S. Lisboa, D. A. Rocha, R. Mejia, A. Sasaki, M. Rosenfeld, L. Matos, D. Ramos, M. Kulcsar
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 25 2019. Accepted: September 15, 2019. Study carried out at Instituto de Câncer do Estado de São Paulo – ICESP, Faculdade de Medicina (FM), Universidade de São Paulo (USP), São Paulo, SP, Brasil This study was presented at the XVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço 2019. Abstract Introduction: The larynx is a organ of the upper aerodigestive tract that plays an essential role in protecting the airways during swallowing. Squamous cell carcinoma is the most common malignant neoplasm affecting this region and early diagnosis has an important role in treatment outcome. Objectives: This study aims to evaluate whether patients with hypopharyngeal and/or laryngeal squamous cell carcinoma (SCC) who underwent organ preservation therapy (OPT) present at the time of relapse some factor that determines the local recurrence of the disease. Methods: Patients submitted to OPT were selected at the Cancer Institute of the State of São Paulo (ICESP), at the end of treatment, from January 2012 to December 2017. We collected retrospective data on demographics, clinical staging, location of the primary tumor, presence or absence of recurrence, weight and percentage of weight loss at different moments, alimentary pathway and symptomatology at the time of relapse. Results: The absence of symptoms was associated with the absence of relapse (p <0.001). Fully oral diet at the last visit was a significant factor for the absence of relapse (p = 0.005). The weight comparison of all the patients before the beginning of OPT and after the end of the treatment, showed an average drop of 3.4 kg. In the group-separated analysis, patients who did not recur showed an average loss of 0.7%. Patients with relapse, showed a loss of 2.0% of the weight at the time of relapse. Conclusion: Weight loss and the presence of symptoms were important predictors of recurrence with statistical significance. These factors may help to better manage these patients, with earlier investigations and, therefore, the possibility of rescue treatments with a shorter duration.
{"title":"Recurrence of laryngeal squamous cell carcinoma in patients undergoing organ preservation therapy: are there symptoms associated with recurrence?","authors":"S. Lisboa, D. A. Rocha, R. Mejia, A. Sasaki, M. Rosenfeld, L. Matos, D. Ramos, M. Kulcsar","doi":"10.4322/ahns.2019.0022","DOIUrl":"https://doi.org/10.4322/ahns.2019.0022","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 25 2019. Accepted: September 15, 2019. Study carried out at Instituto de Câncer do Estado de São Paulo – ICESP, Faculdade de Medicina (FM), Universidade de São Paulo (USP), São Paulo, SP, Brasil This study was presented at the XVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço 2019. Abstract Introduction: The larynx is a organ of the upper aerodigestive tract that plays an essential role in protecting the airways during swallowing. Squamous cell carcinoma is the most common malignant neoplasm affecting this region and early diagnosis has an important role in treatment outcome. Objectives: This study aims to evaluate whether patients with hypopharyngeal and/or laryngeal squamous cell carcinoma (SCC) who underwent organ preservation therapy (OPT) present at the time of relapse some factor that determines the local recurrence of the disease. Methods: Patients submitted to OPT were selected at the Cancer Institute of the State of São Paulo (ICESP), at the end of treatment, from January 2012 to December 2017. We collected retrospective data on demographics, clinical staging, location of the primary tumor, presence or absence of recurrence, weight and percentage of weight loss at different moments, alimentary pathway and symptomatology at the time of relapse. Results: The absence of symptoms was associated with the absence of relapse (p <0.001). Fully oral diet at the last visit was a significant factor for the absence of relapse (p = 0.005). The weight comparison of all the patients before the beginning of OPT and after the end of the treatment, showed an average drop of 3.4 kg. In the group-separated analysis, patients who did not recur showed an average loss of 0.7%. Patients with relapse, showed a loss of 2.0% of the weight at the time of relapse. Conclusion: Weight loss and the presence of symptoms were important predictors of recurrence with statistical significance. These factors may help to better manage these patients, with earlier investigations and, therefore, the possibility of rescue treatments with a shorter duration.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82993144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Galli, Renata Victória Tassara, Marcelo Sousa, M. C. M. D. Castro, O. Cruz
Changes in course of the internal carotid artery (ICA) are uncommon, and dehiscence of the carotid canal with cochlea may occur. A 48-year-old female individual with pulsatile tinnitus. No other otologic symptoms observed. Otolaryngologic examination and audiometric test with normal results. Computed tomography (CT) scan of the mastoid bones showed dehiscence of cochlea with ICA on the right side. An option for monitored observation was made after analysis of the risks and undefined results of surgery. Patient maintained clinical and audiometric profile. Carotid-artery cochlear dehiscence is a condition that must be known, remembered and investigated, because it may mimic other otologic pathologies. Knowledge about it prevents serious complications that can be difficult to reverse.
