Biphasic anaphylaxis after exposure to the first dose of Pfizer-BioNTech COVID-19 mRNA vaccine.

In the setting of a coronavirus disease 2019 (COVID-19) global pandemic and increased disease burden, vaccination has become one of the major solutions. With the increase in vaccination numbers worldwide, it is important to stay vigilant to the potential side effects and life-threatening complications of such vaccines. We report the case of a 30-year-old male with a biphasic allergic reaction post messenger (mRNA) Pfizer-BioNTech COVID-19 vaccination. Several reports of allergic reactions have been cited in the literature after the administration of the mRNA Pfizer-BioNTech COVID-19 vaccine. It is important to keep a high index of suspicion in severe anaphylactic cases as some patients may have a recurrence of symptoms after discharge. It is crucial to acknowledge the potential risk of anaphylaxis in select individuals and have the appropriate measures in place to deal with adverse events. In case of severe symptoms, the administration of epinephrine is advised to prevent the development of a delayed biphasic anaphylactic reaction.

Post-transplant Lymphoproliferative Disease (PTLD) of The Larynx in an Adult With Kidney Transplant; A Case Report.

Post-transplant lymphoproliferative disease (PTLD) is a clinicopathologic entity characterized by an abnormal lymphocytic proliferation that occurs in immunosuppressed patients following organ transplantation. Several sites in the head and neck may be affected by PTLD with rare involvement of the larynx. Affected patients often present with symptoms and signs suggestive of a malignant lesion. Early diagnosis using histopathologic examination is paramount to prevent life-threatening airway compromise. The authors of this manuscript report a 52-year-old women, diagnosed case of renal failure for which she had undergone kidney transplant, who presented with symptoms of laryngeal PTLD. The clinical work-up and management of these cases is reviewed.

Loop underlay tympanoplasty for anterior, subtotal and total tympanic membrane perforations: a retrospective review.

BACKGROUND: The study aims at reporting our experience with loop underlay tympanoplasty, a modification of the underlay technique previously reported, for the reconstruction of anterior, subtotal or total tympanic membrane perforations. METHODS: A retrospective review of charts of patients who have undergone loop underlay tympanoplasty from January 2002 to January 2012 was performed. One thousand one hundred patients were included. Hearing test results preoperatively and postoperatively were reported. On follow up visits, the closure of the tympanic membrane perforation and the improvement of hearing compared to preoperative measurements with absence of complications were considered as successful outcomes of the surgery. RESULTS: At the three-month follow-up visit, the perforation closure rate was found to be 99.3% and Air-Bone Gap closure rate to less than 10 dB was 99.5%. The complication rate, including post-operative infection, was 0.72%. CONCLUSION: The loop underlay technique combines advantages of both underlay and overlay techniques with excellent postoperative outcomes.

Transglottic basaloid squamous cell carcinoma of the larynx.

OBJECTIVE: To report a rare case of Transglottic Basaloid Squamous cell carcinoma of the larynx and review the pathologic features of these lesions. CASE REPORT: A 64 year old male, heavy smoker and alcohol abuser, presented with a 6 month history of hoarseness. Laryngoscopy revealed a right transglottic lesion involving the epiglottis, aryepiglottic fold, ventricle and true vocal fold. Microscopically, the tumor was characterized by infiltrating solid sheets of basaloid cells showing palisading pattern along the edges. In areas of solid growth, tumor cells displayed scant cytoplasm, and hyperchromatic nuclei. A portion of the tumor abutting the thyroid cartilage showed squamous differentiation. An island of tumor cells with comedonecrosis was also noted. Immunohistochemical staining for a number of markers was performed. CONCLUSION: Basaloid squamous cell carcinoma displays a biphasic histology. The stage of the disease at presentation is invariably advanced with metastatic lymphadenopathy in two thirds of the patients.

Status of the remaining parotid duct and gland following superficial parotidectomy.

The changes in Stensen's duct and remaining parotid tissue following superficial parotidectomy have not been studied previously. The aim of this clinical case control study is to describe these changes using sialography and CT-sialography techniques. Fourteen superficial parotidectomy cases underwent parotid sialography bilaterally. CT sialography was also done. Stensen's duct was patent in 11 cases (79%), and non-patent in three cases (21%). Its angle in relation to our reference line was 20 degrees in operated cases versus 37 degrees for the non-operated cases. Following superficial parotidectomy, the remaining parotid tissues usually remain functional and retain drainage through Stensen's duct. Furthermore, superficial parotidectomy changes the direction of this duct. Parotid sialography and CT sialography can still be used to study the status of remaining parotid tissue following superficial parotidectomy. The post-surgical changes should be reviewed with care before interpreting these studies.