is necessary after surgery.

Pleomorphic adenoma is a benign tumor of the salivary glands. It develops preferentially in the parotid gland. The authors report a localization of a pleomorphic adenoma on the palate and discuss the value of CT scan in therapeutic strategy.

Background: Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine-induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. Case Presentation. A 36-year-old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39°C fever, and chills. Standard bacteriological culture was positive for coagulase-negative staphylococci and Escherichia coli, while mycological culture was positive for Candida tropicalis. The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone's clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro-nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow-up with a psychologist in a specialized centre.

Conclusion: The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro-anastomoses are possible.

Background: Absence or aplasia of the major salivary glands is an uncommon diagnosis and is often associated with other congenital abnormalities. Agenesis of a single submandibular gland, however, is an even more rare phenomenon and can be associated with hypertrophy of other salivary glands.

Methods: A 48-year-old female presented to the clinic with a left-sided neck mass below her mandible. Workup including a CT scan showed an absent left-sided submandibular gland and an enlarged sublingual gland protruding through the mylohyoid muscle.

Results: The patient underwent a transoral resection of the mass with subsequent resolution of the mass. The pathology returned as normal salivary gland tissue.

Conclusions: Sublingual gland hypertrophy is a very uncommon presentation for a patient with a neck mass. This situation can arise in the setting of submandibular gland aplasia and compensatory hypertrophy of other salivary glands.

The carotid body paraganglioma is a rare benign neoplasm arising from the chemoreceptor cells of the carotid bulb. The carotid body has the largest collection of paraganglia in the head and neck with 60-70% of head and neck paraganglioma. Paraganglia are clusters of cells originating from the neural crest with histological and cytochemical characteristics of neuroendocrine cells. It is mostly asymptomatic in early presentation but become symptomatic and difficult to manage when the tumor is large. We present a case of a 26-year-old male who presented with a painless, pulsatile, progressively increasing left lateral neck swelling of 5 years duration with Shamblin IIIa. The diagnosis of the tumor was confirmed based on clinical features, histology, and radiological findings. We had difficult surgical dissection of the tumor with neurovascular damage.

Extraosseous Ewing's sarcoma is extremely rare in the soft tissues of the neck, especially in the sternocleidomastoid muscle. It usually manifests clinically as a rapidly growing mass that shows great potential for local spread. The aim of this paper is to present a rare case of еxtraosseous Ewing's sarcoma in the sternocleidomastoid muscle. To the best of our knowledge, this is the first case of extraskeletal Ewing's sarcoma at this location. The patient was admitted to our clinic because of a neck tumefaction. The computerized tomography finding showed a tumor mass, most of which was in the V region of the neck, measuring 40 × 27 × 35 mm. Pathohistological and immunohistochemical findings showed that it was Ewing's sarcoma. Unfortunately, the patient passed away nine months after the initial diagnosis. Extraosseous Ewing sarcoma is a rare, fast-growing malignant tumor manifesting histomorphological similarities to bone Ewing's sarcoma. Most reports state that extraosseous Ewing sarcoma has a worse prognosis than skeletal. Extraosseous Ewing sarcoma should be borne in mind in the differential diagnosis of soft tissue tumors of the neck.

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon tumor-like lesion that has been reported within the nose, paranasal sinuses, and less frequently in the nasopharynx. While it is believed to be benign, its clinical presentation, radiological characteristics, and microscopic features may closely mimic more aggressive tumors of the upper respiratory tract, potentially leading to needless life-altering treatment. Prior to now, there had been no reported cases of this lesion in West Africa. We present a 35-year-old male with persistent bilateral nasal obstruction, difficulty with swallowing, and bilateral reduction in hearing, whose CT findings were highly suggestive of a nasopharyngeal tumor, but upon biopsy and histology showed features most consistent with REAH. Surgery completely alleviated his symptoms with no clinical evidence of recurrence after a 1-year follow-up period.