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Paragangliomas are rare in the larynx. When they do occur there, the most common subsite is the supraglottic compartment. Unlike other neuroendocrine tumors of the larynx, laryngeal paragangliomas are three times as common in women as in men. Although a preoperative biopsy is often performed to establish the diagnosis, this procedure carries a considerable risk of bleeding, which may necessitate a tracheotomy to secure the airway. Immunohistochemical staining is useful in the differential diagnosis to distinguish aparagangliomafrom other neuroendocrine tumors. Computed tomography and/or magnetic resonance imagingwith preoperative angiography and possible embolization are important to obtain prior to treatment. Surgical excision is the treatment of choice. [ABSTRACT FROM AUTHOR]

Objective: Malignant external otitis is a severe infection of the external auditory canal and skull base, which most often affects elderly patients with diabetes mellitus. This disease is still a serious disease associated with cranial nerve complications and high morbidity-mortality rate. Malignant otitis externa requires urgent diagnosis and treatment. The most effective treatment is to control the diabetes and to fight infection with the proper antibiotic and debridement necrotic tissue; sometimes, aggressive surgical management is done. We present our 5-year institutional experience in the management of this disease. The aim of this study was to present our experience with the management of malignant otitis externa., Methods: All patients' records with malignant otitis externa during the last 5 years (2007-2012) were retrieved and reviewed. Diabetes mellitus profile, erythrocyte sedimentation rate, ear swab for culture and sensitivity, computed tomography, and scintigraphy using technetium 99 and gallium 67 were investigated for all patients., Results: During the last 5 years (2007-2012), 10 patients with the diagnosis of malignant otitis externa were admitted to our clinic for investigation and treatment. There were 7 men and 3 women, all between 64 and 83 years of age, with severe persistent otalgia, purulent otorrhea, granulation tissue in the external auditory canal, and diffuse external otitis, and there were 4 patients with facial nerve palsy. Nine patients were confirmed to have a diabetes, and 4 of these 9 cases just had chronic renal failure and underwent dialysis; the remainder 1 case had no diabetes mellitus, but with chronic renal failure on dialysis. Ear swabs for culture and sensitivity usually revealed Pseudomonas aeruginosa. Local debridement and local and systemic antibiotic treatment were sufficient to control the disease. Facial nerve decompression was done in facial paralysis. Hyperbaric oxygen therapy was performed in facial nervy palsy cases., Conclusions: Malignant otitis externa is still a serious disease associated with cranial nerve complications and high morbidity-mortality rate. The most effective treatment is to control the diabetes and to fight infection with the proper antibiotic, debridement necrotic tissue, and sometimes aggressive surgical management. Monitoring of therapy response is done through normalization of erythrocyte sedimentation rate, control of diabetes mellitus, and improvement of computed tomography and radioisotope scanning.

Epidermal inclusion cyst (EIC) is a benign cyst filled with keratin fibers, which can develop in any part of the body. It is commonly seen in the skin, especially on the face, scalp, neck, and trunk, and has the tendency to slowly grow toward deeper epidermis parts and to cause cystic expansion. Epidermal inclusion cysts are not common in mucosal sites such as the larynx; however, these can arise owing to squamous metaplasia of the glands. We present a 52-year-old man with a laryngeal EIC. This is a very rare case in the literature of EIC in the larynx.

Objective: Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from the enlargement of the sebaceous glands beneath the surface of the skin on the nose. Its etiology remains unclear. Treatment of the disease is controversial. In this study, we discussed the treatment of rhinophyma by radiofrequency in 5 patients., Clinical Report: We presented 5 patients with rhinophyma. The patients' median age was 57.4 years. A radiofrequency unit was used in cut/coagulate mode at 10 U. A 0.38-in loop electrode was placed ensuring symmetry until the nose's shape was re-created. All patients achieved a good cosmetic result, which was defined as a near-to-normal nasal contour without clinical scarring or minimal scarring., Conclusions: Rhinophyma is a disease that can badly deform the nose and can be treated by radiofrequency. We described radiofrequency treatment of large rhinophymas with good aesthetic outcomes.

Carotid-cavernous fistulas (CCFs) are anomalous communications between the carotid arterial system and the venous cavernous sinus. They can arise because of spontaneous or trauma causes. Most caroticocavernous fistulas are of spontaneous origin and unknown etiology. Spontaneous CCF may also be associated with cavernous sinus pathology such as arteriosclerotic changes of the arterial wall, fibromuscular dysplasia, or Ehler-Danlos syndrome. Traumatic CCFs may occur after either blunt or penetrating head trauma. Their clinical presentation is related to their size and to the type of venous drainage, which can lead to a variety of symptoms, such as visual loss, proptosis, bruit, chemosis, cranial nerve impairment, intracranial hemorrhage (rare), and so on. Treatment by endovascular transarterial embolization with electrolytically detachable coils is a very effective method for CCF with good outcomes. Carotid-cavernous fistulas have been rarely reported after craniofacial surgery and are uncommon pathologies in otolaryngology practice. In this study, we report a 40-year-old woman with CCF secondary to blunt trauma of functional endoscopic sinus surgery.