Paediatric oral submucous fibrosis – The neglected pre-malignancy of childhood

Publication date: June 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 97
Author(s): Chandala Chitguppi, Tripti Brar
Oral submucous fibrosis in children is one of the devastating consequences of arecanut addiction in children. Arecanut is the fourth commonest psychoactive agents used worldwide. However, regrettably, unlike other addictions like tobacco and alcohol, its use in children has become socially acceptable atleast in a few countries. Consequently, children as young as two years have been noticed to be addicted to arecanuts. It has been a menace in most Asian countries and with increasing population migration, this has picked up even in the west. In order to understand the social factors leading to arecanut addiction in children and prognostic outcomes of paediatric oral submucous fibrosis, this review has been undertaken.



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Intraoperative and postoperative hyperkalaemia after total parathyroidectomy following exposure to cinacalcet in sixteen patients for renal hyperparathyroidism

Abstract

Our clinical observation suggested that patients with prior treatment with cinacalcet and undergoing parathyroidectomy for renal hyperparathyroidism had greater acute hyperkalaemia in the intraoperative and immediate postoperative period

81.25% of the cinacalcet patients recorded an intraoperative or 24 hour postoperative potassium value >6mmol/L compared to 1.67% in the controls (P<0.001)

Cinacalcet patients had greater median percentage rise of potassium from preoperative value (33.33%) compared to control group (11.54%) (P<0.001)

Cinacalcet patients demonstrated greater degree of hypocalcaemia and an increased requirement for intravenous calcium in the postoperative period

The mechanism for this observation/association is unknown, however awareness of the phenomenon is imperative for surgeons, anaesthetists and renal physicians.

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Hearing Optimization in Neurofibromatosis type 2: A Systematic Review

Abstract

Background

It is common for patients with Neurofibromatosis type 2 to develop bilateral profound hearing loss hearing loss and this is one of the main determinants of quality of life in this patient group.

Objectives

The aim of this systematic review was to review the current literature regarding hearing outcomes of treatments for vestibular schwannomas in neurofibromatosis type 2 including conservative and medical management, radiotherapy, hearing preservation surgery and auditory implantation in order to determine the most effective way of preserving or rehabilitating hearing

Search Strategy: A MESH search in PubMed using search terms (("Neurofibromatosis 2"[Mesh]) AND "Neuroma, Acoustic"[Mesh]) AND "Hearing Loss"[Mesh] was performed. A search using keywords was also performed. Studies with adequate hearing outcome data were included. With the exception of the cochlear implant studies (cohort size was very small) case studies were excluded.

Evaluation Method: The GRADE system was used to assess quality of publication. Formal statistical analysis of data was not performed because of very heterogenous data reporting.

Results

Conservative management offers the best chance of hearing preservation in stable tumours. The use of Bevacizumab probably improves the likelihood of hearing preservation in growing tumours in the short term and is probably more effective than hearing preservation surgery and radiotherapy in preserving hearing. Of the hearing preservation interventions, hearing preservation surgery probably offers better hearing preservation rates than radiotherapy for small tumours but recurrence rates for hearing preservation surgery were high. For patients with profound hearing loss, cochlear implantation provides significantly better auditory outcomes than auditory brainstem implantation. Patients with untreated stable tumours are likely to achieve the best outcomes from cochlear implantation. Those who have had their tumours treated with surgery or radiotherapy do not gain as much benefit from cochlear implantation than those with untreated tumours.

Conclusions

This review summarises the current literature related to hearing preservation/rehabilitation in patients with NF2. Whilst it provides indicative data, the quality of the data was low and should be interpreted with care. It is also important to consider that the management of vestibular schwannomas in NF2 is complex and decision making is determined by many factors, not just the need to preserve hearing.

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Sixty-Three Patients Based Survey - Can Sinonasal Outcome Test-22 Be a Suitable Evaluation Method for Septoplasty and Turbinectomy?

Abstract

In this study we evaluated the patient-perceived benefit of surgery for nasal obstruction.

Data were collected prospectively from both sexes of all ages who underwent elective surgery for nasal obstruction. All patients completed Sinonasal Outcome Test-22 (SNOT-22) questionnaire pre- and postoperatively.

During the study period 63 subjects underwent surgery for nasal obstruction (septoplasty and/or turbinectomy).

The median total SNOT-22 score was 35 and 14 pre- and postoperatively, respectively. The median difference between post- and preoperative scores was -15.

We did not find significant correlation between changes in SNOT-22 scores postoperatively and age, gender, follow-up time, operation type or survey method.

We can carefully conclude that SNOT-22 can be a useful instrument for patients undergoing operation for nasal obstruction.

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Thoracic spondylolisthesis and spinal cord compression in diffuse idiopathic skeletal hyperostosis: a case report

Diffuse idiopathic skeletal hyperostosis has long been regarded as a benign asymptomatic clinical entity with an innocuous clinical course. Neurological complications are rare in diffuse idiopathic skeletal hy...

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Novel immunotherapy and treatment modality for severe food allergies.

Purpose of review: In recent years, many studies on oral immunotherapy (OIT) have been conducted; however, few have focused on severe food allergies. The purpose of this review was to assess the efficacy and safety of oral immunotherapies for patients with severe food allergy. Recent findings: We reviewed multiple immunotherapy reports published within a few years or reports focusing on severe food allergies. We also investigated recent studies on OIT and novel food allergy management. Summary: Immunotherapies targeting low-dose antigen exposure and oral food challenges using low-dose target volumes may be safer than conventional OIT. It is necessary to consider which immunotherapy regimen is appropriate based on allergy severity of the patient. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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