Fifty consecutive patients over the age of 15 years undergoing tonsillectomy had one tonsillar fossa obliterated by 2/0 Polydioxanone (PDS II) suture. The opposite side was used as a control. Pain was assessed on a visual analogue scale from the first to tenth post-operative day. Although on the initial post-operative days the pain was more on the sutured side, 41 patients subsequently experienced significant pain relief on that side (P = 0.0001). No complications were encountered due to the tonsillar fossa obliteration. On the 10 day review, the 41 patients indicated in their questionnaire that tonsillar fossa obliteration is a useful procedure to reduce the post-operative pain and would have preferred both sides to be obliterated rather than left to heal by secondary intention.
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Int J Surg Case Rep
January 2025
King Edward Medical University Lahore, Pakistan.
Introduction And Importance: The branchial or pharyngeal apparatus, crucial in embryological development, consists of clefts, arches, pouches, and membranes. Anomalies arising from this apparatus particularly involving the second branchial arch, are rare. Among these anomalies, complete second branchial cleft fistulas, with both external and internal openings, are exceptionally uncommon.
View Article and Find Full Text PDFCase Rep Med
December 2024
Department of Otolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE.
This case report describes a rare presentation of a cartilaginous choristoma of the oral cavity within the tonsillar fossa, emphasizing the importance of recognizing and differentiating this uncommon entity from more frequently encountered oral lesions. A comprehensive clinical and histopathological examination was conducted on a 30-year-old male patient who presented with a painless mass in the nasopharynx. An excisional biopsy was carried out, and a histopathological analysis was conducted to establish a definitive diagnosis.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
December 2024
Division of Neurosurgery, Children's Hospital Los Angeles, Los Angeles, California.
Background: Glossopharyngeal neuralgia (GPN) is a rare condition typically manifesting as paroxysms of sharp, lancinating pain localized to the middle ear and auditory canal, base of the tongue, tonsillar fossa, and region just inferior to the angle of the mandible. Vascular compression is a common etiology, and microvascular decompression (MVD) has been established as a safe and efficacious treatment in adults. With the exception of one report of an adult patient undergoing the procedure for symptomatology that began in adolescence, there are no published cases of MVD for GPN in pediatric patients to the author's knowledge.
View Article and Find Full Text PDFJ Neurosurg Spine
December 2024
7Department of Neurosurgery, Rhode Island Hospital, Warren Alpert Medical School, Brown University, Providence, Rhode Island.
Objective: Craniocervical junction morphology has been associated with Chiari malformation type I (CMI) symptom severity; however, little is known about its deterministic effect on surgical outcomes in patients across age and sex differences. The goal of the present study was to assess the effects of age and sex on surgical outcomes in CMI.
Methods: In the present study, the authors examined MRI-based morphometric data from 115 individuals diagnosed with CMI (54 adults including 39 women and 15 men, and 61 children including 24 girls and 37 boys) and correlated them with Chicago Chiari Outcome Scale (CCOS) scores obtained 1 year after posterior fossa decompression.
Posterior reversible encephalopathy syndrome (PRES) is a reversible clinico-radiological condition primarily affecting the occipito-parietal regions. Thalami, brainstem, and cerebellar involvement with posterior fossa oedema are rare manifestations of this condition. We present the case of a 66-year-old male with a travel history to Thailand who was found collapsed on the floor two weeks after his return.
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