Primary thyroid squamous cell carcinoma - a Scottish National Case Series.

AIM: To present our national case series on primary thyroid squamous cell carcinoma (PTSCC) and add to the current literature about this rare and aggressive disease. METHODS: Scottish pathology departments were contacted and asked to provide details of patients with the diagnosis of PTSCC from the last 10 years. Three patients were included. RESULTS: Patients 1, 2 and 3 underwent surgical resection. Patients 1 and 3 went on to receive chemoradiotherapy. Patient 1 received nivolumab. Patient 1 died 10 months following diagnosis. Patient 2 and 3 are currently living with no recurrence, over two years post-diagnosis. CONCLUSION: This case series has demonstrated an unusually good set of outcomes for a classically rapidly progressing disease with poor survival rates. This raises the question whether there is a subgroup of PTSCC associated with better outcomes and lower mortality. A patient-centred approach will give optimal patient management.

Thyroglossal surgery in Scotland 1981-2010.

BACKGROUND AND AIMS: Thyroglossal surgery is not common in Scotland with 0.013 procedures performed per 1000 population in 2010. There is a growing practice in surgery to consolidate service providers to ensure a minimum 'case volume', with the belief that this will raise standards and improve co-ordination of services. We investigated thyroglossal surgery to see if this had occurred. METHODS AND RESULTS: Data on thyroglossal surgery performed in Scotland from 1981 to 2010 were obtained from the Information Services Division of NHS Scotland. This was analysed to investigate the number of procedures involving thyroglossal tissue, the surgical speciality of operating surgeon and the health board in which the procedure was performed. Whilst the number of thyroglossal operations has remained essentially static over the study period, there has been a steady trend of consolidation of the surgical speciality performing the procedure. In 1981, 58% of thyroglossal surgery was performed by general surgeons, 18% by paediatric surgeons and 15% by ENT surgeons nationally. In 2010, ENT surgeons are performing 81%. CONCLUSIONS: Our data suggest that the provision of thyroglossal surgery is being consolidated in Scotland by speciality and that ENT surgeons are providing this service in the majority of cases.

Differentiated Thyroid Cancer Presenting With Solitary Bony Metastases to the Frontal Bone of the Skull.

A 75-year-old lady was referred to the oral and maxillofacial surgery (OMFS) team with a painless swelling in the midline of her forehead. Investigations diagnosed it as a solitary metastasis of thyroid cancer. Follicular thyroid cancers are known to metastasise to bone; however, bony metastasis to the frontal bone of the skull is very rare. This case highlights how the effective use of a multidisciplinary team can lead to better patient outcomes. The patient went on to have a total thyroidectomy and received both radioactive iodine therapy and radiotherapy to the bony metastasis.

Low-Grade Chondrosarcoma of the Posterior Cricoid Plate.

This case report presents an unusual case of chondrosarcoma arising from the cricoid cartilage of the larynx. Although these are commonly low-grade malignancies, this patient attended an outpatient respiratory clinic with acute airway obstruction, and went on to require a total laryngectomy due to the size of their tumour.

Perceptual Evaluation of Voice Disorder in Children Who Have Had Laryngotracheal Reconstruction Surgery and the Relationship Between Clinician Perceptual Ratingof Voice Quality and Parent Proxy/Child Self-Report of Voice-Related Quality of Life.

Reliability of the GRBAS tool for perceptual evaluation of paediatric voice disorder is measured in this study of children with a history of laryngotracheal reconstruction surgery (LTR). Additionally, the relationship between parent proxy/child self-report of voice-related quality of life with clinician perceptual rating of voice quality is analysed. Eleven children with a history of LTR provided voice recordings following the stimuli set by the CAPE-V protocol. Subjective impact of voice quality on life was measured using the paediatric voice-related quality of life questionnaire. Four trained judges rated the sound files according to both the GRBAS and CAPE-V protocol. Intra-class correlation coefficients were high for both intra-rater and inter-rater judgments across all parameters of the GRBAS protocol, and a strong correlation was found between the grade rating of the GRBAS and the overall severity rating of the CAPE-V. Some elements of parent proxy reporting of voice-related quality of life were significantly negatively correlated with clinician perceptual rating of voice quality, while there was no significant relationship between child self-report and clinician perceptual rating.

Emergency department care of a patient after a total laryngectomy.

Patients who have undergone a total laryngectomy have altered anatomy and physiology. This results in unique and specific issues that must be recognized in order to ensure that this group of patients experience appropriate care. This article looks at the current literature and attempts to highlight specific areas of concern, so that emergency care providers can deliver an equally high standard of care to this patient group as they do to others. A Medline and Google scholar search was conducted using phrases associated with the complications of total laryngectomy. The results were analyzed to identify the most relevant articles that meet our objective. Articles were then organized into the different subheadings used within the article and reviewed. The most up-to-date articles or those that were in the opinion of the authors the most appropriate to convey our objective were included in our review.