Schwannomas of the head and neck are uncommon tumours that arise from any peripheral, cranial or autonomic nerve. Twenty-five to 45 per cent of extracranial schwannomas occur in the head and neck region and thus are usually in the domain of the otolaryngologist. They usually present insidiously and thus are often diagnosed incorrectly or after lengthy delays, however, better imaging and cytological techniques have lessened this to some degree more recently. For benign lesions conservative surgical excision is the treatment of choice bearing in mind possible vagal or sympathetic chain injury. Malignant schwannomas are best treated with wide excision where possible. The role of adjuvant therapy remains uncertain and irrespective of treatment modality prognosis is poor with an overall survival of 15 per cent. However, recent advances in ras oncogene inhibitors may hold hope for the future.
Splenic injury is a rare but potentially life-threatening complication of endoscopy, with very few cases of endoscopic retrograde cholangiopancreatography (ERCP)-induced injury reported in the literature. Here we report a patient with chronic alcoholic pancreatitis who was diagnosed with a sub-capsular splenic laceration nearly 6 days after an ERCP. Clinicians should be alerted to the potential post-procedure complications associated with ERCP, particularly as this procedure is being utilized more frequently for the management of patients with complex hepatobiliary and pancreatic conditions.
The case of a 27 month old male with a congenital midline nasal dermoid cyst is presented. The child attended the Ear, Nose and Throat outpatient's department in July 1995, with an external midline nasal swelling, which had been present at birth and was noted to be gradually increasing in size. Magnetic resonance imaging (MRI) showed a central defect of the nasal bones, with a soft tissue mass at the upper part of the nasal bridge expanding the nasal septum. There was no radiological evidence of intracranial extension. The child had the nasal mass removed under general anesthesia, through an external rhinoplasty incision. Histopathology confirmed that the mass was a fully excised nasal dermoid cyst. Current investigation and management of this condition is discussed.
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