Benign Fibrous Histiocytoma of Larynx: A Rare Case Report.

The Fibrous histiocytoma is one of the mesenchymal tumors that can present as malignant or benign. We reported a 30 years old male, a rare case of benign fibrous histiocytoma of larynx and evaluated the clinical and histological aspect of this patient.

Induction Chemotherapy Followed by either Chemoradiotherapy or Bioradiotherapy in Laryngeal Cancer.

OBJECTIVE: In loco regionally advanced head and neck cancer, the superiority of concomitant cetuximab with radiation over radiation alone has been proven previously. But comparison between chemo radiation and bioradiation has not been well studied. METHODS: Between October 2013 and August 2017, 38 patients with locoregionally advanced laryngeal cancer and more than 50% response to 3 cycles of  induction chemotherapy (docetaxel and cisplatin: both with a dose of 75 mg/m2 on the first day  and 5-flurouracil: 750 mg/m2 during  days 1to 3; repeated every 21 days) were selected to receive either carboplatin (18 patients, AUC 1.5 , weekly) or cetuximab (20 patients, with loading dose of 400 mg/m2 and weekly dose of  250 mg/m2) with radiation. A Kaplan-Meier analysis was used to calculate progression free survival and overall survival rates. The log-rank test was used to compare overall survival between treatment groups. RESULTS: The median follow up time was 36 months. The 2-year organ preservation rate of 78.9% was achieved. The 3- year progression-free survival rates of 65.2%, 72.7% and 58.2% were observed for all patients, carboplatin group and cetuximab group, respectively (p=0.4). The 3-year estimates of overall survival were 67.8%, 69.2 %, and 66.3 % for all patients, carboplatin group and cetuximab group, respectively (p=0.47). Concomitant carboplatin was discontinued in 3 patients due to toxicity Conclusion: Concomitant cetuximab is a reasonable alternative to concomitant chemotherapy. But the difference in treatment outcome between bioradiation and chemoradiation remains to be defined.
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Is there any association between Helicobacter pylori and otitis media with effusion? / Há associação entre Helicobacter pylori e otite média com efusão?

Abstract Introduction: It is proposed that Helicobacter pylori can be responsible for the development of otitis media with effusion. Objective: The aim of this study is to investigate the prevalence of H. pylori in the adenoid tissue and fluid of the middle ear in patients who suffer from adenoid hyperplasia and otitis media with effusion in comparison with those who suffer from adenoid hyperplasia without otitis media with effusion. Methods: This is a case-control study that was carried out in 50 children of age 2-7 years old who were admitted with adenoid hyperplasia. Patients were divided into case and control groups. The study group included 25 patients with adenoid hyperplasia and otitis media with effusion and the control group included 25 patients with adenoid hyperplasia without otitis media with effusion. The patients in both groups underwent surgical adenoidectomy. For the case group we carried out myringotomy and placement of tympanostomy tube, and fluid samples were collected under sterile conditions. The samples were sent to the laboratory for polymerase chain reactions. Results: In the case group H. pylori was found to be positive in 18 samples of the middle ear fluid (70%) and in 1 polymerase chain reaction adenoid tissue sample (4%). In the control group H. pylori was positive in 3 samples of adenoid tissues (12%). There was no gender difference. Conclusion: H. pylori is one of the important bacteria that plays a role in the pathogenesis of otitis media with effusion. Whether adenoid tissue may be a reservoir for H. Pylori is unclear.

Resumo Introdução: Propõe-se que o Helicobacter pylori possa ser responsável pelo desenvolvimento de otite média com efusão. Objetivo: Investigar a prevalência de H. pylori no tecido adenoideano e no fluido da orelha média em pacientes com hiperplasia de adenoide e otite média com efusão em comparação àqueles com hiperplasia de adenoide sem otite média com efusão. Método: Este é um estudo de caso-controle feito em 50 crianças de 2 a 7 anos, com sinais e sintomas de hiperplasia de adenoide. Os pacientes foram divididos em grupo de estudo e grupo controle. O grupo de estudo incluiu 25 pacientes com hiperplasia de adenoide e otite média com efusão e o grupo controle incluiu 25 pacientes com hiperplasia de adenoide sem otite média com efusão. Os pacientes dos dois grupos foram submetidos a adenoidectomia e, no grupo de estudo, realizou-se também miringotomia com colocação de tubo de ventilação e amostras de fluidos foram coletadas sob condições estéreis. As amostras foram enviadas para o laboratório, para investigação por reação de polimerase em cadeia. Resultados: No grupo de estudo, houve positividade para H. pylori em 18 amostras do fluido de orelha média (70%) e uma amostra de tecido adenoideano foi positiva na reação de polimerase em cadeia (4%). No grupo controle, houve positividade para H. pylori em 3 amostras de tecido adenoideano (12%). Não houve diferença entre os gêneros. Conclusão: H. pylori é uma das bactérias importantes que desempenham um papel na patogênese da otite médica com efusão. Se o tecido adenoideano pode ou não representar um reservatório para H. pylori ainda necessita ser esclarecido.

