Case report: nodular fasciitis of the parotid region.

OBJECTIVE: To demonstrate the clinical and histopathological features of nodular fasciitis in the parotid region. CASE REPORT: A 24-year-old man presented with a palpable mass in the superior border of the parotid gland. The mass was firm and immobile, with a smooth surface. Fine needle aspiration cytology revealed proliferating fibroblasts, macrophages and adipocytes among the blood cells. Although a superficial parotidectomy was initially planned, a total excision was performed, as the mass was observed to be located in the periphery of the parotid tissue. Nodular fasciitis was diagnosed, based on the results of immunohistochemical analysis. CONCLUSION: Nodular fasciitis very rarely occurs in the parotid region. These lesions grow quickly, and may be misdiagnosed as sarcoma. Trauma may play a role in their aetiology. Total excision is adequate as treatment.

Efficiency of Stenger test in confirming profound, unilateral pseudohypacusis.

OBJECTIVE: Conscious and deceptive exaggeration of hearing loss is termed pseudohypacusis. Even though the Stenger test has been used in the management of pseudohypacusis for almost a century, its sensitivity, specificity and predictive values for unilateral pseudohypacusis have not previously been reported, to our best knowledge. We investigated the efficiency of the Stenger test in detecting unilateral pseudohypacusis, accepting auditory brainstem response testing as the 'gold standard'. MATERIALS AND METHODS: Candidates with questionable profound or total hearing loss were enrolled in the study. Pure tone audiometry, speech and tonal Stenger tests, and click test auditory brainstem response measurement were performed. Accepting auditory brainstem response testing as the gold standard, the sensitivity, specificity and predictive values of the Stenger test for unilateral, profound pseudohypacusis were assessed. RESULTS: Two hundred military candidates were enrolled in the study. The sensitivity and specificity of the Stenger test in verifying unilateral, profound hearing loss were 99.4 and 70 per cent, respectively. The positive and negative predictive values of the test were 87.5 and 98.4 per cent, respectively. CONCLUSION: The Stenger test is widely used for the evaluation of unilateral or asymmetrical pseudohypacusis. In our opinion, it is a powerfully reliable test. More difficult cases require objective electrophysiological testing to verify functional hearing loss and to exclude specific diagnoses that may imitate pseudohypacusis.

Bilateral maxillary sinus hypoplasia and aplasia: radiological and clinical findings.

Maxillary sinus hypoplasia (MSH) is classified into three types depending upon embryological development of the sinus and uncinate process. Type III MSH is characterized by a near-absence of the uncinate process and an almost absent cleft-like sinus. Bilateral maxillary sinus aplasia or severe hypoplasia with associated paranasal sinus abnormalities is extremely rare. Two cases with severe maxillary sinus hypoplasia/aplasia (one of them with other associated paranasal sinus abnormalities) are presented in this article. This extremely rare abnormality should be kept in mind to prevent misdiagnosis and possible complications during endoscopic sinus surgery.

Effectiveness of hyperbaric oxygen therapy in idiopathic sudden hearing loss.

The aim of this study was to investigate the efficacy of hyperbaric oxygen (HBO) therapy in idiopathic sudden sensorineural hearing loss (ISSHL) by comparing hearing gain and improvement rate in patients who have been placed on both HBO and medical treatment (MT) (37 patients), and patients who have received MT only (17 patients). Both groups were compared with reference to pure tone average (PTA) and the number of patients who experienced hearing gain. Of 37 patients (40 ears) who received HBO + MT, 24 (60 per cent) experienced > or = 10 decibels (dB) improvement in PTA compared to 13 (76.4 per cent) of 17 patients who were placed on MT only. Inter- or intra-group comparison of age stratification (< 50 and > or = 50 ages) did not produce significant differences in PTA and in the number of patients who experienced hearing gain. Although there are numerous studies showing efficacy of HBO therapy; this study did not reveal a trend in favour of HBO therapy.