Low‐cost dual‐action aural foreign‐body extractor

Adequate visualization, appropriate equipment, a cooperative patient, and a skilled physician are keys to successful foreign body removal. The first attempt at removal is critical because success rates markedly decrease after the first failed attempt. Laryngoscope, 119:351–354, 2009     

Detection of paranasal ectopic adrenocorticotropic hormone‐secreting pituitary adenoma by Ga‐68‐DOTANOC positron‐emission tomography–computed tomography

Ectopic adrenocorticotropic hormone (ACTH)‐secreting tumors account for approximately 10% of Cushing's syndrome (CS). We present an extremely rare case of a patient with CS caused by an ectopic ACTH‐secreting pituitary adenoma (EAPA) of the ethmoid sinus. The tumor was identified by positron‐emission tomography–computed tomography (PET/CT) using the somatostatin receptor analogue Ga‐68‐DOTANOC. Transnasal endoscopic resection was performed and the patient showed significant clinical improvement with normalization of the endocrine pituitary axis. Immunostaining showed a somatostatin receptor 2 and 5‐positive ACTH‐producing adenoma. In patients with ectopic ACTH secretion, Ga‐68‐DOTANOC‐PET/CT may play an important role in the localization of EAPA. Transnasal endoscopic resection is the therapy of choice.     

Fulminant epstein‐barr virus‐associated hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) is a rare, severe, and often fatal disorder. Its hereditary and sporadic form can present as a significant diagnostic challenge to the otolaryngologist. This report describes two fatal cases of adult patients with HLH initially presented as infectious mononucleosis to an otorhinolaryngologist. The clinical presentation, serological and histological features, and management are discussed.