RESUMO
Basaloid squamous cell carcinoma (BSCC) is a histologically distinct variant of squamous cell carcinoma. It occurs in various sites of the head and neck region and is believed to carry a dismal prognosis. The palate is a very rare site of BSCC development and only three cases have been reported in the international literature. In this report, we present a case of basaloid squamous cell carcinoma of the soft palate. The therapeutic strategy and histological findings are described in detail, including immunohistochemistry with the use of involucrin, an agent used for the first time for BSCC diagnosis. In addition, a brief review of the literature is presented.
Assuntos
Carcinoma Basoescamoso/diagnóstico , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Palatinas/diagnóstico , Palato Mole , Idoso , Biomarcadores Tumorais/análise , Biópsia , Carcinoma Basoescamoso/patologia , Carcinoma Basoescamoso/radioterapia , Carcinoma Basoescamoso/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/cirurgia , Corantes , Diagnóstico Diferencial , Humanos , Masculino , Invasividade Neoplásica , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Estadiamento de Neoplasias , Neoplasias Palatinas/patologia , Neoplasias Palatinas/radioterapia , Neoplasias Palatinas/cirurgia , Palato Mole/patologia , Palato Mole/cirurgia , Precursores de Proteínas , Radioterapia Adjuvante , Reoperação , Tomografia Computadorizada por Raios XRESUMO
Mind-body interactions have been well recognized and are extendedly studied in the medical literature. There is evidence that the mind and body communicate with each other in a multidirectional flow of information by means of hormones, neurotransmitters/neuropeptides, cytokines, and semaphorines. There are consistent and convincing reports of links between stress and disease onset and progression, e.g. asthma. Growing evidence in the field of psychoneuroimmunology contributes to the understanding of the mechanisms by which stressful events affect physical health. The psychoneuroendocrine system can influence the immune response and thereby the capacity of the organism to cope with illness, and the immune system can have an impact on neuroendocrine function. Such cross-talk among systems is dependent upon feedback loops working to maintain homeostatic equilibrium. The immune system is capable of producing factors, which serve to integrate immune-neuroendocrine circuits with immunoregulatory and metabolic consequences for the organism. The interaction of the immune, nervous and endocrine system may drive an individual to a well recognized biological hypersensitivity and the creation of allergic symptoms (allergic rhinitis, asthma, atopic dermatitis, etc), followed by distinct behavioural patterns characterized as affective hypersensitivity. Semeiometry is a proper tool for large scale investigation of the psychological profile of patients with allergic rhinitis. Statistical analysis of semeiometry questionnaires processed by Greek adult patients in Crete island during 2005, showed that there is relation between occupation and allergy. Housewives, public services employees and private employees appear to be allergic in significantly higher percentage than others. With semeiometry we can find evidence of the bi-directional immunoendocrine--nervous system interactions in patients with allergic rhinitis.
RESUMO
OBJECTIVES: Assessment of the histopathologic effect of transtympanic and intramuscular administration of dexamethasone in an in vivo experimental animal model of middle-ear mucosal inflammation. METHODS: Fifty healthy rabbits weighting 1500-1800 g were randomly divided in three groups. In 10 animals (control group), 0.5 ml of a 20 mg/ml histamine solution was injected transtympanically. In 20 rabbits (group A), histamine challenge followed a three day intramuscular pretreatment with dexamethasone at 1 mg/kg per day. In 20 rabbits (group B), histamine challenge followed pretreatment with dexamethasone via a transtympanic route (0.3 ml, 1.2 mg dexamethasone). Middle-ear mucosa was obtained for histopathology 30 minutes after histamine administration. The following parameters were assessed: inflammation, acute inflammatory component, presence of eosinophils, inflammatory activity and fibrosis. RESULTS: Oedema, vascular dilatation and congestion, inflammation, the presence of an acute (polymorphonuclear) inflammatory component, the presence of eosinophils, and inflammatory activity were found to be of a lesser grade in the mucosae of group B. All differences were found to be statistically highly significant (p<0.01) using the Mann-Whitney test. CONCLUSION: Our findings validate the transtympanic route of dexamethasone administration in counteracting histamine effects.
