RESUMEN
In this clinical case, papillary carcinoma was detected in the ectopic area of the thyroid gland in the presence of an unchanged thyroid gland of natural localization. An extremely rare disease is presented and an examination algorithm is proposed that is recommended to exclude unusual pathology in the absence of a response to ongoing conservative treatment.
Asunto(s)
Carcinoma Papilar , Disgenesias Tiroideas , Neoplasias de la Tiroides , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirugía , Humanos , Tabique Nasal/patología , Disgenesias Tiroideas/diagnóstico , Disgenesias Tiroideas/cirugía , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugíaRESUMEN
The objective of this article is to demonstrate a clinical case with a good outcome by using a maxillary swing approach during the surgical treatment of extensive locally advanced form of the juvenile nasopharyngeal angiofibroma (JNA) stage Fisch-Andrews IIIb (Radkowski IIIb). Thus the maxillary swing approach has given an adequate exposure of the skull base and is an effective approach in the surgical treatment of extensive JNA with a good overview of anatomical structures and has a minimal risk of complications and to evaluate an efficacy of the results.
Asunto(s)
Angiofibroma , Neoplasias Nasofaríngeas , Angiofibroma/diagnóstico , Angiofibroma/cirugía , Humanos , Maxilar , Neoplasias Nasofaríngeas/diagnóstico , Neoplasias Nasofaríngeas/cirugíaRESUMEN
Juvenile nasopharyngeal angiofibroma (JNA) is a hypervascular, blood-supplied, benign tumour affecting the sinuses, nasal cavity, nasopharynx and the base of the skull. For intraoperative hemostasis, pre-operative embolism is a common and recommended procedure, but it has serious disadvantages, such as additional radiation exposure, anesthesia, and the risk of iatrogenic complications associated with the occlusion of the central artery of the retina, orbital and middle cerebral arteries. This article presents a report on successful radical removal of the widespread SAS without resorting to preoperative embolization, but with intraoperative transnazal endoscopic clipping of the internal maxillary artery (IMA).
Asunto(s)
Angiofibroma/terapia , Embolización Terapéutica , Neoplasias Nasofaríngeas/terapia , Endoscopía , Humanos , Nasofaringe , Base del CráneoRESUMEN
AIM: To evaluate and compare the clinical outcome and impact of balloon sinuplasty and functional endoscopic sinus surgery (FESS) on the quality of life of pediatric patients and adolescents suffering from chronic rhinosinusitis (CRS). MATERIAL AND METHODS: A retrospective study was performed of 47 children with failed medical therapy, who were scheduled for surgery. The first one pediatric balloon sinuplasty was performed by Ilya Zyabkin in Filatov Children's City Hospital on the 30-th of August 2012.They underwent treatment by balloon sinuplasty of selected sinuses in 553% (n=26) cases and hybrid FESS with BSP - in 44.7% (n=21). Data were collected, including perioperative CT Lund-Mackay score and SN-5 quality of life findings. RESULTS: Compared with preoperative values, Lund-Mackay scores were significantly lower at 1 year (p<0.05) in 92,3% (n=12) patients after surgery. Moreover, balloon sinuplasty improved sinusrelated quality of life score in 93.3% (n=42) patients for up to 1 year after operation (p<0.05). CONCLUSION: Balloon sinuplasty showed a clinical curative effect in the treatment of children and adolescents with refractory CRS, and was relatively safe by itself. BSP allows to postpone, if necessary, FESS or avoid circular mucosal trauma and infundibulotomy in hybrid FESS with balloon sinuplasty technique.
Asunto(s)
Rinitis , Adolescente , Niño , Enfermedad Crónica , Endoscopía , Humanos , Calidad de Vida , Estudios Retrospectivos , Federación de Rusia , Resultado del TratamientoRESUMEN
INTRODUCTION: For the last decades endoscopic ear surgery has become a common practice. Advantages of the endoscopic technique in middle ear surgery are high definition and magnification of the endoscope with a modern camera and the ability to 'look around the corner' with the angled scope. MATERIAL AND METHODS: From March 2017 to November 2019 in NSRC PHOI named after Dmitry Rogachev in the Department of Oncology and Pediatric Surgery 53 patients (81 surgeries) have undergone endoscopic-assisted ear surgery: 3 biopsies for middle ear neoplasm with the transcanal endoscopic approach, 1 endoscopic tympanoplasty for attic retraction pocket with cholesteatoma, 2 endoscopic removal of middle ear tumors (including 1 combined approach) and 32 endoscopic myringoplasties, 22 canal wall down mastoidectomies for extensive middle ear and mastoid cholesteatoma, 21 second-look surgery with ossiculoplasty with overall good outcome. Age of the patients varied from 2 months to 16 years. Follow up period varied from 1 month to 3 years. RESULTS: Two cases of middle ear tumor removal via endoscopic transcanal approach are described. In one case endoscopic transmeatal approach was used as an addition to the middle fossa approach for removal of facial nerve neurinoma located on the upper surface of petrous bone with expansion to the middle ear cavity. In the second case endoscopic transmeatal approach was used alone for removal of benign tumor (salivary gland choristoma) of middle ear cavity with extension to pneumatic system of petrous bone. In both cases endoscopic approach allowed to biopsy the tumor first and then to remove the tumor in a less invasive way, which lead to faster patient recovery. CONCLUSION: In the majority of cases endoscopic technique is a method of assistance in otologic surgery, but sometimes could be a used a single method in middle ear surgery, allowing less traumatic approach and the implementation of high-definition camera for more precise disease control. In our preliminary experience endoscopic technique could be used in pediatric practice independently of the patient's age.
Asunto(s)
Colesteatoma del Oído Medio/cirugía , Procedimientos Quirúrgicos Otológicos , Niño , Oído Medio , Endoscopía , Humanos , Apófisis Mastoides , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The authors report a clinical case of successful elimination of a recurrent juvenile angiofibroma at the base of the skull (JAFBS) with the application of the optical navigation system and a cold plasma scalpel in the absence of preoperative embolization. It has been demonstrated using the proposed transperygoid approach to the extirpation of the tumour that a recurrent juvenile angiofibroma at the base of the skull can be efficiently removed by means of a modern minimally invasive and at the same time radical surgical method.
Asunto(s)
Angiofibroma , Recurrencia Local de Neoplasia/cirugía , Procedimientos Neuroquirúrgicos/métodos , Neoplasias de la Base del Cráneo , Procedimientos Quirúrgicos Vasculares/métodos , Adolescente , Angiofibroma/patología , Angiofibroma/fisiopatología , Angiofibroma/cirugía , Coagulación con Plasma de Argón/métodos , Humanos , Masculino , Neuronavegación/métodos , Reoperación/métodos , Neoplasias de la Base del Cráneo/patología , Neoplasias de la Base del Cráneo/fisiopatología , Neoplasias de la Base del Cráneo/cirugía , Tomografía Computarizada Espiral/métodos , Resultado del TratamientoRESUMEN
The objective of the present article was to report the current literature data concerning the significance of and prospects for the application of the CT-navigation systems in transnasal endoscopic surgery of neoplasms localized in the nasal cavity, nasopharynx, paranasal sinuses, and the base of the skull in the children.