William S. Gibson

Isolated congenital internal auditory canal atresia with normal facial nerve function

The internal auditory canal forms as a result of mesoderm enveloping the eighth cranial nerve in the developing embryo. The mesoderm eventually transforms into cartilage and ultimately ossifies around the nerve, forming the internal auditory canal. It is theorized that atresia or stenosis of the internal auditory canal results from altered cochleovestibular nerve development secondary to faulty chemotactic mechanisms or a lack of end organ targets. Unilateral internal auditory canal anomalies are frequently seen in conjunction with other inner ear anomalies and occasionally with middle or external ear anomalies. Infrequently, it will occur as either an isolated or bilateral finding, but rarely simultaneously. The few citations of isolated, unilateral or bilateral internal auditory canal anomalies that are reported in the literature are usually associated with other systemic developmental anomalies, such as, cardiac septal defects, polycystic kidney disease, skeletal deformities and duodenal atresia. We present a case report of a patient with bilateral, congenital, internal auditory canal atresia and cochleovestibular deficits but, normal facial nerve function. A review of the literature is discussed as well as diagnostic considerations and treatment options including audiologic and communication rehabilitation.

Infantile subglottic hemangioma: a review and presentation of two cases of surgical excision.

Subglottic hemangioma in infants is a well-defined entity with which otolaryngologists should be familiar. Although benign lesions with a natural history of regression, they may demand the attention of an otolaryngologist to maintain a secure airway. Throughout the years, multiple treatment options have been proposed and utilized for subglottic hemangioma. As of yet, however, there is no consensus as to the best treatment. Surgical excision is one treatment option available to the otolaryngologist which has previously received less attention. We review treatment options and report two cases of surgical excision of infantile subglottic hemangioma. Both patients were extubated by postoperative day number three and have remained symptom free. We support surgical excision as a valuable treatment option.

Traumatic herniation of the buccal fat pad: a report of two cases and a review of the literature.

Two cases of injury resulting in traumatic herniation of the buccal fat pad into the oral cavity are described. A review of the literature reveals that almost all reported cases of traumatic herniation of the buccal fat pad occurred in young children. The majority of cases resulted from penetration of the buccal mucosa and buccinator muscle by a foreign object in the mouth. Treatment generally consisted of excision of the mass followed by primary closure.

Diplophonia in a neonate

Diplophonia has never been described in a neonate. An unusual case, then, of diplophonia in a neonate is described here. There is a description of the acoustic characteristics of this infants cry and a discussion of their significance. This contributes to a review of the differential diagnosis of diplophonia. Moreover, this case further shows the essential relation between laryngoscopic findings and acoustical data.

Moderation of morbidity following tonsillectomy and adenoidectomy: a study of awareness under anesthesia☆

Sixty-seven children between the ages 3 and 10, undergoing tonsillectomy and adenoidectomy, were randomly assigned to one of 3 groups. Therapeutic suggestions recited in English (n = 31), French (n = 19), or continuous white noise (n = 18) were repetitively administered by means of earphones in a double blind design. Randomization to the English condition was associated with a more favorable outcome with respect to all parameters evaluated by physicians and nurses. However, statistical significance could not be demonstrated. Should this observed favorable outcome be legitimate, cortical interpretation of language context was inferred as recovery was not influenced by randomization into the French or white noise conditions. Preoperative behavior, as defined by preoperative upset and cooperation scores, may be predictive of postoperative convalescence. The favorable outcome imparted by the English condition appeared most significant with respect to those patients at highest risk for poor convalescence i.e. poor status preoperative patients.

Mucoepidermoid carcinoma of the palate in a child undergoing growth hormone therapy

tion, or tracheotomy. Open surgical excision offers another newer option for lesions not responsive to these conservative interventions. We present a case report of a patient successfully treated with such an approach. Methods: An 8-week-old infant was diagnosed with a large subglottic hemangioma and underwent excision of the lesion via a cricotracheotomy approach (anterior cricoid spit) approach. Photographic documentation of preoperative and postoperative endoscopy will be presented. Results: The patient was successfully extubated postoperatively with no evidence of recurrence on follow-up bronchoscopy at 6 months. Conclusions: Certain selected cases of subglottic hemangioma may not be amenable to traditional management strategies. An open surgical approach should be considered in these patients as this technique is curative and is supported by the recent literature.