RESUMO
Spontaneous epidural pneumocephalus is a rare condition. The authors reported a 35-year-old male patient with tinnutus, dull headache, and swelling on his head. Patient had a history of head trauma and skull fracture from when he was 5 years old. Cranial computed tomography revealed increase in pneumatization of right mastoid air cells and large epidural air in temporoparietal region. Inner table of right temporal bone got thinner, causing communication of mastoid air cells with epidural space. Epidural air had septations and exerted mass effect on the right parietal lobe with minimal midline shift. Thinning of also right parietal bone caused extension of epidural air into the right parietal subcutaneous tissue and hence subcutaneous swelling. There was no obvious fracture line. Spontaneous epidural pneumocephalus is extremely rare condition that may cause severe complications. There are several etiologic factors. Head trauma can be the eliciting factor in the authors' patient. It is important to be familiar with its presentation and imaging findings to make early diagnosis and treatment.
Assuntos
Espaço Epidural/diagnóstico por imagem , Processo Mastoide/lesões , Pneumocefalia/diagnóstico , Fraturas Cranianas/complicações , Osso Temporal/lesões , Adulto , Humanos , Masculino , Processo Mastoide/diagnóstico por imagem , Pneumocefalia/etiologia , Fraturas Cranianas/diagnóstico , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodosRESUMO
The involvement of lower cranial nerve palsies is less frequent in Ramsay Hunt syndrome caused by varicella zoster virus (VZV). The authors report 1 of extremely rare patients of radiologically proven polyneuropathy of VZV infection with magnetic resonance imaging findings of VII, IX, and X cranial nerve involvement is a 62-year-old female patient, who initially presented with Ramsay Hunt syndrome. Varicella zoster virus infection should be considered even in patients who show unilateral palsy of the lower cranial nerves associated with laryngeal paralysis. Thin-section T2W and T1W images with a contrast agent should be added to the imaging protocol to show the subtle involvement.
Assuntos
Nervo Glossofaríngeo/diagnóstico por imagem , Herpes Zoster da Orelha Externa/diagnóstico , Herpesvirus Humano 3 , Imageamento por Ressonância Magnética/métodos , Dissinergia Cerebelar Mioclônica/complicações , Polineuropatias/diagnóstico , Nervo Vago/diagnóstico por imagem , Feminino , Herpes Zoster da Orelha Externa/complicações , Herpes Zoster da Orelha Externa/virologia , Humanos , Pessoa de Meia-Idade , Polineuropatias/etiologia , Polineuropatias/virologiaRESUMO
The treatment expectations of patients with laryngeal carcinoma and their quality of life after treatment were evaluated. We enrolled patients who were receiving treatment for epidermoid carcinoma of the larynx between January 2011 and January 2012. Their expectations from the treatment were evaluated using the visual analog scale (VAS) prior to and at the end of the treatment. Quality of life was assessed using the EORTC QLQ C 30 and EORTC H&N 35 questionnaires 3 months after completion of the treatment. In addition, the Beck Depression Inventory was used for mood assessment of the patients after treatment. As per the VAS scores pre-treatment, no differences were found between treatment expectations of early and advanced-stage tumors groups in pre-treatment expectations, but post-treatment evaluation statistically found difference between two groups in terms of average VAS score. Emotional, cognitive, and social functions of the EORTC QLQ C 30 questionnaire were the most affected items in the advanced-stage tumor group. Sense and speech problems in the symptom scales of the EORTC H&N 35 questionnaire were found to be significantly higher in patients with advanced-stage tumors than in those with early stage tumors. The present study is the first to assess the treatment expectations of patients with laryngeal carcinoma by using the VAS. Although the treatment expectations of the patients with early and advanced-stage tumors did not differ according to VAS scores in pre-treatment evaluation, early stage groups had better score than advanced-stage group. VAS was an easy and a simple applicable method for evaluating treatment expectations.
Assuntos
Protocolos Antineoplásicos , Carcinoma de Células Escamosas , Depressão , Neoplasias Laríngeas , Complicações Pós-Operatórias , Qualidade de Vida , Transtornos de Sensação , Distúrbios da Fala , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/psicologia , Carcinoma de Células Escamosas/cirurgia , Depressão/diagnóstico , Depressão/etiologia , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/psicologia , Neoplasias Laríngeas/cirurgia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Preferência do Paciente/psicologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/psicologia , Transtornos de Sensação/diagnóstico , Transtornos de Sensação/etiologia , Transtornos de Sensação/fisiopatologia , Transtornos de Sensação/psicologia , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/etiologia , Distúrbios da Fala/fisiopatologia , Distúrbios da Fala/psicologia , Inquéritos e Questionários , Escala Visual AnalógicaRESUMO
The objective of the study was to investigate the relationship between extent of otosclerotic foci and audiological findings in otosclerotic patients with mixed hearing loss using high-resolution computed tomography (HRCT) and also to measure the density of bony labyrinth in otosclerotic patients and compared with control group. This was a retrospective study. Twenty-five patients with clinical otosclerosis and mixed hearing loss were included in the study. The average threshold of air-bone conductions (AC, BC) within the 0.5-4 kHz frequency range, and average air bone gap (ABG) were calculated. Eleven patients with normal HRCT who received cochlear implant were included in the study as the control group. The lesions in HRCT were staged according to their extension. Eight different points of the otic capsule in each patient were measured using HRCT. Fifty ears total, from 25 patients, had bilateral otosclerosis. The mean AC of all the ears was 63 dB, mean BC was 35.2 dB, and mean ABG was 27.8 dB. HRCT staging indicated 22 ears had Grade 1, 21 ears had Grade 2, and 7 ears had Grade 3 lesions. There was a statistically significant difference between the mean AC, BC of ears with Grade 1 and Grade 2 when compared with the mean AC, BC of ears with Grade 3. When comparing the densitometric measurements of fissula ante fenestram localizations, a statistically significant difference was observed. HRCT examination and densitometric measurements in otosclerotic patients with mixed hearing loss presented significant results. We were unable to show a significant relationship between early stage and hearing thresholds, but there was a significant relationship in advanced stage. Densitometric measurements may provide significant results for otosclerosis, particularly for the FAF region when comparing with control group.
