Migraine induced recurrent bloody otorrhea: A spontaneous extra-cranial hemorrhagic phenomena: Case series

xlomafota13 shared this article with you from Inoreader Migraine induced recurrent bloody otorrhea: A spontaneous extra-cranial hemorrhagic phenomena: Case series Via American Journal of Otolaryngology Publication date: January–February 2022 Source: American Journal of Otolaryngology, Volume 43, Issue 1 Author(s): Mashudu Tshifularo View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical outcomes of 34 patients with resistance to thyroid hormone beta: a twenty-year experience in Japan

xlomafota13 shared this article with you from Inoreader Clinical outcomes of 34 patients with resistance to thyroid hormone beta: a twenty-year experience in Japan Via radioactive iodine Endocr J. 2021 Sep 22. doi: 10.1507/endocrj.EJ21-0390. Online ahead of print. ABSTRACT Resistance to thyroid hormone beta (RTHβ) caused by germline mutations in genes encoding thyroid hormone receptor beta (TRβ) is a rare disorder. Little information is available regarding the clinical experience of this syndrome in Japan. We retrospectively reviewed the records of 34 patients with RTHβ (21 adult females and 13 adult males) with positive TRβ mutations identified at our division between 2000 and 2020. Of the 24 patients with available clinical history, 10 (41.7%) received inappropriate treatments such as antithyroid drugs, thyroidectomy, or radioactive iodine. Diagnostic delay and inappropriate management of RTHβ are still present in Japan. Every patient except one demonstrated thyroid hormone profiles indicative of syndrome of inappropriate secretion of thyrotropin (SITSH), characterized by a hormonal profile of hyperthyroxinemia with a non-suppressed TSH concentration. Since the most common forms of hyperthyroidism including Graves' disease feature elevated thyroid hormone levels with suppressed TSH concentrations, early diagnosis of SITSH is critical for preventing inappropriate management. One patient positive for anti-thyroglobulin antibody (Tg-Ab) and anti-thyroperoxidase antibody (TPO-Ab) showed remarkably elevated TSH (>200 μIU/mL) despite thyroid hormone concentrations within the reference ranges. At least one thyroid autoantibody (Tg-Ab, TPO -Ab, or thyrotropin receptor antibodies) was identified in 37.9% (11/29) of the patients tested. One patient developed overt Graves' disease nine years after ‍RTHβ diagnosis. These findings suggest that RTHβ is frequently comorbid with additional autoimmune thyroid disorders. ‍Further research is required to identify the most appropriate treatments for RTHβ patients who develop a second thyroid ‍disorder. PMID:34556608 | DOI:10.1507/endocrj.EJ21-0390 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis Via ear nose throat Ear Nose Throat J. 2021 Sep 23:1455613211044224. doi: 10.1177/01455613211044224. Online ahead of print. ABSTRACT Objective: To evaluate the clinical efficacy of topical nasal Pomegranate Fruit Extract (PFE) for Chronic Rhinitis (CR), Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP), and Chronic Rhinosinusitis without Nasal Polyposis (CRSsNP). Methods: Prospective, double-blinded, randomized study including 111 consecutive patients, between April 2012 and Ja nuary 2017, afflicted by CRSwNP, CRSsNP, and CR. Patients from each group were randomly assigned to either PFE treatment or placebo twice daily for 30 days. Therapeutic efficacy was assessed by Ear Nose and Throat, blood and tomographic examinations, and the SNOT-20 questionnaire. Results: CR patients treated with PFE suffered significantly less from thick nasal discharge, difficulty falling asleep, reduced productivity, reduced concentration, and sadness (P = .004, P = .02, P = .03, P = .007 and P = .02, respectively). Conclusions: Topical nasal PFE was found to have some benefits for CR patients, however, not for CRS with or without Nasal Polyposis. PMID:34555945 | DOI:10.1177/01455613211044224 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prophylactic mastectomy and occult cancer: a ten-year experience at a cancer center

xlomafota13 shared this article with you from Inoreader Prophylactic mastectomy and occult cancer: a ten-year experience at a cancer center Via Association française pour l'étude du cancer Bull Cancer. 2021 Sep 20:S0007-4551(21)00298-8. doi: 10.1016/j.bulcan.2021.05.007. Online ahead of print. ABSTRACT INTRODUCTION: Women identified as high-risk for breast cancer may choose between close follow-up and radical mastectomy. Prophylactic mastectomy, as any other surgery, is associated with benefits and harms. The aim of this study was to assess the morbidity associated with prophylactic mastectomy and to evaluate the prevalence of occult cancers. METHODS: All patients who underwent unilateral or bilateral prophylactic mastectomy between 2007 and 2017 in our institution were eligible for inclusion in this retrospective study. Medical history, type of surgery, occurrence of complication or reoperation and pathological reports were examined in medical charts. RESULTS: 79 women underwent prophylactic mastectomy over the studied period of which 58.2% were contralateral after breast cancer. A genetic mutation was prese nt in 86.1% of cases. Postoperative complications occurred in 43.0% of cases. An additional surgery for medical or esthetic purpose was needed in 72.1% of cases. Occult cancer was found in 11.4% of the pathological reports. Triple negative invasive ductal carcinoma was discovered in two cases (2.5%). DISCUSSION: Prophylactic mastectomy is the only effective preventive action against breast cancer. Women must be clearly informed of possible complications, high reoperation rate and potential pathological findings. Identifying women most at risk for breast cancer would help to better target those who will benefit most from surgery. PMID:34556291 | DOI:10.1016/j.bulcan.2021.05.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical de-escalation for head and neck cancer surgery

