Background: The opioid epidemic in the United States has had devastating consequences, with many opioid-related deaths and a significant economic toll. Opioids have a significant role in postoperative pain management. Here we aim to analyze differences in postoperative opioid and non-opioid pain medications regimens following common otolaryngological surgeries between two large tertiary care medical centers: the Milton S.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
December 2019
Microsurgical free flaps are common in head and neck reconstruction, and their techniques and outcomes have continuously improved during the past decades. However, there are variations in practice among surgeons between the use of closed-suction drainage systems and Penrose drains. The proponents of Penrose drains propose that the negative pressure generated by the closed-suction drainage system may harm the microvascular anastomosis.
View Article and Find Full Text PDFBackground: Lymph node ratio (LNR) is increasingly reported as a potential prognostic tool. The purpose of this review was to analyze the available literature on the prognostic significance of LNR in head and neck squamous cell carcinoma (HNSCC).
Methods: A PubMed internet search was performed and articles meeting selection criteria were reviewed.
Purpose: The admission rate of patients aged 80 years or older (oldest-old) with head and neck (HN) oncologic disease is on the rise. Our goal was to study the demographic characteristics, reasons for admission, types of surgical procedures, and postoperative complications of the oldest-old patients with HN malignancy.
Materials And Methods: We conducted a retrospective cohort study including all inpatients aged 80 years or older who were admitted to the department of otolaryngology-head and neck surgery or department of oral and maxillofacial surgery because of HN oncologic disease between 2009 and 2013.
Objective: To examine the incidence of late presentation of patients with recurrent pleomorphic adenoma (RPA) of the parotid gland.
Methods: This is a retrospective analysis of patients treated in our center. We examined patients demographics, disease characteristics, treatment, and outcome and as well as the time period length from the first discovery of a recurrent mass until seeking treatment at our clinic and its effect on morbidity.
J Laryngol Otol
January 2018
Objective: Cervical metastases in papillary thyroid carcinoma are associated with increased recurrence. However, their effect on survival remains controversial. This study evaluated literature on the prognostic value of lymph node ratio for loco-regional recurrence and survival in metastatic papillary thyroid carcinoma.
View Article and Find Full Text PDFIntroduction: Early diagnosis of acute invasive fungal rhinosinusitis (AIFR) is crucial for patients prognosis and may reduce the extent of surgical debridement. Initial evaluation usually includes paranasal Computed Tomography (CT), with an emphasis on bony erosion which is considered a specific but insensitive radiologic sign. Most studies made no distinction between Aspergillus and Mucor species while addressing CT findings.
View Article and Find Full Text PDFDiagn Microbiol Infect Dis
October 2017
Background: Nasal vestibulitis (NV) is a common infection; however, scant data is available in the literature as it pertains to NV. We aim to describe the clinical characteristics of NV in respect to its potential complications.
Methods: A retrospective chart review of 118 NV cases admitted to a tertiary medical center between 2008 and 2015.
Background: More than 90% of all thyroid cancers are differentiated thyroid carcinomas (DTC) with a 10 year survival rate greater than 90%. The commonly used risk stratification systems for DTC include: European Organization for Research and Treatment of Cancer (EORTC), AGES (Age, histologic Grade, Extent of tumor, Size), AMES (Metastasis) and MACIS (Completeness of resection, local Invasion). Other systems are also utilized.
View Article and Find Full Text PDFEur Arch Otorhinolaryngol
April 2017
The location of Warthin tumor (WT) in the parotid gland impacts the surgical approach and may be indicative of the elusive origin of this intriguing entity. Location in the deep versus superficial lobe of the gland is not directly addressed when defining WT characteristics. Our observation, of rare occurrence of deep lobe WT, if at all, led to the current investigation.
View Article and Find Full Text PDFQuality of life (QoL) has been recognized as an important endpoint in addition to disease-related and global survival. It is particularly important for patients with salivary gland neoplastic disease. For patients who are undergoing benign salivary gland tumor surgery, cosmetic and functional outcomes are extremely important, as these patients' psychological well-being and ability to function in society can be severely impacted.
