Anti-fatigue mats, low back pain, and electromyography: An interventional study.

OBJECTIVES: Increasing bilateral gluteus medius co-activation has been identified as one of the most important factors in developing low back pain due to prolonged standing in healthy people. This study aims to investigate the impact of an anti-fatigue mat on the bilateral gluteus medius co-activation pattern and to report the low back pain subjectively in 2 different standing positions on the normal rigid surface and on the anti-fatigue mat. MATERIAL AND METHODS: While carrying out an easy simulated profession, 16 participants who had no low back pain background were requested to stand for 2 h in each position, with and without using the anti-fatigue floor mat, respectively. At the beginning of standing process and at every 15 min until the time of 120 min lapses, electric activities for the bilateral gluteus medius co-activation and subjective pain level in low back area were collected by the surface electromyogeraphy (EMG) and the visual analogue scale (VAS), respectively in each position. RESULTS: The obtained findings revealed that the anti-fatigue mat significantly decreased subjective pain level in low back area among 15 participants (p < 0.05). However, there was objectively no significant difference in the bilateral gluteus medius co-activation pattern among the participants between the position 1 and the position 2 (p > 0.05). The findings obtained under this study related to the impact of the anti-fatigue mat upon the low back pain based on the increase of > 10 mm on the VAS threshold, which showed that this intervention had no significant impact upon decreasing the number of patients suffering from the low back pain and also minimizing the bilateral gluteus medius co-activation in both pain developer groups (p > 0.05). However, 73% of the participants preferred to apply it. CONCLUSIONS: It seems that the anti-fatigue mat may be useful in reducing the low back pain although it objectively didn't significantly change the gluteus medius co-activation pattern related to the low back pain.

Primary Merkel cell carcinoma of the parotid gland.

Primary Merkel cell carcinoma (MCC) is a neuroendocrine tumor that typically affects older whites. It usually originates in the dermis, but in rare instances it has arisen in other primary sites, including the oral mucosa and the parotid gland. Explanations for the presence of MCC in these atypical locations have included theories of malignant transformation and neuroendocrine migration. We describe the case of a 35-year-old white woman who had an MCC in the parotid gland and no evidence of any other primary cutaneous lesion. A left superficial parotidectomy with facial nerve preservation was performed, and a histologic diagnosis of MCC was made. Positron-emission tomography was negative for other lesions, and postoperative radiation therapy was administered for local control. To the best of our knowledge, this is only the sixth case of a primary MCC of the parotid gland to be reported in the English-language literature; of these 6 patients, ours was by far the youngest. Otolaryngologists should be familiar with this rare but potentially fatal neoplasm.

Primary parotid gland sarcoidosis: case report and discussion of diagnosis and treatment.

Sarcoidosis is a systemic disease of unknown origin that is characterized by noncaseating granulomatous lesions. Primary otolaryngologic manifestations of sarcoidosis are not commonly seen. The documented incidence of parotid gland involvement (either primary or secondary) is only 6%. Extrapulmonary involvement can be present in up to 30% of patients with sarcoidosis and can present at the same time as pulmonary sarcoidosis. We report a case involving a patient with primary unilateral parotid sarcoidosis who returned with bilateral recurrence approximately 4 years after a total unilateral parotidectomy. To the best of our knowledge, this is only the second reported case in the English-language literature of primary parotid sarcoidosis that is the sole manifestation of the disease. We also discuss methods of diagnosis and treatment of head and neck manifestations of sarcoidosis.

Pleomorphic adenoma of the external auditory canal: a case report and review of the literature.

Pleomorphic adenomas of the external auditory canal (EAC) are benign tumors of the ceruminal glands; they are a rare entity. Arising from the lateral cartilaginous portion of the EAC, these lesions can be challenging to diagnose in view of their rare clinical presentation, indolent symptoms, and a lack of familiarity on the part of histopathologists. We report the case of a pleomorphic adenoma in a 32-year-old woman, and we review the literature on glandular neoplasms of the EAC, with particular emphasis on terminology and factors that can hinder the diagnosis.

Patient history and CT findings in predicting surgical outcomes for patients with rhinogenic headache.

The concept of rhinogenic headaches remains a subject of much debate. While many authors have reported good results in treating these headaches with endoscopic sinus surgery, few have attempted to establish objective criteria for identifying the best surgical candidates. We conducted a study of 33 adults with rhinogenic headaches to determine if three elements of the history and/or five aspects of computed tomography (CT) would predict which patients might benefit from the minimally invasive sinus technique (MIST) as the primary treatment modality for their headaches. Postoperative follow-up interviews revealed that endoscopic surgery was widely successful, as 28 patients (84.8%) reported improvement. However, we were unable to find any statistically significant history or CT parameters that predicted surgical outcomes.

Bilateral occult mucosal bridges of the true vocal folds.

A mucosal bridge of the true vocal fold is a rare, benign anatomical finding that can cause dysphonia. It has been described by some in the literature as "occult" as it is often not visibly evident on flexible nasopharyngolaryngoscopy or strobovideolaryngoscopy, but mistakenly diagnosed as a sulcus vocalis (Sataloff RT, Rosen C, Hawkshaw M. Occult mucosal bridge of the vocal fold. Ear Nose Throat J. 1997; 76(12):850).(2) Final diagnosis is usually not made until microscopic direct laryngoscopy is performed and palpation of the true vocal fold reveals the mucosal bridge (Tanaka S, Hirano M, Umeno H, Tanaka Y. Mucosal bridge of the vocal fold [Japanese].(4)Nippon Jibiinkoka Gakkai Kaiho. 1991; 94(12):1853-1856). We describe a case of a 15-year-old boy complaining of long-standing hoarseness and found to have bilateral mucosal bridges of the true vocal folds. Previous reports cite cases of a unilateral mucosal bridge. We believe this is the first reported case of bilateral mucosal bridges.

Marginal-zone B-cell lymphoma of the bony palate presenting as sinusitis.

The diagnosis of low-grade B-cell lymphoma consistent with marginal-zone lymphoma has proven to be challenging when the disease involves the hard palate. The diagnosis is complicated by the nonspecific nature of the presenting symptoms and a difficult-to-differentiate histologic picture. We describe a case of low-grade B-cell lymphoma of the hard palate with a delayed presentation. We also compare the features of this case with the features of the small number of other such cases that have been reported in the literature. Finally, we review the etiology of low-grade B-cell lymphoma, we discuss its radiologic and pathologic features, and we briefly describe the treatment options.

Nevoid basal cell carcinoma syndrome and fetal rhabdomyoma: a case study.

Fetal rhabdomyoma is not generally considered part of nevoid basal cell carcinoma syndrome. However, a review of the literature revealed five patients with this syndrome who also had fetal rhabdomyomas in various locations. We report the first patient with nevoid basal cell carcinoma syndrome and a fetal rhabdomyoma of the tongue. We recommend that embryonal rhabdomyosarcoma be ruled out to avoid overly aggressive treatment of these patients.