In the era of endoscopic sinus surgery, is there still a place for the Caldwell-Luc procedure?.

In the era of endoscopic sinus surgery, is there still a place for the Caldwell-Luc procedure? In this report, we present evidence in favor of the Caldwell-Luc approach to the maxillary antrum in selected cases where endoscopic techniques are inadequate to allow full resolution of the problem. Although this procedure is not as popular as it was in the past, its role in the management of benign paranasal sinus diseases is still important. We focus in particular on use of the Caldwell-Luc procedure for conditions such as fungal mycetoma, foreign body removal, empyema, and benign nasal tumours in areas that are not fully accessible by endoscopy alone. Advantages of this technique are its safety and simplicity; no special instrumentation is necessary. It can be performed with surgical equipment widely available in operating rooms in Greece and elsewhere.

Hypoglossal paresis as the only complication of malignant otitis externa.

BACKGROUND: Ipsilateral hypoglossal nerve (XII) paresis has never been reported as the first and only complication of malignant otitis external (MOE). CASE REPORT: A 73-year-old diabetic male with persistent left temporomandibular joint ache and ear fullness was admitted with the diagnosis of MOE. He received intravenous ciprofloxacin for 14 days and then continued with oral administration (per os). After two months, he returned with otalgia, swallowing difficulty, and ipsilateral XII paresis. He was re-admitted, received intravenous ciprofloxacin for 6 weeks, and continued with per os ciprofloxacin for 6 months. A Ga67-scan 6 months after the first admission revealed no active infection. Two years after his last admission, the patient still has XII paresis. There is no other cranial nerve involvement and inflammatory markers continue to be normal. CONCLUSION: Doctors should consider MOE in the differential diagnosis when there is XII paresis, especially in diabetic and immunocompromised patients.