Hemangioendothelioma of the orbit in a three-month-old infant

2006 Image guidance offers additional benefits in the endoscopic solution of extended cranio-facial malformations A case report ´n Fent b , Ka ´roly Andor Hirschberg a, * , Zolta b ¨ b ´k , Odo ¨n Rezek , Ron von Jako c, Ga ´bor Hraba ´pa ´ssy b Re a Department of Otolaryngology, Saint John Hospi´s ´ tal, Dio arok l-3, H-1125 Budapest, Hungary b Department of Otolaryngology, Faculty of Medicine, Semmelweis University, Budapest, Hungary c General Electric Healthcare-Surgery, Lawrence, MA, USA Computer-assisted endoscopic surgery (CAES) in combination with a transpalatal approach was applied in a 6-year-old girl with extensive craniofacial malformation and bilateral nasal and choanal atresia. The GE Healthcare InstaTrak 3500 Plus surgical navigational system was used. The transnasal and choanal atresia was successfully opened and kept patent. The navigational system was able to point and localize orientations between the distorted anatomy, the instrument tip and in depth measurements for intraoperative planning. In extended anatomical malformation of the nasal passages and the surrounding structures, where the anatomical landmarks are missing or definitely altered computer-aided navigation may facilitate the application of additional endoscopic surgery in combination with more radical surgical approaches. Development of special drills and curved suction devices mounted on the receiver and tailored for such anatomical malformations may offer a complete computer-aided endoscopic solution in similar cases.

IJPORL Extra Abstracts gram of the head and neck was obtained that showed inflammatory stranding involving the right pterygoid, masseter and parotid spaces as well as fluid collection within the right pterygoid (masticator) space. Intraoral drainage was successful. S. Aureus was identified on culture from the drainage site. No apparent focus of infection was identified. Appropriate antibiotics were given and the patient recovered. It is postulated that an ascending infection from the oral cavity to the parotid gland with subsequent involvement of the right masticator space occurred. DOI: 10.1016/j.ijporl.2006.04.019

An unusual case of live fish impaction in hypopharynx in an infant M.K. Aggarwal a, Gautam Bir Singh a,*, Ruchir Dhawan a, Arun Tiwari b a Department of Otorhinolaryngology and HeadNeck Surgery, Institute of Medical Sciences & Sir Sunderlal Hospital, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India b Department of Anaesthesia, Institute of Medical Sciences & Sir Sunderlal Hospital, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India A rare case of live fish impacted in the hypopharynx of a 7 months old male baby is presented that was removed successfully after securing airway. To the authors knowledge such a case has not been reported previously in the literature. DOI: 10.1016/j.ijporl.2006.04.020

Hemangioendothelioma of the orbit in a 3-month-old infant

DOI: 10.1016/j.ijporl.2006.04.018

Masticator space abscess in a 21-month-old child Robert Steelman a,*, Henry Milczuk b, Anna Grosz c a Pediatric Critical Care Medicine & Oral & Maxillofacial Surgery, Oregan Health; Science University, Portland, OR, USA b Pediatric Otorhinolaryngology Head & Neck Surgery, Oregan Health; Science University, Portland, OR, USA c Resident, Otorhinolaryngology, Head & Neck Surgery Oregon Health & Science University Portland, Oregan Health; Science University, Portland, OR, USA A 21-month-old male presented with fever, dehydration and severe trismus. A computerized tomo-

Arie Rosen a,b,c, Aylon Y. Glaser b,*, Don Respler a,b a Ear Nose and Throat Institute of New Jersey, Hackensack, NJ, United States b University of Medicine and Dentistry of New Jersey, Division of Otolaryngology/Head and Neck Surgery, Newark, NJ, United States c New European Surgical Academy (NESA), Germany Hemangioendothelioma of bone, a locally aggressive vascular neoplasm, rarely affects the facial bones. Even less common is a presentation of this tumor affecting the orbit. Excision of orbital rim tumors and consequential reconstructions in infants are especially challenging because calvarian bone grafts are not available and because of the potential for orbital deformity and facial scarring. A case of a 3-month-old female with a rapidly enlarging tumor

IJPORL Extra Abstracts of the inferior orbital rim and maxilla is presented. Resection was accomplished with a unique modified subciliary skin incision; orbital rim reconstruction was accomplished with dermis allograft (Alloderm1) only. DOI: 10.1016/j.ijporl.2006.04.021

