Proton therapy for skull base tumors: A review of clinical outcomes for chordomas and chondrosarcomas

Abstract

Background

Skull base chordomas and chondrosarcomas are rare tumors traditionally treated by surgical resection and adjuvant radiation therapy (RT). We will discuss data evaluating clinical outcomes of proton therapy in the treatment of skull base chordomas and chondrosarcomas.

Methods

A literature review was performed using a MEDLINE search from January 1990 to January 2017.

Results

The published data suggest that the dose intensification allowed by proton therapy has resulted in good clinical outcomes and a tolerable toxicity profile.

Conclusion

Proton therapy is a modern RT technique that has demonstrated improved preliminary clinical outcomes in the treatment of skull base chordomas and chondrosarcomas compared to conventional radiotherapy, and comparable to other advanced photon‐based RT techniques.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BZO1wN

Sclerosis of the arytenoid cartilage and glottic carcinoma: A clinical‐pathological study

Abstract

Background

Given the relevance of any tumor invasion of the arytenoid cartilage or crico‐arytenoid unit to the planning open partial horizontal laryngectomy (OPHL) for laryngeal squamous cell carcinoma (LSCC), it is important to have a reliable radiological test to assess impairments of these structures.

Methods

We retrospectively compared the endoscopic, radiological, and pathological findings in patients with glottic LSCC who underwent OPHL.

Results

The endoscopic finding of a reduced (impaired or absent) vocal cord motility proved more sensitive, with better positive and negative predictive values, but less specific than the radiological finding of complete arytenoid sclerosis in detecting histologically assessable infiltration of the arytenoid cartilage.

Conclusions

Endoscopy retains a key role in the preoperative workup for glottic LSCC. CT evidence of complete sclerosis of the arytenoid cartilage is related to a dangerous contiguity of the tumor to the cartilage.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2LaKFKp

Ototoxicity in locally advanced head and neck cancer patients treated with induction chemotherapy followed by intermediate or high‐dose cisplatin‐based chemoradiotherapy

Abstract

Background

This study evaluated ototoxicity in locally advanced head and neck cancer patients treated in the CONDOR study with docetaxel/cisplatin/5‐fluorouracil (TPF) followed by conventional radiotherapy with concomitant cisplatin 100 mg/m² on days 1, 22, and 43 (cis100+RT) versus accelerated radiotherapy with concomitant cisplatin weekly 40 mg/m² (cis40+ART).

Methods

Sixty‐two patients were treated in this study. Audiometry was performed at baseline, during TPF, before start of chemoradiotherapy, and 1, 4, 8, and 12 months after treatment.

Results

A complete dataset of audiometric data was available of 12 patients treated with high‐dose cisplatin and of 11 patients treated with intermediate‐dose cisplatin. Patients in the high‐dose group showed significant more hearing loss than in the intermediate group at 4 kHz ([z = 1.98; P = .04] and 8 kHz [z = 2.07; P < .03]). Interindividual variation was high in both groups.

Conclusion

After induction TPF, more ototoxicity was observed in chemoradiotherapy with cis100+RT than after chemoradiotherapy with cis40+ART.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BYMfvU

Promotion of skin wound healing using prevascularized oral mucosal cell sheet

Abstract

Background

This study examined the potential use of our newly developed prevascularized oral mucosal cell sheet for the treatment of skin wounds.

Methods

Mucosal cell sheets containing cultured keratinocytes and plasma fibrin without (K sheet) or with a mixture of fibroblasts and endothelial progenitor cells (PV sheet) were transplanted into full‐thickness skin excisional wounds of nude mice.

Results

This technique was successful for in vitro culture; expanding keratinocytes, fibroblasts, and endothelial progenitor cells; and generating prevascularized mucosal cell sheets. Cell sheets promoted in vivo wound healing with rapid wound closure and less scarring compared to controls. This result was more apparent in the PV than the K sheet (P < .05). Wounds covered with cell sheets showed less expression of TGFB1, ACTA2, and FN1 mRNAs than the controls (P < .05).

Conclusion

The prevascularized mucosal cell sheet showed in vivo efficacy and tissue plasticity in cutaneous wounds by promoting accelerated healing.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BX3mhk

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

Abstract

Background

Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse.

Objective

To evaluate prognostic factors of local relapse and local control with TLM (LC‐TLM).

Methods

Local relapse and LC‐TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed.

Results

Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64‐27.03; P < .001), paraglottic involvement (2.42, CI: 1.41‐4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43‐3.14; P < .001), grade of differentiation (1.74, CI: 1.18‐2.57; P = .005), and alcohol consumption (1.4, CI: 0.99‐1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51‐1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement.

LC‐TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03‐0.28; P < .001), paraglottic involvement (0.25, CI: 0.14‐0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32‐0.77; P = .007), margins (0.56, CI: 0.30‐1.04; P = .068), and differentiation (0.68, CI: 0.44‐1.05; P = .087). LC‐TLM correlated with experience (1.71, CI: 1.13‐2.55; P = .010). The most important factors for LC‐TLM were previous radiotherapy failure and paraglottic involvement.

Conclusion

Previous radiotherapy failure is the most important factor for local relapse and LC‐TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC‐TLM, respectively.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BZwPaN

Cutaneous malignant melanoma of the oral cavity following skin graft reconstruction: Case report

Abstract

Background: Malignant melanomas on skin graft recipient sites are rare, with few cases reported in the literature.

Methods: We present a case report of a patient with recurrent cutaneous melanoma in the grafted anterolateral thigh flap of the tongue.

Results: A patient underwent hemiglossectomy with free flap reconstruction for squamous cell carcinoma of the tongue. Five years later the patient was seen with a 1‐cm nodule and surrounding erythroplakia at the recipient site of the graft. Analysis revealed cutaneous malignant melanoma. Patient then related a remote history of a suspected skin melanoma of the donor leg that had been treated with excision, with unknown histology.

Conclusion: This may be the first reported case of a cutaneous malignant melanoma in the oral cavity following an anterolateral thigh free flap reconstruction, emphasizing the importance of obtaining a comprehensive history of skin cancers and closely inspecting the donor site prior to graft harvesting.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BXyttt

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

Abstract

Background

The optimal period of low iodine diet during preparation for radioactive iodine (RAI) ablation in an area with iodine‐rich diet was investigated.

Methods

Ninety‐four patients with thyroid cancer who underwent low iodine diet and RAI were prospectively allocated into 2 groups—thyroxine withdrawal or using recombinant human thyroid stimulating hormone (rhTSH) for TSH stimulation. Their urinary iodine excretion (UIE) patterns were analyzed.

Results

There was no clinicopathological difference between the 2 groups except for tumor size and lymph node status. The UIE (median iodine to creatinine ratio, I/Cr) in the withdrawal group on the 7th and 14th day were 18.3 and 17.9 μg/gCr, respectively, with adequate preparation rate of 93.3% on both days (cutoff value 100 μg/gCr). In the rhTSH group, the median I/Cr on the 7th and 14th day were 48.0 and 45.7 μg/gCr (adequate preparation rates 91.8% and 93.8%), respectively.

Conclusion

One week of low iodine diet is sufficient preparation for RAI regardless of method of TSH stimulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L4rotQ

Venous thromboembolism in head and neck surgery: Risk, outcome, and burden at the national level

Abstract

Background

Venous thromboembolism (VTE) can complicate major surgeries. This study examines the risk and outcomes of VTE in patients who underwent head and neck surgeries.

Methods

Retrospective cross‐sectional analysis utilizing the Nationwide Readmissions Database (2010‐2014). Study population included adults (≥18 year) patients who underwent head and neck surgeries.

Results

A total 386 VTE patients and 116 450 controls included. VTE risk was 0.37%, postoperative mortality was 4.87%. Of VTE, 57.02% identified within the initial admission for surgery, while the rest required readmission within 90 days. VTE high‐risk surgeries included: major ear/skull base surgeries, major nose/paranasal sinuses surgeries, major mouth/tonsil surgeries, major salivary glands/ducts surgeries, major maxillofacial bones/mandible surgeries, and major and nonmajor pharynx and larynx surgeries (P < .05). Those same surgeries were also associated with a high risk of readmission (P < .05).

Conclusions

VTE is associated with a significant mortality risk. Surgeries that involve the pharynx and larynx have the highest risk of VTE and readmission.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BYBiKs

Increased risk of postoperative complications after total thyroidectomy with Graves' disease

Abstract

Background

The effect of Graves' disease on the risk of postoperative complications in patients undergoing total thyroidectomy is unclear.

Methods

The incidence of recurrent laryngeal nerve (RLN) injury and hypoparathyroidism were analyzed between 165 patients with Graves' disease (GD group) and 1:1 matched patients with euthyroid states (control group).

Results

The matched cohorts did not differ in age, sex, body mass index, pathologic diagnosis, and extent of operation. Excised thyroid weight was higher in the Graves' disease than in the control group (60.1 g vs 22.6 g; P < .001). Multivariate analysis showed that Graves' disease significantly increased risks of transient RLN injury (odds ratio [OR] = 4.7, 95% confidence interval [CI] = 1.5‐15.5; P = .010) and transient hypoparathyroidism (OR = 2.8, 95% CI = 1.3‐5.8; P = .007). Rates of permanent complications were comparable in the Graves' disease and control groups.

