Incidence of Pneumonia After Videofluoroscopic Swallowing Study and Associated Factors.

Incidence of Pneumonia After Videofluoroscopic Swallowing Study and Associated Factors.

Dysphagia. 2015 Nov 7;

Authors: Jo H, Park JG, Min D, Park HW, Kang EK, Lee KJ, Baek S

Abstract
Pneumonia after videofluoroscopic swallow study (VFSS) is sometimes considered to be caused by aspiration during VFSS; however, to our knowledge, a relationship between these events has not been clearly investigated. The aim of this study was to assess the incidence of VFSS-related pneumonia and related factors. Overall, 696 VFSS cases were retrospectively reviewed. Cases in which blood culture was performed within 3 days after VFSS due to newly developed infectious signs were considered as post-VFSS infection cases. Pneumonia was suspected when there was some evidence of respiratory infectious signs in clinical, radiological, and laboratory findings. The underlying disease, clinical signs, and VFSS findings of the pneumonia group were assessed. Among 696 cases, pneumonia was diagnosed in 15 patients. The patients in the pneumonia group tended to be older and had higher aspiration rate on VFSS than those in the non-pneumonia group. In the pneumonia group, 2 patients showed no aspiration during VFSS. In 6 patients, pneumonia developed after massive aspiration of gastric content in 5 patients and inappropriate oral feeding with risk of aspiration before VFSS in 1 patient. Only 7 patients (1.0 %) were finally determined as having VFSS-related pneumonia. In conclusion, the 72-h incidence of VFSS-related pneumonia was 1.0 %. Old age and severity of swallowing difficulty are associated with occurrence of pneumonia.

PMID: 26547192 [PubMed - as supplied by publisher]

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Antioxidant therapy in the elderly with tinnitus.

Antioxidant therapy in the elderly with tinnitus.

Braz J Otorhinolaryngol. 2015 Oct 17;

Authors: Polanski JF, Soares AD, de Mendonça Cruz OL

Abstract
INTRODUCTION: Several approaches have been tried for the treatment of tinnitus, from cognitive-behavioral therapies and sound enrichment to medication. In this context, antioxidants, widely used in numerous areas of medicine, appear to represent a promising approach for the control of this symptom, which often is poorly controlled.
OBJECTIVE: To evaluate the effects of antioxidant therapy for tinnitus in a group of elderly patients.
METHODS: Prospective, randomized, double-blinded, placebo-controlled clinical trial. The sample consisted of 58 subjects aged 60 years or older, with a complaint of tinnitus associated with sensorineural hearing loss. These individuals completed the Tinnitus Handicap Inventory (THI) questionnaire before and after six months of therapy. The treatment regimens were: Ginkgo biloba dry extract (120mg/day), α-lipoic acid (60mg/day)+vitamin C (600mg/day), papaverine hydrochloride (100mg/day)+vitamin E (400mg/day), and placebo.
RESULTS: There was no statistically significant difference between THI by degree (p=0.441) and by score (p=0.848) before and after treatment.
CONCLUSION: There was no benefit from the use of antioxidant agents for tinnitus in this sample.

PMID: 26547700 [PubMed - as supplied by publisher]

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Comparing diffusion weighted MRI in the detection of post-operative middle ear cholesteatoma in children and adults.

Comparing diffusion weighted MRI in the detection of post-operative middle ear cholesteatoma in children and adults.

Int J Pediatr Otorhinolaryngol. 2015 Oct 27;

Authors: Nash R, Wong PY, Kalan A, Lingam RK, Singh A

Abstract
INTRODUCTION: There is a limited evidence base for the use of diffusion weighted MRI (DWMRI) in the assessment of post-operative cholesteatoma in children. This is important to address as this technique is particularly relevant in a paediatric setting.
METHODS: We searched a prospectively collected database of patients undergoing DWMRI for the assessment of residual and recurrent cholesteatoma. Imaging findings were correlated with findings at revision surgery. 320 investigations were divided into paediatric and adult groups (90 in children, 230 in adults) and compared.
RESULTS: Operative findings were available for 158 cases, of which 54 were children. The accuracy of DWMRI in children was 96.3%, and in adults was 88.5%. There were no statistically significant differences in the sensitivity, specificity, positive or negative predictive values between adults and children.
DISCUSSION: An increasing number of patients are not undergoing confirmatory surgery after negative DWMRI scans. False negative results are commonly secondary to small foci of disease; false positives have several possible causes. Performing MRI on children can be challenging, but sedation may be helpful in younger children.
CONCLUSION: The performance of diffusion weighted MRI is similar in paediatric and adult settings. This study suggests that DWMRI may be used in clinical practice in a similar way in children and adults.

PMID: 26547234 [PubMed - as supplied by publisher]

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Letter to the Editor regarding "Sinogenic intracranial abscesses".

Letter to the Editor regarding "Sinogenic intracranial abscesses".

