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Indian Journal of Otolaryngology and... Jun 2024To publish a rare case of Kimura's Disease in Temporal Bone. A 27 year-old male presenting with history of right ear pain and discharge for 2 months was thoroughly...
To publish a rare case of Kimura's Disease in Temporal Bone. A 27 year-old male presenting with history of right ear pain and discharge for 2 months was thoroughly evaluated by clinical evaluation, hematological, radiological and histopathological study. Clinical examination revealed a bulge in posterior-inferior quadrant right side of tympanic membrane. HRCT temporal bone revealed a heterogeneous attenuating focal lesion is noted in the region of right middle ear cavity, mastoid antrum mastoid air cells in continuation with the superior aspect of right jugular foramen with erosions and bone destructions, involving the mastoid air cells and sinus plate. Patient was managed surgically with right side canal wall down mastoidectomy and Type 1 Tympanoplasty. Histopathological examination showed focal ulcerated stratified epithelium, dilated elongated congested blood vessels and hemorrhage. Diagnosis was made as Kimura's disease.
PubMed: 38883553
DOI: 10.1007/s12070-023-04454-1 -
Acta Neurochirurgica Jun 2024Samii Type-D jugular foramen schwannomas (JFSs) are the most challenging for neurosurgeons because of anatomical complexity. Various neurosurgical approaches have been...
BACKGROUND
Samii Type-D jugular foramen schwannomas (JFSs) are the most challenging for neurosurgeons because of anatomical complexity. Various neurosurgical approaches have been described to gain access to JF.
METHODS
We present a female with incidental diagnosis of the Type-D JFS. Complete radical resection was achieved via the carotid triangle approach without any bony structure removal. And the patient was discharged asymptomatic and without new-developed neurological deficits.
CONCLUSIONS
The carotid triangle is a secure and appropriate approach for some cases of selected Type-D JFSs. However, the specific indications of this approach should be further explored and investigated.
Topics: Humans; Female; Neurilemmoma; Jugular Foramina; Microsurgery; Neurosurgical Procedures; Skull Base Neoplasms; Treatment Outcome; Magnetic Resonance Imaging; Middle Aged; Adult
PubMed: 38874622
DOI: 10.1007/s00701-024-06159-y -
Folia Morphologica Jun 2024The aim of the study was to describe the comprehensive morphological and morphometric features of the foramina and canals at the base of the cranial cavity in Holstein...
BACKGROUND
The aim of the study was to describe the comprehensive morphological and morphometric features of the foramina and canals at the base of the cranial cavity in Holstein cow using CT images.
MATERIALS AND METHODS
The study was performed on fourteen adult Holstein cow head cadavers. Images taken with MSCT were transferred to the DICOM Viewer program. The MPR and 3D reconstructive tools of the program were used to analyse the foramina and canals.
RESULTS
Although they varied in shape and size, foramina and canals were found bilaterally in all animals. It was observed that the orbitorotund foramen, jugular foramen and oval foramen had a canalicular structure, with the distance between the extra-intra cranial openings measured as 15.0 mm, 5.9 mm and 6.2 mm, respectively. The hypoglossal canal, which was found to be single in 43%, double in 50% and triple in 7% in each body half, was the canal with the most variation in number and shape. The orbitorotund foramen, a canal with an area of 180.6 mm² and a diameter of 18.1 × 12.4 mm is the widest at the skull base, while the optic canal is the narrowest and longest opening with an area of 33.4 mm², a diameter of 8.4 × 5.5 and a length of 17.5 mm.
CONCLUSIONS
This study shows that our knowledge of skull base morphometry in animals is extremely limited. Although the study was conducted on a limited number of materials, it may benefit both regional anatomy knowledge in terms of the data presented and veterinary anatomists, radiologists and clinicians in terms of methodology.
PubMed: 38856316
DOI: 10.5603/fm.100461 -
Cureus Apr 2024The prolonged use of hemodialysis catheters is associated with several complications with infection being the most common. The increased susceptibility to infections in...
