Cochlear fistula found in a naturally healed tympanic cavity

1991 ◽  
Vol 105 (8) ◽  
pp. 656-658 ◽  
Author(s):  
Mamoru Suzuki ◽  
Isao Nishida ◽  
Katsuhiro Hirakawa ◽  
Masafumi Nikaido ◽  
Yasuo Harada
Keyword(s):  
Semicircular Canal ◽  
Posterior Wall ◽  
Japanese Woman ◽  
Mastoid Cavity ◽  
Tympanic Cavity ◽  
Ear Canal ◽  
Horizontal Semicircular Canal ◽  
Old Japanese ◽  
History Of ◽  
Exploratory Surgery

AbstractA cochlear fistula found in a naturally healed mastoid cavity is reported. The patient is a 53-year-old Japanese woman who was complaining of unsteadiness. She hada long history of otorrhoea in childhood. Her tympanic and mastoid cavities were widely open and were covered by thin epithelium. The posterior wall of the ear canal was missing. She had no hearing in the ear but responded to electrical promontory testing. Exploratory surgery was indicated at which fistulae of the basal turn of the cochlea and the horizontal semicircular canal were found. These fistulae were sealed by pieces of bone andmuscle.

scholarly journals Neuroleptic malignant syndrome as part of an akinetic crisis associated with sepsis in a patient with Lewy body disease

2019 ◽  
Vol 12 (2) ◽  
pp. bcr-2018-227216 ◽  
Author(s):  
Saki Manabe ◽  
Hidetaka Yanagi ◽  
Hideki Ozawa ◽  
Atsushi Takagi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Lewy Body ◽  
Cardiopulmonary Arrest ◽  
Lewy Body Disease ◽  
Kidney Injury ◽  
Spontaneous Circulation ◽  
Japanese Woman ◽  
Old Japanese ◽  
History Of ◽  
Tentative Diagnosis

A 65-year-old Japanese woman with Parkinson’s disease, later diagnosed with Lewy body disease, presented with a 2-day history of systemic tremors. She also had fever without rigidity or creatine kinase (CK) elevation. She was diagnosed with sepsis caused by pyelonephritis with acute kidney injury and parkinsonism exacerbation. Although antibiotic and fluid therapy improved her pyuria and renal function, her fever and tremors persisted. On the fourth day, her symptoms worsened and resulted in cardiopulmonary arrest; however, quick resuscitation allowed the return of spontaneous circulation. Simultaneously, hyperthermia, altered consciousness, extrapyramidal symptoms, dysautonomia and CK elevation were noted. Thus, dantrolene administration was initiated with a tentative diagnosis of neuroleptic malignant syndrome (NMS). This caused her fever to subside, and her symptoms gradually improved. It was difficult to distinguish between parkinsonism exacerbation associated with sepsis and NMS. Physicians should consider NMS early on, even if the patient does not fulfil the diagnostic criteria.

scholarly journals Tissue Hypoperfusion, Hypercoagulopathy, and Kidney and Liver Dysfunction after Ingestion of a Naphazoline-Containing Antiseptic

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yuko Ono ◽  
Nozomi Ono ◽  
Kazuaki Shinohara
Keyword(s):  
Liver Dysfunction ◽  
Laboratory Data ◽  
Japanese Woman ◽  
Over The Counter ◽  
Tissue Hypoperfusion ◽  
First Case ◽  
Old Japanese ◽  
History Of ◽  
History Of Depression ◽  
Adrenergic Receptor Agonist