Conclusions

Graves' disease can be a predictive factor for postoperative RLN injury and hypoparathyroidism after total thyroidectomy.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L2RflN

Two‐year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER‐Medicare analysis

Abstract

Background

The aim of the study was to examine prevalence of dysphagia at the population level in head and neck cancer (HNC) survivors.

Methods

Surveillance, Epidemiology, and End Results‐Medicare claims among 16 194 patients with HNC (2002‐2011) were analyzed to estimate 2‐year prevalence of dysphagia, stricture, and aspiration pneumonia, and derive treatment‐ and site‐specific estimates.

Results

Prevalence of dysphagia, stricture, pneumonia, and aspiration pneumonia was 45.3% (95% confidence interval [CI]: 44.5‐46.1), 10.2% (95% CI: 9.7‐10.7), 26.3% (95% CI: 25.6‐26.9), and 8.6% (95% CI: 8.2‐9.1), respectively. Dysphagia increased by 11.7% over the 10‐year period (P < .001). Prevalence was highest after chemoradiation and multimodality therapy.

Conclusion

Comparing to published rates using similar methodology the preceding decade (1992‐1999), prevalence of dysphagia based on claims data was similar in 2002‐2011 in this study. These results suggest persistence of dysphagia as a highly prevalent morbidity, even in the decade in which highly conformal radiotherapy and minimally invasive surgeries were popularized.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L45BTb

Depth of invasion as a predictor of nodal disease and survival in patients with oral tongue squamous cell carcinoma

Abstract

Background

Depth of invasion (DOI) in oral cavity cancer is important in determining prognosis. This study aims to determine optimal cut‐points of DOI for detection of occult disease and survival.

Methods

A retrospective cohort study was completed of previously untreated early stage lateral oral tongue cancer. DOI cut‐points were computed. Multiple logistic regression and multivariate Cox proportional hazards models were used to assess predictors of occult nodal disease and overall survival (OS) and disease‐specific survival (DSS).

Results

Occult nodal disease was found in 55 (26%) of the 212 patients. DOI of 7.25 mm was most predictive for occult nodal disease and 8 mm for OS and DSS. DOI was an independent predictor of OS and DSS.

Conclusion

The optimal DOI cut‐point for detection of occult nodal metastasis was 7.25 and 8 mm for OS and DSS at 5 years. DOI is an independent predictor of OS and DSS.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L69YwX

Elective neck dissection in metastatic cutaneous squamous cell carcinoma to the parotid gland: A systematic review and meta‐analysis

Abstract

Current management of metastatic cutaneous squamous cell carcinoma (CSCC) to the parotid is surgical excision and postoperative radiotherapy. In the node‐negative neck, there is debate about the role of elective neck dissection (END), irradiation or observation. This systematic review assesses the prevalence of occult cervical disease and the evidence for END. A literature search was performed using Medline and Embase. All papers describing management of the neck in metastatic CSCC to the parotid were assessed for inclusion. Eighty‐nine papers were identified and 17 met inclusion criteria. A total of 874 ENDs were performed in 874 patients with metastatic CSCC to the parotid with no clinically evident cervical disease. The overall prevalence of occult disease in a random effects model was 22.5% (95% confidence intervals 18.9‐26.0). The prevalence of occult cervical disease in metastatic CSCC to the parotid is high. END is recommended in this patient group.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BYBk52

Prognostic significance of pretreatment 18F‐fluorodeoxyglucose positron emission tomography evaluation using metabolic tumor volume of the primary tumor and lymph nodes in advanced hypopharyngeal cancer

Abstract

Background

The purpose of this study was to retrospectively evaluate the usefulness of pretreatment positron emission tomography (PET) using metabolic tumor volume (MTV) of the primary tumor and lymph nodes in advanced hypopharyngeal cancer.

Methods

From June 2007 to December 2015, consecutive patients with advanced hypopharyngeal cancer who underwent PET and were treated with definitive radiation therapy were retrospectively reviewed.

Results

A total of 61 patients were eligible for this study. On multivariate analysis, MTV of the primary tumor (MTV‐T) was significantly related to the local control rate and overall survival (OS) (P = .036 and .012, respectively). In patients with lower MTV‐T, MTV of metastatic lymph nodes (MTV‐N) was significantly related to disease‐specific survival and OS (P = .012 and .017, respectively).

Conclusion

MTV‐T is a significant predictor in patients with advanced hypopharyngeal cancer, and MTV‐N is also significant in patients with lower MTV‐T.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L2dgRK

Socioeconomic disparities in a population of patients undergoing total thyroidectomy for benign disease

Abstract

Background

This study examines the effect of insurance status (as a measure of socioeconomic status) on patient with benign thyroid disease.

Methods

A retrospective review was performed among 60 patients undergoing total thyroidectomy for benign thyroid disease. Univariate and multivariable analyses examined the relationship between insurance status and thyroid volume (sum of the left and right lobe volumes).

Results

Twenty‐eight (47%) patients were considered of underinsured/uninsured status, and 32 (53%) patients were considered of private/government/military insurance status. Median pathologic whole thyroid volume was 66 mL (range, 2‐855). After multivariable linear regression, underinsured/uninsured status was the only significant predictor of larger volume (correlation coefficient [r] = 118; 95% CI, 42 to 194; P = .003), after adjusting for age, sex, body mass index, and presence of concomitant thyroid disease and compressive symptoms.

Conclusion

Patients of underinsured/uninsured status suffered more severe disease presentations at time of thyroidectomy, as measured by larger thyroid volumes.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BXNdrX

Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

Abstract

Background

The aim of this study was to evaluate the feasibility, safety, and early surgical outcomes of transoral thyroidectomy and to compare robotic and endoscopic procedures.

Methods

A total of 37 patients underwent robotic (23 cases) or endoscopic (14 cases) transoral thyroidectomy. We compared the outcomes of the two procedures.

Results

Of the 37 patients, 2 were converted to the robotic facelift approach as a result of an intraoperative CO₂ embolism and inability to remove the tumor. The mean operative time was 172.8 ± 37.5 minutes. Transient recurrent laryngeal nerve palsy occurred in one case, and transient hypoparathyroidism in two cases. Most of patients were satisfied with the postoperative cosmesis. There were no significant differences between the robotic and endoscopic procedures, except for operative time, which was significantly longer in the robotic group.

Conclusion

Robotic and endoscopic transoral thyroidectomies are both feasible and safe in appropriate patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L4ilJt

Second infield re‐irradiation with a resulting cumulative equivalent dose (EQD2max) of >180 Gy for patients with recurrent head and neck cancer

Abstract

Background

For locally recurrent head and neck cancer, re‐irradiation with modern techniques like stereotactic body radiotherapy is a promising, possibly curative alternative to palliative systemic therapy.

Methods

We report on 1 patient with nasopharyngeal carcinoma (NPC) and 1 patient with cutaneous squamous cell carcinoma (SCC). Both patients received full dose primary treatment (>66 Gy, EQD2), full dose re‐irradiation (>50 Gy, EQD2), and a second course of re‐irradiation via robotic radiosurgery (CyberKnife) for a second local recurrence.

Results

Both treatments resulted in adequate tumor response. No grade III‐IV acute or late toxicities occurred. Follow‐up at 6 months after third irradiation showed partial remission for the patient with NPC. In the second case (SCC), no toxicities occurred and the tumor was in remission 18 months after last treatment.

Conclusion

These cases show that a second course of re‐irradiation utilizing modern techniques like robotic radiosurgery might be feasible for carefully selected patients with head and neck cancer.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L4rlOG

Increased risk of postoperative complications after total thyroidectomy with Graves' disease

Abstract

Background

The effect of Graves' disease on the risk of postoperative complications in patients undergoing total thyroidectomy is unclear.

Methods

The incidence of recurrent laryngeal nerve (RLN) injury and hypoparathyroidism were analyzed between 165 patients with Graves' disease (GD group) and 1:1 matched patients with euthyroid states (control group).

Results

The matched cohorts did not differ in age, sex, body mass index, pathologic diagnosis, and extent of operation. Excised thyroid weight was higher in the Graves' disease than in the control group (60.1 g vs 22.6 g; P < .001). Multivariate analysis showed that Graves' disease significantly increased risks of transient RLN injury (odds ratio [OR] = 4.7, 95% confidence interval [CI] = 1.5‐15.5; P = .010) and transient hypoparathyroidism (OR = 2.8, 95% CI = 1.3‐5.8; P = .007). Rates of permanent complications were comparable in the Graves' disease and control groups.

Conclusions

Graves' disease can be a predictive factor for postoperative RLN injury and hypoparathyroidism after total thyroidectomy.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L2RflN

Venous thromboembolism in head and neck surgery: Risk, outcome, and burden at the national level

Abstract

Background

Venous thromboembolism (VTE) can complicate major surgeries. This study examines the risk and outcomes of VTE in patients who underwent head and neck surgeries.