The prolonged use of hemodialysis catheters is associated with several complications with infection being the most common. The increased susceptibility to infections in patients on hemodialysis can be attributed to decreased immunity, though age, other comorbidities, and properties of the catheter act as modifiers. Hematogenous spread of the infection can lead to sepsis and seeding into other organs. In this article, we report an unusual case of septic emboli to the brain in a 30-year-old male on prolonged use of a right internal jugular vein (IJV) catheter for hemodialysis. An interesting finding in the case was the presence of a patent foramen ovale (PFO), a persisting embryonic structure that allows right-to-left shunting. It is suspected that this PFO led to the passage of septic emboli from the right IJV site to the brain. Before our case, septic emboli to the brain have been reported to occur from valvular vegetation in case of infective endocarditis. The mainstay of managing patients with septic emboli is the use of antibiotics; additional interventions may be needed on a case-to-case basis.
PubMed: 38826600
DOI: 10.7759/cureus.59419 -
Tomography (Ann Arbor, Mich.) May 2024The purpose of this study was to analyze the prevalence of and complications resulting from temporal bone fractures in adult and pediatric patients evaluated for... (Comparative Study)
Comparative Study
PURPOSE
The purpose of this study was to analyze the prevalence of and complications resulting from temporal bone fractures in adult and pediatric patients evaluated for cranio-facial trauma in an emergency setting.
METHODS
A retrospective blinded analysis of CT scans of a series of 294 consecutive adult and pediatric patients with cranio-facial trauma investigated in the emergency setting was conducted. Findings were compared between the two populations. Preliminary reports made by on-call residents were compared with the retrospective analysis, which was performed in consensus by two experienced readers and served as reference standard.
RESULTS
CT revealed 126 fractures in 116/294 (39.5%) patients, although fractures were clinically suspected only in 70/294 (23.8%); < 0.05. Fractures were longitudinal, transverse and mixed in 69.5%, 10.3% and 19.8% of cases, respectively. Most fractures were otic-sparing fractures (95.2%). Involvement of the external auditory canal, ossicular chain and the osseous structures surrounding the facial nerve was present in 72.2%, 8.7% and 6.3% of cases, respectively. Temporal bone fractures extended into the venous sinuses/jugular foramen and carotid canal in 18.3% and 17.5% of cases, respectively. Vascular injuries (carotid dissection and venous thrombosis) were more common in children than in adults (13.6% versus 5.3%); however, the observed difference did not reach statistical significance. 79.5% of patients with temporal bone fractures had both brain injuries and fractures of the facial bones and cranial vault. Brain injuries were more common in adults (90.4%) than in children (63.6%), = 0.001. Although on-call residents reliably detected temporal bone fractures (sensitivity = 92.8%), they often missed trauma-associated ossicular dislocation (sensitivity = 27.3%).
CONCLUSIONS
Temporal bone fractures and related complications are common in patients with cranio-facial trauma and need to be thoroughly looked for; the pattern of associated injuries is slightly different in children and in adults.
Topics: Humans; Temporal Bone; Male; Female; Adult; Child; Retrospective Studies; Skull Fractures; Adolescent; Middle Aged; Child, Preschool; Aged; Young Adult; Aged, 80 and over; Infant; Multidetector Computed Tomography; Facial Injuries; Prevalence; Emergency Service, Hospital; Craniocerebral Trauma; Tomography, X-Ray Computed
PubMed: 38787016
DOI: 10.3390/tomography10050056 -
Operative Neurosurgery (Hagerstown, Md.) May 2024Surgery of jugular foramen tumors (JFTs) often requires vascular control by means of ligating the internal jugular vein and sigmoid sinus (SS) to allow intrabulbar...
BACKGROUND AND IMPORTANCE
Surgery of jugular foramen tumors (JFTs) often requires vascular control by means of ligating the internal jugular vein and sigmoid sinus (SS) to allow intrabulbar access. Occlusion of the SS traditionally involves presigmoid and retrosigmoid durotomies allowing introduction of ligature devices, predisposing to cerebrospinal fluid (CSF) leakage and pseudomeningoceles. We describe a simple and novel endoluminal sigmoid sinus occlusion (ESSO) technique with Gelfoam that is entirely extradural.