Naphazoline is a peripheral α2-adrenergic receptor agonist commonly used as a topical decongestant. In Japan, over-the-counter antiseptics often contain naphazoline to effect local hemostasis. We present the first case involving the development of hypercoagulopathy, with kidney and liver dysfunction, following a naphazoline overdose. A 22-year-old Japanese woman with a history of depression ingested 160 mL of a commercially available antiseptic containing 0.1% naphazoline. Three days later, she was brought to the emergency department because of general fatigue, nausea, and vomiting. Physical examination revealed cool, pale extremities. Laboratory data showed evidence of severe kidney and liver dysfunction (creatinine, 9.2 mg/dL; alanine aminotransferase, 2948 IU/L), hypercoagulation (D-dimers, 58.3 μg/mL), and thrombocytopenia (platelet count, 90,000/μL). After infusion of normal saline, intravenous administration of alprostadil, and hemodiafiltration, her organ function completely recovered. Because both the kidney and liver express α2-adrenergic receptors, their failure was likely associated with naphazoline overdose-induced hypoperfusion. The most plausible causes of hypercoagulation are peripheral low perfusion and subsequent microthrombus formation. This case illustrates that severe organ dysfunction can occur following over-the-counter antiseptic ingestion and serves as a caution for both drug manufacturers and healthcare professionals.

scholarly journals Dermoscopic Features of Pigmented Bowen's Disease in a Japanese Female Mimicking Malignant Melanoma

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Takayuki Inoue ◽  
Ken Kobayashi ◽  
Mizuki Sawada ◽  
Sumiko Ishizaki ◽  
Haruo Ito ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Skin Lesions ◽  
Japanese Woman ◽  
Bowen’S Disease ◽  
Seborrheic Keratosis ◽  
Bowen's Disease ◽  
Pathologic Features ◽  
Old Japanese ◽  
History Of ◽  
Pigmented Skin Lesions

Various structures have been reported for dermoscopic features of pigmented Bowen's disease (BD), which could be a mimic of various pigmented skin lesions. A 79-year-old Japanese woman presented with a 3-year history of brown-black macule on her right upper arm without symptom. Dermoscopic examination demonstrated irregular flossy streaks, irregular brown dots/globules, blue-whitish regression structures, and overlaying whitish scaly areas. We suspected pigmented skin lesions including seborrheic keratosis, pigmented eccrine poroma, and malignant melanoma and excised completely with a 5 mm margin. Histopathological features were consistent with a diagnosis of pigmented BD. Although similar dermoscopic features might be revealed in pigmented skin lesions and it may occasionally be difficult to distinguish between pigmented BD and other pigmented skin lesions, dermoscopy would be useful in speculating pathologic features of pigmented BD.

scholarly journals Pulsatile nystagmus secondary to semicircular canal dehiscence

2018 ◽  
Vol 11 (1) ◽  
pp. e225963
Author(s):  
Mohamed Hawwas ◽  
Emily Young ◽  
Virangna Taneja ◽  
Darius Rejali
Keyword(s):  
Clinical Sign ◽  
Semicircular Canal ◽  
Mastoid Cavity ◽  
Lateral Semicircular Canal ◽  
Pendular Nystagmus ◽  
History Of ◽  
Cavity Obliteration ◽  
Canal Dehiscence

We report the case of a 69-year-old man with a history of mastoidectomy for cholesteatoma, who developed spontaneous spinning vertigo on debridement of his cavity. Subsequent CT confirmed a lateral semicircular canal fistula, which was surgically closed with mastoid cavity obliteration. Following surgery, he developed a spontaneous, pulse-synchronous horizontal pendular nystagmus. We discuss the pathophysiology of this rare clinical sign.

Congenital cholesteatoma of mastoid origin

2007 ◽  
Vol 121 (11) ◽  
Author(s):  
J H Lee ◽  
S J Hong ◽  
C H Park ◽  
S H Jung
Keyword(s):  
Posterior Fossa ◽  
External Auditory Canal ◽  
Semicircular Canals ◽  
Posterior Wall ◽  
Sigmoid Sinus ◽  
Mastoid Cavity ◽  
Congenital Cholesteatoma ◽  
Computed Tomography Scanning ◽  
History Of ◽  
The Right

AbstractObjective:We report an extremely rare case of congenital cholesteatoma of mastoid origin.Case report:A male patient was admitted with a one-month history of dizziness and headache, plus tinnitus in the right ear. Computed tomography scanning of the temporal bone showed destruction of the posterior wall of the external auditory canal by a lesion of soft tissue density in the right mastoid cavity, and also destruction of the bony plates of the posterior fossa and the sigmoid sinus, and of the mastoid tegmen. During surgery, a huge cholesteatoma sac was observed in the mastoid cavity, containing a large amount of keratinous material. The tegmen mastoideum and the bony plates of the posterior fossa and the sigmoid sinus were also observed to be destroyed. The skin and the tympanic membrane of the external auditory canal were intact, and the middle ear and aditus ad antrum mucosa were normal. The huge cholesteatoma sac was completely excised via a partial translabyrinthine approach, eradicating the superior and posterior semicircular canals.Conclusion:This case of congenital cholesteatoma of mastoid origin was diagnosed by clinical examination, radiological evaluation and surgical findings.

