CASE REPORT: GLOMUS JUGULOTYMPANICUM

Paragangliomas or glomus tumors arise from neural crest derivatives of the autonomic nervoussystem. They account for 0,6% of all head and neck tumors. Glomus jugulare tumors are located in the jugular foramen and are derivatives of the paraganglia in the jugular bulb adventitia. Glomus jugulotympanicum is the term that de- scribes a tumor that has spread into the middle ear cavity

A Case of Long Lasting Atrophic Glossitis Due to Autoimmune Atrophic Gastritis Diagnosed by an Otorhinolaryngologist

Autoimmune gastritis is caused by a pathologic CD4 T cell-mediated autoimmune response directed against H/K -ATPase. Gradually progressive gastric lesions lead to chronic gastritis which is a precursor of intestinal metaplasia leading to gastric cancer, the second leading cause of cancer death worldwide. Silent initially, megaloblastic pernicious anaemia arising from vitamin B12 deficiency presents as atrophic glossitis, which may be the first and only clinical symptom. In everyday practice, tongue diseases are often misdiagnosed. A holistic approach, detailed history and examination may reveal underlying diseases which are the main cause of the symptoms, presenting a significant challenge for the otorhinolaryngologist. We present the case of a 53-year-old woman referred to an otorhinolaryngologist by her family medicine practitioner due to mouth burning syndrome and nausea lasting for ten years. A comprehensive diagnostic approach emphasized the importance of accurate diagnosis and prompt management of specific underlying diagnoses in everyday otorhinolaryngologic practice

Prognostička vrijednost tkivnog proteomskog profila u stadijima I i II malignoga melanoma kože glave i vrata [Prognostic significance of proteomic profiling applied to stages I and II cutaneous malignant melanoma of the head and neck in stages I and II]

Morphohistopathological parameters are the basis for malignant melanoma classification and prognosis. An increasing number of molecular biomarkers offers new potential for refining diagnostic and prognostic disease categories. However, early stage disease prognosis is only partially defined by morphological and histopathological parameters (primary tumor localization, patient age and gender, mitotic rate, lesion thickness and presence of ulceration). This study is based on proteomic profiling of 31 early stage head and neck cutaneus malignant melanoma tissue samples and six pooled benign pigmented nevi tissue, as a control sample. After identifying the global melanoma proteomic profile, expression of individual proteins was correlated with established prognostic factors and patient survival by recursive partitioning. Relations between individual protein expression levels and disease specific survival were analyzed. Analysis revealed, previously unreported proteins, identified as possible prognostic biomarkers. These are: heterogeneous nuclear ribonucleoprotein M, heat shock protein 90 alpha, profilin-1, tubulin - beta chain, annexin-5 and ribosomal protein L7. Heterogeneous nuclear ribonucleoprotein M was identifed as the principal prognostic factor in our data set. It was shown as independent in relation to other prognostic factors, statistically significant and clinically relevant due to an exceedingly high hazard ratio. These findings add a new dimension in relation to novel melanoma biomarkers, especially in for early disease stages

Beyond the Ear: Complications Following Otitis Media

Chronic otitis media (COM) is a prevalent condition typically characterized by recurrent ear infections and inflammation. It can result in a variety of serious complications, such as cholesteatoma, mastoiditis, meningitis, and brain abscess. Left untreated, the cholesteatoma can erode the surrounding bone and lead to irreversible hearing loss, balance problems, and facial nerve paralysis. Mastoiditis, an inflammation of the mastoid bone, causes severe pain, fever, and swelling, and can lead to a lifethreatening infection of the surrounding tissues. Brain abscess can cause headaches, fever, and seizures, and might result in permanent neurological damage or death

The impact of surgery type and prosthesis material on hearing results in stapes surgery

Stapes surgery is generally performed for otosclerosis and there are numerous surgical technicques and prosthesis materials available. Constant eva-luation of postoperative hearing outcomes is crucial for identification and further advancement of the current best option

Accidental removal of glottic carcinoma during direct laryngomicroscopy and follow-up bronchoscopy: a case report

Introduction: Endoscopic surgery for glottic carcinoma is a standardized and safe procedure. However, in certain circumstances and localizations of the lesion, airway management prior and during surgery may pose a significant challenge. Accidental removal of glottic carcinoma during intubation is a very rare occurrence and poses an interesting diagnostic and therapeutic problem. Case report A patient with suspect T1a glottic laryngeal carcinoma was referred to our department because of hoarseness that had been going on for the past month. She had no other complaints. The patient was healthy, a non-smoker and had no other risk factors. The examination revealed a well-perfused lesion in the front two thirds of the left vocal cord. Direct laryngomicroscopy under general anesthesia was indicated. During intubation, the lesion was accidentally torn off with the Storz endoscope. During direct laryngoscopy, no lesion was observed, a limited excision of the tumor base was performed. The tissue was sent for urgent PH analysis and mild atypia was observed by the pathologist. Subsequently, bronchoscopy was performed and the aspirate was sent for PH analysis, which revealed that the aspirate contained carcinoma in situ. The patient was followed-up regularly. During the first 6 months postoperatively, the patient was monitored on a monthly basis. Her voice was fine, and she had no other complaints. One year after the surgery, the patient has been checked-up every 2 months and is still without any complaints. Conclusion: In general, direct laryngomicroscopy is a safe operative method with a high success rate. However, considering the localization and the fact that it is performed under general anesthesia, various problems can occur. This case shows that, despite the difficulties that may occur during the surgery, a correct decision at a moment may lead to the desired result. In addition to the patient\u27s survival, which is the most important aim, the quality of life can also be preserved with the right therapeutic method. This was the case with our patient, who has not had any complaints so far, nor has she shown any signs of recurrence of the disease

