Frontocutaneous Fistula Secondary to Frontal Sinusitis.

Frontocutaneous fistula is a rare complication of frontal sinusitis. This mostly occurs as a result of osteomyelitis of the frontal bone on account of sinusitis. These are managed by endoscopic closure or by external approach depending on the cause and extent of sinusitis. We report on the case of a 57 year old man who presented to our ENT Unit with a defect on the face medial to the right eye.

Anti-musk Myasthenic Crisis in the Puerperium: The Management Dilemma.

Myasthenia gravis (MG) is a chronic neuromuscular junction (NMJ) dysfunction with a wide spectrum of neurological manifestations. MG is as a result of autoantibodies directed against NMJ at the postsynaptic level involving nicotinic or other postsynaptic antigens. The newly identified subtype of MG with antibodies against the muscle-specific receptor tyrosine kinase (Anti-MuSK) shows an unpredictable response to current MG treatment. The initial presentation of this disease entity often poses a diagnostic challenge and a treatment dilemma to the clinician. We present a case of life threatening Anti-MuSK-positive myasthenic crisis occurring during puerperium which required a temporary surgical airway and percutaneous endoscopic gastrostomy tube for feeding. She had dysphonia for 7 years but was not diagnosed. The complications and management dilemma of this case report are highlighted.