Cervical ganglioneuroma ¨ ztu ¨ seyin Katılmıs¸ a , Sedat O Hu ¨ rkcan a , Is¸ıl a,* c ¨ Adadan , Ismail Ozdemir , Hale Algın a, Mine Tunakan b a Department of Otorhinolaryngology and Head and ¨rk Research and Training Neck Surgery, Atatu ˘i, Basın Hospital, Ministry of Health, 2. KBB Klinig Sitesi, Hatay, ˙Izmir, Turkey b ¨rk Research and Department of Patholgy, Atatu Training Hospital, Ministry of Health, I˙zmir, Turkey c ¨rk Research and Training Hospital, Izmir Atatu Department of Otorhinolaryngology and Head and Neck Surgery, Ministry of Health, Izmir, Turkey Ganglioneuromas are rare, benign tumors of neurogenic origin. They usually present in patients under 20 years of age with a slight female predominance. The cervical sympathetic chain is the most frequent structure of origin in the neck. The tumors involving the cervical sympathetic chain causes Horner syndrome characterized by ptosis, myosis, ipsilateral facial anhydrosis and flushing. Magnetic resonance imaging and Computerized tomography are more valuable imaging techniques in the diagnosis of ganglioneuroma. Surgical excision is the treatment of choice. We present a case of cervical ganglioneuroma discussing the diagnosis, treatment protocols and postoperative complications of this benign tumor. DOI: 10.1016/j.ijporl.2006.04.022

Late hearing recovery of postmeningitic deafness in a child after cochlear implantation Kiyofumi Gyo a,*, Naoto Hato a, Nobuhiro Hakuba a, Mayumi Takahashi b, Nobuo Takahashi b a Department of Otolaryngology, Ehime University, Shigenobu, Toon City, Ehime 791-0295, Japan b Ehime Speech and Hearing Rehabilitation Center, Ehime, Japan A 3-year, 9-month-old boy who contracted bilateral total deafness following bacterial meningitis underwent cochlear implant of the right ear 6 months after the onset of deafness. He became a successful cochlear implant user, while hearing in

2007 the non-implanted left ear began to improve 15 months after surgery. His hearing fluctuated in the early phase of recovery, but finally became stable at 60 dB pure tone average 18 months later. At the age of 7 years, he started to use a conventional hearing aid in the left ear and a cochlear implant in the right ear. Now at 11 years old, he takes advantages of the bimodal hearing in speech recognition and sound localization. The present case suggests that close consultation with the parents is essential in deciding on the use of a cochlear implant, in this case explaining the possibility of cochlear ossification and language development delay on one side and the rare incidence of spontaneous recovery on the other side, since we have no means of predicting the outcome of postmeningitic deafness. DOI: 10.1016/j.ijporl.2006.04.023

Hearing changes in the contralateral ear with juvenile unilateral profound hearing loss of unknown origin Akinobu Kakigi *, Hiroaki Nakatani, Taizo Takeda Department of Otolaryngology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan Objectives: Investigate contralateral hearing changes in patients with juvenile unilateral profound hearing loss (JUPHL) of unknown origin because patients with JUPHL have potentially bilateral hearing loss. Study design: A retrospective study. Setting: A tertiary referral center. Patients: Fifty patients with JUPHL of unknown origin included 42 unilaterally deaf patients and 8 patients with hearing loss over 70 dB HL. The age of the patients was less than 15 years old at the first visit to our outpatient clinic. Patients with inner ear anomalies were excluded using CT images. Main outcome measures: The results of pure tone audiometry (PTA) were investigated. To obtain reliable PTA results, patients were over 6 years old. The following items were examined: level, fluctuation and worsening of hearing. Results: A hearing level over 30 dB was observed at 20%, 4%, and 10% of patients in the low, middle and high frequencies, respectively. Hearing fluctuations were observed in 72%, 42% and 64% at the low, middle and high frequencies, respectively. Hearing worsening was observed in 8%, 4% and 4% at the low, middle and high frequencies, respectively. Conclusion: Seventy-two percent of patients with JUPHL had fluctuating hearing at low frequencies, and 8% of them had worsening hearing. These results imply that over 70% of patients with JUPHL may develop contralateral hearing loss and that we have to follow-