ENT

Peritonsillar Abscess Model for Ultrasound Diagnosis Using Inexpensive Materials

Mustafa N Rasheed, BS^*, Keel E Coleman, MD^* and Timothy J Fortuna, MD^*

DOI: https://doi.org/10.21980/J86G9P Issue 5:1 No ratings yet.

By the end of this instructional session learners should be able to: 1) identify and discuss the indications, contraindications, and complications associated with peritonsillar abscesses, 2) properly identify and measure a PTA through ultrasound, and 3) competently perform ultrasound-guided peritonsillar abscess drainage on a simulator and remove fluid.

Case Report: Acute Supraglottitis

Jamie Robin Chu, MD^* and Jonathan G Rogg, MD, MBA^{^}

DOI: https://doi.org/10.21980/J8006V Issue 5:1 No ratings yet.

On arrival, radiographs of the neck soft tissues were obtained, which showed a markedly enlarged epiglottic shadow (red arrow) concerning for epiglottitis. A computed tomography scan of the neck soft tissues with contrast was then obtained which revealed edematous mucosal thickening of the oropharynx (blue arrow) and supraglottic larynx (green arrow) including the epiglottis (purple arrow) concerning for acute infectious pharyngitis and supraglottic laryngitis with severe narrowing of the supraglottic laryngeal lumen, as well as associated extensive inflammation and edema of the superficial and deep left neck spaces. The patient’s white blood cell count was elevated to 25.7x109/L with 87% neutrophils. Her rapid strep test was positive. Otolaryngology was consulted and performed a bedside flexible laryngoscopy which showed significant edema of the epiglottis (orange arrow), vocal cords (white arrow), and arytenoids (black arrow), left greater than right. Based on the findings and concern for impending respiratory failure, the patient received an awake fiberoptic intubation by anesthesia at the bedside.

Infectious Disease ENT Visual EM

Abdominal Pain with Black Tongue

David A Adler, MD^* and Isabel M Algaze Gonzalez, MD^{^}

DOI: https://doi.org/10.21980/J8XS7JIssue 4:1 No ratings yet.

Patient’s tongue had a black discoloration, without elongated filiform papillae. We could not appreciate lymphadenopathy. His abdomen was tender to palpation.

ENT Visual EM

Facial Fracture Induced Periorbital Emphysema

Hamid Ehsani-Nia, DO^* and Robert Eisenstein, MD^*

DOI: https://doi.org/10.21980/J8F05HIssue 3:4 No ratings yet.

Physical exam showed marked left palpebral subcutaneous crepitus, as well as bulbar and palpebral conjunctival bulging. Visual acuity was normal with intact extraocular movements, and normal pupillary exam. Computed tomography (CT) imaging of the face was obtained and revealed multiple displaced fractures involving the left orbital floor and zygomatic arch associated with moderate periorbital and postseptal extraconal gas, resulting in orbital proptosis.

Trauma ENT Visual EM

Foreign Body in Maxillary Sinus: A Rare Case of Chronic Rhinosinusitis

Richard Barnett, DO^* and Meigra Chin, MD^*

DOI: https://doi.org/10.21980/J85H09Issue 3:4 No ratings yet.

Computed tomography (CT) sinus with contrast demonstrated complete opacification of left paranasal sinuses and nasal cavity, and a linear radiopacity within the left maxillary sinus consistent with a foreign body. There were additional left facial subcutaneous radiopaque opacities.

ENT Visual EM

Cauliflower Ear Secondary to a Chronic Auricular Hematoma

Nichole Niknafs, DO^*

DOI: https://doi.org/10.21980/J8S63XIssue 3:4 No ratings yet.

On exam, the patient has a gross deformity to the left pinna that was not painful to touch or fluctuant. Findings and history are consistent with cauliflower ear, secondary to a chronic auricular hematoma.

ENT Visual EM

Sialadenitis

Lauren Sylwanowicz, MD^* and Andrew Wong, MD, MBA^{^}

DOI: https://doi.org/10.21980/J8NH0NIssue 3:4 No ratings yet.

The computed tomography (CT) scan demonstrates prominent enlargement and heterogeneous enhancement of the right submandibular gland (single large arrow) compatible with sialadenitis. There is no evidence of a sialolith or obstruction on the CT. There is associated edema (two small arrows) of the right submandibular space, parapharyngeal space and anterior right neck with partial effacement of the right vallecula and right pyriform sinus.

ENT Visual EM

An Unusual Case of Pharyngitis: Herpes Zoster of Cranial Nerves 9, 10, C2, C3 Mimicking a Tumor

Jason Cheng, DO^*, Gregory Reinhold, DO^* and Rahmon Zuckerman, DO^*

DOI: https://doi.org/10.21980/J8B05K Issue 3:2 No ratings yet.

On exam, the patient was sitting upright while holding an emesis basin filled with saliva. His voice was noticeably hoarse. Examination of the head and neck revealed vesicular eruptions on the left scalp in the V1 dermatome and on the left mastoid process (Images 1 and 2). Physical exam also shows vesicular eruptions on the left posterior oropharynx that did not cross midline (Image 3).

ENT Visual EM

Ramsay Hunt Syndrome

John Costumbrado, MD, MPH^* and Ryan Brenchley, MD^*

DOI: https://doi.org/10.21980/J85S7QIssue 3:2 No ratings yet.

Left-sided cranial nerve VII palsy with flattened forehead creases, inability to keep the left eye open, and drooping of the corner of mouth. Vesicular lesions were found in and posterior to the left ear in a unilateral, dermatomal distribution.

ENT Visual EM

A Case of Otomastoiditis

Chad Correa, BS^* and Claire Thomas, MD^{^}

DOI: https://doi.org/10.21980/J8RK89Issue 3:2 No ratings yet.

The patient underwent computed tomography (CT) of the head which revealed opacification of the left middle ear (red arrow) and mastoid air cells (red circles). Additionally, there was thickening of the soft tissues of the external auditory canal (blue arrowhead), likely reflecting concurrent otitis externa. Based on the imaging, he was admitted for findings consistent with acute otomastoiditis.

ENT Infectious Disease Visual EM