Tonsillectomy, past, future and present

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A Rare Case Report - Dirofilariasis and B-cell Lymphoma in Cervical Lymph Nodes

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Chronic rhinosinuitis with sphenoid sinus mycetoma – Clinical Case and literature review

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Assessment of postoperative pain and foreign body sensation between two surgical methods coblator-assisted tonsillectomy versus conventional method

The tonsillectomy is one of the most common surgical procedure in the world. One of the commonest complications after the surgery are postoperative bleeding and postoperative pain. In relation with thesecomplains and complications the patients have difficult recovery significantsensation of pain and foreign body sensation. The coblation–assisted tonsillectomy is fairly new surgical method and the focus is in the specific aspects of the surgical techniques and postoperative complications. In our prospective comparative study we include 60 patients divided equally: 30 surgically treated with the coblation method and 30 with conventional method. The average age of the participants is 6,87±3,01 in the first group and 8,16±4,74 in the second group. We compare the postoperative pain and the foreign body sensation in both groups. We measured the postoperative pain using Wong-Baker visual analogue scale with face images (0-no pain; 10-hurts worst). We measured the pain on the 1st – 2nd and 7th day after the surgery. We found statistically significant difference (p-value <0.0005) according to this parameter in both groups. In all of the three days after the surgery the pain is less intensive in the coblation group. Regarding the postoperative pain we found statisticallysignificant differences between both methods in favor of coblatorassistedtonsillectomy (p-value- 0.0002)

Thyroglossal Duct Cyst Recurence. A case report

Thyroglossal duct cyst is a congenital malformation that occurs due to incomplete closure of the thyroglossal duct. The cyst typically appears along the midline of the neck on the ventral surface. Apart from being a quiescent embryological remnant, it presents itself clinically at any age and often requires surgical excision. It is the most common congenital tumor neck mass and occurs in 7% of the population. The thyreoglossal cyst may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. Its position in the hyoid bone is extremely rare. There are a few differences between thyroglossal duct cysts (TGDCs) expression in children and adults. The lesion mostly found in children but adult population also possesses this anomaly. Position is almost similar in both age groupswith midline and infrahyoid location while laterality is seen mostly in adults. Size of Cyst is found to be larger in adults. The recurrence and post-operative complication rates between children and adults usually are not significantly different. Malignant transformation is rare and can be diagnosed only after histologic examination of a biopsy specimen.We present a clinical case of a 25 year old female patient, with previoussurgery in childhood (at the age of 7) due to thyroglossal duct cyst. She came to the ENT clinic complaining of painful tumor mass at the middle of her neck 3 centimeters large. Thyroglossal duct cyst recurrence with inflammation was discovered. The patient underwent antibiotic treatment for 10 days as a start and after a week a surgery was performed as a method of definitive treatment

Primary thyroglossal duct cyst papillary carcinoma. Case report and literature review

Aim: Primary papillary carcinoma in a thyroglossal duct cyst (PTGDPC) is a rare pathological condition diagnosed in only 1–2% of the cases of midline neck cysts. Diagnosis is most commonly made postoperatively after the cyst is dissected by Sistrunk’s operation. There is a lot of controversy over the definitive management of PTGDPC and the proper therapeutic approach to it especially when we consider using total thyroidectomy and subsequent adjuvant radioiodine therapy in the treatment. We report a case of papillary carcinoma in a thyroglossal duct cyst and review the relevant literature to clarify what algorithm should a clinician apply in such cases.Materials and methods: We present a case of a 38-year-old woman with papillary carcinoma arising from a cyst in ductus thyroglossus which was histologically identified after Sistrunk’s operation. We discuss also the pathogenesis of papillary carcinoma in a thyroglossal duct cyst and the need to perform thyroidectomy.Results: The patient (T. C.) was a 38-year-old woman hospitalized in the Clinic of Otorhinolaryngology at St. George University Hospital in Plovdiv with a diagnosis of midline neck cyst confirmed by neck computed tomography and ultrasound. Sistrunk’s procedure was used for the patient who was shown by postoperative histology and repeat verification to have papillary carcinoma. The patient’s thyroid was examined scintigraphically yielding inconclusive evidence for neoplasm and then removed by thyroidectomy. No synchronous papillary carcinoma in the thyroid gland was identified. The histology showed nodular colloid goitre. The patient received postoperatively radioactive iodine (I-131) therapy and hormone-replacement therapy with L-thyroxin.Conclusions: We have found total thyroidectomy to be rather controversialapproach to managing papillary carcinoma in a thyroglossal duct cyst. Accurate identification of a possible primary focal area in the thyroid gland followed by total thyroidectomy in conjunction with I-131 ablation and hormone replacement therapy seem far more appropriate in such cases

