Cochlear schwannomas, which are categorized into intracochlear and intravestibulocochlear schwannomas (ICs and IVCs, respectively) are rare and may cause hearing loss (HL). The affected region is invariably correlated with tumor location, which can be detected on magnetic resonance imaging (MRI). We describe the cochleovestibular manifestations of ICs and IVCs. Subjects and Methods: The study included 31 patients with ICs or IVCs. Tumor extent and exact locations were delineated using MRI. Types of HL were subcategorized into the low-to-mid frequency (250 Hz to 1 kHz), mid-to-high frequency (>1 kHz), and all-frequency (universal) HL groups. Results: The tumors involved the entire cochlear turn (two ICs) or extended beyond the cochleae (nine IVCs) in 11 patients, and 20 ICs were located in specific locations as follows: 14 in the basal, 3 in the middle, and 3 in the middle and apical turns. No patient showed tumor invasion of the internal auditory canal or middle ear. The pattern of HL usually reflects the location or extent of a tumor. We observed HL at all frequencies, at low-to-mid frequencies, and at mid-to-high frequencies in 13, 4, and 14 patients, respectively. Dizziness or tinnitus was observed in >50% of patients. Surgical tumor removal was performed in 10 patients, and the remaining patients are undergoing annual monitoring. Conclusions: Cochlear schwannomas may be associated with HL, which may worsen over time and reflect tumor location. Therefore, these lesions should be considered in the differential diagnosis in patients who present with idiopathic, fluctuating, progressive or sudden HL.

Objective: To describe our experience in managing two cases of primary malignant parotid lymphoma. Methods: Design: Case Report Setting: Tertiary University Referral Center Patients: Two Results: Both patients underwent superficial parotidectomy. Despite recurrence in one, the disease was controlled with conservative management. However, the disease was more aggressive in the other, requiring additional chemo-radiotherapy. Conclusion Malignant parotid lymphoma may present with varying stages, grades and clinical courses, requiring different management approaches. The treatment options are based on grading and staging at diagnosis and should be implemented depending on individual case.
Parotid Neoplasms ; Lymphoma

OBJECTIVES: To share our experience in managing a rare involvement of phrenic nerve injury in laryngeal trauma

METHODS:
Design: Case Report
Setting: Tertiary Referral Centre
Patient: One

RESULTS: A 23 year old male sustained blunt laryngeal trauma associated with phrenic nerve injury leading to silent traumatic diaphragmatic paralysis. He underwent tracheotomy and surgical repair of Schaeffer class IV laryngeal injuries, and conservative therapy for the diaphragmatic paralysis, which eventually resolved.

CONCLUSION: Patients with laryngeal trauma may have concomitant phrenic nerve injury causing diaphragmaic paralysis. The diagnosis should be considered particularly if the patient has respiratory problems despite securing the airway by tracheotomy. A high index of suspicion is required in diagnosing such an association. Patients should be closely monitored even though most will recover as some may present with later morbidities. A search of PubMed and OvidSP using the terms "larynx" "laryngeal trauma and "phrenic nerve" did not yield any report of phrenic nerve injury in associaion with laryngeal trauma. To our knowledge, this is may be the first reported case of phrenic nerve injury in association with blunt laryngeal trauma.

Human ; Male ; Young Adult ; Laryngeal Nerve Injuries ; Medication Therapy Management ; Larynx-injuries ; Phrenic Nerve-injuries ; Wounds And Injuries ; Respiratory Paralysis ; General Surgery ; Tracheostomy