Carotidynia Versus Transient Perivascular Inflammation of the Carotid Artery (TIPIC) Syndrome: Finding Common Ground.

Carotidynia remains mired in controversy. Whether to identify this self-limiting unilateral neck pain as a distinct clinical entity or a diagnostic sign associated with a variety of conditions remains a topic of ongoing debate. Adding to the discussion is the occasional finding on imaging studies of a transient inflammatory process surrounding the carotid artery in a number of individuals who present with unilateral neck pain. Although some use carotidynia as the designation of choice by which to identify this inflammatory process, the acronym TIPIC (transient perivascular inflammation of the carotid artery) syndrome is being touted as a far more descriptive and less contentious alternative. Having TIPIC syndrome replace carotidynia, however, need not necessarily signal the latter's outright elimination as some have advocated. When used as a diagnostic sign, carotidynia provides an appreciation of the many conditions that may be associated with idiopathic unilateral neck pain.

Red ear syndrome: Perspectives for the otolaryngologist.

Red ear syndrome (RES) is an unusual, often unrecognized condition that has rarely been reported in the otolaryngology literature despite the presence of symptoms and associated disorders of relevance to the otolaryngologist. When present, RES may have diagnostic value when uncertainties arise in cases of sinus headache and referred otalgia. Despite the appearance of a distinctive red ear, as well as symptoms and associated disorders relating to otolaryngology, discussion of RES is generally limited to neurology-based publications. A red ear is typically the one constant finding in RES while clinical presentation, rate of occurrence, duration, manner of onset, and response to treatment vary on a case-by-case basis. RES may have value as a diagnostic tool in cases of sinus headache and referred otalgia. In recognizing that RES is commonly associated with migraine and not sinus-related headaches, the presence of RES could help confirm a diagnosis of migraine and remove sinus headache from consideration. Temporomandibular joint (TMJ) disorder and cervical pathology are commonly encountered in both RES and referred otalgia. When identifying the cause of referred otalgia proves problematic, the presence of RES should prompt the clinician to concentrate on either TMJ or cervical pathology as the more likely diagnostic possibilities.

Primary B cell lymphoma of the external auditory canal.

Temporal bone lymphomas are rare and typically metastatic neoplasms. We describe a case of primary B cell lymphoma that originated in the external auditory canal of an elderly woman. The diagnosis was based on histopathologic examination supplemented by immunophenotypic analysis. The patient was treated with external-beam radiation and remained disease-free throughout 9 years of follow-up. We also point out that the presence of non-Hodgkin's lymphoma in an unusual site may be an indication that the patient has an acquired immunodeficiency syndrome.