Ceruminous adenoma is a well-circumscribed tumor that originates from apocrine glands located in the external auditory canal (EAC). It is a rare disease that accounts for 5.7% of all EAC and auricular tumors. It usually presents as slow-growing tumor accompanying several ear symptoms; mass, fullness, hearing loss, pruritus and otorrhea. If the detection of the tumor is delayed, the tumor can obstruct the EAC completely and its further growth may lead to deformation of surrounding structures such as the cartilaginous or bony portion of EAC. The wide local excision is the treatment of choice for benign ceruminous gland tumors and thorough histopathologic review is essential in that there is possibility of recurrence and malignant transformation. Herein, we present a case of ceruminous adenoma with cartilage and bony deformation in the EAC with a literature review.
Recently, percutaneous drainage has been more popular because it is relatively simple, convenient, and less invasive. After warfarin overuse, a 71-year-old male patient visited the emergency room with femoral neuropathy caused by a left iliacus muscle hematoma measuring approximately 110×64 mm, 75×60 mm in size on coronal and sagittal computed tomography angiograhy. Without trauma, weakness of the left hip flexor and left knee extensor was noted with strength of 2/5 (poor) each. Immediate medical treatment using vitamin K and fresh frozen plasma was started and percutaneous drainage was performed. Two days after visiting the emergency room, neurological symptoms were improved and non-operative treatment was continued. Twenty four days after being hospitalized, the size of the hematoma was reduced to approximately 75 ×45 mm, 62×40 mm in size. Approximately three months after hospitalization, most of the hematoma was absorbed. After one year, mild atrphy of quadriceps and mild diffuse pain were noted, however, no other symptoms were observed.
Nasal valve collapse is one of the causes of nasal obstruction and must be considered in patients with nasal obstruction. There are several surgical procedures available to treat nasal valve collapse. Spreader grafts can be used in the treatment of nasal valve collapse by widening the internal nasal valve angle and maintaining the widened angle. However, this procedure requires sufficient amount of cartilage harvested from the nasal septum. Especially, in cases of secondary rhinoplasty or some primary nasal surgery with thin septal cartilage, it is difficult to harvest an appropriate amount of cartilage from the septum. Here, we describe an effective technique for using septal cartilage and TnR Nasal Mesh<sup>®</sup> (T&R Biofab Co., Ltd) for spreader grafts with appropriate thickness in nasal valve collapse.
A perilymphatic fistula (PLF) is an abnormal leakage of the perilymph from the inner ear into the middle ear. A PLF may be trauma-induced or may occur with unknown causes. PLF repair should be considered when patients present with sudden or progressive sensorineural hearing loss with positional nystagmus. Although the leakage of perilymph is not always found during the exploration surgery, both hearing loss and dizziness tend to improve immediately after PLF repair. However, about 24% of patients who underwent PLF repair reportedly have experienced recurrent vestibular symptoms, suggesting the possibility of PLF recurrence or other vertigo causes. In this PLF patient, dizziness completely subsided after the PLF repair. However, several months later, the disabling paroxysmal positional vertigo developed, which was diagnosed as benign paroxysmal positional vertigo. Reported herein, with a review of the relevant literature, is a case of paroxysmal positional vertigo several months after PLF repair, where successful vertigo subsidence was finally achieved.
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