Is there any association between Helicobacter pylori and otitis media with effusion?

INTRODUCTION: It is proposed that Helicobacter pylori can be responsible for the development of otitis media with effusion. OBJECTIVE: The aim of this study is to investigate the prevalence of H. pylori in the adenoid tissue and fluid of the middle ear in patients who suffer from adenoid hyperplasia and otitis media with effusion in comparison with those who suffer from adenoid hyperplasia without otitis media with effusion. METHODS: This is a case-control study that was carried out in 50 children of age 2-7 years old who were admitted with adenoid hyperplasia. Patients were divided into case and control groups. The study group included 25 patients with adenoid hyperplasia and otitis media with effusion and the control group included 25 patients with adenoid hyperplasia without otitis media with effusion. The patients in both groups underwent surgical adenoidectomy. For the case group we carried out myringotomy and placement of tympanostomy tube, and fluid samples were collected under sterile conditions. The samples were sent to the laboratory for polymerase chain reactions. RESULTS: In the case group H. pylori was found to be positive in 18 samples of the middle ear fluid (70%) and in 1 polymerase chain reaction adenoid tissue sample (4%). In the control group H. pylori was positive in 3 samples of adenoid tissues (12%). There was no gender difference. CONCLUSION: H. pylori is one of the important bacteria that plays a role in the pathogenesis of otitis media with effusion. Whether adenoid tissue may be a reservoir for H. Pylori is unclear.

Huge tongue lipoma: a case report.

INTRODUCTION: Lipomas are among the most common tumors of the human body. However, they are uncommon in the oral cavity and are observed as slow growing, painless, and asymptomatic yellowish submucosal masses. Surgical excision is the treatment of choice and recurrence is not expected. CASE REPORT: The case of a 30-year-old woman with a huge lipoma on the tip of her tongue since 3 years, is presented. She had difficulty with speech and mastication because the tongue tumor was filling the oral cavity. Clinical examination revealed a yellowish lesion, measuring 8 cm in maximum diameter, protruding from the lingual surface. The tumor was surgically excised with restoration of normal tongue function and histopathological examination of the tumor confirmed that it was a lipoma. CONCLUSION: Tongue lipoma is rarely seen and can be a cause of macroglossia. Surgical excision for lipoma is indicated for symptomatic relief and exclusion of associated malignancy.

Epidemiological characteristics of head and neck cancers in southeast of iran.

BACKGROUND: The aim of this study was to investigate the epidemiological aspects of malignant tumors of head and neck in southeast of Iran, with a view toward analyzing the age, gender and site distribution and histological types. METHODS: All cases with malignant tumor of the head and neck region from 1999 to 2009 were retrieved from the records of cancer registry center of Kerman University of medical sciences and all pathology laboratories of Kerman province. RESULTS: A total of 1604 cases were recruited during the study period. The mean age of patients was 53.03 years (standard deviation: 17.18, range: 2 to 95 years). Patients with a diagnosis of carcinoma were older than those with sarcoma and lymphoma (p<0.01). 18.4% of patients were below the age of 41 years. The overall male to female ratio was 2.74:1. Larynx was the most commonly affected site (46.76%) followed by oral cavity (15.9%). Squamous cell carcinoma was the most common diagnoses (77.5%), followed by lymphoma (9.4%). CONCLUSION: The higher incidence of laryngeal cancer in the head and neck region in southeast of Iran is in agreement with findings of the other parts of Iran. Also, occurrence of head and neck cancer under 41 year olds is greater than what is reported for some countries.

Alterations in the Contra lateral Ear in Chronic Otitis Media.

