Transformation from Sinonasal Seromucinous Hamartoma to Adenocarcinoma: A Case Report

xlomafota13 shared this article with you from Inoreader Transformation from Sinonasal Seromucinous Hamartoma to Adenocarcinoma: A Case Report Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objectives: Sinonasal hamartomas are benign neoplasms composed of disorganized mature tissue elements. Epithelial variants include respiratory epithelial adenomatoid hamartoma (REAH) and seromucinous hamartoma (SMH). Malignant transformation of REAH is rarely reported; however, the malignant transformation of SMH to adenocarcinoma has not been described. We report the first case of a transformation from SMH to adenocarcinoma. Methods: The medical records of a patient pr esenting with sinonasal SMH with malignant transformation to adenocarcinoma were reviewed. The NCBI database was queried for the literature regarding SMH and malignant transformation of sinonasal hamartomas. Results: A 39-year-old man presented with a left nasal mass, nasal obstruction, and epistaxis. Computed tomography and magnetic resonance imaging demonstrated a nonaggressive and heterogeneous left nasal mass with involvement of the middle turbinate and posterior ethmoid sinuses. He underwent endoscopic sinus surgery with complete excision of the mass. Pathology revealed SMH with focal areas of transition to low-grade adenocarcinoma characterized by stromal invasion but no bony, perineural, or lymphovascular invasion. Adjuvant treatment was not recommended. Literature review revealed no reported cases of malignant transformation of SMH. Conclusion: We report the first case of malignant transformation of SMH. Patients with SMH must be counseled that th ere is an extremely rare and potentially unrecognized risk of malignancy that may influence treatment and postoperative monitoring. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomic Measurements of Distances from Lateral Surface of Cranium to Cochlea in Congenital Aural Atresia and Stenosis Patients

xlomafota13 shared this article with you from Inoreader Anatomic Measurements of Distances from Lateral Surface of Cranium to Cochlea in Congenital Aural Atresia and Stenosis Patients Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Studies have shown that higher response levels can be obtained when the bone conduction stimulation position is closer to the cochlea. However, the morphological characteristics of round window niche and posterior tympanum in congenital aural atresia (CAA) and stenosis (CAS) patients were different from the normal. These affected the position of the cochlea at the cranial base. It was still unknown whether the distances from the cranium of CAA and CAS patients to t he cochlea were the same as those of normal patients or not. Objective: To measure distances from various points on the lateral surface of the cranium to the cochlea and the cranium thickness on these points among a CAA group, CAS group and normal control group, which may provide valuable information for the better position of bone conduction stimulation. Methods: CT images of CAA, CAS patients and these patients' healthy sides were analyzed. Firstly, the Frankfurt horizontal plane (Pfrkt) was established. Secondly, a model of part of the cranium was three-dimensionally reconstructed. Then, the Pfrkt plane was rotated down 20, 30 and 40° according to the superior margin of the external auditory canal. At every angle, points 25, 30, 35 and 40 mm away from the superior margin of the external auditory canal were marked out on the surface of the model and recorded as P20A, P30A, P40A, P20B, etc. The spatial dista nces between the cranium and ipsilateral cochlea were defined as lengths of points on the surface of the model to the cochlea apex (CA), cochlear base (CB) and modiolus midpoint (MM), respectively, recorded as P20A/CA, P20A/CB, P20A/MM, P30A/CA, etc. Results and Conclusions: In all groups, the length of P20D/CA was the shortest compared to P30D/CA and P40D/CA (p #x3c; 0.05). The P20A/CB and P20A/MM were also the shortest (p #x3c; 0.05). When the Pfrkt plane was rotated down 30 and 40°, the results were the same as at 20° (p #x3c; 0.05). However, P20D, P30D and P40D were almost on the mastoid air cells. We suggest that the bone conduction stimulation position is placed closer to the ear, while avoiding the mastoid air cells in the CAA and CAS patients. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo

