Acta otorrinolaringologica espanola最新文献

英文中文

Lower lip reconstruction with the Karapandzic flap or the Colmenero flap: Description of results 用Karapandzic皮瓣或Colmenero皮瓣重建下唇：结果描述。

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2024.10.001

Anna Sumarroca , Carmen Vega , Susana López , Andreas Leidinger , Gabriel Pedemonte , Xavier León , José Miguel Costa-González

Background and objective

Reconstruction of medium and large oncological defects of the lower lip must preserve the functionality and aesthetics of the area and is usually solved with local pedicled flaps, rarely compared between them. The aim of this study is to analyse our case series of lower lip reconstruction using the Karapandzic flap or the Colmenero flap, and to describe their techniques and results.

Materials and methods

We performed a retrospective review of patients who underwent lower lip resection and reconstruction with the Colmenero flap or Karapandzic flap during the period 2015–2022 with a minimum follow-up time of more than one year. The defect size, treatment, complications, reinterventions and final outcome were analysed.

Results

A total of 22 patients underwent surgery: 13 of them were reconstructed with Karapandzic flaps, all bilateral (26 flaps) and with a mean defect size of 4.05 cm (2.9–6.5 cm). 9 patients were reconstructed with Colmenero flaps, of which 4 bilaterally (13 flaps), with a mean defect size of 4.16 cm (3–7.5 cm). All flaps were viable and all complications (5 among Karapandzic flaps and 4 among Colmenero flaps), mostly minor, were resolved. There were no statistically significant differences between the sizes of the reconstructed defects or between the complications of the two flaps. All patients had a total oral intake of food, no speech defects and a good final aesthetic result.

Conclusions

The surgical techniques of lower lip reconstruction with the Karapandzic flap or the Colmenero flap are very reliable, simple in design, with similar and very satisfactory functional and aesthetic results.

背景和目的：下唇大中型肿瘤性缺损的重建必须保留该区域的功能性和美观性，通常采用局部带蒂皮瓣来解决，很少对两者进行比较。本研究旨在分析我们使用卡拉潘季奇皮瓣或科尔梅内罗皮瓣重建下唇的系列病例，并描述它们的技术和效果：我们对2015-2022年间接受下唇切除术并使用Colmenero皮瓣或Karapandzic皮瓣进行重建的患者进行了回顾性研究，随访时间至少超过一年。对患者的缺损大小、治疗方法、并发症、再干预和最终结果进行了分析：共有 22 名患者接受了手术：结果：共有 22 名患者接受了手术：其中 13 人采用卡拉潘奇皮瓣重建，均为双侧（26 个皮瓣），平均缺损大小为 4.05 厘米（2.9 - 6.5 厘米）。9名患者使用Colmenero皮瓣进行了重建，其中4名患者使用双侧皮瓣（13个皮瓣），平均缺损面积为4.16厘米（3-7.5厘米）。所有皮瓣均存活，所有并发症（卡拉潘季奇皮瓣 5 例，科尔梅内罗皮瓣 4 例）均已解决，其中大部分为轻微并发症。重建缺损的大小和两种皮瓣的并发症之间没有明显的统计学差异。所有患者均能完全经口进食，无语言缺陷，最终美观效果良好：使用卡拉潘季奇皮瓣或科尔梅内罗皮瓣重建下唇的手术技术非常可靠，设计简单，具有相似且非常令人满意的功能和美学效果。

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引用次数: 0

Fenestrated internal yugular vein crossed by spinal nerve 被脊神经穿过的颈内静脉开孔。

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2024.09.008

Belén Clemente Cuartero , Pedro Díaz de Cerio Canduela , Ricardo Fernández-Valadés Gamez

引用次数: 0

Survival of patients with malignant head and neck tumors diagnosed during the COVID-19 pandemic COVID-19大流行期间确诊的头颈部恶性肿瘤患者的生存率

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2025.02.001

Xavier León , Cristina Valero , Anna Holgado , Cristina Vázquez-López , Rosselin Vásquez , Arnau Parellada , Miquel Quer , Albert Pujol

Objective

The COVID-19 pandemic significantly affected healthcare access worldwide. Few studies have analysed whether the pandemic negatively impacted patients with head and neck malignant tumours diagnosed during this period. This study aims to determine if there were differences in oncological outcomes between patients diagnosed during the pandemic and those diagnosed previously.

Material and methods

A retrospective study was conducted on patients with malignant head and neck tumours diagnosed during the pandemic and the previous five years at a tertiary center.

Results

The study cohort included 872 patients diagnosed between March 2018 and February 2022. The quarter with the fewest diagnoses was the COVID-4 period (March-2020 to June-2020), coinciding with the strictest lockdown phases. There were no significant changes in patient characteristics or treatment types due to the pandemic. No significant differences in 3-year disease-specific survival were observed between patients diagnosed and treated during the COVID period (March-2020 to February-2021, disease-specific survival 73.0%) and those treated during the previous five years (March-2015 to February-2020, disease-specific survival 70.6%, P = 0.377).

