Pub Date : 2018-01-01DOI: 10.4172/2324-8785-c3-013
M. Shikowitz
Recurrent respiratory papillomatosis (RRP), caused by HPV 6/11, is managed by surgery but papilloma frequently recur. COX-2 and its product PGE2 are overexpressed in RRP. Celecoxib, a COX-2 inhibitor, reduces papilloma cell proliferation, increases apoptosis and reduces HPV E6 and E7 expression. A pilot study of celecoxib therapy showed 2 of 3 patients with complete disease remission. We have now conducted a doubleblind placebo-controlled phase II clinical trial of the efficacy of celecoxib for RRP. Patients with moderate-tosevere disease were randomized to celecoxib or placebo for 1 year, then switched to the alternate treatment for 1 year. Surgery was performed every 3 months to remove all papilloma and assess rate of regrowth, with biopsies and blood collected at each surgery. Clinical response was defined as reduction in rate of regrowth of ≥50% for at least 6 months. Persistence of HPV was measured by qPCR. Fifty-one patients were enrolled, 33 competed the study. 64% had HPV6 and 36% had HPV11. 36% of patients improved on celecoxib, but there was no statistical difference between treatment and placebo groups. The rate of spontaneous improvement was much greater than expected. There was no correlation between Citation: Dr. Mark Shikowitz, Clinical trial of celecoxib for recurrent respiratory papillomatosis. Journal of Plastic Surgery and Case Studies Clinical trial of celecoxib for recurrent respiratory papillomatosis
{"title":"Clinical trial of celecoxib for recurrent respiratory papillomatosis","authors":"M. Shikowitz","doi":"10.4172/2324-8785-c3-013","DOIUrl":"https://doi.org/10.4172/2324-8785-c3-013","url":null,"abstract":"Recurrent respiratory papillomatosis (RRP), caused by HPV 6/11, is managed by surgery but papilloma frequently recur. COX-2 and its product PGE2 are overexpressed in RRP. Celecoxib, a COX-2 inhibitor, reduces papilloma cell proliferation, increases apoptosis and reduces HPV E6 and E7 expression. A pilot study of celecoxib therapy showed 2 of 3 patients with complete disease remission. We have now conducted a doubleblind placebo-controlled phase II clinical trial of the efficacy of celecoxib for RRP. Patients with moderate-tosevere disease were randomized to celecoxib or placebo for 1 year, then switched to the alternate treatment for 1 year. Surgery was performed every 3 months to remove all papilloma and assess rate of regrowth, with biopsies and blood collected at each surgery. Clinical response was defined as reduction in rate of regrowth of ≥50% for at least 6 months. Persistence of HPV was measured by qPCR. Fifty-one patients were enrolled, 33 competed the study. 64% had HPV6 and 36% had HPV11. 36% of patients improved on celecoxib, but there was no statistical difference between treatment and placebo groups. The rate of spontaneous improvement was much greater than expected. There was no correlation between Citation: Dr. Mark Shikowitz, Clinical trial of celecoxib for recurrent respiratory papillomatosis. Journal of Plastic Surgery and Case Studies Clinical trial of celecoxib for recurrent respiratory papillomatosis","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70248280","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}
Pub Date : 2018-01-01DOI: 10.4172/2324-8785-c3-014
Naser Khayat
{"title":"Diagnosis and treatment of temporomandibular disorders and sleep apnea","authors":"Naser Khayat","doi":"10.4172/2324-8785-c3-014","DOIUrl":"https://doi.org/10.4172/2324-8785-c3-014","url":null,"abstract":"","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70248342","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}
Pub Date : 2018-01-01DOI: 10.4172/2324-8785.1000359
H. Kanona, R. Farrell, Oswal Rv, T. Tatla
Objectives: To capture information on clinical practice using the CO2 LASER within the upper aerodigestive tract (UADT). Design: A 21 item structured questionnaire survey was sent to consultant-only ENT UK members over a 2-month period between March and May 2017 Main Outcome Measures: Variation in CO2 LASER practice with reference to subspecialty, clinical setting, LASER type, power settings, operating modes and tissue exposure modes. Results: 57 responses were received from consultants working in hospitals across the UK. The commonest indication for transoral LASER surgery (TOLS) was excision of cancer (57.1%) and the most common area of surgery performed was within the larynx (60.4%). See Figure 1 for variation in LASER operating modes. Over 95% of hospitals carry out LASER safety practices. Conclusion: A wide variation in the use of CO2 LASER exists amongst UK Otolaryngologists. The development of new guidelines may promote effective use and minimise avoidable trauma or complications.