View Article and Find Full Text PDFTreatment with the complex preparation containing pantogam, succinic acid, and chitosan normalized the concentration of reduced glutathione and activities of glutathione peroxidase, glutathione reductase, and some NADPH-generating enzymes (glucose-6-phosphate dehydrogenase and NADPH-isocitrate dehydrogenase) in animals with experimental hypoxia/reperfusion of the brain. These results can be explained by suppression of free radical oxidation and normalization of the antioxidant system related to the neuroprotective, antihypoxic, and antioxidant properties of these substances, their involvement into the regulation of cell metabolism under pathological conditions accompanied by oxidative stress.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
August 2014
Objective: There are only sporadic reports of delayed sino-nasal complications associated with nasopharyngeal carcinoma (NPC) treated with radiotherapy. These include choanal stenosis, osteoradionecrosis, chronic sinusitis, and intranasal synechiae. Most likely, these complications are underestimated as in many institutions nasal endoscopies in NPC patients are not performed routinely.
View Article and Find Full Text PDFBackground: Tracheostomy is a frequent, and at times semiurgent, surgical procedure. It is performed in close proximity to the thyroid gland, and in many cases requires division of its isthmus, putting a patient in danger of significant bleeding.
Objectives: To examine prospectively the feasibility of vessel sealing in tracheostomy.
Background: Squamous cell carcinoma of the nasal vestibule (SCCNV) is an uncommon malignancy. Our purpose is to define the incidence of simultaneous and delayed regional metastasis in SCCNV according to the available literature.
Methods: Articles discussing SCCNV and addressing the issue of regional lymph node metastases were reviewed.
Background: The purpose of this study was to show a novel technique for secondary tracheoesophageal puncture (TEP) and myotomy in patients who previously underwent total laryngectomy.
Methods: Fifteen patients underwent secondary TEP and 3 patients underwent myotomy. In 1 patient, both myotomy and TEP were done concurrently.
Background: Lymphomas arising from the parotid gland are an uncommon entity, said to account for only 0.6-5% of tumors or tumor-like lesions of the parotid, and are therefore commonly overlooked. This misdiagnosis often leads to unnecessary diagnostic procedures, delaying the initiation of proper treatment.
View Article and Find Full Text PDFPurpose: To apply the Brandwein-Gensler et al.'s histopathologic risk score (RS) system and to evaluate its impact on locoregional recurrence and overall survival in a series of cases of oral tongue cancer, along with variables of patient age and margin status.
Methods: Sections of the resection specimens (N = 50) were submitted to a RS assignment of three components: the worst pattern of invasion, lymphocytic infiltration and perineural invasion.
Margin status, a major prognostic parameter in oral cancer, was analyzed vis-à-vis the histopathologic parameters of risk scores and stromal myofibroblasts. Specimens of tongue carcinoma (n = 50) were submitted to a risk score assignment consisting of the worst pattern of invasion, lymphocytic infiltration, and perineural invasion. Frequency of stromal myofibroblasts (alpha-smooth muscle actin stain) was assessed.
View Article and Find Full Text PDFJ Otolaryngol Head Neck Surg
August 2009
Objective: The worldwide interest in the use of complementary and alternative medicine (CAM) has been established in multiple surveys. Chronic rhinosinusitis (CRS) is often an unremitting disease with frequent troubling relapses, and despite wide use of endoscopic sinus surgery, conventional medicine may have a smaller contribution than expected. Because of prevalent use of CAM among patients, it is important that physicians acquire basic knowledge of this subject.
View Article and Find Full Text PDFThree uncommon cases of ear trauma caused by a yucca plant leaf spine are presented. One patient presented with tympanic perforation and the second with mixed hearing loss after spontaneous closure. The third patient probably had a perilymphatic fistula with subsequent labyrinthitis and hearing loss.
View Article and Find Full Text PDFOtolaryngol Head Neck Surg
March 2009
Objective: To investigate morbidity, complication rate, and mortality in oldest-old patients who undergo tracheostomy.
Study Design: Historical cohort study.
Subject And Methods: The medical records for 64 patients (>85 years) who underwent standard or percutaneous tracheostomy between 2001 and 2005 in a tertiary care hospital were reviewed for in-hospital and out-of-hospital mortality, complications, and decannulation rate.
Chronic lymphocytic leukemia (CLL) is the most common lymphoid malignancy among adults in the Western world. Small lymphocytic lymphoma (SLL) represents the lymphomatous presentation of CLL. We describe a case in which a diagnosis of laryngeal CLL/SLL was made in an 82-year-old man who had undergone laryngectomy and neck dissection for the treatment of squamous cell carcinoma of the larynx.
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