RESUMO
Transient receptor potential canonical sub-family channel 3 (TRPC3) is considered to play a critical role in calcium homeostasis. However, there are no established findings in this respect with regard to TRPC6. Although the parathyroid gland is a crucial organ in calcium household regulation, little is known about the protein distribution of TRPC channels-especially TRPC3 and TRPC6-in this organ. Our aim was therefore to investigate the protein expression profile of TRPC3 and TRPC6 in healthy and diseased human parathyroid glands. Surgery samples from patients with healthy parathyroid glands and from patients suffering from primary hyperparathyroidism (pHPT) were investigated by immunohistochemistry using knockout-validated antibodies against TRPC3 and TRPC6. A software-based analysis similar to an H-score was performed. For the first time, to our knowledge, TRPC3 and TRPC6 protein expression is described here in the parathyroid glands. It is found in both chief and oxyphilic cells. Furthermore, the TRPC3 staining score in diseased tissue (pHPT) was statistically significantly lower than that in healthy tissue. In conclusion, TRPC3 and TRPC6 proteins are expressed in the human parathyroid gland. Furthermore, there is strong evidence indicating that TRPC3 plays a role in pHPT and subsequently in parathyroid hormone secretion regulation. These findings ultimately require further research in order to not only confirm our results but also to further investigate the relevance of these channels and, in particular, that of TRPC3 in the aforementioned physiological functions and pathophysiological conditions.
Assuntos
Regulação para Baixo , Hiperparatireoidismo Primário , Glândulas Paratireoides , Canais de Cátion TRPC , Canal de Cátion TRPC6 , Humanos , Canais de Cátion TRPC/metabolismo , Canais de Cátion TRPC/genética , Hiperparatireoidismo Primário/metabolismo , Hiperparatireoidismo Primário/genética , Hiperparatireoidismo Primário/patologia , Glândulas Paratireoides/metabolismo , Glândulas Paratireoides/patologia , Feminino , Masculino , Canal de Cátion TRPC6/metabolismo , Canal de Cátion TRPC6/genética , Pessoa de Meia-Idade , Idoso , Adulto , Imuno-Histoquímica , Hormônio Paratireóideo/metabolismoRESUMO
BACKGROUND: This cross-sectional study aimed to assess the frequency and type of firework-associated acoustic trauma occurring in Germany on New Year's Eve 2021, despite the ban on firework sales due to the COVID-19 pandemic. MATERIALS AND METHODS: The survey period lasted 7 days, from 28 December 2021 to 03 January 2022. A questionnaire inquired date, type and treatment of trauma, sex, and age of the patient, and whether the trauma occurred when lighting or watching fireworks. Hearing impairment was classified according to the World Health Organization (WHO grades 0 to 4), and concomitant tinnitus, vertigo, or other injuries were recorded. The questionnaire was sent to the otorhinolaryngology departments of 171 hospitals in Germany. RESULTS: Of 37 otorhinolaryngology departments, 16 reported no and 21 reported 50 patients with firework-associated acoustic trauma. Mean age was 29⯱ 16 years and 41 of 50 patients were males. Of these 50 patients, 22 presented without and 28 with hearing loss, 32 reported tinnitus and 3 vertigo; 20 patients were injured when lighting fireworks and 30 when watching. Hearing impairment was classified as 14â¯× WHO grade 0, 5â¯× WHO grade 1, 4â¯× WHO grade 2, 2â¯× WHO grade 3, and 3â¯× WHO grade 4. Inpatient treatment was received by 8 patients and 11 suffered from concomitant burn injuries. CONCLUSION: Despite the sales ban, some firework-associated acoustic traumas occurred at New Year 2021/2022 in Germany. Some instances led to hospitalization, but an even higher number of unreported cases can be assumed. This study can serve as a baseline for further annual surveys to raise the awareness of the danger of seemingly harmless fireworks for the individual.
Assuntos
Traumatismos por Explosões , COVID-19 , Perda Auditiva Provocada por Ruído , Raio , Zumbido , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Feminino , Traumatismos por Explosões/diagnóstico , Traumatismos por Explosões/epidemiologia , Traumatismos por Explosões/terapia , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/epidemiologia , Estudos Transversais , Pandemias , Zumbido/diagnóstico , Zumbido/epidemiologiaRESUMO
We report on the metachronic appearance of an inverted papilloma in the ipsilateral middle ear after resection of an endonasal inverted papilloma and its malignant transformation. After multiple surgical interventions and adjuvant radiation and chemotherapy, there was recurrence with intracerebral growth, which ultimately led to the patient's death 3 years after the initial presentation.
