Myofibroma of the external auditory canal: report of an adult case.

UNLABELLED: Myofibroma of the external auditory canal: report of an adult case. OBJECTIVE: Myofibroma is a benign fibrous proliferative disease generally reported to occur in neonates and children. Similar lesions have been reported in adults, but solitary tumours affecting the external auditory canal are extremely rare. Only one such case has been reported in the literature. CASE REPORT: The case of solitary myofibroma occurring in the external auditory canal of a 42-year-old woman is presented. The diagnosis of myofibromatosis was made on the basis of its histological appearance and corroborated by immunohistochemical staining. CONCLUSIONS: Clinicians and pathologists must be aware that myofibromatosis may occur in adults at extremely rare locations. Myofibroma should be included in the differential diagnosis of fibrous lesions in the external auditory canal.

Significance of pre-epiglottic space invasion in supracricoid partial laryngectomy with cricohyoidopexy.

Cancerous involvement of the pre-epiglottic space has been known for many years to be an important prognostic factor. The aim of this study was to investigate the prognostic value of pre-epiglottic space invasion, according to the degree of invasion (i.e. absence, minimal or gross), and to assess the oncological suitability for supracricoid partial laryngectomy in patients with supraglottic laryngeal carcinomas. This study included 52 patients with squamous cell carcinomas of the supraglottic and glotto-supraglottic larynx, treated with supracricoid partial laryngectomy-cricohyoidopexy, between 1992 and 2001. Clinical and histopathological parameters were evaluated. Pre-epiglottic space invasion was seen in 35 patients (67.3 per cent); there was gross invasion in seven patients and minimal invasion in 28. Neoplastic invasion of the anterior commissure was seen in 18 patients (34.6 per cent) and thyroid cartilage involvement in eight (15.4 per cent). Neoplastic spread through the extralaryngeal tissues was not seen in any patient. The five-year overall survival was 71.5 per cent for patients with gross pre-epiglottic space invasion, 82.2 per cent for those with minimal pre-epiglottic space invasion, and 76.4 per cent for those without pre-epiglottic space invasion. It was observed that gross or minimal pre-epiglottic space invasion did not have a statistically significant effect on survival. Univariate analysis showed that nodal positivity was associated with a poor prognosis. None of the other parameters analysed showed a statistically significant relationship with survival. Four (7.6 per cent) patients had local laryngeal recurrence. Distant metastasis and a second primary tumour were detected in three (5.8 per cent) and four (7.6 per cent) patients, respectively. The five-year overall survival and cause-specific survival were 78.8 and 82 per cent, respectively. Supracricoid partial laryngectomy with cricohyoidopexy can safely be performed in supraglottic and glotto-supraglottic carcinomas with minimal or gross invasion of the pre-epiglottic space which have no extralaryngeal spread. Nodal status is an important predictor affecting survival.

Do asymptomatic foreign bodies in the maxillary sinus always need to be removed?

Foreign bodies may be displaced into the maxillary sinus as a result of trauma or during dental interventions. They commonly cause chronic sinusitis and/or fungal infections. This paper presents the case of a foreign body lodged in the right maxillary sinus ostium of a 31-year-old female patient. The foreign body was observed incidentally during radiological examination. After careful clinical and radiological examination, it was concluded that the foreign body was a piece of amalgam displaced into the maxillary sinus during a traumatic extraction. It is an uncommon finding to observe an asymptomatic dental foreign body in a position so close to the natural ostium of the maxillary sinus for so many years without any oro-antral fistula formation and/or sinusitis attacks. We describe the non-surgical approach to the case and the need for surgical management will be questioned. The importance of consultation between otolaryngologists and oral and maxillofacial surgeons will also be emphasised.