Case Reports in Otolaryngology最新文献

Tracheostomal myiasis, the infestation of a tracheostomy site by fly larvae, is an uncommon and challenging condition, with limited cases reported in the medical literature. This case report aims to describe both the clinical presentation and management of tracheostomal myiasis in a patient with multiple comorbidities. The patient presented with foul-smelling discharge and visible maggots at the tracheostomy site. Management involved manual removal of larvae, surgical debridement, irrigation with iodine solution, and sealing the stoma with paraffin ointment. This case highlights the need for clinician awareness of this rare complication, particularly in patients with compromised health, and highlights the importance of preventive care and early intervention. As a single case report, it reflects the experience within a broader context of managing tracheostomy-related complications.

Introduction: Hydatid cyst disease is an endemic parasitic infection caused by Echinococcus granulosus. Hydatid cysts occur mainly in the liver and lungs and are rare in the head and neck region, even in endemic areas. Due to their nonspecific clinical manifestations, diagnostic challenges are encountered in such atypical presentations. Case Presentation: We report the case of a 6-year-old girl who presented with a progressively enlarging, painless left postauricular mass. Radiological assessment revealed a well-circumscribed, unilocular cystic lesion at level V of the neck. Surgical resection was performed, and histopathology confirmed a hydatid cyst. Postoperatively, the patient was treated with albendazole. No recurrence was observed at follow-up. Clinical Discussion: Hydatid cysts in the cervical region are exceptionally rare, with only a few cases documented in the literature. The disease can remain asymptomatic for years, often presenting as a slow-growing mass. Imaging with ultrasound and CT is critical in preoperative diagnosis. The gold standard of treatment remains complete surgical excision, reinforced by anthelmintic therapy to prevent recurrence. Conclusion: Although rare, hydatid cyst disease should remain among the differential diagnoses of cystic neck masses, especially in endemic areas. Early diagnosis and intervention are essential in evading complications of the disease such as anaphylaxis or recurrence. Ultimately, prevention remains the most effective strategy, emphasizing the need for community awareness, hygienic practices, and coordinated control efforts to break the parasite's life cycle.

Head and neck myxomas are extremely rare neoplasms, and only a few reports have been in the literature. Specifically, reports of myxomas of the nose and paranasal sinuses are sporadic. Here, we present a rare case of a 47-year-old female with progressive nasal obstruction who was found to have a myxoma arising within the inferior nasal concha-the first reported case of its kind. The diagnosis was confirmed by biopsy, and endoscopic transnasal resection (ETNR) was conducted. ETNR proved effective in resolving symptoms of nasal myxoma, with complete removal of the tumor and no recurrence on follow-up. The operation is described, and the literature on the subject is reviewed.

Introduction: Laryngeal tuberculosis (TB) due to Mycobacterium bovis is an extremely rare cause of airway obstruction. This case report describes a unique instance of acute airway obstruction in an immunocompetent 27-year-old male with down syndrome caused by laryngeal Mycobacterium bovis, shedding light on the challenges of diagnosis and treatment. Case: A 27-year-old male with trisomy 21 presented with progressive shortness of breath, productive cough, dysphonia, and dysphagia. After a failed workup for pneumonia and other conditions, imaging revealed likely epiglottitis and a right upper lung lesion. A tracheostomy was performed due to worsening airway compromise. Biopsy results confirmed granulomatous inflammation and identified Mycobacterium bovis, which was resistant to pyrazinamide. The patient was treated with a modified RIPE regimen and successfully decannulated 2 months later. Conclusion: This case emphasizes the importance of a comprehensive diagnostic approach, including tissue biopsy and culture, in patients with airway compromise of unclear etiology. Mycobacterium bovis, though rare, should be considered in the differential diagnosis of laryngeal TB, especially in cases with progressive symptoms and atypical findings. Early recognition and tailored treatment are critical for favorable outcomes.

Introduction: Draf III is a surgical technique which uses endoscopic approach to access the frontal sinus, by leaving almost no skin markings and having minimal side effects. The technique is most frequently indicated for frontal chronic refractory sinusitis, followed by mucoceles and skull base or paranasal tumors. The aim of Draf III is to drain frontal sinus masses and collections. Clinical Presentation: In this report, we present a 16-year-old male with progressive headaches, dizziness, nausea, and vomiting whose imaging revealed left-predominant bilateral frontal epidural mucocele and abscess. A Draf III approach was chosen, to which bilateral supraorbital trephinations were added for better drainage of the collection. Mucosal grafts were used to avoid crusting and stenosis. Post-operation included a course of antibiotics and steroids with three sessions. On the twelfth-month follow-up, the patient was doing well and had no complaints. Conclusion: A modified Draf III approach is effective for the management of bilateral frontal mucopyocele in treatment-resistant cases, without causing any major complications.

We report a case of sphenoiditis with an epidural abscess due to a fungal infection and a mixed infection with Eikenella corrodens and Aggregatibacter segnis and its clinical course, including a literature review. The patient was a 60-year-old woman who visited the emergency department of our hospital with complaints of a sudden right-sided headache that had persisted for 5 days and vomiting for 1 day. She was admitted to the hospital for an examination. Blood test results indicated a strong inflammatory reaction, and a blood culture revealed Gram-negative bacilli. Based on computed tomography and magnetic resonance imaging findings, right sphenoid sinus mycosis and a right-sided epidural hematoma were suspected, and therefore, endoscopic sinus surgery was performed. Thinning and pulsation of the right lateral wall of the sphenoid sinus were noted intraoperatively. The patient also had bacteremia, and the epidural hematoma was considered to be an abscess. The patient's symptoms improved postoperatively. Thus, she was discharged 20 days following the surgery after continuous administration of meropenem for the right-sided epidural abscess. Although cases of epidural abscesses due to infection of the sphenoid sinus are rare, in patients with severe headaches, the presence or absence of intracranial spread at an early stage must be considered to accurately diagnose and treat the pathology.

