Ear, nose, & throat journal最新文献

The Castleman Disease (CD), also recognized as giant lymph node hyperplasia or vascular follicular lymphoid hyperplasia, is an infrequent lymphoproliferative disorder with substantial clinical variability. Parapharyngeal location of this disease is very rare and in pediatric population it is even rarer. This article presents a case of Unicentric CD (hyaline vascular type) in an 8-year-old female, where the disease was localized within the parapharyngeal space. Clinical manifestations were limited to the presence of a local mass, with no other specific symptoms observed. Laboratory assessments revealed no significant abnormalities. She underwent surgery using a cervical-parotid approach and experienced a good postoperative recovery. Histopathological analysis confirmed the diagnosis. This case underscores the need for a comprehensive evaluation and consideration of uncommon etiologies in the assessment of parapharyngeal masses, even in pediatric patients.

A 45-year-old man presented with a history of chronic left nasal congestion. Nasal endoscopy revealed a pedunculated polypoid mass with glandular epithelium surface on the posterior nasal septum. Computed tomography revealed a 25-mm mass-like growth in the left posterior nasal cavity attached to the nasal septum with a stalk. The patient underwent transnasal endoscopic surgery, and the tumor was removed under a block with safety margin. The final pathological diagnosis was sinonasal seromucinous hamartoma (SH). Sinonasal SH is a rare tumor with only 31 reported cases. Transnasal endoscopic surgery is currently the first-line treatment for sinonasal SH. Differential diagnoses of this lesion include inflammatory polyps, respiratory epithelial adenomatoid hamartoma, and adenocarcinoma. Although SH is a benign tumor, its progression to adenocarcinoma has been reported. Therefore, unilateral posterior nasal tumors must be diagnosed precisely.

Surgical management of head and neck sarcomas presents significant challenges, particularly in advanced stages where curative options are limited. In such cases, palliative care becomes essential to alleviate symptoms and enhance the patient's quality of life. When chemoradiation therapy fails to provide adequate symptom control, palliative surgery may be a viable option. We report the case of a 24-year-old male diagnosed with an extensive and aggressive maxillary chondroblastic osteosarcoma. Despite multiple chemoradiation regimens, the disease progressed rapidly. Due to the substantial deterioration in the patient's quality of life, he underwent major palliative surgery. The procedure involved a left total maxillectomy, right subtotal maxillectomy, left segmental mandibulectomy, orbital exenteration, and resection of the left upper lip, cheek, and nose. Reconstruction was performed using an osteocutaneous fibula free flap and an anterolateral thigh flap. Postoperatively, the patient experienced significant symptom relief without major complications. He was followed for 12 months before being lost to follow-up, remaining disease-free for approximately 8 to 10 months. This case illustrates that in select patients with unresectable and extensively invasive tumors, major palliative resections combined with microvascular reconstruction may offer meaningful improvements in quality of life.

We present a case of a 49 year-old male who suffered from a homicide attempt with a crossbow arrow, resulting in a retained foreign body through his mandible, pterygoids, nasopharynx, and parotid gland. The patient was being managed conservatively with antibiotics to manage symptoms of recurrent infections prior to transfer to our center. The patient developed worsening congestion, foul drainage from the arrow exit wound, as well as developing worsening facial pain. The Head and Neck Oncology, Rhinology, as well as the Neurointerventional radiology services collaborated in a case for the subsequent safe removal of the crossbow arrow. The patient recovered well 3 months post-operatively with improvement in his pain and nasal symptoms.

An uncommon benign condition in neonates, known as congenital epiglottic cyst, can lead to symptoms such as neonatal dyspnea, laryngeal stridor, and, in severe cases, even pose a potential threat of asphyxia-related mortality. A congenital epiglottic cyst is one of the neonatal emergencies. Fibrolaryngoscopy is the predominant method of diagnosis, and early identification, diagnosis, as well as treatment are the key points. Successful endoscopic ablation of congenital epiglottic cysts in 3 newborns was achieved through the utilization of a low-temperature plasma radiofrequency ablation system. Consequently, the purpose of this case report is to assist pediatric emergency physicians in the timely identification of congenital epiglottic cysts with the potential risk of mortality and to provide additional experience in clinical management.

