Clinical medicine insights. Ear, nose and throat最新文献_第4页

Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil. 射频消融对舌扁桃体的靶向治疗。

Clinical medicine insights. Ear, nose and throat Pub Date : 2018-01-08 eCollection Date: 2018-01-01 DOI: 10.1177/1179550617749857

Suvi Renkonen, Antti A Mäkitie, Leif Bäck

{"title":"Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil.","authors":"Suvi Renkonen, Antti A Mäkitie, Leif Bäck","doi":"10.1177/1179550617749857","DOIUrl":"https://doi.org/10.1177/1179550617749857","url":null,"abstract":"Objectives: Benign enlargement of the lingual tonsils due to various causes may cause symptoms that warrant treatment. Conventional lingual tonsillectomy remains a challenging procedure, and there is no established standard procedure. We aimed to review the patients receiving different methods of lingual tonsil surgery for various indications at our institute.Methods: Retrospective clinical data on all patients with an ablative operation of the tongue base during the 8-year period between 2007 and 2014 at the Helsinki University Hospital, Helsinki, Finland, were reviewed. The larger cohort comprised 35 patients, of whom 26 were men (74%). Ten patients had undergone solely lingual tonsil radio frequency ablation (LTRFA). The minimum follow-up time for all patients was 2 years.Results: Of the 10 patients, 5 patients with LTRFA had been operated on because of symptomatic lingual tonsil hypertrophy and 5 because of periodic fever associated with possible lingual tonsil involvement. In 2 of the 5 patients with periodic fever, the fever cycles ended after the operation. Of the 5 patients, 3 patients with symptomatic lingual tonsil hypertrophy have been non-symptomatic after 1 to 3 treatment sessions. The last 2 patients continue to have persistent symptoms. There were no major complications.Conclusions: Development of new approaches for the management of various lingual tonsil conditions is warranted. Lingual tonsil volume reduction by LTRFA seems to be a treatment alternative with low morbidity but with limited curative effect only.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"11 ","pages":"1179550617749857"},"PeriodicalIF":0.0,"publicationDate":"2018-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617749857","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35745312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique. 全听骨置换术:一种新的脂肪介入技术。

Clinical medicine insights. Ear, nose and throat Pub Date : 2018-01-03 eCollection Date: 2018-01-01 DOI: 10.1177/1179550617749614

Issam Saliba, Valérie Sabbah, Jackie Bibeau Poirier

{"title":"Total Ossicular Replacement Prosthesis: A New Fat Interposition Technique.","authors":"Issam Saliba, Valérie Sabbah, Jackie Bibeau Poirier","doi":"10.1177/1179550617749614","DOIUrl":"https://doi.org/10.1177/1179550617749614","url":null,"abstract":"Objective: To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. Study design: This is a retrospective study. Methods: This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers. The new technique consists of interposing a fat graft between the 4 legs of the universal titanium prosthesis (Medtronic Xomed Inc, Jacksonville, FL, USA) to provide a more stable TORP in the ovale window niche. Normally, this prosthesis is designed to fit on the stapes’ head as a partial ossicular replacement prosthesis. Results: The postoperative air-bone gap less than 25 dB for the combined cohort was 69.2% and 41.7% for the TORP-F and the TORP-S groups, respectively. The mean follow-up was 17 months postoperatively. By stratifying data, the pediatric cohort shows 56.5% in the TORP-F group (n = 52) compared with 40% in the TORP-S group (n = 29). However, the adult cohort shows 79.3% in the TORP-F group (n = 52) compared with 43.75% in the TORP-S group (n = 25). These improvements in hearing were statistically significant. There were no statistically significant differences in the speech discrimination scores. The only undesirable outcome that was statistically different between the 2 groups was the prosthesis displacement: 7% in the TORP-F group compared with 19% in the TORP-S group (P = .03). Conclusions: The interposition of a fat graft between the legs of the titanium implants (TORP-F) provides superior hearing results compared with a standard procedure (TORP-S) in pediatric and adult populations because of its better stability in the oval window niche.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"11 ","pages":"1179550617749614"},"PeriodicalIF":0.0,"publicationDate":"2018-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617749614","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35729668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Effects of Minerva Orthosis on Larynx Height in Young, Healthy Volunteers. Minerva矫形器对年轻健康志愿者喉部高度的影响。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-12-15 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617746961

Pegah Saddat Hosseini, Mohammad Taghi Karimi, Saeideh Moayedfar, Marzieh Golabbakhsh, Fatemeh Abnavi

引用次数: 0

Lessons From Unilateral Loss of Cilia: Early Nasal Nitric Oxide Gas Mixing and the Role of Sinus Patency in Determining Nasal Nitric Oxide. 单侧纤毛缺失的教训:早期鼻一氧化氮气体混合和鼻窦通畅在测定鼻一氧化氮中的作用。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-12-13 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617746361

