SARS-CoV-2 vaccine-induced subacute thyroiditis

xlomafota13 shared this article with you from Inoreader SARS-CoV-2 vaccine-induced subacute thyroiditis Via American Journal of Otolaryngology Publication date: Available online 9 September 2021 Source: American Journal of Otolaryngology Author(s): Krupa R. Patel, Mary E. Cunnane, Daniel G. Deschler View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Submental Flap in the Reconstruction of Palatal Defects

xlomafota13 shared this article with you from Inoreader Submental Flap in the Reconstruction of Palatal Defects Via Otolaryngology Indian Abstract Amongst oral cancers, malignancies of the palate and the upper gingivo-buccal complex are relatively uncommon. Following resection, defects in the palate lead to a nasal speech and nasal regurgitation on swallowing. This is best overcome with a prosthetic obturator which occludes the palatal defect and has dentures for the upper alveolus. It may not be possible to fit a prosthetic obturator in edentulous patients and in patients with trismus. Microvascular free flaps though commonly used for such defects, are time consuming, expensive and require a specialised setup. This study assesses the submental flap for its feasibility to repair palatal defects, the sturdiness of the flap, its functional outcome and the oncological safety in using the flap. This is a retrospective analysis of 46 patients, where palatal defects for oral cancers were reconstructed with the submental flap. Oncological safety was studied in 41 patients with a median follow-up of 34.5 month s. 20 patients were studied for their functional outcomes using the parameters, adopted from the University of Washington-Quality of Life questionnaire. Complete flap loss was seen in 4 (8.7%) patients while 2 (4.35%) patients had minor dehiscence. No donor site morbidity was reported. Locoregional Recurrences and distant metastasis were noted in 13 of the 41 patients studied. The mean score was highest for speech at 95.5% while the lowest mean score was for mouth opening at 42.5%. The submental flap is an effective and reliable alternative for the reconstruction of palatal defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent Giant Mucoepidermoid Carcinoma of the Parotid: A Case Report and Review of Literature

xlomafota13 shared this article with you from Inoreader Recurrent Giant Mucoepidermoid Carcinoma of the Parotid: A Case Report and Review of Literature Via Otolaryngology Indian Abstract Mucoepidermoid carcinoma is the most common salivary gland malignancy and about one third occurs in the parotid gland. The peak incidence is commonly seen between the third and fifth decades of life. It routinely presents as a fixed, painless mass below the ear. However, its presentation as a giant mass is exceedingly rare. Here, we report a case of a recurrent giant exophytic mucoepidermoid carcinoma in a young male. He underwent Revision Total Parotidectomy with Modified Radical neck dissection with Sural nerve grafting and an Anterolateral thigh flap reconstruction followed by Adjuvant radiotherapy. The rarity of the clinical presentation and the management challenges faced in a young male are being discussed in this case report. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study

xlomafota13 shared this article with you from Inoreader Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 8:34894211045269. doi: 10.1177/00034894211045269. Online ahead of print. ABSTRACT OBJECTIVES: Close margin is a frequent situation after parotidectomy. The need for systematic prophylactic revision surgery is a question that arises regularly for malignant tumors, as it exposes to a high risk of facial palsy, while oncological benefits are unclear. STUDY DESIGN: retrospective study. SETTING: Multicentric. SUBJECTS AND METHO DS: We included all patients operated for systematic revision surgery in case of close margins after parotidectomy for a malignant tumor and analyzed the rate of tumor residue and its risk factors. RESULTS: A tumor residue was identified in 43.5% of 23 cases, but none in case of initial complete excision with supra-millimetric margins. Invaded lymph nodes were identified in 6 cases, but none in case of low-grade tumors. CONCLUSIONS: Systematic revision seems mandatory in case of infra-millimetric margins and high-grade tumors or positive lymph node; further studies are needed to confirm whether it can be spared for T1-T2/N0 low-grade tumors, with close margins but complete initial excision. PMID:34496666 | DOI:10.1177/00034894211045269 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neck Mass in an Adolescent

xlomafota13 shared this article with you from Inoreader Message: Neck Mass in an Adolescent Saikrishna C. Gourishetti, MD1; Jamie Hittman, MD2; Kevin D. Pereira, MD, MS1,3 Author Affiliations 1Department of Otorhinolaryngology–Head and Neck Surgery, University of Maryland School of Medicine, Baltimore 2Department of Pathology, University of Maryland School of Medicine, Baltimore 3Department of Pediatrics, University of Maryland School of Medicine, Baltimore JAMA Otolaryngol Head Neck Surg. Published online September 9, 2021. doi:10.1001/jamaoto.2021.2314 Full Text A 13-year-old male presented to the pediatric otolaryngology clinic with a 2-year history of a right neck mass that had slowly increased in size. He denied any associated symptoms of pain, fevers, chills, malaise, night sweats, unintentional weight loss, prior history of neck masses, recent upper respiratory tract infections, or skin lesions. He was the product of a full-term pregnancy with up-to-date immunizations. Physical examination revealed a 2.5-cm firm, ovoid, mobile, and nontender mass at the apex of the posterior triangle of the right neck without any associated overlying skin changes. The remainder of the head and neck examination was unremarkable. Doppler ultrasonography revealed a 1.9 × 1.8 × 0.9-cm hypoechoic mass, and subsequent fine-needle aspirates demonstrated cells with elongated nuclei and eccentric blue cytoplasm in a background of myxoid stroma. The mass was excised in entirety without issue. At the time of surgery, the deep surface of the mass was foun d to be adherent to the sternocleidomastoid muscle. The lesion was resected with a cuff of muscle and sent for permanent histopathological examination. This revealed proliferation of bland spindle cells with plump nuclei and eosinophilic cytoplasm arranged as loose fascicles in a background of myxoid stroma (Figure 1). These cells were positive for mucin 4 (MUC4), epithelial membrane antigen (EMA), and transducing-like enhancer of split 1 (TLE1) immunohistochemical stains. Fluorescence in situ hybridization (FISH) revealed a positive FUS (16p11) gene rearrangement. Neck Mass in an Adolescent Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a 13-year-old male who presented with a 2-year history of a right neck mass that had slowly increased in size. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea

xlomafota13 shared this article with you from Inoreader Message: Do children with nonsevere obstructive sleep apnea experience resolution of nocturnal enuresis after adenotonsillectomy? Findings In this econdary analysis of a randomized clinical trial including 393 of the 453 totally enrolled children, those with nonsevere obstructive sleep apnea, those who underwent adenotonsillectomy were more likely to experience resolution of nocturnal enuresis compared with children who did not receive surgery. Nocturnal enuresis was less frequent in girls; other clinical factors, such as age, obesity, and severity of sleep apnea, were not associated with improvement of nocturnal enuresis. Meaning The findings of this study suggest that it may be useful for clinicians to inquire about nocturnal enuresis in children with obstructive sleep apnea and counsel caregivers on the potential benefit associated with adenotonsillectomy. Abstract Importance Children with obstructive sleep apnea (OSA) are at increased risk for nocturnal enuresis (NE). However, randomized clinical trials assessing NE outcomes in children randomized to adenotonsillectomy (AT) vs watchful waiting are lacking. Objective To assess the outcomes of AT vs watchful waiting in children with nonsevere OSA who experience NE. Design, Setting, and Participants Secondary analysis of data from a multicenter randomized clinical trial conducted at tertiary children's hospitals was performed. Participants included 453 children aged 5.0 to 9.9 years with nonsevere OSA who were randomized to either watchful waiting or AT as part of the multicenter Childhood Adenotonsillectomy Trial. Caregivers completed the Pediatric Sleep Questionnaire, which includes a binary item on bed-wetting, at baseline and 7-month follow-up. The trial was conducted between October 2007 and June 2012. Evaluation in this secondary analysis involving NE occurred from October 2019 to March 2021. Interventions Adenotonsillectomy vs watchful waiting in children with NE. Main Outcomes and Measures Prevalence of NE as defined by parental response to the Pediatric Sleep Questionnaire bed-wetting item at baseline and 7-month follow-up. Results Of the 453 children enrolled, 393 were included in analysis; of these, 201 were girls (51.1%). Mean (SD) age at baseline was 6.54 (1.40) years. At baseline, the number of children with NE was similar (2.6%; 95% CI, −0.12% to 0.07%) between the AT (59 [30.7%]) and watchful-waiting (67 [33.3%]) groups. The odds of NE in the watchful-waiting group were approximately 2 times higher than the AT group after 7 months (odds ratio, 2.0; 95% CI, 1.3 to 3.1). Following AT, there was a decrease (−11.0%; 95% CI, −16.3% to −5.7%) in the number of children with NE (n = 38). The prevalence of NE did not change significantly (−0.5%; 95% CI, −5.4% to 6.4%) in the watchful-waiting group (n = 66) at follow-up. Although NE was less frequent in girls (adjusted odds ratio, 0.53; 95% CI, 0.33-0.85), other clinical factors, such as age, race and ethnicity, obesity, and apnea-hypopnea index, were not associated with improvement of NE. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, AT for the treatment of pediatric OSA appears to result in improvement in NE. Further research is needed to assess whether AT is associated with long-term benefits for NE compared with watchful waiting. Trial Registration ClinicalTrials.gov Identifier: NCT00560859 Evaluation of Nocturnal Enuresis After Adenotonsillectomy in Children With Obstructive Sleep Apnea Via JAMA Otolaryngology–Head & Neck Surgery Online First This secondary analysis of a randomized clinical trial of children who underwent adenotonsillectomy for nonsevere obstructive sleep apnea evaluates the prevalence of nocturnal enuresis after the operation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nodular Mass in the Earlobe of an 18-Month-Old Girl

xlomafota13 shared this article with you from Inoreader Message: An 18-month-old girl presented with a 1-year history of a slow-growing mass in the right earlobe. There were no symptoms, such as tenderness or discharge, associated with the mass. She had no history of underlying medical disease or trauma. On physical examination, a 1.5 × 1.0–cm, firm, nodular, angulated, pinkish, nontender mass was observed in the posterior aspect of the right earlobe (Figure, A). The skin over the mass was semitransparent, and the mass moved freely beneath the skin. Under suspicion of a tumorous lesion, complete excision was performed after the patient received general anesthesia. Histopathologic findings were characteristic for 2 cell types; basaloid cells with a nucleus were present in the periphery, and ghost cells without a nucleus were present in the center (Figure, B). Six months after surgery, the wound had healed well, and there has been no recurrence. Nodular Mass in the Earlobe of an 18-Month-Old Girl Via JAMA Otolaryngology–Head & Neck Surgery Current Issue An 18-month-old girl presents with a firm, nodular, angulated, pinkish, nontender mass in the posterior aspect of the right earlobe. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.