Assuntos
Tuba Auditiva , Neoplasias Nasais , Papiloma Invertido , Humanos , Tuba Auditiva/cirurgia , Papiloma Invertido/cirurgia , Nariz/patologia , Orelha Média/cirurgia , Orelha Média/patologia , Neoplasias Nasais/diagnóstico , Neoplasias Nasais/cirurgia , Recidiva Local de NeoplasiaRESUMO
BACKGROUND: This cross-sectional study aimed to assess the frequency and type of firework-associated acoustic trauma occurring in Germany on New Year's Eve 2021, despite the ban on firework sales due to the COVID-19 pandemic. MATERIALS AND METHODS: The survey period lasted 7 days, from 28 December 2021 to 03 January 2022. A questionnaire inquired date, type and treatment of trauma, sex, and age of the patient, and whether the trauma occurred when lighting or watching fireworks. Hearing impairment was classified according to the World Health Organization (WHO grades 0 to 4), and concomitant tinnitus, vertigo, or other injuries were recorded. The questionnaire was sent to the otorhinolaryngology departments of 171 hospitals in Germany. RESULTS: Of 37 otorhinolaryngology departments, 16 reported no and 21 reported 50 patients with firework-associated acoustic trauma. Mean age was 29⯱ 16 years and 41 of 50 patients were males. Of these 50 patients, 22 presented without and 28 with hearing loss, 32 reported tinnitus and 3 vertigo; 20 patients were injured when lighting fireworks and 30 when watching. Hearing impairment was classified as 14â¯× WHO grade 0, 5â¯× WHO grade 1, 4â¯× WHO grade 2, 2â¯× WHO grade 3, and 3â¯× WHO grade 4. Inpatient treatment was received by 8 patients and 11 suffered from concomitant burn injuries. CONCLUSION: Despite the sales ban, some firework-associated acoustic traumas occurred at New Year 2021/2022 in Germany. Some instances led to hospitalization, but an even higher number of unreported cases can be assumed. This study can serve as a baseline for further annual surveys to raise the awareness of the danger of seemingly harmless fireworks for the individual.
Assuntos
Traumatismos por Explosões , COVID-19 , Perda Auditiva Provocada por Ruído , Raio , Zumbido , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Feminino , Traumatismos por Explosões/diagnóstico , Traumatismos por Explosões/epidemiologia , Traumatismos por Explosões/terapia , Perda Auditiva Provocada por Ruído/diagnóstico , Perda Auditiva Provocada por Ruído/epidemiologia , Estudos Transversais , Pandemias , Zumbido/diagnóstico , Zumbido/epidemiologiaRESUMO
BACKGROUND: The aim of this article is to report on the integration of endoscopic ear surgery (EES) into daily clinical practice. MATERIAL AND METHODS: In a monocentric prospective study, the endoscopy unit was set up during even weeks over a period of 10 months and the procedure was primarily started endoscopically via a transmeatal approach. In odd weeks, the endoscopy was omitted. A total of 60 procedures in 59 patients were evaluated. Points of comparison were intraoperative vision, incision-suture time, postoperative hearing outcome, and postoperative otoscopic findings. RESULTS: With the exception of the facial nerve (pâ¯= 0.15 Mann-Whitney Utest), the EES showed significantly improved visualization of all areas in the middle ear. The incision-suture times were similar in both methods. If bimanual placement of an ossicular prosthesis was necessary, the incision-suture time increased disproportionately (MES: 57.18⯱ 9.7â¯min, EES: 76.83⯱ 24.99â¯min; pâ¯= 0.019, *). There were no statistically significant changes related to hearing outcomes when comparing EES with the microscopic technique. There were no postoperative complications in the EES surgery group. CONCLUSION: Integration of EES proved to be successful and advantageous in a real patient collective at this location.