Disseminated neurenteric cyst

2008 ◽  
Vol 9 (4) ◽  
pp. 382-386 ◽  
Author(s):  
Muneyoshi Yasuda ◽  
Hiroshi Nakagawa ◽  
Hiroaki Ozawa ◽  
Chikage Inukai ◽  
Takeya Watabe ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Japanese Woman ◽  
Neurenteric Cyst ◽  
Cerebrospinal Fluid Circulation ◽  
Unsteady Gait ◽  
Old Japanese ◽  
History Of ◽  
Cyst Membrane ◽  
Upper Thoracic ◽  
Cyst Fenestration

This case report presents the unusual holospinal dissemination of a neurenteric cyst, which was successfully treated by fenestration and placement of a subarachnoid-peritoneal (SP) shunt. The patient was a 46-year-old Japanese woman with a history of fourth ventricle neurenteric cysts, which were managed with cyst fenestration in 1996 and 2005. She had been doing well until January 2006, when she developed dizziness and an unsteady gait. A neurological examination revealed a disturbance in the deep sensation of the feet. A neuroimaging evaluation demonstrated multiple cystic lesions in the whole spinal canal, which significantly distorted the spinal cord. Because the spinal cord distortion was the most severe in the lower cervical to upper thoracic areas, a unilateral osteoplastic laminotomy with an endoscopic cyst fenestration was performed in these areas, followed by placement of an SP shunt. The pathological diagnosis was a disseminated neurenteric cyst. There was no malignancy, and the patient has been well, with an improved gait and no signs of peritoneal dissemination, for > 1 year. The present case showed a unique extent of dissemination, which was most likely a secondary characteristic. Neurenteric cysts are well known for their tendency to recur, and total removal is usually difficult because of adhesion of the cyst membrane to important structures. The lesion also compromises cerebrospinal fluid circulation. Cyst fenestration combined with SP shunt placement might be a treatment option in such a case.

scholarly journals A Case of Right Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo with to-and-fro Canal Switch to Right Horizontal Semicircular Canal

2020 ◽  
Vol 3 (01) ◽  
pp. 27-34
Author(s):  
Ajay Kumar Vats
Keyword(s):  
Case Report ◽  
Semicircular Canal ◽  
Early Morning ◽  
Optimal Time ◽  
Vertical Position ◽  
Horizontal Semicircular Canal ◽  
History Of ◽  
The One ◽  
The Right ◽  
Cervical Rotation

Abstract Background Canal switch in BPPV is a phenomenon occurring after therapeutic canalith repositioning maneuvers (CRM), when there is a reflux of the repositioned otoconial debris from utricle to semicircular canal other than the one originally affected. It may be of immediate-type occurring within minutes after CRM or a delayed-type occurring after 2-3 days. Aim The study is a case report. Case Report A 59-year-old female presented with history of severe rotational vertigo as she got up from the bed in the early morning at 5.00 a.m.. Dix-Hallpike test (DHT) on the right elicited an upbeating positional nystagmus (PN). Treatment with multiple consecutive modified right Epley maneuvers (r-MEM) in one session was undertaken. During these maneuvers she continued to have an upbeating PN during the 45-degrees right cervical rotation with the neck in 20-degrees of extension (which is equivalent to right Dix-Hallpike positioning) of the first three sequential r-MEM’s. With the neck maintained in 20-degrees of extension, during fourth consecutive r-MEM, the 45-degrees cervical rotation to right elicited apogeotropic horizontal PN. Supine roll test (SRT) was immediately undertaken. Maximal head yaw positioning to right as well as to the left elicited apogeotropic horizontal PN without torsional component lasting more than one minute, indicating reflux of otoconia from the right P-SCC to the short anterior arm of right H-SCC. She was treated with two sequences of Appiani maneuver and SRT one hour later elicited geotropic upbeating PN with vertigo, indicating second canal switch to P-SCC. It was successfully treated with two sequences of right EM fifteen minutes apart, with instructions to stay upright in between and after the maneuvers. At 24 hours, repeat DHT and SRT were negative and patient was asymptomatic. Conclusion An optimal time delay to perform a verifying positional test after therapeutic session with CRM is crucial to prevent the immediate type of reflux of relocated otoconia from the utricle into a different semicircular canal. In centers, where more than a single EM is performed in a single session of treatment, a delay of 10 to 15 minutes appears to be appropriate between successive maneuvers. A certain period of restraint in the vertical position after CRM may prevent immediate reflux, but this needs to be confirmed by the randomized control trials.

