Thyroid Papillary Microcarcinoma: Diagnostic and Treatment Approaches

The commonly occurring differentiated thyroid cancer is microcarcinoma, which is diagnosed by high-resolution ultrasound and fine-needle aspiration cytology. In view of their low morbidity and mortality, the crucial point is how to manage such microcarcinomas. American and European guidelines aim to minimize the diagnostic and treatment procedures without affecting the diagnostic accuracy and the therapeutic effectiveness. This goal is important for papillary thyroid microcarcinoma patients, who have an good prognosis and almost normal life expectancy. The present review will summarize the clinical and pathological features of thyroid papillary microcarcinoma, including its definition, presentation, pathology, clinical impact, and therapeutic modalities

Long-Term Outcomes of Sialendoscopy in the Management of Sialolithiasis and Idiopathic Chronic Sialadenitis with Ductal Scars

Objective: We aimed to present the long-term outcomes and sialendoscopic findings in only patients with sialolithiasis and ductal scars in idiopathic chronic recurrent sialadenitis who experienced unsuccessful results with conservative treatment and were treated with sialendoscopy.Methods: We retrospectively analyzed the patients with a diagnosis of only sialolithiasis and ductal scars in chronic recurrent sialadenitis who underwent sialendoscopy between January 2011 and June 2016. We collected clinical and intraoperative data including patient age, sex, date of the procedure, the involved gland, operative findings and complications. Follow-up data included whether the symptoms were resolved or recurred and whether any further procedures were performed.Results: Of a total of 38 patients, 16 were excluded from the study due to missing clinical or follow-up data, and analysis was conducted on 22 patients. Twelve were diagnosed with sialolithiasis, while the remaining 10 were diagnosed with idiopathic chronic sialadenitis and had ductal scars. Stone sizes ranged from 2 mm to 10 mm. Mean follow-up time was 39.5 months. The final success rate was 100%. Of the 10 patients with ductal scarring, five had scar in the parotid gland duct, and five in the submandibular gland duct. The mean follow-up time of all ductal scar patients was 47.1 months. The final success rate was 70%.Conclusion:Sialendoscopy is a minimally invasive method for the diagnosis and treatment of sialolithiasis and ductal scars of the salivary glands after failure of conservative treatments in adults

The protective effects of different treatments on rat salivary glands after radiotherapy

WOS: 000387700400056PubMed ID: 27324888This study was aimed to evaluate the efficacy of treatment modalities for minimizing salivary gland damage caused by radiotherapy. Forty rats were divided into five groups. Group 1 had no irradiation or any treatment. Group 2 underwent only 15 Gy single dose radiotherapy. N-acetylcysteine, dexamethasone, hyperbaric oxygen treatment were given, respectively to the group 3, 4 and 5 for 5 days. 15 Gy single dose radiotherapy was applied to the group 3, 4 and 5 on the second day. Pyknosis, lysis, and vacuolization were examined in ductal cells and pyknosis, lysis, vacuolization, inflammation and collective duct damage in acinar cells. Dexamethasone and hyperbaric oxygen did not prove to have a positive effect on acinar and ductal cell. N-acetylcysteine-applied group had statistically significantly lower amount of damage. We determined that the decrease of ductal and acinar cell damage in parotid glands of N-acetylcysteine-applied rats was more distinct and statistically

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

BackgroundPostoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement.MethodsA multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations.ResultsConsensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management.ConclusionSalivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/163491/2/hed26417.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/163491/1/hed26417_am.pd

Klippel Feil sendromlu erişkinlerdeki muhtelif organ anormalliklerinin farkında mıyız?

