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Πέμπτη 8 Απριλίου 2021

Frequent Recurrence of Sinonasal Inverted Papilloma With Carcinoma In Situ in a Multifocal Attachment Pattern: A Case Report and Review of the Literature

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Ear Nose Throat J. 2021 Apr 8:145561321991344. doi: 10.1177/0145561321991344. Online ahead of print.

ABSTRACT

Sinonasal inverted papilloma (SIP) is a benign tumor originating from the nasal cavity and paranasal sinuses. Sinonasal inverted papilloma is characterized by local infiltration, high recurrence, and malignant transformation, and its associated dysplasia ranges from mild, moderate, severe, carcinoma in situ (CIS) to invasive squamous cell carcinoma. Sinonasal inverte d papilloma with carcinoma in situ (IPwCIS) is the highest degree of dysplasia, which is a stage of malignant transformation of IP. Surgical excision and proper adjuvant therapy can help reduce recurrence rates and suppress further deterioration. In this study, we present a patient with IPwCIS who developed 3 recurrences with a multifocal attachment pattern in less than 18 months. We report the clinical manifestations, development, and treatment process in detail. We also performed a literature review to analyze the characteristics of the disease. Despite comprehensive treatment methods, tumor recurrence and further deterioration of IPwCIS persist.

PMID:33829884 | DOI:10.1177/0145561321991344

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Management of Multiple Head and Neck Paragangliomas With Assistance of a 3-D Model

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Ear Nose Throat J. 2021 Apr 8:1455613211009441. doi: 10.1177/01455613211009441. Online ahead of print.

ABSTRACT

INTRODUCTION: Extirpation of multiple head and neck paragangliomas carries challenge due to close anatomic relationships with critical neurovascular bundles.

OBJECTIVES: This study aims to assess whether the application of 3-D models can assist with surgical planning and treatment of these paragangliomas, decrease surgically related morbidity and mortality.

METHODS: Fourteen patients undergoing surgical resection of multiple head and neck paragangliomas were enrolled in this study. A preoperative 3-D model was created based on radiologic data, and relevant critical anatomic relationships were preoperatively assessed and intraoperatively validated.

RESULTS: All 14 patients presented with multiple head and neck paragangliomas, including bilateral carotid body tumors (CBT, n = 9), concurrent CBT with glomus jugulare tumors (GJT, n = 4), and multiple vagal paragangliomas (n = 1). Ten patients underwent genomic analysis and all harbored succinate dehydrogenase complex subunit D (SDHD) mutations. Under guidance of the 3-D model, the internal carotid artery (ICA) was circumferentially encased by tumor on 5 of the operated sides, in 4 (80%) of which the tumor was successfully dissected out from the ICA, whereas ICA reconstruction was required on one side (20%). Following removal of CBT, anterior rerouting of the facial nerve was avo ided in 3 (75%) of 4 patients during the extirpation of GJT with assistance of a 3-D model. Two patients developed permanent postoperative vocal cord paralysis. There was no vessel rupture or mortality in this study cohort.

CONCLUSION: The 3-D model is beneficial for establishment of a preoperative strategy, as well as planning and guiding the intraoperative procedure for resection of multiple head and neck paragangliomas.

PMID:33829883 | DOI:10.1177/01455613211009441

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Nasal Septum Glomus Tumor: A Rare Cause of Unilateral Nasal Obstruction

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Ear Nose Throat J. 2021 Apr 8:1455613211007948. doi: 10.1177/01455613211007948. Online ahead of print.

NO ABSTRACT

PMID:33829885 | DOI:10.1177/01455613211007948

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Frontal Angle: A New Predictor of Difficulty in Endoscopic Frontal Sinus Surgery-A Preliminary Computed Tomography Study

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Ear Nose Throat J. 2021 Apr 8:1455613211003802. doi: 10.1177/01455613211003802. Online ahead of print.

ABSTRACT

OBJECTIVES: The possibility of visualization of the frontal sinus during endoscopic surgery depends on 3-dimensional configuration of the frontal sinus opening (FSO). We aimed to determine the prevalence of unfavorable angulation of the lower part of the posterior wall of the frontal sinus and its relation to FSO diameter.