xlomafota13 shared this article with you from Inoreader Surgical de-escalation for head and neck cancer surgery Via Association française pour l'étude du cancer Bull Cancer. 2021 Sep 20:S0007-4551(21)00302-7. doi: 10.1016/j.bulcan.2021.06.008. Online ahead of print. ABSTRACT Head and neck cancer surgery often has functional and aesthetic consequences. De-escalation surgery is a major concern for surgeons with a constant desire to develop surgical techniques with less invasive approaches and to preserve anatomical structures as much as possible. This was made possible by the appearance of minimally transoral and endonasal surgery as well as by the limitation of the surgical procedure by neoadjuvant treatments or by the limitation of surgical excision without compromising the oncological outcome and patient survival. This evolution continues with the arrival of new technologies such as virtual reality or artificial intelligence. PMID:34556292 | DOI:10.1016/j.bulcan.2021.06.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rupture of a superficial temporal artery pseudoaneurysm following craniotomy

xlomafota13 shared this article with you from Inoreader Rupture of a superficial temporal artery pseudoaneurysm following craniotomy Via leak of cerebrospinal fluid J Surg Case Rep. 2021 Sep 8;2021(9):rjab379. doi: 10.1093/jscr/rjab379. eCollection 2021 Sep. ABSTRACT Pseudoaneurysm of the superficial temporal artery (STA) is a rare entity that has been reported in the literature after trauma or iatrogenic injuries. We describe a unique case of STA pseudoaneurysm rupture and the clinical sequelae associated with its rupture. We report a case of pseudoaneurysm rupture of the STA that occurred 14 days after craniotomy for cerebrospinal fluid leak repair. We also review the literature, diagnosis and treatment of external carotid artery aneurysms. Rupture of a STA pseudoaneurysm is a previously unreported and serious complication that must be quickly recognized in order to control hemorrhage that may have life threatening complications. PMID:34557290 | PMC:PMC8453294 | DOI:10.1093/jscr/rjab379 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporal fluctuations of post-tonsillectomy haemorrhage

xlomafota13 shared this article with you from Inoreader Temporal fluctuations of post-tonsillectomy haemorrhage Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 23. doi: 10.1007/s00405-021-07080-1. Online ahead of print. ABSTRACT PURPOSE: Although haemorrhage is a common and in some cases life-threatening complication after tonsillectomy, surprisingly little is known about the temporal fluctuations of the onset of bleeding. The purpose of this study was to assess circadian and seasonal rhythms of post-tonsillectomy haemorrhage (PTH) and potential ramifications to educate patients and health care staff. METHODS: This retrospective study carried out at a tertiary referral hospital included paediatric and adult patients requiring emergency surgery due to severe PTH between 1993 and 2019. Medical records were reviewed and patient demographics, details regarding the initial procedure, postoperative day of haemorrhage, and start time of emergency surgery were extracted. Descriptive statistics, Kruskal-Wallis test, Mann-Whitney U test, and Chi-square goodness of fit tests were used to detect potential differences. RESULTS: A total of 300 patients with severe PTH and subsequent emergency surgery were identified. The median postoperative duration until PTH was 6 (range: < 1-19) days. 64.7% (n = 194) of all emergency surgeries had to be performed during evening and night hours (6 pm-6 am) (p < 0.0001). Compared to diurnal incidents, the risk of a nocturnal PTH event increased, the longer ago the initial surgery was (p < 0.0001). No seasonal variations were identified. Age, sex, and details of the initial procedure had no significant influence on the start time according to the surgical protocol. CONCLUSION: The discovered temporal fluctuations of PTH are of relevance for patient awareness and preoperative education. Due to possible life-threatening complications, management of severe PTH requires specific resources and trained medical staff on call. PMID:34557959 | DOI:10.1007/s00405-021-07080-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study