Kenneth Rodriguez, Benjamin Gaston, Jay Wasman, Nadzeya Marozkina

{"title":"Lessons From Unilateral Loss of Cilia: Early Nasal Nitric Oxide Gas Mixing and the Role of Sinus Patency in Determining Nasal Nitric Oxide.","authors":"Kenneth Rodriguez, Benjamin Gaston, Jay Wasman, Nadzeya Marozkina","doi":"10.1177/1179550617746361","DOIUrl":"https://doi.org/10.1177/1179550617746361","url":null,"abstract":"Nasal nitric oxide (nNO) measurement is a diagnostic test for primary ciliary dyskinesia (PCD). Here, we have shown the development of unilateral PCD-like symptoms associated with low nNO. A 60-year-old man had been previously healthy but developed unilateral, severe pansinusitis. He required surgical drainage of all left sinuses, and biopsies showed loss of the ciliated epithelium. At 4 weeks, he had unilateral (left-sided), profuse, clear rhinorrhea characteristic of PCD, and his surgical ostia were all patent endoscopically. His left-sided nNO was less than the right side by 37 ± 1.2 nL/min; this difference decreased to 18 ± 0.87 nL/min at 5 weeks and was gone by 6 weeks when his symptoms resolved. Measurements of 2- and 10-second measurements, in addition to standard nNO measurements, identified this discordance. We conclude that nNO reflects, in part, the production of NO by the ciliated epithelium, not just in the absence or occlusion of sinuses. Early (nasal/sinus volume) measures may be better for diagnosing PCD in than standard, steady-state assays in certain populations.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"10 ","pages":"1179550617746361"},"PeriodicalIF":0.0,"publicationDate":"2017-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617746361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35687181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Methamphetamine Use With Subsequent Thyrotoxicosis/Thyroid Storm, Agranulocytosis, and Modified Total Thyroidectomy: A Case Report. 甲基苯丙胺使用导致甲状腺毒症/甲状腺风暴、粒细胞缺乏症和改良全甲状腺切除术1例报告。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-11-17 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617741293

Omar Viswanath, Deanna C Menapace, Don B Headley

{"title":"Methamphetamine Use With Subsequent Thyrotoxicosis/Thyroid Storm, Agranulocytosis, and Modified Total Thyroidectomy: A Case Report.","authors":"Omar Viswanath, Deanna C Menapace, Don B Headley","doi":"10.1177/1179550617741293","DOIUrl":"https://doi.org/10.1177/1179550617741293","url":null,"abstract":"Thyroid storm is a rare, potentially lethal condition involving collapse of the hypothalamic-pituitary-thyroid feedback loop. Thyroid storm carries a significant mortality rate, thus requiring prompt identification and treatment. A 47-year-old woman presented to the emergency department complaining of palpitations, shortness of breath, and emesis for 24 hours after using methamphetamine. Past medical history was significant for untreated hyperthyroidism. Physical examination revealed a prominent, palpable thyroid. The Burch-Wartofsky-Score was 35. Management for thyroid storm included propylthiouracil (PTU), super saturated potassium iodide, intravenous hydrocortisone, and propranolol. However, a rare drug reaction to PTU on day 3 resulted in agranulocytosis. Propylthiouracil was withheld and a modified total thyroidectomy performed on day 8 without complications and the patient discharged on day 10 with levothyroxine. Undertreated hyperthyroidism may predispose patients to catecholamine-induced thyrotoxicosis due to catecholamine hypersensitivity. With known methamphetamine use, methamphetamine toxicity and a methamphetamine-exacerbated thyroid storm need to be included in the differential diagnosis in a patient presenting with signs of thyrotoxicosis. In addition, treating patients with agranulocytosis from PTU with a modified total thyroidectomy using ligation of the vascular supply as the initial surgical step limits release of thyroid hormone into the blood stream during thyroidectomy and decreases the possibility of intra operative thyroid storm.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"10 ","pages":"1179550617741293"},"PeriodicalIF":0.0,"publicationDate":"2017-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617741293","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35306122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Clinical Characteristics of Troublesome Pediatric Tinnitus. 难治性小儿耳鸣的临床特点。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-10-23 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617736521

Annett Szibor, Topi Jutila, Antti Mäkitie, Antti Aarnisalo

{"title":"Clinical Characteristics of Troublesome Pediatric Tinnitus.","authors":"Annett Szibor, Topi Jutila, Antti Mäkitie, Antti Aarnisalo","doi":"10.1177/1179550617736521","DOIUrl":"https://doi.org/10.1177/1179550617736521","url":null,"abstract":"Objectives: The frequency of tinnitus in children and adults is practically the same. However, although adults reveal their symptoms and seek for medical aid, the suffering often remains unrecognized in the young. This is due to both the inability of children to properly describe their symptoms and the lack of recognition.Materials and methods: Among 5768 patients entering our department with complaints of tinnitus between 2010 and 2015, there were only 112 children. A full clinical history and medical status had been determined at the time of presentation and were analyzed retrospectively.Results: The average duration from first complain to clinical presentation was approximately 12 months. A normal hearing capability of less than 25 dB was measured in 80% of the cases. Only 23 patients presented with a hearing impairment. The causes ranged from hearing loss, previous orthodontic treatment, noise trauma, middle ear aeration, muscular neck tension, and skull base fracture. Typical co-morbidities such as sleeping disorders, concentration disorders, and hyperacusis were observed.Conclusions: This retrospective study shows that recognition of tinnitus in the childhood is generally delayed. A better characterization of complaints and triggers, however, is a prerequisite to sensitize medical personnel and caretakers for the suffering and to avoid developmental impairments.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"10 ","pages":"1179550617736521"},"PeriodicalIF":0.0,"publicationDate":"2017-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617736521","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35581318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

