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Malacoplakia of the epiglottis: case report and review of the literature
Scientific Posters
of bone erosion, isolated soft tissue masses of the oral cavity will frequently come to the attention of the otolaryngologist. We present 2 cases, one peripheral ameloblastoma and one peripheral ossifying fibroma, presenting to the otolaryngologist as isolated soft tissue lesions of the oral cavity. We believe these lesions should be acknowledged in the differential diagnosis of soft tissue lesions of the oral cavity. Conclusion: We will furthermore present a review of the oral surgery and oral pathology literature with respect to these rare lesions. Accurate pathologic diagnosis is crucial to appropriate treatment, follow-up, and prognosis. P173 Otoendoscopic Surgery of Retraction Pockets in the Attic Dragoslava Djeric MD PhD (presenter); Nenad Arsovic PhD; Vojko Djukic MD Belgrade Yugoslavia; Belgrade Yugoslavia; Belgrade Yugoslavia
Objectives: The purpose was to report the experience of surgical otoendoscopy of posterosuperior retraction pockets in about 40 tympanoplasties. Methods: We give a detailed description of the specific material as well as of the technique they used. Surgical endoscopy enables a safer excision of the posterosuperior retraction pockets and contributes to reduce appreciably the occurrence of residual cholesteatomas. Results: Among the promoters of middle ear surgical endoscopy, reporting in the literature otologists are more and more likely to use the endoscopic monitoring during tympanoplasties in retraction pockets and cholesteatomas. Conclusion: Using otoendoscopy, we transform our thinking in this type of surgery. In most cases it can be carried out without opening the mastoid. The transmastoid approach is reserved for those pockets with a major extension towards the medial part of the attic or aditus from the facial recess, or when the field is too hemorrhagic for endoscopes to be used easily. P174 Malacoplakia of the Epiglottis: Case Report and Review of the Literature Lance Anthony Manning MD (presenter); Stacey Hudson MD; Thomas J Sebo MD; Eric J Moore MD Rochester MN; Rochester MN; Rochester MN; Rochester MN
Objectives: Malacoplakia is a xanthogranulomatous process that is most often found in the genitourinary system but has also rarely been reported in the head and neck region. Though malacoplakia is thought to be of infectious etiology, it can be confused with malignant lesions. This study describes a case of malacoplakia of the epiglottis in an 80-yearold male patient. There is only one other case of malacoplakia isolated to the epiglottis ever described in the world literature.
In addition, this study reviews the world literature on manifestations of this rare disease process in the head and neck region. The object of this study is to describe the pathology, pathophysiology, and treatment of this disease entity as it pertains to the field of otolaryngology. Methods: This is a retrospective chart review, description, and critical evaluation of a patient who presented with a hypopharyngeal lesion that was excised and following histopathological examination revealed to be malacoplakia. Results: A case of malacoplakia of the epiglottis in an 80-year-old male patient was successfully diagnosed and treated. This report describes the histopathology, pathophysiology, and treatment of this lesion. Conclusion: Malacoplakia in the head and neck region is a very rare disease entity. The otolaryngologist needs to be aware of the existence, diagnosis, and management of malacoplakia in order to include it in the differential diagnosis and not to confuse it with malignant lesions. P175 Endoscopic Management of Intratracheal Ectopic Thyroid Keith Michael Pritchyk MD (presenter); Sonya Malekzadeh MD Arlington VA; Bethesda MD
Objectives: Ectopic thyroid involving the trachea is a rare cause of upper airway obstruction. We present a unique case report of intratracheal ectopic thyroid with endoscopic management. Methods: A young female patient’s clinical course is presented and discussed. We review the incidence, developmental anatomy, radiographic appearance, and treatment of intratracheal ectopic thyroid. Results: The patient presented with shortness of breath with activity, progressing to shortness of breath at rest. An intratracheal subglottic mass occluding approximately 90% of the airway was identified at laryngoscopy. Histologic and immunohistochemical studies confirmed ectopic thyroid without evidence of malignancy. Treatment consisted of an awake tracheotomy to secure the airway, followed by endoscopic resection with the Nd:YAG and CO2 lasers. Conclusion: This is the first reported case of endoscopic laser management of intratracheal ectopic thyroid. Although rare, intratracheal ectopic thyroid must be properly recognized and aggressively treated as it can be life-threatening due to occlusion of the airway. We propose endoscopic CO2 laser resection as the primary mode of treatment. P176 Immunological Aspects of Otitis Media Purulenta Chronica and Its Complications Azizaga Mehtioglu Talishinskiy MD (presenter) Baku Azerbaijan
