Toxic shock syndrome after anterior-posterior nasal packing.

Toxic shock syndrome (TSS) is a severe, potentially life-threatening multisystem disease. It is rather rare with the incidence estimated to be 16.5/100,000 of nasal surgery performed in the United States. A milder degree of TSS may be more common. Surgeons who perform sino-nasal surgery should be aware of this disease, although certain criteria for definite TSS are absent. Early recognition and prompt intervention is important to minimize the morbidity and mortality associated with this disease. This paper presents the first reported case of a milder degree of TSS after anterior-posterior nasal packing in Thailand. The criteria for diagnosis, the pathogenesis, and the management of TSS were reviewed.

Head and neck mycetoma.

Two cases of eumycotic mycetomas in the head and neck region are reported. The first case is the localized mycetoma which involved only the soft tissue of the neck. It was completely excised and the patient needed no further treatment. In the second case, the lesion extensively involved the structures in the parapharyngeal space, submandibular space and carotid sheath. The upper limit is the skull base. The patient was treated by combination of wide excision with radial forearm flap and antifungal agents, however, the prognosis is fair.

Severe epistaxis from rhinosporidiosis: a case report.

Rhinosporidiosis is quite rare in Thailand, but the actual incidence may be higher than the numbers reflect. This is thought to be due to misdiagnosis by physicians who are unfamiliar with this disease entity or physicians who found a case but did not describe its presence. The authors report a case in a 17 year old male with the lesion involving both nasal cavities, nasopharynx and left maxillary sinus presenting with severe epistaxis, which was treated by complete surgical removal with electric cauterization of its base. We warn physicians who face this problem to be aware of this disease entity.