Πέμπτη 3 Φεβρουαρίου 2022

Changes in the Sphenoid Bone Encountered During the Endoscopic Endonasal Transsphenoidal Approach

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Objectives

We estimated volume changes in the posterior bony wall of the sphenoid sinus, as well as alterations in nasal function (including olfactory function and subjective symptoms), after sphenoid mucosal repositioning using the endoscopic endonasal transsphenoidal approach (EETSA).

Methods

During 2010 and 2021, 13 patients underwent sphenoid mucosal repositioning during EETSA, while 24 patients (the control group) did not. Pre- and postoperative paranasal sinus computed tomography and the Mimics program were used to evaluate three-dimensional changes in the posterior wall of the sphenoid sinus. All patients underwent the Connecticut Chemosensory Clinical Research Center (CCCRC) test, the Cross-Cultural Smell Identification Test (CCSIT), Nasal Obstruction Symptoms Evaluation (NOSE), the Sino-Nasal Outcome Test-20 (SNOT-20), and visual analog scale (VAS) evaluation.

Results

The increase in the volume of the posterior wall of the sphenoid sinus after surgery was objectively smaller in the sphenoid mucosal repositioning group than in the control group (P = .046). However, this did not affect olfactory function (as revealed by the CCCRC test or the CCSIT) or subjective symptoms (as revealed by the NOSE, SNOT-20, and VAS scores) (all P > .05).

Conclusion

Surgical closure via sphenoid mucosal repositioning during EETSA reduces the volume of the posterior wall of the sphenoid sinus and facilitates re-operation. We suggest that sphenoid mucosal repositioning is appropriate during EETSA.

Level of Evidence

4 Laryngoscope, 2022

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Oculo-auriculo-vertebral spectrum: new genes and literature review on a complex disease

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J Med Genet. 2022 Feb 2:jmedgenet-2021-108219. doi: 10.1136/jmedgenet-2021-108219. Online ahead of print.

ABSTRACT

Oculo-auriculo-vertebral spectrum (OAVS) or Goldenhar syndrome is due to an abnormal development of first and second branchial arches derivatives during embryogenesis and is characterised by hemifacial microsomia associated with auricular, ocular and vertebral malformations. The clinical and genetic heterogeneity of this spectrum with incomplete penetrance and variable expressivity, render its molecular diagnosis difficult. Only a few recurrent CNVs and genes have been identified as causatives in this complex disorder so far. Prenatal environmental causal factors have also been hypothesised. However, most of the patients remain without aetiology. In this review, we aim at updating clinical diagnostic criteria and describing genetic and non-genetic aetiologies, animal models as well as novel diagnostic tools and surgical managemen t, in order to help and improve clinical care and genetic counselling of these patients and their families.

PMID:35110414 | DOI:10.1136/jmedgenet-2021-108219

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Surgical strategy for squamous cell carcinoma of the external auditory canal: management of locally advanced cases with skull base involvement

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10.1055-a-1733-2585-1.jpg

J Neurol Surg B Skull Base
DOI: 10.1055/a-1733-2585

Objective Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4-subclassification. Methods Patients with SCC of the EAC who underwent curative treatment from 2002-2021 were retrospectively reviewed at our hospital. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS) were analyzed. To clarify the surgical indication for advanced stage, we proposed the T4-subclassification. Results In 46 patients, the tumors were in T1 stage in 8 patients, T2 in 10, T3 in 5, and T4 in 23. The 5-year DSS with T1, T2, T3, and T4 tumors were 100%, 85.7%, 100%, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS (p = 0.23 and p = 0.13). Patients with far advanced stage (T4b) tumors were significantly associated with shorter DSS than those with early stage (T1/T2) and advanced stage (T3/T4a) tumors (p = 0.007 and p = 0.03). Conclusion The present study focused on patients with SCC of the EAC at a University hospital over a period of 20-years, especially with skull base involvement, and a T4-subclassification was proposed. Complete tumor resection in an en bloc fashion could help to achieve a good survival rate even in patients with locally advanced tumors.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Τετάρτη 2 Φεβρουαρίου 2022

Artemisinin resistance: an important emerging clinical problem in tropical medicine

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Int J Physiol Pathophysiol Pharmacol. 2021 Dec 15;13(6):152-157. eCollection 2021.

