Browsing by Author "Worden, Cameron P."

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    Eagle Syndrome: A Rare Case of Atraumatic, Painful Cervical Neck Swelling
    Worden, Cameron P.; Bhandari, Sanjeeb S.; Cable, Benjamin B.; Kuehl, Damon R. (Western Journal of Emergency Medicine, 2020-04-23)
    Introduction: Painful neck swelling is a common emergency complaint but can present diagnostic challenges. Eagle syndrome is a rare clinical entity in which a pathologically elongated styloid process or ossified stylohyoid ligament produces a constellation of symptoms in the head and neck region. Case Report: We present the case of a 50-year-old male with a spontaneous, atraumatic fracture of an elongated styloid process associated with hematoma formation and radiological findings of airway impingement. Discussion: The classic triad for Eagle syndrome consists of unilateral cervicofacial pain, globus sensation, and dysphagia. Diagnosis of Eagle syndrome should be made based on a combination of physical examination and radiological findings. Treatment options vary based on severity of symptoms. Conclusion: Although more likely to be an indolent and progressive complaint, providers in the acute care setting should be familiar with Eagle syndrome due to the potential for a spontaneous fracture of an elongated styloid process to cause acute, painful neck swelling and life-threatening airway compromise. [Clin Pract Cases Emerg Med. 2020;4(2):197–200.]
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    Nonsyndromic bilateral second branchial cleft fistulae: A case report
    Worden, Cameron P.; Michaels, Kenan C.; Magdycz, William P. (Elsevier, 2021-04-27)
    Branchial cleft anomalies are rare congenital malformations that result from the abnormal persistence of branchial clefts during embryogenesis and manifest clinically as cysts, sinuses, or fistulae. In greater than 95% of cases, branchial cleft anomalies originate from remnants of the second branchial cleft. Identification of branchial cleft anomalies, particularly branchial cleft fistulae, are clinically important as these findings may be part of a larger syndromic clinical presentation such as the branchiootorenal syndrome, which necessitates further workup. Branchial cleft anomalies are bilateral in approximately one percent of cases; however, bilateral second branchial cleft fistulae are, for unknown reasons, much rarer. To the best of our knowledge, there have been less than ten cases of nonsyndromic, bilateral second branchial cleft fistulae recorded in the literature. In this report, we present the CASE of a 50-year-old woman with recent left-sided pain, drainage, and swelling in the lower one-third of her neck. The patient reported a history of bilateral “cysts” in the lower one-third of her neck for most of her adult life, which frequently become infected. She denied a personal or family history of renal anomalies or hearing loss. Computed tomography scan with intravenous contrast of the soft tissues of the neck revealed bilateral soft tissue tracts beginning in the region of the tonsillar fossae and extending bilaterally along the anterior borders of the sternocleidomastoid muscle (SCM) down to the skin surface near the level of the thyroid gland, consistent with bilateral second branchial cleft fistulae.
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    Pleural lipomatosis: An often-forgotten intrathoracic tumor
    Worden, Cameron P.; Svoboda, Steven A.; Garcia, Evelyn M. (Elsevier, 2020-04-30)
    Lipomas are benign mesenchymal neoplasms that arise from adipocytes. Most lipomas are found in the subcutaneous tissue; however, they can be present throughout the body. Lipomas arising from the thoracic pleura are exceptionally rare, with only approximately 20 cases ever reported in the literature. While typically asymptomatic, pleural lipomas may cause compressive symptoms such as nonproductive cough, chest pain, and dyspnea if they reach adequate size. A CT scan is usually sufficient for the diagnosis and typically reveals well-defined nodules with homogenous fat attenuation of approximately -50 to - 150 Hounsfield units. Management is dependent on various factors including tumor size and location, associated symptoms, and age of the patient. Pleural lipomatosis, although exceedingly rare, should be maintained in the differential diagnosis for any well-defined, fat-attenuating pleural mass identified on conventional radiologic studies. Here we report a case of pleural lipomatosis associated with bilateral pleural effusions identified in an 83- year-old male presenting with acute onset dyspnea.
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    Traumatic intubation: An under-recognized cause of dysphagia
    Worden, Cameron P.; Bouzaher, Malek H.; Jeyakumar; Anita; Brickman, Todd M. (Elsevier, 2021-04-27)
    Dysphagia is a common complaint, which can have a profound impact on a patient’s health and quality of life. In the surgical patient, endotracheal intubation can result in trauma to structures of the upper aerodigestive tract, which may manifest as a variety of complaints, including dysphagia. In some cases, dysphagia may develop gradually over the course of several months following intubation, and thus may be misdiagnosed or mistakenly associated with other comorbid conditions. Herein, we present a perplexing case of a prior traumatic intubation leading to the development of dysphagia in an elderly woman as a result of progressive enlargement of a fibrovascular lesion likely occurring through the process of normal deglutition. This case highlights traumatic intubation as a potential and underrecognized cause of dysphagia that may elude even experienced clinicians. In the setting of dysphagia without other apparent etiologies, a patient’s medical records should be extensively reviewed for a history of difficult intubation or peri-intubation complaints.