Methods

Retrospective cross‐sectional analysis utilizing the Nationwide Readmissions Database (2010‐2014). Study population included adults (≥18 year) patients who underwent head and neck surgeries.

Results

A total 386 VTE patients and 116 450 controls included. VTE risk was 0.37%, postoperative mortality was 4.87%. Of VTE, 57.02% identified within the initial admission for surgery, while the rest required readmission within 90 days. VTE high‐risk surgeries included: major ear/skull base surgeries, major nose/paranasal sinuses surgeries, major mouth/tonsil surgeries, major salivary glands/ducts surgeries, major maxillofacial bones/mandible surgeries, and major and nonmajor pharynx and larynx surgeries (P < .05). Those same surgeries were also associated with a high risk of readmission (P < .05).

Conclusions

VTE is associated with a significant mortality risk. Surgeries that involve the pharynx and larynx have the highest risk of VTE and readmission.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BYBiKs

Depth of invasion as a predictor of nodal disease and survival in patients with oral tongue squamous cell carcinoma

Abstract

Background

Depth of invasion (DOI) in oral cavity cancer is important in determining prognosis. This study aims to determine optimal cut‐points of DOI for detection of occult disease and survival.

Methods

A retrospective cohort study was completed of previously untreated early stage lateral oral tongue cancer. DOI cut‐points were computed. Multiple logistic regression and multivariate Cox proportional hazards models were used to assess predictors of occult nodal disease and overall survival (OS) and disease‐specific survival (DSS).

Results

Occult nodal disease was found in 55 (26%) of the 212 patients. DOI of 7.25 mm was most predictive for occult nodal disease and 8 mm for OS and DSS. DOI was an independent predictor of OS and DSS.

Conclusion

The optimal DOI cut‐point for detection of occult nodal metastasis was 7.25 and 8 mm for OS and DSS at 5 years. DOI is an independent predictor of OS and DSS.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L69YwX

Sclerosis of the arytenoid cartilage and glottic carcinoma: A clinical‐pathological study

Abstract

Background

Given the relevance of any tumor invasion of the arytenoid cartilage or crico‐arytenoid unit to the planning open partial horizontal laryngectomy (OPHL) for laryngeal squamous cell carcinoma (LSCC), it is important to have a reliable radiological test to assess impairments of these structures.

Methods

We retrospectively compared the endoscopic, radiological, and pathological findings in patients with glottic LSCC who underwent OPHL.

Results

The endoscopic finding of a reduced (impaired or absent) vocal cord motility proved more sensitive, with better positive and negative predictive values, but less specific than the radiological finding of complete arytenoid sclerosis in detecting histologically assessable infiltration of the arytenoid cartilage.

Conclusions

Endoscopy retains a key role in the preoperative workup for glottic LSCC. CT evidence of complete sclerosis of the arytenoid cartilage is related to a dangerous contiguity of the tumor to the cartilage.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2LaKFKp

Second infield re‐irradiation with a resulting cumulative equivalent dose (EQD2max) of >180 Gy for patients with recurrent head and neck cancer

Abstract

Background

For locally recurrent head and neck cancer, re‐irradiation with modern techniques like stereotactic body radiotherapy is a promising, possibly curative alternative to palliative systemic therapy.

Methods

We report on 1 patient with nasopharyngeal carcinoma (NPC) and 1 patient with cutaneous squamous cell carcinoma (SCC). Both patients received full dose primary treatment (>66 Gy, EQD2), full dose re‐irradiation (>50 Gy, EQD2), and a second course of re‐irradiation via robotic radiosurgery (CyberKnife) for a second local recurrence.

Results

Both treatments resulted in adequate tumor response. No grade III‐IV acute or late toxicities occurred. Follow‐up at 6 months after third irradiation showed partial remission for the patient with NPC. In the second case (SCC), no toxicities occurred and the tumor was in remission 18 months after last treatment.

Conclusion

These cases show that a second course of re‐irradiation utilizing modern techniques like robotic radiosurgery might be feasible for carefully selected patients with head and neck cancer.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L4rlOG

Ototoxicity in locally advanced head and neck cancer patients treated with induction chemotherapy followed by intermediate or high‐dose cisplatin‐based chemoradiotherapy

Abstract

Background

This study evaluated ototoxicity in locally advanced head and neck cancer patients treated in the CONDOR study with docetaxel/cisplatin/5‐fluorouracil (TPF) followed by conventional radiotherapy with concomitant cisplatin 100 mg/m² on days 1, 22, and 43 (cis100+RT) versus accelerated radiotherapy with concomitant cisplatin weekly 40 mg/m² (cis40+ART).

Methods

Sixty‐two patients were treated in this study. Audiometry was performed at baseline, during TPF, before start of chemoradiotherapy, and 1, 4, 8, and 12 months after treatment.

Results

A complete dataset of audiometric data was available of 12 patients treated with high‐dose cisplatin and of 11 patients treated with intermediate‐dose cisplatin. Patients in the high‐dose group showed significant more hearing loss than in the intermediate group at 4 kHz ([z = 1.98; P = .04] and 8 kHz [z = 2.07; P < .03]). Interindividual variation was high in both groups.

Conclusion

After induction TPF, more ototoxicity was observed in chemoradiotherapy with cis100+RT than after chemoradiotherapy with cis40+ART.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BYMfvU

Proton therapy for skull base tumors: A review of clinical outcomes for chordomas and chondrosarcomas

Abstract

Background

Skull base chordomas and chondrosarcomas are rare tumors traditionally treated by surgical resection and adjuvant radiation therapy (RT). We will discuss data evaluating clinical outcomes of proton therapy in the treatment of skull base chordomas and chondrosarcomas.

Methods

A literature review was performed using a MEDLINE search from January 1990 to January 2017.

Results

The published data suggest that the dose intensification allowed by proton therapy has resulted in good clinical outcomes and a tolerable toxicity profile.

Conclusion

Proton therapy is a modern RT technique that has demonstrated improved preliminary clinical outcomes in the treatment of skull base chordomas and chondrosarcomas compared to conventional radiotherapy, and comparable to other advanced photon‐based RT techniques.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BZO1wN

Pattern of urine iodine excretion with low iodine diet during preparation for radioactive iodine ablation in patients with thyroid cancer

Abstract

Background

The optimal period of low iodine diet during preparation for radioactive iodine (RAI) ablation in an area with iodine‐rich diet was investigated.

Methods

Ninety‐four patients with thyroid cancer who underwent low iodine diet and RAI were prospectively allocated into 2 groups—thyroxine withdrawal or using recombinant human thyroid stimulating hormone (rhTSH) for TSH stimulation. Their urinary iodine excretion (UIE) patterns were analyzed.

Results

There was no clinicopathological difference between the 2 groups except for tumor size and lymph node status. The UIE (median iodine to creatinine ratio, I/Cr) in the withdrawal group on the 7th and 14th day were 18.3 and 17.9 μg/gCr, respectively, with adequate preparation rate of 93.3% on both days (cutoff value 100 μg/gCr). In the rhTSH group, the median I/Cr on the 7th and 14th day were 48.0 and 45.7 μg/gCr (adequate preparation rates 91.8% and 93.8%), respectively.

Conclusion

One week of low iodine diet is sufficient preparation for RAI regardless of method of TSH stimulation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L4rotQ

Two‐year prevalence of dysphagia and related outcomes in head and neck cancer survivors: An updated SEER‐Medicare analysis

Abstract

Background

The aim of the study was to examine prevalence of dysphagia at the population level in head and neck cancer (HNC) survivors.

Methods

Surveillance, Epidemiology, and End Results‐Medicare claims among 16 194 patients with HNC (2002‐2011) were analyzed to estimate 2‐year prevalence of dysphagia, stricture, and aspiration pneumonia, and derive treatment‐ and site‐specific estimates.

Results

Prevalence of dysphagia, stricture, pneumonia, and aspiration pneumonia was 45.3% (95% confidence interval [CI]: 44.5‐46.1), 10.2% (95% CI: 9.7‐10.7), 26.3% (95% CI: 25.6‐26.9), and 8.6% (95% CI: 8.2‐9.1), respectively. Dysphagia increased by 11.7% over the 10‐year period (P < .001). Prevalence was highest after chemoradiation and multimodality therapy.

Conclusion

Comparing to published rates using similar methodology the preceding decade (1992‐1999), prevalence of dysphagia based on claims data was similar in 2002‐2011 in this study. These results suggest persistence of dysphagia as a highly prevalent morbidity, even in the decade in which highly conformal radiotherapy and minimally invasive surgeries were popularized.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2L45BTb

Promotion of skin wound healing using prevascularized oral mucosal cell sheet

Abstract

Background

This study examined the potential use of our newly developed prevascularized oral mucosal cell sheet for the treatment of skin wounds.

Methods

Mucosal cell sheets containing cultured keratinocytes and plasma fibrin without (K sheet) or with a mixture of fibroblasts and endothelial progenitor cells (PV sheet) were transplanted into full‐thickness skin excisional wounds of nude mice.

