Archives of otolaryngology--head & neck surgery最新文献

{"title":"Recurrence of laryngeal squamous cell carcinoma in patients undergoing organ preservation therapy: are there symptoms associated with recurrence?","authors":"S. Lisboa, D. A. Rocha, R. Mejia, A. Sasaki, M. Rosenfeld, L. Matos, D. Ramos, M. Kulcsar","doi":"10.4322/ahns.2019.0022","DOIUrl":"https://doi.org/10.4322/ahns.2019.0022","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 25 2019. Accepted: September 15, 2019. Study carried out at Instituto de Câncer do Estado de São Paulo – ICESP, Faculdade de Medicina (FM), Universidade de São Paulo (USP), São Paulo, SP, Brasil This study was presented at the XVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço 2019. Abstract Introduction: The larynx is a organ of the upper aerodigestive tract that plays an essential role in protecting the airways during swallowing. Squamous cell carcinoma is the most common malignant neoplasm affecting this region and early diagnosis has an important role in treatment outcome. Objectives: This study aims to evaluate whether patients with hypopharyngeal and/or laryngeal squamous cell carcinoma (SCC) who underwent organ preservation therapy (OPT) present at the time of relapse some factor that determines the local recurrence of the disease. Methods: Patients submitted to OPT were selected at the Cancer Institute of the State of São Paulo (ICESP), at the end of treatment, from January 2012 to December 2017. We collected retrospective data on demographics, clinical staging, location of the primary tumor, presence or absence of recurrence, weight and percentage of weight loss at different moments, alimentary pathway and symptomatology at the time of relapse. Results: The absence of symptoms was associated with the absence of relapse (p <0.001). Fully oral diet at the last visit was a significant factor for the absence of relapse (p = 0.005). The weight comparison of all the patients before the beginning of OPT and after the end of the treatment, showed an average drop of 3.4 kg. In the group-separated analysis, patients who did not recur showed an average loss of 0.7%. Patients with relapse, showed a loss of 2.0% of the weight at the time of relapse. Conclusion: Weight loss and the presence of symptoms were important predictors of recurrence with statistical significance. These factors may help to better manage these patients, with earlier investigations and, therefore, the possibility of rescue treatments with a shorter duration.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82993144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid-artery cochlear dehiscence","authors":"V. Galli, Renata Victória Tassara, Marcelo Sousa, M. C. M. D. Castro, O. Cruz","doi":"10.4322/ahns.2019.0021","DOIUrl":"https://doi.org/10.4322/ahns.2019.0021","url":null,"abstract":"Changes in course of the internal carotid artery (ICA) are uncommon, and dehiscence of the carotid canal with cochlea may occur. A 48-year-old female individual with pulsatile tinnitus. No other otologic symptoms observed. Otolaryngologic examination and audiometric test with normal results. Computed tomography (CT) scan of the mastoid bones showed dehiscence of cochlea with ICA on the right side. An option for monitored observation was made after analysis of the risks and undefined results of surgery. Patient maintained clinical and audiometric profile. Carotid-artery cochlear dehiscence is a condition that must be known, remembered and investigated, because it may mimic other otologic pathologies. Knowledge about it prevents serious complications that can be difficult to reverse.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74381918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cicatricial pemphigoid with laryngeal involvement","authors":"C. Silva, Anna Caroline Rodrigues de Souza Matos, Ana Carla Albuquerque dos Santos, Teresa Nogueira, Viviane Carvalho da Silva","doi":"10.4322/ahns.2019.0028","DOIUrl":"https://doi.org/10.4322/ahns.2019.0028","url":null,"abstract":"Cicatricial pemphigoid is an uncommon chronic autoimmune inflammatory disease that affects predominantly the mucous membranes. The precise cause of this condition is yet to be fully identified, as well as the mechanism behind the commonly observed subepithelial blistering. This manuscript reports a case of cicatricial pemphigoid with laryngeal involvement, which is a rare manifestation of this also uncommon disease. The patient underwent surgery and specimens were submitted