History of the World Hearing Day

BackgroundAccording to recent data from the World Health Organization from 2019, approximately 466 million people are living with a disabling hearing loss, most of them in low- and middle-income countries. Undiagnosed and untreated hearing disorders are proven to be a leading cause for morbidity and cost annually $750 billion. Hearing disorders and hearing loss are believed to higher their prevalence due to the fact that a wide majority of people are exposed to high noises and lack of timely and adequate hearing diagnostics and treatment of ear conditions.MethodsScientific databases – PubMed, SCOPUS and MEDLINE were used to search for the information targeted. The following keywords – World Hearing Day, history, events, prophylaxis, hearing disorders were used. Information from the official websites of the societies involved in celebrating World Hearing Day was included as well. The aim of the following article is to study the history of the event from its foundation till today, aiming to stress out its usefulness. Results and discussionBack in 1995, World Health Assembly passed a resolution WHA48.9, in which attention of the health impact of hearing loss was put – 120 million people worldwide were living with a disabling hearing difficulties. During the World Health Assembly in 2017, with the adoption of the resolution WHA70.13, hearing care and hearing loss were highlighted as a public health issue. Authors claim that most of the causes for hearing loss are preventable.World Hearing Day is an international campaign, organized annually by the Office of Prevention of Blindness and Deafness of the World Health Organization (WHO) on March, 3rd. Organizers claim that World Hearing Day is the largest global awareness event, aiming to bring society’s attention to ear and hearing disorders. It addresses hearing loss. First activities, connected with the World Hearing Day, took place in 2007, after the Beijing Declaration during the 1st International Conference on Prevention and Rehabilitation of Hearing Loss.ConclusionsLegislative measures are need to be undertaken to stress even further the importance of proper hearing. In the era of COVID-19 pandemic and its proven consequences on the hearing and vestibular system, urgent measures for timely diagnostics, treatment and rehabilitation are more than ever needed

Rhinophyma – a clinical case and literature review

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History of the World Sleep Day

BackgroundSleep has also been cherished by society as a basic human need with a crucial importance for human health. People spend around one third of their lives sleeping. Nowadays, it has never been harder to achieve a restful sleep. When sleep is better understand, that will lessen the drawbacks of the different sleep disorders. Healthy sleep is important for maintaining physical and mental health in adult individuals. Sleep deprivation poses a significant risk for the individual and leads to psychological conditions, such as depression and anxiety. Several sleep disorders are known to the science. If breathing during sleep is not regular, a case of obstructive sleep apnea (OSA) may have been diagnosed.The World Sleep Day is traditionally celebrated in March, on the Friday before the Spring vernal equinox of each year. It is a global awareness and internationally recognized event, organized annually since 2008 by the World Sleep Day Committee of the World Sleep Society. Organizers aim to raise awareness of the problems with proper sleep, sleep disorders and aspects connected to it – medical, social, educational and others.MethodsScientific databases – PubMed, SCOPUS and MEDLINE were used to search for the information targeted. The following keywords – World Sleep Day, history, events, prophylaxis, sleep disorders were used. Information from the official websites of the societies involved in celebrating World Sleep Day was included as well.The aim of the following article is to study the history of the event from its foundation till today, aiming to stress out its usefulness.Results and discussionWorld Sleep Days has been internationally celebrated since 2008 for 15 years now. Since 2016, Bulgaria actively participates in all events organized by the World Sleep Society – Scientific symposiums, prophylactic check-ups for obstructive sleep apnea, elective disciplines in the teaching of students are organized. Importance is put on informing society about the dangers of undiagnosed and untreated sleep disorders, especially sleep apnea. Sleep medicine and Dental Sleep medicine are not recognized as medical specialties in the Republic of Bulgaria.ConclusionsProblems of sleep are extremely common in our days. The situation is continuously being worsened due to the hyperconnectivity people experience with the glowing computer and mobile phone screens. It is admirable that specialists in the field and society try to raise awareness and combat the poor sleep quality consequences. Only by doing the abovementioned, alleviation of the undesirable outcomes of irregular sleep can be reached. Legislative measures should be taken in order to certify Sleep medicine and Dental sleep medicine as medical specialties in theRepublic of Bulgaria

Mucocele Originating from the Blandin-Nuhn Glands. A Case Report

Mucocele is a common, benign, mucous containing cystic lesion of the minor salivary glands in the oral cavity, resulting from the retention or extravasation of mucous into the surrounding tissues of lamina propria. They occur in various anatomical locations but the occurrence in the ventral aspect of tongue is rarely seen.We present a clinical case of mucocele of the glands of Blandin-Nuhn in a 12-year-old boy – the path to the diagnosis and management