The Petrosquamosal Sinus: A Rare Vascular Variant Encountered During Cochlear Implantation Surgery.

The petrosquamosal sinus is a rare and almost unknown emissary vein of the temporal bone. It traverses the middle cranial fossa along the petrosquamosal fissure and connects dural sinuses with extracranial venous networks. It is known to undergo normal involution during fetal and early postnatal life, and therefore is rarely found in humans. When encountered during surgery, it can be a significant source of bleeding hindering proper visualization of important surgical landmarks. Here we report the case of a PSS, encountered in a child during cochlear implantation surgery. We discuss its clinical significance and impact on the surgical approach. Laryngoscope, 2024.

Isolated Sudden Bilateral Neurosensory Hearing Loss as a Presentation of Lyme Neuroborreliosis: A Case Study.

Lyme neuroborreliosis (LNB) is a rare but potentially serious manifestation of Lyme disease, caused by the spirochete Borrelia burgdorferi. Although LNB can affect various neurological systems, neurosensory hearing loss as the sole presentation is uncommon. We report a case of a 23-year-old woman who presented with a 2-month history of temporal headache, tinnitus, and instability, which was followed by sudden bilateral hearing loss without any other associated symptoms. Pure-tone audiometry revealed profound bilateral hearing loss. Serological testing for various pathogens was negative, except for B. burgdorferi IgM, which was confirmed using Western blot analysis. The patient received doxycycline treatment; unfortunately, no recovery of hearing was observed. This case report highlights the importance of considering LNB as a potential cause of neurosensory hearing loss, particularly in areas where Lyme disease is endemic, as well as the need for timely diagnosis and treatment to prevent potential complications.

Cochlear Implant Outcomes: Quality of Life in Prelingually Deafened, Late-Implanted Patients.

AIMS: Reevaluating and expanding cochlear implantation's (CI) indication while measuring the quality of life (QoL) outcomes regarding the parent's point of view of prelingually deafened, late-implanted patients, which are widely known to showcases a limited improvement in speech recognition. MATERIALS AND METHODS: A retrospective descriptive and analytic study to assess QoL outcomes from CI in 64 early deafened, late-implanted patients, according to their parent's perspective, between January 2009 and December 2019, using the Nottingham Pediatric Cochlear Implant Program (Nottingham University Hospital, Nottingham, United Kingdom) "Children with cochlear implantation: parents perspective." RESULTS: The most represented age interval is the 5 and 7 interval and the mean age is 10.09 years. There was no sex predominance, with rural origin and high school academicals level preponderance. Fourteen children had experienced neonatal icterus, eight had meningitis, and seven were the result of related marriage. The age of the first consultation was typically over 2 years old, with only 45 schooled children. Age had a significantly statistic correlation between Self-reliance and Well-being and happiness subscales. History of receiving aid and speech therapy has a clear correlation with Self-reliance, Well-being and happiness, and Communication and Education. Schooling statuses, sex, age of appearance, and communication mode were not correlated to any subscale score, and with the exception of Effect of implantation, all the other "Children with cochlear implantation: parent's perspective" subscales were intercorrelated. CONCLUSION: Properly validated QoL assessments for CI are a must, as outcomes of CI expand beyond audiometric performances to include the improvement of QoL.

Parotid's Intranodal Palisaded Myofibroblastoma: A Very Rare Tumour.

Intranodal palisaded myofibroblastoma is a rare benign tumor of the lymph nodes, that arises from smooth muscle cells or myofibroblast, chiefly in the inguinal lymph nodes. Intranodal palisaded myofibroblastoma of the parotid gland is exceedingly scarce, even more, its recurrent characteristic; which underlines the grave importance of a long, strict monitoring and surveillance plan. Alongside these salient points in this unusual case, we also aim to highlight the peculiar difficulties inevitably faced, given the unfortunate lack of typical pathognomonic clinical and radiological features. We therefore, report a rare case of recurrent intranodal palisaded myofibroblastoma, arising in the felt parotid gland in a 53-year-old male patient, diagnosed by anatomopathological and immunopathological analysis. Described as benign tumor intranodal palisaded myofibroblastoma is a scarce myofibroblastic neoplasm of the lymph nodes. Histological and immunopathological features represent the determining factors for the diagnosis, of this favorable prognosis tumor.

Laryngeal Lipoma: An Uncommon Localization, Case Report and Literature Review.

Lipomas are common mesenchymal begin tumors, the head and neck localization accounts for less than 15% of the body lipomas and the laryngeal locating accounting for 0.6%. Laryngeal lipoma can be isolated and intrinsic, submucosal or even pedicled endoluminal mass. Symptoms of the laryngeal localization of this benign tumor is logically determined by its size and location. Surgical excision remains the key treatment as this tumor characterized by its high rates of local recurrence. We thus report a rare localization of this benign tumor in 76-year-old patient admitted to the emergency room for an acute laryngeal dyspnea.

