Active surveillance management of head and neck paragangliomas: case series and review of the literature

2017 ◽  
Vol 131 (7) ◽  
pp. 580-584 ◽  
Author(s):  
L Harrison ◽  
R Corbridge
Keyword(s):  
Head And Neck ◽  
Cranial Nerve ◽  
Relevant Literature ◽  
Case Series ◽  
Surgical Excision ◽  
Major Surgery ◽  
Review Of The Literature ◽  
Lower Cranial Nerve ◽  
Cranial Nerve Palsies ◽  
Head And Neck Paragangliomas

AbstractBackground:Head and neck paragangliomas are rare. They are usually slow-growing, benign, non-catecholamine secreting tumours, traditionally treated with surgical excision. Complications of surgical excision include lower cranial nerve palsies, stroke and death.Method:A retrospective case note analysis was conducted of patients with head and neck paragangliomas treated with a watch-and-scan policy from March 2003 to September 2015, and the relevant literature was reviewed.Results:Fifteen head and neck paragangliomas were identified. None of the patients developed a new lower cranial nerve palsy or progression of their presenting hearing loss during the follow-up period. Five patients displayed an increase in maximum linear dimension of 4 mm over an average of 57.4 months. A review of the literature showed that a watch-and-surveillance scan policy is evolving as a treatment option for head and neck paragangliomas without malignant risk factors.Conclusion:Readily available surveillance scanning in head and neck paragangliomas enables the monitoring of head and neck paragangliomas, which may allow for avoidance of major surgery.

scholarly journals Lower Cranial Nerve Palsies in the COVID-19 Pandemic: A 10-Case Series of Intensive Care Unit Patients

2021 ◽  
pp. 1-4
Author(s):  
Pierre Decavel ◽  
Olympe Nahmias ◽  
Carine Petit ◽  
Laurent Tatu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prone Position ◽  
Cranial Nerve ◽  
Nerve Palsy ◽  
Case Series ◽  
University Hospital ◽  
Cranial Neuropathy ◽  
Lower Cranial Nerve ◽  
Cranial Nerve Palsies

<b><i>Introduction:</i></b> A number of neurological complications of COVID-19 have been identified, including cranial nerve paralyses. We present a series of 10 patients with lower cranial nerve involvement after severe COVID-19 infection requiring hospitalization in an intensive care unit. <b><i>Methods:</i></b> We conducted a retrospective, observational study of patients admitted to the post-intensive care unit (p-ICU) of Besançon University Hospital (France) between March 16 and May 22, 2020. We included patients with confirmed COVID-19 and cranial neuropathy at admission to the p-ICU. All these patients were treated by orotracheal intubation, and all but one underwent prone-position ventilation therapy. <b><i>Results:</i></b> Of the 88 patients admitted to the p-ICU, 10 patients (11%) presented at least 1 cranial nerve palsy. Of these 10 patients, 9 had a hypoglossal nerve palsy and 8 of these also had a deficit in another cranial nerve. The most frequent association was between hypoglossal and vagal palsies (5 patients). None of the patients developed neurological signs related to a global neuropathy. We found no correlation between the intensity of the motor limb weakness and the occurrence of lower cranial nerve palsies. All but 2 of the patients recovered within less than a month. <b><i>Conclusion:</i></b> The mechanical compressive hypothesis, linked to the prone-position ventilation therapy, appears to be the major factor. The direct toxicity of SARS-CoV-2 and the context of immune dysfunction induced by the virus may be involved in a multifactorial etiology.

scholarly journals Head and Neck Paragangliomas in the Czech Republic: Management at the Otorhinolaryngology Department

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 28
Author(s):  
Anasuya Guha ◽  
Martin Chovanec
Keyword(s):  
Head And Neck ◽  
Cranial Nerve ◽  
Case Series ◽  
Clinical Aspects ◽  
Benign Tumors ◽  
Tumor Control ◽  
Cranial Nerve Dysfunction ◽  
Critical Issues ◽  
Head And Neck Paragangliomas ◽  
Jugular Paragangliomas

Head and neck paragangliomas (HNPGLs) are rare neuroendocrine tumors, comprising only 3% of all head and neck tumors. Early diagnosis forms an integral part of the management of these tumors. The two main aims of any treatment approach are long-term tumor control and minimal cranial nerve morbidity. The scope of this article is to present our case series of HNPGLs to stress most important clinical aspects of their presentation as well as critical issues of their complex management. Thirty patients with suspected HNPGLs were referred to our otorhinolaryngology clinic for surgical consultation between 2016–2020. We assessed the demographical pattern, clinicoradiological correlation, as well as type and outcome of treatment. A total of 42 non-secretory tumors were diagnosed—16.7% were incidental findings and 97% patients had benign tumors. Six patients had multiple tumors. Jugular paragangliomas were the most commonly treated tumors. Tumor control was achieved in nearly 96% of operated patients with minimal cranial nerve morbidity. Surgery is curative in most cases and should be considered as frontline treatment modality in experienced hands for younger patients, hereditary and secretory tumors. Cranial nerve dysfunction associated with tumor encasement is a negative prognostic factor for both surgery and radiotherapy. Multifocal tumors and metastasis are difficult to treat, even with early detection using genetic analysis. Detecting malignancy in HNPGLs is challenging due to the lack of histomorphological criteria; therefore, limited lymph node dissection should be considered, even in the absence of clinical and radiological signs of metastasis in carotid body, vagal, and jugular paragangliomas.

