Cochlear fistula in the chronic otitis media (COM) without cholesteatoma is an extremely rare with only a few cases reported in the literature to this date. We describe a case of cochlear fistula observed in a female with COM without cholesteatoma. This report presents the first clinical case of a transtympanic iatrogenic trauma by habitual cotton swabs probably causing cochlear fistula.

Background and Objectives：In patients with Kawasaki disease, retropharyngeal involvements (KDWRPI) is a rare complication. Most reported cases were diagnosed lately because those were often misdiagnosed as bacterial retropharyngeal abscess (BRA). The purpose of this study was to differentiate KDWRPI from BRA in advance. Materials and Methods：We performed a retrospective study comparing children with KDWRPI to those with BRA hospitalized at the university teaching hospital between January 2008 and September 2013. From our retrospectively collected database, we compared clinical, laboratory, and imaging characteristics of KDWRPI and BRA. Results: The study include 11 patients with retropharyngeal involvement on neck computerized tomography (CT) which were divided into two groups. Group A was classified as KDWRPI (n=6) and group B was classified as BRA (n=5). Compared with group B, patients with KDWRPI had lower sodium and albumin (p=0.0176 and 0.0828, respectively). Conclusions：Careful attention to manifestations and close analyses of laboratory findings and CT images may allow otorhinolaryngologists to differentiate KDWRPI from BRA. In the case of retropharyngeal edema on CT, the diagnosis of KDWRPI should not be neglected.

Summary This report describes a case of osteoma cutis diagnosed by physical examination, surgery and histopathological examination. A 2‐year‐old Thoroughbred colt with hindlimb lameness was brought to our facility. Physical examination showed a well‐circumscribed, large plate‐like mass covered with normal haired skin in the right thigh region. Ultrasonography revealed a subcutaneous linear mass. After surgical removal, histopathological examination showed thin mature bone surrounded by fibrocollagenous tissues. To the authors' knowledge, this is the first report of spontaneous idiopathic osteoma cutis in horses.

Background and ObjectivesZZNegative Pressure Wound Therapy (NPWT) has been used in many surgery to treat complicated wound and impaired wound healing by delivering negative pressure at the wound site through a patented dressing, which helps draw wound edges together, remove infectious materials, and actively promote granulation at the cellular level. Recently application of NPWT has been increased to treat deep neck infection. We aimed to retrieve indications and guidelines to treat deep neck infection from our cases and after reviewing articles. Subjects and MethodZZFrom our experience with 9 cases presented as deep neck abscess in which the application of a Vacuum-assisted closure device was used instead of common drainage tubes after surgical evacuation and journal review, indications and guidelines to apply NPWT as one of the tools to treat deep neck infection were retrieved. ResultsZZIndication and Guideline of NPWT. 1) For simple abscess involving single space excepting the mediastinum, intravenous administration of broad-spectrum antibiotics, needle aspiration or simple surgical drainage is recommended. 2) In the case of failure of previous treatments, NPWT will be necessary for immunocompromised hosts such as diabetic patients for whom more than two spaces are involved, the mediastinal involvement, compromised airway or disseminated intravascular coagulation. In severe cases involving the chest, video-assisted thoracoscopic surgery or mediastinoscopy could be used. 3) For patients with improving signs such as decreasing pus, increasing granulation formation, negative culture results from sponge, and normalized C-reactive protein, we can stop NPWT and convert to the regular wound care. ConclusionZZIndication and Guideline of NPWT could be applied to treat deep neck infection. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(2):125-32 Key WordsZZDeep neck infection ㆍNegative pressure wound therapy. Head and NeckKorean J Otorhinolaryngol-Head Neck Surg 2016;59(2): 125-32 / pISSN 2092-5859 / eISSN 2092-6529 http://dx.doi.org/10.3342/kjorl-hns.2016 online © ML Comm

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