Results

This technique was successful for in vitro culture; expanding keratinocytes, fibroblasts, and endothelial progenitor cells; and generating prevascularized mucosal cell sheets. Cell sheets promoted in vivo wound healing with rapid wound closure and less scarring compared to controls. This result was more apparent in the PV than the K sheet (P < .05). Wounds covered with cell sheets showed less expression of TGFB1, ACTA2, and FN1 mRNAs than the controls (P < .05).

Conclusion

The prevascularized mucosal cell sheet showed in vivo efficacy and tissue plasticity in cutaneous wounds by promoting accelerated healing.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2BX3mhk

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

Abstract

Background

Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse.

Objective

To evaluate prognostic factors of local relapse and local control with TLM (LC‐TLM).

Methods

Local relapse and LC‐TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed.

Results

Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64‐27.03; P < .001), paraglottic involvement (2.42, CI: 1.41‐4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43‐3.14; P < .001), grade of differentiation (1.74, CI: 1.18‐2.57; P = .005), and alcohol consumption (1.4, CI: 0.99‐1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51‐1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement.

LC‐TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03‐0.28; P < .001), paraglottic involvement (0.25, CI: 0.14‐0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32‐0.77; P = .007), margins (0.56, CI: 0.30‐1.04; P = .068), and differentiation (0.68, CI: 0.44‐1.05; P = .087). LC‐TLM correlated with experience (1.71, CI: 1.13‐2.55; P = .010). The most important factors for LC‐TLM were previous radiotherapy failure and paraglottic involvement.

Conclusion

Previous radiotherapy failure is the most important factor for local relapse and LC‐TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC‐TLM, respectively.

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Elective neck dissection in metastatic cutaneous squamous cell carcinoma to the parotid gland: A systematic review and meta‐analysis

Abstract

Current management of metastatic cutaneous squamous cell carcinoma (CSCC) to the parotid is surgical excision and postoperative radiotherapy. In the node‐negative neck, there is debate about the role of elective neck dissection (END), irradiation or observation. This systematic review assesses the prevalence of occult cervical disease and the evidence for END. A literature search was performed using Medline and Embase. All papers describing management of the neck in metastatic CSCC to the parotid were assessed for inclusion. Eighty‐nine papers were identified and 17 met inclusion criteria. A total of 874 ENDs were performed in 874 patients with metastatic CSCC to the parotid with no clinically evident cervical disease. The overall prevalence of occult disease in a random effects model was 22.5% (95% confidence intervals 18.9‐26.0). The prevalence of occult cervical disease in metastatic CSCC to the parotid is high. END is recommended in this patient group.

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Prognostic significance of pretreatment 18F‐fluorodeoxyglucose positron emission tomography evaluation using metabolic tumor volume of the primary tumor and lymph nodes in advanced hypopharyngeal cancer

Abstract

Background

The purpose of this study was to retrospectively evaluate the usefulness of pretreatment positron emission tomography (PET) using metabolic tumor volume (MTV) of the primary tumor and lymph nodes in advanced hypopharyngeal cancer.

Methods

From June 2007 to December 2015, consecutive patients with advanced hypopharyngeal cancer who underwent PET and were treated with definitive radiation therapy were retrospectively reviewed.

Results

A total of 61 patients were eligible for this study. On multivariate analysis, MTV of the primary tumor (MTV‐T) was significantly related to the local control rate and overall survival (OS) (P = .036 and .012, respectively). In patients with lower MTV‐T, MTV of metastatic lymph nodes (MTV‐N) was significantly related to disease‐specific survival and OS (P = .012 and .017, respectively).

Conclusion

MTV‐T is a significant predictor in patients with advanced hypopharyngeal cancer, and MTV‐N is also significant in patients with lower MTV‐T.

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Early experience of transoral thyroidectomy: Comparison of robotic and endoscopic procedures

Abstract

Background

The aim of this study was to evaluate the feasibility, safety, and early surgical outcomes of transoral thyroidectomy and to compare robotic and endoscopic procedures.

Methods

A total of 37 patients underwent robotic (23 cases) or endoscopic (14 cases) transoral thyroidectomy. We compared the outcomes of the two procedures.

Results

Of the 37 patients, 2 were converted to the robotic facelift approach as a result of an intraoperative CO₂ embolism and inability to remove the tumor. The mean operative time was 172.8 ± 37.5 minutes. Transient recurrent laryngeal nerve palsy occurred in one case, and transient hypoparathyroidism in two cases. Most of patients were satisfied with the postoperative cosmesis. There were no significant differences between the robotic and endoscopic procedures, except for operative time, which was significantly longer in the robotic group.

Conclusion

Robotic and endoscopic transoral thyroidectomies are both feasible and safe in appropriate patients.

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Evidence of retinal degeneration in Wolfram syndrome.

CONCLUSIONS: Some patients with Wolfram syndrome have a mild retinal degeneration that may be a manifestation of the neuronal involvement that is present in this condition. PMID: 30507261 [PubMed - as supplied by publisher] (Source: Ophthalmic Genetics)

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Evidence of retinal degeneration in Wolfram syndrome.

CONCLUSIONS: Some patients with Wolfram syndrome have a mild retinal degeneration that may be a manifestation of the neuronal involvement that is present in this condition. PMID: 30507261 [PubMed - as supplied by publisher] (Source: Ophthalmic Genetics)

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Clavicle duplication following physeal injury

Abstract

Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis. This remodeling potential and the intact acromioclavicular joint allow the children to be followed by closed reduction. However, there can be new bone formation between epiphysis and displaced metaphysis, resulting in clavicle duplication. Herein, we present the radiographic and computed tomography findings of a post-traumatic duplication of the clavicle in a 5-year-old boy.

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Clavicle duplication following physeal injury

Abstract

Clavicle duplication is a rare entity with limited number of cases reported. Congenital origin and trauma related mechanisms are the main hypotheses to explain this anatomical variation. In skeletally immature patient, trauma may cause physeal-metaphyseal injury in the distal clavicle rather than acromioclavicular strain. The distal epiphysis remains in continuity with acromion and has an intact periosteal sleeve. The periosteal sleeve is extremely osteogenic, and may lead to new bone formation between epiphysis and displaced metaphysis. This remodeling potential and the intact acromioclavicular joint allow the children to be followed by closed reduction. However, there can be new bone formation between epiphysis and displaced metaphysis, resulting in clavicle duplication. Herein, we present the radiographic and computed tomography findings of a post-traumatic duplication of the clavicle in a 5-year-old boy.

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Governor, Storey family dedicate research building at Georgia Cancer Center - The Augusta Chronicle

Governor, Storey family dedicate research building at Georgia Cancer Center  The Augusta Chronicle

Before it was dedicated Monday, pediatric oncologist Ted Johnson walked Sunday through the connector over Laney-Walker Boulevard between the clinic ...

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Ovarian Cancer Market 2018 : Global Industry Trends and Analysis Report - Browse Live News

Ovarian Cancer Market 2018 : Global Industry Trends and Analysis Report  Browse Live News

The latest trending report Global Ovarian Cancer Market by Manufacturers, Countries, Type and Application, Forecast to 2023 offered by ...

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Total endoscopic thyroidectomy versus conventional open thyroidectomy | TCRM - Dove Medical Press

Total endoscopic thyroidectomy versus conventional open thyroidectomy | TCRM  Dove Medical Press

Total endoscopic thyroidectomy versus conventional open thyroidectomy in thyroid cancer: a systematic review and meta-analysis Cong Chen,1,2 Shumin ...

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Tag: Thyroid Cancer Treatment Market Share - The Lander Forum

Tag: Thyroid Cancer Treatment Market Share  The Lander Forum

"Summary. The *fresh* industrial research report Global Thyroid Cancer Treatment Market published and promoted by Market Research Vision brings out ...

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Gender-neutral HPV vaccine urged to reduce cancers - The Times

Gender-neutral HPV vaccine urged to reduce cancers  The Times

A more advanced form of the HPV vaccine should be given to girls and boys to prevent potentially fatal cancers, the health watchdog has said. Under the current ...

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How Do Cigarettes Cause Cancer? - On Cancer - Memorial Sloan Kettering

How Do Cigarettes Cause Cancer?  On Cancer - Memorial Sloan Kettering

Everyone knows that cigarettes cause cancer. But what do we know about how they do it?

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Ovarian Cancer Market 2018 : Global Industry Trends and Analysis Report - Browse Live News

Ovarian Cancer Market 2018 : Global Industry Trends and Analysis Report  Browse Live News

The latest trending report Global Ovarian Cancer Market by Manufacturers, Countries, Type and Application, Forecast to 2023 offered by ...

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Total endoscopic thyroidectomy versus conventional open thyroidectomy | TCRM - Dove Medical Press

Total endoscopic thyroidectomy versus conventional open thyroidectomy | TCRM  Dove Medical Press

Total endoscopic thyroidectomy versus conventional open thyroidectomy in thyroid cancer: a systematic review and meta-analysis Cong Chen,1,2 Shumin ...

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Governor, Storey family dedicate research building at Georgia Cancer Center - The Augusta Chronicle

Governor, Storey family dedicate research building at Georgia Cancer Center  The Augusta Chronicle

Before it was dedicated Monday, pediatric oncologist Ted Johnson walked Sunday through the connector over Laney-Walker Boulevard between the clinic ...

