Papillary adenocarcinoma in submandibular region

Lateral ectopic thyroid is a rare event and even more uncommon is a primary malignancy in lateral ectopic thyroid. We present a case of papillary adenocarcinoma in lateral ectopic thyroid in submandibular space in a 55-year old male. To our knowledge this is the third case documented in the world and the first one in Europe. Lateral ectopic thyroid in this region is easily masqueraded as a submandibular gland swelling and so was our patients' tumor preliminarily diagnosed as a submandibular gland tumor. Furthermore, in the preoperative computed tomography (CT) scan the tissue was misinterpreted being adjacent to the submandibular gland. The diagnosis was revealed during the surgery and confirmed by the histology. This report demonstrates the difficulty in the differential diagnosis of neck masses. Although rare, ectopic tissue should be remembered as a possible diagnosis of all neck masses and the relevant preoperative examination should be performed by skilled professionals.Peer reviewe

Characterization of Vascular Adhesion Molecules that may Facilitate Progenitor Homing in the Post-natal Mouse Thymus

T cell progenitors derive from the bone marrow but must migrate via bloodstream to the thymus in order to differentiate. The mechanism by which the thymus recruits progenitors from the blood is unknown. It is known, however, that there are receptive and refractory periods for progenitor recruitment and that when cells are imported, they enter the thymus through post-capillary venules. Therefore, recruitment is an active process temporally and spatially regulated. In order to characterize the mechanism of recruitment, we evaluated vascular signals known to regulate leukocyte extravasation, with respect to their intrathymic location and temporal fluctuations. We find that CD34, MECA79, VCAM-1, ICAM-1 and VAP-1 are all expressed in thymic blood vessels. MECA79 and VAP-1 appear to be specific for post-capillary venules, while ICAM-1 and VCAM-1 are also found on intrathymic stromal cells. MAdCAM is also expressed in the thymus, but is not associated with vascular tissues. Only MECA79 is upregulated during recruitment peaks, suggesting a role for this molecule in the periodicity of recruitment. Together, these studies reveal potential roles for l-selectin ligands, VCAM-1, ICAM-1 and VAP-1 in progenitor recruitment to the thymus, and implicate the presence of other periodic signals, such as chemokines and cytokines, that cooperate to execute this essential function

Effect of coronavirus disease 2019 on recurrences and follow up of head and neck squamous cell carcinoma

Objective. This prospective study aimed to evaluate possible diagnostic delays in head and neck squamous cell carcinoma recurrences due to the changed follow-up protocol during the coronavirus disease 2019 pandemic. Methods. The follow-up appointments of head and neck squamous cell carcinoma patients treated more than one year prior to the pandemic were changed to telephone appointments in order to reduce physical visits to the hospital. All contacts, reasons for contact and recurrent cancers were recorded. Results. There were 17 recurrences during a seven-month study period among 178 patients treated in the previous year (10 per cent); 14 of these recurrences occurred in patients whose treatment had ended less than one year previously and 3 occurred more than one year after treatment had ended. There was no delay in diagnoses of recurrent tumours or treatment despite reduced visits because of the coronavirus disease 2019 pandemic. Conclusion. According to our analyses, no delay was caused in the diagnoses of recurrent diseases. Follow up by telephone or telemedicine can be considered as part of the follow-up protocol one year after the treatment of head and neck squamous cell carcinoma when necessary.</p

Employment status of young otorhinolaryngologists in Finland during a 10-year period

We determined the employment status of recently graduated otorhinolaryngologist-head and neck surgeons (ENT doctors) in Finland during the past 10 years. We also investigated the job vacancy rate of the Departments of Otorhinolaryngology-Head and Neck Surgery (Department of ORL-HNS). An electronic questionnaire was sent to all ENT doctors who had graduated during 2007-2017 and to chief physicians of all Departments of ORL-HNS. Chi-square and Fisher's test were used in the analyses. Altogether 129 ENT doctors had graduated and 125 (96.9%) responded. Thirty (24%) physicians had been employed in a position that did not correspond to their ENT doctor training. All 30 chief physicians responded and a total of 306 physicians were working at their departments (215 ENT doctors, 91 residents). However, there were only 241 available positions (197 for ENT doctors, 44 for residents). It was estimated that 65 ENT doctors would retire within 10 years. At the moment there does not seem to be a significant shortage of ENT doctors in Finland. The current national volume of resident intake in the ENT training programme is twofold in comparison with the estimated retirement rate in the public sector.Peer reviewe

Satisfaction of young ENT surgeons with their work. A Finnish national study

The objective was to investigate work satisfaction among recently graduated otorhinolaryngologist - head and neck surgeons - (ENT surgeons). An electronic questionnaire was sent to all ENT surgeons graduated in Finland during a ten-year period. Answers about work satisfaction were analyzed in detail with regards to age, gender, university of specialist training, experience, place of work and further education.Altogether 125/129 (96.9%) responded. The majority (87.8%) of the respondents enjoyed their current main occupation. The older age group (>= 40 vsPeer reviewe

