A Rare Case of Severe Burn Injury to the Oropharynx Caused by a Flare Gun

Flare gun injuries are rare, and patients often present with complex trauma that may require multiple operative interventions. Our objective is to explore a case of a 15-year-old male, who presented with second-degree flame burns to the face, left upper extremity and bilateral hands, as well as third-degree burns to the oropharynx and a tongue laceration after a flare gun was discharged into his mouth. The patient underwent multiple debridements of the oral cavity and oropharynx, and his hospital course was complicated by an intra-oral abscess. He eventually made a full recovery and was discharged. This case not only illustrates the need for early operative intervention, but it also underscores the need for awareness campaigns that highlight the dangers of flare guns and similar devices.

Pediatric sensorineural hearing loss, part 2: syndromic and acquired causes

This article is the second in a 2-part series reviewing neuroimaging in childhood SNHL. Previously, we discussed the clinical work-up of children with hearing impairment, the classification of inner ear malformations, and congenital nonsyndromic causes of hearing loss. Here, we review and illustrate the most common syndromic hereditary and acquired causes of childhood SNHL, with an emphasis on entities that demonstrate inner ear abnormalities on cross-sectional imaging. Syndromes discussed include BOR syndrome, CHARGE syndrome, Pendred syndrome, Waardenburg syndrome, and X-linked hearing loss with stapes gusher. We conclude the article with a review of acquired causes of childhood SNHL, including infections, trauma, and neoplasms.

Pediatric sensorineural hearing loss, part 1: Practical aspects for neuroradiologists

SNHL is a major cause of childhood disability worldwide, affecting 6 in 1000 children. For children with prelingual hearing loss, early diagnosis and treatment is critical to optimizing speech and language development, academic achievement, and social and emotional development. Cross-sectional imaging has come to play an important role in the evaluation of children with SNHL because otolaryngologists routinely order either CT or MR imaging to assess the anatomy of the inner ears, to identify causes of hearing loss, and to provide prognostic information related to potential treatments. In this article, which is the first in a 2-part series, we describe the basic clinical approach to imaging of children with SNHL, including the utility of CT and MR imaging of the temporal bones; we review the most recent proposed classification of inner ear malformations; and we discuss nonsyndromic congenital causes of childhood SNHL.

Effect of sodium nitroprusside on compound action potential thresholds in the gerbil cochlea

The presence of active nitric oxide synthase (NOS) in the spiral ganglion cells of the cochlea suggests that the neuromodulator nitric oxide (NO) may play a role in hearing. This study investigated the effects of sodium nitroprusside (SNP), an NO donor, upon cochlear function mediated through its activation of guanylate cyclase. In gerbils, cochlear compound action potential (CAP) thresholds were recorded after cochlear perfusions of control and test solutions in four experimental groups. Perfusions were performed using the following: artificial perilymph solution (APS); the NO donor SNP; the guanylate cyclase inhibitor methylene blue (MB); and sodium dodecyl sulfate (SDS), which facilitates MB entrance into cells. SNP caused significant elevations of CAP thresholds from baseline (25 dB SPL +/- 1.54 dB to 64.3 dB SPL +/- 2.54 dB). SNP with MB also resulted in significant CAP threshold elevations (29.4 dB SPL +/- 4.27 dB to 38.1 dB SPL +/- 4.0 dB); however, these elevations were significantly lower than those seen in SNP perfusions without MB. Drilling perfusion holes and perfusion of APS, APS/SDS, and MB/SDS/APS solutions did not significantly affect CAP thresholds. These results suggest that the NO donor nitroprusside does affect cochlear neuromodulation and effects this mediation in part through NO activation of guanylate cyclase.