ABSTRACT
A 22-year-old male presented with spontaneous unilateral hemolacria and was found to have complete opacification of the ipsilateral nasolacrimal sac and duct. Endoscopic biopsy with histopathologic analysis revealed the diagnosis of nasolacrimal lymphangioma. Additional management included nasolacrimal stenting, and there was no hemolacria recurrence or epiphora. This is the first report of a nasolacrimal lymphangioma and describes the vascular malformation as a potential cause of bloody tearing.
Subject(s)
Dacryocystorhinostomy , Lacrimal Apparatus Diseases , Lacrimal Duct Obstruction , Lymphangioma , Nasolacrimal Duct , Adult , Humans , Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus Diseases/etiology , Lacrimal Apparatus Diseases/surgery , Lymphangioma/complications , Lymphangioma/diagnosis , Male , Neoplasm Recurrence, Local , Young AdultABSTRACT
Head and neck paragangliomas are rare neuroendocrine tumors that arise from paraganglion cells of the parasympathetic nervous system. Paragangliomas arising from the midline skull base have only rarely been reported. Surgery is the mainstay of treatment and adjuvant radiation is often recommended. These tumors can rarely secrete metanephrines and normetanephrines which can complicate operative management. Here we present two cases of clival paragangliomas with unique clinical presentations and review the previous literature on skull base paragangliomas.
Subject(s)
Paraganglioma, Extra-Adrenal/pathology , Skull Base Neoplasms/pathology , Aged , Cranial Fossa, Posterior/pathology , Female , Humans , Male , Paraganglioma, Extra-Adrenal/surgery , Skull Base Neoplasms/surgeryABSTRACT
Periorbital scarring with eyelid retraction can have serious visual effects and can lead to loss of vision or even loss of the eye. Understanding of eyelid anatomy and the delicate balance of its structural supports is critical for the identification of the eyelid disorder responsible for the cicatrix and helps to guide treatment. The 2-finger test and lateral distraction of the lid can also be of significant help in proper diagnosis of the underlying disorder. Proper reconstruction with respect to the anterior and posterior lamellae helps to ensure a favorable outcome.
Subject(s)
Blepharoplasty/methods , Cicatrix/surgery , Eyelids/surgery , Antimetabolites/therapeutic use , Cicatrix/drug therapy , Cicatrix/pathology , Cicatrix/physiopathology , Ectropion/etiology , Ectropion/surgery , Entropion/etiology , Entropion/surgery , Eyelids/anatomy & histology , Eyelids/pathology , Eyelids/physiopathology , Fluorouracil/therapeutic use , HumansSubject(s)
Cerebrospinal Fluid Leak/surgery , Endoscopy/adverse effects , Pneumocephalus/etiology , Pneumocephalus/surgery , Rhinitis/surgery , Sinusitis/surgery , Aged, 80 and over , Cerebrospinal Fluid Leak/diagnostic imaging , Cerebrospinal Fluid Leak/etiology , Chronic Disease , Emergencies , Endoscopes , Endoscopy/methods , Follow-Up Studies , Humans , Male , Pneumocephalus/diagnostic imaging , Postoperative Complications/diagnostic imaging , Postoperative Complications/physiopathology , Postoperative Complications/surgery , Reoperation , Rhinitis/diagnosis , Risk Assessment , Sinusitis/diagnosis , Skull Base/surgery , Tomography, X-Ray Computed/methods , Treatment OutcomeABSTRACT
The evolution of wound care has seen much technological advancement over many decades. Most recently, negative-pressure therapy, by which a vacuum pressure is applied through a wound bed, has dramatically improved the surgical outcomes of complex wounds. Although initial studies focused on wounds to the abdomen, torso, and extremities, more publications are appearing that demonstrate the efficacy of negative-pressure wound therapy in the head and neck. This article reviews the history and evolution of negative-pressure therapy, highlights the current opinions on its mechanism of action, and summarizes its use in complex head and neck wounds.
