ABSTRACT
Background: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by the ossification of entheses. When localized in the cervical paravertebral region, typical signs and symptoms include stiffness, pain, loss of range of motion, and difficulty swallowing.Clinical Presentation: The authors present two less typical respiratory manifestations of DISH due to cervical osteophytes protrusion and obstruction of the upper airway. The first patient was treated conservatively (application of CPAP during nighttime), while the second required emergency intubation and a combined ENT-neurosurgical operation for the removal of osteophytes.Clinical Relevance: Even though dysphagic symptoms are more frequent, DISH may be a cause of airway obstruction and should be included in the differential diagnosis of respiratory distress and OSA.
Subject(s)
Airway Obstruction , Deglutition Disorders , Hyperostosis, Diffuse Idiopathic Skeletal , Osteophyte , Airway Obstruction/diagnostic imaging , Airway Obstruction/etiology , Airway Obstruction/therapy , Cervical Vertebrae , Deglutition Disorders/etiology , Humans , Hyperostosis, Diffuse Idiopathic Skeletal/complications , Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Hyperostosis, Diffuse Idiopathic Skeletal/therapyABSTRACT
BACKGROUND: As reported by increasing literature, a significant number of patients with SARS-CoV-2 infection developed smell/taste disorders. Aim of this study is to determine the prevalence and severity of these symptoms among laboratory-confirmed SARS-CoV-2 patients. Secondary objective is to determine their onset/recovery time. METHODS: This cross-sectional study was conducted from March 10 to 30, 2020 at Novara University Hospital during the COVID-19 Italian outbreak. The 355 enrolled patients answered a questionnaire at 14th (or more) days after proven infection. RESULTS: The overall population prevalence of both smell/taste or one of the two disorders was 70%. They were first symptoms in 31 (8,7%) patients. Most patients reported a complete loss that in half of the cases (49.5%) was fully recovered after 14 days, with a median recovery time of 10 days. CONCLUSION: This study confirms a high prevalence of smell/taste disorders in COVID-19 infection with self-recovery for half cases after about 2 weeks.
Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Olfaction Disorders/epidemiology , Pneumonia, Viral/epidemiology , Taste Disorders/epidemiology , Adult , COVID-19 , Cross-Sectional Studies , Female , Humans , Italy/epidemiology , Male , Middle Aged , Olfaction Disorders/virology , Pandemics , Prevalence , Recovery of Function , SARS-CoV-2 , Sampling Studies , Severity of Illness Index , Taste Disorders/virologyABSTRACT
Extramedullary plasmacytoma (EMP) is a rare variant of plasma cell myeloma that affects soft tissues. The head and neck region are the most affected sites, although others have also been described. Herein we report an uncommon case of EMP of the larynx in a 65-year-old male who presented with a history of progressive dysphonia and hoarseness. Laryngeal fiberscopy evidenced a reddish pedicled voluminous mass in the left false cords and ventricle. Microscopic suspension laryngoscopy was performed under general anaesthesia and a 4 W Acublade CO2 Laser was used for transoral resection of the lesion. This was followed by adjuvant radiotherapy, with the widely recommended doses on the supraglottic region, to achieve better local control. Diagnosis of EMP is based on immunohistochemistry and the exclusion of systemic plasma cell proliferative disorders. Diagnosis of solitary EMP can be made only if studies for disseminated disease and X-ray and/or magnetic resonance imaging of the spine, pelvis, femurs, and humerus and bone marrow biopsy are negative. As there are no internationally established guidelines, treatment of EMP is mainly based on consensus of expert opinion.
ABSTRACT
Hemangiopericytoma is a vascular tumor that is believed to arise from the Zimmermann's pericytes, smooth muscles cells localized around the blood vessels. This tumor presents as a slowly enlarging painless mass with a clear predilection for the musculoskeletal system. The aim of this work was to introduce a peculiar case of a tongue hemangiopericytoma managed by conservative surgical treatment.