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Tag: Thyroid Cancer Treatment Market Share - The Lander Forum

Tag: Thyroid Cancer Treatment Market Share  The Lander Forum

"Summary. The *fresh* industrial research report Global Thyroid Cancer Treatment Market published and promoted by Market Research Vision brings out ...

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Gender-neutral HPV vaccine urged to reduce cancers - The Times

Gender-neutral HPV vaccine urged to reduce cancers  The Times

A more advanced form of the HPV vaccine should be given to girls and boys to prevent potentially fatal cancers, the health watchdog has said. Under the current ...

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How Do Cigarettes Cause Cancer? - On Cancer - Memorial Sloan Kettering

How Do Cigarettes Cause Cancer?  On Cancer - Memorial Sloan Kettering

Everyone knows that cigarettes cause cancer. But what do we know about how they do it?

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What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

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What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

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Getting Back to Basics: 5 Reasons to Use Fingerplays in Sessions

I have fond memories of sitting on my mother's lap just a few inches from her face, imitating her hand movements, and softly singing, "Where is thumbkin? Where is thumbkin? Here I am. Here I am." Does this bring back memories for you as well? Unfortunately, from what I've observed, fewer parents are using this technique of  fingerplays—hand and finger movements combined with sung or spoken words. And that means kids are missing out on the impact of fingerplays on early language and literacy development. They may seem old-fashioned, boring and nonsensical, but I've experienced great success using them in my sessions with young clients. Here are five reasons why it's worth our time as SLPs to share fingerplays with toddler and preschool clients. Fingerplays promote early l...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rp43Ke

What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2G63TBU

Getting Back to Basics: 5 Reasons to Use Fingerplays in Sessions

I have fond memories of sitting on my mother's lap just a few inches from her face, imitating her hand movements, and softly singing, "Where is thumbkin? Where is thumbkin? Here I am. Here I am." Does this bring back memories for you as well? Unfortunately, from what I've observed, fewer parents are using this technique of  fingerplays—hand and finger movements combined with sung or spoken words. And that means kids are missing out on the impact of fingerplays on early language and literacy development. They may seem old-fashioned, boring and nonsensical, but I've experienced great success using them in my sessions with young clients. Here are five reasons why it's worth our time as SLPs to share fingerplays with toddler and preschool clients. Fingerplays promote early l...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rp43Ke

What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2G63TBU

What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2G63TBU

Getting Back to Basics: 5 Reasons to Use Fingerplays in Sessions

I have fond memories of sitting on my mother's lap just a few inches from her face, imitating her hand movements, and softly singing, "Where is thumbkin? Where is thumbkin? Here I am. Here I am." Does this bring back memories for you as well? Unfortunately, from what I've observed, fewer parents are using this technique of  fingerplays—hand and finger movements combined with sung or spoken words. And that means kids are missing out on the impact of fingerplays on early language and literacy development. They may seem old-fashioned, boring and nonsensical, but I've experienced great success using them in my sessions with young clients. Here are five reasons why it's worth our time as SLPs to share fingerplays with toddler and preschool clients. Fingerplays promote early l...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2rp43Ke

What Challenges Did Going to ASHA Convention Help You Overcome?

On the first day of the largest ASHA convention in the organization's history, Leader editors talked to around 600 of the thousands of attendees. We asked about topics we should cover in our new podcast, launching next year. We'd like you to share, too! Please list any topics or experts from the professions you'd like to hear about on the coming Leader podcast in the comment section below. We also asked attendees why they came to Boston in November. We wanted to know what challenges members face and the strategies they hope to learn to help them overcome those challenges. See what your peers shared below. And look for a follow-up post this weekend where attendees share practical ideas they plan to put into practice right away. I lost everything recently in the California wildfires—...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2G63TBU

Getting Back to Basics: 5 Reasons to Use Fingerplays in Sessions

I have fond memories of sitting on my mother's lap just a few inches from her face, imitating her hand movements, and softly singing, "Where is thumbkin? Where is thumbkin? Here I am. Here I am." Does this bring back memories for you as well? Unfortunately, from what I've observed, fewer parents are using this technique of  fingerplays—hand and finger movements combined with sung or spoken words. And that means kids are missing out on the impact of fingerplays on early language and literacy development. They may seem old-fashioned, boring and nonsensical, but I've experienced great success using them in my sessions with young clients. Here are five reasons why it's worth our time as SLPs to share fingerplays with toddler and preschool clients. Fingerplays promote early l...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

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PFAS above EPA limit found at residence in Robinson Twp. - Grand Haven Tribune

PFAS above EPA limit found at residence in Robinson Twp.  Grand Haven Tribune

ROBINSON TWP. — PFAS above the Environmental Protection Agency's lifetime health advisory has been discovered at a residence in Robinson Township.

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Vermillion (NASDAQ:VRML) vs. Response Genetics (RGDXQ) Critical Review - Baseball Daily News

Vermillion (NASDAQ:VRML) vs. Response Genetics (RGDXQ) Critical Review  Baseball Daily News

Response Genetics (OTCMKTS:RGDXQ) and Vermillion (NASDAQ:VRML) are both small-cap medical companies, but which is the better investment? We will ...

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AstraZeneca's Imfinzi fails another phase 3 trial, this time in head and neck cancer - FiercePharma

AstraZeneca's Imfinzi fails another phase 3 trial, this time in head and neck cancer  FiercePharma

AstraZeneca is still stinging from Imfinzi's combo flop in non-small cell lung cancer, but it's already staring down another defeat. Friday, the company said the ...

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MMP-9 as prognosticator in papillary thyroid cancer | BMC Cancer - MD Linx

MMP-9 as prognosticator in papillary thyroid cancer | BMC Cancer  MD Linx

Internal Medicine Article: The role of matrix metalloproteinase-9 as a prognostic biomarker in papillary thyroid cancer.

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AstraZeneca's Imfinzi fails another phase 3 trial, this time in head and neck cancer - FiercePharma

AstraZeneca's Imfinzi fails another phase 3 trial, this time in head and neck cancer  FiercePharma

AstraZeneca is still stinging from Imfinzi's combo flop in non-small cell lung cancer, but it's already staring down another defeat. Friday, the company said the ...

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Vermillion (NASDAQ:VRML) vs. Response Genetics (RGDXQ) Critical Review - Baseball Daily News

Vermillion (NASDAQ:VRML) vs. Response Genetics (RGDXQ) Critical Review  Baseball Daily News

Response Genetics (OTCMKTS:RGDXQ) and Vermillion (NASDAQ:VRML) are both small-cap medical companies, but which is the better investment? We will ...

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PFAS above EPA limit found at residence in Robinson Twp. - Grand Haven Tribune

PFAS above EPA limit found at residence in Robinson Twp.  Grand Haven Tribune

ROBINSON TWP. — PFAS above the Environmental Protection Agency's lifetime health advisory has been discovered at a residence in Robinson Township.

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MMP-9 as prognosticator in papillary thyroid cancer | BMC Cancer - MD Linx

MMP-9 as prognosticator in papillary thyroid cancer | BMC Cancer  MD Linx

Internal Medicine Article: The role of matrix metalloproteinase-9 as a prognostic biomarker in papillary thyroid cancer.

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Prospective, randomized, controlled, open-label study to compare efficacy of a mineral-rich solution vs normal saline after complete ethmoidectomy

Abstract

Purposes

The purpose of this study was to compare the efficacy of a mineral-rich solution vs normal saline solution (0.9% NaCl) following endoscopic complete bilateral ethmoidectomy.

Methods

This was a prospective, multicenter, randomized, controlled, open-label trial in subjects suffering from steroid-resistant sinonasal polyposis. Adults performed 4 nasal irrigations of mineral or saline solutions daily for 28 days. Evaluations included subject-reported RHINO quality of life (QoL) and NOSE scores, tolerability, and satisfaction, the Lund–Kennedy endoscopic score and assessments of crusting, secretions and mucociliary clearance (rhinoscintigraphy).

Results

A total of 189 subjects were randomized. Clinically relevant improvements (> 20 points) in RhinoQOL and NOSE scores were measured in both groups without any significant inter-group difference. Among the subjects with impaired RhinoQOL at pre-inclusion, the change in Impact-RhinoQOL score was significantly superior in mineral-rich vs saline solution at day 21 (p = 0.028) and day 28 (p = 0.027). The Lund–Kennedy score continuously improved in both groups earlier with the mineral-rich solution. Crusts were significantly fewer in number and less severe/obstructive in patients receiving mineral-rich vs saline solution at day 7 (p = 0.026) and day 14 (p = 0.016). Furthermore, secretions disappeared significantly more quickly and were less thick/purulent with mineral-rich solution at day 14 (p = 0.002) and day 21 (p = 0.043). Less epistaxis was reported in the mineral vs saline solution (p = 0.008 at day 21).

Conclusions

Our findings indicate that the composition of a nasal irrigation solution influences endoscopic scores and QoL after sinus surgery for patients over 60, those with an initially poor QoL and higher symptom score, and smokers.

