Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

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Lateral Skull Base Attenuation in Superior Semicircular Canal Dehiscence and Spontaneous Cerebrospinal Fluid Otorrhea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Rizk HG, Hatch JL, Stevens SM, Lambert PR, Meyer TA

Abstract
OBJECTIVES: (1) To quantitatively assess the lateral skull base thickness in patients with superior semicircular canal dehiscense (SSCD) using a standardized and validated radiographic measure and to compare it with that of a population with spontaneous cerebrospinal fluid otorrhea (CSFO). (2) To analyze demographic and clinical factors associated with skull base thickness in the SSCD group.
STUDY DESIGN: Case series with chart review.
SETTING: Tertiary neurotologic referral center.
SUBJECTS AND METHODS: Based on computed tomography imaging of the tegmen, mean skull base thickness was calculated for 16 patients with radiographic and clinical SSCD. Similar measures were performed in 4 comparison groups consisting of adults with spontaneous CSFO (n = 33), as well as 3 control groups recruited from our adult cochlear implant database: 30 obese controls (body mass index [BMI] >30 kg/m(2)), 11 overweight controls (BMI, 25-30 kg/m(2)), and 20 normal weight controls (BMI <25 kg/m(2)).
RESULTS: The SSCD group had a significantly lower mean BMI (28.6 kg/m(2)) than the spontaneous CSFO group (37.7 kg/m(2); P = .0007). The mean skull base thickness of SSCD patients was 17% thinner than that of the CSFO group, 31% thinner vs obese controls, 49% thinner vs overweight controls, and 45% thinner vs normal weight controls. These differences were all statistically significant (P < .05).
CONCLUSION: Patients with SSCD have a marked thinning of the lateral skull base, more so than patients with spontaneous CSF otorrhea and control groups with different BMIs. Skull base attenuation in SSCD patients did not correlate with BMI.

PMID: 27221578 [PubMed - as supplied by publisher]

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Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

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Anterolateral Advancement Pharyngoplasty: A New Technique for Treatment of Obstructive Sleep Apnea.

Otolaryngol Head Neck Surg. 2016 May 24;

Authors: Emara TA, Hassan MH, Mohamad AS, Anany AM, Ebrahem AE

Abstract
OBJECTIVE: To investigate the efficacy of anterolateral advancement pharyngoplasty to enlarge pharyngeal airspace and to decrease palatal and lateral pharyngeal wall collapse in the treatment of obstructive sleep apnea (OSA).
STUDY DESIGN: Prospective study.
SETTING: University medical hospital.
SUBJECTS AND METHOD: Forty-one patients underwent an anterolateral advancement pharyngoplasty procedure according to the following criteria: body mass index <30 kg/m(2), Friedman stage II or III, type I Fujita, nocturnal polysomnography diagnostic of OSA, retropalatal and lateral pharyngeal collapse, and diagnosis with flexible nasoendoscopy during a Müller's maneuver based on a 5-point scale. Patients with retroglossal airway collapse were excluded from the study. The principle of this technique is to advance and fix the palatopharyngeus muscle with the superior pharyngeus constrictor muscle without transecting any of their fascicules anterolateral to the pterygomandibular raphe and anterosuperior to the levator veli palatine muscle.
RESULTS: Pre- and postoperative polysomnography findings (mean ± SD) showed significant statistical differences: apnea hypopnea index (AHI) decreased from 42.1 ± 16.34 to 16.3 ± 10.3 (P ≤ .001); percentage of time with oxyhemoglobin saturation <90% decreased from 18.5% ± 4.2% to 10.1% ± 1.3% (P ≤ .001); and lowest oxygen saturation level increased from 79.9% ± 14.8% to 89.3% ± 11.1% (P ≤ .05). The mean time for patients to return to a normal diet was 12.2 days. There was no postoperative bleeding, velopharyngeal insufficiency, speech alternations, or taste loss. Based on a threshold of a 50% reduction in AHI and AHI <20, surgical success was 86.8%.
CONCLUSION: Anterolateral advancement pharyngoplasty appears to be an effective technique with a high surgical success rate in the treatment of OSA patients with lateral pharyngeal wall collapse.

