A lingual abscess is a rare , potentially lifethreatening disorder. It may present with nonspecific symptoms such as pain, odynophagia, dysphagia, or difficulty in breathing. 1 It may develop idiopathically or secondary to a local trauma, foreign bodies, and surgical trauma. 2 Physical examination usually shows swollen tongue and tenderness. The abscess might be located at the lateral border, anterior 1/3, or posterior 1/3 of the tongue. 3 Although plain radiograms usually do not give valuable information, both magnetic resonance imaging (MRI) and computed tomography (CT) might show abscess. Treatment mainly focuses on airway protection, appropriate antibiotic usage, and drainage. With appropriate treatment, mortality due to lingual abscess is seen in less than 3% of cases. 4
CASE REPORTA 30-year-old female admitted to our outpatient clinic with odynophagia, dysphagia, pain, and tenderness in her tongue. Her complaints were existing for 5 days and getting worse. She did not use any medication before applying to the hospital. She did not have any trauma, surgical, or dental procedure history. She did not have any history of illness, medication usage, smoking, and alcohol consumption. Physical examination revealed swollen tongue with hyperemia in tongue base, with the normal flexible laryngoscopy examination. Oral hygiene was good, and tonsils were at a normal size without any infection signs. She was afebrile (36.6C). After the patient had been hospitalized, laboratory and
Lenfatik malformasyonlar içinde en sık karşılaşılanı kistik higromadır. Lenfanjiyomlar lenfatik sistemin doğuştan bir anomalisi olup, sıklıkla hayatın 1. dekadında görülen nadir tümörlerdir. Etiyolojisinde sıklıkla lenfatik sistemin anormal gelişmesi sorumlu olsa da bazı hastalarda sonradan kazanılmış etmenlerin (travma, enfeksiyon, iyatrojenik, neoplastik) etkili olduğu bildirilmiştir. 1 Lenfanjiyomlar kendi içinde 3 gruba ayrılır: Lenfanjiyom simpleks, kavernöz lenfanjiyom, kistik higroma. 2 Kistik higromalı hastalar doğum sırasında %50-60, 2 yaşına kadar %90 ve ergenlik döneminde %95 tanı alır. 3 Erişkinlerde oldukça nadir tanımlanmıştır. Anormal boşaltım kanallarına sahip primitif lenfatik doku, embriyonel yaşamdayken ortaya çıkar ve lenfatik drenajın bozulmasına sebebiyet verir. 4 Kistik higroma genellikle boyun bölgesinde %75-90 (özellikle arka servikal üçgende) görülmekle birlikte; %20 aksilla, %5 mediastinum, retroperitoneal bölge ve nadir olarak da toraks duvarında görülebilir. 5 Kitle natürü olarak yavaşça büyür ve nadiren spontan olarak gerileyebilir. Kist içine kanama veya enfeksiyon
Objective:
Among other complications of endoscopic skull base surgery, delayed epistaxis has not been given much importance. This report presents postoperative delayed nosebleed cases in a large number of patients who underwent an endoscopic endonasal transsphenoidal approach to the sellar region for resection of lesions.
Methods:
Three hundred and sixty three patients who were reached to the sellar region by endoscopic endonasal transsphenoidal route and operated was included in the study. Retrospective chart reviewing of these patients was performed. The correlation between the duration of nosebleeds, bleeding location, treatment methods and comorbidities of the patients were evaluated.
Results:
Ten patients (3.6%) reported delayed epistaxis in the postoperative period and were referred to the otolaryngology department. Postoperative epistaxis occurred between days 7
th
and 33
th
(mean 16.5) days. The treatment consisted of chemical silver nitrate cauterization in two patients, return to the operating room in three patients, nasal packing in five patients.
Conclusion:
Delayed postoperative epistaxis often has no obvious etiology, and intervention requires teamworking. Well-coordinated teamworking of the neurosurgeon with other specialities such as neuroradiology and otorhinolaryngology is needed to achieve better results.
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