Conclusions

The COVID-19 pandemic led to a decrease in the number of diagnoses of malignant head and neck tumours during the strictest lockdown phases in our country. However, no statistically significant differences in oncological outcomes were observed as a consequence of the pandemic.

目的：COVID-19大流行严重影响了全球医疗保健可及性。很少有研究分析大流行是否对这一时期确诊的头颈部恶性肿瘤患者产生负面影响。本研究旨在确定在大流行期间诊断的患者与以前诊断的患者之间的肿瘤预后是否存在差异。材料和方法：对大流行期间和过去5年在三级中心诊断的头颈部恶性肿瘤患者进行了回顾性研究。结果：该研究队列包括2018年3月至2022年2月期间诊断的872例患者。确诊病例最少的季度是COVID-4期间（2020年3月至2020年6月），恰逢最严格的封锁阶段。由于大流行，患者特征或治疗类型没有显著变化。在新冠肺炎期间（2020年3月至2021年2月，疾病特异性生存率为73.0%）诊断和治疗的患者与前5年（2015年3月至2020年2月，疾病特异性生存率为70.6%,P = 0.377）治疗的患者3年疾病特异性生存率无显著差异。结论：2019冠状病毒病大流行导致我国最严格封锁时期头颈部恶性肿瘤诊断率下降。然而，没有观察到大流行导致的肿瘤预后有统计学显著差异。

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引用次数: 0

Venous by-pass (internal jugular vein-external jugular vein) in patient with bilateral radical neck dissection 双侧根治性颈部清扫术的静脉旁通术（颈内静脉-颈外静脉）。

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2024.10.002

Diego Tébar Calo , Pablo Verges Fort , Simon Brotons Durban , Ángel Pla Mocholi , Bosco Vendrell Marques

引用次数: 0

Postsurgical hypoparathyroidism: Identification of the high-risk patient. A comparison between the ATA protocol and the SEORL-CCC/SEEN consensus 术后甲状旁腺功能减退：高危患者的识别。ata协议与see /SEORL-CCC共识的比较。

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2024.10.003

Miriam García Lerma, Laura Rodrigáñez Riesco, Antonio del Palacio Muñoz, Ricardo Bernáldez Millán, Laura del Río Arroyo, Javier Gavilán Bouzas, Alejandro Castro Calvo

Introduction

Parathyroid hormone (PTH) levels are the most reliable parameter to identify patients with a high risk of post-thyroidectomy hypoparathyroidism. The American Thyroid Association (ATA) developed a consensus where postoperative iPTH (PTHpost) <15 pg/mL suggests a significant risk for hypoparathyroidism. The Spanish Society of Otolaryngology and Head & Neck Surgery (SEORL-CCC) identifies high-risk patients as those with a decrease of preoperative-postoperative PTH levels (PTHdecr) ≥80%. A comparison of the accuracy of both protocols is made.

Materials and methods

An analysis was conducted on all patients who underwent total or completion thyroidectomy over 10 years. A preoperative PTH (PTHpre) and a postoperative PTH (PTHpost) sample were collected. Postsurgical hypoparathyroidism was defined as the presence of hypocalcemia signs or symptoms, or calcium lower than 7 mg/dL in serum levels or 0.95 mmol/L in ionic levels. No patient received treatment without meeting our definition.

Results

711 patients were included. 19% of patients suffered from hypoparathyroidism. The PTHdecr demonstrated a ROC curve with an AUC of 0.98. iPTHpost demonstrated a ROC curve with an AUC of 0.97. The PTHdecr was found to have a statistically superior AUC compared to the PTHpost (p = 0.002). Considering cutoff levels of 80% for iPTHdecr and 15 pg/mL for PTHpost, no statistical differences were found between the sensitivity of both protocols (93% and 95% respectively), but the same cutoff levels showed a superior specificity of PTHdecr (95%) than PTHpost (86%).

Conclusions

SEORL-CCC protocol, which relies on PTHdecr, has demonstrated superior diagnostic accuracy. The cutoff level used showed a superior specificity without sacrificing its sensitivity.

简介：甲状旁腺激素（PTH）水平是识别甲状腺切除术后甲状旁腺功能低下高风险患者最可靠的参数。美国甲状腺协会（ATA）就术后iPTH （PTHpost）的材料和方法达成了共识：对10年来所有接受甲状腺全切除术或完全切除术的患者进行了分析。采集术前PTH （PTHpre）和术后PTH （PTHpost）标本。术后甲状旁腺功能减退被定义为存在低钙症状或体征，或血清钙水平低于7 mg/dL或离子水平低于0.95 mmol/L。没有患者接受不符合我们定义的治疗。结果：共纳入711例患者。19%的患者出现甲状旁腺功能减退。pthdec的ROC曲线AUC为0.98。iPTHpost的ROC曲线AUC为0.97。与PTHpost相比，PTHdecr的AUC具有统计学优势（p = 0.002）。考虑到iPTHdecr的临界值为80%，PTHpost的临界值为15 pg/mL，两种方案的敏感性之间没有统计学差异（分别为93%和95%），但相同的临界值表明PTHdecr（95%）优于PTHpost（86%）。结论：基于PTHdecr的SEORL-CCC方案具有较高的诊断准确性。所使用的截止水平在不牺牲其灵敏度的情况下显示出优越的特异性。