{"title":"A National Survey on CO2 Transoral LASER Surgery amongst 57 UK Otolaryngologists","authors":"H. Kanona, R. Farrell, Oswal Rv, T. Tatla","doi":"10.4172/2324-8785.1000359","DOIUrl":"https://doi.org/10.4172/2324-8785.1000359","url":null,"abstract":"Objectives: To capture information on clinical practice using the CO2 LASER within the upper aerodigestive tract (UADT). Design: A 21 item structured questionnaire survey was sent to consultant-only ENT UK members over a 2-month period between March and May 2017 Main Outcome Measures: Variation in CO2 LASER practice with reference to subspecialty, clinical setting, LASER type, power settings, operating modes and tissue exposure modes. Results: 57 responses were received from consultants working in hospitals across the UK. The commonest indication for transoral LASER surgery (TOLS) was excision of cancer (57.1%) and the most common area of surgery performed was within the larynx (60.4%). See Figure 1 for variation in LASER operating modes. Over 95% of hospitals carry out LASER safety practices. Conclusion: A wide variation in the use of CO2 LASER exists amongst UK Otolaryngologists. The development of new guidelines may promote effective use and minimise avoidable trauma or complications.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2018 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70247264","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}
Pub Date : 2018-01-01DOI: 10.4172/2324-8785-c5-019
F. Shah
{"title":"How to deal with rhinoliths","authors":"F. Shah","doi":"10.4172/2324-8785-c5-019","DOIUrl":"https://doi.org/10.4172/2324-8785-c5-019","url":null,"abstract":"","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70248476","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}
Pub Date : 2017-12-01DOI: 10.4172/2324-8785.1000325
Mami Morita, Ryusuke Hori, Shintaro Fujimura, Y. Okanoue, Tsuyoshi Kojima, K. Omori, K. Shoji
Objective: Fine-needle aspiration cytology (FNAC) is a valuable diagnostic technique. However, the procedure involves backand-forth motions of a needle within a mass, which can lead to unexpected complications. We have developed a novel device and sampling techniques that use vibration and rotation instead of backand-forth motions. Methods: The new device consists of a vibrating motor fixed to the stopper of a 5 ml syringe with its piston. A 22-gauge needle attached to the 5 ml syringe is used for FNAC. Samples were obtained from resected specimens using the following four procedures: suction only; suction and vibration for 5 seconds; suction and 180° rotation of the syringe; and suction, vibration for 5 seconds, and 180° rotation of the syringe. Samples were also obtained using the conventional technique. The numbers of well-visualized follicular groups on glass slides were counted to compare the amounts of cellular material obtained using the five different procedures. Next, 415 patients with thyroid nodules underwent ultrasound-guided FNAC to evaluate the rate of inadequacy. Results: Sufficient amounts of material were obtained from resected specimens using suction, vibration and rotation, and using the conventional technique. Inadequate thyroid FNAC material was obtained in 12.3% of cases. Conclusions: The new device and sampling techniques for thyroid FNAC collected sufficient amounts of adequate material and allowed safe and precise control of the device. Our device and sampling techniques are expected to be widely used not only for thyroid FNAC sampling but also for sampling from other anatomical sites.
