Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Πέμπτη 25 Φεβρουαρίου 2021

Prognostic value of the neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio and systemic immune‐inflammation index in patients with laryngeal squamous cell carcinoma

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Association between sex and survival in patients with head and neck spindle cell carcinoma

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Abstract

Background

Head and neck spindle cell carcinoma (HNSpCC) is a rare histological variant associated with worse outcomes. Our objective was to identify clinicopathological factors associated with survival in patients with HNSpCC compared to patients with conventional head and neck squamous cell carcinoma (HNSCC).

Methods

Using clinical data from the Surveillance, Epidemiology, and End Results database, we performed a survival analysis in patients with HNSpCC or HNSCC between 2004 and 2016.

Results

A total of 458 HNSpCC and 77 104 HNSCC were identified, including 17% and 16% female, respectively. Five‐year disease‐specific survival (DSS) was 63.90% and 73.90% in patients with HNSpCC and HNSCC, respectively. Sex (hazard ratio [HR] for females = 2.816; CI: 1.139–6.965; p = 0.025) was significantly associated with DSS in HNSpCC while no association was observed between sex and DSS in HNSCC.

Conclusion

HNSpCC in women is a specific subgroup of HNSCC, which is associated with a poor prognosis.

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Tension pneumocephalus following an implant removal from spine

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BMJ Case Rep. 2021 Feb 24;14(2):e239694. doi: 10.1136/bcr-2020-239694.

ABSTRACT

Pneumocephalus is commonly seen after skull and maxillofacial fractures. It can also occur following cerebrospinal fluid leak after skull base surgery and epidural catheter placement. We report a rare case report of a 20-year-old man who developed tension pneumocephalus following implant removal from the spine. He responded well to the conservative treatment without any neurological complications.

PMID:33627348 | DOI:10.1136/bcr-2020-239694

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Aggressive Differentiated Thyroid Cancer due to EML4e13-ALKe20 Fusion: A Case Presentation and Review of the Literature

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Case Rep Endocrinol. 2021 Feb 15;2021:8837399. doi: 10.1155/2021/8837399. eCollection 2021.

ABSTRACT

BACKGROUND: Differentiated thyroid cancer (DTC) is an indolent malignancy. It rarely presents with aggressive local invasion and/or distant metastatic disease. Patient findings. We describe a case of a 30-year-old man with a locally aggressive form of papillary thyroid cancer with EML4e13-ALKe20 fusion (EML4: echinoderm microtubule-associated protein-like 4; ALK: anaplastic lymphoma kinase). He presented with right-side cervical lymphadenopathy with a highly suspicious right-side thyroid nodule. Total thyroidectomy and level IV lymph node resection showed extensive bilateral disease, with extrathyroidal and extranodal extension. FDG-PET CT scan following surgery confirmed the presence of significant residual disease in the neck area. He underwent bilateral lateral lymph node dissection followed by radioactive iodine treatment. Somatic mutation testing showed EML4e13-ALKe20 fusion. Summary. This case represents an aggressive form of DTC with EML4e13-ALKe20 fusion. The rapid progression of clinical signs and symptoms and the local extension beyond the thyroid and lymph nodes with the persistence of high-volume local disease after thyroidectomy highlight the aggressive nature of this mutation and the importance of performing genetic analysis to guide future treatments and determine prognosis.

CONCLUSION: This case highlights the importance of using molecular diagnostics in patient care, especially if the presentation is unusual for DTC. A thorough evaluation of the tumor pathology and the somatic mutational profile analysis are important for obtaining vital therapeutic and prognostic guidance.

PMID:33628533 | PMC:PMC7899757 | DOI:1 0.1155/2021/8837399

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Long-term course after inpatient speech therapy: educational and language development of children with severe specific language impairment (SLI)

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HNO. 2021 Feb 24. doi: 10.1007/s00106-021-01005-4. Online ahead of print.

ABSTRACT

BACKGROUND: Studies from primarily English-speaking countries have shown that specific language impairments can lead to disadvantages in educational and professional development. Corresponding studies for Germany have not been published. This study surveys the educational and language outcomes of adolescents and young adults who were treated in an inpatient setting during childhood.

MATE RIALS AND METHODS: A total of 193 young adults who had received inpatient treatment between 1998 and 2005 at the Department of Communication Disorders of the Department of Otorhinolaryngology, Head, and Neck Surgery (ENT) of the Mainz University Medical Center were assessed. The cohort was contacted by telephone and interviewed about aspects of their educational and language development using a specially developed questionnaire. It was possible to include 70 participants in the study.

RESULTS: Almost half (48.6%; n = 34) of the participants had attended a regular elementary school and 50% (n = 35) attended a special school with a focus on speech-language development (others: 1.4%, n = 1). Regarding school-leaving qualifications, 31.5% (n = 22) finished school with an Abitur/Fachabitur (high-school-level certificate), 33% (n = 23) with a Realschulabschluss (secondary school certificate), 30% (n = 21) with a Hauptschulabschluss (lower secondary certificate), and 4% (n = 3) with a special school certificate. Only one participant left school without a qualification. Of the interviewed participants, 71% (n = 50) do not feel any speech language limitations anymore.

CONCLUSION: The results indicate a positive educational and language development of children with SLI after inpatient treatment in Germany. Over 90% of the participants finished school with a regular certification and most of them do not feel any speech and language limitations anymore.

PMID:33629146 | DOI:10.1007/s00106-021-01005-4

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X-shaped lateral neck lump on swallowing

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Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421995037. doi: 10.1177/0003489421995037. Online ahead of print.

ABSTRACT

OBJECTIVE: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition.

DATA SOURCES: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020.

REVIEW METHODS: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed.

RESULTS: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively.

CONCLUSION: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography e stablishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

PMID:33626894 | DOI:10.1177/0003489421995037

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A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

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Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421995037. doi: 10.1177/0003489421995037. Online ahead of print.

ABSTRACT

OBJECTIVE: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition.

DATA SOURCES: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020.

REVIEW METHODS: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed.

RESULTS: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively.

CONCLUSION: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography e stablishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

PMID:33626894 | DOI:10.1177/0003489421995037

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