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Prospective, randomized, controlled, open-label study to compare efficacy of a mineral-rich solution vs normal saline after complete ethmoidectomy

Abstract

Purposes

The purpose of this study was to compare the efficacy of a mineral-rich solution vs normal saline solution (0.9% NaCl) following endoscopic complete bilateral ethmoidectomy.

Methods

This was a prospective, multicenter, randomized, controlled, open-label trial in subjects suffering from steroid-resistant sinonasal polyposis. Adults performed 4 nasal irrigations of mineral or saline solutions daily for 28 days. Evaluations included subject-reported RHINO quality of life (QoL) and NOSE scores, tolerability, and satisfaction, the Lund–Kennedy endoscopic score and assessments of crusting, secretions and mucociliary clearance (rhinoscintigraphy).

Results

A total of 189 subjects were randomized. Clinically relevant improvements (> 20 points) in RhinoQOL and NOSE scores were measured in both groups without any significant inter-group difference. Among the subjects with impaired RhinoQOL at pre-inclusion, the change in Impact-RhinoQOL score was significantly superior in mineral-rich vs saline solution at day 21 (p = 0.028) and day 28 (p = 0.027). The Lund–Kennedy score continuously improved in both groups earlier with the mineral-rich solution. Crusts were significantly fewer in number and less severe/obstructive in patients receiving mineral-rich vs saline solution at day 7 (p = 0.026) and day 14 (p = 0.016). Furthermore, secretions disappeared significantly more quickly and were less thick/purulent with mineral-rich solution at day 14 (p = 0.002) and day 21 (p = 0.043). Less epistaxis was reported in the mineral vs saline solution (p = 0.008 at day 21).

Conclusions

Our findings indicate that the composition of a nasal irrigation solution influences endoscopic scores and QoL after sinus surgery for patients over 60, those with an initially poor QoL and higher symptom score, and smokers.

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Lack of Peds Preventive Care Ups Unplanned Hospital Admissions

Infants and children lacking vaccinations, development checks more likely to be admitted (Source: Pulmonary Medicine News - Doctors Lounge)

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Generic Drugmaker to Sell Alternative to EpiPen Injectors

TRENTON, N.J. (AP) — Generic drugmaker Sandoz announced plans Thursday to start selling an alternative to the EpiPen in the U.S. early next year. The EpiPen injector is used to halt life-threatening allergic reactions to insect bites, nuts and other foods. Brand-name EpiPen, which dominates the market, has been in short supply since spring because of production problems. Sandoz will sell prefilled syringes with the same medicine, the hormone epinephrine, under the name Symjepi. The price will be $250 for two, without insurance. Two generic versions of EpiPen are sold in the U.S. for $300 a pair, including one from EpiPen seller Mylan. The company started selling its own generic after it was blasted for repeated hikes that pushed up its list price from $94 to $608 for a pair of brand-name...

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Lack of Peds Preventive Care Ups Unplanned Hospital Admissions

Infants and children lacking vaccinations, development checks more likely to be admitted (Source: Pulmonary Medicine News - Doctors Lounge)

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Assessing Children’s Readiness to Carry and Use Quick-Relief Inhalers

Publication date: Available online 6 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Anna Volerman, Madeleine Toups, Ashley Hull, Margaret Dennin, Tae Yeon Kim, Stacy Ignoffo, Lisa K. Sharp, Valerie G. Press (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Generic Drugmaker to Sell Alternative to EpiPen Injectors

TRENTON, N.J. (AP) — Generic drugmaker Sandoz announced plans Thursday to start selling an alternative to the EpiPen in the U.S. early next year. The EpiPen injector is used to halt life-threatening allergic reactions to insect bites, nuts and other foods. Brand-name EpiPen, which dominates the market, has been in short supply since spring because of production problems. Sandoz will sell prefilled syringes with the same medicine, the hormone epinephrine, under the name Symjepi. The price will be $250 for two, without insurance. Two generic versions of EpiPen are sold in the U.S. for $300 a pair, including one from EpiPen seller Mylan. The company started selling its own generic after it was blasted for repeated hikes that pushed up its list price from $94 to $608 for a pair of brand-name...

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Lack of Peds Preventive Care Ups Unplanned Hospital Admissions

Infants and children lacking vaccinations, development checks more likely to be admitted (Source: Pulmonary Medicine News - Doctors Lounge)

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Antibiotic choice and MRSA rate in children who are hospitalized for atopic dermatitis

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition of childhood. It is associated with allergic co-morbities including asthma and allergic rhinitis. AD patients are also affected by sleep deprivation and psychosocial problems. Those with uncontrolled AD may require hospitalization.1 Previous studies have shown that about 70% of children who were treated inpatient for AD exacerbation were given an antibiotic.2,3 However, information on the choice of antibiotics used to treat AD exacerbation is limited. (Source: Annals of Allergy, Asthma and Immunology)

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Age-Related Differential Stimulation of Immune Response by Babesia microti and Borrelia burgdorferi During Acute Phase of Infection Affects Disease Severity

Vitomir Djokic, Shekerah Primus, Lavoisier Akoolo, Monideep Chakraborti, Nikhat Parveen (Source: Frontiers in Immunology)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

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Successful treatment of four types of chronic urticaria with anti-IgE omalizumab in the same patient

Urticaria is a skin disorder that is characterized by the appearance of wheals (hives), angioedema or both1. Chronic urticaria (CU) is defined as wheals (with or without angioedema) that persists for ≥6 weeks, and is further classified into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU)1. In most cases of CU a trigger cannot be identified. These cases are defined as CSU. The term inducible urticaria is used when a specific trigger can be linked to the development of CU. (Source: Annals of Allergy, Asthma and Immunology)

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Factors Associated with Dysfunctional Breathing in patients with Difficult to Treat Asthma

ConclusionDysfunctional breathing is common in difficult asthma and associated with worse asthma status and unemployment. The independent association with psychological disorders and nasal obstruction highlight an important interaction between comorbid treatable traits in difficult asthma. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Residual Fluticasone in the Oral Cavity after Inhalation with Different Tongue Positions

Publication date: Available online 7 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Tatsuyoshi Yokoi, Rieko Kondo, Takahiko Horiguchi (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Reduced final height and inadequate nutritional intake in cow’s milk-allergic young adults

ConclusionYoung adults who have cow's milk allergy from infancy are at risk of not reaching their growth potential. Growth and nutritional monitoring and appropriate dietary intervention are of particular importance in these at-risk individuals. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

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The presence of HLA-B75, DR13 homozygosity or DR14 additionally increases the risk of allopurinol induced severe cutaneous adverse reactions in HLA-B*58:01 carriers

ConclusionSecondary screening with HLA-B75, DR13 homozygosity, and DR14 in addition to primary screening with HLA-B*58:01 would enable a more accurate prediction of SCAR occurrence, especially in patients with CRI. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Impact of soymilk consumption on 2,4-dinitrofluorobenzene-induced contact hypersensitivity and gut microbiota in mice.

Authors: Nagano T, Katase M, Tsumura K Abstract Soymilk is rich in phytochemicals such as soy isoflavones (SIs) and soyasaponins (SSs). Dietary SIs and SSs display inhibitory effects on contact hypersensitivity (CHS), which was reported in a mouse model for allergic contact dermatitis (ACD); however, the beneficial effects of soymilk consumption on CHS remain unknown. Here, we studied the effects of drinking soymilk on CHS and gut microbiota. Soymilk consumption attenuated ear oedema and swelling, decreased the infiltration of Gr-1-positive cells into ear tissues, and reduced the production of chemokine (C-X-C motif) ligand 2 and triggering receptor expressed on myeloid cells-1 in ear tissues. The analysis of bacterial 16S ribosomal RNA gene sequences indicated that CHS caused chan...

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Generic Drugmaker to Sell Alternative to EpiPen Injectors

TRENTON, N.J. (AP) — Generic drugmaker Sandoz announced plans Thursday to start selling an alternative to the EpiPen in the U.S. early next year. The EpiPen injector is used to halt life-threatening allergic reactions to insect bites, nuts and other foods. Brand-name EpiPen, which dominates the market, has been in short supply since spring because of production problems. Sandoz will sell prefilled syringes with the same medicine, the hormone epinephrine, under the name Symjepi. The price will be $250 for two, without insurance. Two generic versions of EpiPen are sold in the U.S. for $300 a pair, including one from EpiPen seller Mylan. The company started selling its own generic after it was blasted for repeated hikes that pushed up its list price from $94 to $608 for a pair of brand-name...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EkzbTI

Factors Associated with Dysfunctional Breathing in patients with Difficult to Treat Asthma

ConclusionDysfunctional breathing is common in difficult asthma and associated with worse asthma status and unemployment. The independent association with psychological disorders and nasal obstruction highlight an important interaction between comorbid treatable traits in difficult asthma. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Residual Fluticasone in the Oral Cavity after Inhalation with Different Tongue Positions

Publication date: Available online 7 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Tatsuyoshi Yokoi, Rieko Kondo, Takahiko Horiguchi (Source: The Journal of Allergy and Clinical Immunology: In Practice)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ekz2zE

Lack of Peds Preventive Care Ups Unplanned Hospital Admissions

Infants and children lacking vaccinations, development checks more likely to be admitted (Source: Pulmonary Medicine News - Doctors Lounge)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2SuhnbK

