ABSTRACT
INTRODUCTION: An otogenic brain abscess is a common ENT problem but an otogenic trapezius abscess can also be experienced in otolaryngological practice, particularly in patients with chronic suppurative otitis media. CASE REPORT: We report a rare case of a trapezius abscess in an eight-year-old girl who presented at the ENT, Head and Neck Surgery Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, Pakistan on 15th December, 2010, with a presenting complaint of discharge from her right ear that had been occurring for the last five years. An exploration of the patient's right ear was performed, which showed that there was extensive cholesteatoma and tissue granulation tissues the antrum, attic and middle ear. The trapezius abscess had spread down to her back and was repeatedly drained. The patient was discharged on the 14th day following admission after making a complete recovery. After a regular follow-up period the child has remained disease free. The rare nature of this case prompted us to write this report. CONCLUSION: Chronic suppurative otitis media is a common clinical problem in developing countries. It can result in a number of complications if not treated properly. Although an otogenic trapezius abscess is a rare complication of chronic suppurative otitis media, it must be kept in mind.
ABSTRACT
INTRODUCTION: This study was conducted at the Department of ear, nose, throat, head and neck surgery, Post Graduate Medical Institute Lady Reading Hospital Peshawar. The duration of the study was one year from June 17, 2009 to June 16, 2010. The sample size was 82 patients with solitary thyroid nodule, fulfilling the inclusion criteria. After taking detailed history, thorough examination, relevant investigation and informed consent fine needle aspiration cytology was performed in all cases by the same cytopathologist. Thyroid surgery was performed and specimens were examined by the same histopathologist. The statistical analysis was performed using the statistical program for social sciences (SPSS version 11). MATERIALS AND METHODS: Our study included 82 cases consisting on 57 female and 25 male, with female: male ratio of 2.28: 1.The age of the patients was ranged from 16-65 years with mean age of 42.56 + S.D 11.60 years. Most of the patients presented in 3(rd) and 4(th) decade followed by the 5(th) and 2(nd) decade. The diagnostic yield of Fine Needle Aspiration Cytology (FNAC) in this study was accuracy 82.92%, sensitivity 88.09%, specificity 77.50% and positive predictive value was 80.43%. RESULTS: One hundred twenty six patients entered the study among which 77 (61%) were female and 49 (39%) male. Mean age was obtained as 26.9 ± 7.7 yrs. Up to 79.4% of patients had complaints concerning the cosmetic outcomes, 39.7% with respiratory and 4.8% with olfactory problems. The reason to sue the physician had a significant relationship with the patients' age and sex, and also with the surgeons' experience. CONCLUSION: FNAC has key rule in diagnosis of solitary thyroid nodule because it is safe, minimally invasive and cost effective diagnostic tool.
