scholarly journals Fungus ball in concha bullosa, an unusual site: a case report from hilly region

2017 ◽  
Vol 4 (1) ◽  
pp. 301
Author(s):  
Shaweta . ◽  
R. S. Minhas ◽  
Vineeta Sharma ◽  
Santwana Verma ◽  
Trilok C. Guleria
Keyword(s):  
Case Report ◽  
Sphenoid Sinus ◽  
Case Reports ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Concha Bullosa ◽  
Rare Presentation ◽  
Unusual Site ◽  
Hilly Region

<p class="abstract"><span lang="EN-IN">Fungus is a rare cause of rhinosinusitis in children. Its incidence has been reported as ranging between 13.5 and 28%. Fungus balls are extramucosal tangled masses of fungal hyphae. It commonly involves just one paranasal sinus. Most commonly maxillary sinus is involved and occasionally sphenoid sinus. Concha bullosa is one of the most common anatomical variations in the nasal cavity, with a frequency of reporting ranging from 14-53.6%. There are very few case reports in which Concha bullosa was affected with fungus ball. In this case report 13 years female child presented with complaints of swelling right cheek. The patient underwent endoscopic sinus surgery and there was involvement of concha bullosa and sphenoid sinus with fungus ball. Fungus was confirmed on microscopic examination and culture. Fungus ball is a rare presentation of fungal rhinosinusitis. It should be considered in enlarged middle turbinate with heterogenous opacity on CT. The diagnosis should be confirmed by microscopy or culture.</span></p>

scholarly journals Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Christina Walker ◽  
Vincent Peyko ◽  
Charles Farrell ◽  
Jeanine Awad-Spirtos ◽  
Matthew Adamo ◽  
...  
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Case Reports ◽  
Healthy Woman ◽  
Signs And Symptoms ◽  
Rare Presentation ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Novel Coronavirus

Abstract Background This case report demonstrates pericardial effusion, acute pericarditis, and cardiac tamponade in an otherwise healthy woman who had a positive test result for coronavirus disease 2019. Few case reports have been documented on patients with this presentation, and it is important to share novel presentations of the disease as they are discovered. Case presentation A Caucasian patient with coronavirus disease 2019 returned to the emergency department of our hospital 2 days after her initial visit with worsening chest pain and shortness of breath. Imaging revealed new pericardial effusion since the previous visit. The patient became hypotensive, was taken for pericardial window for cardiac tamponade with a drain placed, and was treated for acute pericarditis. Conclusion Much is still unknown about the implications of coronavirus disease 2019. With the novel coronavirus disease 2019 pandemic, research is still in process, and we are slowly learning about new signs and symptoms of the disease. This case report documents a lesser-known presentation of a patient with coronavirus disease 2019 and will help to further understanding of a rare presentation.

Examining the Safety of Nasogastric Tube Placement after Endoscopic Sinus Surgery

1998 ◽  
Vol 107 (8) ◽  
pp. 662-664 ◽  
Author(s):  
Neil Bhattacharyya ◽  
Harsha V. Gopal
Keyword(s):  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Tube Placement ◽  
Nasogastric Intubation ◽  
Nasogastric Tubes ◽  
Fresh Cadaver ◽  
Nasogastric Tube Placement

Several cases of intracranial injury during the placement of nasogastric tubes have been reported, usually in the setting of anterior skull base fractures. The fovea ethmoidalis and sphenoid sinus are often exposed after endoscopic sinus surgery, so that these structures are potentially placed in the line of contact during nasogastric tube placement. In order to evaluate the ability of the fovea ethmoidalis and roof of the sphenoid sinus to withstand penetration from possible contact during nasogastric tube placement, 12 fresh cadaver heads were studied. After complete endoscopic ethmoidectomy and wide sphenoidotomy, standard 18F and 16F nasogastric tubes were inserted to produce deliberate direct contact with both the fovea ethmoidalis and the sphenoid sinus roof. No penetrations of the fovea occurred in 20 specimen sides with the 18F tube; penetration did occur with the 16F tube in 1 of 13 sides (7.7%). With respect to the sphenoid sinus, no intracranial penetrations occurred in 16 and 11 sides for the 18F and 16F tubes, respectively. The sphenoid sinus was easily entered even in the presence of an intact middle turbinate. These data suggest that although intracranial penetration during nasogastric intubation after endoscopic sinus surgery is an unlikely event, there is a non-negligible risk of such injury. Nasogastric intubation should be performed with caution in patients with a history of sinus surgery.

