Internal Jugular Venous Extension of a Mandibular Osteosarcoma With Literature Review.

Head and neck osteosarcomas (HNOS) account for less than 1% of all head and neck cancers and makeup 6-10% of all primary osteosarcomas. Mandibular osteosarcomas are the second most common subtype of HNOS. They demonstrate higher recurrence rates; however, are amenable to surgery. An 18-year-old male presented with a 2 cm x 3 cm x 2 cm intraoral mass for two months. Biopsy revealed chondroblastic osteosarcoma. Computed tomography revealed extension into the left internal jugular vein. Composite resection of the left mandible, floor of the mouth, ventral tongue, submandibular gland, and modified radical neck dissection with fibular flap repair was performed. Adjuvant chemotherapy and palliative radiotherapy were added. Unfortunately, progressive metastasis to the contralateral mandible and entire spinal cord ensued. We report the first case of head and neck osteosarcoma with intravascular invasion into the internal jugular vein.

Comparison of associated comorbid conditions in patients with benign paroxysmal positional vertigo with or without migraine history: A large single institution study.

PURPOSE: In the largest reported United States (U.S.) cohort of benign paroxysmal positional vertigo (BPPV), does the presence or absence of migraine correlate with increased associations of other factors? MATERIALS & METHODS: A retrospective chart review from a single U.S. neurotology center. Adult patients with BPPV from 2003 to 2017 classified into two groups: 1) with migraine; 2) without migraine. RESULTS: The prevalence of self-reported migraine history in a BPPV-positive population (n = 1481) was 25.8% (n = 382). Among those with BPPV and migraine, 88.5% were female, 8.1% had diabetes, 22.5% had prior history of BPPV, 8.9% had Meniere's disease and recurrence rate was 38.3%. No statistically significant differences between recurrence or resolution rates between the two groups were demonstrated (p > 0.05). Adjusted logistic regression model found that women and those with a prior history of BPPV had significantly higher odds of having both BPPV and migraine conditions compared to their counterparts. In contrast, older age and diabetes were associated with significantly lower odds of concomitant BPPV and migraine. CONCLUSIONS: The prevalence of migraine among the study sample was 25.8%. Female gender, prior history of BPPV, younger age, and lack of diabetes were independently associated with the concurrent comorbidity of BPPV and migraine. These data further substantiate previously reported rates (from smaller studies); and, demonstrate that recurrence and resolution rates are not worse in those with BPPV and migraine compared to the general BPPV population. Findings support an association between migraine and BPPV and enhances one's ability to accurately counsel patients regarding these diseases.