A case of a 74-year-old male with unilateral nasal obstruction, recurrent epistaxis and a right intranasal mass is presented. It was initially diagnosed as hemangioma but final histopathology report revealed oncocytic carcinoma. Oncocytic carcinoma is a rare tumor of the salivary glands with very few reported cases, most of which involve the parotid gland. It has a tendency to recur with inadequate excision. Diagnosis is histopathologic. It is to be emphasized that adequate tissue samples should be taken in order to provide a definite diagnosis from biopsy, and subsequently institute proper definitive management.

Human ; Male ; Aged ; Parotid Gland ; Nasal Obstruction ; Epistaxis ; Salivary Glands ; Biopsy ; Hemangioma ; Neoplasm Recurrence, Local

Objective: To calculate the accuracy, sensitivity, specificity and positive predictive values of the Siemens HearCheck™ Navigator in detecting hearing loss and to compare values of these parameters when the examination is done in a soundproof booth and in a quiet room. Methods: Design: Analytical, cross-sectional study Setting: Tertiary Public University Hospital Patients: Patients seen at the Ear Unit of a tertiary public university hospital from June 2009 to August 2010 were tested using the Siemens HearCheck™ Navigator and pure tone audiometry, inside a soundproof audiometry booth and in a quiet room with an ambient noise of 50dB, with a different investigator for each examination. Each ear was treated as a separate subject. Results obtained from the HearCheck™ Navigator were designated as observed values and were classified as “no hearing loss” for green light, and “with hearing loss” for yellow or red lights. Results were compared with pure tone air conduction averages designated as gold standard values. Normal hearing acuity (0-25 dB) was classified as no hearing loss. Pure tone air conduction averages of 26dB and above were classified as “with hearing loss” and were further stratified as mild hearing loss (26-40dB) and moderate or worse hearing loss (>41 dB). Observed and gold standard values were compared and tabulated in a 2x2 table for all levels of hearing loss, mild hearing loss, and moderate or worse hearing loss. Accuracy, sensitivity, specificity, positive and negative predictive values of the Siemens HearCheck™ Navigator inside a soundproof audiometry booth and in a quiet room were determined using pure tone audiometry as the gold standard. Results: 100 patients (200 ears) were tested, with a median age of 43 years old (range 15-75), and an almost equal number of male and female participants (52 males, 48 females). Accuracy rate of the Siemens HearCheck™ Navigator inside the soundproof audiometry booth and in a quiet room were 82.5% and 84% respectively for all levels of hearing loss. Sensitivity, specificity, positive and negative predictive values were similar whether the examination was done inside the soundproof audiometry booth or in a quiet room. These values were notably higher in patients with moderate or worse hearing loss compared to patients with mild hearing loss. Conclusion The Siemens HearCheck™ Navigator shows potential as an accurate, portable, easy-to-use tool to screen for hearing loss, especially for cases of moderate or worse hearing loss, without the need for soundproof audiometry booths or special training. It is recommended that further studies be done to differentiate degrees of hearing loss, and to evaluate its usefulness in other target populations, including school children and the elderly.
Hearing Loss