Role of Irrigation with Hypertonic Saline for a Recurrent Skull Base Hydatid Cyst: Case Report and Review of the Literature

Abstract

Hydatid cyst is a parasitic disease caused by the tapeworm Echinococcus granulosus. This disease is a rare finding in the head and neck region, and its presentation varies according to the area involved. We report the case of a 25-year-old woman who presented with bilateral neck swelling, which was found on histopathologic examination to be caused by a hydatid cyst. The patient underwent surgical drainage of the cyst and a modified radical mastoidectomy, followed by a 3-month course of treatment with albendazole. However, she experienced a recurrence in the left neck region 1 year later. At that time, reexploration of the left mastoid cavity was performed, with debridement of diseased occipital bone and foramen magnum. Intraoperatively, we used a novel method of saline irrigation with 3% hypertonic saline, previously not tested on exposed nerves, in an attempt to prevent further recurrence. Four years after the second surgery, no disease recurrence was found, and no neurologic sequelae were noted. We conclude that hypertonic saline irrigation can be considered as an option for preventing recurrence in cases that are difficult to clear surgically, especially around cranial nerves, although more studies are needed to document the safety of this approach.

Periprosthetic pathologic fracture following tibial Echinoccocosis: A case report

“…Literature supports a combined surgical and medical approach to cases of musculoskeletal infection with Echinococcus, although the specific duration of antihelminthic therapy is yet to be determined [ 15 , 16 ]. We believe that wide ressection margins can significantly diminish the rate of local recurrence, especially when associated with intraoperative instilation of a povidone-iodine-alcohol solution, or furthermore with hypertonic saline as some evidence regarding this technique may suggest [ 17 ].…”

Equinococosis quística músculo-esquelética primaria de evolución crónica

“…La equinococosis quística músculo-esquelética es poco frecuente, de difícil diagnóstico y tratamiento. Esta presentación generalmente es local, no presenta compromiso visceral y puede manifestarse en cualquier hueso 16 ; sin embargo, se observa con mayor frecuencia en columna vertebral, fémur y pelvis 17 . En la literatura médica existen escasos reportes de equinococosis de localización pelviana única, la mayoría series clínicas pequeñas o casos aislados.…”

Ovarian hydatid cyst: A case report

“…A large swab soaked in hypertonic solution was introduced following which marsupialization was carried out as it proved impossible to perform a radical cystectomy due to the dense adherence between cyst and the vagina. 15 The patient made an uncomplicated postoperative recovery and was discharged from hospital on the 11th postoperative day.…”