Hemanth Vamanshankar

Keratocystic Odontogenic Tumor—Endoscopic Removal: Review of Two Cases

Odontogenic keratocysts (OKCs) have an incidence of 5.4 to 17% of all odontogenic cysts. These OKCs are more common in the mandible, with cysts in the maxilla having incidence of 31.3% only. In the maxilla, they most commonly occur in the canine region. The rarity of this case presentation is in the fact that only 1% of maxillary OKCs will show involvement of maxillary sinus, which was seen in both our patients. Historically, OKCs have been treated by open approaches like Caldwell Luc. We present two of our cases that were treated by endoscopic endonasal approach with review of literature.

Venous malformation of right angular vein.

A 34-year-old lady presented to us with complaints of a progressively enlarging swelling in the region between the medial canthus of right eye and root of the nose, since 4 years. She did not give any history of nasal complaints, epiphora or pain from the swelling. There was no history of trauma to face in the past. On examination, the swelling was found to be about 2 cm × 2 cm in size, soft in consistency and non-tender. There was a bluish hue of the overlying skin. The underlying bone was found to be intact. The swelling was completely compressible on palpation, and would slowly fill up on release. An increase in the size of the swelling was noted on performing valsalva manoeuvre. X ray of the paranasal sinuses did not reveal any underlying bony defect. We proceeded to do a contrast enhanced computed tomogram (CT) in order to establish the diagnosis. CT revealed a 2 cm × 1 cm homogenously enhancing soft tissue density with normal surrounding bony and soft tissues. There was no surrounding soft tissue inflammation or collections noted. The above lesion appeared to be in continuous with a tortuous dilated angular vein which in turn drained into the right external jugular vein (Fig. 1). Hence a diagnosis of venous malformation was established.

Sphenoidal mucocele presenting with persistent headache: a case report

Abstract Mucocele of sphenoid sinus can present with a myriad of symptoms; headache is one of them and sphenoidal mucocele has to be kept in mind when evaluating patients with headache. It can be characterized by an asymptomatic initial period. We present a case of a 75-year-old diabetic and non-hypertensive female patient, presented with persistent headache since six months. After consulting with neurology, neurosurgery and ophthalmology, she was referred to the department of otolaryngology. Computed tomography and magnetic resonance imaging showed features consistent with sphenoidal mucocele with partial erosion of the sella. Endoscopic drainage of the sphenoidal mucocele with bilateral wide sphenoidotomy with posterior septectomy was done; the sphenoid sinus was irrigated with normal saline. The patient’s symptoms improved dramatically in the post-operative period. Sphenoidal mucocele may be an unusual cause of persistent headache. Early diagnosis and treatment are necessary to avoid potential complications.