xlomafota13 shared this article with you from Inoreader Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: The aim of this study was to compare the effects of Brandt-Daroff (BD) exercise and shopping exercise (SE) on the resolution of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) following a successful modified Epley canalith repositioning maneuver (CRP). Methods: This single-blind, randomized clinical trial included patients with posterior semicircular canal type of BPPV. Following the modified Epley maneuver, patien ts that experienced RD were randomly assigned to 3 groups: (i) BD, (ii) SE, and (iii) control groups. Primary outcomes were quantified using the Dizziness Handicap Inventory (DHI). Results: Following CRP, 240 (63%) participants experienced RD. All these patients were followed up weekly for RD. After the resolution of RD, patients were followed up monthly for recurrence. Mean time to recovery was 16.4 ± 10 (range, 5–49) days in the BD group, 11.5 ± 4.6 (range, 6–32) days in the SE group, and 23.4 ± 16.8 (range, 6–89) days in the control group. The SE group recovered significantly faster than the BD and control groups (p #x3c; 0.001). Baseline emotional DHI (E-DHI) scores were significantly correlated with the duration of pre-CRP symptoms (p #x3c; 0.001). Correlation analysis indicated that patients with obesity and diabetes mellitus (DM) recovered later than patients without these comorbidities. Conclusion: We found that RD improved significantly in the SE group compared to the BD and control groups. Additionally, a significant relationship was established between RD and high anxiety levels and DM, and obesity had a negative impact on the resolution of RD. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

3D connectomes of reactive and neoplastic CD30 positive lymphoid cells and surrounding cell types

xlomafota13 shared this article with you from Inoreader 3D connectomes of reactive and neoplastic CD30 positive lymphoid cells and surrounding cell types Via histochem Acta Histochem. 2021 Jul 4;123(5):151750. doi: 10.1016/j.acthis.2021.151750. Online ahead of print. ABSTRACT Classical Hodgkin lymphoma (cHL) is one of the most common malignant lymphomas in Western Europe. It is diagnosed on the basis of histological sections by pathologists using a light microscope. The tumor cells, the Hodgkin- and Reed Sternberg cells (HRS), are visualized by morphology and positive response for the CD30-antigen. The same antigen can also be detected by immunohistochemistry on a reactive counterpart, showing CD30+ cells in special immunoreactions, such as inflammations of lymph nodes (lymphadenitis). CD30+ cells in reactive and neoplastic conditions are surrounded by lymphocytes and histiocytes, forming a micromilieu that enables the survival of the tumor cells, as well as their reactive counterparts. This study deals with an investigation of CD30+-surrounding cells using a confocal laser technology, visualizing the contacts of reactive and neoplastic CD30+ cells with CD68+ macrophages and CD163+ macrophages as well as to PD1+ lymphocytes and B cells (CD20+). CD4 immunostains were not included, because CD4+ cells were too numerous for clear dissection of single cells. 3D images visualized the, so-called, connectomes. Clear differences in the number of contacts between CD30-reactive and neoplastic cells (HRS) with macrophages and B lym phocytes were visible. Lymphadenitis and Mixed Cellularity type of classical Hodgkin Lymphoma (cHL) differed in that Mixed Cellularity (MC) cHL had more connections to macrophages (CD163+) and lower number of connections to B cells (CD20+). The connectomes of both Hodgkin variants MCcHL and Nodular Sclerosis cHL (NScHL) mainly differed in the number of contacts to CD163+ macrophages, which was higher in MCcHL. Investigating the volumes of CD30+ -reactive and neoplastic cells, we found out that reactive cells showed lesser volumes, which correlated with the number of contacts. The comparison between 2D and 3D images, including 3D prints, demonstrated clear advantages of the 3D method. 3D images visualized significantly more and clearly defined intercellular contacts. Complicated cellular networks and their contacts became especially evident in volume and surface evaluations, as well as in 3D prints. PMID:34233254 | DOI:10.1016/j.acthis.2021.151750 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristic differences in radiation‐induced DNA damage response in human papillomavirus‐negative and human papillomavirus‐positive head and neck cancers with accumulation of fractional radiation dose