Cholesteatomas can grow aggressively within the temporal bone due to the accumulation of keratin. If not treated, they can destroy surrounding structures and, therefore, cause many comorbidities. Surgery is the mainstay of treatment. We present a case of massive cholesteatoma involving the facial nerve (FN) with extension into the neck around the FN. The patient underwent a planned multidisciplinary resection of the cholesteatoma without postoperative morbidity.

Anaplastic thyroid carcinoma is a rare and aggressive form of thyroid cancer that has a poor prognosis and a high mortality rate. It is characterized by rapid growth and invasion of nearby tissues. It typically presents as a rapidly growing goiter or nodule that is firm to the touch and firmly attached to the underlying structures. Case reports of unusual presentations of anaplastic thyroid carcinoma have been reported. The presentation of anaplastic thyroid carcinoma mimicking cervical tuberculosis is very unusual. We reported a case of a 65-year-old patient who had a left cervical swelling that had been evolving for 4 months, causing dysphagia. Initial imaging showed a necrotic mass in the left lobe of the thyroid, communicating with a second necrotic mass in the subcutaneous tissue that was fistulized to the skin and suggesting cervical tuberculosis. The mass was incised with pus and whitish material resembling caseous tuberculosis was discharged. Acid-fast bacilli (AFB) Polymerase chain reaction (PCR) was negative and biopsy revealed a nonspecific granulomatous lesion. Due to the growth of the mass and the presence of a permeation nodule, a second biopsy was performed, revealing anaplastic thyroid carcinoma. The patient was referred for radiochemotherapy due to tumor inoperability.

Gouty tophi is a disease characterized by the long-term deposition of monosodium urate crystals in joints or cartilages. The most commonly affected site is the first metatarsophalangeal joint, and gouty tophi in the head and neck region are relatively rare. This article reports a case involving an elderly male with asymptomatic gouty tophi in the thyroid cartilage. The patient had a history of gout for over 10 years and presented with a painless thyroid mass that had been present for at least 3 years. He had not received systemic treatment. Preoperative contrast-enhanced cervical CT results indicated a high likelihood of gouty tophi. Postoperative pathology confirmed the mass to be consistent with gouty nodules. Following the procedure, the patient was treated symptomatically with non-busulfan tablets and colchicine. No recurrence was observed at the 1-year follow-up. This report highlights the need to consider gouty tophi in cases of prolonged gout history and abnormal imaging findings in the head and neck region. Appropriate management, including urate-lowering therapy and surgery, if necessary, can lead to optimal outcomes and prevent recurrences. Further research is warranted to enhance understanding and clinical management of this uncommon regional manifestation of gout.

Fibromatosis or desmoid tumors are rare benign fibroblastic lesions that are rarely present in the head and neck regions. When they do occur in these regions, however, they tend to be aggressive toward the surrounding tissue and be associated with heavy morbidity and mortality. We report the case of a 26-year-old Tunisian female who presented with acute obstructive dyspnea and a 3-week history of cervical swelling. The swelling was initially only located in the left submandibular area, it then gradually extended to all the anterior cervical supra- and infrahyoid regions causing a clinical presentation resembling that of obstructive dyspnea, the patient was admitted, and an emergency tracheotomy was performed. Tissue samples were taken, pathological analysis revealed an aggressive case of fibromatosis. The patient was treated with corticosteroids and antihormonal therapy, the fibrous mass shrunk considerably allowing the removal of the tracheotomy cannula, no tumor recurrence was noted during the observation period. Due to the rarity of this disease, especially in the cervical region, there are no therapeutic guidelines available.

Granular cell tumors (GCTs) are rare benign tumors that can occur in any part of the body. They are most commonly found in the head and neck region, especially the tongue. Laryngeal GCTs are rare, accounting for only 3% to 10% of all GCTs. This case report describes a 4-year-old boy with a laryngeal GCT. The patient presented with a history of hoarseness for 2 years. Stroboscopy revealed a large mass occupying the entire length of the left vocal cord. The mass was successfully removed by microlaryngeal surgery with laser ablation. The patient's symptoms resolved after surgery, and he had an uneventful recovery. This case highlights the importance of considering GCTs in the differential diagnosis of patients with hoarseness. Early diagnosis and treatment can lead to excellent outcomes.