UNILATERAL ARYTENOIDECTOMY FOR INTRACTABLE ASPIRATION FOLLOWING SUPRACRICOID LARYNGECTOMY: A CASE OF SURGICAL DILEMMA

Supracricoid partial laryngectomy (SCPL) is a procedure in which the functions of the larynx are preserved. Swallowing difficulties is the most common functional impairment following SCPL. It has been suggested that sparing the arytenoid cartilages is beneficial for the rapid recovery of the swallowing function after SCPL. In this case report we present a 67-year-old male who underwent SCPL in 2015, in which both arytenoid cartilages were preserved. Following the procedure, the patient had severe aspiration and swallowing problems. In order to save the patient from total laryngectomy a one sided arytenoidectomy was performed successfully. The patient no longer required his gastrostomy tube afer 3 months

The site of the hearing loss in Refsum's disease.

Refsum's disease is a disorder of lipid metabolism with pigmentary retinopathy, demyelinating neuropathy, ataxia, and hearing loss. Previous histological studies have located the site of hearing impairment in the inner ear, but it has never been confirmed audiologicaly in the literature. In this reported case of Refsum's disease, despite hearing loss and absence of response in ABR, robust otoacoustic emissions were measured. Together with these and other audiological findings, we conclude that our case might be the first reported case of Refsum's disease with auditory neuropathy. The site of the hearing abnormality in Refsum's disease may be 'post-outer hair cells' in some cases as in the current case. Because of their limited benefits and risk of noise-induced damage to outer hair cells, the use of hearing aids before otoacoustic emission measurements should be considered cautiously in Refsum's disease. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved

Displacement of a Broken Dental Injection Needle Into the Perivertebral Space

Dental injection needle breakage is an uncommon problem in dental practice. Displacement of the broken fragment into anatomical spaces is, on the other hand, a serious complication that occurs most commonly during inferior alveolar nerve blocks as a result of material wear, incorrect application of the anesthesia technique, or sudden movement of the patient during injection. Further complications such as infection, trismus, and nerve paralysis may exacerbate the condition and, if not treated adequately, life-threatening conditions may develop over time as the fragment dislodges deeper in soft tissues. Clinical symptoms of the patient, as well as the findings gathered from detailed physical examination and radiographic evaluation, are important factors to consider before performing an exploratory surgery. Removal of a broken needle may be troublesome due to its proximity to vital anatomic structures. Multislice computed tomography is a reliable imaging modality that provides accurate information to pinpoint the exact location of the needle fragment.This report describes a case of needle breakage occurred during inferior alveolar nerve block which was performed to extract a third molar tooth and the migration of the broken fragment from the right mandibular ramus area into the perivertebral space, with special emphasis on the surgical retrieval technique with multiplanar computed tomography imaging guidance

An unusual complication of stapes surgery: profuse bleeding from the anteriorly located sigmoid sinus.

Major bleeding during stapes surgery is a rare condition. The anterior course of the sigmoid sinus is comparatively common in contracted mastoid bones, but rare in good pneumatized temporal bones. We report a case of an unusual anterior course of the vertical segment of the sigmoid sinus, which led to profuse bleeding during a stapedotomy operation. The 34-year-old female patient presented with conductive-type hearing loss in the right ear. During the operation, the unintentional sliding movement of a blunt curette caused injury to the anteriorly positioned sigmoid sinus, which was separated from the posterior wall of the external auditory canal by an extremely thin shell of bone. Profuse bleeding from the sigmoid sinus was controlled by pushing the middle part of the oxidised regenerated cellulose inside the lumen, without compromising the sinus flow. After bleeding was restrained, the stapedotomy operation was completed successfully. During the 1-year follow-up, there was neither an air-bone gap nor a sensorineural hearing loss in pure tone audiogram

The Effect of Arytenoidectomy on Functional and Oncologic Results of Supracricoid Partial Laryngectomy

Objective: The effect of arytenoid resection was investigated in patients who had undergone supracricoid partial laryngectomy (SCPL) by comparing functional and oncologic results between patients with both arytenoids preserved with those with one arytenoid resected

Endonasal endoscopic nasopharyngectomy for the treatment of nasopharyngeal papillary adenocarcinoma: Report of a rare case

We report a case of low-grade nasopharyngeal papillary adenocarcinoma in a 9 year-old male that was diagnosed incidentally after an adenoidectomy procedure and treated with endonasal endoscopic nasopharyngectomy without any adjuvant therapy. The patient has been followed up for 3 years with no evidence of recurrence. We point out the importance of preoperative fiberoptic nasopharyngoscopy in the absence of longstanding symptoms in school-aged children and histopathologic examination of adenoidectomy specimens in the presence of atypical findings. We also suggest endonasal endoscopic resection in case of papillary adenocarcinoma

Botulinum Toxin Applications in the Larynx

The primary function of the larynx is protection of the lower respiratory system and, in addition, it facilitates respiration and phonation. Hypertonicity and/or spasm of the laryngeal muscles due to several reasons can cause abnormalities in respiration, digestion and voice. Botulinum toxin has been used successfully in the treatment of adductor spasmodic dysphonia (laryngeal dystonia) for several years. Cricopharyngeal dysphagia, laryngeal tics, laryngeal granulomas and paradoxical vocal cord motions are the other areas, where botulinum toxin can be used. Because of its reversible effects, botulinum toxin is superior to the destructive surgical techniques. In this article, the anatomy and physiology of the larynx is described briefly and botulinum toxin applications in the larynx are discussed. (Archives of Neuropsychiatry 2010; 47 Supplement: 30-4

Rothia mucilaginosa meningitis after sinus surgery: A case report and literature review

Introduction: Rothia mucilaginosa, a member of the family Micrococcaceae, which is a normal flora member of the upper respiratory tract. Infections are very rare, but often causes opportunistic infections in immunosuppressed patients. We report the first case of Rothia mucilaginosa meningitis due to sinus surgery in a healty adult in Turkey. A literature research was done for the meningitis caused by Rothia mucilaginosa until recently