Treatment of auricular seroma: a conservative, innovative, and effective approach.

OBJECTIVE: Auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following trauma. Successful treatment of the seroma remains a challenge because this disease has a high propensity for recurrence. The aim was to study the results of the Plaster of Paris (POP) cast in treatment of seroma in terms of complete resolution of swelling, recurrence, and auricular aesthesis. STUDY DESIGN: Prospective. SETTING: Smt. Kashibai Navale Medical College and General Hospital. MATERIALS AND METHODS: A total of 48 patients with auricular seroma were studied. They were treated with aspiration of the cyst followed by compression dressing with a POP cast, taking the contour of the pinna. The POP cast was kept for 3 days. The patients were followed up for 6 months for recurrence. RESULTS: Out of 48 patients, 43 patients had complete resolution of the swelling in a single application of the POP cast. Five patients needed 2 applications of the POP cast. Not a single patient had recurrence. Temporary discoloration or thickening of the pinna was noted in 8 patients. No major complications like perichondritis were noted. CONCLUSION: Aspiration and contour dressing using POP is an innovative and effective treatment for management of auricular seroma as it prevents surgical trauma and recurrence and gives cosmetically excellent results.

Post-thyroidectomy early serum ionic calcium level: predictor of prolonged hypocalcemia.

One of the more common complications of thyroid surgery is postoperative hypocalcemia, which is potentially serious. Its clinical manifestations range from minimal twitching to life-threatening tetany. Affected patients might require a prolonged hospital stay and supplementation with calcium and vitamin D. In cases of post-thyroidectomy hypocalcemia, it is not always easy to predict which patients will require close monitoring of serum calcium levels. We conducted a study to determine whether early (<24 hr) measurement of serum ionic calcium (SiCa) levels can predict the development of post-thyroidectomy hypocalcemia. We retrospectively analyzed the charts of 150 adults (144 women and 6 men) who had undergone total or partial thyroidectomy, and we identified 42 patients (all women) who had either transient (<1 mo; n = 27) or prolonged (1 to 6 mo; n = 15) temporary hypocalcemia. We found that the patients who turned out to have prolonged hypocalcemia had significantly lower early levels of SiCa than did the patients who later developed only transient hypocalcemia (p = 0.000002). Also, patients with prolonged hypocalcemia had a significantly higher incidence of serious sequelae, including carpopedal spasms and signs of tetany. We conclude that early measurement of SiCa is a reliable predictor of prolonged temporary hypocalcemia following total or partial thyroidectomy.

Primary extra-cranial meningioma in the right submandibular region of an 18-year-old woman: a case report.

INTRODUCTION: Extra-cranial meningioma or ectopic meningioma is a rare tumor. This tumor has been reported in various anatomic sites in the head and neck, mediastinum, skin and soft tissues. We report a rare case of ectopic meningioma in the submandibular region detected by using fine-needle aspiration cytology, histopathology and immunohistochemistry. This case represents another unusual site for extra-cranial meningioma, which prompted us to report it. CASE PRESENTATION: An 18-year-old Dravidian woman presented with swelling in the right submandibular region. The computed tomographic scan findings were suggestive of a neoplastic mass lesion in the right submandibular region. Fine-needle aspiration cytology led to the differential diagnosis of a monomorphic adenoma of a salivary gland or an ectopic meningioma. The patient underwent excision of the submandibular gland and tumor. The histological examination and immunohistochemistry studies confirmed that the lesion was an extra-cranial meningioma. At her two-year follow-up examination, there was no recurrence of the tumor. CONCLUSION: Our experience with this case indicates that, although rare, meningioma should be entertained in the differential diagnosis of a mass lesion in the head and neck region.