ABSTRACT
A 39-year-old male was referred to our service for treatment of an asymptomatic mediastinal mass. The mass was detected on a routine pre-employment chest X-ray. CT scan showed a well-defined soft tissue mass measuring 7.5 × 5.5 × 5.3 cm in close relation to the right border of the heart. A CT-guided biopsy proved to be inconclusive as necrotic tissue was obtained. At exploratory thoracotomy, a well-defined cyst was found attached to the right side of the pericardium. The cyst was totally excised and sent for histopathological examination which came back with a surprise diagnosis of epidermoid cyst.
ABSTRACT
Tapia's syndrome is a rare complication following cardiac surgery. It includes the extracranial involvement of the recurrent laryngeal nerve and the hypoglossal nerve and results in ipsilateral paralysis of the vocal cord and the tongue. It is usually a complication related to anaesthesia and positioning of the head of the patient during surgery. We describe this rare complication which occurred at our institute. A 49-year old man developed Tapia's syndrome after an uneventful coronary artery bypass surgery. He complained of dysphonia, hoarseness of voice and an inability to swallow soon after extubation. The syndrome resolved completely over the following weeks with no neurological deficit.
Subject(s)
Coronary Artery Bypass/adverse effects , Hypoglossal Nerve Diseases/etiology , Patient Positioning/adverse effects , Recurrent Laryngeal Nerve , Vocal Cord Paralysis/etiology , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications , SyndromeABSTRACT
To determine the role of mediastinoscopy (MDS) in the histological diagnosis of isolated mediastinal lymphadenopathy in a centre where more sophisticated investigations, like positron emitting tomography (PET) scan and endobronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) is not available. This is a retrospective study. From January 2006 to December 2009, 31 patients with isolated mediastinal lymphadenopathy underwent MDS to establish a histological diagnosis. The mean age was 36.3 years. Among the patients, 19 were males and 12 were females. The most common symptom was dry cough in 18 (58%) patients. The diagnostic yield was 96.8%, with sarcoidosis being the commonest diagnosis. It was concluded that MDS was vital in establishing a histological diagnosis in patients with isolated mediastinal lymphadenopathy.
