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.
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Comparative Study
Gamma knife radiosurgery for vestibular schwannomas: results of hearing preservation in relation to the cochlear radiation dose.
This study was designed to evaluate hearing preservation after gamma knife radiosurgery (GKRS) and to determine the relation between hearing preservation and cochlear radiation dose in patients with a sporadic vestibular schwannoma (VS). ⋯ Hearing preservation is correlated to the maximal radiation dose at the cochlea. The purpose of developing GKRS techniques was to avoid collateral damage in healthy tissues. This study emphasizes the need for exact radiation planning to reduce the cochlear radiation dose if the hearing is to be preserved. Laryngoscope, 2009.
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Malakoplakia is a rare, chronic inflammatory condition characterized by defective macrophage function. The majority of cases involve the genitourinary tract, but isolated cases have been reported from other organ systems including one prior report involving the maxillary sinus. ⋯ Sinus-specific clinical aspects will be discussed including diagnostic and treatment considerations. Laryngoscope, 2009.
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To determine what characteristics and comorbidities are associated with a higher rate of complications in patients undergoing nasal reconstruction with a forehead flap. ⋯ Smokers with full-thickness defects are shown to be at greater odds for developing a postoperative complication. Laryngoscope, 2009.