Reduced final height and inadequate nutritional intake in cow’s milk-allergic young adults

ConclusionYoung adults who have cow's milk allergy from infancy are at risk of not reaching their growth potential. Growth and nutritional monitoring and appropriate dietary intervention are of particular importance in these at-risk individuals. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EkyVnI

Successful treatment of four types of chronic urticaria with anti-IgE omalizumab in the same patient

Urticaria is a skin disorder that is characterized by the appearance of wheals (hives), angioedema or both1. Chronic urticaria (CU) is defined as wheals (with or without angioedema) that persists for ≥6 weeks, and is further classified into two subtypes: chronic spontaneous urticaria (CSU) and chronic inducible urticaria (CIndU)1. In most cases of CU a trigger cannot be identified. These cases are defined as CSU. The term inducible urticaria is used when a specific trigger can be linked to the development of CU. (Source: Annals of Allergy, Asthma and Immunology)

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Age-Related Differential Stimulation of Immune Response by Babesia microti and Borrelia burgdorferi During Acute Phase of Infection Affects Disease Severity

Vitomir Djokic, Shekerah Primus, Lavoisier Akoolo, Monideep Chakraborti, Nikhat Parveen (Source: Frontiers in Immunology)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2SxSsUM

Impact of soymilk consumption on 2,4-dinitrofluorobenzene-induced contact hypersensitivity and gut microbiota in mice.

Authors: Nagano T, Katase M, Tsumura K Abstract Soymilk is rich in phytochemicals such as soy isoflavones (SIs) and soyasaponins (SSs). Dietary SIs and SSs display inhibitory effects on contact hypersensitivity (CHS), which was reported in a mouse model for allergic contact dermatitis (ACD); however, the beneficial effects of soymilk consumption on CHS remain unknown. Here, we studied the effects of drinking soymilk on CHS and gut microbiota. Soymilk consumption attenuated ear oedema and swelling, decreased the infiltration of Gr-1-positive cells into ear tissues, and reduced the production of chemokine (C-X-C motif) ligand 2 and triggering receptor expressed on myeloid cells-1 in ear tissues. The analysis of bacterial 16S ribosomal RNA gene sequences indicated that CHS caused chan...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2EkyR7s

The presence of HLA-B75, DR13 homozygosity or DR14 additionally increases the risk of allopurinol induced severe cutaneous adverse reactions in HLA-B*58:01 carriers

ConclusionSecondary screening with HLA-B75, DR13 homozygosity, and DR14 in addition to primary screening with HLA-B*58:01 would enable a more accurate prediction of SCAR occurrence, especially in patients with CRI. (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Global Cyclin Dependent Kinase 9 Market Insights 2018-2025 – Astex Pharmaceuticals Inc, AstraZeneca Plc, Bayer AG - Lake View Gazette

Global Cyclin Dependent Kinase 9 Market Insights 2018-2025 – Astex Pharmaceuticals Inc, AstraZeneca Plc, Bayer AG  Lake View Gazette

The "Cyclin Dependent Kinase 9 Market" research report presents an all-inclusive study of the global Cyclin Dependent Kinase 9 market. The report includes all ...

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Assessing Children’s Readiness to Carry and Use Quick-Relief Inhalers

Publication date: Available online 6 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Anna Volerman, Madeleine Toups, Ashley Hull, Margaret Dennin, Tae Yeon Kim, Stacy Ignoffo, Lisa K. Sharp, Valerie G. Press (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Treatment can be continued for mild cutaneous reactions associated with efavirenz

Publication date: Available online 6 December 2018Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Thuraya Isaacs, Reginald Mduzumile Ngwanya, Sipho Dlamini, Jonny Peter, Rannakoe Lehloenya (Source: The Journal of Allergy and Clinical Immunology: In Practice)

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Antibiotic choice and MRSA rate in children who are hospitalized for atopic dermatitis

Atopic dermatitis (AD) is the most common chronic inflammatory skin condition of childhood. It is associated with allergic co-morbities including asthma and allergic rhinitis. AD patients are also affected by sleep deprivation and psychosocial problems. Those with uncontrolled AD may require hospitalization.1 Previous studies have shown that about 70% of children who were treated inpatient for AD exacerbation were given an antibiotic.2,3 However, information on the choice of antibiotics used to treat AD exacerbation is limited. (Source: Annals of Allergy, Asthma and Immunology)

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Young Deaf Adults' Knowledge of Human Papillomavirus (HPV) and Perceived Risk of Vaccine in Preventing Cervical, Anal, Penile, and Oral Cancer

Describe knowledge and risk perception of Human Papillomavirus (HPV) among deaf adults who use American Sign Language (ASL) in comparison to hearing adults in the United States. (Source: Journal of Pediatric and Adolescent Gynecology)

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Masthead.

Authors: PMID: 30522131 [PubMed - in process] (Source: American Journal of Audiology)

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Development of intra-operative assessment system for ossicular mobility and middle ear transfer function.

In this study, a new system with a hand-held probe which enables intraoperative quantitative measurements of ossicular mobility has been developed. This system not only measures the ossicular mobility, but also investigates "local" transmission characteristics of the middle ear by directly applying vibration to the ossicles and measuring cochlear microphonic. The basic performance of this system was confirmed by measuring the mobility of artificial ossicles and cochlear microphonics in an animal experiment. Our system may contribute to selection of a better surgical method and reducing the risks of revision surgery. PMID: 30503297 [PubMed - as supplied by publisher] (Source: Hearing Research)

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Development of intra-operative assessment system for ossicular mobility and middle ear transfer function.

In this study, a new system with a hand-held probe which enables intraoperative quantitative measurements of ossicular mobility has been developed. This system not only measures the ossicular mobility, but also investigates "local" transmission characteristics of the middle ear by directly applying vibration to the ossicles and measuring cochlear microphonic. The basic performance of this system was confirmed by measuring the mobility of artificial ossicles and cochlear microphonics in an animal experiment. Our system may contribute to selection of a better surgical method and reducing the risks of revision surgery. PMID: 30503297 [PubMed - as supplied by publisher] (Source: Hearing Research)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Sy7lXd

Young Deaf Adults' Knowledge of Human Papillomavirus (HPV) and Perceived Risk of Vaccine in Preventing Cervical, Anal, Penile, and Oral Cancer

Describe knowledge and risk perception of Human Papillomavirus (HPV) among deaf adults who use American Sign Language (ASL) in comparison to hearing adults in the United States. (Source: Journal of Pediatric and Adolescent Gynecology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Sz5Fwu

Masthead.

Authors: PMID: 30522131 [PubMed - in process] (Source: American Journal of Audiology)

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Laryngeal Leiomyosarcoma: A Rare Case

Abstract

Laryngeal leiomyosarcoma is a rare smooth muscle malignancy of the head and neck region. Diagnosis is based on immunohistochemistry. Here we present a case of laryngeal leiomyosarcoma that was diagnosed and treated in our center, focusing on the clinical features, histological diagnosis and management of this rare disease.

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A Rare Case of Primary Tuberculous Otitis Media with Bezold’s Abscess

Abstract

Tuberculous Otitis Media is a rare clinical presentation. The signs and symptoms are variable that leads to delayed diagnosis and treatment. Persistent ear discharge not responding to topical and systemic antibiotics should be considered for investigation of tuberculosis. We report a case of Primary Tuberculous Otitis Media who presented with Bezold's Abscess. Patient underwent Mastoidectomy. Diagnosis was made with the Histopathological examination of the suspicious extensive pale granulation tissue. Patient was started on ATT immediately. Greater awareness regarding the disease is needed to make an early diagnosis. Late diagnosis increases the risk of complications. Anti Tubercular Therapy is the treatment of choice. Surgical intervention may be added to drug therapy. In cases with complications, radical surgery will be needed. Bezold's abscess is a rare complication of Otitis Media. CT imaging should be considered in suspected neck abscess patients with history of ear discharge to rule out aural cause of abscess.

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Extra Nasopharyngeal Angiofibroma from Lateral Nasal Wall: A Rare Case Report

Abstract

A 25-year-old male presented with left sided nasal obstruction and epistaxis. To study about a rare case of extranasopharyngeal angiofibroma. Endoscopic evaluation revealed a polypoid mass in the vestibule arising from the lateral wall of the nasal cavity anteroinferior to the left inferior turbinate. Computed tomography scan showed a soft tissue opacity in the vestibule of the left nasal cavity. After the endoscopic excision of the mass, postoperative and histopathological analyses confirmed the diagnosis of an angiofibroma.

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False Identity: Lymphoid Hyperplasia Imitating a Large Paraganglioma

Abstract

The danger of the parapharyngeal space mass comes from the small space and vital neighboring structures. Its differential diagnosis is broad, however benign lymphoid hyperplasia in this region has not been previously reported. The clinical presentation, imaging, surgical findings and pathology slides were reviewed in an adult patient with a parapharyngeal space mass. The literature on somatostatin-positive parapharyngeal space lesions was reviewed. A 51-year old male with otalgia for 3 months, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy demonstrated a paretic true vocal cord. Subsequent MRI demonstrated 4.5 cm post-styloid parapharyngeal space mass displacing the carotid artery anterolaterally. Octreoscan scan showed significant uptake of the somatostatin analog. Angiogram showed prominent vascular blush. The mass was excised transcervically and histopathology demonstrated lymphoid hyperplasia. This case demonstrates that post-styloid parapharyngeal masses may be lateral retropharyngeal nodes. An octreotide-positive lymphoid hyperplasia has never been previously reported.

