RESUMO
Glomus tympanicum is a highly vascular tumour traditionally treated surgically via a post-auricular approach. We present here the first published case in Malaysia where total excision was achieved transcanal endoscopically. The procedure was safe, quick and effective due to the better visualisation of the surgical field with the endoscope. Haemostasis was achieved with a modified suction catheter that performed as a functioning suction diathermy.
Assuntos
Orelha Média/fisiopatologia , Glomo Timpânico/cirurgia , Endoscopia , Feminino , Humanos , Malásia , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
A six-month-old baby with congenital patent ductus arteriosus (PDA), bilateral microtia and canal atresia was referred for hearing assessment. The audiology assessment revealed bilateral profound hearing loss, which is atypical for a case of pure canal atresia. Imaging was performed much earlier than usual and, as suspected, the patient also had bilateral severe inner ear anomaly. It is extremely rare for a person to have both external and inner ear anomaly because of the different embryological origin. The only suitable hearing rehabilitation option for this kind of patients is brainstem implant. However, the parents had opted for sign language as a form of communication.
Assuntos
Microtia Congênita/complicações , Meato Acústico Externo/anormalidades , Nervo Vestibulococlear/anormalidades , Permeabilidade do Canal Arterial/complicações , Meato Acústico Externo/diagnóstico por imagem , Feminino , Perda Auditiva Neurossensorial/congênito , Humanos , Lactente , Tomografia Computadorizada por Raios X , Nervo Vestibulococlear/diagnóstico por imagemRESUMO
INTRODUCTION: This study aims to review the management and discuss the outcome of patients with iatrogenic facial nerve palsy. METHODS: 11 patients with iatrogenic facial nerve palsy (FNP) were evaluated retrospectively in a tertiary centre between June 1995 and September 2008. All the cases were referred from other centres. RESULTS: Ten patients had iatrogenic immediate FNP secondary to mastoidectomy and one had FNP secondary to superficial parotidectomy. Of the ten cases, three had concomitant profound sensorineural hearing loss and one had concomitant labyrinthine fistula. Ten patients underwent facial nerve exploration and one patient was managed conservatively. The second genu was the commonest site of injury (60 percent). Facial nerve recoveries were achieved to Grade I House Brackmann classification in five cases, Grade II in two cases and Grade III in two cases postoperatively. One case defaulted follow-up. One patient, managed conservatively, recovered to FNP Grade II after five months post-injury. CONCLUSION: Mistakes that most likely occurred during mastoid surgery are drilling towards the antrum, causing injury to the facial nerve at the second genu. Early facial nerve exploration and neurolysis resulted in good facial nerve recovery.
Assuntos
Paralisia Facial/etiologia , Paralisia Facial/terapia , Doença Iatrogênica , Processo Mastoide/cirurgia , Paralisia Facial/diagnóstico por imagem , Humanos , Procedimentos Cirúrgicos Otológicos/efeitos adversos , Reoperação , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
A 31 years old Chinese male with acquired immunodeficiency syndrome (AIDS) presented with concurrent mycobacterial infection and a synchronous non-Hodgkin's lymphoma of the nose. The diagnoses were made over a period of two months. Treatment for the mycobacterial infection was administered but he succumbed to the disease shortly after the diagnosis of NHL was established. This was an unusual case where two pathologies occurred in the same site in a patient with AIDS.