{"title":"Carotid-artery cochlear dehiscence","authors":"V. Galli, Renata Victória Tassara, Marcelo Sousa, M. C. M. D. Castro, O. Cruz","doi":"10.4322/ahns.2019.0021","DOIUrl":"https://doi.org/10.4322/ahns.2019.0021","url":null,"abstract":"Changes in course of the internal carotid artery (ICA) are uncommon, and dehiscence of the carotid canal with cochlea may occur. A 48-year-old female individual with pulsatile tinnitus. No other otologic symptoms observed. Otolaryngologic examination and audiometric test with normal results. Computed tomography (CT) scan of the mastoid bones showed dehiscence of cochlea with ICA on the right side. An option for monitored observation was made after analysis of the risks and undefined results of surgery. Patient maintained clinical and audiometric profile. Carotid-artery cochlear dehiscence is a condition that must be known, remembered and investigated, because it may mimic other otologic pathologies. Knowledge about it prevents serious complications that can be difficult to reverse.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74381918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Silva, Anna Caroline Rodrigues de Souza Matos, Ana Carla Albuquerque dos Santos, Teresa Nogueira, Viviane Carvalho da Silva
Cicatricial pemphigoid is an uncommon chronic autoimmune inflammatory disease that affects predominantly the mucous membranes. The precise cause of this condition is yet to be fully identified, as well as the mechanism behind the commonly observed subepithelial blistering. This manuscript reports a case of cicatricial pemphigoid with laryngeal involvement, which is a rare manifestation of this also uncommon disease. The patient underwent surgery and specimens were submitted to histopathological examination and immunofluorescence assays, and both ultimately indicated cicatricial
{"title":"Cicatricial pemphigoid with laryngeal involvement","authors":"C. Silva, Anna Caroline Rodrigues de Souza Matos, Ana Carla Albuquerque dos Santos, Teresa Nogueira, Viviane Carvalho da Silva","doi":"10.4322/ahns.2019.0028","DOIUrl":"https://doi.org/10.4322/ahns.2019.0028","url":null,"abstract":"Cicatricial pemphigoid is an uncommon chronic autoimmune inflammatory disease that affects predominantly the mucous membranes. The precise cause of this condition is yet to be fully identified, as well as the mechanism behind the commonly observed subepithelial blistering. This manuscript reports a case of cicatricial pemphigoid with laryngeal involvement, which is a rare manifestation of this also uncommon disease. The patient underwent surgery and specimens were submitted to histopathological examination and immunofluorescence assays, and both ultimately indicated cicatricial","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75190258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana L V Pequeno, Jônatas Catunda de Freitas, M. Fernandes, Ana Carla Albuquerque dos Santos, Wellington Alves Filho
Mucoepidermoid carcinoma (MEC) is a common malignant tumor composed of mucinous cells, clear cells and squamoid tumor cells. It is usually localized on the salivary glands, however can very rarely be intraosseous. This tumor affects women more than men and is more common in the mandible. In this report, we present a case of a 45-year-old woman with a painless intraoral mass for 10 years which was repeatedly misdiagnosed, evolving into an extensive lesion. After an appropriate approach, she was diagnosed with MEC of the mandible and submitted to a left hemimandibulectomy accompanied by microsurgical reconstruction with excellent results.
