Complicated sinusitis with sphenopalatine artery thrombosis in a COVID-19 patient: a case report.

COVID-19 has been a mystery against healthcare professionals. We herein report a rare presentation of complicated sinusitis with pre-septal cellulitis and hard palatal necrosis in a COVID-19 patient. A 52-year-old male was admitted to the hospital with typical COVID manifestations where he had two successive COVID-19 positive swabs. During his admission, he developed symptoms of right orbital complications of sinusitis along with both clinical and radiological evidence of ipsilateral hard palatal necrosis. Imaging confirmed a diagnosis of right pan-sinusitis complicated with right pre-septal infection and hard palatal bony defect on the same side. Our case focuses on the possible association between these manifestations and the known thromboembolic complications of COVID-19. Ongoing management of such complicated rare cases should be through multidisciplinary team.

The Anatomy and Anatomical Variations of the Round Window Prechamber and Their Implications on Cochlear Implantation: An Anatomical, Imaging, and Surgical Study

Abstract Introduction Over the last decades, there has been a tremendous increase in the number of cochlear implant recipients and, consequently, there is a recent increase of interest in the proper understanding of the anatomy of the round window (RW), which is the most important anatomical land mark during cochlear implant surgery. Objectives The present study was undertaken to assess the detailed surgical and radiological anatomy of the RW prechamber; its shape, directions, measurements, common anatomic variations, and its relationships with different surrounding structures as related to cochlear implantation. Methods A total of 20 cadaveric specimens of human temporal bone were microscopically dissected for the anatomical assessment of the measurements of the RW and its relation to surrounding structures in the tympanum. A total of 20 patients were subjected to cochlear implantation, and a radiological and surgical assessment of the anatomy of their RW prechambers was performed. Results The distances between the RW and the facial canal (FC), the jugular fossa (JF), the carotid canal (CC), and the oval window (OW) were measured. Among the cases subjected to cochlear implantation, the infracochlear tunnel was studied radiologically; the lengths of the anterior and posterior pillars were assessed, and the relation with the direction at which the RW faces was statistically analyzed. Conclusions Proper understanding of the topographic anatomy of the RW, including its direction of opening and the distances from different adjacent structures in the tympanum, is essential for a successful cochlear implantation surgery, since it can help decision-making before the surgery and is useful to avoid many complications, such as misplaced electrode and iatrogenic injury to the surrounding structures.

The Anatomy and Anatomical Variations of the Round Window Prechamber and Their Implications on Cochlear Implantation: An Anatomical, Imaging, and Surgical Study.

Introduction Over the last decades, there has been a tremendous increase in the number of cochlear implant recipients and, consequently, there is a recent increase of interest in the proper understanding of the anatomy of the round window (RW), which is the most important anatomical land mark during cochlear implant surgery. Objectives The present study was undertaken to assess the detailed surgical and radiological anatomy of the RW prechamber; its shape, directions, measurements, common anatomic variations, and its relationships with different surrounding structures as related to cochlear implantation. Methods A total of 20 cadaveric specimens of human temporal bone were microscopically dissected for the anatomical assessment of the measurements of the RW and its relation to surrounding structures in the tympanum. A total of 20 patients were subjected to cochlear implantation, and a radiological and surgical assessment of the anatomy of their RW prechambers was performed. Results The distances between the RW and the facial canal (FC), the jugular fossa (JF), the carotid canal (CC), and the oval window (OW) were measured. Among the cases subjected to cochlear implantation, the infracochlear tunnel was studied radiologically; the lengths of the anterior and posterior pillars were assessed, and the relation with the direction at which the RW faces was statistically analyzed. Conclusions Proper understanding of the topographic anatomy of the RW, including its direction of opening and the distances from different adjacent structures in the tympanum, is essential for a successful cochlear implantation surgery, since it can help decision-making before the surgery and is useful to avoid many complications, such as misplaced electrode and iatrogenic injury to the surrounding structures.

Traumatic pseudoaneurysm of the cavernous carotid: a lethal complication of craniofacial trauma.

Pseudoaneurysm of the cavernous carotid artery is a rare, yet life-threatening complication of craniofacial trauma. It may well present itself with delayed massive epistaxis up to several months after the initial insult. Early recognition and prompt treatment are the key in management and a high index of clinical suspicion is always required. In this article, we report a patient with a penetrating head injury who developed delayed epistaxis along with unilateral abducent and partial oculomotor palsy. Urgent diagnostic carotid angiography was undertaken, followed by endovascular coiling that resulted in no recurrence for a year of follow-up.