PMID: 27221568 [PubMed - as supplied by publisher]

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Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

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Adenotonsillar hypertrophy as a risk factor of dentofacial abnormality in Korean children.

Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3311-6

Authors: Kim DK, Rhee CS, Yun PY, Kim JW

Abstract
No studies for the role of adenotonsillar hypertrophy in development of dentofacial abnormalities have been performed in Asian pediatric population. Thus, we aimed to investigate the relationship between adenotonsillar hypertrophy and dentofacial abnormalities in Korean children. The present study included consecutive children who visited a pediatric clinic for sleep-disordered breathing due to habitual mouth breathing, snoring or sleep apnea. Their palatine tonsils and adenoids were graded by oropharyngeal endoscopy and lateral cephalometry. Anterior open bite, posterior crossbite, and Angle's class malocclusions were evaluated for dentofacial abnormality. The receiver-operating characteristic curve analysis was used to identify age cutoffs to predict dentofacial abnormality. A total of 1,083 children were included. The presence of adenotonsillar hypertrophy was significantly correlated with the prevalence of dentofacial abnormality [adjusted odds ratio = 4.587, 95% CI (2.747-7.658)] after adjusting age, sex, body mass index, allergy, and Korean version of obstructive sleep apnea-18 score. The cutoff age associated with dentofacial abnormality was 5.5 years (sensitivity = 75.5%, specificity = 67%) in the children with adenotonsillar hypertrophy and 6.5 years (sensitivity = 70.6%, specificity = 57%) in those without adenotonsillar hypertrophy. In conclusion, adenotonsillar hypertrophy may be a risk factor for dentofacial abnormalities in Korean children and early surgical intervention could be considered with regards to dentofacial abnormality.

PMID: 25490975 [PubMed - indexed for MEDLINE]

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Anxiety among individuals with visual vertigo and vestibulopathy.

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Anxiety among individuals with visual vertigo and vestibulopathy.

Disabil Rehabil. 2015;37(23):2197-202

Authors: Zur O, Schoen G, Dickstein R, Feldman J, Berner Y, Dannenbaum E, Fung J

Abstract
PURPOSE: Visual vertigo (VV) is a type of dizziness triggered by visual stimuli. Despite a high incidence, its relationship with anxiety is not well-defined or understood. This study evaluated anxiety levels in subjects with VV compared to vestibulopathic subjects without VV and healthy individuals.
METHODS: A cross-sectional study to evaluate anxiety among individuals with VV was conducted twice. The first study included 72 participants (66 to 83 years of age) from senior residential centers. The second included 31 participants from a vestibular rehabilitation program (age range 35-82 years). Study 1 also used the Activities-Specific Balance Confidence (ABC) scale and study 2 the Dizziness Handicap Inventory (DHI).
RESULTS: Subjects were classified as VV positive (27 in study 1, 10 in study 2) or vestibulopathic without VV (30 in study 1, 11 in study 2) based on Head Impulse or Dynamic Visual Acuity Tests and the Dizziness Questionnaire. The remaining were age-matched healthy controls. The outcome of each study demonstrated significantly higher anxiety levels (p = 0.0001) in the VV group compared to the other groups. The results of the ABC test demonstrated that subjects in the VV group had significantly lower self-confidence (p = 0.001) than those in the Vest and Cont groups and performed fewer balance-related activities of daily life. DHI results showed that VV group expressed higher (p < 0.001) mean scores for self-perceived feelings of dizziness and imbalance (54%), compared to the Vest (9%) and Cont groups (1%).
CONCLUSIONS: Anxiety related to VV requires special attention when assessing and managing vestibulopathy, regardless of patient age.
IMPLICATIONS FOR REHABILITATION: Anxiety is a characteristic of subjects with visual vertigo (VV) and vestibulopathy. Anxiety in subjects with VV is not related to age. VV should be considered when subjects with anxiety complain of imbalance. Anxiety and vestibulopathy are often interrelated and should be considered in diagnostic evaluations.

PMID: 25597835 [PubMed - indexed for MEDLINE]

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Periprocedural stroke presenting as isolated unilateral internuclear ophthalmoplegia.

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Periprocedural stroke presenting as isolated unilateral internuclear ophthalmoplegia.