POSTERS
P268
Otolaryngology– Head and Neck Surgery August 2003
of bone erosion, isolated soft tissue masses of the oral cavity will frequently come to the attention of the otolaryngologist. We present 2 cases, one peripheral ameloblastoma and one peripheral ossifying fibroma, presenting to the otolaryngologist as isolated soft tissue lesions of the oral cavity. We believe these lesions should be acknowledged in the differential diagnosis of soft tissue lesions of the oral cavity. Conclusion: We will furthermore present a review of the oral surgery and oral pathology literature with respect to these rare lesions. Accurate pathologic diagnosis is crucial to appropriate treatment, follow-up, and prognosis. P173 Otoendoscopic Surgery of Retraction Pockets in the Attic Dragoslava Djeric MD PhD (presenter); Nenad Arsovic PhD; Vojko Djukic MD Belgrade Yugoslavia; Belgrade Yugoslavia; Belgrade Yugoslavia
Objectives: The purpose was to report the experience of surgical otoendoscopy of posterosuperior retraction pockets in about 40 tympanoplasties. Methods: We give a detailed description of the specific material as well as of the technique they used. Surgical endoscopy enables a safer excision of the posterosuperior retraction pockets and contributes to reduce appreciably the occurrence of residual cholesteatomas. Results: Among the promoters of middle ear surgical endoscopy, reporting in the literature otologists are more and more likely to use the endoscopic monitoring during tympanoplasties in retraction pockets and cholesteatomas. Conclusion: Using otoendoscopy, we transform our thinking in this type of surgery. In most cases it can be carried out without opening the mastoid. The transmastoid approach is reserved for those pockets with a major extension towards the medial part of the attic or aditus from the facial recess, or when the field is too hemorrhagic for endoscopes to be used easily. P174 Malacoplakia of the Epiglottis: Case Report and Review of the Literature Lance Anthony Manning MD (presenter); Stacey Hudson MD; Thomas J Sebo MD; Eric J Moore MD Rochester MN; Rochester MN; Rochester MN; Rochester MN
Objectives: Malacoplakia is a xanthogranulomatous process that is most often found in the genitourinary system but has also rarely been reported in the head and neck region. Though malacoplakia is thought to be of infectious etiology, it can be confused with malignant lesions. This study describes a case of malacoplakia of the epiglottis in an 80-yearold male patient. There is only one other case of malacoplakia isolated to the epiglottis ever described in the world literature.
In addition, this study reviews the world literature on manifestations of this rare disease process in the head and neck region. The object of this study is to describe the pathology, pathophysiology, and treatment of this disease entity as it pertains to the field of otolaryngology. Methods: This is a retrospective chart review, description, and critical evaluation of a patient who presented with a hypopharyngeal lesion that was excised and following histopathological examination revealed to be malacoplakia. Results: A case of malacoplakia of the epiglottis in an 80-year-old male patient was successfully diagnosed and treated. This report describes the histopathology, pathophysiology, and treatment of this lesion. Conclusion: Malacoplakia in the head and neck region is a very rare disease entity. The otolaryngologist needs to be aware of the existence, diagnosis, and management of malacoplakia in order to include it in the differential diagnosis and not to confuse it with malignant lesions. P175 Endoscopic Management of Intratracheal Ectopic Thyroid Keith Michael Pritchyk MD (presenter); Sonya Malekzadeh MD Arlington VA; Bethesda MD
Objectives: Ectopic thyroid involving the trachea is a rare cause of upper airway obstruction. We present a unique case report of intratracheal ectopic thyroid with endoscopic management. Methods: A young female patient’s clinical course is presented and discussed. We review the incidence, developmental anatomy, radiographic appearance, and treatment of intratracheal ectopic thyroid. Results: The patient presented with shortness of breath with activity, progressing to shortness of breath at rest. An intratracheal subglottic mass occluding approximately 90% of the airway was identified at laryngoscopy. Histologic and immunohistochemical studies confirmed ectopic thyroid without evidence of malignancy. Treatment consisted of an awake tracheotomy to secure the airway, followed by endoscopic resection with the Nd:YAG and CO2 lasers. Conclusion: This is the first reported case of endoscopic laser management of intratracheal ectopic thyroid. Although rare, intratracheal ectopic thyroid must be properly recognized and aggressively treated as it can be life-threatening due to occlusion of the airway. We propose endoscopic CO2 laser resection as the primary mode of treatment. P176 Immunological Aspects of Otitis Media Purulenta Chronica and Its Complications Azizaga Mehtioglu Talishinskiy MD (presenter) Baku Azerbaijan
POSTERS
P268
Otolaryngology– Head and Neck Surgery August 2003