Assuntos
Colesteatoma da Orelha Média , Otolaringologia , Procedimentos Cirúrgicos Otológicos , Humanos , Estudos Prospectivos , Centros de Atenção Terciária , Resultado do Tratamento , Procedimentos Cirúrgicos Otológicos/métodos , Endoscopia/métodos , Orelha Média , Estudos RetrospectivosRESUMO
Pott's puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics. We present a series of four cases of PPT that occurred in two children (6 and 9 years) and in two young adults (17 and 19 years). All patients were treated by an interdisciplinary team of pediatric, neurosurgical, ENT, radiological, and neuroradiological specialists. Antibiotic treatment was combined with single endoscopic surgery in one case and combined endoscopic sinus surgery with an open transcranial approach to drain intracranial abscess formation in three cases. It is important to be aware that PPT occurs in children with the finding of intracranial abscess formation. Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease.
Assuntos
Seio Frontal , Sinusite Frontal , Tumor de Pott , Criança , Drenagem , Endoscopia , Humanos , Tumor de Pott/diagnóstico por imagem , Tumor de Pott/cirurgia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Pott's puffy tumor (PPT) is an infection of the frontal sinus with subperiosteal and intracranial abscess formation and one of the rare entities in pediatrics. We present a series of four cases of PPT that occurred in two children (6 and 9 years) and in two young adults (17 and 19 years). All patients were treated by an interdisciplinary team of pediatric, neurosurgical, ENT, radiological, and neuroradiological specialists. Antibiotic treatment was combined with single endoscopic surgery in one case and combined endoscopic sinus surgery with an open transcranial approach to drain intracranial abscess formation in three cases. It is important to be aware that PPT occurs in children with the finding of intracranial abscess formation. Therefore, a close interdisciplinary cooperation for successful treatment is needed in this rare disease.
Assuntos
Sinusite Frontal , Tumor de Pott , Abscesso , Criança , Drenagem , Endoscopia , Sinusite Frontal/diagnóstico , Sinusite Frontal/terapia , Humanos , Tumor de Pott/cirurgia , Tumor de Pott/terapia , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Transcervical sonography has become an integral part of the diagnostic spectrum of otorhinolaryngology, as evidenced by its firm inclusion in continuing education catalogs and guidelines. For these reasons, the user should be aware of a basic understanding of ultrasound physics and of technical innovations. A standardized examination scheme with structured reporting and documentation is an elementary prerequisite to meet the daily clinical challenges and to be able to answer specific questions. In this educational article, we span from an introduction to structured examination techniques to a clinical update on sonography of the cephalic glands and cervical lymph nodes.
Assuntos
Neoplasias de Cabeça e Pescoço , Pescoço , Cabeça , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Linfonodos/patologia , Metástase Linfática/patologia , Pescoço/diagnóstico por imagem , UltrassonografiaRESUMO
OBJECTIVES: Cochlea Implants (CI) are the preferred treatment for deaf and highly hearing imparied people. While deaf people already profit enormously from any regained hearing perception, it is not as easy to predict a profitable outcome for people with a remaining sense of hearing. To provide patients the best possible outcome in speech understanding, a lot of parameters have to be identified and adjusted. The aim of this study is to show the influence of objective parameters on classified speech understanding using collected data. MATERIAL AND METHODS: A total of 52 patients and 65 ears aged between 18 and 80 years were included in this study. ECAP-thresholds from intraoperative measurements and impedance were used as objective parameters. T- and C/M-levels were defined as subjective parameters. To classify the performance the value of speech understanding was used. RESULTS: Differences between both groups (age, time after implantation) were not significant. The gained word scores at 500âHz correlated significantly with the results of the speech perception threshold on two-digit numbers. The electrode impedances correlated on average with speech understanding with constant variability. The distributions of objective and subjective parameters showed partially significant differences. Many distributions showed significant differences to the normal distribution. Accordingly, the overlapping areas of the significance levels are very narrow. CONCLUSION: Higher impedances and incorrectly adjusted T-levels resulted in a worse speech understanding. Relation of C/M-levels to ECAP thresholds seem to be crucial for good speech understanding.
Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Implante Coclear/métodos , Audição , Humanos , Pessoa de Meia-Idade , Fala , Adulto JovemRESUMO
The term "endoscopic ossiculoplasty" refers to surgical methods with the intention to reconstruct the ossicular chain using endoscopic vision. Apart from malformations and injuries, inflammatory processes cause the majority of indications for ossicular reconstruction. This article offers a commented overview of current literature and preliminary personal experience.
