Temporal bone malignancies (TBM) are a rare but distinct group of conditions accounting for less than 0.2% of head and neck cancers and have an estimated annual incidence of less than 6 in 1 million. Squamous cell carcinoma (SCC) accounts for the majority of these malignancies, which is reflected in the literature since there are 21 published case series on temporal bone SCC and only case reports for non-squamous malignancies. TBMSCC has a poor prognosis in part due to their locally aggressive nature and complex anatomy. Progress in treatment remains slow given the rarity of this condition. Additionally, two main issues remain: 1. Lack of prognostic factors; 2. Multiple treatment strategies with little evidence on their effectiveness.
Dehiscence of the superior semicircular canal (SSC) as a cause of disequilibrium was first described by Minor et al in 1998 (Minor et al., 1998). In the subsequent two decades a large body of information has been generated and the condition has become well recognized. In this review we will examine the characteristic clinical manifestations of superior semicircular canal dehiscence (SSCD) and the current diagnostic modalities and treatment options.
We present a case of a 69 year old female with a spontaneous, diffuse, painful, swollen and bruised anterior neck. She also had concurrent use of a direct oral anticoagulant (DOAC), apixaban. We discuss the investigation and management of a spontaneous neck haematoma, as well as the management dilemmas with DOACs and severe bleeding.
This is a clinical photograph showing a standard transverse cervical collar incision which appears to be halfway between the suprasternal notch and cricoid cartilage. The incision is approximately 5-6 centimetres in length and is usually performed during thyroid surgery or 4-gland exploration for parathyroid disease. It appears that tissue glue has been applied for skin closure and a surgical drain can be seen emerging below the incision. The presence of a drain suggests that the patient may have had a total thyroidectomy as there is a move away from using drains for a standard diagnostic hemithyroidectomy.
This is a clinical photograph of a young boy drooling/dribbling (saliva incontinence). He also appears to be breathing with mouth open at rest and his tongue appears slightly large. If this is true macroglossia, it may be associated with an underlying syndrome such as Down’s. There is also evidence of nasal discharge and excoriation around oral cavity.