Intracavernous Aneurysm Mimicking Tolosa-Hunt Syndrome.

Introduction: Tolosa-Hunt syndrome (THS) is a disorder related to inflammation of cavernous sinus and superior orbital fissure that usually presents with ophthalmoplegia and oculomotor nerve palsies. The etiology of the syndrome is unknown and the diagnosis is set by exclusion of other clinical conditions that manifest in a similar way. Intracranial aneurysms, such as intracavernous ones, should be included in the differential diagnosis as they can compress cranial nerves leading to similar clinical presentation.

Evaluation of Effects of Diabetes Mellitus, Hypercholesterolemia and Hypertension on Bell's Palsy.

The aim of this study is to evaluate the effects of diabetes mellitus, hypertension and hypercholesterolemia on the clinical presentation and outcome of Bell's palsy. The study (comorbidity) group consisted of 50 patients with Bell's palsy associated with diabetes, hypertension, or hypercholesterolemia; the control group included 46 patients with Bell's palsy, but without comorbid diseases. The House-Brackmann grading system (I to VI) was used in order to assess the initial and final facial functions.

Percutaneous endoscopic gastrostomy through a cervical esophageal fistula. An alternative, much improved technique for patient safety.

Purpose: Percutaneous endoscopic gastrostomy [PEG] by the pull-technique is easy and safe to perform through the oral cavity. However, the presence of a cervical esophageal fistula, either due to tumor invasion or simply inflammation and tissue necrosis after previous intervention or radiotherapy, in the anterior cervical region is of crucial importance when passing the endoscope and the PEG catheter from the mouth downwards.

Methods: We describe a modification of the standard peroral PEG, which is to insert the endoscope from the cervical esophageal opening instead of the oral cavity, and we support the use of this "stoma" as a way to protect it and avoid possible forceful dilatation/expansion when advancing the endoscope and the gastrostomy catheter through the mouth.