The role of herpes simplex virus (HSV) and varicella zoster virus (VZV) in acute peripheral facial palsy (APFP) was evaluated according to clinical symptomatology and serologic findings in a series of 70 patients seen over a one-year period. Peak morbidity of APFP occurred in the 21 to 30 years age group. Most patients were under 40 years of age and there were more female than male patients. Concomitant dysfunction of one or more other cranial nerves was present in most patients. The sera of patients were examined for IgG antibodies to HSV and VZV by the indirect immunoperoxidase technique. The geometric mean titer for VZV antibodies was significantly higher in the VZV-seropositive APFP patients than in the seropositive matched healthy control subjects. Nine APFP patients had increased or fourfold-rising VZV antibody titers on subsequent examinations, although six of them had presented without any evidence of zosterian eruption. The proportion of APFP patients with HSV antibodies at the time of admission was significantly higher than that of matched control subjects. No significant difference was found in the geometric mean titer for HSV antibodies between seropositive APFP patients and the seropositive control subjects. Only one patient in the series showed a fourfold rise in HSV antibodies, although the clinical symptomatology was compatible with this infection in 17 patients. The significance of serologic studies in determining the etiology of APFP is discussed.

Adolescent↗

PubMed1979

Malignant fibrous histiocytoma of the maxillary sinus.

A rare localization of a malignant fibrous histiocytoma is presented. Review of the literature showed that the biological behavior of this group of tumors is obscure. The histomorphologic pattern does not always reflect the malignant character, the tendency for recurrence, and the metastasizing potential of the individual tumor. Radiotherapy is ineffective, so the surgeon must opt for radical excision. Additional clinical reports, long-term follow-up, and electron microscopic studies are needed to establish the biological behavior of this group of tumors.

Histiocytoma, Benign Fibrous↗

PubMed1979

Medullary carcinoma of the thyroid.

Three patients with medullary carcinoma of the thyroid gland, one sporadic and two familial, are described. One of the patients presented at a late stage of the disease with evidence of wide dissemination and severe diarrhea, which was controlled by indomethacin. The value of venous catheterization and plasma thyrocalcitonin measurements in evaluating the extent of the disease was demonstrated in this case.

Adult↗

PubMed1979

Traumatic labyrinthine fistulas.

During the last 10 years, the rupture of the inner ear windows, as an entity, has been introduced in the differential diagnosis of the acute vestibulocochlear syndrome. Head trauma, Valsalva-like maneuvers and barotrauma due to diving accidents are now described as etiologic factors in the pathogenesis of labyrinthine fistula. Four cases were explored and repaired in the last four years in our department. Ataxia was the prominent symptom in three, while positional nystagmus and vertigo were consistent findings in all four cases. The definitive evidence of the fistula can be proved only by exploratory tympanotomy. In this report, the importance of the consideration of this entity in the differential diagnosis of vestibulocochlear syndrome in victims of traffic and diving accidents is emphasized.

Adolescent↗

PubMed1978

The aberrant cervical thymus. Embryology, Pathology, and clinical implications.

Cervical thymic anomalies are not as rare as previously suggested. Six cases were encountered over a relatively short period of time, prompting us to report them and emphasize the importance of this entity. Five of the six patients were children, two of them infants less than one year old. The occurrence of thymic remnants in the neck of young children is not surprising, considering the nature and behavior of the thymus at different stages of life. After a brief embryologic survey, the various types of cervical thymus (solitary ectopic, cystic, or partially arrested descent) and their pathogenesis are discussed. The rare occurrence of thyroid and parathyroid tissue within the mass of a large cervical thymic cyst is reported and evaluated. Cervical thymic lesions can either be symptomless or cause severe dyspnea and dysphagia, especially in the young infant. Accurate diagnosis and an intelligent surgical approach in the child with a cervical mass can avoid the obvious parental apprehension and lead to the correct treatment. Symptoms due to pressure on neighoring structures are promptly eliminated after excision, and prognosis is excellent.

Adult↗

PubMedDate not supplied

Low-grade papillary adenocarcinoma of buccal mucosa salivary gland origin.

