14 research outputs found
Corneal Topography With Upper Eyelid Platinum Chain Implantation Using the Pretarsal Fixation Technique
Purpose: To determine the effect of upper eyelid platinum chain implantation, with the pretarsal fixation technique, on corneal astigmatism. Methods: This is a prospective, cohort study. Fifteen eyes of 15 patients underwent upper eyelid platinum chain implantation, with the pretarsal fixation technique, for facial nerve palsy. Information recorded included patient demographics, etiology for facial palsy, weight of the implant, time from onset of paresis to upper eyelid platinum chain implantation, associated surgical procedures, and preoperative and postoperative corneal topography measurements. Results: Of the 15 patients studied, 10 were male and five were female. The mean age was 55.9 ± 13.8 years (range, 33–87 years). The most common etiology for facial palsy was acoustic neuroma. The weight of the implant ranged from 0.6 to 1.6gr (median 1.2gr). The time from onset of paresis to upper eyelid platinum chain implantation varied from 1 week to 3 months (median 1 month). Four patients had an associated procedure to correct the effect of paralytic ectropion. There was no statistically significant difference in with the rule astigmatism before and after platinum chain implantation. Conclusions: Upper eyelid platinum chain implantation, with the pretarsal fixation technique, does not appear to cause significant change in corneal astigmatism. This is contrary to data for pretarsal gold weight implantation, which does induce significant with the rule astigmatism
Resection of giant ethmoid osteoma with orbital and skull base extension followed by duraplasty
<p>Abstract</p> <p>Background</p> <p>Osteomas of ethmoid sinus are rare, especially when they involve anterior skull base and orbit, and lead to ophthalmologic and neurological symptoms.</p> <p>Case presentation</p> <p>The present case describes a giant ethmoid osteoma. Patient symptoms and signs were exophthalmos and proptosis of the left eye, with progressive visual acuity impairment and visual fields defects. CT/MRI scanning demonstrated a huge osseous lesion of the left ethmoid sinus (6.5 cm × 5 cm × 2.2 cm), extending laterally in to the orbit and cranially up to the anterior skull base. Bilateral extensive polyposis was also found. Endoscopic and external techniques were combined to remove the lesion. Bilateral endoscopic polypectomy, anterior and posterior ethmoidectomy and middle meatus antrostomy were performed. Finally, the remaining part of the tumor was reached and dissected from the surrounding tissue via a minimally invasive Lynch incision around the left middle canthus. During surgery, CSF rhinorrhea was observed and leakage was grafted with fascia lata and coated with bio-glu. Postoperatively, symptoms disappeared. Eighteen months after surgery, the patient is still free of symptoms.</p> <p>Conclusion</p> <p>Before management of ethmoid osteomas with intraorbital and skull base extension, a thorough neurological, ophthalmological and imaging evaluation is required, in order to define the bounders of the tumor, carefully survey the severity of symptoms and signs, and precisely plan the optimal treatment. The endoscopic procedure can constitute an important part of surgery undertaken for giant ethmoidal osteomas. In addition, surgeons always have to take into account a possible CSF leak and they have to be prepared to resolve it.</p
Corneal Topography With Upper Eyelid Platinum Chain Implantation Using the Pretarsal Fixation Technique
Purpose: To determine the effect of upper eyelid platinum chain implantation, with the pretarsal fixation technique, on corneal astigmatism. Methods: This is a prospective, cohort study. Fifteen eyes of 15 patients underwent upper eyelid platinum chain implantation, with the pretarsal fixation technique, for facial nerve palsy. Information recorded included patient demographics, etiology for facial palsy, weight of the implant, time from onset of paresis to upper eyelid platinum chain implantation, associated surgical procedures, and preoperative and postoperative corneal topography measurements. Results: Of the 15 patients studied, 10 were male and five were female. The mean age was 55.9 ± 13.8 years (range, 33–87 years). The most common etiology for facial palsy was acoustic neuroma. The weight of the implant ranged from 0.6 to 1.6gr (median 1.2gr). The time from onset of paresis to upper eyelid platinum chain implantation varied from 1 week to 3 months (median 1 month). Four patients had an associated procedure to correct the effect of paralytic ectropion. There was no statistically significant difference in with the rule astigmatism before and after platinum chain implantation. Conclusions: Upper eyelid platinum chain implantation, with the pretarsal fixation technique, does not appear to cause significant change in corneal astigmatism. This is contrary to data for pretarsal gold weight implantation, which does induce significant with the rule astigmatism
Primary localized laryngeal amyloidosis presenting with hoarseness and dysphagia: a case report
<p>Abstract</p> <p>Introduction</p> <p>Primary localized laryngeal amyloidosis is an extremely rare condition. It usually presents with hoarseness, pain and/or difficulty in breathing.</p> <p>Case presentation</p> <p>We present the case of a 23-year-old woman with primary localized laryngeal amyloidosis who presented with hoarseness and dysphagia.</p> <p>Conclusion</p> <p>A search of PubMed shows that dysphagia in patients with laryngeal amyloidosis has been reported only once, although this symptom is relatively common in other conditions presenting with laryngeal mass. There were no signs of any systemic disease in our patient and diagnosis was established histopathologically. She was treated surgically by microlaryngoscopy under general anesthesia and the mass was excised using a CO<sub>2</sub> laser technology method.</p