Accidental removal of glottic carcinoma during direct laryngomicroscopy and follow-up bronchoscopy: a case report

Introduction: Endoscopic surgery for glottic carcinoma is a standardized and safe procedure. However, in certain circumstances and localizations of the lesion, airway management prior and during surgery may pose a significant challenge. Accidental removal of glottic carcinoma during intubation is a very rare occurrence and poses an interesting diagnostic and therapeutic problem. Case report A patient with suspect T1a glottic laryngeal carcinoma was referred to our department because of hoarseness that had been going on for the past month. She had no other complaints. The patient was healthy, a non-smoker and had no other risk factors. The examination revealed a well-perfused lesion in the front two thirds of the left vocal cord. Direct laryngomicroscopy under general anesthesia was indicated. During intubation, the lesion was accidentally torn off with the Storz endoscope. During direct laryngoscopy, no lesion was observed, a limited excision of the tumor base was performed. The tissue was sent for urgent PH analysis and mild atypia was observed by the pathologist. Subsequently, bronchoscopy was performed and the aspirate was sent for PH analysis, which revealed that the aspirate contained carcinoma in situ. The patient was followed-up regularly. During the first 6 months postoperatively, the patient was monitored on a monthly basis. Her voice was fine, and she had no other complaints. One year after the surgery, the patient has been checked-up every 2 months and is still without any complaints. Conclusion: In general, direct laryngomicroscopy is a safe operative method with a high success rate. However, considering the localization and the fact that it is performed under general anesthesia, various problems can occur. This case shows that, despite the difficulties that may occur during the surgery, a correct decision at a moment may lead to the desired result. In addition to the patient\u27s survival, which is the most important aim, the quality of life can also be preserved with the right therapeutic method. This was the case with our patient, who has not had any complaints so far, nor has she shown any signs of recurrence of the disease

Asimptomatski apsces mozga uzrokovan kroničnom upalom uha - prikaz slučaja

Bolesnik star 23 godine koji se prati od 2019. godine zbog lijevostrane kronične upale srednjeg uha. Posljednjih nekoliko godina sluh na lijevo uho mu je slabiji, bez tinitusa i vrtoglavice. Indicirana je timpanoplastika lijevo. Prilikom hospitalizacije navodi da je tri tjedna prije termina operacije i hospitalizacije imao kratkotrajnu epizodu febriliteta, bolnost lijevog uha i glavobolju, te je upala liječena lokalno antibiotskim kapima. Laboratorijska obrada učinjena dan prije primitka u bolnicu pokazala je uredne upalne parametre, a predoperativna dijagnostika nije pokazala patoloških osobitosti. Otoskopski se vidjelo obilje sekreta u zvukovodu, te ranije opisivana perforacija u gornjem kvadrantu s nešto upalnog sekreta. U općoj anesteziji, tehnikom CWU (zatvorenom tehnikom timpanomastoidektomije), prilikom širenja stražnje granice mastoidektomije, otvorila se kolekcija gnoja između kosti i dure, te se nakon drenaže gnojnog sadržaja pristupilo otvorenoj tehnici (CWD). Učini se mikrobiološki bris, te se po uklanjanju gnoja vidi oskudna likvoreja i granulacije dure. Eksponirana dura zatvori se graftom hrskavice i temporalne fascije tipa gasket seal. Postoperativno se učini CT, te se opiše intracerebralni apsces lokaliziran temporalno bazalno, iznad piramide lijeve temporalne kosti, veličine 20 mm s intenzivnom rubnom imbibicijom kontrasta, te širokom zonom edema, uz apsces. Na MR s kontrastom opisan je apsces dimenzija 31×19×19 mm temporalno lijevo, uz blaži kompresivni učinak na lijevu lateralnu komoru, uz minimalan pomak struktura središnje linije udesno za 2-3 mm. S obzirom na to da bolesnik nije imao neurološke ispade perioperativno, uz mirne upalne parametre je nakon konzilijarnog pregleda neurokirurga i infektologa indicirano konzervativno liječenje. Započeta je terapija Cefepimom 3×2 g i.v + Medazol 3×500 mg i.v + Vankomicin 2×1.5 g i.v. Mikrobiološkim pregledom brisa apscesa izolirani su Parvimonas micra, Veilonella sp i Finegoldia magna, te je uvedena ciljana terapija ceftriaksonom i medazolom. Kontrolni MR mozga (9. 5. 2023.), dva mjeseca nakon operacije, u komparaciji s prijašnjim nalazom pokazuje dobru regresiju edema lijevog temporalnog režnja, te se opisuje znatno manja apscesna kolekcija veličine 5×6×5 mm