Cochlear nerve deficiency in cochlear aplasia is a contraindication for cochlear implantation (CI) anticipating poor auditory response. Few authors have reported auditory outcomes even without nerves following CI. This study outlines the audiological outcomes of a patient in early childhood with cochlear aplasia and cochlear nerve deficiency who underwent CI. Auditory and speech-language development were assessed using the Categories of Auditory Performance (CAP) scale, Speech Intelligibility Rating (SIR) scale and Ling-6 sound test; at the time of switch-on, after 6 and 12 months of auditory verbal therapy. Significant differences across CAP, SIR and Ling-6 sound detection scores were noted, with the highest mean scores at the 12th-month postimplantation, indicating substantial improvement in auditory and speech-language skills. In cochlear aplasia cases, residual cochlear elements and nerve fibres cannot be ruled out. Our report emphasises the need for research, as this has the potential to impact the existing guidelines for CI candidacy.

Tracheal necrosis is a rare complication of a thyroidectomy, almost exclusively following the resection of invasive thyroid carcinoma with tracheal involvement. We report a case of delayed tracheal necrosis following a routine thyroidectomy for noninvasive papillary thyroid carcinoma likely secondary to a postoperative seroma. This complication was successfully managed with a temporary tracheostomy.

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Mesiodens is the most common type of supernumerary tooth, located between the maxillary central incisors. A young man was referred by his orthodontist for management of a supernumerary tooth located in quadrant I, superposed to the bottom of the right maxillary sinus, distally orientated with the crown in contact with the apex of the palatal root of the maxillary first molar. The tooth was found on a panoramic radiography before starting his orthodontic treatment. To remove it and in order to study, its relationship to the anatomical structures a cone-beam CT examination was performed. This revealed the presence of a mesiodens located on the right paramedian maxillary area. Pericoronal tissue submitted for histopathological examination showed an uninflamed dental follicle. Healing was uneventful. This case shows that mesiodens outside the arch, located in the posterior palate, may be not discovered in a panoramic radiograph.

A man in his 30s with primary hyperparathyroidism underwent an elective four-gland parathyroid exploration with intraoperative parathyroid hormone monitoring. On the fourth postoperative day (POD), the patient presented to the emergency department with severe symptomatic hypocalcaemia. ECG findings were in keeping with inferior-posterior ST-elevation myocardial infarction (STEMI); however, he was asymptomatic with no chest pain. Biochemistry revealed elevated serial troponin levels. Coronary angiogram and transthoracic echocardiogram were normal, suggesting coronary vasospasm, mimicking STEMI on ECG because of severe hypocalcaemia post parathyroidectomy. This is an uncommon and unreported complication of parathyroid surgery. The patient was successfully managed with intravenous calcium and discharged on oral calcium replacement on the tenth POD.

We present a case of a 72-year-old women who presented with a persistent sore throat and productive cough. On flexible nasendoscopy examination, she was found to have a fairly superficial ulcer affecting the laryngeal surface and tip of her epiglottis. On her second microlaryngoscopy and biopsy, direct immunofluorescent staining of the biopsy was analysed and the histological findings were in keeping with a diagnosis of mucous membrane pemphigoid (MMP). MMP is a rare chronic autoimmune condition characterised by the presence of blistering subepithelial lesions that can cause scarring. Laryngeal MMP affects only 1 in 10 million people and can lead to life-threatening airway compromise arising from scarring and stenosis. As there is a large spectrum of disease, it is important to adopt a multidisciplinary approach including dermatologists, otolaryngologists and ophthalmologists for prompt diagnosis and early recognition of potential complications, maximising functional outcomes for patients.

Goltz syndrome or focal dermal hypoplasia (FDH), is an X-linked dominant condition which predominantly involves the skin, limbs and eyes. In otolaryngology, FDH has been poorly described, but can result in increased symptoms of obstructive sleep apnoea requiring surgery. There have also been documented cases of mixed severe hearing loss secondary to congenital ossicular anomalies. More frequently, patients present to the ear-nose-throat clinic with symptoms of dysphagia, secondary to papillomatosis. A 36-year-old woman presented with pain, irritation and dysphagia with a known diagnosis of FDH. She was subsequently investigated with an oesophago-gastro-duodenoscopy, Barium Swallow and an MRI neck scan with contrast. Lymphoid hyperplasia was found on investigation and the patient underwent a panendoscopy with CO2 laser to the lesion with good clinical outcome. This case report highlights the need for multidisciplinary team involvement to ensure full consideration of management options.

A cook airway exchange catheter is a long hollow and semirigid catheter which is routinely used for endotracheal tube (ETT) exchange in the intensive care unit setting or even in the operating room in an event of unexpected difficult airway. We describe a novel technique of using an ETT exchanger with the help of a rigid laryngoscope to facilitate intubation as a strategy in a patient with an anticipated difficult airway due to laryngeal cancer presenting as stridor with respiratory distress.

The most common benign tumour of the major salivary glands is the pleomorphic adenoma. They are seen rarely in the minor salivary glands, usually in hard palate, soft palate and nasopharynx. Pleomorphic adenomas in nasal cavity are unusual and may be misdiagnosed because they have predominant myoepithelial cellularity and fewer myxoid stromata compared with those elsewhere. We present a case of 38-year-old male with a 2-year history of left nasal obstruction and epistaxis since 6 months. Diagnostic nasal endoscopic examination showed a soft lobulated mass in left nasal cavity attached to anterior part of the septum. Radiological examination demonstrated soft tissue mass filling left nasal cavity with an eroded septum. The biopsy from the mass was suggestive of pleomorphic adenoma and was resected endoscopically. Histopathological examination was consistent with pleomorphic adenoma. These are rare tumours of the nasal cavity and can be managed effectively with the endoscopic approach.