to histopathological examination and immunofluorescence assays, and both ultimately indicated cicatricial","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75190258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous mucoepidermoid carcinoma","authors":"Ana L V Pequeno, Jônatas Catunda de Freitas, M. Fernandes, Ana Carla Albuquerque dos Santos, Wellington Alves Filho","doi":"10.4322/ahns.2019.0008","DOIUrl":"https://doi.org/10.4322/ahns.2019.0008","url":null,"abstract":"Mucoepidermoid carcinoma (MEC) is a common malignant tumor composed of mucinous cells, clear cells and squamoid tumor cells. It is usually localized on the salivary glands, however can very rarely be intraosseous. This tumor affects women more than men and is more common in the mandible. In this report, we present a case of a 45-year-old woman with a painless intraoral mass for 10 years which was repeatedly misdiagnosed, evolving into an extensive lesion. After an appropriate approach, she was diagnosed with MEC of the mandible and submitted to a left hemimandibulectomy accompanied by microsurgical reconstruction with excellent results.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77874136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of survival and factors associated with oral cancer","authors":"Thiago Demétrio Nogueira Costa e Silva, Emidiana Raquel Rodrigues de Souza Oliveira, Sheila Maria da Conceição Costa, Cláudia Isabel Silva Carlos","doi":"10.4322/ahns.2019.0007","DOIUrl":"https://doi.org/10.4322/ahns.2019.0007","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 18, 2018. Accepted: February 21, 2019. The study was carried out at Liga Mossoroense de Estudos e Combate ao Câncer (LMECC), Mossoró, RN, Brasil. Abstract Introduction: Oral cancer accounts for 5.2% of all malignancies in men in Brazil, and is considered the most common cancer of the head and neck (H&N) region, excluding skin cancer. Despite the diagnostic and therapeutic advances in the oncology area, disease-free survival is still low. Objective: To describe and analyze patient survival and the factors associated with oral cancer. Methods: A retrospective, observational study was conducted through analysis of the medical charts of H&N cancer patients assisted at the Mossoro League of Cancer Research and Combat (LMECC) from 2006 to 2015. The data were analyzed by exploratory descriptive statistics. Survival was described using the Kaplan-Meier method. Results: There was predominance of men (59.7%), with a mean age of 65 years, Caucasians (56.6%), farmers (52.0%) from Mossoró (RN), Brazil (66.7%), and smokers (88.4%). In the majority of cases, tumor occurred in the tongue (52.6%), at an advanced stage (73.6%), and was first treated predominantly with surgery (69.6%). Mean survival time of the patients was 2524 days, and was lower in patients with lymph node metastasis and in those submitted to nonsurgical treatment. Mortality rate was 45.5%. Conclusion: The high rates of mortality and advanced stage patients indicate late diagnosis, which reflects the need for preventive actions, training of health professionals, and improved access to the health system.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86830014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic hypoparathyroidism after thyroid surgery: Benefits of specialized and personalized care in a tertiary public hospital","authors":"M. Tavares, F. Vanderlei, M. Teixeira, D. A. Rocha, S. Serrano, Luis Felipe de Barros Ura, R. Moyses","doi":"10.4322/ahns.2019.0017","DOIUrl":"https://doi.org/10.4322/ahns.2019.0017","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 24, 2019. Accepted: October 01, 2019. The study was carried out at Serviço de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brasil. Article presented at the XXVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, in August 2019 Abstract Introduction: As the number of thyroid operations increases, the incidence of complications also increases, including transitory and definite hypoparathyroidism. Since each patient presents different and unpredictable symptoms, affecting several organs and systems, they need personalized care. Even when patients presented with low calcium blood levels, the previous results were considered acceptable, usually using oral prescriptions of calcium carbonate and calcitriol. We created in March 2017 a specialized outpatient treatment facility for those patients focused on generating experience and knowledge about