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1.
Eur Ann Otorhinolaryngol Head Neck Dis ; 138(3): 169-175, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33191161

RESUMO

OBJECTIVES: There are emerging reports of the effectiveness of in-office awake vocal-fold corticosteroid injection in the treatment of exudative vocal-fold lesions. The aim of this study was to review this therapy and specify indications, practical modalities and outcomes. STUDY DESIGN: Systematic review of the literature without meta-analysis. METHODS: A systematic review by PubMed search for the period January 2000 to December 2018 was carried out. RESULTS: Nine articles were included, for a total of 502 lesions: nodules (46.4%), polyps (31.7%), and Reinke's edema (21.9%). Submucosal injection of low-dose triamcinolone acetonide (0.1 to 0.3mL) was transoral, transcutaneous or transnasal via flexible endoscope with operating channel. Lesion volume was significantly reduced in more than 90% of cases, with significant vocal improvement in all studies. Relapse rates ranged between 4% and 31%, with time to relapse of 1 to 40 months. CONCLUSIONS: First-line treatment of exudative glottic lesions by submucosal corticosteroid injection provides at least transient significant reduction in lesion volume and vocal improvement. It is consensually reserved to moderate-sized mainly exudative lesions without fibrosis. In-office injection provides an immediate therapeutic response in case of vocal impairment, enabling surgery under general anesthesia to be postponed.


Assuntos
Edema Laríngeo , Pólipos , Corticosteroides , Humanos , Edema Laríngeo/patologia , Pólipos/patologia , Prega Vocal/patologia
2.
Strahlenther Onkol ; 191(3): 217-24, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25245468

RESUMO

BACKGROUND AND PURPOSE: Positron emission tomography (PET) with [(18)F]-fluoromisonidazole ([(18)F]-FMISO) provides a non-invasive assessment of hypoxia. The aim of this study is to assess the feasibility of a dose escalation with volumetric modulated arc therapy (VMAT) guided by [(18)F]-FMISO-PET for head-and-neck cancers (HNC). PATIENTS AND METHODS: Ten patients with inoperable stages III-IV HNC underwent [(18)F]-FMISO-PET before radiotherapy. Hypoxic target volumes (HTV) were segmented automatically by using the fuzzy locally adaptive Bayesian method. Retrospectively, two VMAT plans were generated delivering 70 Gy to the gross tumour volume (GTV) defined on computed tomography simulation or 79.8 Gy to the HTV. A dosimetric comparison was performed, based on calculations of tumour control probability (TCP), normal tissue complication probability (NTCP) for the parotid glands and uncomplicated tumour control probability (UTCP). RESULTS: The mean hypoxic fraction, defined as the ratio between the HTV and the GTV, was 0.18. The mean average dose for both parotids was 22.7 Gy and 25.5 Gy without and with dose escalation respectively. FMISO-guided dose escalation led to a mean increase of TCP, NTCP for both parotids and UTCP by 18.1, 4.6 and 8% respectively. CONCLUSION: A dose escalation up to 79.8 Gy guided by [(18)F]-FMISO-PET with VMAT seems feasible with improvement of TCP and without excessive increase of NTCP for parotids.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Hipóxia Celular/efeitos da radiação , Misonidazol/análogos & derivados , Neoplasias Otorrinolaringológicas/radioterapia , Tomografia por Emissão de Pósitrons , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador/métodos , Radioterapia de Intensidade Modulada/métodos , Radioterapia/métodos , Idoso , Carcinoma de Células Escamosas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Misonidazol/uso terapêutico , Estadiamento de Neoplasias , Neoplasias Otorrinolaringológicas/patologia , Prognóstico , Carga Tumoral/efeitos da radiação
3.
Rev Laryngol Otol Rhinol (Bord) ; 132(3): 167-72, 2011.
Artigo em Francês | MEDLINE | ID: mdl-22533072

RESUMO

INTRODUCTION: Chondrocalcinosis is a microcrystalline arthropathy that principally affects the knee. It is a rare disorder, usually asymptomatic, that occurs mainly in the elderly people. PURPOSE: To report a case of a temporomandibular joint chondrocalcinosis with ossicular contact revealed by a conductive hearing loss. CASE REPORT: We describe the case of a 57-year-old man with a right conductive sudden hearing loss of 15 dB. The CT scan revealed a lytic lesion in the right attic extended to the middle cerebral fossa in contact with the ossicles with a suspicion of lysis of the head of the malleus. MRI showed a lesion enhancing after gadolinium injection on T1 weighted images. A biopsy revealed a chondrocalcinosis of the temporomandibular joint. Due to the complexity of surgical excision and the benin character of the lesion, a medical treatment and a radiologic follow-up every six months were proposed. CONCLUSION: Chondrocalcinosis of the temporo-mandibular joint is rare especially when it is revealed by a hearing loss. We present here a review of the literature.


Assuntos
Condrocalcinose/diagnóstico , Perda Auditiva Condutiva/diagnóstico , Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/patologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Condrocalcinose/complicações , Condrocalcinose/diagnóstico por imagem , Condrocalcinose/patologia , Seguimentos , Perda Auditiva Condutiva/tratamento farmacológico , Perda Auditiva Condutiva/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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