The clinicopathologic features of a low-grade papillary adenocarcinoma arising in minor salivary gland tissue are presented. This tumor demonstrates a predilection for minor salivary glands of the oral cavity, a slow growth pattern, recurrence in spite of radical excision, and a tendency to produce nodal metastasis. This is the second documented case in the English literature of this recently defined subtype of polymorphous low-grade adenocarcinoma arising in a minor salivary gland of the buccal mucosa.

Adenocarcinoma, Papillary↗

PubMedDate not supplied

Iatrogenic cholesteatoma of the neck.

Epidermal cysts of the upper neck may appear years after ipsilateral radical mastoidectomy for cholesteatoma. Three patients are presented, and the etiological factors operating in the development of such tumors in these patients and others cited in the literature are discussed.

Adolescent↗

PubMedDate not supplied

Multiple trichoepithelioma occluding both external auditory canals.

Multiple trichoepithelioma is an uncommon skin disease with autosomal dominant transmission. It is characterized by multiple, benign facial skin lesions. These lesions constitute a formidable cosmetic and therapeutic problem. Treatment modalities are numerous and varied. In a few rare cases, confluence of the lesions may result in occlusion of the auditory canal, with consequent loss of hearing. In such cases the treatment of choice should be excision and split-thickness skin grafting.

Ear Canal↗

PubMedDate not supplied

Branchial cleft cyst manifesting as hypoglossal nerve palsy.

Hypoglossal nerve palsy occurred in 2 patients with infected second branchial arch cleft cyst. This very unusual complication of the congenital anomaly has been related to the mechanical compression of the mass. Histologic features of the perineural coat were also suggestive for this etio-pathogenesis.

Adult↗

PubMedDate not supplied

T-tube modification to decrease the risk of plugging.

Laryngotracheal stenosis is a recognized complication of local injuries, such as prolonged intubation. Surgical reconstruction with the use of a tracheal T-tube is widely recommended. We report a serious complication consisting of the sudden obstruction of the T-tube by viscous secretions. In order to prevent this undesirable consequence, a simple modification of the T-tube technique is proposed.

Airway Obstruction↗

PubMedDate not supplied

Temporomandibular arthritis in familial Mediterranean fever.

Temporomandibular joint arthritis is a rare manifestation of familial Mediterranean fever and should be considered in patients of Mediterranean origin. Recently we treated four patients suffering from this condition, and intra-articular corticosteroid injection resulted in rapid resolution of the pain and disability in two. Computed tomography confirmed the usefulness of this therapeutic modality.

Adult↗

PubMedDate not supplied

Sternocleidomastoid myoperiosteal flap for the repair of laryngeal and tracheal wall defects.

A myoperiosteal flap consisting of the steronocleidomastoid muscle and clavicular periost was successfully used in the repair of deficient laryngeal and cervical tracheal wall in three cases. Complete epithelialization took place with no granuloma formation in any of the three. This flap proved to be rigid enough to form a noncollapsed wall at times of alternative pressure changes. The method described consists of a one-stage procedure where the donor site is in the same surgical field as the defect. There is no interference with any vital function and no apparent cosmetic defect. Therefore, it can be considered a viable alternative to procedures already in use.

Adolescent↗

PubMedDate not supplied

Uncommon clinical manifestations in a case of thyroid carcinoma.

A case of multiple, functional bone metastases from a previously operated follicular thyroid carcinoma is reported in an apparently euthyroid patient. Additional uncommon clinical manifestations encountered in this case were: 1) mandibular metastasis mimicking an intraoral arteriovenous malformation, 2) extensive, destructive, and expansive intraspinal metastases in the thoracic vertebral column protruding into the posterior mediastinum and causing severe spinal lesions, and 3) the precipitation of a fatal thyroid crisis following radioactive iodine treatment.

Adenocarcinoma↗

PubMedDate not supplied

Transverse cervical myelopathy: an unusual complication of retropharyngeal abscess.

Retropharyngeal abscess complicated by suppuration in the central nervous system, intra- or extraaxial, is rare. Acute transverse myelopathy complicating a retropharyngeal abscess may be more frequent than epidural spinal abscess and usually affects the thoracic cord. Therefore, the occurrence of acute high cervical transverse myelopathy is rarely encountered and warrants reporting. The need for neuroradiologic diagnostic evaluation is emphasized in order to rule out a surgically treatable lesion.

Abscess↗