QJM. 2015 Feb;108(2):165

Authors: Saini M, Bte Idu Jion Y

PMID: 25114281 [PubMed - indexed for MEDLINE]

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[Tumors of the lacrimal drainage system].

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[Tumors of the lacrimal drainage system].

HNO. 2016 May 24;

Authors: von Goscinski C, Koch KR, Cursiefen C, Heindl LM

Abstract
BACKGROUND: The prevalence of tumors affecting the lacrimal drainage system is low, thus generating a risk of late diagnosis and treatment in clinical routine. However, these tumors can be potentially life-threatening, which emphasizes the relevance of early diagnosis and treatment.
OBJECTIVE: This review focuses on the symptoms, incidence, management, and prognosis of the different tumor entities affecting the lacrimal drainage system.
METHODS: The study provides a PubMed-based literature review and presents own clinical results.
RESULTS: Alongside detailed medical history taking and comprehensive clinical examination, precise inspection during external dacryocystography is important for diagnosis of tumors affecting the lacrimal drainage system. There is a wide spectrum of tumor entities located in the lacrimal drainage system. The tumors are classified into three groups: primary epithelial, primary nonepithelial, and inflammatory lesions. The most common primary epithelial tumors include papilloma, squamous cell carcinoma, and transitional cell carcinoma. The most common nonepithelial tumors include fibrous histiocytoma, malignant lymphoma, and malignant melanoma; while the most common inflammatory lesions comprise sarcoidosis, Wegener granulomatosis, and pyogenic granuloma. Treatment depends on the entity and stage of the tumor. In the case of malignancy, a multimodal and interdisciplinary approach is usually indicated.
CONCLUSION: Differential diagnostic signs in favor of a malignancy include a long medical history, predisposing conditions in the patient's history, a mass above the medial canthal ligament, teleangiectasis above the mass, and serosanguinous secretion.

PMID: 27222017 [PubMed - as supplied by publisher]

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[Efferent tear ducts in the focus of ophthalmic and otorhinolaryngologic surgeons].

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[Efferent tear ducts in the focus of ophthalmic and otorhinolaryngologic surgeons].

HNO. 2016 May 24;

Authors: Struck HG, Heichel J

PMID: 27222016 [PubMed - as supplied by publisher]

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Does clinician continuity influence hearing aid outcomes?

Does clinician continuity influence hearing aid outcomes?

Int J Audiol. 2016 May 25;:1-8

Authors: Bennett RJ, Meyer C, Eikelboom RH

Abstract
OBJECTIVE: To evaluate whether clinician continuity is associated with successful hearing aid outcomes.
DESIGN: A prospective cohort study. Clinician continuity was defined as occurring when a patient was cared for by the same clinician for the hearing assessment, hearing aid selection process, hearing aid fitting and programming, and subsequent hearing aid fine tuning appointments. The hearing aid outcome measures included self-reported hearing aid use, benefit and satisfaction as well as self-reported handling skills and problems experienced with hearing aids.
STUDY SAMPLE: Four hundred and sixty-eight adult hearing aid users (mean age 73.9 years ±10.9) and 26 qualified audiologists (mean age 34 years ±6.34) recruited from a single hearing clinic in Perth, Western Australia.
RESULTS: There were no significant differences in hearing aid outcomes between participants who experienced clinician continuity and those who did not.
CONCLUSIONS: Within a controlled practice setting, hearing aid outcomes may not be adversely effected if services are provided by more than one clinician.

PMID: 27224042 [PubMed - as supplied by publisher]

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Book Review.

Book Review.

Int J Audiol. 2016 May 25;:1

Authors: Baguley DM, Fagelson M

PMID: 27223682 [PubMed - as supplied by publisher]

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Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity-modulated radiotherapy.

Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity-modulated radiotherapy.

