Enhancement of the subarachnoid space after intravenous administration of gadolinium contrast agent is not common. Enhancement usually occurs in pathological conditions that increase the permeability ...of the blood–cerebrospinal fluid barrier, most notably in meningitis. We herein describe possible subarachnoid enhancement in patients with no apparent effect on the meninges. These patients had clinical signs of Meniere’s disease and underwent specific magnetic resonance imaging of the inner ear to possibly visualize endolymphatic hydrops. The endolymphatic space can be noninvasively imaged by intravenous administration of contrast agent, usually at a double dose, 4 hours before the scanning process. During this time, the contrast agent penetrates not only the perilymph but also the subarachnoid space, where the highest concentration occurs after 4 hours according to some studies.
DEVELOPMENTAL ANOMALIES IN THE NECK Chrobok, Viktor; Šatanková, Jana; Dědková, Jana ...
Listy klinické logopedie,
9/2017, Letnik:
1, Številka:
2
Journal Article
Recenzirano
Odprti dostop
An outline of developmental anomalies in the neck of children and adolescents is provided. These include, in particular, lateral cervical fistulas and cysts, medial cervical cysts, and anomalies of ...large cervical vessels. The aim is to give speech and language pathologists an insight into the issue and to highlight the possibility of swallowing disorders in some diseases demonstrated in case reports.
Mucocutaneous mycotic infections are common complications in patients on IL-17 inhibitor therapy. We report a case of a 33-year-old male with severe psoriasis and psoriatic arthritis on secukinumab ...combined with methotrexate and prednisone with swelling, otorrhea, and pain of the right ear and external auditory canal. Due to progressive hypacusis, a surgical solution was chosen. Tissue samples taken during surgery revealed the presence of Aspergillus fumigatus. Aspergillosis should be suspected in prolonged otorrhea, especially in immunocompromised patients. Without intervention, the disease could be fatal.
Introduction: Inflammatory myofibroblastic tumour (IMT) is a rare tumour with borderline biological behaviour composed of fibroblasts and myofibroblasts and accompanied by non-neoplastic inflammatory ...cells. It occurs mostly in children and young adults. The disease is most commonly seen in abdominal soft tissues (omentum, mesentery, etc.), in the lungs and also has been reported in other parts of gastrointestinal tract and other organs. In the head and neck region IMT is not so common, it may occur in larynx, trachea or nasal sinuses. The primary therapeutic approach is a complete surgical excision. Radiation, chemotherapy or biological treatment modalities are used in aggressive, non-resectable, and recurrent tumours or in case of metastases. Aims: Through a case report on a small set of patients and up-to-date information from the literature, the authors want to share knowledge about the rare diagnosis of IMT in ENT, its possible clinical manifestations, differential diagnosis and appropriate treatment. The group of patients, the case report: The paper presents patients with IMT treated at the Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove in the years 2013–2020. The case of a 11-year-old boy with progressive dyspnoea caused by polypoid tracheal tumour is discussed in more detail. The tumour was removed by external surgical approach with bronchoscopy assistance. Histological examination proved an IMT. Conclusion: IMT is a rare neoplasm which must be included in the differential diagnosis of tumours of the respiratory tract, especially in children and young adults. The treatment consists of complete surgical removal and regular follow-up due to the risk of local recurrence. Keywords: inflammatory myofibroblastic tumour – dyspnoea in a child – tracheal tumour
Canal wall down mastoidectomy is one of the most effective treatments for cholesteatoma. However, it results in anatomical changes in the external and middle ear with a negative impact on the ...patient's quality of life. To provide complete closure of the mastoid cavity and normalize the anatomy of the middle and external ear, we used human multipotent mesenchymal stromal cells (hMSCs), GMP grade, in a guinea pig model. A method for preparing a biomaterial composed of hMSCs, hydroxyapatite, and tissue glue was developed. Animals from the treated group were implanted with biomaterial composed of hydroxyapatite and hMSCs, while animals in the control group received hydroxyapatite alone. When compared to controls, the group implanted with hMSCs showed a significantly higher ratio of new bone formation (p = 0.00174), as well as a significantly higher volume percentage of new immature bone (p = 0.00166). Our results proved a beneficial effect of hMSCs on temporal bone formation and provided a promising tool to improve the quality of life of patients after canal wall down mastoidectomy by hMSC implantation.
