hx: newborn with difficulty breathing relieved by crying

20
R esident on callCM H cases Collected by: Lisa H .Low e,M D

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Page 1: Hx: Newborn with difficulty breathing relieved by crying

Resident on call CMH cases

Collected by: Lisa H. Lowe, MD

Page 2: Hx: Newborn with difficulty breathing relieved by crying

Hx: Newborn with difficulty breathing relieved by crying

Page 3: Hx: Newborn with difficulty breathing relieved by crying

Findings:

•Narrow anterior choana/nares with abnormal “waist” like shape of the maxillary spines and medial angulation of the nasal walls

•Central mega incisor

Page 4: Hx: Newborn with difficulty breathing relieved by crying

Hx: Pyriform aperture stenosis

Normal nasal cavity for comparison (walls of max sinuses and septum are parallel, not funnel shaped)

•Other midline anomalies are common such as holoprosencephaly and central megaincisor

Page 5: Hx: Newborn with difficulty breathing relieved by crying

Hx: 5 year old with bulging forehead

Page 6: Hx: Newborn with difficulty breathing relieved by crying

Findings:

•Defect in between nasal bone and frontal bone

•Brain bulges through the defect

Page 7: Hx: Newborn with difficulty breathing relieved by crying

Dx: Nasofrontal encephalocele

•Congenital extension of brain through skull at the Glabella (should never biopsy this mass)

•Treated surgically

Page 8: Hx: Newborn with difficulty breathing relieved by crying

Hx: 1 mo male old w/ swollen eye

Page 9: Hx: Newborn with difficulty breathing relieved by crying

Findings:

•Well defined area left medial canthus with minimal peripheral enhancement of the wall

•Lt mass in nose

•Lt soft tissue swelling preseptal

Page 10: Hx: Newborn with difficulty breathing relieved by crying

Dx: Dacrocystitis

•Needs prophylactic antibiotics and definitive therapy somewhat urgently to prevent infection and nasolacrimal duct damage

Page 11: Hx: Newborn with difficulty breathing relieved by crying

Hx: Right eye swelling 12 week old

Page 12: Hx: Newborn with difficulty breathing relieved by crying

Findings:•Well defined area right medial canthus with minimal peripheral enhancement of the wall and fluid level

•Rt mass in nose

•Rt soft tissue swelling preseptal

Page 13: Hx: Newborn with difficulty breathing relieved by crying

Dx: Dacrocystocele•Well defined area right medial canthus with minimal peripheral enhancement of the wall and fluid level

•Rt mass in nose

•Rt soft tissue swelling preseptal

Page 14: Hx: Newborn with difficulty breathing relieved by crying

Hx: 4y male fvr, recent dental procedure

Page 15: Hx: Newborn with difficulty breathing relieved by crying

Findings

•Sublingual fluid with cellulitis/inflammation

Page 16: Hx: Newborn with difficulty breathing relieved by crying

Dx: Sublingual abscess due to tooth abscess

Page 17: Hx: Newborn with difficulty breathing relieved by crying

Hx: Lt facial swelling & redness 2ym

a

Page 18: Hx: Newborn with difficulty breathing relieved by crying

Findings

a

•Enhancing left parotid with tiny foci of low density; rt is normal; no calcifications

Page 19: Hx: Newborn with difficulty breathing relieved by crying

Dx: Parotitis

a

•Unilateral usually bacterial or due to stone. Mumps is bilateral. Can be viral also

Page 20: Hx: Newborn with difficulty breathing relieved by crying