scholarly journals Wholly Endoscopic Permeatal Removal of a Petrous Apex Cholesteatoma

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Todd Kanzara ◽  
Jagdeep Singh Virk ◽  
Sanjiv Chawda ◽  
Anthony O. Owa
Keyword(s):  
Case Report ◽  
Facial Palsy ◽  
Relevant Literature ◽  
Epileptic Seizures ◽  
Petrous Apex ◽  
Initial Decision ◽  
Profound Deafness ◽  
The Face ◽  
Facial Reanimation ◽  
History Of

We report a case of a petrous apex cholesteatoma which was managed with a wholly endoscopic permeatal approach. A 63-year-old Caucasian male presented with a 10-year history of right-sided facial palsy and profound deafness. On examination in our clinic, the patient had a grade VI House-Brackmann paresis, otoscopic evidence of attic cholesteatoma behind an intact drum, and extensive scarring of the face from previous facial reanimation surgery. Imaging review was suggestive of petrous apex cholesteatoma. An initial decision to manage the patient conservatively was later reviewed on account of the patient suffering recurrent epileptic seizures. A wholly endoscopic permeatal approach was used with successful outcomes. In addition to the case report we also provide a brief description of the technique and a review of the relevant literature.

Deep Temporal Nerve Transfer for Facial Reanimation: Anatomic Dissections and Surgical Case Report

2017 ◽  
Vol 15 (1) ◽  
pp. 81-88
Author(s):  
Mark A Mahan ◽  
Walavan Sivakumar ◽  
David Weingarten ◽  
Justin M Brown
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Nerve Transfer ◽  
Lateral Approach ◽  
Multiple Sources ◽  
Facial Muscles ◽  
First Case ◽  
The Face ◽  
Facial Reanimation ◽  
History Of

Abstract BACKGROUND Facial nerve palsy is a disabling condition that may arise from a variety of injuries or insults and may occur at any point along the nerve or its intracerebral origin. OBJECTIVE To examine the use of the deep temporal branches of the motor division of the trigeminal nerve for neural reconstruction of the temporal branches of the facial nerve for restoration of active blink and periorbital facial expression. METHODS Formalin-fixed human cadaver hemifaces were dissected to identify landmarks for the deep temporal branches and the tension-free coaptation lengths. This technique was then utilized in 1 patient with a history of facial palsy due to a brainstem cavernoma. RESULTS Sixteen hemifaces were dissected. The middle deep temporal nerve could be consistently identified on the deep side of the temporalis, within 9 to 12 mm posterior to the jugal point of the zygoma. From a lateral approach through the temporalis, the middle deep temporal nerve could be directly coapted to facial temporal branches in all specimens. Our patient has recovered active and independent upper facial muscle contraction, providing the first case report of a distinct distal nerve transfer for upper facial function. CONCLUSION The middle deep temporal branches can be readily identified and utilized for facial reanimation. This technique provided a successful reanimation of upper facial muscles with independent activation. Utilizing multiple sources for neurotization of the facial muscles, different potions of the face can be selectively reanimated to reduce the risk of synkinesis and improved control.

A Case of Unrelenting Facial Swelling

2022 ◽  
pp. 074880682110701
Author(s):  
Lindsay Y. Chun ◽  
Paul O. Phelps
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Facial Palsy ◽  
Radiographic Imaging ◽  
Presenting Symptoms ◽  
Difficult Diagnosis ◽  
Facial Swelling ◽  
The Face ◽  
History Of ◽  
Patient’S History

Melkersson-Rosenthal syndrome (MRS) is an uncommon disorder with presenting symptoms that typically involve the face and orofacial structures. It is a difficult diagnosis to make, as it may present with a protracted course of seemingly unrelated dermatological, ocular, and neurological findings. This case report reviews the presentation, workup, and diagnosis of a 75-year-old woman who presented with orofacial swelling, facial palsy, and tongue fissuring that had intermittently recurred over 10 years without a unifying diagnosis. Extensive medical history, photography, laboratory workup, and radiographic imaging were performed to identify the diagnosis of MRS in this patient. Our case highlights the challenge and importance of critically evaluating and consolidating a patient’s history of their present illness, physical examination, and ancillary testing to successfully establish a unifying diagnosis, especially when the diagnosis is relatively rare and diverse in its range of affected populations and symptomatology.