Klippel-Feil syndrome (KFS) is characterized by a classical triad (short neck, low posterior hair line, limitation of neck movements). Segmentation problems of cervical vertebra cause the main clinic in patients, and extraskeletal anomalies are also reported. The aim of this study is to review and emphasize common clinical findings of KFS patients. Between 2000 and 2011, 120 individuals with facial asymmetry and short neck were evaluated. Forty-two adult patients with KFS were included in this study. Patients were assessed for associated skeletal and extraskeletal pathologies. There were 41 male (98%) and 1 female (2%) individuals. Of forty-two patients, thirty-one (n=31; 74%) were classified as type I, nine (n=9; 21%) as type II, and two (n=2; 5%) as type III. Classical clinical triad was detected in all patients. Congenital scoliosis has been observed in all patients except one. Sprengel deformity was observed in 10 individuals (24%). Associated other system disorder ratios were 9.5% for urogenital problems, 23.8% for cardiovascular pathologies and 31% for audiological problems. Spinal and other multi-organ pathologies of patients with KFS may lead to serious problems which may eventually need medical treatment. Detailed assessment for possible systemic disorders and close follow-up may be helpful for KFS patients.Klippel-Feil Sendromu (KFS) klasik bir üçleme ile karakterizedir (kısa boyun, düşük arka saç çizgisi, boyun hareketlerinde kısıtlılık). Asıl klinik tabloya servikal vertebranın segmentasyon problemleri neden olurken, iskelet sistemi dışındaki anomaliler de bildirilmiştir. Bu çalışmada KFS’lu hastalarda yaygın görülen klinik bulguların gözden geçirilmesi ve vurgulanması amaçlanmıştır. 2000-2011 yılları arasında yüz asimetrisi olan ve kısa boyunlu 120 kişi değerlendirilmiştir. 42 KFS’lu erişkin bu çalışmaya dahil edilmiştir. Hastalar iskelet sistemi ve iskelet dışı patolojiler açısından incelenmiştir. Hastaların 41’i erkek (%98) ve biri kadındır (%2). 42 hastanın 31’i tip I (%74), 9’u tip II (%21) ve 2’si (%5) tip III olarak sınıflandırılmıştır. Klasik klinik üçlü bulgu hastaların hepsinde saptanmıştır. Biri hariç tüm hastalarda skolyoz saptanmışken, Sprengel deformitesi 10 hastada (%24) gözlenmiştir. Eşlik eden diğer organ patolojilerinin %9,5’i ürogenital sistem, %23,8’i kardiyovasküler sistem ve %31’i işitme patolojileri idi. KFS’lu hastalardaki omurga ve diğer organ patolojileri sonuçta tıbbi tedavi gerektiren ciddi sorunlara yol açabilir. KFS’lu hastalarda olası bir sistemik problemin saptanması amacıyla detaylı bir inceleme veya yakın klinik takip yararlı olabilir

Late Self-Extraction of a Traumatically Displaced Molar Tooth From the Maxillary Sinus

WOS: 000306710200034PubMed: 22801180An unusual case of late self-extraction of an impacted left maxillary third molar that was displaced into the left maxillary sinus after a traffic accident is described. The patient had been operated on for a maxillofacial trauma after a traffic accident in a plastic and reconstructive surgery department 18 years ago. He was admitted to our clinic 12 years ago for obstruction and periodically purulent drainage from the left side of the nose. A displaced tooth in the middle meatus was diagnosed, and the patient refused a surgical procedure to remove the tooth. The tooth was self-extracted from the nasal cavity 1 year later. One week after the extraction, the patient was mostly healed and had no complaints

Postoperative Cephazolin Usage is Sufficient for Preventing Infection after Septoplasty Procedure

The use of antibiotics in septoplasty is a common practice among most ear, nose, and throat doctors; however, there are few studies proving the efficacy, which is considered as unnecessary by some authors. The aim of this pilot study was to evaluate the effect of two different kinds of antimicrobial agent on efficacy and safety after septoplasty surgery and to show that use of cephazolin, 1.0 g, postoperatively, might be sufficient for preventing infection after septoplasty procedure. Patients were randomly divided into two groups with a simple randomization method. The first group of 80 patients received cephazolin, 1.0 g i.v., once postoperatively and the second group of 80 patients received amoxicillin–clavulanate orally for 7 days postoperatively (1000 mg). An early and late postoperative questionnaire and nasal endoscopy evaluation was performed and patients were followed up in the outpatient service to investigate the presence of complications. There was no significant difference in postoperative pain between groups A and B, using visual analog scale scores at the 1st postoperative day. There were no differences related to the amount of purulent discharge found at the lower margin of the inferior turbinate through nasal endoscopy performed on the 14th day postoperatively. There were no statistical significances among groups for complications rates and postoperative endoscopic evaluation. Septoplasties are considered potentially contaminated surgeries, and cephazolin, 1.0 g i.v., given once postoperatively is enough to prevent potential complications with its easy and effective use

Evaluation of Early and Late Term Outcomes of Radiofrequency Surgery in the Treatment of Inferior Turbinate Hypertrophy