Assuntos
Dexametasona/administração & dosagem , Glucocorticoides/administração & dosagem , Otite Média/tratamento farmacológico , Animais , Modelos Animais de Doenças , Histamina , Injeções Intramusculares/métodos , Coelhos , Distribuição Aleatória , Membrana TimpânicaRESUMO
Teratomas and dermoids or hairy polyps of the head and neck are rare congenital tumours, often confused and reported to appear as single masses, that may cause upper aerodigestive tract impairment. Their histological classification, origin and embryological basis of development have been a topic of debate in the past and recent literature. We report a case of an infant presenting with a multifocal bigerminal teratoma in the nasopharynx and the neck, causing a deep neck infection, and discuss the unique clinicopathological aspects of this case.
Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Teratoma/diagnóstico , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Neoplasias Nasofaríngeas/diagnóstico , PescoçoAssuntos
Condrossarcoma/diagnóstico por imagem , Neoplasias Laríngeas/diagnóstico por imagem , Condroma/diagnóstico por imagem , Condroma/patologia , Condrossarcoma/patologia , Condrossarcoma/cirurgia , Diagnóstico Diferencial , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/cirurgia , Laringoscopia , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios XRESUMO
Upper airway obstruction, because of bilateral vocal cord paralysis, presents a serious challenge to the Otolaryngologist. Various surgical techniques have been advocated for the management of patients with vocal cord paralysis. Among these techniques, the individual use of laser CO(2) arytenoidectomy and posterior cordotomy has gained wide acceptance. In this report, we describe our experience in the management of bilateral vocal cord paralysis by combining posterior partial cordotomy as described by Dennis and Kashima, with total arytenoidectomy as described by Ossoff et al. We report the long-term results in the management of 18 patients treated in our department during the last 8 years.
Assuntos
Obstrução das Vias Respiratórias/etiologia , Cartilagem Aritenoide/cirurgia , Terapia a Laser , Paralisia das Pregas Vocais/cirurgia , Prega Vocal/cirurgia , Adulto , Idoso , Obstrução das Vias Respiratórias/cirurgia , Endoscopia , Humanos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Resultado do Tratamento , Paralisia das Pregas Vocais/complicaçõesRESUMO
Among 40 children undergoing tonsillectomy for recurrent pharyngitis, 15 (37.5%) had presented preoperatively with complaints compatible with PFAPA syndrome. All 15 had had periodic fever every three to four weeks and pharyngitis; 12 (80%) had cervical adenitis and five (33%) aphthous stomatitis. All children had been well between episodes and showed a dramatic postoperative improvement. PFAPA syndrome is not uncommon among children having tonsillectomy. Tonsillectomy is curative in most of these patients.
Assuntos
Febre/complicações , Linfadenite , Faringite , Estomatite Aftosa , Doenças do Colo do Útero , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Contagem de Leucócitos , Masculino , Periodicidade , Faringite/cirurgia , Recidiva , Síndrome , Tonsilectomia/métodosRESUMO
Malignant tumors of the temporal bone are rare neoplasms. Adenoid cystic carcinoma (ACC) is the most common malignant tumor of minor salivary glands, while a quite rare tumor of the major. It is considered a slow-growing tumor with a course that is characterized by local recurrences and late distant metastases to lungs (80-90%), bone and liver. When metastases occur in bone especially the spine, the course of disease is usually fulminant. Intracranial involvement can occur by direct extension, hematogenous or perineural spread and represents an advanced stage of the disease. In this paper, we present a rare case of temporal bone ACC reporting for the first time simultaneous bony and pulmonary distant metastases. The origin, the pathology, the imaging techniques, the differential diagnosis, the treatment options and the prognosis of these tumors are discussed.
