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INTRODUCTION: The phenomenon of neglected foreign bodies is a significant cause of morbidity in soft tissue injuries and may present to dermatologists as delayed wound healing, localized cellulitis and inflammation, abscess formation, or foreign body sensation. Localization and removal of neglected soft tissue foreign bodies (STFBs) is complex due to possible inflammation, indurations, granulated tissue, and fibrotic scar. This paper describes a simple method for the quick localization and (surgical) removal of neglected STFBs using two 23-gauge needles without ultrasonographic or fluoroscopic guidance. MATERIALS AND METHODS: A technique based on the use of two 23-gauge needles was used in 41 neglected STFBs in order to achieve proper localization and fixation of foreign bodies during surgery. RESULTS: Surgical removal was successful in 38 of 41 neglected STFBs (ranging from 2-13mm in diameter). CONCLUSION: The cross-needle-guided technique is an office-based procedure that allows the successful surgical removal of STFBs using minimal soft tissue exploration and dissection via proper localization, fixation, and propulsion of the foreign body toward the surface of the skin.
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INTRODUCTION: Otorrhea and granulation tissue in Canal Wall Down mastoidectomy (CWD) is the common problem in cholesteatoma removal and leads to many discomfort for both the patient and the physician. The main objective in CWD is creating the dry cavity, so the topical antibiotic and acetic acid in variable saturations are used for this purpose. In this study we evaluate the effectiveness of topical MMC and chemical cautery by acetic acid. MATERIALS AND METHODS: Study population consists of 50 patients with cholesteatoma whom underwent CWD. All patient allocated randomly in two study groups, MMC and acetic acid. After 3 weeks, the first visit is planned, extension of granulation tissue and dryness of cavity are evaluated and topical drugs are used in blind fashion. MMC in 4% and acetic acid in 12.5% saturation are applied. Other visits are completed at next month and 3 months later. RESULTS: Both methods are effective in treatment of granulation tissue. In each group both treatment were effective too but MMC was more effective than acid acetic in the treatment of granulation tissue after 4 weeks. CONCLUSION: Based on our findings, it is clear that topical MMC is very effective in the treatment of granulation tissue and in CWD. It results in dry cavity much better than acetic acid without any complication.
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Lingual thyroid (LT) tissue is the most frequent ectopic location of the thyroid gland. We report 5 cases of symptomatic LT and discuss the new surgical approach. Transoral approach and coblation assisted excision of LT was performed. Postoperative follow-up for all patients was like as tonsillectomy management without tracheotomy. It's seem that this approach is much better than other such as tongue-splitting, transcervical transhyoid, pharyngotomy, with an infrahyoid approach, combined cervical and intraoral approach, Mandibular midline osteotomy.
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We sought better understanding about the facial nerve anatomy in the rare inner ear Michel anomaly to help better define this aplasia and prevent potential complications in surgery on these patients. The data from computed tomography scans and magnetic resonance images of six Michel aplastic ears (three patients) were evaluated for a facial nerve course. Facial nerve course and anatomic landmarks were noted. Based on data obtained from this group of very rare patients, three different facial nerve anatomies were encountered. The first patient had normal-looking mastoid cells, normal middle ear ossicles, and a completely formed facial nerve canal through the middle ear. The second patient had pneumatized mastoid air cells despite an anomalous ossicular chain. This patient also had a facial nerve canal but not through the middle ear. In the third patient, although mastoid cells were present, neither ossicles nor a definite facial nerve canal could be detected. With guidance provided by the anatomy of the other parts of the ear, such as air cells and the ossicular chain, the danger zones posing a high probability of facial nerve injury can be predicted. Although all Michel aplasias may have aplastic petrous bone in common, there are some degrees of variation.