Cases reported "Necrosis"

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11/128. Nasal alar necrosis.

    OBJECTIVE: To describe an unrecognized clinical entity, nasal alar necrosis, and propose recommendations regarding the diagnosis, pathophysiology, and management of these cases. STUDY DESIGN: Retrospective review of four patients with this condition. methods: Histories, treatments, and outcomes were evaluated using office and hospital chart data. RESULTS: We noted that three patients had prior trauma or surgery, other than to the nose, in the head and neck region. All four patients had comorbidities such as diabetes, hypothyroidism, depression, or tobacco abuse. Three patients had sensory deficits over the distribution of the maxillary nerve, and three volunteered that they had a habit of picking the crusted wound. Two patients improved over several months with aggressive wound care. One patient refused treatment and another underwent successful reconstruction. CONCLUSIONS: After malignant and granulomatous diseases were ruled out, our evaluations suggested that the pathogenesis was multifactorial including several factors alone or in combination, such as, hypoesthesia, self-mutilation, and an inadequate blood supply. Deficits in vascularity and sensory innervation must be considered as potential obstacles in reconstruction. Psychological problems causing factitious wounding may complicate therapeutic interventions.
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keywords = neck
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12/128. Late sequelae of radiation therapy in cancer of the head and neck with particular reference to the nasopharynx.

    Sequlae of radiation therapy may be late in occurring and varied in their manifestations. Although some are untreatable and progressive, the risk of development of some other sequelae can be minimized by careful application of radiotherapy or by ancillary measures, such as dental decay prophylaxis. Some of the serious sequelae secondary to radiation therapy of the nasopharynx have been summarized. These include radiation myelitis, paralysis of the cranial nerves, stricture of the pharynx, radiation-induced cancer, and necrosis with fatal hemorrhage.
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ranking = 4
keywords = neck
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13/128. Encapsulated anaplastic thyroid carcinoma with three-year disease-free survival.

    This is a report of an unusual anaplastic thyroid carcinoma case with capsule and long disease-free survival. This 74-year-old male, with an asymptomatic nodule in the mid-line neck for 5 years, was treated with total thyroidectomy. light microscopy and immunohistochemistry showed an anaplastic carcinoma of the thyroid isthmus. There were no signs of carcinoma elsewhere either at the time of surgery or 35 months later, when the patient was last seen.
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ranking = 1
keywords = neck
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14/128. CT findings of descending necrotising mediastinitis via the carotid space ('Lincoln Highway').

    A 3-year-old girl with fever and neck swelling showed widening of the superior mediastinum on chest radiographs. Contrast-enhanced CT of the neck revealed ill-defined low-attenuation areas with a thick, enhanced rim adjacent to the hypertrophied palatine tonsil. The abscess extended inferiorly within the carotid sheath between the carotid artery and the internal jugular vein into the anterior mediastinum. The carotid space is considered an important conduit of descending necrotising mediastinitis and is called the 'Lincoln Highway' as previously suggested.
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ranking = 2
keywords = neck
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15/128. Case report: total parenteral nutrition extravasation associated with spinal cord compression and necrosis.

    A preterm infant, whose course was complicated by sepsis, necrotizing enterocolitis with jejunal perforation, intraventricular hemorrhage and cerebellar hemorrhage, suffered permanent and total paralysis below the neck from extravasation of parenteral nutrition fluids through a femoral venous catheter. MRI imaging revealed extravasation of fluid into the paraspinus musculature with extension into the spinal canal. This fluid was identified as hyperalimentation and intralipid. Postmortem examination found evidence of necrosis of the spinal cord as well as perforation of the right iliac vein.
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ranking = 1
keywords = neck
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16/128. brain necrosis after permanent low-activity iodine-125 implants: case report and review of toxicity from focal radiation.

    Focal irradiation has emerged as a useful modality in the management of malignant brain tumors. Its main limitation is radiation necrosis. We report on the radiation dose distribution in the cerebellum of a patient who developed imaging and autopsy diagnosis of radiation necrosis after permanent iodine-125 implants for a solitary osseous plasmacytoma of her left occipital condyle. A 55-year-old woman initially presented with neck and occipital pain and a lytic lesion of her left occipital condyle. A cytological diagnosis of solitary osseous plasmacytoma was made by transpharyngeal needle biopsy. After an initial course of external beam radiation, the patient required further treatment with systemic chemotherapy 21 months later for clinical and radiographic progression of her disease. She ultimately required subtotal surgical resection of an anaplastic plasmacytoma with intracranial extension. Permanent low-activity iodine-125 seeds were implanted in the tumor cavity. Satisfactory local control was achieved. However, clinical and imaging signs of radiation damage appeared 28 months after iodine-125 seed implantation. Progressive systemic myeloma led to her death 11 years after presentation and 9 years after seed implantation. radiation dose distribution is described, with a discussion of toxicity from focal radiation dose escalation.
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ranking = 1
keywords = neck
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17/128. Carotid artery aneurysm secondary to cystic medial necrosis.

    Carotid artery aneurysm secondary to cystic medial necrosis is a rare clinical entity. We report a 59-year-old Chinese male patient who presented with a pulsatile right neck swelling for 2 months. Partial resection of the aneurysm with primary anastomosis of the internal carotid artery was performed. Histopathological examination of the aneurysmal wall demonstrated cystic degeneration of the media with accumulation of glycosaminoglycan material, consistent with the features of cystic medial necrosis. The pathogenesis of carotid artery aneurysm secondary to cystic medial necrosis is discussed.
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ranking = 1
keywords = neck
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18/128. Catastrophic necrosis of the neck.

    This case report illuminates the high possibility of catastrophic complications in the lateral neck, the vagaries associated with the preoperative therapeutic information, the technical effort to gain maximum surgical security, and the overwhelming complications associated with chemotherapy, irradiation, and surgical intervention.
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ranking = 5
keywords = neck
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19/128. Synergistic necrotizing cellulitis as a complication of peritonsillar abscess.

    peritonsillar abscess, a complication of tonsillitis, is not uncommon. The usual treatment consists of needle aspiration or surgical drainage and antibiotic treatment. tonsillectomy may be used in the management of this condition, either at the time of diagnosis or after an interval period. Severe complications of peritonsillar abscess are rare. Synergistic necrotizing cellulitis is a fulminant infection associated with spread along fascial plains, necrosis of connective tissue and muscle, and high mortality. It is usually otondogenic in origin in the cervicofacial area and occurs in debilitated or immune compromised patients. We discuss cervicofacial-necrotizing soft tissue disease and report an unusual case of extensive synergistic necrotizing cellulitis of the neck, chest, and shoulder as a result of a peritonsillar abscess.
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ranking = 1
keywords = neck
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20/128. Avascular necrosis of the head of the talus without death of the body: report of an unusual case.

    A case of fracture of the neck of the talus with dislocation of the subtalar joint is reported in which the head of the talus underwent avascular necrosis while the body remained alive.
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keywords = neck
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