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引用次数: 0

Complications after fine-needle aspiration cytology and core-needle biopsy in benign head & neck neoplasms 头颈部良性疾病的细针穿刺细胞学检查和核心针活检术后并发症。

Acta otorrinolaringologica espanola

Pub Date : 2025-03-01 DOI: 10.1016/j.otoeng.2024.09.006

Alfonso Rodriguez-Urzay , Maria Landa-Garmendia , Jon Alexander Sistiaga-Suarez , Jose Angel González-Garcá , Ehkiñe Larruscain-Sarasola , Mikel Beristain , Carlos Miguel Chiesa-Estomba

Introduction

Benign neck masses are one of the most common causes of clinical consultation in head & neck (H&N) clinics. Fine needle aspiration cytology (FNAC) and core needle biopsy (CNB) have become among the main strategies for the diagnostic work-up of palpable and non-palpable neck lumps. Moreover, numerous studies have established the safety, high diagnostic yield, and added value of image-guided H&N biopsies, which play an important role in diagnosis, staging, and treatment planning, and can obviate the need for surgery for many patients. Nonetheless, despite the success of both techniques, there is a lack of recent studies regarding their safety and associated complication rates.

Material & method

A retrospective analysis was performed of prospective data on patients undergoing ultrasound-guided FNAC or CNB for benign H&N disease (e.g., salivary gland benign tumors, branchial cleft cyst, thyroglossal duct, cyst, lipoma, or neurinoma) between June 2016 and June 2021 in a tertiary university hospital.

Results

Overall, 192 patients were included (105 [54.7%] men and 87 [45.3%] women). The Kolmogorov-Smirnov test indicated that our data were normally distributed (p = 0.452). The mean age of enrolled patients was 54 ± 10 (range: 18–87). The anatomical site most commonly affected was a major salivary gland (74%). Regarding incidence and type of complications, nine (4.7%) patients experienced complications, infection being the most common problem. The risk of complications was highest in patients with branchial cleft cysts who had undergone FNAC (p = 0.028). Overall, the risk of complications was not associated with the type of technique (p = 0.603; OR: 0.942; 95% confidence interval = 0.245–3.624).

Conclusion

According to our results, FNAC and CNB are generally safe and reliable procedures in the diagnostic work-up of H&N lumps. Nevertheless, physicians should be aware of certain risks associated with these procedures.

导言：良性颈部肿块是头颈部（H&N）门诊最常见的临床病因之一。细针穿刺细胞学检查（FNAC）和核心针活检（CNB）已成为可触及和不可触及颈部肿块的主要诊断方法。此外，大量研究证实，图像引导下的 H&N 活检具有安全性、高诊断率和附加值，在诊断、分期和治疗计划中发挥着重要作用，可使许多患者免于手术。然而，尽管这两种技术都很成功，但近期缺乏有关其安全性和相关并发症发生率的研究：对一家三级大学医院2016年6月至2021年6月期间接受超声引导FNAC或CNB治疗良性H&N疾病（如唾液腺良性肿瘤、腮裂囊肿、甲状舌管、囊肿、脂肪瘤或神经瘤）的患者的前瞻性数据进行了回顾性分析：共纳入 192 例患者（男性 105 例[54.7%]，女性 87 例[45.3%]）。Kolmogorov-Smirnov检验表明，我们的数据呈正态分布（P = 0.452）。登记患者的平均年龄为 54 ± 10（18-87 岁）。最常受影响的解剖部位是主要唾液腺（74%）。关于并发症的发生率和类型，9 名患者（4.7%）出现了并发症，其中感染是最常见的问题。接受过 FNAC 检查的腮裂囊肿患者出现并发症的风险最高（p = 0.028）。总体而言，并发症风险与技术类型无关（P = 0.603；OR：0.942；95% 置信区间 = 0.245-3.624）：根据我们的研究结果，FNAC 和 CNB 在 H&N 肿块的诊断工作中通常是安全可靠的程序。尽管如此，医生仍应注意与这些程序相关的某些风险。

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引用次数: 0

Acta otorrinolaringologica espanola

Pub Date : 2025-01-01

引用次数: 0

Acta otorrinolaringologica espanola

Pub Date : 2025-01-01

引用次数: 0

Acta otorrinolaringologica espanola

Pub Date : 2025-01-01

引用次数: 0

Acta otorrinolaringologica espanola

Pub Date : 2025-01-01

引用次数: 0

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

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Acta otorrinolaringologica espanola

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