Subglottic cysts in preterm infants: superficially located cysts versus deeply buried cysts in the mucosa.

PURPOSE: To analyze the reason for the diversity of the clinical course of subglottic cysts and discuss their pre- and coexistence with subglottic stenosis. METHODS: The medical records of patients who were treated for subglottic cysts between 2003 and 2020 were retrospectively reviewed and direct laryngoscopy videos were analyzed to assess the healing patterns of their disease. RESULTS: Of the 15 patients, 10 had a history of intubation in the neonatal period. In 11 patients, the cysts were transparent and well defined, and no recurrence of subglottic cysts occurred after the initial surgery. In four patients, the cysts were located deep in the mucosa and did not have the typical appearance of a cyst, but rather of a stenotic segment; all of them had a history of intubation and three of them required laryngotracheal reconstruction. CONCLUSION: Transparent, thin-walled superficial subglottic cysts with healthy surrounding mucosa can easily be treated with endoscopic marsupialization; however, the treatment of deep subglottic cysts can be challenging. The coexistence of subglottic cysts and subglottic stenosis is not rare. We point out the need for considering the possibility of a missed deep submucosal cyst in a seemingly refractory case of pediatric subglottic stenosis with atypical endoscopic findings and with a background history of prior intubation.

Can Oxidative Stress Parameters Be Used as Biomarkers for the Discrimination of Malignant Head and Neck Tumors.

OBJECTIVE: In this study the authors have investigated oxidative stress parameters in sera and tissues, and evaluated their significance for the differentiation of malignant and benign tumors. METHODS: The study included 104 patients who were operated for head and neck tumors, and 45 healthy volunteers. Group 1 (n = 56) consisted of patients with malignant, Group 2 (n = 48) consisted of patients with benign tumors, and Group 3 (n = 45) was the control group. While both tissue and plasma samples were collected from groups 1 and 2, only plasma samples were collected from Group 3. Plasma and tissue levels of oxidative status were determined by using an automated measurement method. RESULTS: Serum analysis revealed that total oxidant status (TOS) and oxidative stress index (OSI) values of Group 1 were significantly higher than those of Groups 2 and 3, and total antioxidant status (TAS) values of Group 1 were significantly lower than those of Groups 2 and 3. TAS values of Group 2 were lower than those of Group 3, but the difference was not statistically significant. Biochemical tissue analysis revealed that TOS and OSI values of Group 1 were significantly higher than those of Group 2, while TAS values of Group 1 were significantly lower than those of Group 2. CONCLUSIONS: There is a significant difference between the total oxidative stress parameters of malignant and benign head and neck tumors. The authors think that total oxidative stress parameters can be used as a practical, cheap, and easy method for discriminating malignant tumors from benign tumors.

RGB Measurements From Endoscopic Photography as a New and Objective Diagnostic Method for Chronic Tonsillitis.

PURPOSE: This study assessed the diagnostic role of a digital photographic assessment of chronic tonsillitis. This study was performed at a tertiary referral center. METHODS: Three cohorts of children were studied based on their diagnoses: current chronic tonsillitis (before tonsillectomy), previous chronic tonsillitis (3 months after tonsillectomy), and healthy children (control group). Oropharyngeal regions of all subjects were examined and photographed endoscopically. Red/green/blue (RGB) values of particular oropharyngeal points were then measured. FINDINGS: The current chronic tonsillitis group differed significantly from the other 2 groups. The RGB values of the current chronic tonsillitis group were significantly higher than those of the previous chronic tonsillitis group (3 months after tonsillectomy) and the control group (P = 0.018 (red), P = 0.024 (green), and P = 0.004 (blue)). The RGB values did not differ significantly between the previous chronic tonsillitis group and the control group (P = 0.684 [red], P = 0.890 [green], and P = 0.672 [blue]). The RGB values of the previous chronic tonsillitis group decreased significantly 3 months after tonsillectomy (P = 0.015 [red], P = 0.033 [green], and P = 0.001 [blue]). Sensitivity was 80%, specificity was 90%, the positive predictive value was 59%, the negative predictive value was 96%, and the general power of the test was 88.6% regarding the power and competence of the RGB test in the diagnosis of chronic tonsillitis. IMPLICATIONS: Measuring RGB values may be an inexpensive and simple way to quickly provide objective and corroborative information on hyperemia of the anterior pillars in diagnosing chronic tonsillitis in conjunction with subjective methods.

RGB measurements as a novel objective diagnostic test for otitis media with effusion.

CONCLUSIONS: This study revealed a significant correlation between red-green-blue (RGB) values of tympanic membrane (TM) images and the presence of effusion in the middle ear. These results confirm that endoscopic RGB evaluation is a rapid and non-invasive procedure yielding objective results. OBJECTIVE: To investigate, in cases of otitis media with effusion (OME), the correlation of the TM color changes with the presence and viscosity of the effusion in the middle ear. METHODS: Endoscopic images of the TMs of 52 patients (group 1) and 52 healthy controls (group 2) were taken during their otologic examinations. RGB values of particular points were measured on the TM images of both groups. Additionally, in group 1 the viscosity of each effusion taken by paracentesis during surgery was also measured intraoperatively with a viscometer. Patients with viscosity values lower and higher than 450 cP (centipoise) were subdivided into groups 1a and 1b, respectively. RESULTS: Study and control groups were comparable regarding the number of patients and their mean ages (p > 0.05). Statistically significant differences were found in RGB values of the TM between groups 1 and 2, but not between groups 1a and 1b.