Friday, November 27, 2009

Infratemporal hydatid cyst: a case presenting with blindness


The Journal of Laryngology & Otology 
Cambridge University Press
Copyright © JLO (1984) Limited 2009
doi:10.1017/S0022215109991927
N Yazdania1 c1A Basama1M Heidaralia1S Sharif Kashania1a2M Hasibia3 and Z Mokhtaria1
a1 Otorhinolaryngology Research Centre, Amir-Alam Hospital, Tehran University of Medical Sciences, Iran
a2 Department of Radiology, Amir-Alam Hospital, Tehran University of Medical Sciences, Iran
a3 Department of Infectious Diseases, Amir-Alam Hospital, Tehran University of Medical Sciences, Iran

Abstract

Objective: We report a very rare case of a hydatid cyst in the infratemporal fossa, causing visual loss over a 10-day period, which disappeared with rapid surgical and medical treatment.
Case report: A 14-year-old girl presented with right exophthalmos and visual loss. Over a 10-day period, her visual acuity had decreased to detection of hand motion only, due to pressure on the optic nerve caused by a parapharyngeal cyst pressing through a inferior orbital fissure on the right side. A craniotomy had previously been performed for a right frontoparietal hydatid cyst. The patient had been treated intermittently with albendazole. The patient was primarily diagnosed with hydatid cyst, on the basis of her previous medical history and radiological findings, and underwent surgery. Three cysts were carefully removed from the right maxillary sinus, via a standard Caldwell–Luc approach, and the surgical area was irrigated with hypertonic saline.

Conclusion: Infratemporal hydatidosis is very rarely reported in the world literature, although hydatid cysts are endemic in many countries, including Iran. We discuss the common presenting features, investigation and treatment options for infratemporal hydatosis. Constant evaluation of adjacent organs is necessary, with treatment as required, due to the propensity of hydatidosis to recur in essential organs. Immediate surgery is recommended, both to prevent the development of disease and to improve the prognosis.
(Accepted July 23 2009)


Correspondence:
c1 Address for correspondence: Dr S Sharif Kashani, Radiology Department, Amir-Alam Hospital, Tehran University of Medical Sciences, Sadi St, Enghelab Ave, Tehran, Iran Fax: 00982166704805 E-mail: Sh_Sh_md_rad@yahoo.com

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