RESUMEN
The Rationale: A 19-year-old female presented to the Otorhinolaryngology Department. Patient Concerns: Pain over the right side of the neck below the angle of the mandible following a fall on a pin cushion after a fight with her brother. She reported that the wound might have been caused by a sewing needle lodged in the pin cushion. Diagnosis: X-ray soft-tissue neck lateral view revealed a radiopaque linear shadow on the right side of the neck at the level of the C1-C2 vertebrae. On contrast-enhanced computed tomography, a linear (needle-like) foreign body at the level of C1-C2 was approximately 1.6 cm deep from the skin. The internal jugular vein seemed to be compressed between the needle and vertebrae. Treatment: Foreign body was explored and removed under general anaesthesia by an open lateral cervical approach. Outcomes: The patient's postoperative recovery was uneventful. Take-away Lesson: Due to early diagnosis, management, and a team of experienced surgeons, anaesthesiologists, and support staff, any morbidity or mortality was avoided.
RESUMEN
Rhinosinusitis is an extremely prevalent disorder that has a significant impact on the quality of life of affected individuals. Nasal septal deviation may either cause osteomeatal obstruction or may interfere with proper airflow and potentially predispose to sinusitis. This study was aimed to findThe incidence of various types of DNS andTo find co relation between NSD and sinus pathologyThis work was done on 100 cases with clinical features of deviated nasal septum and co existing features of rhinosinusitis. Detailed nasal endocopic examination was done. DNS was classified according to Mladina system of classification. CT PNS was done in all cases and rhinosinusitis documented according to Lund-Mackay scoring system. Finally an attempt was made to correlate DNS and Rhinosinusitis.Type II and Type I deviations were the most common types of septal deviations found. 84% of the patients with DNS had rhinosinusitis. There was a statistically significant correlation between nasal septal deviation and rhinosinusitis with p value ≤ 0.05. Our study also significantly correlates the predisposition of rhinosinusitis on the same side as DNS. We hereby conclude that in a case of DNS, co-existent rhinosinusitis should be ruled out, first by detailed history taking and then if warranted by CT-PNS. Such chronic patients treated by septoplasty alone may never be relieved of their symptoms. Thus combined septopasty and FESS is advisable.
RESUMEN
Epidermoid cysts are abnormal structures originating from abnormal ectoderm and are benign and slow growing. These are found anywhere in the body. They arise during embryonic fusion due to entrapment of epithelial remnants and sometimes due to faulty implantation of the epithelium. The cysts can be epidermoid (squamous epithelium), true dermoid (skin apppendages), and teratoid (all germ layers). They are usually diagnosed by fine-needle cytological aspiration and require imaging to plan line of treatment. Diagnostic dilemma is always an issue as cystic lesions are commonly found in the head-and-neck region. Here, we present a case of large epidermoid cyst involving sublingual and submandibular region.
RESUMEN
To evaluate the incidence of anatomical variations in sinonasal area by nasal endoscopy and CT scan paranasal sinuses and to correlate the anatomical variations in sinonasal area with extent of disease. The present study was conducted on 40 patients of chronic sinusitis. All the patients underwent CT scan paranasal sinus axial and coronal view and nasal endoscopy. The most common anatomical variations were agger nasi cells (80 %), deviated nasal septum (72.5 %) and concha bullosa (47.5 %). Other anatomical variations seen in sinonasal region were uncinate process variations, paradoxical middle turbinate, haller cells, accessory ostia of maxillary sinus, multiseptated sphenoid. Osteomeatal unit (87.5 %) and maxillary sinuses (87.5 %) were the most commonly involved which was followed by anterior ethmoids (70 %), posterior ethmoids (50 %), frontal sinuses (32.5 %) and the sphenoids (20 %). Considering the results obtained, we believe that anatomical variations may increase the risk of sinus mucosal disease. We therefore, emphasize the importance of a careful evaluation of CT study in patients with persistent symptoms of chronic rhinosinusitis.