CLINICAL PRESENTATION
An extended anterolateral infralabyrinthine approach with ESSO was performed in 33 patients with JFTs. After ligating the internal jugular vein, the SS is opened and Gelfoam is placed endoluminally into the proximal SS. Care is taken to avoid occlusion of the venous outflow of the vein of Labbe to avoid temporal lobe venous infarction. Hemostatic gelatin matrix is injected distally to stop venous backflow from the inferior petrosal sinus. The jugular venous system is isolated, and the outer jugular wall can be opened to expose the JFT for resection. There were no complications of temporal lobe venous infarction or postoperative hematoma observed. Four patients with intradural tumor extension developed pseudomeningoceles. For patients with purely extradural JFTs, none developed postoperative incisional CSF leaks and one had pseudomeningocele.
CONCLUSION
This ESSO technique is fast and effective, permitting occlusion of the SS during JFT surgery. It has the advantage of being entirely extradural, avoiding durotomy which can result in postoperative CSF leak. It is important to keep the Gelfoam distal to the transverse-sigmoid junction to avoid occlusion of the vein of Labbe inlet and temporal lobe venous infarction.
PubMed: 38752769
DOI: 10.1227/ons.0000000000001165 -
BMJ Case Reports May 2024A man in his 80s, with a history of diabetes, hypertension and coronary artery disease, presented with bilateral painless progressive vision loss 2 years prior. His...
A man in his 80s, with a history of diabetes, hypertension and coronary artery disease, presented with bilateral painless progressive vision loss 2 years prior. His examination showed subnormal best corrected visual acuity of 20/50 and 20/80 in the right eye and left eye (LE), respectively, grade II relative afferent pupillary defect in LE, normal anterior segment, intra-ocular pressure (IOP) and defective colour vision in both eyes (BE). Fundus examination revealed optic disc pallor, disc collaterals and grade 2 hypertensive retinopathy in BE. Automated perimetry showed advanced field loss in BE. MRI of the brain and orbits with contrast showed signs of raised intracranial pressure, and magnetic resonance angiogram of the brain showed multiple arterio-venous channels along with the right transverse and sigmoid sinuses. The patient was referred to a neuroradiologist for further evaluation, and cerebral angiogram confirmed multifocal high-flow dural arterio-venous fistulae at right jugular foramen, transverse and sigmoid sinuses. He underwent Onyx liquid embolization.
Topics: Humans; Male; Central Nervous System Vascular Malformations; Embolization, Therapeutic; Optic Disk; Aged, 80 and over; Cerebral Angiography; Magnetic Resonance Angiography; Diagnosis, Differential; Magnetic Resonance Imaging
PubMed: 38749525
DOI: 10.1136/bcr-2022-253192 -
SAGE Open Medical Case Reports 2024Collet-Sicard syndrome is a rare neurological disorder caused by injury to the cranial nerve pairs IX, X, X, and XII. The author reports on a previously fit 27-year-old...
Collet-Sicard syndrome is a rare neurological disorder caused by injury to the cranial nerve pairs IX, X, X, and XII. The author reports on a previously fit 27-year-old man who presented with dysphagia, choking on drinking water, hoarseness, weakness when turning the neck and shrugging the shoulders, and unexplained weight loss. Enhanced magnetic resonance imaging indicated a space-occupying lesion at the right jugular foramen. After surgical resection, the pathologic findings suggested a paraganglioma of the right jugular foramen and confirmed the diagnosis of Collet-Sicard syndrome. After postoperative treatment with a combination of acupuncture and modern medicine, the patient's symptoms significantly improved. This article analyzes previous literature regarding Collet-Sicard syndrome etiology and reports the case of a patient with a rare etiology, whose prognosis improved significantly after treatment with a combination of acupuncture and modern medicine.
PubMed: 38737561
DOI: 10.1177/2050313X241249613 -
AJNR. American Journal of Neuroradiology Jun 2024() is an anaerobic bacteria that causes invasive head and neck infections in children. Several studies have demonstrated an increasing prevalence of as the causative...