INTRODUCTION: Chronic otitis media (COM), a persistent and durable inflammation and infection of the middle ear, is a common disorder. Alterations in the contralateral ear in sufferers have been observed in recent years. Because only a few studies have been reported in this area, we performed this study in order to assess alterations in the contralateral ear of patients with COM. MATERIALS AND METHODS: Cross-sectional and descriptive methods were used in 100 patients with COM who were selected for surgical treatment and admitted to hospital. An information form was completed for all patients including demographic data, medical history of otoscopy and paraclinical examinations such as pure tone audiometry (PTA), tympanometry, Schuller radiography, and high resolution computed tomography (HRCT). All data were processed using SPSS (version 18) software and descriptive statistical tests. RESULTS: According to otoscopy, PTA, tympanometry and graphical analysis, 60% of patients experienced disorders of the contralateral ear. Otoscopy analysis showed 54% of patients had a disorder of the contralateral ear, with the most common disorder being perforation of the ear drum. PTA showed a 48% incidence of contralateral ear problems (85% conductive hearing impairment; 12.5% sensorineural hearing impairment; 1.2% mixed). A total of 73.2% of patients with conductive hearing loss had a problem across all frequencies, while half of the patients with sensorineural hearing impairment had problems at frequencies greater than 1000 Hz. According to tympanometry, 38% of patients had problem in the contralateral ear. HRCT and Schuller graphical analyses indicated 31.5% and 36% occurrence of contralateral ear disorders, respectively. CONCLUSION: More than 50% of patients with COM in one ear have a chance of also presenting with the disease in the other ear. Outcomes of this study and previous studies have shown that COM should not be perceived as a disease limited to one ear, because in most cases the progress of the disease can affect both ears.

Sequential chemoradiotherapy in advanced laryngeal cancer: an institutional experience.

AIM: The objective of this study was to determine the efficacy of sequential chemoradiation for larynx preservation. METHODS: Between October 2002 and December 2007, 76 patients with T3, T4 and N+ laryngeal cancer who had refused a laryngectomy or had unresectable disease (medically or surgically) enrolled in this study. The chemotherapy consisted of three cycles of docetaxel (75 mg/m(2) on day 1), cisplatin (75 mg/m(2) on day 1) and 5-flurouracil (5-FU) (750 mg/m(2) by infusion on days 1-3). All patients were assigned to receive radiotherapy (70 Gy to primary site). The Kaplan-Meier method was used to obtain survival outcomes. RESULTS: The median follow up was 36 months. A chemotherapy clinical response (complete and partial) was observed in 51 patients (67.1%). The 2-year laryngeal preservation rate was 75%. Actuarial progression-free survival rates of 71% and 67% were observed at 2 and 3 years, respectively. Actuarial overall survival rates were 83% and 71% at 2 and 3 years, respectively. Disease progression was seen in 26 patients (34.2%). Grade 3 and 4 neutropenia occurred in 39 (51.3%) patients. CONCLUSION: Sequential chemotherapy with docetaxel, cisplatin and 5-flurouracil followed by radiation may be an alternative to a laryngectomy in patients with advanced laryngeal cancer.

Opium and risk of laryngeal cancer.

OBJECTIVES/HYPOTHESIS: The study was performed to investigate the possible association between opium dependency and laryngeal cancer. STUDY DESIGN: A hospital-based, group-matched, case-control study was presented. METHODS: Ninety-eight patients with laryngeal cancer and 312 age- and gender-matched control subjects were selected at the otorhinolaryngology ward of a referral university-affiliated hospital. Data on cigarette smoking and alcohol and opium dependency were collected before surgery through semi-structured interview. RESULTS: The crude odds ratios of laryngeal cancer were 15.07 (95% confidence interval [CI], 6.92-32.8 [P <.0001]) for cigarette smoking, 21.55 (95% CI, 10.54-44 [P <.0001]) for opium dependency, and 1.84 (95% CI, 1.008-3.38 [P <.048]) for male gender. Because of strong associations, a logistic regression model was prepared; the odds ratio for gender in the final model was 0.87 (95% CI, 0.39-1.92 [P =.11]). According to the results, it seemed that gender was not an independent risk factor for laryngeal cancer. Also, the adjusted odds ratios for smoking (5.21) (95% CI, 2.33-11.67 [P <.002]) and opium dependency (10.74) (95% CI, 5.76-20.02 [P <.002]) were lower than the crude odds ratios, but both ratios were significant. The mean patient ages were 55.1 years (SD = 12.05 y) in opium-dependent patients and 65.6 years (SD = 12.8 y) in opium-nondependent patients (P =.01). CONCLUSION: The results of the study suggest that opium dependency is not only an independent possible risk factor for laryngeal cancer but also significantly increases the likelihood of developing of the disease at a younger age.