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  • ISSN: 2379-948X
    Volume 4, Issue 3
    Research Article
    Stefan Cimbollek*, Maria del Robledo Avila, Manuel Prados, and Joaquin Quiralte
    An unexpected reaction characterized by an intermittent rhinitis shortly before the next dose of specific immunotherapy and which disappeared after the allergen injection dose, was controlled by simply shortening the conventional maintenance frequency.
    Jeong-Rok Kim, HwibinIm, Sung Won Chae, and Jae-Jun Song*
    Background and Objectives: Benign tumors of the external auditory canal (EAC) are rare among head and neck tumors. The aim of this study was to analyze the clinical features of patients who underwent surgery for an EAC mass confirmed as a benign lesion.
    Methods: This retrospective study involved 53 patients with external auditory tumors who received surgical treatment at Korea University, Guro Hospital. Medical records and evaluations over a 10-year period were examined for clinical characteristics and pathologic diagnoses.
    Results: The most common pathologic diagnoses were nevus (40%), osteoma (13%), and cholesteatoma (13%). Among the five pathologic subgroups based on the origin organ of the tumor, the most prevalent pathologic subgroup was the skin lesion (47%), followed by the epithelial lesion (26%), and the bony lesion (13%). No significant differences were found in recurrence rate, recurrence duration, sex, or affected side between pathologic diagnoses. The overall recurrence rate after excision was 11% and higher in patients with fibro epithelial polyp, intra epidermal pilarepithelioma, and chronic inflammation. Culture of otorrhea identified pathogens in half of patients with recurrence, and the recurrence rate was considerably higher (50%) in cases confirmed to be infected by microorganism.
    Conclusion: Our results indicated that nevus was the most common pathologic diagnoses. The overall recurrence rate was 11%. Benign external auditory canal lesions that originate from the epithelium and bony canal should be observed closely in the postoperative follow-up period. Furthermore, treatment of infection is thought to be important for preventing recurrence.
    Andrea Marzullo*, Teresa Lettini, Maria Luisa Fiorella, Vincenzo Di Nicola, Graziana Arborea, Federica Pezzuto, Francesco Fortarezza, Leonardo Resta and Gabriella Serio
    Advanced head and neck squamous cell carcinoma (SCC) is a disease that metastasizes predominantly to the locoregional lymph nodes. The presence of regional metastases is crucial for staging, therapeutic decision making and prognosis. For patients with clinically negative neck nodes, there are two major management strategies: elective neck dissection or follow-up. Sentinel lymph node biopsy (SLNB) using radioisotope injection has been developed for breast cancer and cutaneous melanoma, and this method is considered the gold standard for SLNB, although in head and neck cancer, the method is not widely accepted because the radioisotope injection has to be performed under general anesthesia. This study aimed to evaluate the diagnostic reliability of sentinel lymph node biopsy in SCC of the larynx, identified using Rouvière's scheme dissection, and that can be routinely excised without contrast-enhancement.
    A systematic clinical and pathological review was performed of 1500 cases of laryngectomy subjected to radical or functional neck dissection. Most patients had a tumor with negative (pN0) lymph nodes. Among 170 patients with neck metastases there were 125 cases with 1 or 2 positive nodes and 45 cases with 3 or more metastatic nodes. The most frequent loci of metastasis were the Kuttner, the omohyoid or the prelaryngeal lymph nodes; in 159 cases one or more of these were involved. In 11 cases the metastasis affected other different nodes. The possible causes of these exceptions are also investigated. In conclusion, the Kuttner, omohyoid and prelaryngeal lymph nodes are eminently suitable for use as sentinel lymph nodes.
    Jorge Rodrigues*, Ana Castro Sousa, Alexandra Gomes, Patrícia Gomes, Alexandre Mexedo, and Rui Fonseca
    Background and objectives: Type I tympanoplasty is a common otologic surgery which aims to repair the eardrum integrity. Different views have been reported concerning this procedure in young ages and the best moment to perform surgery remains controversial. Surgery in early adolescence appears to achieve the same outcomes than adulthood and without disadvantages of childhood. Characteristics of perforation and the functioning of the Eustachian tube were proposed as determinants of prognosis; however their effect also remains unclear. This study aims to analyse the success rates of type I tympanoplasty in adolescence and ascertain the existence of variables that may predict surgery outcomes.
    Subjects and methods: We present a retrospective study of 52 teenagers who undergone type I tympanoplasty, between January 2004 and December 2013. We analysed the impact of age, site, size and cause of perforation, state of middle ear and the existence of contralateral disease on anatomic and audiometric success.
    Results: Our patients presented a mean age of 15.9 years. The eardrum closure was verified in 80.8% and the audiometric success was achieved in 76.9% of cases. Presence of tympanosclerosis in the middle ear and disease in contralateral ear reduced significantly anatomic and audiometric success rate.
    Conclusion: Type I tympanoplasty is a surgical procedure with good results in adolescence, similar to those found in adults. Deterioration of middle ear and Eustachian tube dysfunction appear to reduce prognosis.
    Short Communication
    Rebecca Leonard*
    Objective: To evaluate the reliability of two new tools for quantifying pharyngeal residue on fluoroscopic swallow studies.
    Methods: The Bolus Clearance Ratio (BCR) is a measure of radiopaque bolus material pre- and post- swallow. The Pharyngeal Clearing Ratio (PRR) compares bolus post-swallow to the two-dimensional representation of the pharynx at rest. Each is made using tools that permit semi-automatic, quantitative calculations. Three experienced clinicians measured each ratio for 50 dysphagic patients during swallows of a 20ml bolus recorded during fluoroscopic evaluations. One clinician repeated the 50 studies four weeks later.
    Results: Intra-class correlation coefficients (ICCs) were used to assess reliability across the three raters for both BCR and PRR. The inter-class correlation for BCR was .916 (p<.000, 95% C.I. = .70-.98); for PRR, the ICC was .923 (p<.000, 95%, C.I. = .85-.95). The intra-class correlation for BCR was .922 (p<.000, 95% C.I. = .80-.98); for PRR, .909 (p<.000, 95% C.I. = .76-.95).
    Conclusions: Most assessments of residue are subjective and limited in reliability and application. The quantitative measures described here produced excellent inter- and intra-rater reliability. The utility of BCR and PRR for clinical and investigational purposes is discussed, as are their limitations and plans for future development.
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