xlomafota13 shared this article with you from Inoreader Characteristic differences in radiation‐induced DNA damage response in human papillomavirus‐negative and human papillomavirus‐positive head and neck cancers with accumulation of fractional radiation dose Via Head & Neck Abstract Background Superior treatment responses by patients with human papillomavirus (HPV) positive head and neck squamous cell carcinoma (HNSCC), compared to patients with HNSCC from other causes, drive biomarker research to optimize treatment. Most HNSCC patients receive radiation therapy delivered as a fractionated course. Changing HPV status in HNSCC from a positive prognostic marker to a predictive one requires biomarkers that capture cellular radiation response to cumulative dose. Methods Nuclear enlargement, γH2AX expression and micronuclei count, were studied in six HNSCC cell lines after 4 Gy fractionated X-irradiation. Results All HNSCC cell lines displayed altered cellular responses, indicating increasing inability to repair radiation damage with subsequent radiation fractions. Increases in nuclear area were significantly greater among HPV positive cell lines (207% and 67% for the HPV positive and HPV negative groups, respectively). Conclusions A different character of DNA repair dysfunction in the HPV positive group suggests greater chromosomal translocation with accumulated radiation dose. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Deep Neck Infections: Demographic and Clinical Factors Associated with Poor Outcomes

xlomafota13 shared this article with you from Inoreader Deep Neck Infections: Demographic and Clinical Factors Associated with Poor Outcomes Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Deep neck infections (DNIs) are abscesses located in the profound spaces of the neck and constitute one of the most common otolaryngological life-threatening emergencies. The aim of this study is to review the clinical and demographic data of patients with DNI and identify factors associated with prolonged hospitalization, reoperation, and mortality. Methods: Retrospective review and analysis of 75 patients with DNI admitted from January 2015 to Decem ber 2019 in a tertiary referral hospital. Results: Of 75 patients, 50 (66.6%) were males and 25 (33.3%) females. Age ranged from 18 to 91 years with a mean of 41.79 (±15.48). DNIs were odontogenic in 49 patients (65.3%). History of diabetes mellitus (DM) was positive in 26 patients (34.6%). The submandibular space was involved in 57 patients (76%). Streptococcus spp. were isolated in 35 patients (46%). Intubation for airway preservation was needed in 21 patients (28%) and tracheostomy in 6 (8%). Mediastinitis presented in 8 patients (10.67%), with a mortality rate of 62.5% (n = 5). Mean hospital stay was 9.13 days (±7.2). DM (p = 0.016), age (p = 0.001), BMI classification 3, 4, and 6 (p = 0.041), and intensive care unit (ICU) admission (p = 0.009) were associated with a longer stay. Surgical drainage was performed after 1.71 days (±1.65). Surgical reintervention was needed in 6 cases (8%) and was associated with temporal (< i>p = 0.001) and masticator (p = 0.002) space involvement and DM (p = 0.009). Overall mortality was 8% and decreased to 1.5% when mediastinitis was excluded. Mediastinitis (p = 0.001), ICU admission (p #x3c; 0.0001), Streptococcus spp. (p = 0.019), and low hemoglobin levels (p = 0.004) were associated with mortality. Discussion/Conclusion: DNIs are entities associated with high morbimortality. Mediastinitis and airway obstruction are life-threatening possible complications and should be promptly evaluated. Low HB could be used as a predicting factor for mortality. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Targeted chemodenervation of the posterior belly of the digastric muscle for the management of jaw discomfort in facial synkinesis

xlomafota13 shared this article with you from Inoreader Targeted chemodenervation of the posterior belly of the digastric muscle for the management of jaw discomfort in facial synkinesis Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 9:S1748-6815(21)00297-7. doi: 10.1016/j.bjps.2021.05.045. Online ahead of print. ABSTRACT BACKGROUND: Botulinum toxin (BT-A) chemodenervation has been proved to significantly improve the physical and psychological well-being of patients suffering from facial synkinesis. Despite this, a cohort of patients has persistent tightness and discomfort around the angle of the jaw, which may be caused by synkinesis within the posterior belly of digastric (PBD) muscle. This study was designed to evaluate the benefits of ultrasound-guided BT-A injections into the PBD. METHODS: Thirty-three patients with recalcitrant tightness and discomfort around the angle of the jaw, despite maximal facial therapy and platysmal chemodenervation were selected for inclusion. Patients underwent ultrasound-guided BT-A injection into the ipsilateral PBD muscle (skin puncture site 1 cm inferior and posterior to the angle o f mandible). Outcomes consisted of the Facial Disability Index (FDI), Synkinesis Assessment Questionnaire (SAQ), and a visual analogue scale (VAS) designed to assess tightness and pain around the PBD when moving the jaw, swallowing, and masticating. Questionnaires were completed two weeks before and postinjection. Statistical analysis was performed using a paired t-test. RESULTS: Nineteen patients completed the post-treatment outcome questionnaire. A statistically significant improvement was noted in the physical and social function aspects of the FDI and all aspects of the patient-reported VAS scores apart from tightness and pain on jaw retrusion and swallowing. There was no significant difference in the SAQ. CONCLUSION: This study has demonstrated the patient-perceived benefit of ultrasound-targeted BT-A chemodenervation of PBD. This represents a low-risk treatment option that can be easily added to the repertoire of treatments offered to patients with post paralysis f acial synkinesis. PMID:34233854 | DOI:10.1016/j.bjps.2021.05.045 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidental Finding of a Persistent Stapedial Artery in a Patient Presenting With Conductive Hearing Loss