Int J Pediatr Otorhinolaryngol. 2015 Oct 23;

Authors: Gelabert-González M, Arán-Echabe E

PMID: 26547233 [PubMed - as supplied by publisher]

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Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

Eur Arch Otorhinolaryngol. 2015 Nov 7;

Authors: Arslanoğlu S, Eren E, Özkul Y, Ciğer E, Kopar A, Önal K, Etit D, Tütüncü GY

Abstract
The objective of this study was to determine the incidence of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma; and the association between clinicopathological parameters and thyroid gland invasion. Medical records of 75 patients with laryngeal and hypopharyngeal squamous cell carcinoma who underwent total laryngectomy with thyroidectomy were reviewed, retrospectively. Preoperative computed tomography scans, clinical and operative findings, and histopathological data of the specimens were evaluated. There were 73 male and two female patients with an age range of 41-88 years (mean 60.4 years). Hemithyroidectomy was performed in 62 (82.7 %) and total thyroidectomy was performed in 13 patients (17.3 %). Four patients had histopathologically proven thyroid gland invasion (5.3 %). In three patients, thyroid gland involvement was by means of direct invasion. Thyroid gland invasion was significantly correlated with thyroid cartilage invasion. Therefore, prophylactic thyroidectomy should not be a part of the treatment policy for these tumors.

PMID: 26547312 [PubMed - as supplied by publisher]

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Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

Management of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma.

Eur Arch Otorhinolaryngol. 2015 Nov 7;

Authors: Arslanoğlu S, Eren E, Özkul Y, Ciğer E, Kopar A, Önal K, Etit D, Tütüncü GY

Abstract
The objective of this study was to determine the incidence of thyroid gland invasion in laryngeal and hypopharyngeal squamous cell carcinoma; and the association between clinicopathological parameters and thyroid gland invasion. Medical records of 75 patients with laryngeal and hypopharyngeal squamous cell carcinoma who underwent total laryngectomy with thyroidectomy were reviewed, retrospectively. Preoperative computed tomography scans, clinical and operative findings, and histopathological data of the specimens were evaluated. There were 73 male and two female patients with an age range of 41-88 years (mean 60.4 years). Hemithyroidectomy was performed in 62 (82.7 %) and total thyroidectomy was performed in 13 patients (17.3 %). Four patients had histopathologically proven thyroid gland invasion (5.3 %). In three patients, thyroid gland involvement was by means of direct invasion. Thyroid gland invasion was significantly correlated with thyroid cartilage invasion. Therefore, prophylactic thyroidectomy should not be a part of the treatment policy for these tumors.

PMID: 26547312 [PubMed - as supplied by publisher]

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Cytological accuracy and radiological staging in patients with thyroid cancer in Glasgow.

Cytological accuracy and radiological staging in patients with thyroid cancer in Glasgow.

Eur Arch Otorhinolaryngol. 2015 Nov 7;

Authors: Montgomery J, Hendry J, Van der Horst C, Hunter MA, MacKenzie K, Hilmi O

Abstract
To assess the accuracy of initial combined cytological accuracy and radiological staging of patients suspected of having thyroid malignancy with their final histopathology. Retrospective case series in a tertiary referral centre for head and neck malignancy. All patients with malignant thyroid cytology and cytology suspicious for malignancy, between the dates of June 2010 and July 2014, were included. The pre-operative staging was compared against the final histological staging. Demographics and outcomes for each patient were recorded. Sixty-five patients were recorded in this group. 20 (30.7 %) were male. The mean age at presentation was 51 years (SD 16.8 years). 39 (60 %) patients were aged over 45 years. Fine needle aspiration cytology (FNAC) was performed in all patients and was Thy 4 in 40 (62 %) and Thy 5 in 25 (38 %). Following surgery or subsequent biopsy, FNAC was found to be accurate in 38/40 (Thy 4) and 25/25 (Thy 5) cases in diagnosing malignancy, with Thy 4 yielding 95 % malignancy and Thy 5 % 100 %. Fifty-eight patients underwent a surgical procedure for thyroid cancer. Two further patients had a diagnostic hemi-thyroidectomy for later proven benign disease. Five patients due to medical co morbidities, inoperable disease or refusal of surgery were managed non-surgically. In the surgical group 16 patients underwent a diagnostic hemi-thyroidectomy and 11 of these required a completion thyroidectomy. Forty-six patients underwent total thyroidectomy. Forty-six patients underwent a neck dissection: 27 prophylactic central compartment neck dissections and 19 planned therapeutic neck dissections were performed. Radiological staging correctly predicted final pathological TNM staging in 25 (43 %) patients. 27 (47 %) patients had radiological staging which under staged their final histological staging and 6 (10 %) patients had scans that over staged their cancer. Of those that were under staged, 15 (56 %) had their nodal disease under staged (following prophylactic central neck dissection). Radiological staging comprised ultrasound (n = 58) and CT scanning (n = 45/58 pre-operatively). Pre-operative staging in thyroid cancer should include cytology, ultrasound and CT scanning. Unless low-risk papillary thyroid cancer is suspected pre-operatively, patients with Thy 4 cytology can be given the offer of a total thyroidectomy as surgical management.

PMID: 26547311 [PubMed - as supplied by publisher]

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