Head Neck. 2016 May 25;

Authors: Parahyba CJ, Ynoe Moraes F, Ramos PA, Haddad CM, da Silva JL, Fregnani ER

Abstract
BACKGROUND: The purpose of this study was to evaluate the distribution of the intensity-modulated radiotherapy (IMRT) dose delivered to the teeth, maxilla, and mandible.
METHODS: The mean dose (Dmean) and maximum dose (Dmax) of radiation for the maxilla, mandible, and teeth of 63 patients with oropharyngeal (n = 44) or nasopharyngeal (n = 19) tumors were retrospectively evaluated.
RESULTS: The posterior regions of the mandible received the highest doses, and the teeth received lower doses than the bones (maximum dose, p < .001; average dose, p < .001). The Dmax (p < .001) and Dmean (p < .001) depended on primary tumor location. The superior bones and teeth of patients with nasopharyngeal tumors received more radiation than those of patients with oropharyngeal tumors.
CONCLUSION: A dose distribution map was generated based on the estimated doses received, which could allow prediction of the areas most affected by radiation and facilitate further correlations with dental complications after radiotherapy. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224929 [PubMed - as supplied by publisher]

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Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis.

Comparison between Focus Harmonic scalpel and other hemostatic techniques in open thyroidectomy: A systematic review and meta-analysis.

Head Neck. 2016 May 25;

Authors: Cannizzaro MA, Borzì L, Lo Bianco S, Okatyeva V, Cavallaro A, Buffone A

Abstract
BACKGROUND: The purpose of this review was to compare the efficacy and surgical outcomes of total thyroidectomy between the Focus Harmonic scalpel (Ethicon, Cincinnati, OH) and other hemostatic procedures.
METHODS: An extensive search was conducted using the PubMed and Cochrane databases from January 2008 to October 2014. Operating time, blood loss, pain, complications, and hospital stay were evaluated.
RESULTS: When compared with conventional techniques or LigaSure Precise Vessel Sealing System (Medtronic, Minneapolis, MN), the use of the Focus Harmonic scalpel reduced operative time by 22,428 minutes and blood loss by 13,914 mL. Length of hospital stay was significantly shorter in the Focus Harmonic scalpel group with a mean reduction of 0.410 days.
CONCLUSION: According to our meta-analysis, when comparing the Focus Harmonic scalpel versus conventional techniques, it seems evident that the use of this device in thyroid surgery is associated with a mean reduction in operating time, blood loss, and hospital stay, without any increase in pain and complications. There was no appreciable difference between the Focus Harmonic scalpel and the LigaSure Precise Vessel Sealing System. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224745 [PubMed - as supplied by publisher]

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Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment.

Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment.

Head Neck. 2016 May 25;

Authors: Hoeben A, van de Winkel L, Hoebers F, Kross K, Driessen C, Slootweg P, Tjan-Heijnen VC, van Herpen C

Abstract
BACKGROUND: Sinonasal intestinal-type adenocarcinomas (ITACs) are epithelial tumors of the nasal cavity and the paranasal sinuses, often related to professional exposure to organic dust, mainly wood or leather. It is a rare cancer. If resectable, surgery is the treatment of choice. Postoperative radiotherapy is often indicated to increase local control. Systemic treatment (chemotherapy, targeted agents, or immunotherapy) of irresectable ITACs and/or metastasized disease is less standardized.
METHODS: Articles on ITAC histopathology, molecular profile, and current treatment options of this specific tumor were identified and reviewed, using the electronic databases Pubmed, Medline, Cochrane, and Web of Science.
RESULTS: This article reviews what is currently known on the histopathology, tumorigenesis, molecular characteristics, and standardized treatment options of ITAC.
CONCLUSION: More translational research is needed to identify druggable targets that may lead to a personalized treatment plan in order to improve long-term outcome in patients with locally advanced and/or metastasized ITAC. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27224655 [PubMed - as supplied by publisher]

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Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model.

Evaluation of type II thyroplasty on phonatory physiology in an excised canine larynx model.

