Lateral Side Of Neck Research Articles

Case report: Pseudoxanthomaelasticum

Pseudoxanthoma elasticum (PXE) is a rare multisystem disorder of autosomal recessive inheritance. It is characterized by progressive mineralization and fragmented, calcified elastic fibres of skin, eye and cardio-vascular system (CVS). It is due to the loss of functional mutation ABCC6 gene.We report such a rare case of PXE with earliest skin manifestation and with no other ophthalmological and CVS findings.This is a case report of 26 years old female complaining of 1 year history of asymptomatic yellow-orange raised lesions on right lateral side of neck.On clinical examination, yellow-orange micro-papules coalescing to form plaques were noticed over right lateral side of neck. Fundoscopy revealed bilateral myopic degenerative changes with no other specific findings. Histopathology of said lesions showed atrophic epidermis with abnormal elastic fibres in the mid-dermis confirming the diagnosis. Course and prognosis were explained to the patient and she was advised regular follow-up.PXE is rare in occurrence, with no definite and effective treatment. It has a good prognosis if retinal and cardio-vascular complications are regularly monitored and prevented.

Cervical sympathetic chain schwannoma: a case report

Neurogenic tumors including Schwannoma are the rare cause of the lateral neck swelling. We present a case of cervical sympathetic plexus schwannoma that was successfully managed by surgical excision. A 30-year-old male presented with complaints of painless slow growing swelling on the right side of neck of 6 months duration. On examination a single, non-tender, pulsatile swelling of 4×3 cm in the right lateral side of neck was seen beneath the anterior margin of the sternocleidomastoid and just below the angle of the mandible. Magnetic Resonance Imaging (MRI) neck showed a well-defined lesion of size 4.5×4.6×6 cm in the right carotid space with features suggestive of neurogenic tumour arising from sympathetic plexus, likely Schwannoma. Surgical excision of the tumour was done. Intra-operatively a well encapsulated lesion was present in the right carotid sheath arising likely from right cervical sympathetic plexus. Histopathological examination confirmed the diagnosis of Schwannoma. Post-operatively patient developed mild ptosis of right eye; however at 6 months follow-up patient is doing fine without any evidence of residual neurological loss or recurrence.

Branchial Cyst: A Case Report

Branchial cyst is a rare developmental disorder which is diagnosed rarely. Remnants of Branchial are present at birth but may become clinically significant later in life. We report a case of 14-year-old male patient with an asymptomatic branchial cyst over lateral side of neck. These cyst originate from remnants of branchial arches or branchial pouches. The definitive treatment of is complete surgical excision of the cyst. Complete surgical excision prevents recurrence or other complications.

Proximally placed signal acquisition sensoric for robotic tissue tool interactions

Abstract Robotic surgeries are still limited with respect to the surgeon’s natural senses. The tactile sense is exceptional important in conventional clinical procedures. To identify critical structures inside the tissue, palpation is a commonly used technique in conventional open surgeries. The underlying organ or pathological structures conditions (healthy, abnormally hard or soft) can for example be localized and assessed through this process. Palpation needs a tactile sense; however, that is commonly not available or limited in robotic surgeries. The palpation need was already addressed by several research groups that integrated complex sensor-feedback-systems into prototype surgical instruments for robotic systems. We propose a new technique to acquire data of the tissue tool interaction of the surgical instruments. The structure borne transmission path is used to measure acoustic emission (AE) at the outpatient (proximal) end of the instruments with the help of different sensors attached to the surface of the surgical tool. Initial tests were performed using a microphone in combination with a stethoscope. This setup showed promising results and a more integrated prototype was subsequently designed. A piezoelectric charge accelerometer was used as vibration sensor and compared to a MEMS microphone. A signal acquisition system was developed to acquire signals from both sensors in parallel. The sensors were then attached onto the shaft of a daVinci Prograsp Forceps instrument. According to the surgery observation, a series of simulated experiments was conducted. The tip of the grasper was swiped manually over a human subject’s dorsal and palmar hand side, lateral side of neck and over the carotid artery. Additionally, contact with soft tissue and other instruments were evaluated since these are events of interest during surgery. Advanced signal processing techniques allowed the identification and characterization of significant events such as palpation dynamics, contact and pulsation. Signals acquired by the MEMS microphone showed the most promising results. This approach will now be used to build a prototype for further evaluation in a clinical setup. The paper presents the first results that show that this novel technique can provide valuable information about the tool-tissue interaction in robotic surgery that typically can only be obtained through advanced distal sensor systems or actual human touch.

Internal jugular phlebectasia as an incidental finding in cervical spine surgery

Idiopathic internal jugular phlebectasia, occurs either unilaterally or bilaterally affecting the internal jugular vein is a rare congenital variation often diagnosed during childhood. It usually presents with a benign swelling over the lateral side of neck on the affected side, seen on exertion. A-30-year old male was operated for anterior cervical dissectomy from right lateral approach and was diagnosed per-operatively as internal jugular phlebectasia. The surgery was abandoned at this stage on the advice of cardiothoracic surgeon to investigate the patient for the secondary etiological factors for internal jugular vein dilatation. The patient was reassured without any active intervention for the phlebectasia and cervical dissectomy was performed in the second surgery through the lateral approach from left side. This case is presented in view of rarity and suggested that during preoperative workup the nearby structures like carotid sheath should be evaluated by magnetic resonance imaging to avoid such per-operative surprises.