Assuntos
Prótese Ossicular , Substituição Ossicular , Ossículos da Orelha/diagnóstico por imagem , Ossículos da Orelha/cirurgia , Orelha Média , Endoscopia , Estudos Retrospectivos , Resultado do Tratamento , TimpanoplastiaRESUMO
Sonography of the head and neck area plays a major role in both outpatient and inpatient ear, nose and throat medicine. Transcervical ultrasound is an important imaging method, especially in lymph node and tumor diagnostics. Its advantage is the ubiquitous availability and the excellent combinability with endoscopy and palpation. Despite decades of experience with sonography in the head and neck area, in contrast to the transcutaneous application, the transoral or endosonographic approach has so far not been widely used. Here it is often not due to the technical capabilities of the examiner, but rather to the unusual approach within the scope of the investigation. In this context, endosonography may be used primarily in tumor diagnostics in order to establish a complete sonographic examination from in- and outside.
Assuntos
Endossonografia , Neoplasias de Cabeça e Pescoço , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática , Pescoço , UltrassonografiaRESUMO
Owing to the lack of specific symptoms, diagnosis of head and neck squamous cell carcinoma (HNSCC) may be delayed. We evaluated volatile organic compounds in tumor samples from patients suffering from HNSCC and tested the hypothesis that there is a characteristic altered composition in the headspace of HNSCC compared with control samples from the same patient with normal squamous epithelium. These results provide the basis for future noninvasive breath analysis in HNSCC. Headspace air of suspected tumor and contralateral control samples in 20 patients were analyzed using ion-mobility spectrometry. Squamous cell carcinoma was diagnosed in 16 patients. In total, we observed 93 different signals in headspace measurements. Squamous cell carcinomas revealed significantly higher levels of volatile cyclohexanol (0.54 ppbv , 25th to 75th percentiles 0.35-0.86) compared with healthy squamous epithelium (0.24 ppbv , 25th to 75th percentiles 0.12-0.3; p < 0.001). In conclusion, head and neck squamous cell carcinoma emitted significantly higher levels of volatile cyclohexanol in headspace compared with normal squamous epithelium. These findings form the basis for future breath analysis for diagnosis, therapy control and the follow-up of HNSSC to improve therapy and aftercare.
Assuntos
Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Compostos Orgânicos Voláteis/química , Idoso , Idoso de 80 Anos ou mais , Testes Respiratórios , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Carcinoma de Células Escamosas de Cabeça e Pescoço/química , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Compostos Orgânicos Voláteis/metabolismoRESUMO
Urothelial carcinoma (UC) is the fourth most frequent tumor in Western countries and upper tract urothelial carcinoma (UTUC), affecting pyelocaliceal cavities and ureter, accounts for 5-10% of all UCs. Computed tomography urography (CTU) is now considered the imaging modality of choice for diagnosis and staging of UTUC, guiding disease management. Although its specificity is very high, both benign and malignant diseases could mimic UTUCs and therefore have to be well-known to avoid misdiagnosis. We describe CTU findings of upper urinary tract carcinoma, features that influence disease management, and possible differential diagnosis.
Assuntos
Carcinoma de Células de Transição , Ureter , Neoplasias Urológicas , Carcinoma de Células de Transição/diagnóstico por imagem , Humanos , Tomografia Computadorizada por Raios X , Urografia , Neoplasias Urológicas/diagnóstico por imagemRESUMO
PURPOSE: Gagging may be a challenge in daily otorhinolaryngology (ORL) routine. This cross-sectional study aimed to examine conditions of gagging as limitation to ORL examination and the efficacy of acupressure as tool to reduce exaggerated gagging. METHODS: The study was conducted on a total of 360 study subjects. There was a survey part and a routine ORL examination with observation of gagging behaviour. Through binomial univariate logistic regression, predictors of clinically relevant exaggerated gagging were identified. Wilcoxon signed rank test was used to evaluate efficacy of acupressure point CV-24 to reduce gagging while examination. RESULTS: First gagging's relevance was indicated by over 40% of study subjects showing clinically relevant exaggerated gagging. Furthermore, we found that more psychogenic than somatogenic features proved to be predictors of exaggerated gagging. Third acupressure point CV-24 showed statistical significant reduction of gagging intensity and improved examination feasibility. CONCLUSION: Awareness of exaggerated gagging's predictors are the first step to deal with gagging in daily practice. Acupressure might be an effective tool to overcome gagging in the affected patients. LEVEL OF EVIDENCE: We suggest at least Level IV according to Oxford (UK) CEBM Levels of Evidence.
