Spontaneous air in the retropharyngeal space presenting with hypoxemia and neck pain in a child with neuroblastoma: A case report : A case report

424 was put under cimetidine (40 mg/(kg day)) with a good outcome. DOI: 10.1016/j.ijporl.2007.08.031

Christmas decorations may become aerodigestive foreign bodies Andrew Thamboo, Jeffrey P. Ludemann *, Keith H. Riding Department of Pediatric Otolaryngology, British Columbia’s Children Hospital, University of British Columbia, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada

We present two cases of foreign body aspiration that occurred during the 2004-2005 Christmas season. In one 8-month-old boy, the hardware from a Christmas tree ornament became a supraglottic foreign body. In another 10-month-old boy, a metallic sticker in the shape of a Christmas tree traveled from the glottis to the nasopharynx and back to the glottis. The winter holidays are a time when children may have less supervision and greater exposure to potential aerodigestive foreign bodies. It is especially important that parents are vigilant and that physicians are perceptive of the symptoms of foreign body aspiration, especially during the holiday season. DOI: 10.1016/j.ijporl.2007.10.025

Abstracts Head Neck Surg. 119 (1993) 113—116; R. Hermans, B. De Foer, M.H. Smet, J. Leysen, Eosinophilic granuloma of the head and neck: CT and MRI features in three cases, Pediatr. Radiol. 24 (1994) 33—36; T.V. McCaffrey, T.J. McDonald, Histiocytosis X of the ear and temporal bone: review of 22 cases, Laryngoscope 89 (1979) 1735—1742]. The otologic findings of LCH are similar to otomastoiditis and therefore LCH should be considered as a possible differential diagnosis in very young patients presenting with signs and symptoms suggestive of chronic otitis media.

DOI: 10.1016/j.ijporl.2007.10.026

Sebaceous adenoma of the parotid gland in a 16-year-old girl Xue-Peng Xiong a,b, Jun Jia a, Yi-Fang Zhao a, San-Gang He a,b,* a Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China b Key Laboratory for Oral Biomedical Engineering of Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, PR China

Sebaceous adenomas of salivary gland origin are rare tumors, which mainly occurred in elderly adults. We present a case of sebaceous adenoma of the parotid gland in a 16-year-old girl.

Case study: Langerhans’ cell histiocytosis (LCH) Nico Jonas a,*, Wakisa Mulwafu a, Sally-Anne Khosa b, Marc Hendricks c a Division of Otolaryngology, University of Cape Town Medical School, South Africa b Department of Anatomical Pathology, Red Cross Children’s Hospital, South Africa c Haematology/Oncology Service, Red Cross Children’s Hospital, South Africa

The clinical spectrum of Langerhans cell histiocytosis (LCH) can be very diverse. Pathology can range from a single bony lesion to systemic disease with multi-organ dysfunction. Up to 61% of patients with LCH have otologic involvement and in 5—25% it might be the initial form of presentation [A.J. Goldsmith, D. Myssiorek, E. Valderrama, M. Patel, Unifocal Langerhans’ cell histiocytosis (eosinophilic granuloma) of the petrous apex, Arch. Otolaryngol.

DOI: 10.1016/j.ijporl.2007.10.027

Spontaneous air in the retropharyngeal space presenting with hypoxemia and neck pain in a child with neuroblastoma: A case report Mona Shete *, Jerome Thompson Otolaryngology-Head & Neck surgery, University of Tennessee HSC, Court Avenue, Ste B226, Memphis, TN 38163, United States

A 9-year-old white male with a stage IV neuroblastoma of thorax since 4 years of age presented to the routine clinic visit with several days history of nonproductive cough, neck pain and progressive dyspnea. The oxygen saturation was 87%. His head and neck exam was insignificant and there was no crepitus or tenderness to neck palpation. Chest X-ray