Epilogue: On the Current and Future State of Historical Writing

2018 ◽  
Author(s):  
Allan Megill
Keyword(s):  
Historical Writing ◽  
Conceptual Difficulty ◽  
Universal History ◽  
The Past ◽  
Initial Decision ◽  
Future State ◽  
The Face ◽  
History Of

This epilogue argues that historians ought to be able to produce a universal history, one that would ‘cover’ the past of humankind ‘as a whole’. However, aside from the always increasing difficulty of mastering the factual material that such an undertaking requires, there exists another difficulty: the coherence of universal history always presupposes an initial decision not to write about the human past in all its multiplicity, but to focus on one aspect of that past. Nevertheless, the lure of universal history will persist, even in the face of its practical and conceptual difficulty. Certainly, it is possible to imagine a future ideological convergence among humans that would enable them to accept, as authoritative, one history of humankind.

scholarly journals Osteoporosis-Related Simultaneous Four Joints Fractures and Dislocation after a Seizure: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-4
Author(s):  
Abdullah S. AlOmran
Keyword(s):  
Vitamin D ◽  
Case Report ◽  
Clinical Examination ◽  
Epileptic Seizures ◽  
Antiresorptive Therapy ◽  
Multiple Fractures ◽  
Steroid Use ◽  
Skeletal Injury ◽  
History Of ◽  
Rule Out

A case of steroid-induced osteoporosis-related multiple fractures and dislocations are described after a seizure is reported. Patient had two years history of steroid use with no supplement or antiresorptive therapy. There was a delay in the diagnosis which affected an otherwise good outcome in such situations. It is recommended that patients on steroid should be given calcium, vitamin D, and an antiresorptive. Furthermore, a meticulous clinical examination is required in patients who are on steroids and suffer epileptic seizures to rule out skeletal injury.

scholarly journals Reversible splenial lesion syndrome due to oxcarbazepine withdrawal: case report and literature review

2018 ◽  
Vol 46 (3) ◽  
pp. 1277-1281 ◽  
Author(s):  
Chaoyang Jing ◽  
Lichao Sun ◽  
Zhuo Wang ◽  
Chaojia Chu ◽  
Weihong Lin
Keyword(s):  
Case Report ◽  
Corpus Callosum ◽  
Epileptic Seizures ◽  
Resonance Imaging ◽  
Splenial Lesion ◽  
History Of ◽  
Reversible Lesion ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Splenial Lesion Syndrome

Background Reversible splenial lesion syndrome is a distinct entity radiologically characterized by a reversible lesion in the splenium of the corpus callosum. According to previous reports, this condition may be associated with antiepileptic drug use or withdrawal. We herein report a case of reversible splenial lesion syndrome associated with oxcarbazepine withdrawal. Case Report A 39-year-old man presented with an 8-year history of epileptic seizures. During the previous 3 years, he had taken oxcarbazepine irregularly. One week prior to admission, he withdrew the oxcarbazepine on his own, and the epilepsy became aggravated. Magnetic resonance imaging (MRI) revealed an isolated lesion in the splenium of the corpus callosum with slight hypointensity on T1-weighted imaging and slight hyperintensity on T2-weighted imaging. Regular oxcarbazepine was prescribed. Over a 5-month follow-up period, repeat MRI showed that the abnormal signals in the splenium of the corpus callosum had completely disappeared. Conclusion Reversible splenial lesion syndrome is a rare clinicoradiological disorder that can resolve spontaneously with a favorable outcome. Clinicians should be aware of this condition and that oxcarbazepine withdrawal is a possible etiological factor.

scholarly journals Extensive Subcutaneous Emphysema and Pneumomediastinum after Ecstasy Ingestion

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
A. Gungadeen ◽  
J. Moor
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Young Adult ◽  
Conservative Management ◽  
Subcutaneous Emphysema ◽  
Rare Case ◽  
Relevant Literature ◽  
Radiological Imaging ◽  
Neck Swelling ◽  
History Of

Objective. To present a rare case of extensive subcutaneous emphysema and spontaneous pneumomediastinum following ingestion of Ecstasy in a young adult. We also review the relevant literature and discuss how this case supplements it.Case Report. We report a case of a 19-year-old man with a history of painless neck and chest swelling, and no chest pain or breathlessness, after consuming Ecstasy tablets. Radiological imaging showed evidence of pneumomediastinum and extensive subcutaneous emphysema. The patient remained well under observation and his symptoms improved with conservative management.Conclusions. Subcutaneous emphysema and pneumomediastinum after Ecstasy ingestion is uncommon. Cases are often referred to the otolaryngologist as they can present with neck and throat symptoms. Our case showed that the severity of symptoms may not correlate with severity of the anatomical abnormality and that pneumomediastinum should be suspected in Ecstasy users who present with neck swelling despite the absence of chest symptoms. Although all cases reported so far resolved with conservative management, it is important to perform simple investigations to exclude coexisting serious pathology.

scholarly journals Spontaneous subcutaneous emphysema in a male toddler in a health facility in Nasarawa state: A case report

2021 ◽  
Vol 2 ◽  
pp. 53-55
Author(s):  
Surajudeen Oyeleke Bello ◽  
Sandra Umejiaku ◽  
Taofik Oluwaseun Ogunkunle ◽  
Oyetundun Fausat Afolabi ◽  
Ahmed Ashuku Yakubu
Keyword(s):  
Case Report ◽  
Supportive Care ◽  
Subcutaneous Emphysema ◽  
Complete Resolution ◽  
Rare Complication ◽  
Childhood Pneumonia ◽  
Peripheral Hospital ◽  
The Face ◽  
History Of ◽  
Subcutaneous Tissues

