Head and neck cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2014
The most common indication for this is residual or recurrent tumour. This may be clinically obvious, be suggested by serial CT scanning or present as intractable ‘perichondritis’. Diagnosis of tumour in relation to the latter may only be possible by careful examination of the laryngectomy specimen. Chronic pain, dysphonic voice and airway compromise (which in itself sometimes necessitates a tracheostomy) will often lead the patient to request surgery even in the absence of overt tumour recurrence. Another indication is a larynx that is rendered scarred and incompetent, usually several years post radiotherapy. The symptoms usually precipitating the decision to proceed with surgery are chronic stridor and/or intractable aspiration.
Head and Neck Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
The most common indication for this is residual or recurrent tumor. This may be clinically obvious, be suggested by serial CT scanning, or present as intractable “perichondritis.” Diagnosis of tumor in relation to the latter may only be possible by careful examination of the laryngectomy specimen. Chronic pain, dysphonic voice, and airway compromise (which in itself sometimes necessitates a tracheostomy) will often lead the patient to request surgery even in the absence of overt tumor recurrence. Another indication is a larynx that is scarred and incompetent, usually several years post-RT. The symptoms usually precipitating the decision to proceed with surgery are chronic stridor, pain, and/or intractable aspiration.
Perichondritis of the External Ear
John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed in Paediatrics, The Ear, Skull Base, 2018
Acute perichondritis should be prevented by careful placement of ear piercings away from the cartilaginous pinna. Surgery in and around the ear should avoid trauma to cartilage and tight head bandages. Haematomas of the auricle should be drained promptly and using careful aseptic techniques. The meticulous management of burn injuries to the ears should include the use of prophylactic antibiotics against Gram-negative bacteria and diligent local care including daily dressings and the removal of eschars and crusts.
The benefits of ultrasonography in diagnosing and assessing auricular chondritis, arthritis, and tenosynovitis in a patient with relapsing polychondritis
Published in Modern Rheumatology Case Reports, 2019
Satoshi Shinohara, Koji Sakamoto
In October 2014, biopsy of the right auricle was performed. Histology indicated perichondritis; inflammatory cells, mainly neutrophils, had infiltrated into the cartilage and its surroundings. Around the aggregation of neutrophils, the edge of the cartilage was irregular and eosinophilic changes in the cartilage were noted. Angiogenesis was observed in the subcutaneous tissues in the vicinity of the cartilage, but not in the cartilage itself. Subcutaneous tissue surrounding angiogenesis was edematous (Figure 3(a,b)). These histological findings indicated early stage RP. She was diagnosed with RP according to McAdam’s criteria: fulfilment of bilateral auricular chondritis, non-erosive and non-deforming inflammatory polyarthritis, ocular inflammation, and audiovestibular damage with a histology of auricular chondritis.
A novel technique C-conchoplasty in canal wall down tympnomastoidectomy
Published in Acta Oto-Laryngologica, 2023
Qin Luo, Yingchao Zheng, Dazhi Shi, Zhiqiang Luo
Our technique can effectively enlarge the meatal cross-sectional S. The postoperative V/S is closer to the normal ears than that without conchoplasty and the greater the difference from the normal V/S, the longer the ear drying time. We have managed to achieve a dry, auto-cleaning ear with very good cosmetic results in all cases. We have not had any cases of stenosis or troublesome granulation, cholesteatoma recurrence, perichondritis, auricular deformity and other complications. Epithelialization of the cavity and cosmetically successful outcomes were achieved in all cases. Perichondritis secondary to cartilage excision, although theoretically possible, has not been observed in our cases. This is consistent with many authors’ reports [5 and 6,15–17]. We believe that strict aseptic operation, careful dressing changes and rational use of antibiotics can avoid auricular perichonditis as much as possible [18]. In addition, the cartilage removed during we performed C-conchoplasty may be used as a good material for tympanoplasty and mastoid obliteration. The good cosmetic appearance of the concha postoperative is shown in Figures 5 and 6. No patients performed with our technique have complained about poor cosmesis on follow-up. In the end, a large external auditory meatus allows ventilation of the mastoid cavity as well as easy access for examination and debridement of the entire cavity.
Schnitzler syndrome refractory to anakinra: successful treatment with canakinumab
Published in Journal of Dermatological Treatment, 2023
Angel Luis Salcedo-Mingoarranz, María Dorado-Fernández, Sofía García-Martínez, Paz Collado-Ramos, Nicolás Silvestre-Torner
A 64-year-old woman affected by skin rash and a monoclonal gammopathy of uncertain significance (small lambda IgG peak) was admitted in October 2009 with fever, severe rash, elevated CRP and dyspnea. In 2011, two episodes of fever, erythema and arthralgia were reported. Although perichondritis was initially considered, all laboratory data resulted negative: electrophysiological study, immunoglobulin, antinuclear antibody, antineutrophil cytoplasmic antibodies, anti-SCL-70, extractable nuclear antigens, anti-beta 2 glycoprotein I and anticardiolipin. Two skin biopsies were performed showing a pattern of leukocytoclasia without vasculitis (Figure 1(A)), thus, methotrexate was prescribed but without any clinical benefit. Afterwards, amyloidosis and Sjögren’s syndrome were considered as possible diagnosis, based on multiple episodes of paresthesia, facial swelling and punctuate keratitis, however, all laboratory parameters were within reference values.