HPV Type 6 and 18 Coinfection in a Case of Adult-Onset Laryngeal Papillomatosis: Immunization with Gardasil.

Laryngeal papillomatosis (LP) is a rare human papillomavirus (HPV) related disease that often requires multiple surgical interventions and residual impairment of voice is almost inevitable. We report the case of a patient with adult onset recurrent LP, showing moderate dysplasia and coinfection with HPV types 6 and 18. The tetravalent HPV vaccine Gardasil was prescribed off label, with the aim of triggering an immunogenic response and consequently reducing the probability of further recurrences.

Use of the pedicled nasoseptal flap in the endoscopic management of cholesterol granulomas of the petrous apex.

Background: Nowadays the endoscopic approach represents a useful alternative to traditional surgical approaches in the treatment of cholesterol granulomas (CGs) of the petrous apex (PA). Recently the nasoseptal flap (NSF) has been employed to permit long-term patency of drainage site. The purpose of this study is to report our experience with the NSF in the endoscopic management of CG and to analyze the advantages, limitations, and outcomes of the technique.

Comparison of three different polyvinyl alcohol packs following functional endoscopic Nasal surgery.

Objectives/hypothesis: To compare the extent of bleeding and patient discomfort during packing removal of three different polyvinyl alcohol (PVA) packs: 1) a standard PVA sponge (s-PVA) (Mondocel Standard 10 cm; Mondomed NV, Hamont-Achel, Belgium); 2) a PVA sponge with oxidized cellulose (oc-PVA) (Merocel Hemox 10 cm; Medtronic Xomed Surgical Products, Jacksonville, FL); and 3) a PVA sponge with polyethylene film (pf-PVA) (Merocel 2000 8 cm; Medtronic Xomed Surgical Products, Jacksonville, FL), after functional endoscopic sinus surgery and inferior turbinoplasty.

Study Design: A prospective, randomized, blinded, controlled trial.

Methods: Ninety consecutive patients were enrolled and randomized to receive in each side one pack in the middle meatus and another pack of the same material in the nasal fossa.

Palatovaginal (pharyngeal) artery: clinical implication and surgical experience.

The palatovaginal or pharyngeal artery is a small branch of the internal maxillary artery supplying the nasopharynx. Bleeding from this artery is exceptional and only one case of traumatic epistaxis from this artery has been reported previously. We report a case of a 66-year-old male presenting with right recurrent posterior epistaxis.

Mediastinal abscess and esophageal stricture following voice prosthesis insertion.

The use of a tracheo-esophageal voice prosthesis is a well-established procedure to restore the voice in total laryngectomees. The insertion of the prosthesis is not a risk-free procedure, various complications having been reported especially in irradiated patients. Here described is a case of an esophageal rupture after secondary tracheo-esophageal puncture with mediastinal abscess in a patient previously treated with pharyngo-laryngectomy and subsequent radiotherapy for a left pyriform sinus carcinoma, which required immediate surgical drainage through a left cervical approach.

Primary orbital eosinophilic angiocentric fibrosis with intranasal extension.

Background: Eosinophilic angiocentric fibrosis is a chronic, idiopathic disorder that usually involves the upper respiratory tract and features progressive submucosal perivascular fibrosis of unknown etiology. To our knowledge, only 5 cases of eosinophilic angiocentric fibrosis with primary orbital involvement have been reported.

Methods And Results: We report the case of a 46-year-old man with right proptosis and lateral globe displacement caused by a primary eosinophilic angiocentric fibrosis extending from the orbit into the anterior ethmoid.

Pediatric follicular dendritic cell sarcoma of the head and neck: a case report and review of the literature.

Objective: Follicular dendritic cell sarcoma is a rare disease with a non-specific and insidious presentation that is further complicated by difficult diagnostic and therapeutic assessment.

Methods: The database PubMed was searched for reports of follicular dendritic cell sarcoma between 1986 (first case published) and 2012. All of the articles presenting informations regarding one or more cases of follicular dendritic cell sarcoma of the head and neck region, in patients less than 18 years of age, were included.

Oncocytic Schneiderian papillomas: Clinical behavior and outcomes of the endoscopic endonasal approach in 33 cases.

Background: The purpose of this study was to evaluate the clinical behavior of oncocytic Schneiderian papillomas in relation to the rate of malignant transformation and recurrences and to report the long-term results of the endoscopic endonasal treatment.

Methods: A retrospective analysis was carried out on patients with oncocytic papilloma, endoscopically managed over the past 20 years, at 2 university centers following a uniform policy.

Results: Thirty-three patients were treated between November 1991 and December 2010.

