The Laryngoscope
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Review Case Reports
Diagnostic and surgical dilemmas in hereditary medullary thyroid carcinoma.
Medullary thyroid carcinoma (MTC) is a rare malignancy arising from the parafollicular C cells within the thyroid gland. The majority of cases are sporadic, but at least 30% are hereditary in nature. Inherited forms of MTC occur as familial MTC or as a manifestation of multiple endocrine neoplasia type 2. ⋯ Several issues regarding the diagnosis and treatment of MTC remain controversial. Genetic penetrance and virulence are variable. We present an index case of familial MTC to illustrate common difficulties in the initial diagnosis and dilemmas in the surgical approach, followed by a review of current literature relevant to the management of hereditary MTC.
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To determine whether smokers and former smokers have different outcomes of otologic surgery compared to nonsmokers. Smokers have been shown to have worse outcomes in other surgeries, including facial plastics procedures, and it is hypothesized that they will have worse outcomes after ear surgery. Former smokers benefit from reduced risk of heart disease and lung disease after quitting for a period of time. It is also hypothesized that former smokers' risk of ear disease will be reduced over time. ⋯ Smokers have significantly worse chronic ear disease than nonsmokers. Surgery in smokers is more extensive and leads to worse hearing outcomes than nonsmokers. Subsequent surgeries are more common in smokers. Former smokers who quit <5 years are similar to current smokers, whereas those who quit >5 years were similar to nonsmokers.