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  • ISSN: 2379-948X
    Volume 2, Issue 7
    Case Report
    Deepak Verma*, Himani Lade, Gul Motwani, Anupal Deka and Noor Malik
    We are reporting a rare case of spontaneous atraumatic mediastinal hematoma in a previously apparently healthy middle aged female who presented with acute onset dysphagia, increasing neck swelling and spontaneous neck and chest bruising. Plain chest radiograph showed widening of the mediastinum. Contrast CT scan of neck and chest revealed a soft tissue swelling in retropharyngeal space causing esophageal compression anteriorly confirming the diagnosis of Posterior Mediastinal Hemorrhage. There are only few cases of posterior mediastinal hemorrhage reported in the literature. The etiology remains uncertain and the treatment modalities can be classified into 2 broad categories: conservative and operative management. We present this rare condition and its management discussed.
    Isaac Zucker, Barry O'Sullivan, Rory McConn Walsh and James Paul O'Neill*
    Background: Temporal Bone Malignancies (TBMs) are a rare but distinct set of neoplasms with a multifactorial etiology.
    Case Presentation: We report a case of a present a case of 62 year old male with high risk squamous cell carcinoma of the pinna which despite primary surgery and adjuvant radiation disseminated into the temporal bone requiring combined salvage surgery.
    Discussion: The Etiology, symptoms, staging system and surgical procedure of TBMs are discussed along with a detailed review of the three-team approach involving a neuro-otology surgeon, head and neck oncologic surgeon and plastic surgeon, are discussed in approaching surgery of TBMs.
    Conclusion: In our center a multidisciplinary approach including a neuro-otology surgeon, head and neck oncologic surgeon and plastic surgeon are essential for surgical salvage resection and reconstruction of TBMs.
    Riste Saat*, Laura J. Lempinen, Anu Laulajainen-Hongisto, Antti Markkola and Jussi Jero
    Abstract: We describe an initially misdiagnosed case of a meningioma en plaque of the temporal bone. The tumor had obliterated the external ear canal, induced a chronic inflammation and a cholesteatoma of the external and middle ear, and complicated with an external fistula and intracranial abscess formation. Massive bone involvement and scarce soft tissue component of the skull base meningioma en plaque often pose differential diagnostic challenges in imaging. We hereby review some typical CT and MRI characteristics that could help making the correct diagnosis.
    Selman Karaci* and Rustu Kose
    Abstract: The maxilla located in the mid face between strong frontal bars and the andibula. The maxilla consists of a body and four processes: Frontal, zygomatic, palatine, and alveolar processes. The body involves a space to form the maxillary sinus. Different, patterns of maxillary fractures were defined by René Le Fort, which he designed ‘‘lines of weakness'' and he also described sagittal fractures of the maxilla and palate.
    In our case, the intensity and direction of the impact caused to a whole fragment. The fractured bones that were laid in the same unit. The nasal-maxillary triangle and alveolar processes and teeth of the maxilla and a half shelf of the palate. The presented case is of interest because of the maxillary and midline sagittal fracture of the palate, in a monoblock form displaced excessively posteriorly, it has satisfactorily restored preinjury occlusal relationship. Stabilization is achieved by applying plate fixation.
    The split palate and sagittal maxillary fractures are less commonly encouraged than the other types of Le Fort fractures. Palatal fractures have been classified by a number of authors on the basis of fracture location, surgical approaches to be employed and stabilization preferences. The involvement of maxillary alveolus in the fracture results in difficulties in the maintenance of maxillary dental alignment post-fracture fixation.
    Research Article
    Pradeep Pradhan*, Abhimanyu Amant and Priti Lal
    Background: Circumferential elevation of tympanomeatal flap is considered to be an effective surgical procedure for tympanic membrane grafting. Here we have demonstrated its technique and compared its results between subtotal and anterior perforations by placing the graft medial and lateral to handle of malleus respectively.
    Material and methods: 34 patients with chronic otitis media underwent type I underlay tympanoplasty with circumferential elevation of tympanomeatal flap. Temporalis graft was placed medial and lateral to handle of malleus in 18 (group A) and 16 (group B) patients respectively. The results were compared between two groups after 06 months.
    Results: TM closure was found in 84% and 93% patients in group A and group B respectively (p=0.58) at the end of 6 months. In group A, the air bone (AB) closure was 9.44 dB and in group B it was 8.70 dB (p=1.00). Overall mean AB closure was found to be 9.09 dB. There were no major postoperative complications noticed in both the group.
    Conclusion: Circumferential flap elevation in subtotal and anterior perforation is an effective surgical technique in type I tympanoplasty with successful outcome. Media or lateral placement of graft to handle of malleus did not significantly affect the final outcome.
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