A rare localization of actinomycosis mimicking ulcerative malignancy.

Actinomycosis is a chronic, suppurative, and granulomatous process caused by Actinomycetes, saprophytic bacteria normally residing in the oral cavity. It can involve any organ, but the cervicofacial disease is the most frequent. Pharyngolayngeal involvement is rare and usually occurs secondary to the oral or cervical disease.

A novel technique for tailoring frontal osteoplastic flaps using the ENT magnetic navigation system.

Conclusion: The ENT magnetic navigation system is potentially useful and offers the most accurate technique for harvesting frontal osteoplastic flaps. It represents a valid tool in the wide range of instruments available to rhinologists.

Objective: Precise delineation of the boundaries of the frontal sinus is a crucial step when harvesting a frontal osteoplastic flap.

Omental Well-Differentiated Liposarcoma: US, CT and MR Findings.

Liposarcomas are the most common of sarcoma tumours, they are usually located in the lower limbs, retroperitoneum, or abdominal cavity; up to date, only a few cases of omental liposarcoma with different histotype have been described. We present a case of omental well-differentiated liposarcoma and discuss imaging findings on ultrasound, computed tomography, and magnetic resonance to differentiate omental liposarcomas from other abdominal tumour entities.

Cardiocutaneous fistula in a delayed iathrogenic ventricular perforation of the heart: computed tomographic and magnetic resonance imaging findings.

Cardiac iathrogenic lesions can occur during diagnostic or therapeutic procedures. Resistance of the heart to an injury may cause a delay from the traumatic event to onset of the symptomatology or to heart rupture. We describe a rare case cardiac perforation with delayed rupture of the heart in a patient previously submitted to radiation therapy for breast cancer.

Laryngeal true malignant mixed tumor.

Background: True malignant mixed tumor, also known as carcinosarcoma, is a salivary gland type malignant neoplasm, which is extremely rare, and only a few cases arising in the larynx have been previously reported.

Methods And Results: We report a case of true malignant mixed tumor arising in the larynx of a 65-year-old woman successfully treated with surgery. Histologically, the neoplasm was composed of variably mixed, neoplastic glandular, spindle, and chondroid tissues.

Distortion-product otoacoustic emission: early detection in deferoxamine induced ototoxicity.

Objective: Deferoxamine therapy in lifelong transfusion-dependent anaemias, as beta-thalassemia major, is associated with an increased risk of ototoxic changes. With increasing survival rates, prevention and/or early detection of ototoxicity are important for providing management options. The predictive value of pure-tone audiometry in early detection of ototoxicity has been questioned, particularly in the higher frequencies.

Effective management of intrathoracic anastomotic leak with covered self-expandable metal stents. Report on three cases.

Intrathoracic anastomotic leakage is one of the major complications of esophageal surgery that can lead to high mortality rate. Depending on the clinical presentation, therapeutic options include surgical reintervention and conservative management with or without external drainage or stenting. In this paper, we report a series of three patients, two men and one woman, mean age of 55.

Lymph node axillary metastasis from occult contralateral infiltrating lobular carcinoma arising in accessory breast: MRI diagnosis.

We describe a case of right axillary lymph node metastasis of an occult infiltrating lobular carcinoma arising from accessory mammary gland of the left upper anterior chest wall. Ultrasonography and mammography were normal bilaterally. Magnetic resonance imaging (MRI) revealed a 3.

Endoscopic treatment of antrochoanal polyps.

The antrochoanal polyp (Killian polyp) is an infrequent, benign neoplasm, which arises from the maxillary sinus to reach the ipsilateral choana. The treatment of this disease is essentially surgical, by means of a wide antrostomy. The aim of the study was to compare the results obtained on 23 consecutive cases of antrochoanal polyps endoscopically treated between February 1997 and January 2000 with those reported in the literature, with particular regard to the surgical technique adopted, the histological features, the patterns of its development and the clinical outcomes.

Paget's disease of the nipple diagnosed by MRI.

Background: Paget's disease of the breast is a rare manifestation of breast carcinoma.

Case Report: The patient presented with a red lesion of the left nipple-areola complex. Breast physical examination, ultrasonography and mammography were normal bilaterally.

Bilateral oncocytoma of the parotid gland.

Oncocytic neoplasms are a group of rare tumours that mostly affect the parotid gland (80%), sometimes affect the submandibular gland (9%) and rarely affect the intraoral minor salivary glands. The incidence of oncocytic neoplasms represents approximately 1% of parotid neoplasms and bilateral presentation is very rare. Herein we describe a single case involving bilateral presentation of oncocytoma of the parotid glands.