Anisocoria with orbital floor fractures: worry and wait.

We present a new complication: transient pupillary dilatation in an eye that sustained a posterior orbital floor blow-out fracture. By reviewing the neural pathways involved with pupillary motor function, we surmise the causes of this complication to include trauma to the ciliary ganglion, short ciliary nerves, or the parasympathetic motor root. This type of injury has only recently been reported in the ophthalmologic literature, and has not, prior to this report, been included in the otolaryngologic literature.

Squamous cell proliferative lesion of the nasopharynx in a newborn.

Nasopharyngeal tumors in the newborn are exceedingly rare. Typically, initial symptoms are breathing or eating difficulties. A case is presented of a patient in whom bleeding began following diagnostic passage of nasopharyngeal catheters. Surgical excision was required on the third day of life, and histologic review revealed a squamous cell proliferative lesion consistent with squamous cell carcinoma. The infant's postoperative course was uneventful. Specimens from a nasopharyngeal biopsy done six weeks later revealed only reactive lymphoid hyperplasia and a 6 months of age, the child's condition was normal. After review of the available literature and this patient's pathologic condition, it is believed that this lesion represents an otherwise unclassifiable squamous cell proliferation previously not described.

An unusual otolaryngological problem--mucocutaneous lymph node syndrome (Kawasaki's syndrome) case report.

A case of Kawasaki's syndrome is reported, involving a 12 year old Caucasian male who presented with a sore throat, tonsillar hypertrophy, bilateral cervical swelling, and fever. A maculopapular rash present was attributed to a reaction to methicillin. An initial diagnosis of peritonsillar cellulitis with deep lateral neck space cellulitis and abscess was made. Negative surgical exploratory findings and subsequent development of specific signs and symptoms prompted the diagnosis of Kawasaki's disease. Treatment with salicylates proved effective and the patient was discharged home. Kawasaki's disease, a disorder of unknown origin with potentially fatal results, is not an uncommon condition. An awareness of this entity with its protein manifestations is warranted by the otolaryngologist who may well be the first doctor on the scene. Prompt and early treatment with salicylates may well decrease morbidity and potential mortality of this enigmatic disease.