Health-Related Quality of Life in Children With Cochlear Implants From Parents' Perspective.

BACKGROUND AND OBJECTIVES: To evaluate the health-related quality of life (HRQoL) in parents of children with cochlear implants and assess influencing factors. These data can enable practitioners to support patients and their families in utilizing the cochlear implant and its benefits to the fullest extent. Subjects and. METHODS: A retrospective descriptive and analytic study was conducted at the Implantation center Mohammed VI. Parents of cochlear implant patients were asked to fill out forms and answer a questionnaire. Participants included parents of children <15 years old who underwent unilateral cochlear implantation between January 2009 and December 2019, presenting with bilateral severe to profound neurosensory deafness. Participants completed the children with cochlear implantation: parent's perspective (CCIPP) HRQoL questionnaire. RESULTS: The mean age of the children was 6.49±2.55 years. The mean time between implantation for each patient and this study was calculated as 4.33±2.05 years. There was a positive correlation between this variable and the following subscales: communication, well-being and happiness, and the process of implantation. For these subscales, the score was higher as the delay was greater. Parents of children who received speech therapy before implantation were more satisfied on the following subscales: communication, general functioning, well-being and happiness, implantation process, implantation effectiveness, and support for the child. CONCLUSIONS: The HRQoL is better in families of children who received their implant at an early age. This finding raises awareness of the importance of systemic screening in newborns.

ENT Emergencies During the First Wave of the COVID-19 Pandemic at the Mohammed VI Hospital in Marrakech: Comparative Study Between Pre-and During COVID Pandemic in ENT Department.

The rapid global spreading of SARS-CoV2 virus had triggered a state of alert in health systems imposing safety measures to limit its spreading. The aim of our study is to compare the number and type of emergency admissions in our university hospital between the first wave of COVID-19 pandemic and the same period of the previous year. A decrease in the number of patients and the nature of pathologies admitted to the emergency room during the COVID-19 pandemic. This study highlights that the Covid 19 epidemic and the containment have largely reduced the influx of patients treated in the ENT university emergency department of Marrakech, thus demonstrating that level 2 regional hospitals can take care of the majority of ENT emergencies and leave access to the level 3 university hospital to patients requiring heavy and multidisciplinary management.

A tonsillar location of a malignant schwannoma: a case report.

INTRODUCTION: Malignant schwannoma is a malignant tumor of differentiation of Schwann cells or perineural cells. OBSERVATION: The patient was a 74-year-old woman with no particular pathological history. She presented swallowing difficulty of solids and odynophagia, evolving for 1 year. Physical examination revealed a budding tumor of the left palatine tonsil without cervical adenopathy. The CT scan confirmed the lesions and the absence of tumor extensions. Histological and immunohistochemical examination of the biopsy sample of the tonsil tumor concluded to be a malignant schwannoma. The patient underwent a tonsillectomy with postoperative follow-up. DISCUSSION: Malignant schwannomas are aggressive tumors. They usually occur in young adults. They mainly affect nerves and soft tissues. Occurrence in the amygdala is rare. CONCLUSION: The association of malignant schwannoma of the palatine tonsil and advanced age is rare.

Endobronchial Tuberculosis Simulating Acute Foreign Body Inhalation: A Case Report.

Endobronchial tuberculosis is a rare form of pulmonary tuberculosis, that can be due to the rupture of an infected lymph node through bronchial wall or lymphatic spread to the lining of the bronchial tree. Clinical presentation is non-specific, and can simulate inhalation of a foreign body. Otolaryngologists should be aware of its presentation often atypical. The following case is an unusual presentation of endobronchial tuberculosis in a 23-month-old patient initially diagnosed as a foreign body in the respiratory tract with acute dyspnea with unilateral wheezing and suspected foreign body on chest computed tomography. Bronchoscopy revealed a granulomatous mass in carina and both primary bronchi. Granuloma ablation improved patient's respiratory status. The pathology revealed an epithelioid and gigantic cellular with caseous necrosis compatible with tuberculosis. This unusual presentation of tuberculosis should be known to otolaryngologists and pediatricians in view of the frequency of tuberculosis in our context as well as increase in its incidence.

[Fistulized thyroid abscess revealing esophageal carcinoma in a young adult]. / Abcès thyroïdien fistulisé révélant un carcinome œsophagien chez un adulte jeunee.