Laryngoscope. 2016 May 25;

Authors: Devine EE, Hoffman MR, McCulloch TM, Jiang JJ

Abstract
OBJECTIVES/HYPOTHESIS: Type II thyroplasty is an alternative treatment for spasmodic dysphonia, addressing hyperadduction by incising and lateralizing the thyroid cartilage. We quantified the effect of lateralization width on phonatory physiology using excised canine larynges.
METHODS: Normal closure, hyperadduction, and type II thyroplasty (lateralized up to 5 mm at 1-mm increments with hyperadducted arytenoids) were simulated in excised larynges (N = 7). Aerodynamic, acoustic, and videokymographic data were recorded at three subglottal pressures relative to phonation threshold pressure (PTP). One-way repeated measures analysis of variance assessed effect of condition on aerodynamic parameters. Random intercepts linear mixed effects models assessed effects of condition and subglottal pressure on acoustic and videokymographic parameters.
RESULTS: PTP differed across conditions (P < .001). Condition affected percent shimmer (P < .005) but not percent jitter. Both pressure (P < .03) and condition (P < .001) affected fundamental frequency. Pressure affected vibratory amplitude (P < .05) and intrafold phase difference (P < .05). Condition affected phase difference between the vocal folds (P < .001).
CONCLUSIONS: Hyperadduction increased PTP and worsened perturbation compared to normal, with near normal physiology restored with 1-mm lateralization. Further lateralization deteriorated voice quality and increased PTP. Acoustic and videokymographic results indicate that normal physiologic relationships between subglottal pressure and vibration are preserved at optimal lateralization width, but then degrade with further lateralization. The 1-mm optimal width observed here is due to the small canine larynx size. Future human trials would likely demonstrate a greater optimal width, with patient-specific value potentially determined based on larynx size and symptom severity.
LEVEL OF EVIDENCE: NA Laryngoscope, 2016.

PMID: 27223665 [PubMed - as supplied by publisher]

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Expression of the extracellular sulfatase SULF2 is associated with squamous cell carcinoma of the head and neck.

Expression of the extracellular sulfatase SULF2 is associated with squamous cell carcinoma of the head and neck.

Oncotarget. 2016 May 20;

Authors: Flowers SA, Zhou X, Wu J, Wang Y, Makambi K, Kallakury BV, Singer MS, Rosen SD, Davidson B, Goldman R

Abstract
Sulfatase 2 (SULF2), an extracellular sulfatase that alters sulfation on heparan sulfate proteoglycans, is involved in the tumorigenesis and progression of several carcinomas. SULF2 expression has not been evaluated in squamous cell carcinoma of the head and neck (HNSCC). Here we report results of IHC of SULF2 expression in HNSCC tissue. SULF2 was detected in 57% of tumors (n = 40) with a significant increase in intensity and number of stained cells compared to adjacent cancer-free tissue (p-value < 0.01), increasing with cancer stage when comparing stages 1 and 2 to stages 3 and 4 (p-value 0.01). SULF2 was not detected in epithelial cells of cancer-free controls, and expression was independent of patient demographics, tumor location and etiological factors, smoking and HPV infection by p16 IHC analysis. Sandwich ELISA was performed on serum of HNSCC patients (n = 28) and controls (n = 35), and although SULF2 was detectable, no change was observed in HNSCC. Saliva, collected by mouthwash, from HNSCC patients (n = 8) and controls (n = 8) was also tested by ELISA in a preliminary investigation and an increase in SULF2 was observed in HNSCC (p-value 0.041). Overall, this study shows that SULF2 is increased in HNSCC independent of tissue location (oral cavity, oropharynx, larynx and hypopharynx), patient demographics and etiology. Although no change in SULF2 was detected in HNSCC serum, its detection in saliva makes it worthy of further investigation as a potential HNSCC biomarker.

PMID: 27223083 [PubMed - as supplied by publisher]

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[Effective analysis of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal carcinoma].

[Effective analysis of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal carcinoma].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May 7;51(5):372-7

