Question of the Week - August 2021
August 16th, 2021
A 25-year-old male presents to the otology clinic for evaluation of chronic right-sided hearing loss. His past medical history is significant for multiple facial reconstructive surgeries, lipoepidermoid resections, and mandible implant surgery. Physical exam findings include a right-sided hypoplastic mandible, multiple surgical scars, and preauricular skin tags bilaterally. Microscopic evaluation of the right ear shows severe stenosis of the auditory canal, along with cerumen and keratin debris. CT scan confirms the presence of cholesteatoma in the right ear and normal appearance of the left ear. The patient was most likely diagnosed with which of the following congenital disorders?
A. CHARGE syndrome
B. Treacher-Collins syndrome
C. Goldenhar syndrome
D. VACTERL syndrome
E. Wildervanck syndrome
August 2nd, 2021
A 64-year-old male patient with a history of untreated hypertension presents to the emergency department with an intractable nosebleed that began a few hours ago. Over the past 3-4 days, he had nasal congestion partially relieved by over-the-counter naproxen, but has resulted in recurrent sneezing and blowing his nose frequently. He states that he also feels liquid running down his throat that tastes like metal. He initially attempted to stop the bleeding by pinching his nose and leaning forward, but his wife drove him to the ED after he began to feel dizzy and nauseous. In the ED, multiple attempts to control the bleeding with nasal packing are unsuccessful. Which of the following locations is the most likely etiology of this patient’s symptoms?
A. Anterior ethmoidal artery
B. Internal carotid artery
C. Kiesselbach plexus
D. Sphenopalatine artery
E. Superior labial artery