THYMIC CYSTS IN CHILDREN: AN UNUSUAL CAUSE OF UPPER AIRWAY OBSTRUCTION

2128 Rectus cervicalis–—Anomalous muscle in the anterior compartment of the neck P. Jani a, N. Gibbins a,*, D. Riches b a Department of Otolaryngology, Addenbrooke’s Hospital, Long Road, CB2 2QQ Cambridge, UK b Department of Anatomy, Gonville and Caius College, Trinity Street, CB2 1TA Cambridge, UK We present a supernumerary muscle in the anterior compartment of the neck previously undescribed in the English electronic literature–—rectus cervicalis. History: A 3-year-old boy presented with a history of recurrent infections of a mid-line neck lesion with an associated skin tag. Treatment: This was excised under general anaesthetic. An unusual mid-line lesion consisting of a skin tag and a tubular tract and muscle bands running from a notched mandible to the manubrium were noted. Discussion: The anomalous muscle seen in this patient resembled the rectus abdominis muscle. Cases of rectus sternalis have been reported. The authors propose that this is the first recoded case of rectus cervicalis. DOI: 10.1016/j.ijporl.2006.06.023

Migration of cut Foley catheter for posterior nasal packing into main bronchus Hajime Arima *, Haruko Ota, Masatoshi Fukumoto Department of Anesthesia, Okazaki City Hospital, 3-1 Goshoai, Koryuji-cho, Okazaki 444-8553, Japan Inadequate placement of Foley catheter for posterior nasal packing can cause upper airway obstruction, which is not noticed until tracheal extubation when the catheter is placed under general anesthesia. Here we present a 4-yearold girl, who required nasopharyngeal packing with Foley catheter to control bleeding after adenoidectomy. Upon extubation, asphyxia developed and the catheter was emergently cut to deflate the balloon, then the distal portion of the catheter was found in the main bronchus. To avoid rare but hazardous complication, direct laryngoscopic inspection of the balloon is required just before tracheal extubation and intranasal Foley catheter should not be cut. DOI: 10.1016/j.ijporl.2006.06.024

IJPORL Extra Abstracts Adenoidectomy due to obstructive neonatal adenoid hypertrophy secondary to Cytomegalovirus infection in an 8-week-old infant Suay Ozmen, Zuhal Akcoren *, Umut M. Akyol Hacettepe University Faculty of Medicine, Departments of Pediatric Pathology and Otorhinolaryngology, 06100 Ankara, Turkey Adenoid hypertrophy is a common feature of childhood. It is thought to be caused by the antigen stimulated increased activity of B-lymphocytes. Obstructive adenoid hypertrophy, on the other hand, is extremely rare in the neonatal period. We present a 2-month-old female patient with difficulty in nasal breathing due to obstructive adenoid hypertrophy. Endoscopic examination, tissue removal and biopsy were performed. Lymphoid hyperplasia and inclusion-bearing cytomegalic cells within the endothelium were seen in the histopathologic examination. Cytomegalovirus (CMV) infection of the nasopharynx is very rare. An adenoidectomy was performed and the symptoms of the patients were immediately disappeared. To our knowledge, this is the youngest case with CMV related adenoid hypertrophy necessitating adenoidectomy. DOI: 10.1016/j.ijporl.2006.06.025

Thymic cysts in children: An unusual cause of upper airway obstruction Erkan Karatas a, * , Semih Mumbuc a , Cengiz Durucu a, Akif Sirikci b, ˇinar a, Muzaffer Kanlikama a, Kemal ˇ Serkan Gokp c Bakir , Sule Ekiz c a Gaziantep University, Medical Faculty, Department of Otolaryngology Head and Neck Surgery, Gaziantep, Turkey b Gaziantep University, Medical Faculty, Department of Radiology, Gaziantep, Turkey c Gaziantep University, Medical Faculty, Department of Pathology, Gaziantep, Turkey The thymic cysts (TC) are rare, benign tumors of the neck and mediastinum. We reported a case of TC and discussed the physiopathology, differential diagnosis and treatment of this lesion. A 9-yearold male presented with a history of lateral neck swelling. Ultrasound revealed a cystic mass that was giving an impression of branchial cleft cyst. MRI demonstrated a multiloculated enhancing soft tissue lesion extending into the retropharyngeal space displacing the airway. The mass was completely excised. Histological evaluation of specimen