ABSTRACT

Artemisinin is an important antimalarial drug which is originated and developed from Chinese traditional herbal regimen. At present, artemisinin is used as an antimalarial drug for treatment of drug resistant malarial infection. The effectiveness of artemisinin is clinically accepted. Hence, artemisinin is currently used as main drug for malaria treatment in many tropical countries. Artemisinin resistance is a new emerging clinical problem in tropical medicine. New mutation can result in artemisinin resistance and the resistance becomes important new emerging problem in clinical malariology. It is necessary to control of artemisinin use and searching for new effective drug against artemisinin resistant malaria. In this article, the authors summarizes on important updated information regarding artemisinin resistance.

PMID:35103097 | PMC:PMC8784654

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Modified genioglossus advancement with radiofrequency tongue base reduction for retroglossal collapse in obstructive sleep apnea patients

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Publication date: Available online 2 February 2022

Source: American Journal of Otolaryngology

Author(s): Tarek Abdelzaher Emara, Ahmed Ashraf S. Elhamshary, Ahmed Soliman Elkady, Ahmed Mohamed Mahmoud Elhewity, Hesham Abdelrahman Abdelsamee

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A review of neoplasms with MITF/MiT family translocations

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Histol Histopathol. 2022 Feb 2:18426. doi: 10.14670/HH-18-426. Online ahead of print.

ABSTRACT

Microphthalmia-associated transcription factor (MITF/MiT) family is a group of basic helix-loop-helix leucine zipper (bHLH-LZ) transcription factors including TFE3 (TFEA), TFEB, TFEC and MITF. The first renal neoplasms involving MITF family translocation were renal cell carcinomas with chromosome translocations involving ASPL-TFE3/t(X;17)(p11.23;q25) or MALAT1-TFEB/t(6;11)(p21.1;q12), and now it is known as MiT family translocation RCC in 2016 WHO classification. Translocations involving MITF family genes also are found in other tumor types, such as perivascular epithelioid cell neoplasm (PEComa), Alveolar soft part sarcoma (ASPS), epithelioid hemangioendothelioma, ossifying fibromyxoid tumor (OFMT), and clear cell tumor with melanocytic differentiation and ACTIN-MITF translocation. In this review, we summarize the features of different types of neoplasms with MITF family translocations.

PMID:35107169 | DOI:10.14670/HH-18-426

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Sonographische Diagnostik tonsillärer Abszesse: Eigene Erfahrungen und eine systematische Übersicht

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Laryngorhinootologie
DOI: 10.1055/a-1744-6305

Hintergrund Die transkutane Sonografie ist seit einigen Jahrzehnten ein fester Bestandteil der bildgebenden Diagnostik im Kopf-Hals-Bereich. Insbesondere in der Darstellung von Abszessen der Fossa tonsillaris ist die Sonografie eine schnelle, sichere und kostengünstige diagnostische Methode. Diese Arbeit soll einen Überblick über die derzeit publizierten Studien in Bezug auf die diagnostische Wertigkeit geben. Material und Methoden Systematische Literaturrecherche in folgenden Online-Datenbanken: PubMed und MEDLINE nach den Suchbegriffen transcutaneous ultrasound, tonsillar abscess, peritonsillar abscess, intratonsillar abscess, peritonsillar cellulitis und parapharyngeal abscess. Bewertung der wissenschaftlichen Relevanz der Arbeiten nach festgelegten Kriterien. Ergebnisse Die Publikationen wurden in Bezug auf die klinische Anwendung, die klinische Befunderhebung und die diagnostische Genauigkeit analysiert. Die Sensitivität und Spezifität werden je nach Studie und Patientenkollektiv zwischen 67 % und 100 % bzw. 50 % und 93 % angegeben. Schlussfolgerungen In Zusammenschau der aktuell publizierten Ergebnisse verspricht die transkutane Sonografie ein großes Potenzial, die Diagnostik des Peritonsillarabszesses zu verbessern, und ermöglicht eine gute Abgrenzbarkeit zur peritonsillären Zellulitis. Dies ist für das klinische Management von Patienten mit Abszessverdacht von entscheidender Bedeutung.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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