Head and Neck Medicine by Alexandros G.Sfakianakis

Accuracy of 18FDG PET/CT for the detection of distant metastases using clinical development of distant metastases and a minimal follow-up of twelve months as reference standard. Comparison of overall survival between patients diagnosed with distant metastases during initial screening and patients diagnosed with distant metastases during follow-up.

Results

In 23 (12%) of the 190 patients 18FDG PET/CT detected distant metastases at screening. Sensitivity and negative predictive value were 46.2% (95% CI 32.6 – 59.7) and 82.6% (95% CI 76.8 – 88.5). No difference in median overall survival from the time of distant metastases detection was found between patients diagnosed with DM during work-up or during follow up.

Conclusions

In head and neck squamous cell carcinoma patients with high risk factors 18FDG PET/CT has a high negative predictive value for the detection of distant metastases and should be used in daily clinical practice, although the sensitivity is limited when long term follow-up is used as reference standard.

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Correlation between septal body size and inferior turbinate hypertrophy on computed tomography scans in fifty patients: A radiological analysis

Abstract

The septal body contains expansile tissue that may behave in a similar manner to the inferior turbinate. It is situated in the nasal valve region and, like the inferior turbinate, can cause changes in the nasal cross-sectional area and resistance to airflow.

Septal body hypertrophy combined with inferior turbinate hypertrophy may result in changes to nasal cross-sectional area and resistance to airflow.

Septal body hypertrophy is likely to accompany inferior turbinate hypertrophy.

Septal body thickness demonstrated significant positive correlation with the widths of the anterior turbinate medial mucosa and middle turbinate lateral mucosa. Septal body length demonstrated significant correlation with the widths of the anterior turbinate lateral mucosa and posterior turbinate lateral mucosa.

Septal body hypertrophy is significantly associated with inferior turbinate hypertrophy and narrowed internal nasal valve area. These results indicate that clinicians should check for concomitant septal body hypertrophy in patients with inferior turbinate hypertrophy.

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Σάββατο 27 Ιανουαρίου 2018

Applying the Ts of referred otalgia to a cohort of 226 patients

Abstract

Referred or secondary otalgia is the complaint of ear pain arising from pathology of non-otologic locations with which the ear shares common neural pathways. The pain can present in various degrees of intensity and characteristics while severity is not proportional to the seriousness of the underlying cause^1,2.

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Superiorly Curved Scalp Incision for Implantation of Magnetic Transcutaneous Bone Conduction Devices: Multicentre Experience of 60 patients

Abstract

The authors describe the use of superiorly curved scalp Incision for Implantation of Magnetic Transcutaneous Bone Conduction Devices

They describe a new technical aspect to minimise numbness issues in a series of 60 patients from two tertiary referral centres.

An inferiorly-based flap design will help to preserve branches of the great auricular and lesser occipital nerves, which normally sacrificed with the original technique.

Superiorly curved scalp Incision will be suitable for subsequent retroauricular incision that is used in auricular reconstruction in microtia patients.

These easily reproducible technical modification comfortable be used safely for Implantation of Magnetic Transcutaneous Bone Conduction Devices, especially patients with auricular dysplasia where auricular reconstruction is planned

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Intracranial suppurative complications of ear, nose and throat infections: a single-centre cohort study of 65 patients

Abstract

In the Picardie region of northern France, the prevalence of intracranial suppurative complications (particularly empyema) of ear, nose and throat infections seems to have increased over the last 10 to 15 years.

Three possible reasons for the increased incidence in this region are the inappropriate use of antibiotics, low socioeconomic status, and poor access to high-quality healthcare.

Intracranial complications affect both sexes and all ages.

If a patient suffering from sinusitis or (especially) otitis media complains of headache, the possible presence of an intracranial suppurative complication must be always be considered and should prompt immediate medical imaging (a cranial CT scan and MRI) for confirmation of the diagnosis.

Early diagnosis and multidisciplinary pharmacological and surgical management (focused on the intracranial complication) should enable complete recovery in more than three quarters of these cases

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A Retrospective Case Series of 1773 patients

Abstract

A peritonsillar abscess (PTA) is a collection of pus between the pharyngeal musculature and palatine tonsil capsule. It is the most common deep space infection of the head and neck region and the most common indication for acute ORL hospital admission ¹. Causative microorganisms include Gram negative rods, Gram positive cocci and anaerobes ². Usual treatment is aspiration +/- incision and drainage of PTA, but there is practice variation based on geographical location ³.

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Association between periodontitis and chronic kidney disease: systematic review and meta-analysis

Abstract

A systematic review and meta-analysis was conducted to evaluate the association between periodontitis (PD) and chronic kidney disease (CKD) and to explore the potential influence of periodontal treatment in CKD patients. Databases (PubMed, Web of Science, Science direct, Cochrane Database) were screened for relevant articles, focusing on the periodontal status of patients with CKD, published until December 2017. Five-hundred fifty-three articles were identified and 37 fulfilled the inclusion criteria and were considered in this systematic review. Seventeen articles were included in the meta-analysis and 7 in the review focusing on the impact of periodontal treatment. Most of the identified studies indicated an increased incidence of PD in CKD patients. Meta-analysis showed an association between CKD and PD and strength of this association was increased when severe PD was considered (OR=2.39 (1.70 – 3.36)). The association could be observed even after adjustment for major CKD risk factors or use of precise diagnosis criteria (OR=2.26 for severe PD (1.69 – 3.01)). Analysis of cohort studies indicated an incident rate ratio (IRR) of 1.73. Periodontitis is associated with CKD after multivariable adjustment. Further studies are necessary to determine whether prevention or treatment of PD can reduce the incidence and/or severity of CKD.

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