Thyroid abscess is an extremely rare condition. Its diagnosis is often late, which predisposes to serious complications. We report a case of thyroid abscess in a young adult who presented to the emergency room for a basi-cervical swelling associated with dysphonia, dysphagia and dyspnea. Neck ultrasound showed a collection of left thyroid lobe. A cervicothoracic computed tomography objectified an abcess of the left lobe of the thyroid fistulising in the hyoid muscles beneath and left piriform sinus with thickening of the hypopharynx and upper esophageal sphincter. The puncture brought a purulent fluid. Panendoscopy revealed the presence of a tumor proliferation of the upper esophageal sphincter. A biopsy with histological examination concluded to a squamous cell carcinoma. This observation indicates that the thyroid abscess may be the mode of discovery of esophageal cancer. Hence the interest to seek an underlying cause in cases of thyroid abscess.

Voluminous Laryngeal Schwannoma Treated with Endoscopic Laser Approach.

Laryngeal schwannomas are rare benign encapsulated neurogenic tumors that represent less than 1.5% of all benign laryngeal tumors. We report a case of voluminous laryngeal schwannoma that was incidentally found during endotracheal intubation for thyroidectomy in a 43-year-old woman with clinical findings, features of radiologic and histopathologic examinations. The tumor was removed by CO2 laser during microlaryngoscopy. In this case report, we present a challenging approach that can be used in diagnosis and treatment of laryngeal schwannomas. Complete removal of the tumor should be considered as the initial approach to minimize morbidity.

Fungal nasal septum abscess caused by Aspergillus flavus complicating sinonasal surgery.

The fungal nasal septum abscess is a rare localized invasive form of fungal rhinosinusitis. Rare cases have been described in the literature. In this article, we intend to describe a new case of fungal nasal septum abscess caused by Aspergillus flavus in diabetic patient after sinonasal surgery. A 53-year-old woman with a history of uncontrolled type 2 diabetes and asthma developed a nasal septum abscess after a sinonasal endoscopic surgery which was performed for nasal polyposis. Needle aspiration of the abscess was performed and the pus cultures were positive for Aspergillus flavus. The patient was treated with antifungal drugs and surgical drainage of the abscess. A clinical and biological improvement was observed. Her case has been followed up for 18 months, and there hasn't been any recurrence of the infection. The fungal nasal septum abscess should be suspected in patients who do not respond adequately to standard treatment of nasal septum abscess, especially patients with risk factors of fungal rhinosinusitis.

Oral amelanotic malignant melanoma: a case report.

Amelanotic malignant melanoma is an extremely rare and aggressive oral tumor. Herein we report the case of a 42-year-old woman presented with a painful growth in anterior maxillary region. Intra-oral examination showed a non-pigmented exophytic mass occupying the anterior maxillary sector. Incisional biopsy with immunohistochemistry examination revealed a malignant melanoma as it strongly expressed melan A and S-100. Facial computed tomography showed extension to the maxillary bone and hard palate. After thoraco-abdominal computed tomography revealing absence of metastasis, tumor resection was performed respecting 2cm security margin. Oral localization of malignant melanoma is rare especially its amelanotic variant. Lack of pigmentation makes the diagnosis more difficult, usually resulting in treatment delay and making the prognosis even worse. Early detection by histological and immunochemistry examination combined to wide resection are the keys to improving the survival for patients with oral amelanotic melanoma.

Woakes' syndrome.

Woakes' syndrome is a rare entity defined as recurrent sinonasal polyposis with a consequent nasal pyramid deformity. Only a few cases are reported in the literature. The goal of this study is to present the features of Woakes' syndrome through a clinical case. A 42-year-old man presented with a history of ASA triad. He started self-medication for 5 years. He returned to the otorhinolaryngology department for the aggravation and persistence of symptoms. CT scans showed the deformity and thinning of the nasal bones. A functional endoscopic sinus surgery and correction of nasal pyramid deformity were performed. At 6 months' follow-up, good functional and aesthetic outcomes were observed. Woakes' syndrome was described more than 130 years ago. Treatment includes endoscopic sinonasal surgery and local treatment. Adequate management and good adherence to the therapeutic protocol could be factors to prevent this syndrome.

Choanal stenosis post radiotherapy for nasopharyngeal carcinoma: about an endoscopic management.

Choanal atresia is a rare complication of radiation for nasopharyngeal carcinoma, which has to be early detected. Its treatment is based on endoscopic endonasale surgery. We report a rare case of choanal stenosis observed in a 54-year-old patient, Ho presented 4 years after the end of radiotherapy for nasopharyngeal carcinoma, a progressive bilateral nasal obstruction, anosmia, and rhinorrhea without bleeding. The diagnostic of fibrous stenosis was confirmed by endonasal endoscopic examination coupled to CT scan of nasopharynx. The recanalization via endoscopic endonasal surgery with tube calibration gave a great functional result with the improvement of nasal symptoms. Even after 6 months of follow-up, there were no signs of restenosis.

Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body.

SUMMARY: Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. OBJECTIVE: We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. CASE REPORT: A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. CONCLUSION: Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.