METHODS: One hundred and twenty-eigh t computed tomography (CT) scans were retrospectively reviewed to measure (1) the angle between the nasal floor and the plane tangent to the posterior table of the frontal sinus above the most posterior aspect of the anterior buttress (frontal angle, FA) and (2) dimensions of the FSO.

RESULTS: The FA ranged from below 30° to 90°. Nearly 13% of sinuses (16.4% of patients) showed FA about 90°, which should enable good visualization of the sinus with the 30° scope after opening and clearing the frontal recess, while 4% (6.25% of patients) showed FA ≤ 30°. The anterior-posterior diameter (A-PD) was below 5 mm in 17.6% of sinuses (26.6% of patients). There was a significant correlation between FA and A-PD. Unfavorable combination of FA and A-PD (<45°, <5 mm) was present in 5.2% of sinuses (8.6% of patients), and extremely unfavorable combination (<30°, <5 mm) in 0.8% (0.8% of patients).

CONCLUSIONS: The FA shows great interindividual variability, which is very likely to reflect the possibility of inspection of the frontal sinus. This implies a need for further prospective clinical studies to validate FA as a predictor of difficulty in frontal sinus surgery.

PMID:33829887 | DOI:10.1177/01455613211003802

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Congenital Aural Fistula Developing Between the Third and Fourth Hillocks of the Embryonal Helix and Presenting a Large Temporal Mass: A Case Report

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Ear Nose Throat J. 2021 Apr 8:1455613211009150. doi: 10.1177/01455613211009150. Online ahead of print.

ABSTRACT

This report aimed to introduce a very rare presentation of congenital aural fistula and its treatment. A 13-year-old girl presented with a mass on the right temporal region with protrusion of the helix. She noticed a mass a month previously, and the mass gradually swelled with pain. Pus discharged from the pit behind the helix. Mastoiditis was suspected; however, t he tympanic membrane was normal. Magnetic resonance imaging revealed a cystic mass in the temporal region. The surgical removal of the mass was performed using a postauricular incision. The mass was cystic and had a stem connected to the pit. Insertion of a probe into the pit showed a connection to the mass. The mass was totally removed with the skin around the pit. Histologically, the cyst connected to the fistula and its lumen was covered with squamous cells. A diagnosis of a congenital aural fistula developed posterior to the helix was made. Considering its location, the fistula had been formed between the third and fourth hillocks of the embryonal helix. Aural fistula developed posteriorly is very rare, and it mimicked a temporal tumor or mastoiditis with a protruding auricle. Careful observation of the skin and consideration from developmental aspects are needed for an accurate diagnosis.

PMID:33829886 | DOI:10.1177/01455613211009150

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Nodular Fasciitis in the Cavity of Auricular Concha: A Case Report

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Ear Nose Throat J. 2021 Apr 8:1455613211006006. doi: 10.1177/01455613211006006. Online ahead of print.

ABSTRACT

Nodular fasciitis (NF) has a low incidence, many classification subtypes and large histological variations. We describe a 17-month-old child who presented with a mass in the right cavity of auricular concha that was successfully cured by 2 procedures. In pediatric patients with fibroproliferative lesions, the possibility of NF should be excluded to avoid misdiagnos is and overtreatment.

PMID:33829880 | DOI:10.1177/01455613211006006

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Porcine endometrial 3D co-culture: Morphological changes in 3D endometrium tissues according to hormonal changes

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Histol Histopathol. 2021 Apr 8:18335. doi: 10.14670/HH-18-335. Online ahead of print.

ABSTRACT

Cells cultured as monolayers proliferate well, but do not sustain their differentiation characteristics. Previous studies have investigated the interactions between cells and growth factors or cytokines by establishing either in vivo or in vitro three-dimensional (3D) cultures. Using porcine uterine epithelial cells and endometrial cells, the current study was designed to develop a 3D uterine culture system and investigate the response to hormone treatment. Formation of the 3D uterine model was similar to that of uterus from the group supplemented with calcium and magnesium, and the addition of these ions altered the spectrum of basement membrane degrading enzyme expression and activity. In particular, the epithelial cell junctions in the 3D model most closely resembled those of an actual uterus when the medium was supplemented with calcium a nd magnesium; the intercellular basement membrane structure was also tall under these conditions. The study confirmed that Casp-3 expression was lowest in the P4 (progesterone) treatment group, and this hormone was the most potent stimulus for formation of the endometrial cell layer. Therefore, the addition of calcium and magnesium plays an important role in the formation of a 3D uterine model, and the addition of P4 hormone mimics uterine thickening by stimulating growth of the epithelial cell layer.

