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Case Review |
Clinical
Photograph of The Week |
An 27-year old male presented with 12-day history of
painful neck swelling associated with fever, odynophagia and difficulty
in opening the mouth. The only other significant history is that of
recent dental extraction for recurrent painful tooth. Examination revealed the signs shown in this picture,
as well as brawny fullness of the submental / submandibular area. His
temperature at presentation in the ER was 39.50C.
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What is the Diagnosis? |
1. 110th
American Academy of ORL, Head & Neck Surgery Annual Meeting & OTO EXPO, September
17-20, 2006; Toronto, Canada.
2.
42nd
South African ENT Congress joint meeting with the British Association of
Otolaryngology - Head & Neck Surgery, October 8 - 11, 2006; Cape Town,
South Africa. Click
HERE for More Info
3.
16th Annual oto-rhino-laryngological society of Nigeria (ORLSON) General Meeting
& Scientific Conference; November 22nd - 25th, 2006; Kaduna, Nigeria
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This recent study from China (Zumeng Y. et al,
Otolaryngol Head Neck Surg. 2006 Sep;135(3):458-462.),
with an EBM rating of B-3b observed that preserving both the great
auricular nerve and the parotid gland facia significantly reduces
incidence of sensory deficit as well as Frey syndrome. Abstract:
OBJECTIVE: To reduce the incidence of sensory deficits and Frey's
syndrome by modifying the traditional superficial parotidectomy. STUDY
DESIGN: After raising the skin flap, the parotid gland fascia (PGF) was
elevated to form a posterior pedicle fascial flap and then was replaced
after the gland removal. The great auricular nerve (GAN) that runs
within the PGF was not separated, so both the GAN and the PGF were
preserved. Before this modification, the GAN and PGF were examined
anatomically. The complication rates in the modified and control groups
were compared. RESULTS: 1) The GAN, which runs within the thick and
pycnotic PGF, trifurcates into postauricular, preauricular and lobule
branches. The modification could be carried out practically based on
the anatomy study. 2) Long-term sensory deficit was encountered in
13.3% of the control group, but 0% in the modified one. Frey's syndrome
was suffered by 66.7% and 16.7% cases in the control and modified group
respectively. The incidence of other complications was not
significantly different. CONCLUSION: Our modification is practical. It
decreases the complications significantly. |
Journal Watch :Challenges
in management of childhood sensorineural hearing loss in sub-Saharan Africa,
Nigeria.- Lasisi et al, 2006
1. Dr Lasisi of the Department of
Otolaryngology, UCH, Ibadan, Nigeria will take over the review of Journal Watch
Page, effective from next issue. We wish to
congratulate him and wish him all the best in this new role.
2. DODA
2006, capable of advanced hearing measure, and also paediatric hearing
assessment is being developed. If you requested for and got a free copy of DODA,
you may also look out for this latest version dubbed DODA-i, as well as for an
additional page on outcome of hearing assessment using DODA.
3. A subweb of this site, dedicated to online
publications of otorhinolaryngological grand round presentations across
Institutions all over Africa will soon take off. The subweb once active can be
accessed at http://www.otolaryngologyinafrica.net/grandround/ .
This page, is already active and you are enjoined to take
advantage of this to send in your grand round presentations. Also watch out for
online discussion forum for discussion of issues concerning otolaryngologists,
but not really of clinical nature at
http://otolaryngologyinafrica.net/discussionforum/
Till Next Week,
Biodun
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© Copyright Dr 'Biodun Olusesi, 2005 - 2006
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