xlomafota13 shared this article with you from Inoreader Incidental Finding of a Persistent Stapedial Artery in a Patient Presenting With Conductive Hearing Loss Via ear nose throat Ear Nose Throat J. 2021 Jul 8:1455613211032005. doi: 10.1177/01455613211032005. Online ahead of print. ABSTRACT A persistent stapedial artery is a congenital vascular malformation that can cause tinnitus and/or conductive hearing loss. Although rare, this case highlights the importance of recognizing aberrant anatomy as a potential cause of patients' symptoms. It also demonstrates how to recognize and treat patients with a symptomatic persistent stapedial artery. PMID: 34233519 | DOI:10.1177/01455613211032005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Maggot Infection in a Patient With Nasal Non-Hodgkin's Lymphoma

xlomafota13 shared this article with you from Inoreader Nasal Maggot Infection in a Patient With Nasal Non-Hodgkin's Lymphoma Via ear nose throat Ear Nose Throat J. 2021 Jul 8:1455613211031024. doi: 10.1177/01455613211031024. Online ahead of print. ABSTRACT We describe a case of nasal non-Hodgkin's lymphoma in a 79-year-old Chinese patient accompany with nasal myiasis. The first 2 biopsies in this case were false negative. Subsequently, nasal maggots developed in this patient. After removing all maggots under nasal endoscopy, the patient continued to have recurrent fever and was transferred to a higher hospital for fu rther treatment, in which he received a third biopsy. Unfortunately, several hours after the biopsy, the patient died for severe nasal bleeding. The final biopsy result indicated the neoplasm of the left nasal cavity was non-Hodgkin's lymphoma. This case illustrates the importance of repeated biopsies for nasal non-Hodgkin's lymphoma if necessary. Nasal myiasis is a secondary disease of nasal non-Hodgkin's lymphoma in this case. PMID:34233486 | DOI:10.1177/01455613211031024 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Septal Perforation Due to Desmopressin Nasal Spray Use

xlomafota13 shared this article with you from Inoreader Nasal Septal Perforation Due to Desmopressin Nasal Spray Use Via ear nose throat Ear Nose Throat J. 2021 Jul 8:1455613211026425. doi: 10.1177/01455613211026425. Online ahead of print. ABSTRACT Perforations of the nasal septum have many etiologies and occasionally result from intranasal medicated spray use. This case report describes a perforation related to the use of desmopressin nasal spray, which has not been previously reported in the literature. Clinical considerations presented in this article include appropriate technique of nasal spray applicatio n, appropriate monitoring of patients on intranasal sprays, and indications for evaluation by an otolaryngologist. Septal perforation treatment success is improved with an early diagnosis. PMID:34233494 | DOI:10.1177/01455613211026425 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Renin-Angiotensin-Aldosterone System Imbalance and Altered Aquaporin Activity: A New Perspective for COVID-19-Associated Xerostomia

xlomafota13 shared this article with you from Inoreader Renin-Angiotensin-Aldosterone System Imbalance and Altered Aquaporin Activity: A New Perspective for COVID-19-Associated Xerostomia Via ear nose throat Ear Nose Throat J. 2021 Jul 8:1455613211030348. doi: 10.1177/01455613211030348. Online ahead of print. NO ABSTRACT PMID:34233506 | DOI:10.1177/01455613211030348 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.