Assuntos
Carcinoma Adenoide Cístico/diagnóstico por imagem , Carcinoma Adenoide Cístico/secundário , Neoplasias Cranianas/diagnóstico por imagem , Neoplasias Cranianas/patologia , Osso Temporal/diagnóstico por imagem , Osso Temporal/patologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Paragangliomas are rare, usually benign tumours of the head and neck region, located along the cranial nerves and the big vessels. Vagus paraganglioma represents less than 3% of all cases of paragangliomas of the head and neck. Approximately 10% of vagus paragangliomas are presented as bilateral masses. We present the case of 75 year old female with bilateral paraganglioma, and papillary cancer of the thyroid gland at the time of diagnosis. Diagnostic and therapeutic procedures are discussed with special regard to possible complications.
Assuntos
Neoplasias dos Nervos Cranianos/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Paraganglioma/diagnóstico , Doenças do Nervo Vago/diagnóstico , Idoso , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/patologia , Carcinoma Papilar/cirurgia , Neoplasias dos Nervos Cranianos/patologia , Neoplasias dos Nervos Cranianos/cirurgia , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Paraganglioma/patologia , Paraganglioma/cirurgia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Nervo Vago/patologia , Nervo Vago/cirurgia , Doenças do Nervo Vago/patologia , Doenças do Nervo Vago/cirurgiaRESUMO
Tinnitus is a common complaint among people who suffer from auditory disorders. Altering the patients' response to tinnitus and the development of coping techniques are the most important goals of the therapeutic or suppression methods. This is the first study in the Greek population to investigate the personality characteristics and coping techniques of tinnitus patients. We have studied the relation between the subjective assessment of tinnitus intensity with factors such as sex, age, duration of symptom, and degree of hearing loss. We have also studied the possible relation between the patients' personality characteristics on their attitude towards tinnitus. The participants were 80 tinnitus sufferers, men and women, between 18 and 65 years of age. The personality characteristics were assessed with the Minnesota Multiphasic Personality Inventory (MMPI). The mean MMPI scores in both men and women were within the normal range. The duration of symptoms did not prove to be an important factor for the patients' subjective assessment of the tinnitus intensity. Most patients showed "effective" coping style, were well adjusted to tinnitus, and had no significant interference in their everyday functioning. The above are discussed in the context of the influence of geographical, climatological, economic, social, and cultural factors that influence psychological functioning.
Assuntos
Personalidade , Zumbido , Adaptação Psicológica , Adolescente , Adulto , Grécia/epidemiologia , Humanos , MMPI , Masculino , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida , Índice de Gravidade de Doença , Zumbido/diagnóstico , Zumbido/epidemiologia , Zumbido/psicologiaRESUMO
Laser-assisted uvulopalatoplasty (LAUP) is an outpatient mode of treatment for snoring and perhaps for some mild cases of obstructive sleep apnea syndrome. LAUP results in severe throat pain that usually lasts for 8 to 14 days. Sucralfate adheres to proteins at the duodenal ulcer site, forming a protective coating against gastric acid, pepsin, and bile salts, that promotes healing. If a similar protective coating could be created at the area of LAUP trauma, morbidity may be diminished. Twenty-eight patients have undergone LAUP treatment-2 with mild obstructive sleep apnea syndrome and 26 with simple snoring. A block-randomized, single blind clinical study was performed. Sucralfate was administered in 14 patients (group A) every 6 hours for 15 days as a swish and swallow, whereas the other 14 patients (group B) received water for injection with a strawberry flavor as placebo with the same dosing. As a conclusion, sucralfate significantly lowered postoperative pain and the need for analgesic drug use as well as the total number of the days the patients needed to almost reach their normal diet quantity (> or = 80% of normal quantity).
