Mpox Pharyngitis.

A case of mpox pharyngitis in absence of cutaneous lesions is reported. Usually, clinical presentation is either a cutaneous eruption or a combination of cutaneous and mucosal lesions. In patients with atypical pharyngitis, regardless of the presence of skin lesions, pharyngeal swabs should be collected to rule out mpox.

Severe Hypoplasia of Paranasal Sinuses and Turbinates.

This case report describes a patient in their 40s with a history of bronchiectasis, azoospermia, and epididymal cysts who presented with bilateral nasal obstruction.

Fallopian Canal Meningocele Causing Cerebrospinal Fluid Rhinorrhoea.

Fallopian canal meningocele is an extremely rare cause of cerebrospinal fluid rhinorrhoea. Also, due to complex anatomical relations and a lack of experience, its management remains a challenge. Here we report a case focusing on its clinical course, radiological features, and management.

Labyrinthine Bifurcation of the Facial Nerve.

The labyrinthine bifurcation of the facial nerve is extremely rare. Diverse congenital temporal bone anomalies usually coexist, and a detailed preoperative evaluation is needed to detect them. We report a case of labyrinthine bifurcation of the facial nerve detected on the preoperative evaluation of a patient with congenital aural atresia.

Intralabyrinthine neurinoma: Management, exeresis and auditory restoration with cochlear implant.

BACKGROUND AND OBJECTIVE: Vestibular schwannoma is a benign tumour that originates in the eighth cranial nerve. It is termed intralabyrinthine schwannoma (ILS) when it develops in the inner ear, this being a rare origin. We present our experience in the management of three patients with ILS. MATERIALS AND METHODS: The results of tumour excision and cochlear implantation were evaluated in three patients with ILS: two intracochlear schwannomas (ICS) and one intravestibular schwannoma (IVS). RESULTS: Prior to surgery, all patients presented progressive sensorineural hearing loss and tinnitus. Complete tumour resection and cochlear implantation was possible in all patients, with favourable hearing rehabilitation. CONCLUSIONS: The therapeutic approach will depend on tumour size, growth rate, degree of hearing loss and presence of vestibular symptoms. Cochlear implantation (CI) in patients with ILS is possible when the cochlear nerve is present and functional. CI in patients, whether or not preceded by tumour excision, is an option with good hearing results in selected patients.

Giant deep lobe parotid tumor removal via total parotidectomy without mandibulotomy. A simple and safe technique.

The transmandibular route is often combined with the transparotid-transcervical approach when extensive surgical field exposure is required, as in the case of deep parotid lobe tumors measuring over 4 cm in size. This procedure implies great morbidity and prolongs surgery time. Furthermore, in cases where additional lip division is performed, the aesthetic outcomes may be poorer. A description is made of the technique used for the removal of giant pleomorphic adenomas of the parapharyngeal space, without mandibulotomy. Key words:Parapharyngeal space tumor, pleomorphic adenoma, transcervical-transparotid approach, transmandibular approach.

Effects of Omalizumab Treatment in Patients With Recalcitrant Nasal Polyposis and Mild Asthma: A Multicenter Retrospective Study.

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a clinical entity with specific features that impacts significantly on patient quality of life (QoL). CRSwNP is often associated with asthma and is difficult to control and manage despite pharmacological and/or surgical treatment. Omalizumab, a monoclonal anti-IgE antibody, has emerged as a putative therapeutic option. OBJECTIVE: To evaluate the effects of omalizumab on nasal polyp (NP) size and QoL assessed by Sino-Nasal Outcome Test-22 (SNOT-22) in patients with recalcitrant CRSwNP and mild asthma. METHODS: A multicenter retrospective analysis of patient data from the Community of Valencia (Spain) was performed. Adult patients with recalcitrant CRSwNP and comorbid mild asthma receiving compassionate use of omalizumab were included. NP size measured by total nasal endoscopic polyp score (TPS) and QoL evaluated through the SNOT-22 questionnaire were assessed at baseline and monthly over 12 months. An ordinal regression model was built to analyze the results. RESULTS: A total of 23 CRSwNP patients with a mean age (± SD) of 54.78 ± 9.46 years were included. Nineteen suffered from aspirin-exacerbated respiratory disease (AERD). In all patients, a significant and sustained reduction in TPS was observed over time, accompanied by improvements in QoL reflected in lower SNOT-22 scores. In the ordinal regression model, time but not total IgE, age or tissue eosinophilia impacted on NP size and SNOT-22 outcomes. Additionally, improvements in QoL were not explained by reductions in the size of polyps. CONCLUSION: Omalizumab was effective for the treatment of patients with recalcitrant CRSwNP and mild asthma, even when AERD was present, by reducing NP size and improving QoL; treatment time was a key factor. SNOT-22 improvements were not explained by decreases in TPS, indicating that omalizumab may be effective in all patients, regardless of polyp size.