Polyps originating from accessory middle turbinate and secondary middle turbinate

2012 ◽  
Vol 126 (7) ◽  
pp. 729-732 ◽  
Author(s):  
H Jung ◽  
S K Park ◽  
J-R Kim
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
World Literature ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Histopathological Analysis ◽  
Middle Meatus ◽  
The World ◽  
Paranasal Sinus Computed Tomography

AbstractObjective:We report two extremely rare cases of polyps from unilateral accessory middle turbinates, one of which coexisted with a polyp from an inferomedially projecting, pneumatised, secondary middle turbinate.Methods:Case report and literature review concerning accessory middle turbinate and secondary middle turbinate.Results:Two patients presented with unilateral nasal obstruction. In both patients, nasal endoscopy revealed polypoid masses originating from the middle meatus. Paranasal sinus computed tomography and histopathological analysis confirmed the presence of polyps originating from an accessory middle turbinate and secondary middle turbinate, which were resected uneventfully via endoscopic sinus surgery.Conclusion:To our knowledge, this is the first report in the world literature of polyps originating from a unilateral accessory middle turbinate and secondary middle turbinate. Pre-operative recognition of these rare anatomical variations is of particular importance in avoiding intra-operative complication.

Recurrent facial paraesthesia secondary to maxillary antral cyst and dehiscent infraorbital canal: case report

2007 ◽  
Vol 121 (6) ◽  
pp. 1-2 ◽  
Author(s):  
N Sharma ◽  
M De ◽  
P Pracy
Keyword(s):  
Case Report ◽  
Atmospheric Pressure ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Infraorbital Nerve ◽  
Rare Presentation ◽  
Infraorbital Canal ◽  
Computed Tomography Scanning ◽  
Nerve Dysfunction ◽  
Tomography Scanning

Objectives: To report a rare presentation of dehiscent infraorbital canal associated with a maxillary antral cyst.Case report: A 26-year-old woman presented with symptoms of right infraorbital nerve dysfunction experienced while travelling by aeroplane. She was subsequently diagnosed with dehiscent infraorbital canal and large maxillary antral cyst on computed tomography scanning. The cyst was removed by endoscopic sinus surgery, and the patient's symptoms resolved.Discussion: The effects of barotrauma on the ears and paranasal sinuses are reviewed. This is the first report of infraorbital nerve dysfunction caused by altered atmospheric pressure in the presence of dehiscent infraorbital canal and maxillary antral cyst. Endoscopic sinus surgery was successful in relieving the symptoms in this case.

scholarly journals Oral Phenytoin Toxicity Causing Sinus Arrest: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Ravi K. Thimmisetty ◽  
Janardhana Rao Gorthi ◽  
Mahmoud Abu Hazeem
Keyword(s):  
Case Report ◽  
Cardiac Toxicity ◽  
Case Reports ◽  
Sinus Node ◽  
Seizure Disorder ◽  
Sinus Arrest ◽  
Rare Presentation ◽  
Phenytoin Toxicity

We present a case of sinus node arrest leading to symptomatic junctional bradycardia from oral phenytoin toxicity, which is a rare presentation. Our patient had no prior cardiac history and was on phenytoin therapy for seizure disorder. Although bradycardia is more commonly associated with intravenous phenytoin and there were few case reports of bradycardia with oral phenytoin reported, the literature is limited. In this case report, we also reviewed the pathophysiology of phenytoin-induced cardiac toxicity.

scholarly journals Subacute Thyroiditis After SARS-CoV-2 Infection Presenting With Pyrexia of Unknown Origin

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A957-A957
Author(s):  
Santosh Singh
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Unknown Origin ◽  
Subacute Thyroiditis ◽  
Pathophysiological Mechanism ◽  
Rare Presentation ◽  
Pyrexia Of Unknown Origin ◽  
Upper Limit ◽  
First Case ◽  
Heart Rhythm Disorders