IJPORL Extra Abstracts revealed lymphoid cell populations and degenerated Hassall’s corpuscles around cysts as a TC. TC are rare lesions that typically present as an asymptomatic cervical or mediastinal mass and are usually diagnosed after surgical extirpation. Complete surgical resection is the treatment of choice, but for the excellent prognosis with minimal morbidity, observation alone may be an option in asymptomatic patients. DOI: 10.1016/j.ijporl.2006.07.027

Pallister-Killian syndrome: A case with sensorineural hearing loss Ayc¸a C ¸iprut *, Ferda Akdas¸ Department of Audiology, Marmara University Medical School, Istanbul, Turkey Pallister-Killian syndrome (PKS) is a rare disorder caused by tetrasomy 12p mosaicism. Pallister-Killian syndrome (PKS) is characterized by multiple congenital anomalies including pigmentary skin changes, mental retardation, and the mosaic presence of a tissue-limited isochromosome 12p [i(12p)]. Hearing loss is not reported very often in PKS patients. The purpose of the study is to present a Pallister-Killian syndrome patient with severe sensorineural hearing loss. Bilateral severe sensorineural hearing loss was diagnosed in a 28-month-old child with PKS. The child was fitted with hearing aids and began to receive auditory habilitation. The child benefited from the amplification. Hearing screening is recommended for children with multiple anomalies including PKS in order to prevent the harmful effects of the hearing loss. DOI: 10.1016/j.ijporl.2006.07.028

Lingual alveolar soft part sarcoma treated only by conservative resection Junsun Ryu a, Youngmee Kwon b, Byung-Kiu Park c, Yuh-Seog Jung a,* a Head and Neck Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang, Gyeonggi-do 411-764, Republic of Korea b Center for Breast Cancer, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang, Gyeonggi-do 411-764, Republic of Korea c Pediatrics Oncology Clinic, Center for Specific Organs Cancer, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang, Gyeonggi-do 411-764, Republic of Korea

2129 Alveolar soft part sarcoma (ASPS) is a rare disease and there is no generally accepted treatment guideline yet. We report a case of lingual ASPS in a child who was treated only by conservative resection without further adjuvant treatment modalities. A 3-year-old girl was diagnosed as ASPS of the left dorsolateral portion of the mobile tongue, in which transoral partial glossectomy was performed subsequently. The tumor appeared to be well encapsulated and the resection could be done in a more limited way rather than conventional glossectomy in tongue cancer. No adjuvant treatments were added following surgery. Neither metastasis nor recurrence was detected 32 months afterwards. The lingual ASPS exhibits patterns distinct from ASPS in other anatomical locations, such as extremity. Local or distant metastasis is relatively rare and the clinical course is often better than other sites. Definitive treatment is usually possible even with functional resection as a single treatment modality. The pertinent literature is reviewed. DOI: 10.1016/j.ijporl.2006.07.029

A rare cause of rhinolithiasis: Ectopic tooth ¨ mer ¨slu ¨ b, O Hilmi Alper S¸enkal a,*, Ahmet Emre Su a ¨ Faruk Unal a Hacettepe University, Faculty of Medicine, Department of Otorhinolaryngology, Head and Neck Surgery, 06100 Hacettepe, Ankara, Turkey b Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Department of Otorhinolaryngology, Bolu, Turkey Rhinolith describes the pathology which is formed by means of deposition of salts on an organic or inorganic nidus in the nose. A nidus may be endogenous or exogenous. A rinolith may develop on an endogenous nidus such as dried blood clots, desquamated epithelium, dried purulent material, bone fragments and rarely ectopic tooth. A 23-year-old male patient presented to our clinic with one-sided nasal obstruction, nasal discharge and deformity of nose. Anterior rhinoscopy, nasal endoscopy and computed tomography (CT) scan revealed a rinolith in the right nasal cavity. In this case, preoperative CT scan and postoperative histological examination revealed that the nidus of the rhinolith was an intranasal ectopic tooth. We herein discuss ectopic tooth as a rare cause of rhinolithiasis. DOI: 10.1016/j.ijporl.2006.07.030