Abstracts

425

was normal but neck X-ray showed a strip of air in the retropharyngeal space. Last transplant was allogeneic BMT 9 months back followed by grade-III chronic graft versus host disease of skin and gut. The CT scan of neck and chest confirmed pneumomediastinum with retropharyngeal air and bilateral faint pulmonary infiltrates. Systemic steroids were added to the treatment to stabilize his respiratory condition. After 10 days of ICU stay his condition improved and he was discharged home. Repeat neck X-ray after 14 days showed near complete resolution of retropharyngeal air. From the clinical, radiological picture as well as therapeutic response to steroids the most likely diagnosis was cryptogenic organizing pneumonia formerly known as ‘‘bronchiolitis obliterans with organizing pneumonitis’’ (BOOP). Pneumomediastinum is reported in the literature as a rare cause of spontaneous air in the retropharyngeal space. Usually pneumomediastinum is a terminal event but in our patient it was a presenting symptom of BOOP. We also report a subtle presentation of BOOP and complete resolution with steroids.

b

DOI: 10.1016/j.ijporl.2007.10.028

Unusual protracted course of non-tuberculous mycobacterium otomastoiditis in a child

Silent sinus syndrome associated with nasal foreign body

Chun-Hsiang Chang, Kai-Nan Lin, Yi-Ho Young, Wei-Chung Hsu * Department of Otolaryngology, National Taiwan University Hospital, 1, Chang-te Street, Taipei, Taiwan

V. Fidan Department of Otolaryngology/Head and Neck Surgery, Numune Government Hospital, Hastaneler Street, Erzurum 25200, Turkey

Silent sinus syndrome is characterized by enophtalmus and hypoglobus caused by the maxillary atelectasis. Approximately 160 cases have been published in the literature but none of them due to a nasal foreign body. A case with silent sinus syndrome related to a foreign body has been presented in this article. Utmost attention should be paid management of the nasal foreign body because it may be the reason for silent sinus syndrome. DOI: 10.1016/j.ijporl.2007.10.029

Intranasal mucocele of the nasolacrimal duct–—A cause of neonatal nasal obstruction W. Raith a,*, F. Reiterer a, G. Wolf b, M. Riccabona c, W. Mueller a, B. Urlesberger a a Department of Paediatrics, University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria

Department of Otorhinolaryngology, University of Graz, Auenbruggerplatz 20, A-8036 Graz, Austria c Department of Radiology, University of Graz, Auenbruggerplatz 9, A-8036 Graz, Austria After a spontaneous delivery, a healthy female newborn showed a cyanotic spell. The medical inspection shows a healthy newborn, only the nose was difficult to probe with the smallest tube. This leads to the diagnosis nasal obstruction. The nasal-endoscopy shows cystic malformations which restrict the inferior nasal meatus totally on both sides and the common nasal meatus on the right side [2]. With ultrasound and magnetic resonance imaging these malformations were identified as a mucocele caused by a blocked nasolacrimal duct. By a following nasal-endoscopy the blocked duct was resected. After that the baby could breathe without any symptoms of airway obstruction. DOI: 10.1016/j.ijporl.2007.11.016

Mycobacterium chelonae, one of the rapidly growing non-tuberculous mycobacteria, is a rare but increasingly recognized cause of otomastoiditis. Recently, we have experienced an unusual protracted course in a 6-year-old girl with acute otomastoiditis on the left ear caused by M. chelonae, 8 months after ventilation tube insertion. During 142 consecutive admission days, she was treated with repeated surgical interventions coupled with longterm administration of antimicrobial agents. One year after discharge, she was rather well without recurrent otorrhea. In conclusion, when a child with intractable draining ear after ventilation tube insertion, unusual pathogen, e.g. M. chelonae should be taken into consideration, which deserves further confirmation. Subsequently, surgical intervention coupled with prolonged antibiotic treatment is essential to eradicate the infectious foci from middle ear and mastoid cleft. DOI: 10.1016/j.ijporl.2007.11.017