XXI Massive Pharyngeal Hemorrhages

Pseudoaneurysm of the internal carotid artery: A forgotten complication of tonsillitis?

“…The pattern of sudden, severe, recurrent haemorrhage seen in our patient is typical of an internal carotid pseudoaneurysm or erosion. Many patients have a palpable neck mass (Woodruff, 1945;Metson, 1956;Hogarth, 1959;Todman, 1960;Alexander et al, 1968;Langenbrunner and Dajani, 1971;Stevens, 1990), but the few enlarged nodes seen in our patient rapidly resolved on benzylpenicillin. Neurological involvement may occur, particularly in the form of an ipsilateral Homer's syndrome (Zook and Glover, 1970;Blum and McCaffrey, 1983), but cranial nerves VII, IX, X, XI, XII may also be affected (Metson, 1956;Alexander et al, 1968;Zook and Glover, 1970;Eneroth and Tham, 1971;Langenbrunner and Dajani, 1971;Gilchrist, 1973).…”

“…Thirteen further cases of carotid artery erosion (of which four prsented with aural haemorrhage) have been recorded (Woodruff, 1945;Richardson, 1946;Harrison, 1954;Hogarth, 1959;Todman, 1960;Hays, 1964;Alexander et al, 1968;Langenbrunner and Dajani, 1971;Garino and Ryan, 1987), and it is possible that pseudoaneurysm formation may have occurred in some of these. Most of the reported cases have been in children, with some in young adults.…”

Calcifying or Ossifying Fibroma of the Frontal Sinus

“…al. (1944), Woodruff (1945) and others. The patients generally present with displacement of the eye such as occurs in cases of mucocele of the frontal sinus, and may have discomfort and pain in the affected area.…”