Background: When compared to removal of cervical goiters, patients undergoing removal of substernal goiter have been found to have higher rates of complications, including recurrent laryngeal nerve injury, bleeding, and hypoparathyroidism. Previous literature has discussed hemithyroidectomy versus total thyroidectomy for cervical goiters showing that the less invasive procedure was a reasonable option with decreased morbidity overall.

A 17-year-old high school boy who complained of severe positional vertigo visited our hospital. He belonged to an American football team in high school, and his head often hit opponents during games. The vertigo was strongest when his left ear was down in the supine position. Physical examination and computed tomography revealed no abnormalities. However, positional testing revealed apogeotropic direction-changing horizontal nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Additionally, in the supine position, a null point for horizontal nystagmus was identified, beyond which the nystagmus changed direction. This null point was evident when the head was turned 10 degrees to the side. The diagnosis was right lateral canal type of BPPV caused by cupulolithiasis. He was treated with the Gufoni maneuver and reported a decreased incidence of positional vertigo upon re-evaluation.

Background: Foreign bodies in the paranasal sinus is a relatively rare. Furthermore, most of foreign bodies in the paranasal sinuses occur in the maxillary sinus, and reports of foreign bodies in frontal sinus are few. Extracranial abscesses caused by sinusitis with foreign bodies is a rare, but it sometimes cause serious complications. We report four cases of extracranial abscess caused by sinusitis exacerbated by a foreign body.

Background: When compared to removal of cervical goiters, patients undergoing removal of substernal goiter have been found to have higher rates of complications, including recurrent laryngeal nerve injury, bleeding, and hypoparathyroidism. Previous literature has discussed hemithyroidectomy versus total thyroidectomy for cervical goiters showing that the less invasive procedure was a reasonable option with decreased morbidity overall. Methods: A retrospective chart review was performed at 2 tertiary academic medical centers. The search was performed using the CPT codes for substernal removal of thyroid 60270 and 60271. Results: 38 patients were identified between the years 2011-2017. Patients who underwent hemithyroidectomy in this study, had a trend toward older age, higher rate of medical co-morbidities and small size of non-dominant thyroid lobe. No patients who underwent hemithyroidectomy at this institution during this study period required completion thyroidectomy.

Background: Foreign bodies in the paranasal sinus is a relatively rare. Furthermore, most of foreign bodies in the paranasal sinuses occur in the maxillary sinus, and reports of foreign bodies in frontal sinus are few. Extracranial abscesses caused by sinusitis with foreign bodies is a rare, but it sometimes cause serious complications. We report four cases of extracranial abscess caused by sinusitis exacerbated by a foreign body.

A missed parathroid adenomas are the most common cause of surgical failure in persistent primary hyperparathyroidic patients. Abnormalities in the normal migration of the parathyroid glands during embryological development of the head and neck may result in considerable variability in the location of parathyroid tissue. Imaging studies were crucial in localizing the neoplasms in these patients. It is important to develop a strategy to systematically locate these glands either by preoperative investigations or surgical exploration. We describe a patient with persistent primary hyperparathyroidism who underwent three unsuccessful surgical procedures due to an intravagal parathyroid adenoma.

A missed parathroid adenomas are the most common cause of surgical failure in persistent primary hyperparathyroidic patients. Abnormalities in the normal migration of the parathyroid glands during embryological development of the head and neck may result in considerable variability in the location of parathyroid tissue. Imaging studies were crucial in localizing the neoplasms in these patients. It is important to develop a strategy to systematically locate these glands either by preoperative investigations or surgical exploration. We describe a patient with persistent primary hyperparathyroidism who underwent three unsuccessful surgical procedures due to an intravagal parathyroid adenoma.

Background: When compared to removal of cervical goiters, patients undergoing removal of substernal goiter have been found to have higher rates of complications, including recurrent laryngeal nerve injury, bleeding, and hypoparathyroidism. Previous literature has discussed hemithyroidectomy versus total thyroidectomy for cervical goiters showing that the less invasive procedure was a reasonable option with decreased morbidity overall.

Background: Foreign bodies in the paranasal sinus is a relatively rare. Furthermore, most of foreign bodies in the paranasal sinuses occur in the maxillary sinus, and reports of foreign bodies in frontal sinus are few. Extracranial abscesses caused by sinusitis with foreign bodies is a rare, but it sometimes cause serious complications. We report four cases of extracranial abscess caused by sinusitis exacerbated by a foreign body.

A 17-year-old high school boy who complained of severe positional vertigo visited our hospital. He belonged to an American football team in high school, and his head often hit opponents during games. The vertigo was strongest when his left ear was down in the supine position. Physical examination and computed tomography revealed no abnormalities. However, positional testing revealed apogeotropic direction-changing horizontal nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Additionally, in the supine position, a null point for horizontal nystagmus was identified, beyond which the nystagmus changed direction. This null point was evident when the head was turned 10 degrees to the side. The diagnosis was right lateral canal type of BPPV caused by cupulolithiasis. He was treated with the Gufoni maneuver and reported a decreased incidence of positional vertigo upon re-evaluation.

A 17-year-old high school boy who complained of severe positional vertigo visited our hospital. He belonged to an American football team in high school, and his head often hit opponents during games. The vertigo was strongest when his left ear was down in the supine position. Physical examination and computed tomography revealed no abnormalities. However, positional testing revealed apogeotropic direction-changing horizontal nystagmus. Rightward nystagmus in the left-ear-down supine position was stronger than leftward nystagmus in the right-ear-down supine position. Additionally, in the supine position, a null point for horizontal nystagmus was identified, beyond which the nystagmus changed direction. This null point was evident when the head was turned 10 degrees to the side. The diagnosis was right lateral canal type of BPPV caused by cupulolithiasis. He was treated with the Gufoni maneuver and reported a decreased incidence of positional vertigo upon re-evaluation.