A Case of Warthin's Tumor Associated with Primary Tuberculosis of the Parotid Gland / 대한이비인후과학회지

Warthin's tumor is a common neoplasm of the major salivary glands. Tuberculosis of the parotid gland is rare. It may result from the involvement of intraparotid lymph nodes or the infection of parenchyma, either primary or secondary to nodal disease. Clinically, tuberculosis of the parotid may not be distinguishable from a neoplasm. This report presents a patient with a parotid mass that was thought to be a malignancy but, after surgery, was diagnosed to be Warthin's tumor associated with tuberculosis.

A Clinical Study of the Cervical Necrotizing Fasciitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: To clarify the presenting signs and symptoms, clinical course, pathologic organisms, and management of cervical necrotizing fasciitis. SUBJECTS AND METHOD: We retrospectively reviewed the inpatient charts treated at our ENT department for cervical necrotizing fasciitis. Seven such patients were identified as having been treated from January 2002 to December 2004. RESULTS: During the 36-months period, 7 adults consisting of 5 males and 2 females with cervical necrotizing fasciitis were diagnosed and treated. The mean age was 45 years ranging from 25 to 59 years. All patients had infections in more than five fascial spaces. The most commonly involved sites of infection were the superficial neck space (100%), followed by submandibular (85.7%), and parapharyngeal and submental space (57.1%). The most commonly known associated preceding illness were tonsillitis and dental abscess (28.5%). Painful neck swelling and difficulty in moving the neck were the most frequent symptoms and signs. The most common pathogen was Streptococcus species (4/7), followed by Staphylococcus epidermidis and Klebsiella pneumoniae (1/6). The mean duration of hospitalization was 17.2 days (range, 8-24). Leukocytosis (WBC>10000/mm3) was found in all patients. All patients received parenteral antibiotics and surgical drainage after admission. Six patients recovered and one patient died after surgical drainage. Tacheotomy was performed on five patients. CONCLUSION: Cervical necrotizing facilitis is an uncommon but often fatal bacterial infection of the skin, subcutaneous fat, superficial fascia, and deep fascia. It is characterized by marked tissue edema, rapid spread of inflammation, and signs of systemic toxicity. High index of suspicion, prompt aggressive surgery, appropriate antibiotics, and supportive care are the mainstays of management.

Traumatic Pseudoaneurysm of the Superficial Temporal Artery / 대한이비인후과학회지

Pseudoaneurysm of the superficial temporal artery is very rare and can potentially be a critical cause of facial masses. Most pseudoaneurysms form as a result of blunt trauma and present as painless, pulsatile tumors that may be associated with neuropathic findings and enlarged size. They can be accurately diagnosed through physical examination alone. The treatment of choice is surgical ligation and resection. We present a case of traumatic pseudoaneurysm of the superficial temporal artery caused by blunt injury and discuss pertinent diagnosis and treatment option.

Primary Hodgkin's Lymphoma of the Parotid Gland / 대한이비인후과학회지

Hodgkin's lymphoma with its primary manifestation in the parotid gland is an exceedingly rare entity and seldom described in the literature. The vast majority of lymphoma occurs within lymph nodes. Lymphoma of parotid glands are typically a manifestation of systemic disease processes. This case report describes a parotid gland mass as a first symptom of Hodgkin's lymphoma. The patient underwent surgical excision and chemotherapy. The final diagnosis was established after an excisional biopsy and immunohistochemical staining.