Artículos

MRI and CT of Nasopharyngeal Carcinoma

Razek AA, King A; American Journal of Roentgenology 198 (1), 11-8 (Jan 2012)

OBJECTIVE: This article reviews the MRI and CT of nasopharyngeal carcinoma. Extension of nasopharyngeal tumors, especially into the skull base and the deep facial spaces, is well illustrated on imaging. Assessment of retropharyngeal and cervical lymphadenopathy is important for treatment planning. MRI is commonly used for monitoring patients after therapy. CONCLUSION: Imaging can detect effect of radiation on surrounding structures. The imaging findings that help to differentiate nasopharyngeal carcinoma from simulating lesions are discussed.
 

Early experience of radio frequency coblation in the management of intranasal and sinus tumors

 Syed MI, Mennie J, Williams AT; The Laryngoscope (Jan 2012)


The purpose of this study was to evaluate the safety and efficacy of the use of radiofrequency coblation for endoscopic resection of intranasal and sinus tumors. A review was conducted of 15 adult patients with intranasal and or sinus tumors endoscopically treated with radio frequency coblation between November 2008 and November 2010 at St. John's Hospital at Livingston, a tertiary referral center that covers otolaryngology services for the southeast of Scotland. Fifteen patients with intranasal and sinus tumors were treated with transnasal endoscopic resection using radiofrequency coblation. The tumors included inverted papilloma (seven), paraganglioma (one), glomangiopericytoma (one), capillary hemangioma (one), hemangiopericytoma (one), juvenile angiofibroma (one), juvenile ossifying fibroma (one), oncocytic adenoma (one), and transitional cell carcinoma (one). We found that radiofrequency coblation is a useful and safe tool associated with minimal blood loss (<200 mL to 600 mL) in the resection of these tumors, and the average operating time was 1.67 hours. Radio frequency is a rapidly evolving technique and in the future will have an increasing role to play in the endoscopic resection of intranasal and sinus tumors
 

Management and Outcomes of Chronic Otitis Media in Patients Who Received Solid Organ Transplantation

 Yu MS, Kim HC, Ahn JH; Otolaryngology - Head and Neck Surgery (Jan 2012)

Objectives. Control of perioperative infection can increase the success rate of organ transplant. The incidence, clinical features, and optimal management of chronic otitis media (COM) in solid organ transplant recipients have not been adequately evaluated. We therefore assessed the incidence and clinical course of COM in solid-organ transplant recipients.Design. Case series with chart review.Setting. Tertiary referral center.Subjects and Methods. We reviewed the medical records of 3278 patients who underwent solid organ transplantations between February 1995 and December 2007 to identify those diagnosed with COM before and after transplant. We analyzed the long-term clinical course and management of COM in these patients.Results. Of 3278 solid organ transplant recipients, 65 (2.0%) were diagnosed with pretransplant COM with a perforated ear drum, including 31 liver, 28 renal, and 6 heart transplant recipients. The primary symptom was otorrhea, followed by hearing disturbance, otalgia, and tinnitus. Middle ear swab culture showed bacterial growth in 17 of the 40 patients (42.5%) with suppurative COM. Of these 40 patients, 14 underwent tympanomastoid surgery (operation group) and 26 were prescribed antibiotics (medication group). The remaining 25 patients, with dry perforated ear drums and well-pneumatized mastoids, were observed without treatment (observation group). After transplantation, the incidence of otorrhea was significantly lower in the operation group (11.1%) than in either the medication (26.9%) or observation (26.7%) group (P = .040, .048, respectively).Conclusions. Precise diagnosis and proper surgical intervention for COM may reduce the rate of otorrhea and exacerbation of COM in solid organ transplant recipients.
 

Transtympanic Injections of N-acetylcysteine for the Prevention of Cisplatin-induced Ototoxicity: A Feasible Method With Promising Efficacy

 Riga MG, Chelis L, Kakolyris S, Papadopoulos S, Stathakidou S, Chamalidou E, Xenidis N, Amarantidis K, Dimopoulos P, Danielides V; American Journal of Clinical Oncology: Cancer Clinical Trials (Nov 2011)

OBJECTIVES:: Ototoxicity is a common and irreversible adverse effect of cisplatin treatment with great impact on the patients' quality of life. N-acetylcysteine is a low-molecular-weight agent which has shown substantial otoprotective activity. The role of transtympanic infusions of N-acetylcysteine was examined in a cohort of patients treated with cisplatin-based regimens. PATIENTS AND METHODS:: Twenty cisplatin-treated patients were subjected, under local anesthesia, to transtympanic N-acetylcysteine (10%) infusions in 1 ear, during the hydration procedure preceding intravenous effusion of cisplatin. The contralateral ear was used as control. The number of transtympanic infusions was respective to the number of administered cycles. Hearing acuity was evaluated before each cycle with pure tone audiometry by an audiologist blinded to the treated ear. RESULTS:: A total of 84 transtympanic infusions were performed. In treated ears, no significant changes in auditory thresholds were recorded. In the control ears cisplatin induced a significant decrease of auditory thresholds at the 8000 Hz frequency band (P=0.008). At the same frequency (8000 Hz), the changes in auditory thresholds were significantly larger for the control ears than the treated ones (P=0.005). An acute pain starting shortly after the injection and lasting for a few minutes seemed to be the only significant adverse effect. CONCLUSIONS:: Transtympanic injections of N-acetylcysteine seem to be a feasible and effective otoprotective strategy for the prevention of cisplatin-induced ototoxicity. Additional studies are required to further clarify the efficiency of this treatment and determine the optimal dosage and protocol.

Major salivary gland disorders in children and adolescents

Przewozny T, Stodulski D, Stankiewicz C; Polish Otolaryngolo
gy 65 (5), 350-356 (Sep 2011)


The aim of this study was a review of 67 children treated for salivary gland tumors in the ENT Department Medical University of Gdansk since 1974 to 2008. In that group we observed 52 children with tumor of the parotid gland, 13 with tumor of submandibular gland and 2 with subligual gland tumors. Tumor-like lesions were stated the largest group of tumors and were observed in 33 (49%) of children, mainly of chronic sialadenitis (17 cases). Predominant number of tumors was observed in scholarschip children. The most common symptoms were slow enlargement of tumor and swelling of the salivary gland. In the group of benign tumors most common was pleomorphic adenoma (19 cases) and in the group of malignant tumors most common was clear cell carcinoma (2 cases) and rhabdomyosarcoma (2 cases). In this report the authors describe basic epidemiological and clinical data (age, sex, duration of symptoms, histological structure of tumor, diagnostic methods, methods and results of treatment) and observations connected with differences of salivary gland tumors in that group of patients.
 

Sinonasal involvement in sarcoidosis: a report of seven cases and review of literature

Sinonasal involvement in sarcoidosis: a report of seven cases and review of literature; Gulati S, Krossnes B, Olofsson J, Danielsen A; European Archives of Oto-Rhino-Laryngology (Sep 2011)
Sarcoidosis is a chronic systemic disease of unknown etiology characterized by non-caseating inflammation involving one or more organs with predilection for pulmonary and upper respiratory tract involvement. It presents with a variety of signs and symptoms which can be generalized or focused on a single organ. Sinonasal involvement is reported in about 1% of cases of sarcoidosis.

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