Laryngeal fracture is a rare condition that can lead to significant problems with airway patency,... more Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
Background: Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year... more Background: Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year-old Aboriginal man with a large tympanic membrane perforation and a schneiderian-type papilloma filling the middle ear. The aim of this study is to familiarise clinicians with this uncommon disease through discussion of its clinical presentation, diagnostic considerations and management. Methods: A search of English language peer-reviewed literature was undertaken using the key words 'schneiderian-type papilloma', 'inverted papilloma' and 'middle ear'. Results: A total of 29 cases (including the present case) of schneiderian-type papilloma involving the middle ear were reviewed. Common presenting symptoms include hearing loss, otalgia and otorrhoea. Middle ear disease is associated with higher rates of recurrence and malignant transformation than its sinonasal counterpart. Radical surgical resection is the only curative treatment. Conclusion: Schneiderian-type pa...
Background: Laryngeal fracture is a rare condition that can lead to significant problems with air... more Background: Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. Case Report: We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. Conclusion: This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
Transactions - Pennsylvania Academy of Ophthalmology and Otolaryngology, 1977
E ven though the facial nerve is the most commonly injured cranial nerve, penetrating trauma thro... more E ven though the facial nerve is the most commonly injured cranial nerve, penetrating trauma through the external auditory canal leading to facial nerve paralysis is extremely rare. Transtympanic facial nerve paralysis is well known to otolaryngologists as "slag injuries" in which molten metal or hot sparks enter the ear during welding. 1 Iatrogenic injuries to the facial nerve are also well documented and can occur during otologic surgery and when removing a foreign body from the ear. 2-4 However, only a few cases of nonthermal, noniatrogenic transtympanic damage to the facial nerve have been reported. We present a rare case of facial nerve paresis caused by accidental penetrating trauma and review the literature on this uncommon mechanism of injury.
Neuropsychiatric complications are common in patients with chronic hepatitis C undergoing treatme... more Neuropsychiatric complications are common in patients with chronic hepatitis C undergoing treatment with interferon alpha. These side effects include alterations of mood, cognition, and neuroendocrine function and are unpredictable. In a number of neurological disorders characterized by neuropsychiatric symptoms and cognitive dysfunction, inheritance of an apolipoprotein E (APOE) epsilon4 allele is associated with adverse neuropsychiatric outcomes. The authors present evidence that the APOE genotype may influence a patient's neuropsychiatric response to interferon alpha treatment. The inheritance of APOE genotypes was examined in 110 patients with chronic hepatitis C treated with interferon alpha. A retrospective investigation was conducted by assessing the rates of psychiatric referral and neuropsychiatric symptoms experienced during treatment along with other complaints indicating psychological distress. A highly statistically significant association was seen between APOE geno...
Background: Laryngeal fracture is a rare condition that can lead to significant problems with air... more Background: Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. Case Report: We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. Conclusion: This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
We describe a case of a 57-year-old man with severe vertigo, associated with nausea and vomiting,... more We describe a case of a 57-year-old man with severe vertigo, associated with nausea and vomiting, left-sided bloody otorrhea, hearing loss, and tinnitus, following a traumatic puncture by a palm frond. We present the diagnostic dilemma associated with the traumatic pneumolabyrinth, the potential for perilymphatic fistula, and the controversies in management.
Laryngeal fracture is a rare condition that can lead to significant problems with airway patency,... more Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
Background: Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year... more Background: Schneiderian-type papilloma of the middle ear is a rare finding. We present a 46-year-old Aboriginal man with a large tympanic membrane perforation and a schneiderian-type papilloma filling the middle ear. The aim of this study is to familiarise clinicians with this uncommon disease through discussion of its clinical presentation, diagnostic considerations and management. Methods: A search of English language peer-reviewed literature was undertaken using the key words 'schneiderian-type papilloma', 'inverted papilloma' and 'middle ear'. Results: A total of 29 cases (including the present case) of schneiderian-type papilloma involving the middle ear were reviewed. Common presenting symptoms include hearing loss, otalgia and otorrhoea. Middle ear disease is associated with higher rates of recurrence and malignant transformation than its sinonasal counterpart. Radical surgical resection is the only curative treatment. Conclusion: Schneiderian-type pa...
Background: Laryngeal fracture is a rare condition that can lead to significant problems with air... more Background: Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. Case Report: We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. Conclusion: This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
Transactions - Pennsylvania Academy of Ophthalmology and Otolaryngology, 1977
E ven though the facial nerve is the most commonly injured cranial nerve, penetrating trauma thro... more E ven though the facial nerve is the most commonly injured cranial nerve, penetrating trauma through the external auditory canal leading to facial nerve paralysis is extremely rare. Transtympanic facial nerve paralysis is well known to otolaryngologists as "slag injuries" in which molten metal or hot sparks enter the ear during welding. 1 Iatrogenic injuries to the facial nerve are also well documented and can occur during otologic surgery and when removing a foreign body from the ear. 2-4 However, only a few cases of nonthermal, noniatrogenic transtympanic damage to the facial nerve have been reported. We present a rare case of facial nerve paresis caused by accidental penetrating trauma and review the literature on this uncommon mechanism of injury.
Neuropsychiatric complications are common in patients with chronic hepatitis C undergoing treatme... more Neuropsychiatric complications are common in patients with chronic hepatitis C undergoing treatment with interferon alpha. These side effects include alterations of mood, cognition, and neuroendocrine function and are unpredictable. In a number of neurological disorders characterized by neuropsychiatric symptoms and cognitive dysfunction, inheritance of an apolipoprotein E (APOE) epsilon4 allele is associated with adverse neuropsychiatric outcomes. The authors present evidence that the APOE genotype may influence a patient's neuropsychiatric response to interferon alpha treatment. The inheritance of APOE genotypes was examined in 110 patients with chronic hepatitis C treated with interferon alpha. A retrospective investigation was conducted by assessing the rates of psychiatric referral and neuropsychiatric symptoms experienced during treatment along with other complaints indicating psychological distress. A highly statistically significant association was seen between APOE geno...
Background: Laryngeal fracture is a rare condition that can lead to significant problems with air... more Background: Laryngeal fracture is a rare condition that can lead to significant problems with airway patency, voice production, and swallowing. Conflict in the literature exists regarding the most suitable way to manage this injury. Case Report: We present the case of a 29-year-old Caucasian man who sustained a displaced fracture of the thyroid cartilage due to blunt trauma. He reported no swallowing, breathing, or voice problems after 1 year, and his recovery can be attributed to the early recognition and proper management of his condition. Conclusion: This case illustrates the importance of ensuring a high level of suspicion for laryngeal fracture in the acute trauma patient. Early identification of this injury allows early intervention that not only protects the airway but also improves long-term voice and airway outcomes.
We describe a case of a 57-year-old man with severe vertigo, associated with nausea and vomiting,... more We describe a case of a 57-year-old man with severe vertigo, associated with nausea and vomiting, left-sided bloody otorrhea, hearing loss, and tinnitus, following a traumatic puncture by a palm frond. We present the diagnostic dilemma associated with the traumatic pneumolabyrinth, the potential for perilymphatic fistula, and the controversies in management.
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Papers by Peter Gochee