Migrating fish bone presenting as a neck fistula.

The case report describes an extremely rare finding of fish bone migration from the aerodigestive tract causing a neck fistula 2 years after its ingestion. Detailed case study and surgical treatment is presented. This case highlights the need for further assessment in presence of a high clinical suspicion of foreign body ingestion with a normal physical examination of the upper aerodigestive tract, to avoid serious and potential life-threatening complications later on.

Endoscopic resection of invasive glomangiopericytoma following preoperative embolisation.

We present a case of a 60-year-old woman with a 2-year history of nasal obstruction and unilateral recurrent epistaxis. Anterior rhinoscopy identified a unilateral hypervascular lobular mass occupying the entire left nasal cavity. Imaging studies documented an extensive soft tissue density lesion in the left nasal cavity with complete infiltration of the anterior ethmoid, limited indentation of the medial wall of the orbit, bone demineralisation of the cribriform plate and involvement of the anterior cranial fossa. The diagnosis of locally invasive glomangiopericytoma was obtained preoperatively through biopsy of the lesion, which resulted in a self-limited epistaxis that was easily controlled by nasal packing, confirming the vascular nature of the lesion. We discuss the diagnostic work up, imaging and surgical approach of this tumour, and review the recent literature on endoscopic treatment of these lesions.

The human olfactory mucosa.

Studies of the tissues of the human olfactory mucosa have been performed to investigate olfactory dysfunction and, more recently, olfactory mucosa has attracted a novel interest of investigators because it can be used as an early marker of neurodegenerative conditions of the brain and as a source of multipotent neural stem cells, with applications in regenerative medicine. The olfactory mucosa is readily available to the otolaryngologist, but the harvesting of this tissue must be safe, effective, and reliable, obtaining as little tissue as necessary, while avoiding unnecessary harm to the remaining olfactory tissue and function. The purpose of this review is to summarize the results of the most important studies and knowledge with regard to the human olfactory mucosa and its applications, emphasizing the issue of the distribution of the olfactory mucosa in the nasal cavities.

Otosclerosis of the incus.

OBJECTIVE: To report a case of a patient with otosclerosis of the incus. PATIENTS: A 61-year-old woman with a progressive hearing loss on her left ear and a computed tomographic scan of the temporal bone revealing an expansible lesion of the incus. INTERVENTIONS: The ossicle was removed by using a transtympanomastoid approach; the ossicular chain was reconstructed using a titanium partial ossicular replacement prosthesis. MAIN OUTCOME MEASURE: The diagnosis of the disease was obtained by means of histopathologic examination of the specimen. RESULTS: The patient obtained a good postoperative hearing result. The histopathologic examination of the specimen documented an otosclerosis of the incus. CONCLUSION: Otosclerotic involvement of the middle ear ossicles, apart from footplate, was very rarely mentioned. Most subjects were incidentally diagnosed postmortem by means of examination of specimens from temporal bone collections. The diagnosis and treatment of a patient with otosclerosis of the incus is exceptional; however, otosclerosis should be considered in the differential diagnosis of expansible lesions of the ossicles.

Sudden sensorineural hearing loss following intramuscular administration of penicillin.

We report a case of sudden hearing loss in a patient with acute exudative tonsillitis, occurring 15 minutes after the intramuscular administration of penicillin. Audiological evaluation documented a profound sensorineural hearing loss of the cochlear type. The mechanism of the hearing loss was probably an immediate hypersensitivity (type I) allergic drug reaction. Penicillin is used frequently for the treatment of several infections. Allergic reactions to penicillin are well known and include urticaria, maculopapular exanthems, angio-oedema, bronchospasm and anaphylaxis, but sudden hearing loss has never been recorded.