Congenital Nasal Disorders
Raymond W Clarke in Diseases of the Ear, Nose & Throat in Children, 2023
A portion of the developing brain may herniate through the bony skull base and become ‘trapped’ below the cribriform plate within the nasal cavity. This will present as a nasal mass and persist in the nose, often with acute nasal obstruction in the newborn. An encephalocoele contains both meninges and neurological tissue in direct continuity with the intracranial structures (Figure 17.3). A meningocoele is similar but contains no neurological tissue, just the meninges and cerebro-spinal fluid. A glioma contains nerve tissue (glial cells, usually with fibrous and vascular tissue) but is discrete from the intracranial contents, i.e. it has become ‘pinched off’. Glial heterotopia refers to the presence of a mass of such tissue in an aberrant site, i.e. the nasal cavity or the nasopharynx where it may have migrated some distance from its intracranial origin.
Ectopic Pregnancy and Pregnancy of Unknown Location
Arianna D'Angelo, Nazar N. Amso in Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
The diagnosis of heterotopic pregnancy is considered as one of the most challenging conditions due to the presence of the intrauterine pregnancy, which can give the clinician a false reassurance of a normally located pregnancy. In one study, 50% of heterotopic pregnancies were missed by ultrasound [136,137]. Early diagnosis is crucial for optimal management; thus, caution should always be taken when examining women who have clinical symptoms and/or signs of ectopic pregnancy, even if a normal intrauterine pregnancy is visualized and this is even more important if the pregnancy is through an IVF [128,134,138]. The diagnosis should also be considered in the presence of more than one corpus luteum on scan. The sonographic features of heterotopic pregnancy are essentially similar to those of an intrauterine pregnancy in addition to ectopic pregnancy. Although in most of the cases the ectopic component is tubal, other types of ectopic pregnancies have been reported [136,139,140–142] (Figures 17.16–17.22).
The Small Intestine
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie in Bailey & Love's Short Practice of Surgery, 2018
A Meckel’s diverticulum is a persistent remnant of the vitellointestinal duct and is present in about 2% of the population. It is found on the antimesenteric side of the ileum, commonly approximately 60 cm from the ileocaecal valve and is classically 5 cm long (Figure69.11). A Meckel’s diverticulum is a congenital diverticulum. It contains all three coats of the bowel wall and has its own blood supply. It may be vulnerable to obstruction and inflammation in the same way as the appendix; indeed, when a normal appendix is found at surgery for suspected appendicitis, a Meckel’s diverticulum should be looked for by examining the small bowel, particularly if free fluid or pus is found. In approximately 20% of cases, the mucosa of a Meckel’s diverticulum contains heterotopic epithelium of gastric, colonic or pancreatic type. The presence of heterotopic mucosa may predispose to the development of complications. The vast majority of Meckel’s diverticulae are asymptomatic and Meckel’s diverticulum is notoriously difficult to see with contrast radiology. Meckel’s diverticulum may, however, present clinically in the following ways:
Review of long-term outcomes of disc arthroplasty for symptomatic single level cervical degenerative disc disease
Published in Expert Review of Medical Devices, 2018
Siddharth A. Badve, Pierce D. Nunley, Swamy Kurra, William F. Lavelle
Based on the mid- to long-term evidence, the following summarizes some inferences that can be made. CDA appears to offer better overall success rates and statistically significant superior functional outcomes (NDI, VAS neck and arm, SF-36, neurological success) in comparison to ACDF. CDA performs better than ACDF concerning the need for additional surgical interventions and these differences have been statistically significant. Pertaining to implant-related adverse events, CDA offers a better safety profile in comparison to ACDF. There appears to be some evidence suggesting a lesser incidence of radiological adjacent segment degeneration in the CDA group. This was more evident at the superior level, but it has yet to be shown if there is an obvious variance in the rate of symptomatic adjacent segment disease between CDA and ACDF. Heterotopic ossification is a concern with the incidence and severity being quite variable. The predisposing factors and the precise mechanisms are unknown; however, certain studies quote male gender and/or the device type may play an important role. A majority of patients continue to demonstrate functionality in the form of preservation of range of motion at the CDA level. CDA appears to be a more commercially viable alternative in the management of symptomatic cervical DDD with some advantage over ACDF procedure; however, CDA has to remain functional for a longer time period to offer this advantage.
Ectopic orbital brain tissue: a case report with radiographic and clinical review
Published in Orbit, 2023
Maja Magazin, Laurence J. Eckel, M. Tariq Bhatti, Andrea A. Tooley
Orbital heterotopic brain tissue is usually best evaluated with various imaging modalities, which can help confirm the diagnosis and monitor progression. Based on all published cases to date, 62% (21/34) were evaluated with computed tomography (CT), while 50% (17/34) were evaluated with MRI, 20% (7/34) with ultrasound, and 9% (3/34) with X-ray or cerebral angiography. CT imaging noted bony abnormalities in 41% (14/34) of patients and 18% (6/34) presented with orbital wall defects associated with lesions located in the medial orbit and orbital apex. Orbital wall thinning, orbital wall expansions, scalloping of the orbital wall, and concave deformities were also frequently described. On CT imaging, ectopic lesions were described as well circumscribed and well defined (24%), homogenous (14%), with rim enhancement (14%), and calcium deposits (14%).
Natural conception resulting in a ruptured heterotopic pregnancy in a multiparous woman
Published in Baylor University Medical Center Proceedings, 2020
Vimal B. Shenoy, C. J. Buckley
Heterotopic pregnancies, or pregnancies with an extrauterine and intrauterine pregnancy concurrently, are rare, with a prevalence of 0.6 to 2.5 per 10,000 pregnancies.1 They are becoming increasingly common with the advent of assisted reproduction techniques, with an incidence estimated at 1 to 3 in 100 for single embryo transfer. Since the incidence in natural fertilizations is low, at approximately 1 in 30,000,2 most clinicians have a low index of suspicion for heterotopic pregnancy among patients presenting in the second trimester. We present the case of a multiparous woman who presented in hemorrhagic shock from a ruptured heterotopic pregnancy.
Related Knowledge Centers
- Gray Matter Heterotopia
- Grey Matter
- White Matter
- Ventricular System
- Meckel'S Diverticulum
- Exaptation
- Paraphyly
- Chitin
- Choristoma
- Heterotopy