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1.
BMJ Case Rep ; 12(9)2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31527210

RESUMO

We present a case of an 88-year-old man with high-grade chondrosarcoma of the larynx. The patient presents with a history worsening dysphonia and dyspnoea treated with antibiotic and corticosteroid therapy as it was a bronchopneumonia. Thanks to fibrolaryngoscopy, radiological imaging and final biopsy with immunohistochemistry, we have done differential diagnosis with the others sarcomas of the larynx. The histological diagnosis and the correct grading are essential for treatment and management of the pathology. The best treatment is primary surgical resection with negative margins. Chemoradiotherapy may provide some benefit if there are margin positive resections or with palliative intent. In our case, we performed only surgery treatment and a close follow-up at 1-3-6 months and after every 6 months. After 18 months from surgery, there are no signs of recurrence of disease.

2.
J Craniofac Surg ; 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31449205

RESUMO

The authors present a case of a 33-year-old male patient with obstructive sleep apnea syndrome who was treated with a mandibular advancement device with excellent results. The aim of this study is to underline the importance of new instruments that allow evaluating the upper airway with greater precision, such as cone beam tomography. Given the diagnosis and treatment, the upper airway was assessed using cone beam tomography; an increase in UA volume of 22% was observed (initial volume 22,962 mm), along with a 28% increase in area (initial area 971 mm). The evaluation of the UA using teleradiography also showed an increase in the points evaluated, with the midpoint of the soft palate presenting the greatest increase.

3.
BMJ Case Rep ; 12(7)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31296620

RESUMO

We present a case of an odontogenic abscess, first spreading at the lateral cervical level and then in mediastinum. We isolated an anaerobic bacterium, Prevotella corporis, rarely documented in literature. The mortality rates of cervical abscesses secondary to odontogenic infections and complicated by mediastinitis vary from 10% to 40%. Treatment of descending mediastinitis involves multidisciplinary teams such as otorhinolaryngology, thoracic surgeons, infectious disease physicians, anesthetists and intensivists. Due to the combined treatment with surgical drainage within 48 hours of hospitalisation, antibiotics and subsequent hyperbaric oxygen therapy, we have achieved complete recovery of the patient.

5.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040145

RESUMO

We present a case of a 16-year-old girl with interruption of papyracea lamina and herniation of the periorbital fat covered by a bone shell. The patient presents with a history of diplopia and visual disturbances ever since she can remember. Thanks to radiological imaging and biopsy, we have done differential diagnosis with periorbital lipoma, intraosseous lipoma and intramuscular lipoma of medial rectus. Diagnostic for images is necessary for a correct operative planning. Endoscopic sinus surgery with computer-assisted navigation is the safest and most effective method to remove the lesion that was closely related to the medial rectum muscle and to the anterior ethmoidal artery. The patient after surgery and in 1 year of follow-up reports the disappearance of symptoms.

6.
Am J Case Rep ; 20: 175-178, 2019 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-30739122

RESUMO

BACKGROUND The Say-Barber-Biesecker-Young-Simpson (SBBYS) variant of Ohdo syndrome is characterized by congenital hypothyroidism, facial dysmorphism, postaxial polydactyly, and mental retardation. The SBBYS variant of Ohdo syndrome is extremely rare with only 19 cases previously reported in the literature. A case is presented of chronic otitis media associated with cholesteatoma in a six-year-old boy with the SBBYS variant of Ohdo syndrome. CASE REPORT A 6-year-old boy presented with perforation of the tympanic membrane and a cholesteatoma in the mesotympanic-attic region associated with chronic otitis media. The child had previously been diagnosed with the SBBYS variant of Ohdo syndrome. Following computed tomography (CT) and magnetic resonance imaging (MRI), tympanoplasty was performed with removal of the lesion. CONCLUSIONS This is the first case described in the literature of chronic otitis media associated with cholesteatoma in a patient with the SBBYS variant of Ohdo syndrome. This case demonstrates the importance of specialist otolaryngology referral for patient management.


Assuntos
Blefarofimose/complicações , Colesteatoma da Orelha Média/complicações , Hipotireoidismo Congênito/complicações , Cardiopatias Congênitas/complicações , Deficiência Intelectual/complicações , Instabilidade Articular/complicações , Otite Média/complicações , Criança , Colesteatoma da Orelha Média/diagnóstico por imagem , Doença Crônica , Facies , Humanos , Imagem por Ressonância Magnética , Masculino , Doenças Raras
7.
Am J Case Rep ; 20: 184-188, 2019 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-30745558

RESUMO

BACKGROUND The purpose of this study is to demonstrate the advantages of 3D volume rendering in postoperative control of implants placement compared to high-resolution computed tomography (HRCT). CASE REPORT We describe 3 patients who underwent HRCT study with and without 3D volume rendering after surgery for cochlear implantation. In 2 patients, the traditional HRCT showed a suspected malposition of the array, excluded only by the rendering reconstruction. In the other patient, thanks to the 3D rendering, we were able to identify the complete migration of the array out of the cochlea and the tip of the electrode near the opening of internal auditory canal, while the traditional images showed only that the array was not rolled up inside the cochlea. CONCLUSIONS HRCT showed complex anatomic structures of the inner ear and contents of the middle ear cavity. The volume rendering, in the postoperative control, generates interactive 3D images of the cochlear implant, facilitating a clearer representation of the topographic complex of the cochlea, giving more detailed diagnostic information than the HRCT.


Assuntos
Implantes Cocleares , Imagem Tridimensional , Tomografia Computadorizada Multidetectores/métodos , Osso Temporal/diagnóstico por imagem , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Auris Nasus Larynx ; 46(4): 520-525, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30528105

RESUMO

OBJECTIVE: In the last years endoscopic sinus surgery (ESS) is improved with the introduction of computer assisted navigation (CAN). In this retrospective study we evaluated the usefulness of CAN in endoscopic sinus surgery and studied its advantages over conventional endoscopic sinus surgery. METHODS: We retrospectively reviewed the records of 96 patients with chronic rhinosinusitis (CRS). 48 patients undergoing endoscopic sinus surgery with surgical navigation (A group) and other 48 without navigation (B group). Data about percentage of complications, olfactory function (Visual Analogue Scale), Sino-nasal Outcomes Test (SNOT-22), Rhinosinusitis Quality of Life (RhinoQoL), recurrence (CT Lund-Mackay score), total nasal resistance (rhinomanometry) and duration of the intervention were collected and analyzed. RESULTS: A group evidenced a decrease of recurrence rate (p=0.009), a reduction of total nasal resistance (p=0.007), of frontal recess stenosis (p=0.04) and of nasal symptomatology (p=0.008). QoL had a better improvement in group A. Rate of other complications and olfactory function did not show statistically significant differences between the two groups. The average calibration time was approximately 11min in the A group. Total time of surgical procedure does not evidenced statistically significant difference between the two groups (p>0.05) but if it is considered only the time of the surgical intervention, the difference of duration is significant reduced statistically (p<0.05) in CAN surgery. CONCLUSION: Computer assisted navigation in ESS can be useful for the most experienced surgeons, especially in the frontal recess surgery, decreasing the recurrence rate and reducing the total nasal resistance.

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