Ultrasound Changes in Salivary Glands after Radioactive Iodine Treatment in Benign Diseases and Differentiated Cancer of Thyroid Glands in Consideration of Dose and Time Dependency.

PURPOSE: To assess ultrasound (US) features observed in salivary glands after radioactive iodine treatment (RAIT) in relation to the dose and time interval after RAIT. MATERIALS AND METHODS: A retrospective analysis of US findings regarding the salivary glands of patients presenting after RAIT due to thyroid cancer (Group 1, n=99) or benign thyroid diseases (Group 2, n=25). The control group consisted of randomly selected patients (no RAIT, Group 3, n=100). Groups were compared regarding RAIT dose, symptoms, and US findings (duct dilation, hypoechoic/heterogeneous parenchyma, parenchymal loss). The association of the presence of US parameters after RAIT with various dose levels (2000-15000MBq) and time intervals (24, 60, 120 months) and the differences between the groups was evaluated. RESULTS: Significant differences between US parameters were noted when comparing Group 1 with Group 2 or 3. Nothing of relevant significance was noted when Groups 2 and 3 were compared. US features indicating a slight or moderate sialadenitis showed the most significant associations with doses <4000MBq and time intervals <24 months after RAIT. US changes indicating a serious sialadenitis or even gland atrophy showed the most significant association at doses between >7000-9000MBq and when US was performed >60 months after RAIT. CONCLUSION: Our results point to a dose and time dependency of pathologic US findings in RAIT-induced effects on the major salivary glands. Based on the US findings, a better estimation of the current impact of RAIT on the salivary glands and the further prognosis appears possible.

Calcification in Salivary Gland Cancer Mimicking Sialolithiasis-A Diagnostic Pitfall on Imaging: Report of Two Cases and Brief Review of the Literature.

Objectives: Sialolithiasis is the most common cause of calcifications detected with ultrasound in patients with chronic inflammatory symptoms and swellings of the salivary glands. Other differential diagnoses of calcifications are extremely rare and mostly benign. Methods: Case report and literature review. Results: Two rare cases of malignant parotid gland tumors with calcifications in a localization typical for sialolithiasis, which were mistaken for salivary calculi based on image findings, are presented. Conclusions: This report intends to highlight the pitfalls in the imaging of parotid gland diseases. Even if malignant tumors of the parotid gland with calcifications are extremely rare, in ambiguous cases, differential diagnoses should be considered carefully. A high suspicion index of the need for further diagnostics in cases with calcifications is practical and could include missing periprandial symptoms, no obstruction signs in the proximal duct, and missing evidence of sialolithiasis in sialendoscopy.

[Abscesstonsillectomy: Uni- or bilateral?] / Abszesstonsillektomie: Uni- oder bilateral?

OBJECTIVE: In addition to an empirical use of antibiotics for treatment of a peritonsillar abscess (PTA) there is a drainage of pus or the abscess tonsillectomy. Postoperative bleeding after abscesstonsillectomy (ABTE) is this surgery's most feared complication which can rarely lead to patients' deaths. The objective of this study was to compare bleeding complications of ABTE with and without contralateral tonsillectomy (TE) and to analyze the occurrence of a metachronous PTA at the contralateral side. METHODS: Retrospective study of n= 655 patients undergoing ABTE with and without TE of the contralateral side from 2004 to 2019. Bleeding complications needing surgical hemostasis were analyzed regarding demographic and surgical parameters. In addition, occurrence of PTA and need for ABTE of the contralateral side after unilateral ABTE were evaluated. RESULTS: Overall, 10/655 (1.5 %) patients presented with postoperative bleeding after ABTE. In 404/655 an ABTE with contralateral TE was performed. Here, 8/404 (1.98 %) patients showed contra- or bilateral bleeding. Only in 2/251 (0.7 %) patients occurred a bleeding complication after unilateral ABTE. Therefore, bleeding after unilateral ABTE was significantly lower than ABTE with contralateral TE (1.98 % vs. 0.7 %, p= 0.001). In 0.8 % of the patients a contralateral ABTE was necessary due to a metachronous PTA. CONCLUSION: Overall, the rate of postoperative bleeding after ABTE (1.5 %) was low. Unilateral ABTE showed significantly lower postoperative bleeding rates compared to ABTE with contralateral TE. Consequently, the indication of a contralateral TE must be very strict.

Virtual reality jogging as a novel exposure paradigm for the acute urge to be physically active in patients with eating disorders: Implications for treatment.

The acute urge to be physically active is a relevant clinical phenomenon in patients suffering from eating disorders. In this study with n = 20 female patients with anorexia nervosa and n = 10 female patients with bulimia nervosa, a virtual reality (VR) jogging paradigm was applied as a novel highly immersive 3D exposure paradigm. Patients were asked to rate their acute urge to be physically active during the exposure procedure. A 10-item self-report questionnaire (smQ) was developed to capture the cognitive, emotional, and behavioral aspects of the acute urge to move. We hypothesized that exposure would lead to habituation of the urge to be physically active. We also hypothesized that leptin levels would be associated with the degree of the subjective urge to be physically active, while habituation would be associated with a decrease in stress hormones (α-amylase, cortisol, and cortisone in saliva). A statistically significant change in subjective scores in the smQ from baseline to postexposure was seen. Our novel VR paradigm may serve as a therapeutic tool for exposure and habituation of the urge of acutely engaging in physical activity in patients with eating disorders.