BACKGROUND AND PURPOSE
() is an anaerobic bacteria that causes invasive head and neck infections in children. Several studies have demonstrated an increasing prevalence of as the causative agent in acute mastoiditis in children, with associated high rates of intracranial complications such as epidural abscess and sinus venous thrombosis, to name a few. requires a treatment protocol that differs from the empiric treatment that is tailored to more common pathogens (eg, group A streptococci, pneumonia), and hence expediting the diagnosis is important. For evaluating complicated acute mastoiditis in children, cranial CT venography remains the imaging study of choice in most medical centers due to its availability in emergency situations. Based on our clinical experience, our hypothesis is that children with -associated complicated acute mastoiditis can be differentiated from those with other etiologies using CT venography.
MATERIALS AND METHODS
CT venography studies of 76 children hospitalized and treated for complicated acute mastoiditis were retrospectively reviewed. Retrieved imaging data included intracranial complications (epidural abscess, sinus venous thrombosis), cranial bone-related complications, and extracranial complications (subperiosteal abscess, temporomandibular joint abscess, and soft-tissue inflammation). The cohort was divided into children with -related disease (study group) and those with non--related disease (control group).
RESULTS
Thirty-seven children (49%) comprised the study group, and 39 children in whom the causative agents were other bacteria comprised the control group. There were significantly higher rates of complications in the study group: sinus venous thrombosis ( < .001), perisigmoid epidural abscess (= .036), and extramastoid osteomyelitis (< .001). Thrombosis in venous sites beyond the sigmoid sinus and jugular foramen (a pattern consistent with an otogenic variant of Lemierre syndrome) and emphysematous osteomyelitis were found only among children in the -related study group (32% and 22% accordingly).
CONCLUSIONS
In children with complicated acute mastoiditis, CT venography findings of emphysematous osteomyelitis and/or thrombosis in venous sites beyond the sigmoid sinus and jugular foramen (a pattern consistent with the otogenic variant of Lemierre syndrome) should lead the radiologist to suggest -related mastoiditis.
Topics: Humans; Mastoiditis; Fusobacterium necrophorum; Male; Child; Female; Child, Preschool; Fusobacterium Infections; Retrospective Studies; Adolescent; Infant; Acute Disease; Tomography, X-Ray Computed; Phlebography; Sinus Thrombosis, Intracranial
PubMed: 38724201
DOI: 10.3174/ajnr.A8217 -
World Neurosurgery May 2024We compared the diameter of the jugular foramen (JF) between normal individuals and those with a diagnosis of craniovertebral junction abnormalities, such as Chiari...
OBJECTIVE
We compared the diameter of the jugular foramen (JF) between normal individuals and those with a diagnosis of craniovertebral junction abnormalities, such as Chiari malformation type I (CMI) and/or basilar invagination (BI).
METHODS
This cross-sectional analytical study measured the diameter of the right and left JF on magnetic resonance imaging scans of patients divided into 4 groups: 68 with combined CMI and BI (CMI+BI), 42 with isolated BI, 45 with isolated CMI, and 102 control cases. The t test determined sex differences, and univariate analysis of variance with Tukey's post hoc test assessed JF differences between groups.
RESULTS
Considering all combinations of laterality and sex, the CMI+BI group had a JF narrower than their respective control groups. The JF was bilaterally narrower in the BI group than in the control group only in the women. Regardless of laterality, the CMI group had a wider JF than did the CMI+BI group in men and did not differ from that of the control group. In the female patients with CMI, the right JF did not differ from that of the controls and was wider than that in the CMI+BI group. Also, the left JF was narrower than that in the control group and did not differ from that in the CMI+BI group.
CONCLUSIONS
JF narrowing is associated with CMI and BI when combined in the same patient. When CMI or BI are detected separately, they do not imply evident changes in JF morphometry. It is expected that these findings could bring empiric substrate to support theories that claim a possible role of intracranial pressure disturbances as a triggering factor for CMI.
PubMed: 38710405
DOI: 10.1016/j.wneu.2024.04.172