xlomafota13 shared this article with you from Inoreader Surgical management and oncological outcome of non-squamous cell carcinoma of the larynx: a bicentric study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 24. doi: 10.1007/s00405-021-07076-x. Online ahead of print. ABSTRACT PURPOSE: Non-squamous cell carcinoma (non-SCC) accounts for about 5% of laryngeal malignancies. Survival data are limited, and consensus on management principles is lacking. The present study reviews our experience in the surgical treatment of non-metastatic non-SCC of the larynx and compares oncological and functional outcomes in a cohort of patients affected by traditional SCC. METHODS: We collected data on 592 patients affected by laryngeal neoplasms. Univariate and multivariable survival analyses were performed using Cox proportional-hazards models; survival estimates were reported by hazard ratios (HR) with 95% confidence intervals (CI), and survival curves were established with the Kaplan-Meier method. RESULTS: We identified 326 patients affected by untreated SCC, while 21 had non-SCC histotypes. The non-SCC cohort was composed of 5 soft tissue sarcomas, 8 chondrosarcomas, 2 adenoid cystic carcinomas, 2 neuroendocrine carcinomas, 2 solitary fibrous tumors, 1 Kaposi's sarcoma, and 1 malignant peripheral nerve sheath tumor. Overall survival and disease-specific survival were not significantly different according to histology (p = 0.6 and p = 0.349, respectively). The non-SCC group showed an increased risk of recurrence (HR 5.87; CI95 2.15-16.06; p < 0.001). Nonetheless, no significant difference (p = 0.31) was found at multivariable analysis between the two groups in total laryngectomy-free survival with an organ preservation rate over 5 years of 81% for the non-SCC histologies. CONCLUSION: Non-SCC is a broad spectrum pathology, but generalized laryngeal surgical management principles are still feasible and it is possible to identify patients amenable to conservative surgical treatment without affecting survival. PMID:34557960 | DOI:10.1007/s00405-021-07076-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parapharyngeal Lymph Node Metastasis From Papillary Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Parapharyngeal Lymph Node Metastasis From Papillary Thyroid Carcinoma Via ear nose throat Ear Nose Throat J. 2021 Sep 24:1455613211045566. doi: 10.1177/01455613211045566. Online ahead of print. ABSTRACT Metastatic parapharyngeal lymph nodes (LNs) from papillary thyroid carcinomas (PTC) are uncommon and can easily remain undetected. We describe a case that involves a 62-year-old woman treated for a PTC, who presented a rise in serum thyroglobulin (TG) levels. A computed tomography scan was performed, and revealed metastatic nodes in the left parapharyngeal space (P PS). A surgical resection of the nodes was performed with external cervical approach. A histological exam confirmed the diagnosis of a metastatic LN of a PTC. The aim of this report is to emphasize on the possibility of parapharyngeal metastatic nodes in PTC and to describe the diagnosis methods, treatment options, and impact on the prognosis. PMID:34558348 | DOI:10.1177/01455613211045566 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Gland Metastasis From Endometrial Carcinoma Causing Acute Severe Dyspnea

xlomafota13 shared this article with you from Inoreader Thyroid Gland Metastasis From Endometrial Carcinoma Causing Acute Severe Dyspnea Via ear nose throat Ear Nose Throat J. 2021 Sep 24:1455613211045564. doi: 10.1177/01455613211045564. Online ahead of print. ABSTRACT Thyroid metastasis from cervical carcinomas is an extremely rare disease; therefore, only a few cases have so far been reported in the literature. Due to the lack of data and the heterogeneity of clinical cases, the percentage of patients affected by thyroid metastases eligible to undergo surgery is not easily predictable. This report describes a rare case of endo metrioid adenocarcinoma metastasized to the thyroid gland. A 72-year-old woman was referred to the ENT department of our hospital (Ospedale Degli Infermi di Biella, Italy) presenting with dyspnea and rapidly worsening condition, in need of emergency surgery. The peculiarity of this case lies in the metastasis isotype rarity, in its voluminous dimension, and in its mediastinal localization, which required the intervention of a multidisciplinary team to establish successful treatment planning. PMID:34558343 | DOI:10.1177/01455613211045564 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Transcanal Endoscopic Approach for Management of Pulsatile Tinnitus due to High-Riding Dehiscent Jugular Bulb

xlomafota13 shared this article with you from Inoreader A Transcanal Endoscopic Approach for Management of Pulsatile Tinnitus due to High-Riding Dehiscent Jugular Bulb Via ear nose throat Ear Nose Throat J. 2021 Sep 24:1455613211043683. doi: 10.1177/01455613211043683. Online ahead of print. ABSTRACT Pulsatile tinnitus (PT) caused by a high-riding dehiscence jugular bulb (HDJB) is a rare but treatable otology disease. There are several managements include transcatheter endovascular coil embolization, transvenous stent-assisted coil embolization, or resurfacing the dehiscent bony wall of high jugular bulb under the use of microscope. Among those options, surgic al resurfacing of HDJB might be an effective and safe choice with less destruction. However, previous studies approached middle ear cavity via microscope can only provide a lateral, indirect view, while resurfacing the vessel through a transcanal endoscopic ear surgery (TEES) approach may give surgeon a direct and easy way to manage HDJB. In this report, we presented a case of 40-year-old woman with HDJB and shared our clinical consideration and reasoning of the surgical management of PT via a transtympanic approach by TEES rather than a transmastoid approach. PMID:34558341 | DOI:10.1177/01455613211043683 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.