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Volume 124 - Issue 7 - July 2010

The Journal of Laryngology & Otology Volume 124 - Issue 7 -
Contents

Page 2 of 2

Clinical Records

  • Necrotising fasciitis complicating Haemophilus influenzae type b epiglottitis in an adult

  • C Chalmers
  • Published online by Cambridge University Press:
    23 November 2009, pp. 807-809
  • Objective:

    To present the first reported case of Haemophilus influenzae type b epiglottitis leading to necrotising fasciitis.

    Method:

    Case report and review of the literature regarding the association of necrotising fasciitis with Haemophilus influenzae infection and with epiglottitis.

    Case report:

    A previously well, 64-year-old woman presented with epiglottitis, and subsequently developed necrotising fasciitis of her chest wall. The cause of both infections was Haemophilus influenzae serotype b. This organism has frequently been implicated in epiglottitis, but has not previously been reported to cause simultaneous necrotising fasciitis. The patient became critically ill, requiring intensive care management, but following surgical debridement and antibiotic treatment she made a full recovery.

    Conclusion:

    Although increasingly uncommon, clinicians must continue to be proficient in the diagnosis and management of epiglottitis, and to be aware of its full range of possible complications. This case report highlights a previously unknown and potentially fatal complication of Haemophilus influenzae type b epiglottitis.

  • Congenital cholesteatoma of mastoid region manifesting as acute mastoiditis: case report and literature review

  • H Hidaka, E Ishida, K Kaku, H Nishikawa, T Kobayashi
  • Published online by Cambridge University Press:
    11 December 2009, pp. 810-815
  • Objectives:

    We report an extremely rare case of congenital cholesteatoma of the mastoid region, presenting as acute mastoiditis. We also review the 16 previously reported cases of congenital cholesteatoma of the mastoid region.

    Case report:

    A 65-year-old man presented with left-sided, post-auricular swelling and pain. Acute mastoiditis was diagnosed, with computed tomography demonstrating destruction of the bony plates of the posterior cranial fossa and sigmoid sinus. Initial surgery revealed a cholesteatoma in the mastoid, with no extension into the aditus ad antrum or attic. These findings were confirmed by pathological and immunohistochemical analysis of the surgical specimen, the latter using involucrin. The cholesteatoma matrix was completely removed in a second operation.

    Conclusions:

    Including this case, only four of the 17 reported cases of congenital cholesteatoma of the mastoid region showed post-auricular pain or swelling, indicating acute mastoiditis. Clinicians should bear in mind that congenital cholesteatoma may be present in patients presenting with mastoiditis, particularly adults.

  • Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases

  • P Puraviappan, I P Tang, D J Yong, N Prepageran, R L Carrau, A B Kassam
  • Published online by Cambridge University Press:
    11 December 2009, pp. 816-819
  • Background:

    Tuberculosis can cause extensive osseo-ligamentous destruction at the cranio-vertebral junction, leading to atlanto-axial instability and compression of vital cervico-medullary centres. This may manifest as quadriparesis, bulbar dysfunction and respiratory insufficiency.

    Aim:

    We report two patients presenting with spinal stenosis and cord compression secondary to cranio-vertebral tuberculosis, who were successfully decompressed via an endoscopic, endonasal approach.

    Study design:

    Two case reports.

    Methods and results:

    Both patients were successfully decompressed via an endoscopic, endonasal approach which provided access to the cranio-vertebral junction and upper cervical spine.

    Conclusion:

    An endoscopic, endonasal approach is feasible for the surgical management of cranio-vertebral junction stenosis; such an approach minimises surgical trauma to critical structures, reducing post-operative morbidity and the duration of hospital stay.

Book Reviews

Front Cover (OFC, IFC) and matter

  • JLO volume 124 issue 7 Cover and Front matter

  • Published online by Cambridge University Press:
    25 June 2010, pp. f1-f4
    • Article
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Back Cover (IBC, OBC) and matter

  • JLO volume 124 issue 7 Cover and Back matter

  • Published online by Cambridge University Press:
    25 June 2010, pp. b1-b3
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