{"title":"Intraosseous mucoepidermoid carcinoma","authors":"Ana L V Pequeno, Jônatas Catunda de Freitas, M. Fernandes, Ana Carla Albuquerque dos Santos, Wellington Alves Filho","doi":"10.4322/ahns.2019.0008","DOIUrl":"https://doi.org/10.4322/ahns.2019.0008","url":null,"abstract":"Mucoepidermoid carcinoma (MEC) is a common malignant tumor composed of mucinous cells, clear cells and squamoid tumor cells. It is usually localized on the salivary glands, however can very rarely be intraosseous. This tumor affects women more than men and is more common in the mandible. In this report, we present a case of a 45-year-old woman with a painless intraoral mass for 10 years which was repeatedly misdiagnosed, evolving into an extensive lesion. After an appropriate approach, she was diagnosed with MEC of the mandible and submitted to a left hemimandibulectomy accompanied by microsurgical reconstruction with excellent results.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77874136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thiago Demétrio Nogueira Costa e Silva, Emidiana Raquel Rodrigues de Souza Oliveira, Sheila Maria da Conceição Costa, Cláudia Isabel Silva Carlos
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 18, 2018. Accepted: February 21, 2019. The study was carried out at Liga Mossoroense de Estudos e Combate ao Câncer (LMECC), Mossoró, RN, Brasil. Abstract Introduction: Oral cancer accounts for 5.2% of all malignancies in men in Brazil, and is considered the most common cancer of the head and neck (H&N) region, excluding skin cancer. Despite the diagnostic and therapeutic advances in the oncology area, disease-free survival is still low. Objective: To describe and analyze patient survival and the factors associated with oral cancer. Methods: A retrospective, observational study was conducted through analysis of the medical charts of H&N cancer patients assisted at the Mossoro League of Cancer Research and Combat (LMECC) from 2006 to 2015. The data were analyzed by exploratory descriptive statistics. Survival was described using the Kaplan-Meier method. Results: There was predominance of men (59.7%), with a mean age of 65 years, Caucasians (56.6%), farmers (52.0%) from Mossoró (RN), Brazil (66.7%), and smokers (88.4%). In the majority of cases, tumor occurred in the tongue (52.6%), at an advanced stage (73.6%), and was first treated predominantly with surgery (69.6%). Mean survival time of the patients was 2524 days, and was lower in patients with lymph node metastasis and in those submitted to nonsurgical treatment. Mortality rate was 45.5%. Conclusion: The high rates of mortality and advanced stage patients indicate late diagnosis, which reflects the need for preventive actions, training of health professionals, and improved access to the health system.
资金支持:无。利益冲突:本文发表未声明存在利益冲突。提交日期:2018年9月18日。录用日期:2019年2月21日。该研究是在Liga Mossoroense de Estudos e Combate ao ncer (LMECC)， Mossoró， RN, brazil进行的。摘要简介:口腔癌占巴西男性所有恶性肿瘤的5.2%，被认为是头颈部(H&N)地区除皮肤癌外最常见的癌症。尽管肿瘤领域的诊断和治疗取得了进步，但无病生存率仍然很低。目的:描述和分析口腔癌患者的生存及相关因素。方法:通过分析2006 - 2015年在Mossoro癌症研究与斗争联盟(LMECC)协助的H&N癌症患者的病历，进行回顾性观察研究。采用探索性描述性统计对数据进行分析。生存率采用Kaplan-Meier法。结果:男性居多(59.7%)，平均年龄65岁，白人(56.6%)，来自Mossoró (RN)、巴西(66.7%)的农民(52.0%)和吸烟者(88.4%)。在大多数病例中，肿瘤发生在舌部(52.6%)，晚期(73.6%)，首先以手术治疗为主(69.6%)。患者的平均生存时间为2524天，而淋巴结转移患者和接受非手术治疗的患者的平均生存时间较低。死亡率为45.5%。结论:高死亡率和晚期患者表明诊断较晚，这反映了采取预防措施、培训卫生专业人员和改善卫生系统可及性的必要性。
{"title":"Analysis of survival and factors associated with oral cancer","authors":"Thiago Demétrio Nogueira Costa e Silva, Emidiana Raquel Rodrigues de Souza Oliveira, Sheila Maria da Conceição Costa, Cláudia Isabel Silva Carlos","doi":"10.4322/ahns.2019.0007","DOIUrl":"https://doi.org/10.4322/ahns.2019.0007","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 18, 2018. Accepted: February 21, 2019. The study was carried out at Liga Mossoroense de Estudos e Combate ao Câncer (LMECC), Mossoró, RN, Brasil. Abstract Introduction: Oral cancer accounts for 5.2% of all malignancies in men in Brazil, and is considered the most common cancer of the head and neck (H&N) region, excluding skin cancer. Despite the diagnostic and therapeutic advances in the oncology area, disease-free survival is still low. Objective: To describe and analyze patient survival and the factors associated with oral cancer. Methods: A retrospective, observational study was conducted through analysis of the medical charts of H&N cancer patients assisted at the Mossoro League of Cancer Research and Combat (LMECC) from 2006 to 2015. The data were analyzed by exploratory descriptive statistics. Survival was described using the Kaplan-Meier method. Results: There was predominance of men (59.7%), with a mean age of 65 years, Caucasians (56.6%), farmers (52.0%) from Mossoró (RN), Brazil (66.7%), and smokers (88.4%). In the majority of cases, tumor occurred in the tongue (52.6%), at an advanced stage (73.6%), and was first treated predominantly with surgery (69.6%). Mean survival time of the patients was 2524 days, and was lower in patients with lymph node metastasis and in those submitted to nonsurgical treatment. Mortality rate was 45.5%. Conclusion: The high rates of mortality and advanced stage patients indicate late diagnosis, which reflects the need for preventive actions, training of health professionals, and improved access to the health system.