A single-center multidisciplinary study analyzing thyroid nodule risk stratification by comparing the thyroid imaging reporting and data system (TI-RADS) and American thyroid association (ATA) risk of malignancy for thyroid nodules.

OBJECTIVES: The thyroid imaging reporting and data system (TI-RADS) and 2015 American Thyroid Association (ATA) guidelines are two well-known risk stratification systems for classifying thyroid nodules based on cancer risk. This study aims to evaluate the diagnostic efficacy of these two systems in predicting malignancy in patients undergoing thyroid surgery. METHODS: We studied data on 120 individuals who were scheduled to undergo surgery for benign or malignant nodular diseases of the thyroid gland between October 2017 and October 2019. The TI-RADS category and ultrasound pattern based on ATA guidelines were assigned to dominant thyroid nodule categories by two experienced radiologists blinded to patients' previous thyroid ultrasonography and fine-needle aspiration biopsy results. A pathologist with experience in thyroid diseases blinded to patients' sonographic and clinical data reviewed the thyroidectomy specimens. RESULTS: A total of 120 patients, 88 women and 32 men, were included in our study. Final histopathological results were as follows: 50% (n=60) papillary thyroid carcinoma, 36.6% (n=44) benign nodular thyroid diseases, 4.1% (n=5) follicular adenoma, 2.5% (n=3) hurtle cell adenoma, 1.7% (n=2) follicular thyroid carcinoma, 1.7% (n=2) medullary thyroid carcinoma, 1.7% (n=2) hurtle cell carcinoma, and 1.7% (n=2) follicular tumor of uncertain malignancy potential. The sensitivity, specificity, positive predictive value, and negative predictive value for TI-RADS were 80%, 56%, 72%, and 67%, respectively, and that for ATA were 80%, 64%, 76%, and 69%, respectively. CONCLUSION: The TI-RADS and ATA showed similar rates of sensitivity, specificity, NPV, and PPV. Our observed risk of malignancy was higher than expected for the ACR TI-RADS 3-5 categories and the very low, low, and intermediate suspicion risk strata in the ATA guidelines. We found no difference between observed and expected malignancy risk for the ACR TI-RADS 2's and ATA's high suspicion categories.

Association Between Mean Platelet Volume, Platelet Count, and Distribution Width With Depth of Invasion in Oral Cancers.

INTRODUCTION: To examine the potential predictive roles of the preoperative mean platelet volume (MPV), platelet count (PC), and platelet distribution width (PDW) in patients with oral cancer and their association with the depth of invasion (DOI). METHODS: This retrospective study included 122 patients (66 males, 56 females) diagnosed with oral cancer between January 2009 and January 2015 by our Otolaryngology Department. At diagnosis, the mean age was 64.6 ± 13.9 years. The average follow-up period was 39.2 ± 23.9 months. RESULTS: We found significant differences in all parameters (PDW, MPV, PC) based on the positivity of the lymph node and the tumor stage. The mean PDW, MPV, and PC were significantly higher in the exitus group than in the survivor group (P = .010, .036, and .047, respectively). In patients with high PDW, we observed a lower progression-free survival. We observed that PDW had a significant impact on the recurrence of the disease. Platelet distribution width, MPV, and PC were significant prognostic factors. A high PDW increased fatality 4.1 times, and a high MPV increased fatality 4.7 times (P = .040 and .032, respectively). We found in a univariate analysis that tumor grade, PDW, MPV, and PC were predictive factors for fatality. On multivariate analysis, we found that MPV, PC, and predictors were independent of tumor grade. We observed an association between MPV and DOI. CONCLUSION: High PC, MPV, and PDW could be meaningful prognostic predictors for low survival rates. Mean platelet volume appears to be a more effective marker because it is associated with the DOI and prognosis. However, further research is required to confirm our findings.

Cerebrospinal Fluid Leak After Septoplasty in Crouzon Syndrome.

ABSTRACT: Crouzon syndrome presents with craniofacial deformities due to early fusion of cranial sutures. Deviation of the nasal septum could be seen clinically in Crouzon syndrome. Cerebrospinal fluid leaks (CSF) after septoplasty are extremely rare and typically present with simple rhinorrhea, meningitis, and pneumocephalus. Herein, we report an adult patient with Crouzon syndrome who experienced CSF complication after septoplasty surgery.Supplemental Video: CSF leak repair operation, http://links.lww.com/SCS/B930.

Delayed diagnosed Gradenigo's syndrome associated with acute otitis media.

Gradenigo's syndrome presents as a triad of retroorbital pain, ipsilateral abducens palsy, and purulent otorrhea. If the otologic pathologies in Gradenigo's syndrome go unnoticed, the condition could be misdiagnosed with neurological diseases because of retroorbital pain and abducens palsy. Treatment of Gradenigo's syndrome remains controversial. Although some reports state that long-term antibiotic treatment is sufficient, we recommended that management ought to be guided on a case-by-case basis depending on patient and disease factors. Herein, we report a delayed diagnosed pediatric case of Gradenigo's syndrome associated with acute otitis media that was treated with ventilation tube insertion.

A Very Rare Complication of Hyaluronic Acid Injection for Medialization Laryngoplasty: A Case With Laryngeal Abscess.

Hyaluronic acid injection for medialization laryngoplasty is a safe procedure performed on patients with glottic incompetence. Laryngeal abscess formation as a complication of injection laryngoplasty is a very rare complication, and, as we know from the literature, there has been only one case of laryngeal abscess after injection laryngoplasty in a patient with a type-I laryngeal cleft. We document for the first time a laryngeal abscess resulting from hyaluronic acid injection laryngoplasty for unilateral vocal fold paralysis. Prompt evaluation of the patient was necessary. Our patient was treated with antibiotics and corticosteroids without a need for intubation. One year after injection, the patient's Voice Handicap Index-10 score was still good and within the range of normal values.