Cavernous haemangioma of the temporal bone.

Cavernous haemangioma of the temporal bone is a rare lesion and nearly always of limited extent. A case of a large and rapidly progressive temporal bone haemangioma in a child is presented. Negative angiography led to biopsy at which profuse and troublesome haemorrhage was encountered. Subsequent Red Blood Cell labelled scan demonstrated blood pooling in the lesion. The combination of positive RBC labelled scan and negative angiography can only occur in lesions in which blood pooling takes place, enabling biopsy with its hazards to be avoided. The tumour was resected using a skull base, infratemporal approach. Morbidity was minimal. There was no evidence of recurrence at a 15 month follow-up.     

Maxillary haemangioma

Maxillary haemangioma is a rare entity. It presents with a painless, slow-growing swelling and if it involves the paranasal sinuses it may present with severe epistaxis, mimicking a malignancy. A case of haemangioma arising in the bony maxilla and causing a cosmetic problem is presented here.     

鼻内窥镜技术在面中部骨折治疗中的应用

报告8例面中部骨折病人，其中鼻额筛复合骨折6例，击出性骨折（眶底暴折）2例。治疗中结合鼻内窥镜技术，获得了术前诊断明确，术中操作细致、准确，术后恢复迅速，8例均治愈出院，随访半年～1年疗效满意。     

Management of subglottic haemangioma

Between 1980 and 1993, 10 infants underwent endoscopic treatment and/or open surgical excision of a subglottic haemangioma. Of the eight children treated with the laser, four showed simple evolution following a single laser treatment, one required repeated laser treatments and two needed tracheotomy despite repeated laser treatments The last three children developed moderate subglottic stenosis. Laser treatment was followed by open surgical excision in one child. Two children underwent primary surgical excision, allowing extubation between 8 and 10 days post-operatively. After a period in which we systematically treated subglottic haemangiomas with the laser, these findings have led us to employ open surgery in children with large subglottic haemangiomas or when airway obstruction requires a tracheostomy.     

Subglottic haemangioma in children

Our experience with the treatment of 23 cases of subglottic haemangioma in children at the Hospital for Sick Children is presented. Different modalities of treatment are mentioned, with particular emphasis on excision with laryngo-tracheoplasty and the use of CO2 surgical laser. In a self-limiting lesion, our present policy is to use the CO2 laser to accelerate the rate of regression while minimizing morbidity and mortality.     

Tracheal haemangioma: case report

A case of lobular capillary haemangioma of the trachea is presented. The patient gave a history of foreign body sensation in the throat and multiple episodes of haemoptysis. The chest X-ray was normal. A spiral computed tomograph (CT) with three-dimensional reconstruction revealed a small tracheal mass in the antero-lateral wall of the trachea, which was excised by endoscopy. The histopathological diagnosis was lobular capillary haemangioma, a rare, benign tumour of the trachea. A high index of suspicion with the spiral CT finding was responsible for early diagnosis of the tumour.     

Capillary haemangioma of the ethmoid

Capillary haemangiomas involving the ethmoid are rare. Two cases are reported here. Both the cases presented with recurrent severe ephtaxis. In both the cases there were erosion of the middle turbinate. Endoscopic sinus surgery was done.     

Nasal bone fractures and the use of radiographic imaging: An otolaryngologist perspective

ObjectiveTo determine radiologic preferences of practicing otolaryngologists regarding isolated nasal bone fractures.Study designAn 8-question survey on isolated nasal bone fractures was designed.SettingSurveys were sent to all otolaryngology residency program directors for distribution among residents and faculty. Additional surveys were distributed to private practice otolaryngology groups.Results140 physicians responded to the survey. 57% of the respondents were practicing otolaryngologists (75% with 10+ years of experience), while 43% of respondents were residents-in-training. 56% of respondents treated 1–5 nasal bone fractures per month. 80% of all respondents reported imaging being performed prior to consultation. If imaging was obtained before consultation, plain films and computed tomography (CT) maxillofacial/sinus scans were the most frequent modalities. 33% of residents and 70% of practicing otolaryngologists report imaging as ‘rarely’ or ‘never’ helpful in guiding management. 42% of residents and 20% of practicing otolaryngologists report asking for imaging when it wasn't already obtained. Decreased use of radiography was associated with greater years in practice and higher frequency of fractures treated.Conclusions and relevanceOtolaryngologists seldom request imaging to evaluate and treat isolated nasal bone fractures. When ordered, imaging is utilized more often among residents-in-training and non-otolaryngology consulting physicians. This study highlights an opportunity to educate primary care and emergency room providers as well as otolaryngology residents on the value of comprehensive physical exam over radiographic imaging in the work-up of isolated nasal fractures. In addition, widespread adoption of a “no x-ray policy” in this setting may result in better resource utilization.     

Osseous haemangioma of inferior turbinate.

We present a case of osseous haemangioma arising within the inferior turbinate.     

Ossifying haemangioma of the frontal sinus

First described by Natali, the ossifying haemangioma is a rare entity. Although cases of ossifying haemangioma have been described in the literature, no involvement of the frontal sinus has been presented yet. We present a 46-year-old female patient who complained of recurrent cephalalgia and pressure in her forehead for 3 months. A computerized tomography scan demonstrated a compact radiopaque density arising from the floor of the middle cavity of her frontal sinus. Surgery was performed using the coronal approach. A rhomboid-shaped ossified tumour in the middle cavity of the frontal sinus was found with no signs of bleeding, partially obstructing the right sinus ostium. The small tumour was removed at the very base showing slight bleeding. Two weeks later, during the clinical follow-up, the patient did not complain of any of her previous symptoms. Previous studies have presented ossifying haemangioma of the temporal bone as an extremely aggressive entity affecting the 7th cranial nerve. In our case, the frontal sinus showed no signs of destruction of the adjacent tissue, and the only associated symptom was frontal cephalalgia. Because no critical surgical complications have been observed, no further changes to the surgical procedure appear necessary. We recommend performing a computerized tomography 6-12 months after surgery for follow-up to detect possible tumour regrowth.     

Cavernous haemangioma of the parapharyngeal space

Parapharyngeal space swellings due to various pathological processes have been reported in the literature. We report a case of cavernous haemangioma of the parapharyngeal space in an adult female patient. To the best of our knowledge this is the first such case reported in the English literature.     

A cavernous haemangioma of the thyroid gland

Haemangioma of the thyroid gland is extremely rare. We report a case of a cavernous haemangioma of the neck that was located both inside and outside the thyroid gland of a 21-year-old man. Ultrasonography of the neck revealed numerous calcified nodules. Computed tomography (CT) showed a large calcified soft tissue mass in the right lobe of the thyroid. Based on the imaging findings a papillary thyroid carcinoma was suspected, but examination of the surgical specimen revealed a huge cavernous haemangioma containing numerous phleboliths.     

Intramuscular haemangioma of head and neck region

Intramuscular haemangiomas are rare benign haemangiomas occurring within the skeletal muscle. These are uncommon tumours in the head and neck region and occur most frequently on the trunk and extremities. Fewer than 80 cases of intra-muscular haemangioma in the head and neck region have been reported in the literature. A case of intramuscular haemangioma of the sternocleidomastoid muscle is presented. The review of occurrence and natural history of such tumours is described and clinical and radiological presentation, histological classifications and treatment modalities are discussed.