Thursday, September 16, 2021

Thyroid Hemiagenesis Accompanying an Ectopic Lingual Thyroid

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Ear Nose Throat J. 2021 Sep 16:1455613211036229. doi: 10.1177/01455613211036229. Online ahead of print.

ABSTRACT

Lingual thyroid is an uncommon condition and cases accompanying thyroid hemiagenesis are rarely documented. Patients with thyroid hemiagenesis are usually asymptomatic and generally diagnosed incidentally. Herein, we reported the case of thyroid hemiagenesis accompanying an ectopic lingual thyroid with euthyroidism and presented with regional symptoms.

PMID: 34525880 | DOI:10.1177/01455613211036229

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Sinonasal Tissue Remodelling during Chronic Rhinosinusitis

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The purpose of this review is to summarise contemporary knowledge of sinonasal tissue remodelling during chronic rhinosinusitis (CRS), a chronic disease involving long-term inflammation of the paranasal sinuses and nasal passage. The concept of tissue remodelling has significant clinical relevance because of its potential to cause irreversibility in chronic airway tissues. Recent studies have indicated that early surgical treatment of CRS may improve clinical outcome. Tissue remodelling has been described in the literature extensively with no consensus on how remodelling is defined. This review describes various factors implicated in establishing remodelling in sinonasal tissues with a special mention of asthma as a comorbid condition. Some of the main histological features of remodelling i nclude basement membrane thickening and collagen modulation. This may be an avenue of research with regard to targeted therapy against remodelling in CRS.
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Association of Functional Outcomes in Tracheoesophageal Voicing With Intratracheal Pressures and Esophagram Findings

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This cohort study examines the association between intratrache al manometric pressure, speech function, and proximal esophageal abnormalities in patients with tracheoesophageal voice prosthesis.
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Sensitivity of Communicative Participation Item Bank for Measuring Unilateral Vocal Fold Immobility

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This case series examines differences in patients' scores on the Communicative Participation Item Bank before and after treatment of unilateral vocal fold immobility and how the scores compare with qualitative self-reports of treatment outcomes.
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A Novel Case of Clofazimine-Induced Purple Nasal Mucosal Discoloration

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This case report describes a woman in her 70s with a history o f Mycobacterium abscessus pulmonary infection refractory to multiple medication regimens over the preceding decade who presented with clofazimine-induced purple nasal mucosal discoloration.
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Cystic Neck Mass

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A 44-year-old woman presented to the otolaryngology clinic with a 6-month history of a right neck mass with compressive symptoms. She first noticed swelling that progressed to pressure and dyspnea while supine. She reported fatigue but denied pain, voice change, weight loss, hemoptysis, and dysphagia. A physical examination revealed a visible and palpable fullness to the right neck without overlying cutaneous or sinus tract changes. Results of a complete blood cell count, a thyroid stimulating hormone test, triiodothyronine and levorotatory thyroxine testing, and a complete metabolic panel were normal. Ultrasonography showed a 7.9 × 6.3-cm septate cystic mass lateral to the right thyroid gland. A contrast-enhanced computed tomography scan of the neck demonstrated a large, nonenhancing cystic-appearing lesion abutting the lateral and posterior margins of the right thyroid lobe and extending from th e level of the piriform sinus to the thoracic inlet (Figure). Ultrasound-guided fine-needle aspiration revealed clear fluid with a parathyroid hormone (PTH) level of 67 pg/mL (reference range, <100 pg/mL; to convert to ng/L multiply by 1.00). A barium swallow study showed no communication between the cyst and the piriform sinus. Excision in the operating room was performed, and right thyroid lobectomy was necessary because of the intimate association of the lesion to the thyroid lobe.

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A 44-year-old woman presented with a 6-month history of a righ t neck mass with compressive symptoms. What is your diagnosis?
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Defective Levothyroxine Response in a Patient with Dyshormonogenic Congenital Hypothyroidism Caused by a Concurrent Pathogenic Variant in Thyroid Hormone Receptor-β

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Thyroid, Ahead of Print.
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Pilot study on the value of Raman spectroscopy in the entity assignment of salivary gland tumors

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by Till Jasper Meyer, Elena Gerhard-Hartmann, Nina Lodes, Agmal Scherzad, Rudolf Hagen, Maria Steinke, Stephan Hackenberg

Background

The entity assignment of salivary gland tumors (SGT) based on histomorphology can be challenging. Raman spectroscopy has been applied to analyze differences in the molecular composition of tissues. The aim of this study was to evaluate the suitability of RS for entity assignment in SGT.