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86830014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Tavares, F. Vanderlei, M. Teixeira, D. A. Rocha, S. Serrano, Luis Felipe de Barros Ura, R. Moyses
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 24, 2019. Accepted: October 01, 2019. The study was carried out at Serviço de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brasil. Article presented at the XXVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, in August 2019 Abstract Introduction: As the number of thyroid operations increases, the incidence of complications also increases, including transitory and definite hypoparathyroidism. Since each patient presents different and unpredictable symptoms, affecting several organs and systems, they need personalized care. Even when patients presented with low calcium blood levels, the previous results were considered acceptable, usually using oral prescriptions of calcium carbonate and calcitriol. We created in March 2017 a specialized outpatient treatment facility for those patients focused on generating experience and knowledge about hypoparathyroidism. Objective: To analyze the challenges and the impact of specialized care in diagnosis, treatment and in follow-up of patients with postoperative hypoparathyroidism, with potential to improve teaching and further research possibilities in the subject. Methods: 61 patients were studied: 55 women, age 18-55. A retrospective study was performed, considering specialized guidelines. We also analyzed blood levels of calcium, parathyroid hormone, vitamin D, and other minerals; kidney function; bone structure. Results: Some patients needed drug dose adjustments up to 66%. We were able to identify kidney structural and functional changes. We could share those experiences in a multidisciplinary way, contributing significantly to provide more experience to the medical residents. Conclusion: Specialized outpatient treatment is responsible for providing more efficient and safe treatment to the patients, and it is also important to enable further medical research.
{"title":"Chronic hypoparathyroidism after thyroid surgery: Benefits of specialized and personalized care in a tertiary public hospital","authors":"M. Tavares, F. Vanderlei, M. Teixeira, D. A. Rocha, S. Serrano, Luis Felipe de Barros Ura, R. Moyses","doi":"10.4322/ahns.2019.0017","DOIUrl":"https://doi.org/10.4322/ahns.2019.0017","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: June 24, 2019. Accepted: October 01, 2019. The study was carried out at Serviço de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brasil. Article presented at the XXVII Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, in August 2019 Abstract Introduction: As the number of thyroid operations increases, the incidence of complications also increases, including transitory and definite hypoparathyroidism. Since each patient presents different and unpredictable symptoms, affecting several organs and systems, they need personalized care. Even when patients presented with low calcium blood levels, the previous results were considered acceptable, usually using oral prescriptions of calcium carbonate and calcitriol. We created in March 2017 a specialized outpatient treatment facility for those patients focused on generating experience and knowledge about hypoparathyroidism. Objective: To analyze the challenges and the impact of specialized care in diagnosis, treatment and in follow-up of patients with postoperative hypoparathyroidism, with potential to improve teaching and further research possibilities in the subject. Methods: 61 patients were studied: 55 women, age 18-55. A retrospective study was performed, considering specialized guidelines. We also analyzed blood levels of calcium, parathyroid hormone, vitamin D, and other minerals; kidney function; bone structure. Results: Some patients needed drug dose adjustments up to 66%. We were able to identify kidney structural and functional changes. We could share those experiences in a multidisciplinary way, contributing significantly to provide more experience to the medical residents. Conclusion: Specialized outpatient treatment is responsible for providing more efficient and safe treatment to the patients, and it is also important to enable further medical research.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79592020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria da Graça Caminha Vidal, O. Cervantes, M. F. Daubermann, Fernando Cogo Manduca, Aloysio Enck Neto