Nonsurgical Management of Silent Sinus Syndrome With Hyaluronic Acid Gel
A 44-year-old woman was referred with 3 mm of left enophthalmos and a
deep superior sulcus. She was diagnosed 6 months earlier with silent
sinus syndrome and had undergone a left middle-meatal antrostomy with
improvement of her hypoglobus but not of her enophthalmos and superior
sulcus deformity. Two milliliters of Restylane SubQ (Q-Med AB, Uppsala,
Sweden) was injected as a single bolus in the intraconal and extraconal
posterior orbit via a standard transcutaneous inferotemporal approach
using a primed green 21-gauge needle. Immediate reduction of
enophthalmos by approximately 2 mm and superior sulcus improvement were
noted. This remained stable at 6 months. The symptoms and signs of
silent sinus syndrome can be effectively corrected with this minimally
invasive nonsurgical option. To our knowledge, the use of hyaluronic
acid gel for the treatment of enophthalmos in silent sinus syndrome has
not been previously reported
Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review
Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23%) and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.</p
<it>L</it>-DOPA decarboxylase mRNA expression is associated with tumor stage and size in head and neck squamous cell carcinoma: a retrospective cohort study
Abstract Background Head and neck squamous cell carcinoma (HNSCC) represents one of the most commonly diagnosed malignancies worldwide. The DDC gene encodes L-DOPA decarboxylase, an enzyme catalyzing the decarboxylation of L-DOPA to dopamine. We have recently shown that DDC mRNA is a significant predictor of patients’ prognosis in colorectal adenocarcinoma and prostate cancer. The aim of the current study was to analyze the DDC mRNA expression in HNSCC patients. Methods 53 malignant tumors were resected from the larynx, pharynx, tongue, buccal mucosa, parotid glands, and nasal cavity, as well as from 34 adjacent non-cancerous tissues of HNSCC patients, and were homogenized. Total RNA was isolated and converted into first-strand cDNA. An ultrasensitive real-time PCR method based on the SYBR Green chemistry was used for DDC mRNA quantification in head and neck tissue specimens. Relative quantification was performed using the comparative Ct (2-ddCt) method. Results DDC mRNA levels were lower in squamous cell carcinomas (SCCs) of the larynx and tongue than in adjacent non-cancerous tissue specimens. Furthermore, low DDC mRNA expression was noticed in laryngeal and tongue tumors of advanced TNM stage or bigger size, compared to early-stage or smaller tumors, respectively. No statistically significant differences were observed between SCCs resected from pharynx, buccal mucosa, or nasal cavity, and their normal counterparts. Conclusion This is the first study examining the DDC mRNA expression in HNSCC. According to our results, DDC mRNA expression may constitute a potential prognostic biomarker in tongue and/or larynx SCCs, which principally represent the overwhelming majority of HNSCC cases.</p
Congenital aural atresia reconstruction: A surgical procedure with a long history
Background: Pinna deformities, combined with congenital aural atresia,
have been a matter of serious debate in the literature as they are
associated with major aesthetic and functional problems that are
difficult to manage. These problems have been described as early as 2000
BC. The aim of the present article is to approach the whole problem as
one (pinna malformation and aural atresia) and present the history as
well as the current approaches in reconstruction.
Methods: Extensive literature search and medical history books were used
as scientific sources.
Results: For many centuries, the prevalent view was that any surgical
attempts to reconstruct the pinna and the ear canal were of little
value. In addition, the aesthetic result of these early surgical
procedures was mostly unacceptable. Over time, new surgical techniques
and synthetic materials were used, leading to satisfactory and lasting
aesthetic and functional results in selected patients, improving their
quality of life, while reducing the complication rate. However, many
cases are still challenging for plastic surgeons and ENT surgeons alike.
Conclusions: Despite significant progress in the field, surgery for
pinna deformities combined with congenital aural atresia still remains
one of the most challenging and risky procedures. Accurate audiological
evaluation of newborns as well as assessment of their craniofacial
development is necessary and can help the plastic surgeons and
otologists choose proper candidates for surgical repair and a suitable
and age-appropriate therapeutic plan. History and repeated failures have
taught us that close multidisciplinary approach is of paramount
importance. (C) 2009 British Association of Plastic, Reconstructive and
Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved
Metastatic Sarcoma of the Tongue: Pleomorphic Malignant Fibrous Histiocytoma and Literature Review
Metastatic tumors of the tongue are rare, most commonly arising from carcinomas of the lung, kidney, breast, and melanomas. They usually appear in end-stage disease, especially in the tongue base, probably because of the rich blood supply. Metastatic sarcomas of the tongue are even rarer. We report the seventh case of metastatic tongue sarcoma and the first one in the literature, arising from a pleomorphic malignant fibrous histiocytoma (MFH) of the lower extremity. ENT surgeons, Maxillofacial surgeons, and Oncologists should be aware of the possibility of metastatic sarcomas of the tongue, even though these lesions are extremely rare. Furthermore, metastatic sarcomas of the tongue represent a late manifestation of a previously identified primary tumor, although if the primary site has not been identified, a thorough investigation to locate an occult tumor should be conducted