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Abstract: Petrous apex effusions are rare disorders and usually occur in the petrous apex (PA) having well-aerated cells and it may present with several symptoms or can be diagnosed incidentally on imaging methods obtained for another reason. If there are persistent symptoms despite the conservative treatment in symptomatic patients, a surgical attempt can be considered. In patients with favorable hearing levels and with the well-pneumatized petrous bone, PA cells may be effectively drained through subcochlear or supracochlear approaches by preserving patient's hearing levels. In this case report, the authors presented a severe symptomatic patient with petrous apex effusion who did not respond to conservative treatment and petrous apex drainage was performed via the subcochlear approach., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2020 by Mutaz B. Habal, MD.)

Sinolith is a calculus in the paranasal sinuses. It has been also known as antrolith, rhinolith, antral calculi, antral stone, or antral rhinolith. The pathogenesis of calculi formation within a paranasal sinus is still not known. Chronic infection, foreign material, poorly draining sinus, and fungal infection are the main predisposing factors. Isolated sphenoid sinus lesions are rare, and most of them are inflammatory diseases. The main symptom of sphenoid sinus lesions is headache. Headache may be the only symptom of sphenoid sinus lesions. Sinolith is mostly encountered in the maxillary sinus followed by the frontal sinus and the ethmoid sinus. There was only 1 publication about sinolith localized in the sphenoid sinus in the English language literature. We report a case of an isolated sinolith localized in the sphenoid sinus. The treatment of choice should be surgical removal of the sinolith. Endoscopic surgery especially through the transnasal route should be the first-choice surgical treatment of isolated sphenoid sinus lesions.

Laryngocele is generally defined as abnormal dilatations of the laryngeal saccule. Its etiology is not well known but probably caused by congenital and acquired causes. It is uncommon and usually asymptomatic. It may be seen at any age but is most commonly presented at fifth and sixth decades. They are defined as internal, external, and mixed (combined) types according to their relationship with the thyrohyoid membrane. External laryngocele extends upward and protrudes through the thyrohyoid membrane to the neck. Infection of the laryngocele can cause acute symptoms or worsens existing symptoms. An infected laryngocele is known as laryngopyocele. It is an extremely rare disease and needs urgent diagnosis and treatment. We report a rare case of an external laryngopyocele that presented as upper airway obstruction. We also discussed the effect of needle aspiration in the emergency treatment of external laryngopyocele.