Characterization of Vascular Adhesion Molecules that may Facilitate Progenitor Homing in the Post-natal Mouse Thymus

T cell progenitors derive from the bone marrow but must migrate via bloodstream to the thymus in order to differentiate. The mechanism by which the thymus recruits progenitors from the blood is unknown. It is known, however, that there are receptive and refractory periods for progenitor recruitment and that when cells are imported, they enter the thymus through post-capillary venules. Therefore, recruitment is an active process temporally and spatially regulated. In order to characterize the mechanism of recruitment, we evaluated vascular signals known to regulate leukocyte extravasation, with respect to their intrathymic location and temporal fluctuations. We find that CD34, MECA79, VCAM-1, ICAM-1 and VAP-1 are all expressed in thymic blood vessels. MECA79 and VAP-1 appear to be specific for post-capillary venules, while ICAM-1 and VCAM-1 are also found on intrathymic stromal cells. MAdCAM is also expressed in the thymus, but is not associated with vascular tissues. Only MECA79 is upregulated during recruitment peaks, suggesting a role for this molecule in the periodicity of recruitment. Together, these studies reveal potential roles for L-selectin ligands, VCAM-1, ICAM-1 and VAP-1 in progenitor recruitment to the thymus, and implicate the presence of other periodic signals, such as chemokines and cytokines, that cooperate to execute this essential function

Deep neck space infections: an upward trend and changing characteristics

Purpose This study reviews our experience with deep neck space infections (DNIs) requiring surgical intervention, includingcervical necrotizing fasciitis. The aim of the study was to identify predisposing and aggravating factors of the disease andrecognize the possible factors that can lead to life-threatening complications and slow down the healing process.Methods We compare the results to previous data from 1985 to 2005 to fnd possible alterations and changing trends. Thecharacteristics of four lethal cases are described. This retrospective analysis includes patient data from 2004 to 2015 intertiary referral hospital and in total, 277 patients were found.Results Surgical drainage through a neck opening±intraoral incision was made in 215 (77.6%) patients, an intraoral incision was only made in 62 patients (22.4%). ICU care was needed in 66 (23.8%) cases. Odontogenic etiology (44.8%) wasthe most common origin. The most common comorbidity was a psychiatric disorder and/or dementia and occurred in 55(19.9%) patients. Patients with underlying illnesses were more likely to be admitted to the ICU (p=0.020), required a longerICU stay (p=0.004) and repeated surgery (p=0.009). Gas formation seemed to be predictive of a more severe course ofinfection. Early extraction of the odontogenic foci was related to a lower length of stay (LOS) (p=0.039).Conclusion The annual numbers have risen from 14 to 24 cases per year when compared to previous data. DNIs remain cause of lethal complications; the mortality was 1.4% and overall complications occurred in 61 (22.0%) patients.</p

Practical aspects of sentinel node biopsy in oral cavity cancer: all nodes that emit a signal are important

Background and objectivesSentinel node biopsy (SNB) is a safe and effective way to examine an N0 neck in early-stage oral cavity cancer (OCC). In this study, we evaluated the variables of SNB detection, surgery, and outcome.Material and methods Ninety-two patients with N0 OCC examined with SNB were included. Number and brightness of nodes detected on preoperative imaging and during surgery were analyzed and compared with histological findings. Patients with recurrent disease were evaluated separately and the effect of smoking and alcohol consumption was analyzed.ResultsEighteen patients had at least malignant cells in the sentinel lymph node (SLN); 18 patients had recurrent disease and nine patients died from the cancer. The negative predictive value of SNB was 95%. Six patients did not have metastases in the node with the strongest signal, but metastases were found in an SLN with a weaker signal. Smoking and alcohol consumption did not affect disease-specific or overall survival.Conclusion and significanceSNB has been confirmed to be safe and effective in early stage N0 OCC. However, it is important to carefully harvest up to four hottest SLNs that emit a signal. Treatment of patients with only isolated tumor cells (ITC) in the SLN appears to be necessary.</p

Survival and Larynx Preservation in Early Glottic Cancer : A Randomized Trial Comparing Laser Surgery and Radiation Therapy

Purpose: The prognosis of glottic T1a laryngeal squamous cell carcinoma (LSCC) is excellent with both transoral laser surgery (TLS) and radiation therapy (RT). Our aim was to compare TLS and RT treatment results in a randomized study. Methods and Materials: Of 56 male patients with glottic T1a LSCC, 31 were randomized for TLS and 25 for RT. Survival and larynx preservation data were collected from medical records. Results: Five-year overall survival (OS) was 87%, disease-specific survival (DSS) was 97%, and recurrence-free survival (RFS) was 81% in patients treated with TLS. Five-year OS was 92%, DSS was 100%, and RFS was 88% in patients treated with RT. The primary treatment method was not associated with OS, RFS, or DSS in a log-rank test. The larynx preservation rate was similar in both groups (TLS, 97%; RT, 92%; P = .575). Conclusions: In a prospective randomized setting oncological outcomes of both treatment modalities (TLS or RT) for T1a LSCC were similar. (C) 2022 Elsevier Inc. All rights reserved.Peer reviewe