Assuntos
Cóclea , Perda Auditiva Condutiva-Neurossensorial Mista , Otosclerose , Adulto , Idoso , Idoso de 80 Anos ou mais , Condução Óssea , Cóclea/diagnóstico por imagem , Cóclea/patologia , Pesquisa Comparativa da Efetividade , Densitometria/métodos , Feminino , Perda Auditiva Condutiva-Neurossensorial Mista/diagnóstico , Perda Auditiva Condutiva-Neurossensorial Mista/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Otosclerose/complicações , Otosclerose/diagnóstico , Gravidade do Paciente , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodosRESUMO
Metastasis to palatine tonsils are rare, accounting from only 0.8% of all tonsillar tumors, so far only 100 cases reported in the English literature. Only a few cases have been reported for small cell and non-small cell lung cancer as a primary site. With a diagnosis of small cell lung cancer, a 68-year-old male patient relapsed after six cycles of chemotherapy in tonsilla palatina and cervical lymph nodes. Patients died 26 months after being diagnosed with lung cancer and 2 months after detection of tonsil metastasis. We present the current case report because of the rarity of metastasis to tonsil in lung cancer.
Assuntos
Neoplasias Pulmonares/patologia , Carcinoma de Pequenas Células do Pulmão/secundário , Neoplasias Tonsilares/secundário , Idoso , Evolução Fatal , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/tratamento farmacológico , Metástase Linfática , Masculino , Carcinoma de Pequenas Células do Pulmão/diagnóstico por imagem , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/patologia , Neoplasias Tonsilares/diagnóstico por imagem , Neoplasias Tonsilares/tratamento farmacológico , Neoplasias Tonsilares/patologiaRESUMO
OBJECTIVES/HYPOTHESIS: Mean platelet volume is the measurement of the average size of platelets in the blood, and red blood cell distribution width is the variability of the size of red blood cells in circulation. This study aimed to investigate if there was any relationship between mean platelet volume, red blood cell distribution, and epistaxis. STUDY DESIGN: Prospective controlled trial. METHODS: The study included 90 patients admitted to Ankara Atatürk Hospital and Samsun Medicana Hospital with complaints of recurrent epistaxis, and a control group of 90 healthy subjects. Blood samples were taken from all patients and control group subjects. Mean platelet volume and red blood cell distribution parameters were examined and compared between the two groups. RESULTS: The mean platelet volume levels were determined as 8.86 ± 0.1 in the control group and 8.36 ± 0.1 in the patient group. The difference between the two groups with respect to mean platelet volume was statistically significant (P < .05). The mean red blood cell distribution levels were determined as 12.68 ± 0.32 in the control group and 11.90 ± 0.16 in the patient group. The difference between the two groups with respect to red blood cell distribution was also statistically significant (P < .05). CONCLUSIONS: The results of this study showed a clinical finding of lower mean platelet volume and red blood cell distribution levels in epistaxis. These findings could be beneficial in new investigations into epistaxis mechanisms.
Assuntos
Epistaxe/sangue , Epistaxe/fisiopatologia , Índices de Eritrócitos/fisiologia , Volume Plaquetário Médio , Adulto , Biomarcadores/sangue , Contagem de Eritrócitos , Feminino , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Valores de Referência , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Turquia , Adulto JovemRESUMO
Rhinoliths are calcified masses in the nasal cavity caused by the deposition of nasal, lacrimal, and inflammatory mineral salts by accretion around an endogenous or exogenous nidus. Rhinoliths can be seen as incidental findings on panoramic radiography, although they typically appear blurred due to remaining outside the focus. Therefore, rhinoliths may be difficult to recognize; this difficulty can lead to misdiagnosis. Computed tomography (CT)/cone beam CT (CBCT) scans are generally necessary to define the precise location and to make a differential diagnosis. This article describes radiologic features of five cases of rhinoliths that were detected incidentally on panoramic radiographs. CT or CBCT images were obtained before removing the rhinoliths.