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Microscopic Thyroidectomy: A Prudent Option

Abstract

Microscopic Thyroidectomy is not a new surgical technique but it is not explored much. The routine use of microscope in thyroid surgery can reduce the rate of nerve palsy and hypocalcemia. Nine cases were done exclusively with the microscope only and postoperative nerve palsy and hypocalcemia were noted. We have also discussed about optimum working distances and magnification for critical structures during thyroid surgery. No patient has any nerve palsy while one patient reported transient hypocalcemia. Recurrent laryngeal nerve could be identified at 2 × but optimal magnification for dissection of nerve should be 4 ×. We find this technique easy to adopt and critical structures can be identified and preserved easily with microscopic thyroidectomy then conventional and loupe technique. It is better to have standardized and optimum working distance and magnification during different steps of surgery. It is great teaching tool in view of its better illumination and magnification.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PsoOOW

Microscopic Thyroidectomy: A Prudent Option

Abstract

Microscopic Thyroidectomy is not a new surgical technique but it is not explored much. The routine use of microscope in thyroid surgery can reduce the rate of nerve palsy and hypocalcemia. Nine cases were done exclusively with the microscope only and postoperative nerve palsy and hypocalcemia were noted. We have also discussed about optimum working distances and magnification for critical structures during thyroid surgery. No patient has any nerve palsy while one patient reported transient hypocalcemia. Recurrent laryngeal nerve could be identified at 2 × but optimal magnification for dissection of nerve should be 4 ×. We find this technique easy to adopt and critical structures can be identified and preserved easily with microscopic thyroidectomy then conventional and loupe technique. It is better to have standardized and optimum working distance and magnification during different steps of surgery. It is great teaching tool in view of its better illumination and magnification.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PsoOOW

False Identity: Lymphoid Hyperplasia Imitating a Large Paraganglioma

Abstract

The danger of the parapharyngeal space mass comes from the small space and vital neighboring structures. Its differential diagnosis is broad, however benign lymphoid hyperplasia in this region has not been previously reported. The clinical presentation, imaging, surgical findings and pathology slides were reviewed in an adult patient with a parapharyngeal space mass. The literature on somatostatin-positive parapharyngeal space lesions was reviewed. A 51-year old male with otalgia for 3 months, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy demonstrated a paretic true vocal cord. Subsequent MRI demonstrated 4.5 cm post-styloid parapharyngeal space mass displacing the carotid artery anterolaterally. Octreoscan scan showed significant uptake of the somatostatin analog. Angiogram showed prominent vascular blush. The mass was excised transcervically and histopathology demonstrated lymphoid hyperplasia. This case demonstrates that post-styloid parapharyngeal masses may be lateral retropharyngeal nodes. An octreotide-positive lymphoid hyperplasia has never been previously reported.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zOqvRH

Laryngeal Leiomyosarcoma: A Rare Case

Abstract

Laryngeal leiomyosarcoma is a rare smooth muscle malignancy of the head and neck region. Diagnosis is based on immunohistochemistry. Here we present a case of laryngeal leiomyosarcoma that was diagnosed and treated in our center, focusing on the clinical features, histological diagnosis and management of this rare disease.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Ptcdv3

A Rare Case of Primary Tuberculous Otitis Media with Bezold’s Abscess

Abstract

Tuberculous Otitis Media is a rare clinical presentation. The signs and symptoms are variable that leads to delayed diagnosis and treatment. Persistent ear discharge not responding to topical and systemic antibiotics should be considered for investigation of tuberculosis. We report a case of Primary Tuberculous Otitis Media who presented with Bezold's Abscess. Patient underwent Mastoidectomy. Diagnosis was made with the Histopathological examination of the suspicious extensive pale granulation tissue. Patient was started on ATT immediately. Greater awareness regarding the disease is needed to make an early diagnosis. Late diagnosis increases the risk of complications. Anti Tubercular Therapy is the treatment of choice. Surgical intervention may be added to drug therapy. In cases with complications, radical surgery will be needed. Bezold's abscess is a rare complication of Otitis Media. CT imaging should be considered in suspected neck abscess patients with history of ear discharge to rule out aural cause of abscess.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zPFc72

Extra Nasopharyngeal Angiofibroma from Lateral Nasal Wall: A Rare Case Report

Abstract

A 25-year-old male presented with left sided nasal obstruction and epistaxis. To study about a rare case of extranasopharyngeal angiofibroma. Endoscopic evaluation revealed a polypoid mass in the vestibule arising from the lateral wall of the nasal cavity anteroinferior to the left inferior turbinate. Computed tomography scan showed a soft tissue opacity in the vestibule of the left nasal cavity. After the endoscopic excision of the mass, postoperative and histopathological analyses confirmed the diagnosis of an angiofibroma.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2PtcaPT

Teenage boys to get lifesaving HPV jab in the next school year - Independent.ie

Teenage boys to get lifesaving HPV jab in the next school year  Independent.ie

Thousands of teenage boys are to be offered a lifesaving vaccine - currently administered only to girls - to protect them against deadly cancers.

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Global Head and Neck Cancer Market Outlook By Top Players And Future Forecasts Details Till 2027 - Euro Watchers By MarketResearch.Biz

Global Head and Neck Cancer Market Outlook By Top Players And Future Forecasts Details Till 2027  Euro Watchers By MarketResearch.Biz

This report gives a complete overview of the Global Head and Neck Cancer Market to 2027, covering the different aspects such as product definitions along with ...

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Study: Immunotherapy better than chemotherapy for subtype of head and neck cancer - Science Codex

Study: Immunotherapy better than chemotherapy for subtype of head and neck cancer  Science Codex

A randomized clinical trial involving 97 medical centers in 20 countries, including Moores Cancer Center at UC San Diego Health, found that treating patients ...

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Teenage boys to get lifesaving HPV jab in the next school year - Independent.ie

Teenage boys to get lifesaving HPV jab in the next school year  Independent.ie

Thousands of teenage boys are to be offered a lifesaving vaccine - currently administered only to girls - to protect them against deadly cancers.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2SDdxxj

Global Head and Neck Cancer Market Outlook By Top Players And Future Forecasts Details Till 2027 - Euro Watchers By MarketResearch.Biz

Global Head and Neck Cancer Market Outlook By Top Players And Future Forecasts Details Till 2027  Euro Watchers By MarketResearch.Biz

This report gives a complete overview of the Global Head and Neck Cancer Market to 2027, covering the different aspects such as product definitions along with ...

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Study: Immunotherapy better than chemotherapy for subtype of head and neck cancer - Science Codex

Study: Immunotherapy better than chemotherapy for subtype of head and neck cancer  Science Codex

A randomized clinical trial involving 97 medical centers in 20 countries, including Moores Cancer Center at UC San Diego Health, found that treating patients ...

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PFAS above EPA limit found at residence in Robinson Twp. - Grand Haven Tribune

PFAS above EPA limit found at residence in Robinson Twp.  Grand Haven Tribune

ROBINSON TWP. — PFAS above the Environmental Protection Agency's lifetime health advisory has been discovered at a residence in Robinson Township.

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VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society - Abbotsford News

VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society  Abbotsford News

Jaiden Duncan grew his hair for nearly 4 years to make a donation to the Society's wig-making program.

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Advocates: Medicaid waiver could hurt mentally ill, vulnerable populations - Forward Kentucky

Advocates: Medicaid waiver could hurt mentally ill, vulnerable populations  Forward Kentucky

Some people with mental illness and certain medical conditions will have trouble navigating the requirements of the state's Medicaid waiver.

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VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society - Abbotsford News

VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society  Abbotsford News

Jaiden Duncan grew his hair for nearly 4 years to make a donation to the Society's wig-making program.

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PFAS above EPA limit found at residence in Robinson Twp. - Grand Haven Tribune

PFAS above EPA limit found at residence in Robinson Twp.  Grand Haven Tribune

ROBINSON TWP. — PFAS above the Environmental Protection Agency's lifetime health advisory has been discovered at a residence in Robinson Township.

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Advocates: Medicaid waiver could hurt mentally ill, vulnerable populations - Forward Kentucky

Advocates: Medicaid waiver could hurt mentally ill, vulnerable populations  Forward Kentucky

Some people with mental illness and certain medical conditions will have trouble navigating the requirements of the state's Medicaid waiver.

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Maternal Subfertility and Offspring's Asthma: Is There a Link? (CME/CE)

(MedPage Today) -- Norwegian data find association; immune dysregulation may be common thread (Source: MedPage Today Allergy)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

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Maternal Subfertility and Offspring's Asthma: Is There a Link? (CME/CE)

(MedPage Today) -- Norwegian data find association; immune dysregulation may be common thread (Source: MedPage Today Allergy)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2SAyN6C