Summary Rhinogenic inflammatory intracranial complications are relatively rare, but they are very serious and can be fatal. The diagnosis is mainly based on anamnesis, objective examination, imaging ...methods and laboratory findings. Our case study is devoted to an intracranial complication of sinusitis of a 17-year-old patient. It was a subperiosteal abscess with simultaneous subdural abscess in the frontal region and osteomyelitis of the frontal bone. The patient came to the otorhinolaryngology clinic at Jičín Regional Hospital with prolonged rhinosinusitis, after already receiving primary therapy of oral aminopenicillin with a temporary effect. An objective examination revealed slight swelling in the area of the root of the nose and eyelids, rhinoendoscopic swelling of the mucous membranes with mucopurulent secretion in the middle nasal passage on the left. The original suspicion of an orbital complication of rhinosinusitis was ruled out by a CT scan. The patient was hospitalized and treated with intravenous antibiotics, corticoids and the nasal cavity was treated locally and the inflammatory parameters decreased gradually. During hospitalization, swelling of soft tissues progressed frontally, without neurological symptoms. Due to the suspicion that there was an intracranial complication of rhinosinusitis, a CT scan of the paranasal sinuses and brain was performed. The radiologist diagnosed subdural empyema and osteomyelitis of the frontal bones. An acute transfer to the neurosurgery clinic of the University Hospital in Hradec Králové for intravenous antibiotic therapy and surgical intervention by a neurosurgeon and otorhinolaryngologist was arranged. Postoperative healing was favourable. Key worlds paranasal sinuses – sinusitis – subdural abscess – osteomyelitis
Grisel’s syndrome – case report Kossuthová, Nicol; Mejzlík, Jan; Zadrobílek, Karel ...
Otorinolaryngologie a foniatrie,
5/2021, Letnik:
70, Številka:
2
Journal Article
Recenzirano
Introduction: By definition from the literature, Grisel’s syndrome is described as non-traumatic rotational atlantoaxial instability between C1 and C2 vertebrae. It can occur during an infection of a ...soft tissue in the cervicocranial region or after an operation in the ENT region. Because of the frequent occurrence after operations, we inclined to the definition which includes a traumatic subluxation as a cause of origin, and it’s not defined as non-traumatic only. The instability manifests itself with abnormal head posture that is called torticollis. Increased incidence in adolescence is more common because of a greater ligamentous laxity of the joint capsules, increased perfusion of antlantoaxial regions and longer alar ligaments. In this article, the case of a child with Grisel’s syndrome after adenotomy is described. The pathophysiology, symptomatology, diagnostic management and treatment are discussed. Keywords: Grisel’s syndrome – torticollis – atlantoaxial instability – adenotomy
Introduction: Nontuberculous mycobacterial (NTM) infection of lymph nodes in young children is a rare disease. The increasing incidence has been observed after termination of vacciation in Czech ...Republic in November 2010. Aim of the study: To provide an overview of the clinical picture, dia gnostic options and therapeutic approach in children with neck lymph nodes aff ected by non-tuberculous mycobacteria. Methods: Retrospective cohort study of patients with confi rmed NTM infection treated at the Clinic of Otorhinolaryngology and Head and Neck Surgery of Faculty Hospital Hradec Kralove from 2010 to 2021. The inclusion criterion was proof of the causative agent of the disease (nontuberculous mycobacteria) by culture or molecular bio logical technique (PCR). Results: A total of 19 children with an average age of 26 months (range 12–42, SD 7.27) were enrolled. The most frequent pathogen was Mycobacterium avium (N = 16). Culture examination was positive in 84% (N = 16) of cases, PCR was positive in 47% of patients (N = 9). All children from the group underwent both surgical and antibio tic treatment. The most frequently used antibio tics were a combination of a macrolide antibio tic (clarithromycin) with an antituberculotic drug (rifampicin). In 6 children, an incision was made along with drainage of the lesion and for the duration of the infl ammation a complete extirpation of the pathological tissue under general anaesthesia followed. A total of 15 children underwent probatory extirpation of the pathological neck lymph node. We performed block dissections of the infected tissue in 7 children for residual infl ammation. Conclusion: The most eff ective treatment of the infection seems to be the exstirpation of all aff ected lymph nodes with surrounding tissue and combination of antibio tic (macrolide) with antituberculotic agent (rifampicin). Key words mycobacterial infection – nontuberculous mycobacteria – cervical lymphadenitis – children
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