scholarly journals A Case Series of Malignant Otitis Externa Mimicking Malignancy

2021 ◽  
Vol 64 (1) ◽  
pp. 36-41
Author(s):  
Vengathajalam Selvamalar ◽  
Nik Adilah Nik Othman ◽  
Mohd Khairi Daud
Keyword(s):  
Cranial Nerve ◽  
Otitis Externa ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Case Series ◽  
Lower Cranial Nerve ◽  
Cortical Mastoidectomy ◽  
Cranial Nerve Palsies ◽  
Adjacent Structures ◽  
Malignant Otitis Externa

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

scholarly journals Head and neck inflammatory pseudotumor: Case series and review of the literature

2016 ◽  
Vol 29 (6) ◽  
pp. 440-446 ◽  
Author(s):  
Sagar Kansara ◽  
Diana Bell ◽  
Jason Johnson ◽  
Mark Zafereo
Keyword(s):  
Head And Neck ◽  
Inflammatory Pseudotumor ◽  
Case Series ◽  
Surgical Excision ◽  
Excisional Biopsy ◽  
Disease Recurrence ◽  
Neck Mass ◽  
Level Ii ◽  
Oral Corticosteroids ◽  
Inflammatory Pseudotumors

Inflammatory pseudotumor (IP) is an uncommon idiopathic lesion that often imitates malignancy clinically and radiologically. Inflammatory pseudotumors have been found to occur in various sites but rarely in the head and neck. The histopathology, imaging, and treatment of three unique cases of head and neck inflammatory pseudotumors are described in this case series. Patients in Cases 1 and 2 presented with right level II neck mass and left parotid tail mass, respectively. The patient in Case 3 presented with otalgia, jaw pain and trismus, and a left parapharyngeal space mass. The tumors in Cases 1 and 3 significantly decreased in size with tapered courses of oral corticosteroids. The tumor in Case 2 was surgically excised without disease recurrence. Malignancy must be ruled out with incisional or excisional biopsy. Treatment includes surgical excision, oral corticosteroids, or both. The literature shows that radiotherapy and small-molecule inhibitors may be promising alternatives.

Cranial nerve palsies in patients with hematological malignancies: a case series

2020 ◽  
Vol 130 (8) ◽  
pp. 777-780 ◽  
Author(s):  
Luca Diamanti ◽  
Giulia Berzero ◽  
Diego Franciotta ◽  
Paola Bini ◽  
Milena Furione ◽  
...  
Keyword(s):  
Cranial Nerve ◽  
Hematological Malignancies ◽  
Case Series ◽  
Cranial Nerve Palsies

Nasopharyngeal Mucormycotic Osteitis: A New Syndrome Characterized by Initial Presentation of Multiple Cranial Nerve Palsies

1980 ◽  
Vol 88 (2) ◽  
pp. 146-153 ◽  
Author(s):  
Mamdouh S. Bahna ◽  
Paul H. Ward ◽  
Horst R. Konrad
Keyword(s):  
Cranial Nerve ◽  
Clinical Syndrome ◽  
Review Of The Literature ◽  
Eighth Cranial Nerve ◽  
Nerve Paralysis ◽  
Cranial Nerve Paralysis ◽  
Biopsy Specimens ◽  
Cranial Nerve Palsies ◽  
Base Of The Skull ◽  
Multiple Cranial Nerve

Rhinocerebral mucormycosis, a highly lethal fungal infection of the head and neck, is commonly recognized by its classic appearance. Two cases of this newly recognized clinical syndrome with isolated unilateral peripheral cranial nerve V, VI, VII, IX, X, XI, and XII palsies and initial sparing of the eighth cranial nerve are presented. Examination revealed that each patient had ulceration of the nasopharynx and osteitis of the base of the skull. Nose, orbits, paranasal sinuses, and intracranial nervous systems were initially spared. The cause of this obscure cranial nerve paralysis was diagnosed from biopsy specimens of the nasopharyngeal tissues and the demonstration of nonseptate hyphae. Review of the literature did not indicate that this syndrome had previously been recognized. The name nasopharyngeal mucormycotic osteitis is suggested.

Sign in / Sign up

Export Citation Format

Share Document