Authors: Yan F, Zhang XX, Ma L, Liu MB, Chen NX, Wang JL, Wu WM, Huang DL

Abstract
OBJECTIVE: To evaluate the therapeutic effects, larynx preservation and adverse events of non-surgical combined treatments for laryngeal organ preservation in locally advanced laryngeal squamous cell carcinomas(SCCs).
METHODS: Forty-six patients with locally advanced laryngeal carcinoma (T2-4, N0-N3) were treated individually with non-surgical combined treatments for larynx preservation (LP). These treatments included concurrent chemoradiotherapy (CCRT)(±epidermal growth factor receptor (EGFR) inhibitor), induction chemotherapy (ICT) followed by CCRT(± EGFR inhibitor), or concurrent radiotherapy and EGFR inhibitor. Radiation therapy was given to a total dose of 60-70 Gy. The Kaplan-Meier method was used to determine the overall survival. Side-effects were evaluated with the established Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 criteria.
RESULTS: The average follow-up time was 31.8 months (range 6-95 months). All patients completed the planned radiotherapy without treatment breaks, and 45(97.8%) of 46 patients completed the planned chemotherapy.The 3-year and 5-year overall survival rates were 87.3%and 67.2%, respectively.The 5-year larynx preservation rate was 100.0%. The 3-year and 5-year progression free survival rates were 95.1% and 87.7%, respectively. The most common acute side effect in grade 3 was oropharyngeal mucositis. After treatment, tracheotomy was still required in 2 patients with glottis cancer for laryngeal edema or stenosis. No patient depended on a percutaneous gastrostomy and experienced speech impairment.
CONCLUSION: Patients with locally advanced laryngeal cancer can be offered non-surgical combined treatments for laryngeal preservation and the high quality of life, showing a higher laryngeal preservation survival rate with minimal toxicities.

PMID: 27220298 [PubMed - in process]

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Discussion.

Related Articles

Discussion.

Surgery. 2016 Jan;159(1):63-4

Authors:

PMID: 26603843 [PubMed - indexed for MEDLINE]

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Editorial: Translaryngeal vocal cord ultrasound: Ready for prime time.

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Editorial: Translaryngeal vocal cord ultrasound: Ready for prime time.

Surgery. 2016 Jan;159(1):67-9

Authors: Parangi S

PMID: 26522697 [PubMed - indexed for MEDLINE]

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Editorial: Laryngeal evaluation for thyroid surgery: Back to the basics.

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Editorial: Laryngeal evaluation for thyroid surgery: Back to the basics.

Surgery. 2016 Jan;159(1):65-6

Authors: Shaha AR

PMID: 26453133 [PubMed - indexed for MEDLINE]

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Discussion.

Related Articles

Discussion.

Surgery. 2016 Jan;159(1):57

Authors:

PMID: 26422762 [PubMed - indexed for MEDLINE]

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Role of gradients in vocal fold elastic modulus on phonation.

Related Articles

Role of gradients in vocal fold elastic modulus on phonation.

J Biomech. 2015 Sep 18;48(12):3356-63

Authors: Bhattacharya P, Kelleher JE, Siegmund T

Abstract
New studies show that the elastic properties of the vocal folds (VFs) vary locally. In particular strong gradients exist in the distribution of elastic modulus along the length of the VF ligament, which is an important load-bearing constituent of the VF tissue. There is further evidence that changes in VF health are associated with alterations in modulus gradients. The role of VF modulus gradation on VF vibration and phonation remains unexplored. In this study the magnitude of the gradient in VF elastic modulus is varied, and sophisticated computational simulations are performed of the self-oscillation of three-dimensional VFs with realistic modeling of airflow physical properties. Results highlight that phonation frequency, characteristic modes of deformation and phase differences, glottal airflow rate, spectral-width of vocal output, and glottal jet dynamics are dependent on the magnitude of VF elastic modulus gradation. The results advance the understanding of how VF functional gradation can lead to perceptible changes in speech quality.

PMID: 26159059 [PubMed - indexed for MEDLINE]

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Arytenoid cartilage chondroma.

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Arytenoid cartilage chondroma.

Ear Nose Throat J. 2014 Aug;93(8):298

Authors: Portnoy JE, Sataloff JB, Hawkshaw MJ, Sataloff RT

PMID: 25181657 [PubMed - indexed for MEDLINE]

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[Analysis of predictors of malignancy of nodular goiters: about 500 cases].

[Analysis of predictors of malignancy of nodular goiters: about 500 cases].

Pan Afr Med J. 2016;23:88

Authors: Bouaity B, Darouassi Y, Chihani M, Touati MM, Ammar H

Abstract
Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only final histology provides certainty of diagnosis. Clinicians should base their clinical practice and patient management on a body of clinical arguments.

PMID: 27222685 [PubMed - in process]

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