ABSTRACT
We present an unusual case of a 54-year-old Chinese lady presenting to the ears, nose and throat clinic after family members noticed that her hearing had progressively deteriorated over the preceding weeks. She also complained of tinnitus. Examination of the ears, nose and throat was unremarkable. Flexible nasoendoscopy demonstrated swelling in the postnasal space, which, following biopsy, was shown to be pathognomonic of tuberculosis. This was successfully treated with multidisciplinary input and the patient made a complete recovery.
Subject(s)
Hearing Loss/etiology , Nasopharynx/microbiology , Tinnitus/etiology , Tuberculosis/complications , Asian People , Female , Humans , Middle Aged , Nasopharynx/pathology , Tuberculosis/diagnosis , Tuberculosis/therapySubject(s)
Cotton Fiber , Ear Diseases/etiology , Mastoid/parasitology , Myiasis/diagnosis , Aged , Animals , Anti-Infective Agents, Local/therapeutic use , Ear Diseases/diagnosis , Ear Diseases/parasitology , Female , Foreign Bodies/complications , Humans , Hydrogen Peroxide/therapeutic use , OtoscopyABSTRACT
A neck mass, which rapidly increases in size over several weeks, is concerning for all involved. When accompanied by other symptoms suggesting sinister underlying pathology, efficient management and rapid diagnosis are vital. The causes may include primary or metastatic carcinoma, or lymphoreticular malignancy. Other non-sinister pathology may account for the swelling such as reactive lymph nodes or benign neoplasms. A benign neoplasm of the lymphatic system known as a lymphangioma may rarely be the cause of a mass in the neck in adults. More commonly found in infants, with approximately 40% found at birth, they are seldom encountered in adults. In children, they have the propensity to infiltrate into and around muscles and neurovascular structures, occasionally leading to difficult surgical excision. The authors present an unusual case of an adult patient with an expansile mass in the supraclavicular fossa of insidious onset. It was associated with dysphagia and hoarseness of voice.
Subject(s)
Head and Neck Neoplasms/diagnosis , Hoarseness/etiology , Lymphangioma/diagnosis , Head and Neck Neoplasms/complications , Humans , Lymphangioma/complications , Middle AgedABSTRACT
In light of the introduction of the European Working Time Directive and Modernising Medical Careers initiative, this article reports the results of a study to see whether junior doctors possess adequate skills to correctly interpret lateral soft tissue neck X-rays and if they receive adequate training.