A Case of a Very Elongated Styloid Process. 茎突极长一例。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-09-04 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617728899

YaLi Liu, Huaian Yang, Xiangguo Cui

引用次数: 1

Is Outpatient Thyroid Surgery for Everyone? 门诊甲状腺手术适合所有人吗?

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-08-08 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617724428

Dale Butler, Sarah Oltmann

引用次数: 14

Case Report: Recurrent Mucoepidermoid Carcinoma of the Tongue in Adult Female Patient With Lung Cancer. 病例报告:成年女性肺癌患者舌粘膜表皮样癌复发。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-07-13 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617720462

Arielle Rubin, John Davis, Karim Jreije, Henry Wu, Randy Oppenheimer

{"title":"Case Report: Recurrent Mucoepidermoid Carcinoma of the Tongue in Adult Female Patient With Lung Cancer.","authors":"Arielle Rubin, John Davis, Karim Jreije, Henry Wu, Randy Oppenheimer","doi":"10.1177/1179550617720462","DOIUrl":"https://doi.org/10.1177/1179550617720462","url":null,"abstract":"There is a steady rise in incidence of malignant salivary gland tumors in the United States, with mucoepidermoid carcinoma (MEC) the most frequent. Although 40% of MECs are found in the parotid gland, these lesions possess the capacity to develop anywhere along the aerodigestive tract. Here, we present a case of recurrent tongue MEC in a young adult female patient with history of lung malignancy and multiple brain metastases. Without a universally accepted management protocol for recurrent MECs, the current clinical practice uses tumor grade, location, and clinical progression to determine both prognosis and goals of care. The patient had transoral laser excision of the first MEC lesion in 2013. Her tongue MEC recurred 3 years later with 2 distinct lesions. One was discovered on physical examination and computed tomography and the other diagnosed intraoperatively 1 month later. These lesions were located on a previously unaffected portion of dorsal tongue base. These lesions were completely excised in the operating room. The patient currently remains on chemotherapy. This underscores the importance for developing a guideline that delineates the most efficacious surveillance and treatment plans for recurrent MECs.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"10 ","pages":"1179550617720462"},"PeriodicalIF":0.0,"publicationDate":"2017-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617720462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35365698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Yellow Nail Syndrome With Dramatic Improvement of Nail Manifestations After Endoscopic Sinus Surgery. 内窥镜鼻窦手术后指甲表现显著改善的黄指甲综合征。

Clinical medicine insights. Ear, nose and throat Pub Date : 2017-07-05 eCollection Date: 2017-01-01 DOI: 10.1177/1179550617718184

Yu Hosokawa, Akihito Kuboki, Aya Mori, Hiroaki Kanaya, Tsuguhisa Nakayama, Shinichi Haruna

{"title":"Yellow Nail Syndrome With Dramatic Improvement of Nail Manifestations After Endoscopic Sinus Surgery.","authors":"Yu Hosokawa, Akihito Kuboki, Aya Mori, Hiroaki Kanaya, Tsuguhisa Nakayama, Shinichi Haruna","doi":"10.1177/1179550617718184","DOIUrl":"https://doi.org/10.1177/1179550617718184","url":null,"abstract":"Objectives: Yellow nail syndrome (YNS) is a rare disease of unknown cause characterized by the triad of yellow nails, respiratory manifestations, and lymphedema. Although several therapies for YNS have been reported, there is no common consensus in the treatment. In this case report, we present a case of 56-year-old woman with YNS, whose nail manifestation was dramatically improved after endoscopic sinus surgery for the treatment of chronic rhinosinusitis.Methods: Endoscopic sinus surgery involving middle meatal antrostomy was performed for the case of YNS with chronic rhinosinusitis and bronchiectasis resistant to antibacterial drugs.Results: A month after the surgery, the patient's nails eventually showed dramatic improvement.Conclusions: Otorhinolaryngologists should recognize that chronic rhinosinusitis can be a symptom of YNS, and that the aggressive treatment including surgical approach for chronic rhinosinusitis may be a useful in the control of nail manifestation in YNS.","PeriodicalId":89906,"journal":{"name":"Clinical medicine insights. Ear, nose and throat","volume":"10 ","pages":"1179550617718184"},"PeriodicalIF":0.0,"publicationDate":"2017-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1179550617718184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35474634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4