Ear, nose, & throat journal
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Objective: This study aimed to assess the serum levels of vitamin D in an Egyptian cohort of children with allergic rhinitis (AR) and to evaluate any correlation of vitamin D status with the disease severity. Patient and methods: One hundred twenty children with AR and 100 healthy children were included in our study. We studied the serum levels of vitamin D 25(OH)D and 1,25(OH)2D in all participants. ⋯ We found significant negative correlations between mean 25(OH)D levels and total nasal symptom score (r = -.62, p = .002) and total immunoglobulin E levels (r = -.27, p = .013) in AR group. Conclusions: Vitamin D deficiency is a frequent finding among Egyptian children with AR when compared to the healthy group. A significant inverse association was observed between vitamin D levels and AR disease severity.
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The objective of this study was to report the feasibility and safety of a novel 4-trocar approach for transoral endoscopic thyroidectomy via the vestibular. ⋯ Transoral endoscopic thyroidectomy with 4 trocars via vestibular approach is an effective and feasible method. Markedly, this technique can assist surgeons to expose and preserve both parathyroid glands and recurrent laryngeal nerve easily when performing transoral endoscopic thyroidectomy.
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We evaluated the efficacy of medical treatment on thiol-disulfide balance despite ongoing allergic stimulation. ⋯ Thiol/disulfide homeostasis may be used as a marker to evaluate the efficacy of persistent AR treatments. After the treatment, the increase in SH levels suggested the decrease in oxidative stress, even though allergen exposure continued.
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Hypercalcemic crisis is a rare endocrine emergency that occurs in a small percentage of patients with primary hyperparathyroidism. Although modern diagnostic capabilities allow timely diagnosis and intervention, hypercalcemic crisis still has a high potential for morbidity and mortality. We report an adult patient with a history of kidney stones who presented with heart palpitations, shortness of breath, fatigue, nausea, and 20-pound weight loss over 2 months. ⋯ After medical optimization, the patient underwent definitive treatment with surgical parathyroidectomy via a transcervical approach. At operation, a large parathyroid adenoma was removed from a posterior-superior mediastinal location dorsal to the recurrent laryngeal nerve with subsequent normalization of calcium and PTH. We discuss the timing of parathyroidectomy in cases of hypercalcemic crisis and the surgical approach to ectopic parathyroid glands in the mediastinum.
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Chronic rhinosinusitis (CRS) is one of the most common inflammations in the upper airway. Despite the wide prevalence of CRS, the pathogenesis of this disease is poorly understood. Several components of the innate immune system may play a significant role in CRS, including Toll-like receptor 4 (TLR4), TLR9, and high-mobility group box 1 protein (HMGB1). This study was conducted to determine the expression of TLR4, TLR9, HMGB1, and pNFκ-B p65 in paraffin-embedded blocks of patients with CRS with nasal polyps compared with those of the control group. ⋯ Both HMGB1 and TLR4 are increased in the paranasal sinus mucosa of patients with CRS. These results suggest a possible contribution of HMGB1 and its internal receptor (TLR4) in the pathophysiology of CRS.