Introduction: Thyroid cancer is the most common endocrine cancer, corresponding to 1% of all malignancies in the 30-74 age group. Cases of primary thyroid sarcomas are rare in the literature. They tend to present an unfavorable clinical course. Case report: Female patient, 66 years old, presented a visible neck mass with progressive growth for 2 years ago, reporting dysphagia for solids. Presence of exophytic nodular growth in the left lobe was evidenced through the examinations, and classified as Bethesda I through fine needle aspiration biopsy (FNAP). Total thyroidectomy revealed a low-grade myxofibrosarcoma (MFS). Discussion: MFS presents higher incidence in the elderly. Diagnosed by histopathological examination, evaluation through magnetic resonance imaging (MRI) is necessary in order to analyze the surgical resection plans with tumor-free margins. As MFS presents rare occurrence in the thyroid gland and a high local recurrence rate, adjuvant radiotherapy can be considered as a form of recurrence control.
{"title":"Myxofibrosarcoma of the thyroid gland","authors":"Maria da Graça Caminha Vidal, O. Cervantes, M. F. Daubermann, Fernando Cogo Manduca, Aloysio Enck Neto","doi":"10.4322/ahns.2019.0027","DOIUrl":"https://doi.org/10.4322/ahns.2019.0027","url":null,"abstract":"Introduction: Thyroid cancer is the most common endocrine cancer, corresponding to 1% of all malignancies in the 30-74 age group. Cases of primary thyroid sarcomas are rare in the literature. They tend to present an unfavorable clinical course. Case report: Female patient, 66 years old, presented a visible neck mass with progressive growth for 2 years ago, reporting dysphagia for solids. Presence of exophytic nodular growth in the left lobe was evidenced through the examinations, and classified as Bethesda I through fine needle aspiration biopsy (FNAP). Total thyroidectomy revealed a low-grade myxofibrosarcoma (MFS). Discussion: MFS presents higher incidence in the elderly. Diagnosed by histopathological examination, evaluation through magnetic resonance imaging (MRI) is necessary in order to analyze the surgical resection plans with tumor-free margins. As MFS presents rare occurrence in the thyroid gland and a high local recurrence rate, adjuvant radiotherapy can be considered as a form of recurrence control.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"213 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73574637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 30, 2019. Accepted: November 17, 2019. The study was carried out at Faculdade de Medicina, Departamento de Cirurgia, Universidade Federal de Goiás (UFG), Goiânia, GO, Brasil. Abstract Introduction: Thyroglossal duct cyst (TDC) is the most commonly found cervical congenital mass, occurring in approximately 7% of the population; however, data on TDC in Brazil are scarce. Objective: To outline the Brazilian scenario in the treatment of TDC and review the literature on this theme. Methods: Retrospective epidemiological study with a descriptive approach using secondary data collected from the SIH/DataSUS (Sistema de Internações Hospitalares/Sistema Nacional de Informação em Saúde) between 2008 and 2018, along with an analysis of the revisions on TDC published over the past ten years. Results: Between 2008 and 2018, there were 23,602 hospital admissions for TDC excision, with an average of 2,145 procedures per year, resulting in an average of 11.85 procedures per 100,000 inhabitants in the period evaluated. Admissions occurred predominantly in the Southeast and Northeast regions, at an average cost of BRL 1,054,977.66 per year to the health system of the country. The literature search resulted in 52 review articles addressing the pathogenesis, diagnosis and management of TDC, which are explained in this study. Conclusion: TDC is a congenital entity predominantly treated in the country at relevant costs to the health system, demanding accuracy on the knowledge of its pathogenesis for better diagnosis and management of patients with this condition.
