Herpes encephalitis, often involving the temporal lobe, is one of the major causes of auditory agnosia in children, a rare state that is characterized by the inability to comprehend speech and nonverbal sounds. We report three child cases of auditory agnosia after contracting herpes encephalitis, based on the diagnosis by audiological examination and the radiological image findings. In all patients, audiometry revealed a moderate threshold elevation with a normal auditory brainstem response threshold. However, they were unable to perceive speech, music and environmental sounds. Magnetic resonance imaging of the brain showed bilateral atrophy of the auditory cortex and auditory radiation, in all cases.
Cystic hygroma is recognized in infants and children as a benign tumor of the neck. Local injection of OK-432 for cystic hygroma is commonly performed as the therapy of first choice. However, although OK-432 therapy showed remarkable effectiveness, differentiation between cystic hygroma and hemangioma was quite important for a good outcome. A 1-year-old-girl, whose CT and MRI showed large multilobular cystic tumor of the lateral neck expanding to the contralateral side, was diagnosed as cystic hygroma and treated with intralesional injection of OK-432. In this case, the hygroma decreased remarkably. A 3-year-old-girl, whose Tl MRI showed an isointense and partially hypointense tumor of the lateral neck, was diagnosed as a cystic hygroma with a hemangioma and treated with intralesional injection of OK-432. In this case, the hygroma decreased considerably, but the hemangioma persisted. In these cases, MRI and CT could not accurately differentiate cystic hygroma from hemangioma, but ultrasonography and biopsy provided useful information for reliable diagnosis and treatment.
A juvenile angiofibroma initially arises from the nasopharynx with high blood flow. The treatment method for the tumor should be examined carefull aynd decide bdyu sing enhance CdT, MRI and X?ray examination. Recently, we treated a 13?year-old boy with tumor recurrence. We selected Weber's incision to complete the total resection of the recurrent tumor. The patient has been tumor-free since surgery for 1.8 years. Multi-directional enhanced CT and MRI are useful for decidings urgica ml ethod asnd the limits of incision a, nd will contribut teo the preventio onf head and neck tumor recurrence.
Maxillary lesions rarely arise in infants and children. This paper reports 3 pedia tric cases of maxillary lesions which we encountered recently. Case 1: A 2-year-3-month-old boy was brought to our hospital with left maxillary swelling. Diagnosed as having an odontogenic cyst, he underwent a radical operation of the maxillary sinus. Case 2: A girl without defecation since birth was diagnosed as having ileus and surgically treated. A pathological diagnosis of cystic fibrosis was established postoperatively. She was referred to our department for the examination of increasing nasal obstruction. The maxillary bone was swollen on both sides. Because the patient complained of cheek pain, local therapy was performed through a counter opening of the maxillary sinus created in the nasal cavity. Case 3: A 15-year-old-girl with congenital hydrocephalus had been followed-up at the department of neurosurgery. She was referred to our department for the examination of swollen cheeks. CT revealed large cystic lesions in the bilateral maxillary sinuses. Radical operation of the maxillary sinus was performed. The post operative diagnosis of odontogenic keratocyst was made and pathological examination of biopsy specimens suggested the diagnosis of Gorlin syndrome. The patient should be carefully followed-up because of the malignant potential of the disease. Although maxillary lesions rarely arise in infants and children, clinicians should be aware of these rare conditions.
Intracranial complications of rhinosinusitis have been decreasing with r ecent advances in medicine. However, these diseases in children are still present, and recently cases following a serious clin ical course have been reported. We report a case of bacterial meningitis with frontal sinusitis. Previous reports and our case suggest that the incidence of intracranial complications of sinusitis is high in young males. Frontal sinusitis is most frequently encountered in cases of intracranial complications. Therefore, immediate and proper treatment is required when young males are suspected of having frontal sinusitis.
Thirteen children with cochlear implants participated in the experiments designed fo ascertaining the perception of music. Most subjects showed good ability for discriminating rhythm pattern. They also achieved good scores in both pitch differentiation and melody differentiation tests, but the mean score of their melody identification tests was lowest. These results indicate that implantees can easily detect pitch change itself, though they have difficulty in detecting the direction of pitch change (high/low). Singing voices of implantees were compared with those of normal hearing children. Lengths of notes in the songs of subjects were as accurate as those of controls, but continual pitch changes were less accurate, and the register was narrower.