Background: Spontaneous subcutaneous emphysema (SSE) is a clinical condition in which air escapes into the subcutaneous tissues. It is a rare complication of childhood pneumonia and often occurs with pneumothorax and/or pneumomediastinum. Although the sight of a child with SSE could be frightening, it is mostly benign requiring in most cases supportive care. We report a case of SSE complicating pneumonia in an 18-month-old toddler that was managed conservatively. Case Report: An 18-months-old toddler was admitted with a 5-day history of progressive swelling of the face, scalp, upper limbs, and trunk. He was referred from a peripheral hospital where he was admitted for 5 days with pneumonia and had received antibiotics, intravenous fluid, and oxygen therapy. Clinical evaluation revealed extensive subcutaneous emphysema and right-sided pneumothorax. Antibiotics were optimized and the patient was provided supportive care and monitored for 7 days with complete resolution of the emphysema. Conclusion: SSE could complicate childhood pneumonia but it has a benign course. Effective treatment of underlying pneumonia alongside supportive care will achieve complete resolution.

scholarly journals Dieulafoy’s lesion of the rectum: a case report and review of the literature

2017 ◽  
Vol 05 (09) ◽  
pp. E939-E942 ◽  
Author(s):  
Mo Wang ◽  
Xiang Bu ◽  
Jing Zhang ◽  
Shanshan Zhu ◽  
Ying Zheng ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Practice ◽  
Gastrointestinal Bleeding ◽  
Gastrointestinal Disease ◽  
Relevant Literature ◽  
Clinical Manifestations ◽  
Review Of The Literature ◽  
Dieulafoy’S Lesion ◽  
Surgical Interventions ◽  
History Of

AbstractOne patient with Dieulafoy’s lesion (DL) of the rectum who had a history of anal receptive intercourse is described and the relevant literature reviewed. DL is rare in clinical practice and is extremely rare in the rectum. It often affects patients with no history of cirrhosis or gastrointestinal disease and occurs with abrupt or recurrent gastrointestinal bleeding. Visible vessels can usually be found by endoscopy and coinstantaneous treatments are essential while surgical interventions can occur when necessary. The diagnosis of DL is mainly based on clinical manifestations and endoscopic features, and endoscopic treatment is the first option for hemostasis.

scholarly journals Retrosigmoid approach for resection of petrous apex meningioma

2014 ◽  
Vol 36 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Daniel G. de Souza ◽  
Leo F. S. Ditzel Filho ◽  
Girma Makonnen ◽  
Matteo Zoli ◽  
Cristian Naudy ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Retrosigmoid Approach ◽  
Petrous Apex ◽  
Total Removal ◽  
Who Grade ◽  
Facial Numbness ◽  
The Face ◽  
History Of ◽  
The Right ◽  
Neurologically Intact

We present the case of a 50-year-old female with a 1-year history of right-side facial numbness, as well as an electric shock-like sensation on the right-side of the face and tongue. She was previously diagnosed with vertigo and trigeminal neuralgia. MRI was obtained showing a large right cerebellopontine angle mass. A retrosigmoid approach was performed and total removal was achieved after dissection of tumor from brainstem and cranial nerves IV, V, VI, VII and VIII. Pathology confirmed the diagnosis of a meningioma (WHO Grade I). The patient was discharged neurologically intact on the third postoperative day free of complications.The video can be found here: http://youtu.be/-tR0FtMiUDg.

Posterior orbital cellulitis: case report and literature review

2013 ◽  
Vol 127 (11) ◽  
pp. 1148-1151 ◽  
Author(s):  
K Allan ◽  
H Atkinson ◽  
F Agada
Keyword(s):  
Case Report ◽  
Relevant Literature ◽  
Clinical Signs ◽  
Visual Disturbance ◽  
Orbital Cellulitis ◽  
Sphenoid Sinusitis ◽  
Intravenous Antibiotics ◽  
Permanent Loss ◽  
History Of ◽  
The Right

AbstractIntroduction:It is rare for isolated sphenoid sinusitis to cause orbital cellulitis. We present a rare case of posterior orbital cellulitis, so caused, together with a review of the relevant literature.Case report:A 29-year-old woman presented with a 6-week history of progressive, unilateral, retro-orbital and periorbital right eye pain. On examination, the only finding was reduced visual acuity in the right eye. A computed tomography scan demonstrated right frontal and sphenoid sinus opacification. Sphenoidotomy and frontal sinus trephination were subsequently performed, following failure to respond to intravenous antibiotics. After surgery, the patient's vision returned to normal.Conclusion:Isolated sphenoid sinusitis is rare but can cause significant visual disturbance and permanent loss of vision. Vague symptoms unsupported by clinical signs at presentation are a feature of posterior orbital cellulitis. The presented case highlights the problem, and the need for a high index of clinical suspicion even in the absence of firm clinical signs, in order to prevent permanent visual loss.

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