PMID:33829420 | DOI:10.14670/HH-18-335

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Digging Into Dermatillomania: Scalp Reconstruction in a Complex Patient

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Via Eplasty

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Eplasty. 2021 Mar 27;21:ic3. eCollection 2021.

NO ABSTRACT

PMID:33828637 | PMC:PMC7997828

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Evaluation of hearing preservation in adults with a slim perimodiolar electrode

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Eur Arch Otorhinolaryngol. 2021 Apr 8. doi: 10.1007/s00405-021-06755-z. Online ahead of print.

ABSTRACT

PURPOSE: Numerous endeavors have been undertaken to preserve hearing in cochlear implant (CI) patients. Particularly, optimization of electrode array design aims at preservation of residual hearing (RH). This study examines whether a slim perimodiolar (PM) electrode array could bear the capability to preserve hearing.

METHODS: A total of 47 patients underwent cochlear implantation receiving the PM electrode. (i) Patients with pure tone audiogram (PTA) thresholds better than 85 dB and/or hearing loss for Freiburg speech test numbers less than 60 dB and more than 50% maximum monosyllabic understanding were assigned to the RH group (n = 17), while all others belonged to the noRH group (n = 30). (ii) Another group implanted with a slim straight, lateral wall (LW) electrode was recruited for comparison.

RESULTS: We compared 17 RH-30 noRH patients all receiving the PM electrode. RH in PM recipients decreased faster than in LW recipients. No significant differences were observed between both (RH v/s noRH) groups in NRT thresholds, Freiburg speech test and A§E® phonemes. Analogous satisfaction levels were indicated through the questionnaires in terms of sound quality, hearing in silence, noise and directional hearing in both groups.

CONCLUSIONS: The results suggest that hearing preservation is influenced not only by electrode shape but various factors. This study opens an avenue for further investigations to elucidate and enumerate the causes for progressive hearing loss.

PMID:33830367 | DOI:10.1007/s00405-021-06755-z

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The occult foreign body in the larynx

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HNO. 2021 Apr 8. doi: 10.1007/s00106-021-01043-y. Online ahead of print.

NO ABSTRACT

PMID:33830301 | DOI:10.1007/s00106-021-01043-y

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Endoscopic Left Central Lymph Node Dissection of Thyroid Cancer: Safe, Feasible, and Relatively Easy

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Surg Innov. 2021 Apr 8:1553350620983640. doi: 10.1177/1553350620983640. Online ahead of print.

ABSTRACT

Purpose. The purpose of this study was to explore the feasibility of left central lymph node dissection (CLND) in endoscopic thyroidectomy via chest-breast approach (ETCB). Methods. Retrospective analysis of 57 cases of left CLND (group A) via ETCB, 35 cases of open left CLND (group B), and 90 cases of right CLND via ETCB (Group C) were performed from October 2014 t o October 2019. Surgical data, complications, and follow-up data were compared among group A and group B, group A and group C, respectively. Results. There were no significant differences between group A and group B in intraoperative blood loss, tumor size, lymph node (LN) metastasis rate, dissected LN number, metastatic LN number, serum thyroglobulin (sTg), radioactive iodine uptake (RAIU), radioactive technetium uptake (RATU), radionuclide imaging of the residual area (RITRA), and radionuclide imaging of suspicious lymph node metastasis (RISLNM). There were no significant differences between group A and group C in age, operation time, intraoperative blood loss, postoperative hospital stay, tumor size, LN metastasis rate, dissected LN number, metastatic LN number, hypoparathyroidism, sTg, RAIU, RATU, RITRA, and RISLNM. There were 5 cases of temporary recurrent laryngeal nerve (RLN) palsy and 1 case of recurrence in group C. Besides, 1 case of lymphatic leakage was in group A . Conclusion. For selected cases, endoscopic left CLND is safe, feasible, efficient, and more easier than endoscopic right CLND.

PMID:33830818 | DOI:10.1177/1553350620983640

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