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On February 23, 2018, PubMed Central Canada (PMC Canada) will be taken offline permanently. No author manuscripts will be deleted, and the approximately 2,900 manuscripts authored by Canadian Institutes of Health Research (CIHR)-funded researchers currently in the archive will be copied to the National Research Council’s (NRC) Digital Repository over the coming months. These manuscripts along with all other content will also remain publicly searchable on PubMed Central (US) and Europe PubMed Central, meaning such manuscripts will continue to be compliant with the Tri-Agency Open Access Policy on Publications.

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1.  Differentiation between CSF Otorrhea and Rhinorrhea in an Obscure Case of Recurrent Meningitis 
Leakage of cerebrospinal fluid in the skull base may be accompanied with recurrent meningitis. The site of leakage may either be anterior (in the nose and paranasal sinuses) or posterior (in the temporal bone). Various imaging techniques can be used to precisely locate the point of leakage but despite all the advances in imaging techniques there are still some rare cases in which the surgeon can’t be sure on the management approach before the beginning of surgery.
Case Report:
In this article we present one of these cases; we used intrathecal fluorescein to locate the source of the leak and made the final decision on the operating table.
Intrathecal fluorescein is helpful in locating the leakage in the ear or the nose in ambiguous cases.
PMCID: PMC3989878  PMID: 24745002
CSF; Fluorescein; Recurrent meningitis; Rhinorrhea.
2.  Congenital Vomer Agenesis: Report of Two Cases  
Congenital vomer agenesis is an extremely rare condition in which the vomer bone does not fully develop, which can lead to septal perforation.
Case Report:
We report two cases with a defect in the vomer bone in the posteroinferior portion of the septum, found accidentally while performing a pre-operative CT scan for nasal obstruction evaluation. They were diagnosed with congenital vomer agenesis.
There are afew reports of vomer agenesis in literatures. By increasing usage of sinonasal endoscopic examination,we expect to address more cases in the future.
PMCID: PMC5448033
Congenital; Endoscopic examination; Nasal septum; Vomer agenesis
3.  Subcutaneous Emphysema, Pneumomediastinum and Pneumothorax in a Patient with Dermatomyositis 
Spontaneous pneumomediastinum, pneumothorax, and subcutaneous emphysema are rare, but serious complications of inflammatory myopathies and occur more commonly in DM than PM. complications of dermatomyositis (DM) and polymyositis (PM), both of which can be fatal.
Case Report:
A 20-year-old woman was admitted with neck pain, dyspnea, cough, and fever. She had been diagnosed with dermatomyositis 21 months prior. A thorax computed tomography (CT) scan revealed ground glass opacities in her lungs, pneumomediastinum, pneumothorax, and subcutaneous emphysema. Despite intensive immunosuppressive therapy, clinical deterioration and radiological progression were observed, ultimately the patient died.
During the care for a patient with dermatomyositis, the otorhinolaryngologist should be cautious of rapidly progressive and fatal neck subcutaneous emphysema. For a patient with dermatomyositis and with normal bronchoscopy and esophagoscopy, the main treatment is control of dermatomyositis with medical therapy. Therefore, a tracheostomy and/or mechanical ventilation may not be necessary.
PMCID: PMC5380398
Dermatomyositis; Pneumomediastinum; Pneumothorax; Polymyositis; Subcutaneous emphysema
4.  An Unusual Cause of Dysphonia with Hemoptysis: A Laryngeal Live Leech  
Foreign bodies in the upper airway are one of the most challenging otolaryngology emergencies and have various presentations depending on their physical properties and location. Leeches are blood-sucking hermaphroditic worms that vary in color, length, and shape. They usually reside in fresh-water streams and lakes. When rural untreated water is drunk, leeches may localize in the nose, pharynx, and esophagus, or rarely in the larynx.
Case Report:
This case is a man who was referred to our otolaryngology clinic with a complaint of hemoptysis and mild respiratory distress. The patient’s symptoms were all relieved post operatively and he was discharged on the second day following the procedure.
Leeches should be suspected as an airway foreign body in patients with a recent history of drinking stream water.
PMCID: PMC4087858  PMID: 25009809
Dysphonia; Hemoptysis; Leech
5.  Unilateral Recurrent Laryngeal and Hypoglossal Nerve Paralysis Following Rhinoplasty: A Case Report and Review of the Literature  
Injury to cranial nerves IX, X, and XII is a known complication of laryngoscopy and intubation. Here we present a patient with concurrent hypoglossal and recurrent laryngeal nerve paralysis after rhinoplasty.
Case Report:
The patient was a 27-year-old woman who was candidate for rhinoplastic surgery. The next morning after the operation, the patient complained of dysphonia and a sore throat .7 days after the operation she was still complaining of dysphonia. She underwent a direct laryngoscopy, and right TVC paralysis was observed. Right hypoglossal nerve paralysis was also detected during physical cranial nerve function tests. Hypoglossal and recurrent laryngeal nerve function was completely recovered after 5 and 7 months, respectively, and no complication was remained.
Accurate and atraumatic intubation and extubation, true positioning of the head and neck, delicate and gentle packing of the oropharynx, and maintenance of mean blood pressure at a safe level are appropriate methods to prevent this complication during anesthesia and surgical procedures.
PMCID: PMC3915070  PMID: 24505575
Hypoglossal Nerve; Paralysis; Recurrent Laryngeal Nerve; Rhinoplasty
6.  Nasal Septum Perforation due to Methamphetamine abuse 
Spontaneous Perforation of the nasal septum is an uncommon condition. Nasal inhalation of substances such as cocaine has long been linked to this Perforation.
Case Report:
This report describes the case of a 46-year-old woman who was addicted to methamphetamine and who presented with perforation of the nasal septum.This is the first reported case of nasal septal necrosis linked to nasal inhalation of methamphetamine.
Patient history and assurance regardingillegal drug consumption and abuse is a key point for fast and accurate diagnosis. The pathophysiology of drug-induced sinunasal disease and a review of the literature are also presented.
PMCID: PMC3846244  PMID: 24303420
Drug abuse; Methamphetamine; Septal perforation

Results 1-6 (6)