{"title":"Application of a Novel Vibrating Device for Fine-Needle Aspiration Cytology","authors":"Mami Morita, Ryusuke Hori, Shintaro Fujimura, Y. Okanoue, Tsuyoshi Kojima, K. Omori, K. Shoji","doi":"10.4172/2324-8785.1000325","DOIUrl":"https://doi.org/10.4172/2324-8785.1000325","url":null,"abstract":"Objective: Fine-needle aspiration cytology (FNAC) is a valuable diagnostic technique. However, the procedure involves backand-forth motions of a needle within a mass, which can lead to unexpected complications. We have developed a novel device and sampling techniques that use vibration and rotation instead of backand-forth motions. \u0000Methods: The new device consists of a vibrating motor fixed to the stopper of a 5 ml syringe with its piston. A 22-gauge needle attached to the 5 ml syringe is used for FNAC. Samples were obtained from resected specimens using the following four procedures: suction only; suction and vibration for 5 seconds; suction and 180° rotation of the syringe; and suction, vibration for 5 seconds, and 180° rotation of the syringe. Samples were also obtained using the conventional technique. The numbers of well-visualized follicular groups on glass slides were counted to compare the amounts of cellular material obtained using the five different procedures. Next, 415 patients with thyroid nodules underwent ultrasound-guided FNAC to evaluate the rate of inadequacy. \u0000Results: Sufficient amounts of material were obtained from resected specimens using suction, vibration and rotation, and using the conventional technique. Inadequate thyroid FNAC material was obtained in 12.3% of cases. \u0000Conclusions: The new device and sampling techniques for thyroid FNAC collected sufficient amounts of adequate material and allowed safe and precise control of the device. Our device and sampling techniques are expected to be widely used not only for thyroid FNAC sampling but also for sampling from other anatomical sites.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48865769","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}
Pub Date : 2017-12-01DOI: 10.4172/2324-8785.1000329
O. Olajuyin, Obimakinde Os, Olatunya Os, Olajide Tg
Background: Red eye of otolaryngologic origin could present a diagnostic conundrum. A clear understanding of the otolaryngologic differential diagnosis is required to clinch a diagnosis. In this paper, we describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin. Objective:To describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin with a view to facilitate early diagnosis and treatment. Methods: Records of patients with red eyes of otolaryngologic origin were reviewed. The otolaryngologic culprits and features that proved their culpability were highlighted. Results: In all, 32 patients with red eyes of otolaryngologic origin were seen. Majority had used eye drops as primary eye care. About 71.9% seen by the general practitioners were referred to ophthalmologists on account of persistent ocular symptoms. The otolaryngologic culprits were mostly nasal and paranasal diseases. Eight(25%) required conservative treatment, 24(75%) required surgical intervention and 3(9.4%) developed complete blindness. Conclusion: This study shows that red eyes of otolaryngologic origin are mostly caused by nasal and paranasal sinus diseases. However, both patients and general practioners could be misled to believe the eye is the primary source of the ocular symptoms. Such diagnostic conundrum are associated not only with increased morbidities but also cost of treatments. The need to have a clear understanding of the otolaryngologic differential diagnosis of red eyes is hereby stressed. Also, the public must desist from arbitrary use of eye drops and the slogan: “If symptoms persits after 2 days consult your doctor” should be a community watchword.
{"title":"Red Eye: The Red Herring of Otolaryngologic Diseases","authors":"O. Olajuyin, Obimakinde Os, Olatunya Os, Olajide Tg","doi":"10.4172/2324-8785.1000329","DOIUrl":"https://doi.org/10.4172/2324-8785.1000329","url":null,"abstract":"Background: Red eye of otolaryngologic origin could present a diagnostic conundrum. A clear understanding of the otolaryngologic differential diagnosis is required to clinch a diagnosis. In this paper, we describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin. \u0000Objective:To describe some diferential diagnosis and diagnostic features of red eyes of otolaryngologic origin with a view to facilitate early diagnosis and treatment. Methods: Records of patients with red eyes of otolaryngologic origin were reviewed. The otolaryngologic culprits and features that proved their culpability were highlighted. \u0000Results: In all, 32 patients with red eyes of otolaryngologic origin were seen. Majority had used eye drops as primary eye care. About 71.9% seen by the general practitioners were referred to ophthalmologists on account of persistent ocular symptoms. The otolaryngologic culprits were mostly nasal and paranasal diseases. Eight(25%) required conservative treatment, 24(75%) required surgical intervention and 3(9.4%) developed complete blindness. \u0000Conclusion: This study shows that red eyes of otolaryngologic origin are mostly caused by nasal and paranasal sinus diseases. However, both patients and general practioners could be misled to believe the eye is the primary source of the ocular symptoms. Such diagnostic conundrum are associated not only with increased morbidities but also cost of treatments. The need to have a clear understanding of the otolaryngologic differential diagnosis of red eyes is hereby stressed. Also, the public must desist from arbitrary use of eye drops and the slogan: “If symptoms persits after 2 days consult your doctor” should be a community watchword.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49187701","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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