The presence of a foreign object within the body often triggers an inflammatory reaction, which can result in the formation of a foreign body granuloma. In Japan, such a granuloma caused by gauze is specifically referred to as “gauzeoma,” while the internationally accepted term for this condition is “gossypiboma.” Although reports of gossypiboma are infrequent following abdominal surgeries in Japan, cases occurring after nasal sinus surgeries are even rarer. This report details a unique instance of gossypiboma in a patient who was initially suspected of having sinus-organized hematoma before undergoing surgical intervention. The present patient, a 47-year-old male, had undergone sinus surgery at another medical facility over 20 years ago, but specific details about the earlier procedure were not available for review. Based on findings from an endoscopic examination and imaging studies, the initial diagnosis was left maxillary sinus organized hematoma with recurrent rhinosinusitis. This diagnosis led to the decision to proceed with the surgical treatment. This report not only presents the case but also includes an extensive literature review focused on differentiating between gauzeomas and organized hematomas. This review provides valuable insights into the diagnostic challenges of these conditions and highlights the importance of an accurate diagnosis.

Cerebral blood flow disorders can cause dizziness; however, this can be challenging to confirm. We report a case of dizziness in which blood flow disorder was suspected. A 45-year-old woman underwent endovascular treatment for basilar artery aneurysm. She subsequently developed a right medullary infarction that resulted in left incomplete hemiparesis, right hearing loss, and dizziness. The infarction site did not match the symptoms of hearing loss and dizziness, and the symptoms persisted, leading her to be referred to our hospital. On examination, there was no spontaneous nystagmus; however, horizontal rotatory nystagmus to the left was observed in the head-shaking nystagmus test. Pure-tone audiometry revealed elevated thresholds in the right ear at high frequencies (500, 1,000, 2,000, 4,000, and 8,000 Hz), with thresholds of 35, 35, 45, 70, and 90 dB, respectively. Equilibrium function tests revealed that the patient’s cVEMP and oVEMP values were normal. The vHIT showed a reduced gain (0.45) with catch-up saccades in the right posterior semicircular canal, a slight gain reduction (0.77) in the right lateral semicircular canal, and a normal lower limit (0.86) in the right anterior semicircular canal, suggesting impairment centered in the right posterior semicircular canal. These findings suggest that the patient’s dizziness may have been caused by vestibular dysfunction due to a blood flow disorder. Blood flow disorders should be considered in cases of sudden sensorineural hearing loss and dizziness of unknown origin.

Relapsing polychondritis (RP) presents with a variety of clinical symptoms, and there are cases for which a definitive diagnosis takes time. We report a case of RP that was diagnosed by histopathological examination of tracheal cartilage resected through tracheostomy, after presenting with lower respiratory tract symptoms only. The patient was a 72-year-old male. CT performed for detailed examination of pneumonia caused by COVID-19 revealed thickening of the tracheal and bronchial walls. Despite treatment for pneumonia, the wall thickening persisted and the patient experienced prolonged exertional dyspnea. Gallium-67 scintigraphy showed localized accumulation in the trachea and bronchi, leading the patient to visit our department for further examination. Histopathological examination of the tracheal cartilage resected through tracheostomy confirmed the diagnosis of RP. Currently, the patient is being managed on maintenance therapy with steroids and immunosuppressants, and there has been no recurrence. RP can cause airway obstruction due to inflammation of the airway cartilage in the larynx and trachea, making early diagnosis and treatment crucial. Treatment involves steroids and immunosuppressants; however, use of these drugs before a definitive diagnosis may reduce the sensitivity of histological diagnosis, thus, it is preferable to avoid steroid use before a definitive diagnosis. If a biopsy of the tracheal cartilage is necessary for histological diagnosis of tracheal lesions, tracheal fenestration is likely to be a useful procedure.

We herein report a case of parapharyngeal space abscess caused by parotitis. A 76-year-old man who had complained of right subauricular pain received antibiotic treatment for right parotitis at a previous clinic. He visited our department with swelling in the right subauricular region and trismus. We administered lascufloxacin (LSFX), but exacerbation of right parotitis was noted upon reevaluation 7 days later. A contrast-enhanced CT scan revealed abscess formation in the infra-auricular region, around the mandible, and in the parapharyngeal space. The patient was admitted to hospital and started on intravenous tazobactam/piperacillin (TAZ/PIPC). He was discharged on the 6th day of hospitalization. Ear and odontogenic infections were ruled out, and a diagnosis of parapharyngeal space abscess caused by parotitis was made.