scholarly journals Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion

2021 ◽  
pp. 73-76
Author(s):  
Shinjiro Kono ◽  
Patricia Ann L. Lee ◽  
Hirohiko Kakizaki ◽  
Yasuhiro Takahashi
Keyword(s):  
Differential Diagnosis ◽  
Japanese Woman ◽  
Soft Tissue Lesion ◽  
Palpebral Conjunctiva ◽  
Biopsy Specimens ◽  
Body Sensation ◽  
Old Japanese ◽  
History Of ◽  
The Right ◽  
Conjunctival Lesion

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.

scholarly journals Coincidence of Large Adrenal Cyst and Prominent Hyporeninemic Hyperaldosteronism

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Takaaki Sakaue ◽  
Yosuke Okuno ◽  
Kosuke Mukai ◽  
Shingo Fujita ◽  
Junji Kozawa ◽  
...  
Keyword(s):  
Japanese Woman ◽  
Vascular Endothelial ◽  
Abdominal Ct ◽  
Adrenal Cyst ◽  
Old Japanese ◽  
Resected Tumor ◽  
History Of ◽  
Endothelial Cyst ◽  
Stage Renal Disease ◽  
End Stage

A 67-year-old Japanese woman who had end-stage renal disease was referred to our hospital for kidney transplantation. Abdominal CT revealed a large adrenal mass with inhomogeneity. She had a history of hospitalization for stroke and heart failure and exhibited prominent hyporeninemic hyperaldosteronism. Histological examination of the resected tumor with anti-CYP11B2 antibody indicated that she had a vascular endothelial cyst with primary aldosteronism (PA) due to multiple adrenocortical micronodules. This report implicates the pathological interaction between adrenal vascular cysts and PA-mediated vascular damage of the adrenal vein.

scholarly journals A Fatal Case of Relapsing Pneumonia Caused by Legionella pneumophila in a Patient with Rheumatoid Arthritis After Two Injections of Adalimumab

2013 ◽  
Vol 6 ◽  
pp. CCRep.S11641 ◽  
Author(s):  
Masatoshi Hayashi ◽  
Hiroshi Kuraishi ◽  
Takeshi Masubuchi ◽  
Kaneyuki Furihata ◽  
Yuka Aida ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Antibiotic Therapy ◽  
Legionella Pneumophila ◽  
Fatal Case ◽  
Japanese Woman ◽  
First Episode ◽  
Pertinent Literature ◽  
Intravenous Antibiotic ◽  
Old Japanese ◽  
History Of

We present a rare fatal case of relapsing pneumonia caused by Legionella pneumophila in a patient with rheumatoid arthritis after only two injections of adalimumab. A 78-year-old Japanese woman with a 14-year history of rheumatoid arthritis was prescribed adalimumab because her disease activity remained high. However, 8 days after her second injection of adalimumab, she was admitted to our hospital and diagnosed with pneumonia caused by L. pneumophila. Following intravenous antibiotic therapy, she recovered completely from pneumonia and was discharged on day 10, but pneumonia relapsed, resulting in death 79 days after the first episode of pneumonia. L. pneumophila can lead to recurrence of pneumonia that can ultimately prove fatal, similar to the present case. A review of the pertinent literature is also presented.

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