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  • ISSN: 2379-948X
    Volume 3, Issue 9
    Case Report
    Eloy PH*, Pravas V, Sensou S, Minovnina J, Andde dorlodot CL, and Nollevaux MC
    Fungus ball is defined as the non-invasive accumulation of dense fungal concrements in a solitary sinus. Bone, blood vessels, and sinus mucosa are free of fungal elements. It is usually encountered in immune competent individuals with a female preponderance. It can involve the maxillary or the sphenoid sinuses.
    The authors aim to report the clinical presentation, imaging and surgical treatment of 2 patients presenting with a fungus ball developed exclusively in the frontal sinus and operated on successfully endoscopically and endonasally.
    They review the literature about this very uncommon entity.
    Georges Dumas, M. Filidoro, Cindy Colombe, and Sebastien Schmerber*
    Multiple sclerosis(MS) is most often revealed by motor, sensitive symptoms with paresthesia, ocular symptoms, and more seldom by symptoms with rapidly installed hearing loss and vertigo.We report an observation with initialsymptoms of a peripheral pathology mimicking a meningo-neuritis. A 22 years old young woman was addressed as anemergency for a sudden peripheral symptomatology associating a sudden right hearing loss with ear fullness,vertigo with vomiting and a right peripheral facial palsy. The patient had a spontaneous nystagmus beating toward the left side suppressed by fixation and sensory neural hearing loss on low frequencies. The Fukuda tests initially deviated toward the right side. The caloric test showed a right hypofunction at 75% and a correlated consistent left preponderance. The head shaking test (HST) and skull vibration induced nystagmus test (SVINT) revealed a left nystagmus. Blood samples results andcervical vestibular evoked myogenic potentials (cVEMP) were normal. Brainstem evoked response audiometry (BERA) demonstrated a retro-cochlear disease with a Wave V prolonged latency on the right side. A CSF lumbar puncturerevealedaoligoclonal band on electrophoresis and the MRI a pons intra-axial nodular image on the VII and VIIIth nerve pathway in the immediate vicinity of the right vestibular nucleus (hyper signal T2 and T1 Gadolinium contrast fixation). The evolution surveyed in neurology was totally regressive. A further disease relapseconfirmed dissemination in time and location of the pathology.
    Conclusion: Inaugural vestibular symptoms are seldom in MS. The ensnaring initial pseudo-peripheral presentation of this case is explained by the plaquelocation in close vicinity on the pons intra-axial cranial nerves pathway route. BERA are essential to reveal a neuronal conduction impairment on auditory nerve related to a demyelination process.
    Xu Xinni, Sein Lwin, and Ong Yew Kwang*
    The pericranial flap is a well-vascularized, robust flap which is used to reconstruct anterior skull base defects following resection of skull base tumours. Failure of this flap is uncommon. However when it occurs, the consequences are potentially disastrous and it poses a challenge to further reconstruction. We report the first case of onlay pericranial flap breakdown following endoscopic craniofacial resection. Possible contributing factors are identified and further management is discussed. With the endoscopic approach being increasingly utilised for craniofacial resection, it is imperative to be mindful of these factors to minimize the risks of onlay pericranial flap failure.
    Cameron Y. S. Lee*
    Oroantral communication (OAC) is a common complication following extraction of maxillary premolar and molar teeth. This is due to the close anatomic proximity of the roots of these teeth to the maxillary sinus. The most frequent methods utilized in the office described in the literature to close an oroantral communication involve the use of a buccal or palatal rotational advancement flap or use of the buccal fat pad. These surgical procedures require appropriate surgical skill and training to manage this type of complication and are associated with donor sit morbidity, such as avascular flap necrosis that can lead to soft tissue graft failure to close the OAC, infection and extreme postoperative patient discomfort. The goal of this case report is to describe a technique to close the OAC with a non-resorbable high-density polytetrafluoroethylene (dPTFE) membrane (Osteogenics, Lubbuck, TX) that leads to predictable soft tissue regeneration and consistent closure of the OAC.
    Short Communication
    Liane Sousa Teixeira*, Gustavo Bachega, Ricardo Valadares, Helga Moura Kehrle, Thiago Ottoni Bittencurt, and Ronaldo Campos Granjeiro
    Introduction: The ringing in the ears is defined as the presence of one or more sounds in the ear or the head without having an external corresponding sound stimulus. It has been classified in many ways and lots of studies have investigated the origin of the ringing in the ears, though many hypotheses have yet not been proved. The ringing in the ears has an adverse effect upon the quality of daily life and can be accompanied by discomfort of sleep.
    Objective: Evaluate the quality of sleep in patients with the ringing in the ears through the application of specific questionnaires.
    Methodology: It's a study of the prospective and observational type, which was developed between August 2013 and August 2014 at the otorhinolaryngology. Care Protocol - Tinnitus Handicap Inventory, Epworth Sleepiness Scale and The Pittsburg Sleep Quality Index (PSQI) were used in the evaluation. The sample of the group which was studied, constituted 93 patients who complained of ringing in the ear, and 30 patients, without ringing in the ear, who constituted the control group.
    Results: The analyses revealed the the worst indices of discomfort of ringing in the ear are associated with the highest measures of the Epworth scale, being Statistically significant (P= 0,008). Besides, the highest values of the Pittsburgh scale correlate with the discomfot of ringing and the worst quality of sleep. Conclusion: The data obtained from this task prove that, the bigger the discomfort of the ringing, the worse the quality of sleep is.
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