Artículos

Management of the lymph node-positive neck in the patient with human papillomavirus-associated oropharyngeal cancer

Garden A, Gunn G, Hessel A, Beadle B, Ahmed S, El-Naggar A, Fuller C, Byers L, Phan J, Frank S, Morrison W, Kies M, Rosenthal D, Sturgis E; Cancer (Jun 2014)

The goal of the current study was to assess the rates of recurrence in the neck for patients with lymph node-positive human papillomavirus-associated cancer of the oropharynx who were treated with definitive radiotherapy (with or without chemotherapy). 

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Mucopolysaccharidosis: Otolaryngologic findings, obstructive sleep apnea and accumulation of glucosaminoglycans in lymphatic tissue of the upper airway

Gönüldaş B, Yılmaz T, Sivri H, Güçer K, Kılınç K, Genç G, Kılıç M, Coşkun T; International Journal of Pediatric Otorhinolaryngology 78 (6), 944-9 (Jun 2014)

OBJECTIVE The aim of this study is to evaluate otolaryngologic problems (upper airway obstruction, obstructive sleep apnea, restriction of mouth opening, middle ear effusion, hearing and breathing problems) and their treatments on mucopolysaccharidoses (MPS) patients and to investigate accumulation of glucosaminoglycans (GAG) in the upper airway biochemically and pathologically.

METHODS 76 MPS patients were evaluated. Forty-two MPS patients underwent polysomnography (PSG) for obstructive sleep apnea (OSA). Pre- and postoperative PSG results of 18 patients were compared. The success and complications of treatments for OSA in MPS were evaluated. Biochemical and histopathological accumulation of GAG in tonsil and adenoid tissue and middle ear effusion were analyzed and compared with the control group.

RESULTS Forty patients out of 42 tested with PSG had OSA (95%). Adenoid grade, Mallampati grade, restricted mouth opening, rate of difficult intubation were significantly different among MPS subtypes. MPS types III and IV had significantly lower Mallampati scores; type VI had significantly worse mouth opening; and type III had significantly better mouth opening and higher rate of easy intubation when compared to other MPS types. There was no significant difference between MPS subtypes according to tonsil grade, adenoid grade, rate of otitis media with effusion and OSA severity. Statistically significant difference was found between GAG accumulation in adenoid tissue and middle ear effusion of MPS and control group (p<0.05). However, GAG accumulation in tonsil was not significantly different between MPS and control group. There was a statistically significant improvement in postop Apnea-Hypopnea Index (AHI) compared to preop AHI (p<0.05).

CONCLUSIONS Most MPS patients have airway obstruction and OSA due to adenotonsillar hypertrophy. Most of these children benefit from adenotonsillectomy, after which OSA significantly improves. They experience high recurrence rate after adenoidectomy; though this is not clinically problematic. They also suffer from conductive hearing loss due to OME, which has to be treated with ventilation tube insertion. However, such operations are usually complicated by difficult endotracheal intubation and restricted mouth opening. Sometimes tracheotomy may be necessary. Tracheotomy is also highly complicated in MPS patients. Significant accumulation of GAG in middle ear fluid and adenoid tissue is present; however, GAG appears not to accumulate in tonsillar tissue.

Neuroelectrical imaging investigation of cortical activity during listening to music in prelingually deaf children with cochlear implants

Marsella P, Scorpecci A, Vecchiato G, Maglione A, Colosimo A, Babiloni F; International Journal of Pediatric Otorhinolaryngology 78 (5), 737-43 (May 2014)

OBJECTIVE To date, no objective measure of the pleasantness of music perception by children with cochlear implants has been reported. The EEG alpha asymmetries of pre-frontal cortex activation are known to relate to emotional/affective engagement in a perceived stimulus. More specifically, according to the'withdrawal/approach'model, an unbalanced de-synchronization of the alpha activity in the left prefrontal cortex has been associated with a positive affective state/approach toward a stimulus, and an unbalanced de-synchronization of the same activity in the right prefrontal cortex with a negative affective state/withdrawal from a stimulus. In the present study, High-Resolution EEG with Source Reconstruction was used to compare the music-induced alpha asymmetries of the prefrontal cortex in a group of prelingually deaf implanted children and in a control group of normal-hearing children.

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Otogenic lateral sinus thrombosis: Case series and controversies

Funamura J, Nguyen A, Diaz R; International Journal of Pediatric Otorhinolaryngology 78 (5), 866-70 (May 2014)

OBJECTIVES The aim of this study is to (1) report the clinical presentation, treatment, and sequelae in a series of pediatric patients with otogenic lateral sinus thrombosis and (2) to review the most controversial aspects of management of this rare intracranial complication of otitis media.

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Evaluation of usefulness of fine-needle aspiration cytology in the diagnosis of tumours of the accessory parotid gland: a preliminary analysis of a case series in Japan

Iguchi H, Wada T, Matsushita N, Oishi M, Teranishi Y, Yamane H; Acta Oto-Laryngologica 1-3 (May 2014)

The accuracy and sensitivity of fine-needle aspiration cytology (FNAC) in this analysis were not satisfactory, and the false-negative rate seemed to be higher than for parotid tumours. The possibility of low-grade malignancy should be considered in the surgical treatment of accessory parotid gland (APG) tumours, even if the preoperative results of FNAC suggest that the tumour is benign.

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Nasopharyngeal tuberculosis presenting as massive cervical lymphadenopathy and hearing loss

Ozcan C, Vaysoglu Y, Güçlütürk T, Apa DD, Görür K; Journal of Craniofacial Surgery 23 (4), 341-3 (Jul 2012)
ABSTRACT: Lymphadenitis is the most common form of tuberculosis in the head and neck region, but it can be seen in the other areas of the head and neck. Nasopharyngeal tuberculosis is a rare condition without pulmonary and systemic involvement. The majority of patients present with neck mass.

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A Novel Technique to Repair Moderate-Sized Nasoseptal Perforations

Raol N, Olson K; Archives of Otolaryngology - Head and Neck Surgery 1-3 (Jul 2012)
OBJECTIVES To describe a novel technique for closure of moderate-sized nasoseptal perforations and to review the current literature on various techniques for closure of nasoseptal perforations.

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