Unveiling the Rarity: A Fascinating Case of Chondro-Osseous Respiratory Epithelial Adenomatoid Hamartoma (COREAH) in the Sinonasal Tract.

Chondro-osseous respiratory adenomatoid hamartoma (COREAH) are extremely rare benign lesions of the sinonasal tract. It is present in 3 to 83-year-olds. It originates from various sites of the sinonasal tract; the most common site is the posterior lateral wall of the nasal cavity. Imaging calcification is an important finding in COREAH. In this case report, we present an exceptionally rare occurrence involving a 55-year-old female patient who exhibited symptoms of nasal obstruction, bleeding from the left side of the nasal cavity and loss of smell. We aim to share our experience in managing this unique condition. Diagnostic nasal endoscopic examination of the patient revealed a reddish, fleshy polypoidal mass in the left nasal cavity arising from the lateral wall of the left nasal cavity posteriorly and extending anteriorly into the left nasal cavity. The patient underwent an excisional biopsy. Upon microscopic examination, we observed a hamartomatous proliferation of respiratory-type glands exhibiting mucinous metaplasia. Additionally, numerous spicules of mature bone were present, a distinctive feature of COREAH. The patient underwent a 6-month follow-up, during which no recurrent growth was detected within the nasal cavity.

Sublingual Space Schwannoma: An Uncommon Tumour in a Unique Anatomical Location.

A Schwannoma is a benign tumour originating from Schwann cells within the peripheral, cranial, or autonomic nerves. Typically, these tumours manifest as a solitary, slow-growing mass with smooth surface, usually devoid of significant symptoms. Schwannomas most frequently appear in individuals aged 30-50 years. Although they are relatively uncommon, approximately one-fourth of all Schwannomas are found in the head and neck area. Its occurrence within the oral cavity, with the tongue being the most common site, followed by the palate, floor of the mouth, buccal mucosa, lips, and jaws. Diagnosing these tumours before surgery can be challenging, and in most instances, a definitive diagnosis can only be established through surgical intervention and subsequent histological examination. Immunohistochemistry plays a crucial role in confirming the diagnosis, as it shows that Schwannoma cells exhibit a positive reaction to the S-100 protein. Here, we present a case of a Schwannoma in the floor of the mouth, observed in an 18-year-old male patient.

Advances in Lingual Thyroid Management Using Coblation Technology: A Case Series Study.

Lingual thyroid is a rare, abnormal ectopic thyroid tissue seen at the base of the tongue. It is a rare embryological anomaly caused by the failure of the descendence of the thyroid gland from the foramen caecum to its normal prelaryngeal area. The main aim of our study is to discuss recent advancements in the management of lingual thyroid using coblation technology. We are discussing the prospective study of 12 lingual thyroid cases that came to the government ENT hospital, Koti, in Hyderabad, from July 2016 to July 2023. All patients were assessed by a detailed history, blood investigations, fine needle aspiration cytology, radiological investigations, technetium-99 scintigraphy, and an endocrinologist opinion. In our study, all cases were hypothyroid and showed difficulty in swallowing and a few cases showed bleeding from the mouth, and difficulty in breathing, hence all 12 cases underwent coblation-assisted excision of swelling and with lifelong thyroxine supplementation. For all 12 cases, demographic, clinicopathological data and radiological data were recorded. Treatment depends on the age of the patient, the severity of symptoms, precipitating factors like puberty or pregnancy, or any other comorbidities with the disease. In our study, all cases were symptomatic and hypothyroid status, hence all 12 cases underwent coblation-assisted excision of swelling and lifelong thyroxine supplementation. All cases were followed up for 2 years with good recovery, minimal patient discomfort after surgery, and lifelong levothyroxine supplementation. Lingual thyroids have a female preponderance. In our study, all were female. Thyroid scintigraphy plays an important role in diagnosis, along with ultrasonography. In all symptomatic cases, surgery with Coblation-assisted excision of swelling is the treatment of choice, with good recovery, minimal patient discomfort after surgery and with lifelong levothyroxine supplementation.

Angiolymphoid Hyperplasia with Eosinophilia of the External Auditory Canal.

Angiolymphoid hyperplasia with eosinophilia is a rare, benign, vaso-proliferative disease with a dense eosinophilic inflammatory infiltrate seen in the intradermal or subcutaneous region. It is also termed an epitheloid hemangioma, and it mostly affects females rather than males. It is seen as reddish to brown, fleshy, proliferative, papular, or nodular lesion affecting the head and neck region, most commonly the auricular and periauricular regions. The aetiology is unknown, but the most likely causes are trauma, infection, and hyperestrogenic condition like pregnancy or the use of oral contraceptive agents. It usually measures about 2-3 cm in size. It should be differentiated from Kimura disease, which is characterized by chronic inflammation and large subcutaneous nodules in the head and neck region. Here is a rare case report of angiolymphoid hyperplasia in a middle-aged male patient involving the external auditory canal of the left ear.

Beyond the Blockage: Unveiling Diagnosis and Management of Choanal Atresia-A Case Series.

Choanal atresia is a rare congenital disorder characterised by anatomical closure of the posterior choana in the nasal cavity due to failed recanalization during foetal development. The main aim of our study is to focus on our experience with choanal atresia and its management. In this study, we are discussing the prospective study of 12 cases of choanal atresia that came to a tertiary hospital from July 2017 to July 2022. All 12 choanal atresia cases underwent thorough evaluation, including history, blood investigations, nasal endoscopy, and CT scanning. Intra-nasal endoscopic choanoplasty with stenting was performed on all patients, followed by a 2-year follow-up, except for one case that missed follow-up after 6 months. All 12 cases were female, with their ages varying from newborn to 4 months old. In our study, 75% were unilateral and 25% were bilateral cases from newborn to 4 months old. The right was more prevalent in unilateral choanal atresia. The mixed type was the most commonly observed. The most common symptom was difficulty breathing and a running nose. All cases achieved an adequate patent airway. No intraoperative complications were noted in any case. All cases of choanal atresia can be diagnosed by a cold spatula test, failure to pass an intra-nasal catheter, and a CT scan is confirmatory. Surgical correction with endoscopic intranasal choanoplasty and stenting has less morbidity, a high success rate, and a lower recurrence rate.