Assuntos
Acupressão , Engasgo/prevenção & controle , Otolaringologia , Adulto , Estudos Transversais , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: The aim of this study was to assess the interrater reliability of ultrasound for diagnosing sialolithiasis. MATERIALS AND METHODS: A total of 100 consecutive patients with signs of obstructive sialadenopathy were evaluated. The patients all underwent ultrasound examinations in a standardized manner conducted by one specialist with extensive experience in the management of salivary gland disorders and proficiency in head and neck ultrasonography. The video recordings were sent to six colleagues with comparable experience without providing any further information about the patients' medical history and physical examination. RESULTS: The overall agreement between the seven observers was substantial, with a κ of 0.765 for the 100 cases and a percentage agreement level of 88.29â±â3.01â% (range: 83-94â%). The range of agreement on this video set for observer pairs varied from substantial to almost perfect agreement (0.663 to 0.878). Among the few false-negative findings (5.4â%), 71.8â% were due to distal sialolithiasis. Two-thirds of the false-positive findings (3.7â%) were due to fibrotic stenosis. CONCLUSION: The study confirmed the diagnostic value of ultrasound in sialolithiasis and demonstrated a very high level of interrater agreement, even in the absence of additional clinical patient information, thus further underscoring the importance of ultrasound as the examination of first choice in sialolithiasis.
Assuntos
Cálculos das Glândulas Salivares , Ultrassonografia , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Cálculos das Glândulas Salivares/diagnóstico por imagem , Gravação em VídeoRESUMO
High-resolution ultrasonography, including color duplex modes, is a well-established and proven imaging method that is used in addition to computed tomography for re-staging after primary nonsurgical therapy for head and neck cancer in many European countries. No evidence-based international re-staging guidelines are available. Decisions as to whether to carry out neck dissection after primary radiotherapy or chemoradiotherapy are often made in the relevant tumor boards and are therefore subject to variance. High-resolution ultrasonography clearly detects morphological changes such as intranodal necrotic areas and alterations in the hilar vascularization pattern. Another important aspect of ultrasonography is that it allows accurate check-ups on dynamic changes during the follow-up period. This article reviews the role of ultrasonography in the follow-up and re-staging of patients with neck disease after primary chemoradiotherapy.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Metástase Linfática , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/secundário , Quimiorradioterapia , Europa (Continente) , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática/diagnóstico por imagem , Estadiamento de Neoplasias , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
A german-wide inquiry was performed for the evaluation of diagnostic ultrasound, current applications and the significance in the head and neck area throughout 2013 and 2014. We focused on the integration of the ultrasound diagnostic in the ENT routine and compared the implementation of ultrasound in the practice and in the clinical setting. Furthermore the current concepts of standardization in sonographic documentation, training guidelines and assessment of clinical impact of the ultrasound were evaluated.
Assuntos
Cabeça/diagnóstico por imagem , Pescoço/diagnóstico por imagem , Padrões de Prática Médica/estatística & dados numéricos , Ultrassonografia/estatística & dados numéricos , Alemanha , Humanos , Otorrinolaringopatias/diagnóstico por imagemRESUMO
The sneezing reflex is a common phenomenon in human beings and animals. Until now largely uninvestigated sneezing phenomenon is the photic sneeze reflex, also known as the ACHOO (Autosomal Cholinergic Helio-Ophtalmologic Outburst). This light induced sneezing reflex is triggered by a bright light like the sun but also by artificial light. In former publications the prevalence of this phenomenon in the population is specified up to 35 % and can result in a potential endangerment in numerous everyday situations as driving a car or controlling an airplane. In our present study we interviewed 1042 patients in the Department of Otorhinolaryngology of the Saarland University Hospital using standardized questionnaires to analyse epidemiological data as age, gender and known diseases. Additionally, the questionnaire focused on the occurrence of sneezing events, extend of sneezing, potential triggers, and methods of evasion. In our data analysis, we were able to show a high prevalence of the ACHOO in 57 % of our cohort, suffering from regular light induced sneezing events. Excluding subjects reporting only occasional sneezing events our results were comparable to findings in literature. As expected a familial disposition was observed, additionally tobacco smoking correlated with light induced sneezing events. Analyzing a large cohort, we were able to demonstrate that the prevalence of the ACHOO in the german population may be higher than expected. Taken into account the potential hazard caused by this phenomenon, further investigations should identify the pathophysiologic pathway.