Voice aspects in children with precocious puberty.

PURPOSE: In this prospective study, we aimed to investigate the difference in voice acoustic parameters between girls with idiopathic central precocious puberty (ICPP) and those who developed normally during prepuberty. MATERIALS AND METHODS: Our study recruited 54 girls diagnosed with ICPP and randomly sampled 51 healthy prepubertal girls as the control. Tanner stages, circulating hormone levels and bone ages of the girls with ICPP and the age and body mass index (BMI) of all participants were recorded. Acoustic analyses were performed using PRAAT computer-based voice analysis software and the mean pitch (F0), jitter, shimmer, noise-to harmonic-ratio (NHR) and harmonic-to-noise ratio (HNR) values were compared in the patient and control groups. RESULTS: The two groups did not significantly differ in age or BMI. In the evaluation of the F0 and jitter values, we were found to be lower in the control group than in the patient group. However, we did not find a statistical significance. The mean shimmer values of the patient group were significantly higher than those of the control group. In addition, a statistically significant difference was noted for the mean HNR and NHR values (P < 0.001). A moderate negative correlation was found between shimmer and hormone levels in the patient group. CONCLUSIONS: Voice acoustic parameters one of the defining features of girls with ICPP. Voice changes in acoustic parameters could reflect hormonal changes during puberty. Clinicians should suspect ICPP when there is a change in the voice.

Baseline Low Prognostic Nutritional Index Predicts Poor Survival in Locally Advanced Nasopharyngeal Carcinomas Treated With Radical Concurrent Chemoradiotherapy.

BACKGROUND: To retrospectively assess the impact of prognostic nutritional index (PNI) on survival outcomes of patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with concurrent chemoradiotherapy (CCRT). METHODS: This study incorporated 154 patients with LA-NPC who received exclusive cisplatinum-based CCRT. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of pretreatment PNI cutoffs influencing survival results. The primary end point was the interaction between the overall survival (OS) and PNI values, while cancer-specific survival (CSS) locoregional progression-free survival (LR-PFS), distant metastasis-free survival (DMFS), and PFS were the secondary end points. RESULTS: A rounded PNI cutoff value of 51 was identified in ROC curve analyses to exhibit significant link with CSS, OS, DMFS, and PFS outcomes, but not LR-PFS. Patients grouping per PNI value (≥51 [N = 95] vs <51 [N = 49]) revealed that PNI < 51 group had significantly shorter median CSS (P < .001), OS (P < .001), DMFS (P < .001), and PFS (P < .001) times than the PNI ≥ 51 group, and the multivariate results confirmed the PNI < 51 as an independent predictor of poor outcomes for each end point (P < .05 for each). The unfavorable impact of the low PNI was also continued at 10-year time point with survival rates of 77.9% versus 42.4%, 73.6% versus 33.9%, 57.9% versus 27.1%, and 52.6% versus 23.7% for CSS, OS, DMFS, and PFS, respectively. Additionally, we found that PNI < 51 was significantly associated with higher rates of weight loss >5% over past 6 months (49.2% versus 11.6%; P = .002) compared to PNI < 51 group. CONCLUSION: Low pre-CCRT PNI levels were independently associated with significantly reduced CSS, OS, DMFS, and PFS outcomes in patients with LA-NPC treated with definitive CCRT.

Comparing local anesthetic infiltration of the peritonsillar region and glossotonsillar sulcus for post-tonsillectomy pain management.

PURPOSE: The objective of this study was to compare the efficacy of peritonsillar and glossotonsillar sulcus infiltration with bupivacaine to manage postoperative pain and odynophagia in children undergoing tonsillectomy. METHODS: Fifty children (5-10 years of age) undergoing tonsillectomy due to recurrent tonsillar infections were enrolled in the study and assigned into two groups receiving either pre-incisional peritonsillar (Group 1, n = 25) or glossotonsillar sulcus (Group 2, n = 25) infiltration with 1 mg/kg bupivacaine (0.5%) totaling 5 mL in volume. At different time intervals following arrival to the post-anesthesia care unit (PACU), the participants in each group were evaluated for pain using the modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) and for odynophagia using a four-point scale (1-none, normal or no difficulty with swallowing, 2-mild, mild difficulty with swallowing, 3-moderate, moderate difficulty with swallowing, and 4-severe, no swallowing or swallowing only with maximal effort). Additional parameters were assessed for 24 h post-surgery, including time to first administration of analgesic, additional analgesic requirements, nausea/vomiting, allergic reaction, and bleeding. RESULTS: Infiltration of either region with bupivacaine yielded similar analgesic effects at different times following the surgery (P = 0.065). Time to first analgesic treatment and additional analgesic requirements were not significantly different between groups (P = 0.181). Compared to the Group 1, Group 2 was associated with significantly lower odynophagia scores at different times after the surgery (P = 0.020). CONCLUSION: Present results indicate that the infiltration of local anesthetics to glossotonsillar sulcus is a safe, practical, and effective pain management intervention without risk of significant side effects for children undergoing tonsillectomy.

Relationship between tissue and serum eosinophilia in children undergoing adenotonsillectomy with allergic rhinitis

Background/aim: Previous reports suggested that allergic/eosinophilic inflammation affects the adenoid and tonsillar tissue. The aim of this study is to evaluate and compare the tissue and serum eosinophilia in children undergoing adenotonsillectomy with allergic rhinitis. Materials and methods: The clinical registers of 125 children undergoing adenoidectomy/tonsillectomy due to adenoid/tonsil hypertrophy were examined and reviewed retrospectively. Fifty-seven children with positive skin prick test and symptoms of allergic rhinitis were included in the study as the atopic group, whereas 68 children with no allergic symptoms and negative skin prick test were included as the nonatopic group. Consequently, the total immunoglobulin E level and the serum and tissue eosinophilia of the atopic and nonatopic groups were compared. Results: Serum eosinophilia in the atopic group was found to be significantly higher than in the nonatopic group (P = 0.045). A significantly higher eosinophil count was found in adenoid/tonsil tissue of the atopic group (P < 0.001, P = 0.023, respectively). However, no significant correlation between tissue and serum eosinophilia was found. Conclusion: The inconsistency between tissue and serum eosinophilia in atopic children would particularly indicate a role of local atopy in adenotonsillar hypertrophy. Further studies are needed to better understand the effect and usefulness of serum and tissue eosinophilia in children with allergic rhinitis.

A Giant Congenital Soft Tissue Sinonasal Fibromyxoma of the Nose in a Newborn Baby.

Myxomas of the nose are very rare benign neoplasms. They grow slowly, infiltrate the surrounding bone cortex, and develop multiple local recurrences with no distant metastasis. Almost, even knowing seen at any age, it is very rare in newborn. The authors present a patient with sinonasal soft tissue fibromyxoma in a newborn baby nose followed by the literature.

Inflammatory myofibroblastic tumor: a rare tumor in the tongue.

Inflammatory myofibroblastic tumor is composed of myofibroblast and inflammatory cell infiltration of the tissue. Malign transformation and recurrence rate of this tumor is rare and accepted as benign fibroinflammatory disease. The main etiology is unclear, but infection, trauma, and immunologic event are accused. In this study, we presented a 75-year-old man with a mass on his tongue, which was diagnosed as "inflammatory myofibroblastic tumor." This type of tumor is rarely seen in the tongue and might be difficult to diagnose. Complete mass excision was provided for an adaquete treatment.