Introduction: Chronic rhinosinusitis (CRS) is a widely prevalent disease. Retained objects as the cause of CRS are not commonly reported in the literature. The impact of the removal of this object is also a point of interest. The purpose of this case report was to investigate a patient whose CRS was suspected to be due to a foreign object and his postoperative course. Case Presentation: A 37-year-old male patient presented to the clinic with a chief complaint of right-sided nasal congestion, severe maxillary sinus pressure, and green thick nasal drainage for many years. He reported a history of dental and endonasal surgery on that side 8 years ago in Saudi Arabia. Imaging showed complete opacification of the right maxillary sinus and anteroinferior nasal cavity and several irregular-shaped radio-opaque materials within this region. His symptoms were refractory to medical management, and he chose to undergo endoscopic sinonasal surgery. A piece of gauze was removed from the right sinonasal cavity and maxillary sinus. In the weeks following surgery, his symptoms and inflammation fully resolved. Conclusions: Retained objects or material within the nose and sinuses are not commonly reported in the literature. This patient's CRS was secondary to a preventable cause. His increased morbidity after his initial surgery 8 years ago could have been avoided with careful attention to surgical counts.

Background: Schwannomas are benign, slow-growing tumors that develop from Schwann cells in the nerve sheath and can occur in peripheral, cranial, or autonomic nerves. Foramen ovale schwannomas are a rare variant in the head and neck region representing 1%-2% of all intracranial schwannomas, with parapharyngeal space involvement complicating surgical resection. Case Presentation: A 48-year-old male presented with headaches after an episode of light-headedness along with facial pain. MRI showed a well-defined lesion measuring 50 × 40 × 20 mm in the left masticator space, extending superiorly up to the left temporal lobe. CT imaging revealed a 28 × 25 × 31-mm lesion in the left masticator space, extending through the foramen ovale into the medial left temporal lobe. The tumor was classified as Type ME under the Yoshida and Kawase system, involving both the middle cranial fossa and extracranial extension. Management: A minimally invasive endoscopic transnasal approach was used for tumor resection, prioritizing preservation of the internal maxillary and carotid arteries. This approach was selected for its reduced morbidity and quicker postoperative recovery, as the tumor's medial location made it amenable to endoscopic access. The patient had an uneventful recovery. No new neurological deficits were reported at follow-up, and facial pain improved significantly. Conclusion: This report reviews the current literature on the diagnosis and management of trigeminal schwannoma, highlighting minimally invasive techniques as effective alternatives to traditional surgical approaches.

Background: Chondroblastoma is a rare and benign bone tumor originating from immature chondroblasts. Chondroblastoma typically affects long bones; however, it can also occur in the skull, especially the temporal bone. The anterior skull base is a rare location for this tumor, with only two reported cases. Case Presentation: A 26-year-old woman presented with epiphora in her right eye and progressive proptosis on the same side. She had a previous biopsy that confirmed the presence of a giant cell tumor of the bone and had undergone an unsuccessful endoscopic surgery. A comprehensive endoscopic procedure subsequently revealed a cartilage-producing neoplasm consistent with chondroblastoma. Conclusion: We presented a successful case of surgical resection of a chondroblastoma in the anterior skull base. Additionally, we reviewed the existing literature and previously documented cases.

We describe a third variant of Eagle syndrome characterized by (1) neck pain (2) giant, hypertrophied styloid processes, (3) mobile styloid process due to pseudoarthrosis, and (4) combined facial nerve compression/entrapment leading to facial spasms and paralysis. Our patient presented with symptoms of Eagle syndrome, bilateral giant styloid processes, and left facial spasms progressing to left facial paresis/paralysis. CT findings included a pseudoarthrosis of the base of a giant left styloid process and overgrowth of bone superior to the styloid base. The mobile styloid process resulted in compression of the facial nerve exiting the stylomastoid foramen and facial spasms with head rotation to the left. Bony overgrowth superior to the pseudoarthrosis led to stenosis of the facial canal distal mastoid segment. Along with compression from the styloid, nerve entrapment contributed to facial paresis that progressed to facial paralysis. Left styloidectomy was performed to alleviate impingement on the facial nerve, and left canal wall-up tympanomastoidectomy with facial nerve decompression was performed to alleviate entrapment caused by bony overgrowth. Two months postoperatively, the patient's left facial paralysis improved to mild left eyelid lag without signs or symptoms of ocular exposure. The patient developed delayed first-bite syndrome successfully treated with amitriptyline. She did not report postoperative dysgeusia. Our patient's left facial paresis was initially attributed to viral neuritis, and the possibility of Eagle syndrome was not initially considered. The relative rarity and varied presentations of Eagle syndrome often create a diagnostic challenge, especially for patients with progressive symptoms. Our patient's presentation emphasizes the importance of a thorough head and neck evaluation of any patient presenting with head and neck signs or symptoms persisting for longer than 3 weeks as well as awareness of what we believe is the first description of a third variant of Eagle syndrome.