Abstract Subacute thyroiditis(SAT) is associated with viral(destructive) or post-viral(inflammatory) origin.[1]The most common clinical characteristics of SAT are female sex preponderance, anterior neck pain and fever.[2,3] Heart rhythm disorders and silent cervical forms have been described in SAT associated with SARS-CoV-2 infection,which occurs 16 to 36 days after resolution of COVID-19.[1,3] Symptomatic improvement occurs in a few days after initiation of therapy with sterods or NSAID.[3] Pyrexia of Unknown Origin (PUO) is a very rare presentation of SAT.[2] Hereby, a case of SAT, presenting with painful neck swelling and persistent fever (5weeks duration), two weeks after resolution of COVID-19, is being discussed. The index patient was a 50-year old obese,normotensive, diabetic (10 years duration, HbA1c-6.6% on SU, metformin, sitagliptin and dapagliflozin) male. TSH was suppressed (0.02 mIU/L), FT4 (3.06 ng/dl, upper limit of normal-1.48ng/dl) and FT3 (3.9 pg/ml, upper limit of normal-3.71 pg/ml) were elevated. Total T4 and T3 were normal. HS-CRP was markedly elevated. IL-6 and TBG were not estimated. Cervical USG revealed diffuse hypoechogenecity of thyroid gland and thyromegaly. There was reduced uptake in thyroid scan (technetium). The patient became afebrile after 4 days of initiation of 30 mg prednisolone (tapered by 10 mg every 5 days). The initial tachycardia reverted to sinus rhythm with marked reduction of neck tenderness. This case highlights certain considerations for SAT associated with SARS-CoV-2 infection. Firstly, it can present with PUO (first case report). Secondly, it may be associated with normal total T4 and T3 which can happen due to reduced TBG consequent upon increased IL-6.[4] References: 1. Caron Philippe: Thyroid disorders and SARS-CoV-2 infection: From pathophysiological mechanism to patient management. Ann Endocrinol (Paris), 2020, Sept. 2. Fever of Unknown Origin as a Sole Presentation of Subacute Throiditis in an Elderly Patient. A Case Report with Literature Review. Raj R, Yada S, Jacob A et al: Hindawi Case Reports in Endocrinology, 2018, Article ID 5041724 3. Brancatella A, Ricci D, Latrofa F et al: Is subacute thyroidits an underestimated manifestation of SARS-CoV-2 infection? Insights from a case serie. J Clin Endocrinol Metab, 2020, Aug 11, dgaa537. 4. Bartaleno L, Brogioni S, Grasso L and Martino E: Increased serum interleukin-6 concentration in patients with subacute thyroiditis:relationship with concomitant changes in serum T4-binding globulin concentration. Journal of Endocrinological Investigation, 1993, 16, 213-218.

scholarly journals Radiological significance of the sinonasal anatomical variants in recurrent acute rhinosinusitis patients

2017 ◽  
Vol 5 (6) ◽  
pp. 2379
Author(s):  
Niranjan Sahu ◽  
Satya Sundar G. Mohapatra ◽  
Siba N. Rath ◽  
Rabindra N. Padhy
Keyword(s):  
Nasal Septum ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variants ◽  
Acute Rhinosinusitis ◽  
Computed Tomography Images ◽  
Osteomeatal Complex

Background: Recurrent acute rhinosinusitis (RARS), a low form chronic rhinosinusitis is frequently under evaluated. The significance of sinonasal anatomical variants of osteomeatal complex (OMC) and spheno-ethmoidal (SE) recess regions in patients of RARS is assessed.Methods: Retrospective analysis of coronal sinonasal computed tomography images of 120 RARS patients presented with sinonasal anatomical variants during November 2013 to October 2016 was carried out. Patients with acute and expansile sinonasal lesions are excluded.Results: Sinonasal anatomical variants in the regions of OMC and SE recess are responsible for obstruction of normal mucociliary drainage of corresponding paranasal sinuses in presence of inflammation predisposing to RARS. Anatomical variants of nasal septum were, deviated nasal septum (DNS) in 86 (72%) and septal spur in 58 (48%) patients. Anatomical variants in OMC region were, pneumatized middle turbinate (concha bullosa) in 50 (48%), paradoxical middle turbinate in 38 (28%), giant ethmoid bulla in 35 (32%), agger nasi cell in 29 (38%), Haller cell in 23 (15%), pneumatised uncinate process in 20 (18%), medialized uncinate process in 18 (22%) and septated maxillary sinus in 5 (4%) patients. Anatomical variants in SE recess were superior concha bullosa in 14 (12%) and septal bullosa in 11 (9%) patients.Conclusions: OMC pattern of recurrent rhinosinusitis is often prevalent in patients of RARS due to abundance of anatomical variants in the OMC region. DNS or ethmoid bulla when gets associated with concha bullosa increased the incidence of RARS. Present analysis would help surgeons to evaluate RARS patients for selective endoscopic sinus surgery.

Sign in / Sign up

Export Citation Format

Share Document