Augmentation of Scarred Vocal Folds With Centrifuged and Emulsified Autologous Fat Grafts.

OBJECTIVE: To review the results of a series of patients with glottic insufficiency caused by scarred vocal folds who underwent injection laryngoplasty with centrifuged and emulsified autologous fat. STUDY DESIGN: Prospective cohort. SETTING: Single center, tertiary institution. SUBJECTS AND METHODS: Examination of the medical records of 21 patients operated on through injection laryngoplasty with fat grafts for the treatment of dysphonia was performed. All patients were operated on between January of 2015 and September of 2019. The voice variables measured were the GRABS (Grade, Roughness, Breathiness, Asthenia, Strain) scale, the Voice Handicap Index-10 (VHI-10), maximum phonation time, jitter, shimmer, and harmonic/noise ratio before surgery and 8 months later. RESULTS: Twenty-six injection laryngoplasties were performed in 21 patients during the reviewed period. Seventeen were men, and 4 were women. Mean age was 57.2 (range, 18-80) years. Mean (SD) follow-up time was 20.7 (9.3) months. Etiology of dysphonia was scarring after tumor resection in 17 patients and sulcus vocalis in 4. Five patients received an additional injection laryngoplasty. Statistically significant improvements were observed in all the parameters evaluated (P < .05). CONCLUSIONS: Injection laryngoplasty with fat grafts processed through centrifugation and emulsification is an effective technique for the treatment of dysphonia caused by glottic insufficiency related to scarred vocal folds, with minimal complication rates.

Multicentric recurrent parotid pleomorphic adenoma in a child.

Mixed tumours of the parotid gland are rare in childhood and recurrence of this tumour is infrequent. Some authors report a higher rate of recurrence with some histological subtypes, like hypocellular variant. Female sex and young age at initial treatment are also risk factor for recurrence. Also the first surgical treatment, tumour enucleation or parotidectomy, has been implicated as a cause for recurrence. We present a case of a multicentric doubly recurrent parotid pleomorphic adenoma, 7 and 14 years after tumour enucleation, in a 9-year-old child. All the nodules resected showed the hypocellular variant of pleomorphic adenoma. We consider the relationships between the choice of treatment, the histologic subtypes of pleomorphic adenomas and multifocal tumours and recurrence. In this case, we believe the recurrence was related to surgical enucleation previously performed and the hypocellular histological subtype. We conclude that tumour enucleation is a risk factor for recurrence and total parotidectomy is the treatment of choice for pleomorphic parotid adenoma also in childhood.

[Solitary extramedullary plasmocytoma of tubaric tonsil]. / Plasmocitoma solitario extramedular de amígdala tubárica.

Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma. The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours.

[Chondromyxoid fibroma of the left maxillary and ethmoid sinuses]. / Fibroma condromixoide de seno maxilar y etmoides izquierdos.

Chondromyxoid fibroma is an infrequent bone tumour in the craniofacial bones and exceptional in the paranasal sinuses. This unusual location, its non-specific clinical manifestation and aggressive behaviour with local destruction and a high recurrence rate can complicate precise diagnosis and treatment.

Malignant fibrohistiocytoma of the parotid region. Report of a case.

Most salivary gland tumors are benign, malignant lesions accounting for 15-30% of the total. The most frequent site of salivary gland neoplasms is the parotid gland (80% of all cases). We present a case of malignant fibrohistiocytoma with atypical features due to its location (in the parotid region), size and rapid growth. Generally, this type of tumor arises in the lower limbs and in the abdomen. When located in the parotid gland, these lesions appear as a firm, slow growing and painless mass. Due to the low frequency of such lesions and their clinical behavior, the imaging study and fine-needle aspiration biopsy findings tend to diagnose them as pleomorphic adenoma. The definitive diagnosis requires microscopic study of the resection piece using immunohistochemical techniques. The treatment of choice is surgery, occasionally associated to radiotherapy. The success of treatment is dependent upon complete resection of the tumor - long term follow-up being necessary due to the risk of recurrence or distant metastasis.