Πέμπτη 30 Σεπτεμβρίου 2021

The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers

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Abstract

Background

Numerous studies and guidelines suggest an outcome detriment from radiation treatment breaks (rTBs) and the need for compensatory dosing in patients with head and neck cancer.

Methods

In a consecutive cohort of 521 patients with oropharyngeal squamous cell carcinoma (OPSCC), we investigated the impact of rTBs and prolongation of overall treatment time (OTT) on OS, DFS, LRC, and cancer recurrence using competing risk and multivariate analyses.

Results

Neither OTT prolongation by ≤2 days nor rTBs of ≤3 days were associated with detriments to clinical outcomes. Consecutive breaks of ≥3 days were also not significantly associated with detriment to clinical outcomes. There was significantly increased competing mortality in those with longer breaks.

Conclusions

In OPSCC patients treated with definitive concurrent chemoradiotherapy, there is no significant association between disease failure and total rTBs of ≤3 consecutive or scattered days. Further investigation is needed for longer breaks.

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Hybrid Ameloblastoma Arising from a Treated Odontogenic Keratocyst of the Mandible: A Case Report With Literature Review

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Abstract

Odontogenic Keratocyst (OKC) is an odontogenic cyst of developmental origin arising from remnants of the dental lamina. Malignant or benign transformations though rare have been noticed from their epithelium. Ameloblastomatous transformation from an OKC is extremely rare with such lesions being referred to as combined/"hybrid" odontogenic lesions. In this article, we present an intriguing case of a 60-year-old male who was operated on for OKC of the anterior mandible 3 years before, who came back with a complaint of swelling over the same site. Incisional biopsy revealed the acanthomatous type of ameloblastoma for which segmental resection with immediate reconstruction using recon plate was done. Excision biopsy revealed a plexiform variant as well, thus exhibiting a hybrid pattern. Surgeons should be aware of this hybrid presentation of ameloblastoma arising from the epithelium of OKC as the acanthomatous subtype is known for its notorious genetic behav ior leading to recurrence and aggressive nature of this tumor.

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Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

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Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print.

ABSTRACT

Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petrous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surg ically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications.

PMID:34587824 | DOI:10.1177/01455613211048966

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Basal cell adenoma of the parotid gland: A rare entity

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Ear Nose Throat J. 2021 Sep 29:1455613211045524. doi: 10.1177/01455613211045524. Online ahead of print.

ABSTRACT

Basal cell adenoma (BCA) is a rare benign salivary gland tumor accounting for only 1-2% of all salivary gland tumors. We report a case of a 50-year-old man presenting a BCA of the parotid gland. A pleomorphic adenoma was initially suspected based on radiological features and fine needle aspiration cytology findings (FNAC).

PMID:34587790 | DOI:10.1177/01455613211045524

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Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

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pubmed-meta-image.png

Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print.

ABSTRACT

Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petr ous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surgically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications.

PMID:34587824 | DOI:10.1177/01455613211048966

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A Case of Nasal Rhinosporidiosis in the United States

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Ear Nose Throat J. 2021 Sep 29:1455613211049004. doi: 10.1177/01455613211049004. Online ahead of print.

ABSTRACT

Rhinosporidiosis, an infectious granulomatous disease, is seldom encountered in the United States. We present a case of rhinosporidiosis in a 26-year-old man, who presented with an unusual mass in his nasal cavity. Suspicion for rhinosporidiosis was high due to the patient's travel and activity history. After imaging and proper diagnosis, surgery was performed to excise the lesion. As international travel resumes during the COVID-19 pandemic, the potential for encountering this rare organism is heightened.

PMID:34587820 | DOI:10.1177/01455613211049004

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COVID-19 and anosmia: The story so far

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Ear Nose Throat J. 2021 Sep 29:1455613211048998. doi: 10.1177/01455613211048998. Online ahead of print.

ABSTRACT

OBJECTIVES: The pandemic has affected over 182 million coronavirus disease 2019 (COVID-19) cases worldwide. Accumulated evidence indicates that anosmia is one of the significant characteristics of COVID-19 with a high prevalence. However, many aspects of COVID-19-induced anosmia are still far from being fully understood. The purpose of this review is to summarize recent developments in COVID-19-induced anosmia to increase awareness of the condition.

METHODS: A literature search was carried out using the PubMed, Embase, Web of Science, and Scopus. We reviewed the latest literature on COVID-19-induced anosmia, including mechanisms of pathogenesis, olfactory testing, anosmia as predictive tool, pathological examinations, imaging findings, affected factors, co-existing diseases, treatments, prognosis, hypothesis theories, and future directions.

RESULTS: The possible pathogenesis of COVID-19-induced anosmia may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The D614G spike variant may also play a role in the increased number of anosmia patients. Anosmia may also be an essential indicator of COVID-19 spread and an early indicator of the effectiveness of political decisions. The occurrence and develop ment of COVID-19-induced anosmia may be influenced by smoking behaviors and underlying diseases such as type 2 diabetes, gastroesophageal disorders, and rhinitis. Most patients with COVID-19-induced anosmia can fully or partially recover their olfactory function for varying durations. COVID-19-induced anosmia can be treated with various approaches such as glucocorticoids and olfactory training.

CONCLUSION: Anosmia is one of the main features of COVID-19 and the underlying disease of the patient may also influence its occurrence and development. The possible pathogenesis of COVID-19-induced anosmia is very complicated, which may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system.

PMID:34587819 | DOI:10.1177/01455613211048998

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Continuous Intraoperative Vasopressor Use in Head and Neck Free-Flap Reconstruction

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This cohort study investigates the association between continu ous vasopressor use and the incidence of reoperation in the early postoperative period for patients undergoing free-flap reconstruction.
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Nonsurgical Risk Factors Associated With Pharyngocutaneous Fistula After Laryngectomy

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This multicenter cohort study of adult patients with laryngeal cancer uses data from a national database to identify nonclinical risks associated with the formation of pharyngocutaneous fistula after total laryngectomy.
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An Unusual Case of Bilateral Chylothorax After Neck Dissection

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This case report describes a woman in her 30s who underwent to tal thyroidectomy with modified radical neck dissection due to papillary thyroid cancer and was subsequently diagnosed with bilateral chylothorax secondary to cervical thoracic duct injury.
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Levels of Triamcinolone Acetonide in Human Perilymph and Plasma After Intratympanic Application

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This randomized clinical trial compares levels of triamcinolon e acetonide in perilymph and plasma after intratympanic injection.
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Addressing the safety of hyaluronic acid dermal filler injections during the SARS CoV-2 pandemic worldwide vaccination

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J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00420-4. doi: 10.1016/j.bjps.2021.08.037. Online ahead of print.

NO ABSTRACT

PMID:34588152 | DOI:10.1016/j.bjps.2021.08.037

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