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To evaluate the relationship between the occurrence of tracheocutaneous fistula of the proximal tracheal stump regarding the indication (therapeutic or prophylactic) of laryngotracheal separation surgery (LTS) and regarding the presence of a current or previous tracheostomy when LTS was performed. Retrospective analysis of 66 patients submitted to LTS. The tracheocutaneous fistula occurred in 14 (21.2%) patients. Twelve (33.3%) of 36 patients whose indication was therapeutic and in two (6.7%) of 30 patients whose indication was prophylactic (p = 0.019). It occurred in 8 (57.1%) of 14 patients who had undergone tracheostomy prior to completion of LTS, while occurred in 6 (11.5%) patients who had not previously undergone tracheostomy (n = 52) (p = 0.0009). The incidence of tracheocutaneous fistula as a postoperative complication of laryngotracheal separation is high and occurs mainly in patients whose indication is therapeutic and for those with a current or previous tracheostomy. Despite the significant incidence, most of them closed spontaneously through the adoption of conservative therapy.

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ObjectiveTo report a case of Creutzfeldt-Jakob disease (CJD) that presented atypical initial manifestations and highlight the importance of complementary investigation to avoid diagnosis delay.PatientsA 54-year-old female patient who presented with vertigo with positional nystagmus, nausea, and vomiting as initial CJD manifestations.InterventionNeuro-otological and brain magnetic resonance images, which showed abnormal hyperintense cortical signal in both hemispheres.Main Outcome MeasureWe reached a presumptive diagnosis of the prion disease after the first magnetic resonance imaging. Eventually, the patient presented with typical neurological findings and met the criteria for probable CJD.ResultsOur case report presents a patient with sporadic CJD who experienced dizziness as an initial manifestation and met the diagnostic criteria for probable CJD a few weeks after symptoms onset.ConclusionWe believe that this case may serve to help otolaryngologists pay better attention to cases of dizziness associated with neurological signs and highlight the importance of complementary investigation using magnetic resonance imaging and neuro-otological tests to prevent delayed or incorrect diagnosis.

Inverted papilloma is a rare sinonasal neoplasm. It can be locally invasive and potentially degenerate to a malignant tumor.We present a case report of a 36-year-old woman who was treated for nasal inverted papilloma for over 10 years and presented bilateral temporal bone, and pulmonary involvement. Several procedures were performed to completely remove the tumor. Even without evidence of malignant degeneration, the patient continued battling tumor recurrences. To the best of our knowledge, this report presents the first case of a multicentric inverted papilloma with nasal, bilateral temporal bone, and pulmonary metachronous localization.