Methods

Raman data were collected in deparaffinized sections of pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC). Multivariate data and chemometric analysis were completed using the Unscrambler software.

Results

The Raman spectra detected in ACC samples were mostly assigned to nucleic acids, lipids, and amides. In a principal component-based linear discriminant analysis (LDA) 18 of 20 tumor samples were classified correctly.

Conclusion

In this proof of concept study, we show that a reliable SGT diagnosis based on LDA algorithm appears possible, despite variations in the entity-specific mean spectra. However, a standardized workflow for tissue sample prep aration, measurement setup, and chemometric algorithms is essential to get reliable results.

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Susac Syndrome: A Rare cause of Bilateral Sensorineural hearing loss from North India—A Case Report with Review of literature

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Abstract

Susac Syndrome (SS) is a rare unique autoimmune underdiagnosed disorder characterized by the clinical triad of central nervous system (CNS) dysfunction, sensorineural hearing impairment, and branch retinal artery occlusion (BRAO). Objectives The purpose of reporting the case is to succinctly highlight this enigmatic condition with focus on otological and audiological aspect of SS and also to augment awareness of this disease among otolaryngologists neurologists, psychiatrists and ophthalmologists. Additionally we reviewed the otological menifestations and audiological findings related to SS. Methods A case of 38 year old female is presented with bilateral SNHL as the initial symptom of SS. The review of otological and audiological findings of previous 10 year case reports was executed using the PRISMA protocol on 20 cases. Results It was seen that inspite of the ear being one of the main organs involved in the SS very few had undergone detailed audiological assessment. Our review of literature showed that only 40% cases had done audiological assessment other than PTA, out of which only 5% had undergone complete audiological workup. 30% of the patients were having auditory symptoms as presenting chief complaint. Conclusion Otolyryngologists should keep SS in differentials when a case of SNHL of unknown etiology is encountered.We emphasize the use newer noninvasive Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation diagnostic tools like Optical coherence tomography (OCT), MRI and detailed audiological tests for timely diagnosis of SS. Further multidisciplinary assessment protocols should be used to prevent the development of severe sequelae.

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Age Related Immunosenescence Epstein-Barr Virus-positive Mucocutaneous Ulcer of the Palate Mimicking Medication-related Osteonecrosis of the Jaw

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Abstract

Epstein-Barr virus (EBV) -positive mucocutaneous ulcer (EBVMCU) was first described as a lymphoproliferative disorder in 2010. In recent years, EBVMCU has been reported in the field of oral surgery. On the other hand, medication-related osteonecrosis of the jaw (MRONJ) is an osteomyelitis that occurs in patients receiving antiresorptive agents including bisphosphonates (BP) and/or denosumab developing with bacterial infections such as dental diseases and mucositis. MRONJ caused by EBVMCU in the elderly has not been reported. Here, we report a rare case of MRONJ caused by EBVMCU in the elderly. The patient, an 82-year-old woman, had received BP for more than 2 years. An ulcerative lesion was found in the palatal mucosa; biopsy performed from the site confirmed the diagnosis of EBVMCU. At follow-up, the lesion disappeared spontaneously. At the 6-month follow-up, bone formation was observed at the site of the lesion, and the sequestrum was removed. At the 12-mo nth follow-up healing of the EBVMCU region was seen indicating a good prognosis.

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Current and Emerging Medical Therapies for Dizziness

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Medical therapies for dizziness are aimed at vertigo reduction, secondary symptom management, or the root cause of the pathologic process. Acute peripheral vertigo pharmacotherapies include antihistamines, calcium channel blockers, and benzodiazepines. Prophylactic pharmacotherapies vary between causes. For Meniere disease, betahistine and diuretics remain initial first-line oral options, whereas intratympanic steroids and intratympanic gentamicin are reserved for uncontrolled symptoms. For cerebellar dizziness and oculomotor disorders, 4-aminopyridine may provide benefit. For vestibular migraine, persistent postural perceptual dizziness and mal de débarquement, treatment options overlap and include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants and calcium channel blockers.
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