The human body has a system of detecting and destroying abnormal cells such as cancer cells and immunotherapy against cancer has been studied for decades. Checkpoint inhibitors target immune checkpoints and suppress the cancer cells from escaping the immune system. Two checkpoint inhibitors, Nivolumab and Pembrolizumab have been approved in Japan for recurrent/metastatic head and neck cancer. Awareness for side effects called immune related adverse events (irAE) is important and constructing a multidisciplinary team including medical oncologists is crucial. Task shifting from surgical oncologists to medical oncologists is also an important issue.
Among cervical abscesses, abscess of the temporal muscle is rare, and its pathological characteristics are still not fully understood. Temporal muscle is one of the masticatory muscles, and pathology involving this muscle can lead to problems with mouth-opening and swelling of the temporal region of the head. The inflammation may also affect the masseter, inner/outer pterygoid muscles, and adjacent gaps in the masticatory muscle gap, and the clinical picture varies depending on the pattern of spread of the inflammation. We encountered a case of temporal muscle abscess that manifested as face pain in a patient with no underlying disease. It is important not only to evaluate the lesion by CT and other imaging modalities, but also to focus on the physical findings, such as mouth-opening disorders and temporal swelling. Spreading downward is typical for neck abscess, but the abscess that we encountered spread upward along the temporal muscle. Our patient improved after incision and drainage of the abscess and antibiotic therapy.
Solitary fibrous tumor (SFT) is a mesenchymal tumor that mostly arises from the parietal layer of the pleura and is relatively rare in the head and neck region.
Herein, we present the case of a patient with SFT who presented with an anterior cervical swelling.
A 39-year-old man visited our hospital with a left anterior neck swelling. Palpation revealed a soft mass. Various imaging examination were performed, but all showed atypical findings and no definitive diagnosis could be made. Therefore, a tissue biopsy was performed, which revealed the diagnosis of SFT. The tumor was benign in this case and was surgically removed.
Surgical resection for SFT is association with a good prognosis but since some tumors can be malignant, early removal is recommended. Although the tumor is usually benign and the risk of recurrence is low, there have been reports of recurrence, and long-term follow-up is required.
Cases with intranasal foreign bodies are commonly encountered in daily clinical ENT practice. Children under 6 years of age are said to account for a significant percentage of these cases; it is considered that children in this age group often insert objects into their noses out of curiosity or mischief. Inorganic foreign materials, such as metals, are less prone to foreign body infection, and therefore tend to remain in place for a long time. In the case of multiple magnetic foreign bodies, a characteristic phenomenon may occur because of the magnetic attraction between the objects. We report a case of a magnetic foreign body discovered incidentally under the mucosa of the nasal septum in a child. A 7-year-old boy who underwent head CT for facial trauma was incidentally found to have foreign bodies on both sides of the nasal septum. The foreign body on the right side was visible and could be removed immediately, whereas the one on the left side was located under the nasal septal mucosa and was difficult to remove; it was eventually removed using an endoscope under general anesthesia. There was no evidence of infection associated with the foreign body on either side of the nasal septum. The foreign bodies had been squeezing the nasal septum for at least several months, causing the cartilage around the foreign body to become partially defective. There are some reports of multiple magnetic foreign bodies in the nasal septum causing nasal septal perforation. In otolaryngology practice, foreign bodies in the nasal cavity are commonly encountered, but in the case of multiple magnetic objects, they may remain in situ for prolonged periods of time and cause partial tissue loss. Therefore, in order to reduce the possibility of nasal septal perforation, it is considered important to perform surgery with careful consideration of the paying careful attention to selecting the most suitable incision site.
Epipharyngeal Abrasive Therapy (EAT) is a treatment used for early cold, which is characterized by epipharyngeal inflammation, in which a cotton swab soaked in zinc chloride is used to scrape the epipharynx. Zinc chloride is known to exert anti-inflammatory effects, and is therefore used at some medical facilities. EAT rarely causes olfactory dysfunction, however, there are a few reports. Overseas, zinc gluconate is sold in the market and used for early colds, and there have been reports that it could cause olfactory dysfunction. Furthermore, zinc sulfide and zinc oxide have also been reported to cause olfactory dysfunction in animal experiments. We encountered a case of olfactory dysfunction that was thought to be caused by zinc chloride; we considered that the mechanism underlying the olfactory dysfunction caused by zinc chloride was the same as that underlying olfactory dysfunction caused by other zinc compounds, and report the case here with a review of the literature.