RESUMEN
Proboscis lateralis is a rare craniofacial malformation for which no embryological basis has been established. The condition presents with a tubular, nose like structure arising from the medial canthal area or orbit roof. We describe here such a case that was surgically treated.
RESUMEN
Chronic retropharyngeal abscess caused by tuberculosis is rare. It should be suspected in a person who presents with a destructive lesion of the vertebra and a retropharyngeal mass. Early diagnosis and treatment are necessary to prevent the serious complications of the disease. We present the case of a patient who came to our clinic with collapse of the C5-C6 vertebrae and retropharyngeal abscess. We were able to avoid any complications by initiating early surgical drainage and antituberculous therapy.
Asunto(s)
Vértebras Cervicales , Imagen por Resonancia Magnética , Absceso Retrofaríngeo/diagnóstico , Tuberculoma/diagnóstico , Tuberculosis de la Columna Vertebral/diagnóstico , Antituberculosos/uso terapéutico , Vértebras Cervicales/patología , Terapia Combinada , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Músculos del Cuello/patología , Músculos del Cuello/cirugía , Absceso Retrofaríngeo/cirugía , Tuberculoma/cirugía , Tuberculosis de la Columna Vertebral/cirugíaRESUMEN
CONCLUSION: All bones of the facial skeleton and spine are susceptible to osteomyelitis due to various predisposing conditions. Current radiological tools are sufficient to provide adequate diagnosis. Treatment can be conservative resection of the diseased bone with adequate clearance in all cases except in cases of osteomyelitis due to osteoradionecrosis (ORN) where resection has to be more radical. OBJECTIVE: In today's antibiotic era, osteomyelitis in the head and neck is a rare occurrence. Dealing with osteomyelitis in head and neck bones is not the same as in other bones of the body due to the nature of the bones, complex anatomy of the region, and esthetics. Our purpose was to analyze the behavior of osteomyelitis in the head and neck bones and its management. MATERIALS AND METHODS: A total of 84 cases of osteomyelitis in head and neck were reviewed in a 10-year period. Pus for culture, antibiotic sensitivity, and radiology were the main investigations. A medical line of treatment was effective in acute cases. Surgery was opted for in chronic cases. RESULTS: Mandible, frontal bone, cervical spine, maxilla, temporal bones, and nasal bones were involved, in descending order of frequency, i.e. the mandible was the most common bone affected. Nine patients were diagnosed as having acute osteomyelitis (11%); 75 were diagnosed as having chronic osteomyelitis (89%). Radiation-induced ORN leading to osteomyelitis was the most common cause of osteomyelitis of the mandible (13 of the 32 cases; 41%). Odontogenic infections and chronic sinusitis each gave rise to osteomyelitis in 3 of 10 cases (30%) of the patients with osteomyelitis of the maxilla. Chronic sinusitis was the main cause of frontal bone osteomyelitis in all 20 cases (100%). Tuberculosis (10 of 15 cases; 67%) and malignancy (5 of 15 cases; 33%) were the main predisposing factors in cervical spine osteomyelitis. Malignant external otitis (MEO) with diabetes mellitus was an underlying factor in all four cases of osteomyelitis of the temporal bone. Of the 18 patients with a diagnosis of ORN, the mandible was found to be the most susceptible bone (13 cases; 72%), followed by the maxilla (four cases; 22%) and cervical spine (1 case). Acute osteomyelitis responded to antibiotics. Sequestrectomy was carried out in all chronic cases but in cases of ORN more radical surgery was performed.
Asunto(s)
Vértebras Cervicales/microbiología , Osteomielitis/etiología , Osteomielitis/terapia , Cráneo/microbiología , Enfermedad Aguda , Adolescente , Adulto , Anciano , Antibacterianos/uso terapéutico , Vértebras Cervicales/cirugía , Enfermedad Crónica , Complicaciones de la Diabetes , Drenaje , Femenino , Infección Focal Dental/complicaciones , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/complicaciones , Osteomielitis/diagnóstico , Osteorradionecrosis/complicaciones , Otitis Externa/complicaciones , Procedimientos Quirúrgicos Otorrinolaringológicos , Estudios Retrospectivos , Rinosporidiosis/complicaciones , Sinusitis/complicaciones , Cráneo/cirugía , Resultado del Tratamiento , Tuberculosis/complicaciones , Heridas y Lesiones/complicacionesRESUMEN
Sinonasal lymphomas are uncommon malignancies. They are difficult to differentiate from carcinomas, and immunohistochemistry is needed to make the diagnosis. We describe an unusual case of a T cell lymphoma that involved only the paranasal sinuses in a middle-aged man. The patient presented with a complete loss of vision in one eye and lateral rectus muscle palsy, but no nasal symptoms.
Asunto(s)
Linfoma de Células T/diagnóstico , Neoplasias de los Senos Paranasales/diagnóstico , Adulto , Ceguera/etiología , Quimioterapia Adyuvante , Diagnóstico Diferencial , Humanos , Inmunohistoquímica , Antígenos Comunes de Leucocito/análisis , Linfoma de Células T/complicaciones , Linfoma de Células T/patología , Linfoma de Células T/cirugía , Masculino , Invasividad Neoplásica , Nariz/cirugía , Neoplasias de los Senos Paranasales/complicaciones , Neoplasias de los Senos Paranasales/patología , Neoplasias de los Senos Paranasales/cirugía , Radioterapia Adyuvante , Resultado del TratamientoRESUMEN
Respiratory obstruction and stridor in infants and children are not uncommon. A rare cause of these life-threatening symptoms is congenital saccular cyst. An accurate diagnosis of saccular cyst can be made by eliciting a good history, by endoscopic visualization of the lesion, and by computed tomography. Endoscopic excision is the preferred treatment for infants, whereas an external approach is reserved for older children. It can be difficult for anesthetists to intubate infants when the anatomy of the larynx is distorted, but the choice of tracheotomy for an infant has many drawbacks as well. We discuss the clinical presentation and management of a 3-month-old boy who was brought to us with a congenital laryngeal saccular cyst.
Asunto(s)
Quistes/congénito , Quistes/cirugía , Enfermedades de la Laringe/congénito , Enfermedades de la Laringe/cirugía , Quistes/diagnóstico , Epiglotis/patología , Humanos , Lactante , Enfermedades de la Laringe/diagnóstico , Laringoscopía , Masculino , Ruidos Respiratorios/etiología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Tracheal agenesis is a rare and uniformly lethal congenital malformation. It presents with severe respiratory distress at birth. In this anomaly there is a congenital absence of the trachea and the bronchus communicates with the esophagus. The diagnosis should be suspected in newborn infant with respiratory distress whose intubation is impossible. This report describes our experience in two such cases.