hypoparathyroidism. Objective: To analyze the challenges and the impact of specialized care in diagnosis, treatment and in follow-up of patients with postoperative hypoparathyroidism, with potential to improve teaching and further research possibilities in the subject. Methods: 61 patients were studied: 55 women, age 18-55. A retrospective study was performed, considering specialized guidelines. We also analyzed blood levels of calcium, parathyroid hormone, vitamin D, and other minerals; kidney function; bone structure. Results: Some patients needed drug dose adjustments up to 66%. We were able to identify kidney structural and functional changes. We could share those experiences in a multidisciplinary way, contributing significantly to provide more experience to the medical residents. Conclusion: Specialized outpatient treatment is responsible for providing more efficient and safe treatment to the patients, and it is also important to enable further medical research.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79592020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myxofibrosarcoma of the thyroid gland","authors":"Maria da Graça Caminha Vidal, O. Cervantes, M. F. Daubermann, Fernando Cogo Manduca, Aloysio Enck Neto","doi":"10.4322/ahns.2019.0027","DOIUrl":"https://doi.org/10.4322/ahns.2019.0027","url":null,"abstract":"Introduction: Thyroid cancer is the most common endocrine cancer, corresponding to 1% of all malignancies in the 30-74 age group. Cases of primary thyroid sarcomas are rare in the literature. They tend to present an unfavorable clinical course. Case report: Female patient, 66 years old, presented a visible neck mass with progressive growth for 2 years ago, reporting dysphagia for solids. Presence of exophytic nodular growth in the left lobe was evidenced through the examinations, and classified as Bethesda I through fine needle aspiration biopsy (FNAP). Total thyroidectomy revealed a low-grade myxofibrosarcoma (MFS). Discussion: MFS presents higher incidence in the elderly. Diagnosed by histopathological examination, evaluation through magnetic resonance imaging (MRI) is necessary in order to analyze the surgical resection plans with tumor-free margins. As MFS presents rare occurrence in the thyroid gland and a high local recurrence rate, adjuvant radiotherapy can be considered as a form of recurrence control.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73574637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroglossal cyst: Brazilian panorama","authors":"R. V. T. Filho","doi":"10.4322/ahns.2019.0023","DOIUrl":"https://doi.org/10.4322/ahns.2019.0023","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 30, 2019. Accepted: November 17, 2019. The study was carried out at Faculdade de Medicina, Departamento de Cirurgia, Universidade Federal de Goiás (UFG), Goiânia, GO, Brasil. Abstract Introduction: Thyroglossal duct cyst (TDC) is the most commonly found cervical congenital mass, occurring in approximately 7% of the population; however, data on TDC in Brazil are scarce. Objective: To outline the Brazilian scenario in the treatment of TDC and review the literature on this theme. Methods: Retrospective epidemiological study with a descriptive approach using secondary data collected from the SIH/DataSUS (Sistema de Internações Hospitalares/Sistema Nacional de Informação em Saúde) between 2008 and 2018, along with an analysis of the revisions on TDC published over the past ten years. Results: Between 2008 and 2018, there were 23,602 hospital admissions for TDC excision, with an average of 2,145 procedures per year, resulting in an average of 11.85 procedures per 100,000 inhabitants in the period evaluated. Admissions occurred predominantly in the Southeast and Northeast regions, at an average cost of BRL 1,054,977.66 per year to the health system of the country. The literature search resulted in 52 review articles addressing the pathogenesis, diagnosis and management of TDC, which are explained in this study. Conclusion: TDC is a congenital entity predominantly treated in the country at relevant costs to the health system, demanding accuracy on the knowledge of its pathogenesis for better diagnosis and management of patients with this condition.