A 57-year-oldpatient diagnosed witha right glomus jugularae was referred to the ENT unit TH/Anuradhapura for further management. Multidisciplinary discussion and multi-modality imaging confirmed the diagnosis to be a jugular schwannoma. The Patient underwenttumour excision via a combined petro-occipital trans-sigmoidal approach withclose perioperative monitoring and post-operative rehabilitation.This article discusses the importance of a detailed history, examination and multimodality imaging for correct diagnosis of jugular foramen lesions which governs the selection of the surgical approach.
Key Messages 1. Rhino-orbital symptoms and sings in an immunocompromised patient along with fat stranding in CT scan are strongly suggestive of RCM. 2. Sinoscopy under anesthesia may be required for definitive diagnosis of RCM as nasal examination can be completely normal in early stages. 3. Liposomal Amphotericin along with other supportive measures and strict fluid/ electrolyte balance can reduce mortality significantly 4. Topical conventional Amphotericin packaging is an important adjunct to systemic therapy.
A 49-year-old female with grade 3 tracheal stenosis underwent Coblator assisted recanalization and mytomycin-C application. Montgomery T-Tube was used to stent the lumen and she was successfully decanulated after one year. We believe that use of Coblator, mytomycin-C and T-tube resulted in successful outcome.
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