RESUMEN
OBJECTIVES: In patients with papillary thyroid cancer (PTC), sentinel lymph node (SLN) radio-guided biopsy is not routinely used for detection of involved neck lymph nodes (NLN); 99mTc- antimony sulfide colloid (99mTc- ASC) has been used for this purpose. In this study, besides 99mTc-ASC another radiotracer, 99mTc-phytate (99mTc-P) with different doses and injection methods were evaluated. METHODS: Twenty-two patients, scheduled to undergo thyroidectomy for PTC, were injected for radio-guided SLN biopsy in the morning of operation in 3 groups: intra tumoral injection of about 1 mCi 99mTc-P (group A; n=5); peritumoral injection of less than 3 mCi 99mTc-ASC (group B; n=6); and peritumoral injection of 3 to 5 mCi 99mTc-ASC with application of massage (group C; n=9). A patient refused to complete the study. A patient with follicular thyroid cancer was also excluded. No NLN was detected in the pre-operative ultra-sonographic examinations of all patients. Central neck dissection was done for all the participants. The presence of radio guided detected NLN and results of pathology were assessed. RESULTS: In group A and B, no SLN was detected. NLNs were resected in 4 patients in group A and B; 2 of them involved by the tumor. In group C, 6 out of 9 patients (66.7%) had between 1 to 6 SLNs; the procedure failed to detect NLN in a patient in group C with surgically resected reactive NLN (failure rate 1 out of 7). CONCLUSION: The results underscored the significance of SLN radio guided biopsy in patients with PTC; the radiotracer, dose and method of injection may affect the detection rate.
RESUMEN
This study investigate the effect of stapes surgery on bone conduction (BC) improvement in otosclerotic patients with mixed hearing loss and also compare the effect of three different types of surgery (complete stapedectomy, partial stapedectomy and microfenestration stapedotomy) on this improvement. We retrospectively reviewed surgical database of 84 otosclerotic patients with mixed hearing loss. Sixty-two patients (75%) had significant improvement in BC after surgery (P = 0.03). In 85% of patients with follow-up time longer than 1 year, this improvement had remained. Improvement in BC after surgery was better in partial stapedectomy group (82.6%) and complete stapedectomy group (80.8%) in comparison with microfenestration stapedotomy group (63%) (P = 0.052).