资金支持:无。利益冲突:本文发表未声明存在利益冲突。提交日期:2019年9月30日。录用日期:2019年11月17日。该研究是在巴西GO . goi尼亚联邦大学Goiás (UFG) Cirurgia系医学部进行的。摘要简介:甲状舌管囊肿(TDC)是最常见的宫颈先天性肿块，约占人口的7%;然而，关于巴西贸易发展的数据很少。目的:概述巴西治疗TDC的情况，并回顾有关这一主题的文献。方法:采用描述性方法，采用2008年至2018年从SIH/DataSUS (Sistema de Internações Hospitalares/Sistema Nacional de informa o em Saúde)收集的二次数据进行回顾性流行病学研究，并分析过去十年发表的TDC修订。结果:2008年至2018年期间，共有23,602例TDC切除术入院，平均每年2145例手术，在评估期间平均每10万居民进行11.85例手术。收治主要发生在东南部和东北部地区，该国卫生系统每年的平均费用为1,054,977.66雷亚尔。通过文献检索，我们获得了52篇关于TDC发病机制、诊断和治疗的综述文章，本文对此进行了解释。结论:TDC是一种先天性疾病，主要在国内进行治疗，对卫生系统造成了相关费用，因此需要准确了解其发病机制，以便更好地诊断和管理这种疾病的患者。
{"title":"Thyroglossal cyst: Brazilian panorama","authors":"R. V. T. Filho","doi":"10.4322/ahns.2019.0023","DOIUrl":"https://doi.org/10.4322/ahns.2019.0023","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: September 30, 2019. Accepted: November 17, 2019. The study was carried out at Faculdade de Medicina, Departamento de Cirurgia, Universidade Federal de Goiás (UFG), Goiânia, GO, Brasil. Abstract Introduction: Thyroglossal duct cyst (TDC) is the most commonly found cervical congenital mass, occurring in approximately 7% of the population; however, data on TDC in Brazil are scarce. Objective: To outline the Brazilian scenario in the treatment of TDC and review the literature on this theme. Methods: Retrospective epidemiological study with a descriptive approach using secondary data collected from the SIH/DataSUS (Sistema de Internações Hospitalares/Sistema Nacional de Informação em Saúde) between 2008 and 2018, along with an analysis of the revisions on TDC published over the past ten years. Results: Between 2008 and 2018, there were 23,602 hospital admissions for TDC excision, with an average of 2,145 procedures per year, resulting in an average of 11.85 procedures per 100,000 inhabitants in the period evaluated. Admissions occurred predominantly in the Southeast and Northeast regions, at an average cost of BRL 1,054,977.66 per year to the health system of the country. The literature search resulted in 52 review articles addressing the pathogenesis, diagnosis and management of TDC, which are explained in this study. Conclusion: TDC is a congenital entity predominantly treated in the country at relevant costs to the health system, demanding accuracy on the knowledge of its pathogenesis for better diagnosis and management of patients with this condition.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"2016 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86542565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Gatti, J. Pacheco, N. Ahumada, C. Lehn, F. Walder
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 02, 2019. Accepted: February 09, 2019. The study was carried out at Otorhinolaryngology and Head and Neck Surgery Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço UNIFESP, São Paulo, SP, Brasil. Abstract Introduction: Through the knowledge of the metastatic pathways of the Squamous Cell Carcinoma (SCC) of the larynx, the lymph node level with a higher probability of involvement can be predicted. The surgeon uses this knowledge to determine the extension of neck dissection to perform. However, the longer the surgery, the greater the morbidity for the patient. When the metastatic risk is >20%, neck dissection of that cervical level is necessary. In cases of clinically evident (cN+) metastasis, uni or bilaterally, comprehensive neck dissection is determinant for the treatment, however there is no consensus about neck dissection for contralateral clinically negative neck (cN-). Objective: To evaluate if patients with laryngeal SCC homolateral cN+ and contralateral cNshould be submitted to bilateral neck dissection. Methods: The team reviewed medical records from 135 patients with a diagnosis of laryngeal malignancy between March/2009 and September/2017, analyzing gender, age, tobacco and alcohol comsumption, primary tumor site, neck dissection laterality, clinical and pathological contralaterality, staging, tumor recurrence or late metastasis and survival Results: We observed that 40.74% were pN+ on at least one side after neck dissection, which 87.27% performed bilateral neck dissection. Of these, 66.67% did not have contralateral metastasis, 87.5% had no previously clinically evident metastasis. Conclusion: Patients contralateral cNhave a risk <20% for occult metastasis and should not routinely go through bilateral neck dissection.
