Departments » Case of the Month

Management of Bilateral Tinnitus and Nasal Tumor

A 53-year-old man with a one-month history of bilateral tinnitus. An MRI detected a sphenoid tumor incidentally, and a contrast-enhanced computed tomography scan revealed a partially enhanced tumor in the left sphenoidal sinus that destroyed part of the skull base.

Management of an Unusual Middle Ear Foreign Body

A 42-year-old male was recently fitted for occupational ear molds to protect him from excessive noise exposure at work and further hearing loss. During the fitting, he experienced severe, sudden otalgia and vertigo and complained that hearing loss in the left ear, his better-hearing ear, had worsened.

Weight Loss and Hoarseness in a 38-Year-Old Woman

A woman presented with a chief complaint of throat pain of four weeks duration and hoarseness of several years duration. She eventually presented to the otolaryngology clinic complaining of a four-week history of odynophagia associated with a frequent urge to clear her throat.

Parotid Mass Diagnostic Dilemma

A 75-year-old man presented with a left ear lobule melanoma and was found, on examination, to have a concurrent right parotid mass and bilateral cervical lymphadenopathy. A CT scan of the neck confirmed a 2-cm right superficial parotid mass containing both solid and cystic components without any pathognomonic characteristics, as well as bilateral cervical lymphadenopathy with multiple 2- to 3-cm lymph nodes. FNA biopsy of the parotid mass was consistent with carcinoma, whereas FNA samples from the cervical lymph nodes were non-diagnostic.

Decade-Long Progressive Dysphagia with Intermittent Regurgitation

A 78-year-old woman presented with a 10-year history of progressive dysphagia for solid foods and pills, with intermittent regurgitation of pills but not food. No aspiration or weight loss was reported. Her past medical history was significant for breast cancer, hypothyroidism and arthritis. No head and neck masses were appreciated. A modified barium swallow was obtained.

Baseball Foul Tip Causing Frontal Sinus Fracture

A 14-year-old boy sustained blunt trauma to the forehead from a foul-tipped baseball. Significant past medical history consisted of allergic rhinitis treated with over-the-counter cetirizine (Zyrtec). On examination, the patient had right frontal sinus depression with overlying edema. There were no palpable nasal bone or orbital rim abnormalities. Baseball threads were seen on the overlying skin as well as ecchymosis on the nasal dorsum and under both eyes.