IJPORL Extra Abstracts

Image guidance offers additional benefits in the

endoscopic solution of extended cranio-facialmalformations

2006

A case report

Andor Hirschberg a,*, Zoltan Fent b, KarolyHrabak b, Odon Rezek b, Ron von Jako c, GaborRepassy b

aDepartment of Otolaryngology, Saint John Hospi-tal, Dios arok l-3, H-1125 Budapest, HungarybDepartment of Otolaryngology, Faculty of Medi-cine, Semmelweis University, Budapest, HungarycGeneral Electric Healthcare-Surgery, Lawrence,MA, USA

Computer-assisted endoscopic surgery (CAES) incombination with a transpalatal approach wasapplied in a 6-year-old girl with extensive cranio-facial malformation and bilateral nasal and choanalatresia. The GE Healthcare InstaTrak 3500 Plus sur-gical navigational system was used. The transnasaland choanal atresia was successfully openedand kept patent. The navigational system was ableto point and localize orientations between the dis-torted anatomy, the instrument tip and indepth measurements for intraoperative planning.In extended anatomical malformation of the nasalpassages and the surrounding structures, where theanatomical landmarks are missing or definitelyaltered computer-aided navigation may facilitatethe application of additional endoscopic surgeryin combination with more radical surgicalapproaches. Development of special drills andcurved suction devices mounted on the receiverand tailored for such anatomical malformationsmay offer a complete computer-aided endoscopicsolution in similar cases.

DOI: 10.1016/j.ijporl.2006.04.018

Masticator space abscess in a 21-month-old child

Robert Steelman a,*, Henry Milczuk b, Anna Grosz c

a Pediatric Critical Care Medicine & Oral & Max-illofacial Surgery, Oregan Health; Science Univer-sity, Portland, OR, USAb Pediatric Otorhinolaryngology Head & Neck Sur-gery, Oregan Health; Science University, Portland,OR, USAc Resident, Otorhinolaryngology, Head & NeckSurgery Oregon Health & Science University Port-land, Oregan Health; Science University, Portland,OR, USA

A 21-month-old male presented with fever, dehy-dration and severe trismus. A computerized tomo-

gram of the head and neck was obtained thatshowed inflammatory stranding involving the rightpterygoid, masseter and parotid spaces as well asfluid collection within the right pterygoid (mastica-tor) space. Intraoral drainage was successful. S.Aureus was identified on culture from the drainagesite. No apparent focus of infection was identified.Appropriate antibiotics were given and the patientrecovered. It is postulated that an ascending infec-tion from the oral cavity to the parotid gland withsubsequent involvement of the right masticatorspace occurred.

DOI: 10.1016/j.ijporl.2006.04.019

An unusual case of live fish impaction inhypopharynx in an infant

M.K. Aggarwal a, Gautam Bir Singh a,*, RuchirDhawan a, Arun Tiwari b

aDepartment of Otorhinolaryngology and Head-Neck Surgery, Institute of Medical Sciences & SirSunderlal Hospital, Banaras Hindu University,Varanasi 221005, Uttar Pradesh, IndiabDepartment of Anaesthesia, Institute of MedicalSciences & Sir Sunderlal Hospital, Banaras HinduUniversity, Varanasi 221005, Uttar Pradesh, India

A rare case of live fish impacted in the hypopharynxof a 7 months old male baby is presented that wasremoved successfully after securing airway. To theauthors knowledge such a case has not beenreported previously in the literature.

DOI: 10.1016/j.ijporl.2006.04.020

Hemangioendothelioma of the orbit in a3-month-old infant

Arie Rosen a,b,c, Aylon Y. Glaser b,*, Don Respler a,b

a Ear Nose and Throat Institute of New Jersey,Hackensack, NJ, United StatesbUniversity of Medicine and Dentistry of NewJersey, Division of Otolaryngology/Head and NeckSurgery, Newark, NJ, United StatescNew European Surgical Academy (NESA), Germany

Hemangioendothelioma of bone, a locally aggres-sive vascular neoplasm, rarely affects the facialbones. Even less common is a presentation of thistumor affecting the orbit. Excision of orbital rimtumors and consequential reconstructions in infantsare especially challenging because calvarian bonegrafts are not available and because of the potentialfor orbital deformity and facial scarring. A case of a3-month-old female with a rapidly enlarging tumor