Assuntos
Antiulcerosos/uso terapêutico , Terapia a Laser/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Dor Pós-Operatória/tratamento farmacológico , Palato Mole/cirurgia , Apneia Obstrutiva do Sono/cirurgia , Sucralfato/uso terapêutico , Úvula/cirurgia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Método Simples-CegoRESUMO
Deformed cartilage remodeling appears to be a challenge, as cartilage tends to keep its initial shape because of internal stresses. Cartilage can be remodeled with heat, and this report describes the use of a CO2 laser beam for in vitro cartilaginous tissue remodeling. Straight cartilage samples were removed from the ears of 21 rabbits deprived of perichondrium and remodeled with the CO2 laser at an output power of 3 W, a spot diameter of 2 mm, and an exposure time of 0.5 second. The remodeled cartilages and control samples were implanted into the rabbits' backs and retrieved 6 to 12 months later. Histologic and morphological analysis showed that the irradiated cartilages retained both their shape and their viability. This may be a useful clinical technique for in situ remodeling of a deformed cartilage in operations such as septoplasty.
Assuntos
Cartilagem da Orelha/cirurgia , Cartilagem da Orelha/transplante , Terapia a Laser/métodos , Animais , Condrócitos/fisiologia , Condrócitos/ultraestrutura , Cartilagem da Orelha/ultraestrutura , Microscopia Eletrônica , Modelos Animais , Coelhos , Regeneração/fisiologia , Transplante Autólogo/métodosRESUMO
Cerebral frontal lobe abscess may be a frequent intracranial complication of paranasal sinusitis. An unusual case of cerebral abscess complicating massive polyposis is described in a patient with history of previous severe head trauma 30 years ago. Imaging evaluation using both computed tomography and magnetic resonance imaging is important to diagnose such rare entities.
Assuntos
Abscesso Encefálico/etiologia , Traumatismos Craniocerebrais/complicações , Lobo Frontal , Pólipos Nasais/complicações , Idoso , Abscesso Encefálico/diagnóstico , Abscesso Encefálico/cirurgia , Traumatismos Craniocerebrais/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pólipos Nasais/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Plasmocitoma/diagnóstico por imagem , Plasmocitoma/patologia , Anti-Inflamatórios/uso terapêutico , Antineoplásicos Alquilantes/uso terapêutico , Cortisona/uso terapêutico , Quimioterapia Combinada , Feminino , Humanos , Melfalan/uso terapêutico , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/tratamento farmacológico , Plasmocitoma/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
Among all foreign bodies impacted at the esophagus, the safety pin still seems to be a challenge for the specialist. This is a report of 2 cases presenting infants with open safety pin impacted in the esophagus. The strategy and intraoperative management of this rare finding is discussed in detail.
Assuntos
Esofagoscopia/métodos , Esôfago/cirurgia , Corpos Estranhos/diagnóstico , Corpos Estranhos/cirurgia , Estômago/cirurgia , Endoscopia/métodos , Esôfago/diagnóstico por imagem , Feminino , Seguimentos , Corpos Estranhos/diagnóstico por imagem , Humanos , Lactente , Masculino , Radiografia , Estômago/diagnóstico por imagem , Resultado do TratamentoRESUMO
OBJECTIVE: A foreign body aspiration in the tracheobronchial tree is a dangerous and common medical emergency in childhood, with serious and potentially lethal consequences. It must be suspected in children with a suggestive history, even though the clinical symptoms or radiographic findings are not pathognomonic for foreign body aspiration. METHODS: In this study 210 pediatric cases, with a suggestive history of foreign body aspiration undergoing bronchoscopy in the last 8 years in the department, were reviewed. In all cases bronchoscopy was performed under general anesthesia using a Storz ventilation bronchoscope with distal cold light illumination. RESULTS: In 130 patients a foreign body was discovered, in 17 cases pus was aspirated and in 63 cases there were no findings. Seventy-eight (60%) foreign bodies were found in the right main bronchus, 43 (33.1%) in left main bronchus, seven (5.4%) in both bronchi and two (1.5%) were found in the subglottic area. The incidence of bronchoscopy during the last 8 years was 28 procedures per 100000 children population per year in the island of Crete. CONCLUSION: More attention should be given to the need for a careful history and the use of radiographs as supplemental information to make the decision to perform a bronchoscopy. The parents, also, should pay attention not to allow children dry fruits and small toys, as well as, teaching their children to avoid any physical or emotional activity while having a full mouth.