{"title":"Incidence of contralateral cervical metastasis in laryngeal tumors","authors":"A. Gatti, J. Pacheco, N. Ahumada, C. Lehn, F. Walder","doi":"10.4322/ahns.2019.0004","DOIUrl":"https://doi.org/10.4322/ahns.2019.0004","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 02, 2019. Accepted: February 09, 2019. The study was carried out at Otorhinolaryngology and Head and Neck Surgery Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço UNIFESP, São Paulo, SP, Brasil. Abstract Introduction: Through the knowledge of the metastatic pathways of the Squamous Cell Carcinoma (SCC) of the larynx, the lymph node level with a higher probability of involvement can be predicted. The surgeon uses this knowledge to determine the extension of neck dissection to perform. However, the longer the surgery, the greater the morbidity for the patient. When the metastatic risk is >20%, neck dissection of that cervical level is necessary. In cases of clinically evident (cN+) metastasis, uni or bilaterally, comprehensive neck dissection is determinant for the treatment, however there is no consensus about neck dissection for contralateral clinically negative neck (cN-). Objective: To evaluate if patients with laryngeal SCC homolateral cN+ and contralateral cNshould be submitted to bilateral neck dissection. Methods: The team reviewed medical records from 135 patients with a diagnosis of laryngeal malignancy between March/2009 and September/2017, analyzing gender, age, tobacco and alcohol comsumption, primary tumor site, neck dissection laterality, clinical and pathological contralaterality, staging, tumor recurrence or late metastasis and survival Results: We observed that 40.74% were pN+ on at least one side after neck dissection, which 87.27% performed bilateral neck dissection. Of these, 66.67% did not have contralateral metastasis, 87.5% had no previously clinically evident metastasis. Conclusion: Patients contralateral cNhave a risk <20% for occult metastasis and should not routinely go through bilateral neck dissection.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84741717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Neves, Ana Beatriz Ribeiro Fonseca, Camila Y. Koike, Davi Knoll Ribeiro, M. Lera, R. Santos
Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 06, 2019. Accepted: November 17, 2019. The study was carried out at Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil. This study was presented at the Congresso Brasileiro de Cirurgia de Cabeça e Pescoço – August 2019 Gramado, RS. Abstract Introduction: Parathyroidectomy (PTX) is one of the forms to treat hyperparathyroidism (HPT) after renal transplantation (RT), but choosing the appropriate surgical technique is controversial. The option for more conservative surgeries, such as subtotal parathyroidectomy (STPX), has been expanding owing to the lower risk of definitive HPT and its effectiveness in controlling hypercalcemia. Objective: To evaluate the efficacy of STPX as a definitive treatment for hyperparathyroidism after renal transplantation (HPTRT) and determine whether there is a relationship between percentage intraoperative parathyroid hormone (ioPTH) decay levels and parathyroid hormone (PTH) values on the first postoperative day and surgical success. Methods: This retrospective study analyzed the medical records of prospectively followed patients diagnosed with HPT-RT submitted to STPX in two tertiary hospitals (Brazilian Unified Health System SUS) for two years. Patients were allocated in two groups according to operative success (SG normalization of ionized calcium (iCa) and PTH six months after surgery) or operative failure (FG persistence of high iCa and PTH). The percentage ioPTH decay levels and the postoperative PTH absolute values on the first postoperative day were evaluated in both groups. Results: Of the total sample of 31 patients, surgical treatment was successful in 27 cases (87%). No statistically significant differences were observed between the groups for the percentage ioPTH decay levels (SG = 71.51% vs. FG = 70.4%), as well as for the PTH absolute values on the first postoperative day (SG = 52.69pg/ mL vs. FG = 54.55pg/mL). Conclusion: Subtotal parathyroidectomy is an effective and safe procedure for treating HPT-RT; however, the use of PTH levels remains subjective and cannot be considered as a predictor of surgical success.