Introduction: Inferior turbinate hypertrophy (ITH) plays an important role in the complaint of nasal obstruction. Surgical procedures are preferred to reduce the inferior turbinate if medical treatments fail to achieve satisfactory results. Numerous surgical techniques have been tried for inferior turbinate surgery. Recently, inferior turbinate radiofrequency ablation (RFA) has come forward among these surgical techniques. The aim of this study was to evaluate results of inferior turbinate RFA in patients who did not benefit from medical therapy. Patients and Methods: The study included 32 patients who are suffering from nasal obstruction because of ITH. All the patients did not benefit from medical therapy. Topical and infiltrative anesthesia was performed before the application. Severities of the patients' complaint of nasal obstruction were subjectively evaluated by using a visual analogue scale (VAS) preoperatively, and postoperatively on six weeks and one year. The effects of inferior turbinate RFA on mucociliary activity were evaluated in the same period by a saccharin test. Results: The mean preoperative VAS score was 6.47. The mean postoperative 6-week and 1-year VAS scores were 4.13 (P<0.001) and 4.47 (P<0.001), respectively. There was a statistically significant decrease in postoperative VAS scores compared to preoperative VAS scores. The average saccharin test results for the right nasal cavity preoperatively, 6 weeks postoperatively, and 1 year postoperatively were 11.03 minutes, 11.75 minutes (P=0.054), and 11.69 minutes (P=0.074), respectively. The average saccharin test results for the left nasal cavity preoperatively, 6 weeks postoperatively, and 1 year postoperatively were 10.91 minutes, 11.22 minutes (P=0.268), and 11.59 minutes (P=0.187), respectively. There were no statistically significant differences between preoperative and postoperative saccharin test results for each nasal cavity. Conclusion: Inferior turbinate RFA can be used alone effectively in the treatment of nasal obstruction caused by ITH. Results of inferior turbinate RFA are satisfactory for at least one year without causing impairment in physiologic mucociliary activity or other adverse effects. [Arch Clin Exp Surg 2014; 3(1.000): 34-39

Smoking-induced control of miR-133a-3p alters the expression of EGFR and HuR in HPV-infected oropharyngeal cancer.

PURPOSE:Human papillomavirus (HPV) infected oropharyngeal squamous cell carcinoma (OPSCC) patients have a better prognosis compared to HPV(-) counterparts. However, a subset of HPV(+) patients with a smoking history fail to respond to the standard of care treatments such as radiation and chemotherapy. To understand the underlying mechanism driving HPV(+) OPSCC patient resistance to treatment and recurrence, we sought to identify and characterize the differentially expressed miRNAs and their target genes in HPV(+) smokers and non-smokers. EXPERIMENTAL DESIGN:MicroRNA expression analysis was performed using Nanostring in tumor tissues isolated from a prospective cohort of HPV(+) smoking (n = 9) and HPV(+) (n = 13) non-smoking OPSCC patients. Identified miRNAs of interest were further validated using qRT-PCR in cigarette smoke extract (CSE) treated HPV(+) and E6/E7 overexpressing HPV(-) cells. RESULTS:In comparison to OPSCC HPV(+) non-smokers, 38 miRNAs were significantly altered in the HPV(+) smoker patients cohort and out of that 9 were downregulated. Altered miRNA expression was also detected in the serum and metastatic lymph nodes of HPV(+) smokers versus non-smokers. Expression of miR-133a-3p was significantly downregulated in OPSCC smokers, HPV(+) cells and E6/E7 overexpressing HPV(-) cells treated with CSE. Reduction of miR-133a-3p induced the upregulation of miR-133a-3p target mRNAs EGFR and HuR. CONCLUSIONS:Our results indicate that miR-133a-3p is a target of smoking-induced changes in HPV(+) patients and alters the expression of EGFR and HuR which may promote HPV associated oropharyngeal cancer. Therefore, future treatment strategies for HPV(+) OPSCC smokers should focus on EGFR inhibition and the development of selective therapies to target HuR

Promoter region mutations of the telomerase reverse transcriptase (TERT) gene in head and neck squamous cell carcinoma

Objective. The aim of the present study was to assess the prevalence of TERT promoter region mutations in tumor samples of patients with squamous cell carcinoma at different sites of the head and neck region and correlate it with patients' clinicopathologic data