Treatment of bilateral vocal cord paralysis following permanent recurrent laryngeal nerve injury

Bilateral vocal cord paralysis is a serious illness requiring emergency intervention to resolve the potentially life-threatening respiratory distress. Several surgical procedures were proposed to help improve the airway and to eliminate the tracheostoma in those patients with permanent paralysis. All the procedures have their own advantages and disadvantages. We conducted a retrospective study of 30 patients affected by bilateral vocal cord paralysis following total thyroidectomy. All the patients underwent total thyroidectomy for benign thyroid pathology. In 26 patients (86.6%), cord paralysis occurred during the perioperative stage; and in the remaining 4 cases (13.3%), it occurred within the following 6 months. We treated all these bilateral recurrent laryngeal nerve paralysis patients with arytenoidectomy alone in 5 patients and arytenoidectomy with concomitant true and false posterior cordectomy in the remaining 25 patients. Twenty-four of the 25 patients who underwent the combined procedures (96%) reported subjective respiratory improvement and were decannulated within 60 days, being able to return to their normal daily activities. This study demonstrates that arytenoidectomy associated with posterior cordectomy is a satisfactory surgical treatment of bilateral vocal cord paralysis because it leads to a considerable and stable enlargement of the breathing space

Cellular Automaton Study of Time-Dynamics of Avalanche Breakdown in IMPATT Diodes

Employing a recently developed efficient cellular automaton technique for solving Boltzmann's transport equation for realistic devices, we present a detailed study of the carrier dynamics in GaAs avalanche p-i-n (IMPATT) diodes. We find that the impact ionization in reverse bias p-i-n diodes with ultrathin (less than 50 nm) intrinsic regions is triggered by Zener tunneling rather than by thermal generation. The impact generation of hot carriers occurs mainly in the low-field junction regions rather than in the high field intrinsic zone. The calculations predict significantly more minority carriers on the n-side than on the p-side

A solitary fibrous tumor of the parotid gland: Case report

Introduction: Solitary fibrous tumor is a rare neoplasm that can affect any part of the body, also head and neck region. Etiology is unknown. The incidence is slightly higher in males, the age ranges from 11 to 79 years. Presentation of case: It's the first case in our country of left parotid solitary fibrous tumor, removed by partial parotidectomy with facial nerve preservation. Histology examination showed diffuse spindle-shaped cells proliferation, moderate polymorphism, low mitotic index (<4 mitoses per 10 HPF), partially bordered by fibrous capsule. Immunohistochemistry showed STAT6, CD34, CD99 positivity. Six-months follow-up didn't show sign of recurrence. Discussion: Solitary fibrous tumor is a mesenchymal spindle cell neoplasm with fibroblastic differentiation ubiquitous in soft tissues, that involved the head and neck region in 6 % of cases. Etiology is unknown. The possible pathogenesis is NAB2-STAT6 gene fusion. It's asymptomatic or symptoms are related to space-occupying mass. Diagnostic work up involves imaging, immunohistochemistry, histology. Radiographic finding may lead to incorrect assessment of the mass: the same imaging features are present in pleomorphic adenoma, the most frequent tumor of salivary glands. Conclusion: This case report aims to stress that, although rare, solitary fibrous tumor should be considered in differential diagnosis in case of indolent salivary gland mass, since it may require more invasive approach (e.g., total parotidectomy, adjuvant radiotherapy). It would like to highlight the role of multidisciplinary team to define the best therapy, tailored for the patient, as well as to give awareness to a rare but sometimes aggressive tumor

Familial occurrence of warthin tumour: Our experience and review of the literature

The tumour of Warthin (WT) is the second parotid tumour for frequency after the pleomorphic adenoma, it represents about 2% to 15% of all parotid tumors. The pathogenesis of familial Warthin Tumour is unknown, even if cytogenetic abnormalities have been identified in Warthin Tumour. Among the inducing factors there is the smoke which has an important role. Familial occurrence of Warthin Tumour is rare, only five reports in the literature. Two of them were reported in brothers, two in a mother and son and one in monozygotic twins. We quote a case of familiar Warthin Tumour arisen in two brothers and we present a review of the Literature

Pleomorphic adenoma of the lateral nasal wall: case report

Pleomorphic adenoma is the most common tumour of the salivary glands. However, it is extremely rare for these to originate in the nose and even when they do so, it is most commonly in the nasal septum. It is important to be aware of the paucity of presenting symptoms (nasal obstruction and epistaxis), as the lesion may not be recognized immediately. Growth is generally restricted locally and the tumour is not known to spread to the neighbouring structures. Surgical resection is the treatment of choice. Recurrences and evolution to malignancy are not frequent, but long-term follow-up is recommended. The case is presented of pleomorphic adenoma arising from the lateral wall of the right nasal cavity, in a 34-year-old male, which was resected completely, endoscopically. Histological and immunohistochemical evaluation revealed the presence of a pleomorphic adenoma

A RETROSPECTIVE STUDY OF ORAL AND OROPHARYNGEAL CARCINOMA IN THE WESTERN SICILY POPULATION

The main risk factors of oral/oropharyngeal carcinomas (OPCs) are smoking and alcohol. Recently, another risk factor has been identified: Human Papilloma Virus (HPV). This study is aimed to define demographic and clinical data of OPC in western Sicilian native population and their correlation with HPV. A retrospective study was carried out on 112 patients with OPC: 66.96% were males and 55.36% were over 65; 75% smoked more than 20 cigarettes/day; 64.28% did not drink alcohol. HPV was detected in 48/112 patients: 54.17% were females and 41.67% were under 65; the most affected subsite was palatine tonsil. Statistically significant association between age (over 65), gender (female), anatomical subsite (palatine tonsil) and HPV-related carcinoma was found. Our study confirmed a significant diffusion of OPCs in western Sicilian population and the crucial role of HPV. In our opinion, it’s mandatory to search for HPV in biopsy sample to schedule the best therapeutic protocol