资金支持:无。利益冲突:本文发表未声明存在利益冲突。提交日期:2019年2月6日。录用日期:2019年11月17日。这项研究是在Departamento de Otorrinolaringologia e Cirurgia de Cabeca e Pescoco联邦德圣保罗大学(UNIFESP)、SP,巴西圣保罗。摘要简介:甲状旁腺切除术(PTX)是肾移植(RT)后治疗甲状旁腺功能亢进(HPT)的一种形式，但选择合适的手术技术存在争议。更保守的手术选择，如甲状旁腺次全切除术(STPX)，由于最终HPT的风险较低，其在控制高钙血症方面的有效性，一直在扩大。目的:评价STPX作为肾移植术后甲状旁腺功能亢进(HPTRT)的最终治疗方法的疗效，探讨术中ioPTH(甲状旁腺激素)下降百分比及术后第一天甲状旁腺激素(PTH)值与手术成功率之间的关系。方法:回顾性分析巴西两家三级医院(巴西统一卫生系统SUS)两年内前瞻性随访诊断为HPT-RT的STPX患者的病历。根据手术成功(术后6个月电离钙(iCa)和甲状旁腺激素的SG正常化)或手术失败(高iCa和甲状旁腺激素的FG持续)将患者分为两组。观察两组患者术后第1天ioPTH衰减百分比及术后PTH绝对值。结果:31例患者中，手术治疗成功27例(87%)。两组间ioPTH衰减百分比(SG = 71.51% vs. FG = 70.4%)及术后第1天PTH绝对值(SG = 52.69pg/ mL vs. FG = 54.55pg/mL)差异无统计学意义。结论:甲状旁腺次全切除术是治疗HPT-RT有效、安全的方法;然而，甲状旁腺激素水平的使用仍然是主观的，不能被认为是手术成功的预测因素。
{"title":"Outcome of subtotal parathyroidectomy for surgical treatment of hyperparathyroidism after renal transplantation","authors":"M. Neves, Ana Beatriz Ribeiro Fonseca, Camila Y. Koike, Davi Knoll Ribeiro, M. Lera, R. Santos","doi":"10.4322/ahns.2019.0024","DOIUrl":"https://doi.org/10.4322/ahns.2019.0024","url":null,"abstract":"Financial support: None. Conflicts of interest: No conflicts of interest declared concerning the publication of this article. Submitted: February 06, 2019. Accepted: November 17, 2019. The study was carried out at Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brasil. This study was presented at the Congresso Brasileiro de Cirurgia de Cabeça e Pescoço – August 2019 Gramado, RS. Abstract Introduction: Parathyroidectomy (PTX) is one of the forms to treat hyperparathyroidism (HPT) after renal transplantation (RT), but choosing the appropriate surgical technique is controversial. The option for more conservative surgeries, such as subtotal parathyroidectomy (STPX), has been expanding owing to the lower risk of definitive HPT and its effectiveness in controlling hypercalcemia. Objective: To evaluate the efficacy of STPX as a definitive treatment for hyperparathyroidism after renal transplantation (HPTRT) and determine whether there is a relationship between percentage intraoperative parathyroid hormone (ioPTH) decay levels and parathyroid hormone (PTH) values on the first postoperative day and surgical success. Methods: This retrospective study analyzed the medical records of prospectively followed patients diagnosed with HPT-RT submitted to STPX in two tertiary hospitals (Brazilian Unified Health System SUS) for two years. Patients were allocated in two groups according to operative success (SG normalization of ionized calcium (iCa) and PTH six months after surgery) or operative failure (FG persistence of high iCa and PTH). The percentage ioPTH decay levels and the postoperative PTH absolute values on the first postoperative day were evaluated in both groups. Results: Of the total sample of 31 patients, surgical treatment was successful in 27 cases (87%). No statistically significant differences were observed between the groups for the percentage ioPTH decay levels (SG = 71.51% vs. FG = 70.4%), as well as for the PTH absolute values on the first postoperative day (SG = 52.69pg/ mL vs. FG = 54.55pg/mL). Conclusion: Subtotal parathyroidectomy is an effective and safe procedure for treating HPT-RT; however, the use of PTH levels remains subjective and cannot be considered as a predictor of surgical success.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80559906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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