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86542565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of contralateral cervical metastasis in laryngeal tumors","authors":"A. Gatti, J. Pacheco, N. Ahumada, C. Lehn, F. Walder","doi":"10.4322/ahns.2019.0004","DOIUrl":"https://doi.org/10.4322/ahns.2019.0004","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 02, 2019. Accepted: February 09, 2019. The study was carried out at Otorhinolaryngology and Head and Neck Surgery Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço UNIFESP, São Paulo, SP, Brasil. Abstract Introduction: Through the knowledge of the metastatic pathways of the Squamous Cell Carcinoma (SCC) of the larynx, the lymph node level with a higher probability of involvement can be predicted. The surgeon uses this knowledge to determine the extension of neck dissection to perform. However, the longer the surgery, the greater the morbidity for the patient. When the metastatic risk is >20%, neck dissection of that cervical level is necessary. In cases of clinically evident (cN+) metastasis, uni or bilaterally, comprehensive neck dissection is determinant for the treatment, however there is no consensus about neck dissection for contralateral clinically negative neck (cN-). Objective: To evaluate if patients with laryngeal SCC homolateral cN+ and contralateral cNshould be submitted to bilateral neck dissection. Methods: The team reviewed medical records from 135 patients with a diagnosis of laryngeal malignancy between March/2009 and September/2017, analyzing gender, age, tobacco and alcohol comsumption, primary tumor site, neck dissection laterality, clinical and pathological contralaterality, staging, tumor recurrence or late metastasis and survival Results: We observed that 40.74% were pN+ on at least one side after neck dissection, which 87.27% performed bilateral neck dissection. Of these, 66.67% did not have contralateral metastasis, 87.5% had no previously clinically evident metastasis. Conclusion: Patients contralateral cNhave a risk <20% for occult metastasis and should not routinely go through bilateral neck dissection.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84741717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome of subtotal parathyroidectomy for surgical treatment of hyperparathyroidism after renal transplantation","authors":"M. Neves, Ana Beatriz Ribeiro Fonseca, Camila Y. Koike, Davi Knoll Ribeiro, M. Lera, R. Santos","doi":"10.4322/ahns.2019.0024","DOIUrl":"https://doi.org/10.4322/ahns.2019.0024","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 06, 2019. Accepted: November 17, 2019. The study was carried out at Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil. This study was presented at the Congresso Brasileiro de Cirurgia de Cabeça e Pescoço – August 2019 Gramado, RS. Abstract Introduction: Parathyroidectomy (PTX) is one of the forms to treat hyperparathyroidism (HPT) after renal transplantation (RT), but choosing the appropriate surgical technique is controversial. The option for more conservative surgeries, such as subtotal parathyroidectomy (STPX), has been expanding owing to the lower risk of definitive HPT and its effectiveness in controlling hypercalcemia. Objective: To evaluate the efficacy of STPX as a definitive treatment for hyperparathyroidism after renal transplantation (HPTRT) and determine whether there is a relationship between percentage intraoperative parathyroid hormone (ioPTH) decay levels and parathyroid hormone (PTH) values on the first postoperative day and surgical success. Methods: This retrospective study analyzed the medical records of prospectively followed patients diagnosed with HPT-RT submitted to STPX in two tertiary hospitals (Brazilian Unified Health System SUS) for two years. Patients were allocated in two groups according to operative success (SG normalization of ionized calcium (iCa) and PTH six months after surgery) or operative failure (FG persistence of high iCa and PTH). The percentage ioPTH decay levels and the postoperative PTH absolute values on the first postoperative day were evaluated in both groups. Results: Of the total sample of 31 patients, surgical treatment was successful in 27 cases (87%). No statistically significant differences were observed between the groups for the percentage ioPTH decay levels (SG = 71.51% vs. FG = 70.4%), as well as for the PTH absolute values on the first postoperative day (SG = 52.69pg/ mL vs. FG = 54.55pg/mL). Conclusion: Subtotal parathyroidectomy is an effective and safe procedure for treating HPT-RT; however, the use of PTH levels remains subjective and cannot be considered as a predictor of surgical success.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80559906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}