Head & neck
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Case Reports
Dermatomyositis paraneoplastic syndrome before symptomatic tonsillar squamous cell carcinoma: a case report.
Paraneoplastic syndromes are systemic or organ-related functional tumor-associated changes that arise distant to the tumor. ⋯ To our knowledge, this is the first report of dermatomyositis as a paraneoplastic syndrome of tonsillar SCC in North America. We suggest that clinicians should monitor for signs of persistent or recurrent dermatomyositis symptoms as this may herald development or a return of the underlying malignancy.
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Invasive differentiated thyroid cancer (DTC) is relatively frequent, yet there is a paucity of specific guidelines devoted to its management. The Endocrine Committee of the American Head and Neck Society (AHNS) convened a panel to provide clinical consensus statements based on review of the literature, synthesized with the expert opinion of the group. ⋯ After endorsement by the AHNS Endocrine Committee and Quality of Care Committee, it received final approval from the AHNS Council.
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Clinical Trial
Ultrasound-guided intratumoral indigo carmine injection for intraoperative, surgeon-performed tumor localization.
The purpose of this study was to evaluate the feasibility of ultrasound-guided intratumoral indigo carmine injections for intraoperative localization of small head and neck tumors and to introduce our surgeon-performed technique. ⋯ Ultrasound-guided intratumoral indigo carmine injections were technically feasible as an intraoperative procedure and were performed safely by a head and neck surgeon to facilitate localization of small head and neck tumors, even in revision cases.
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Review Case Reports
Lemierre syndrome: study of 11 cases and literature review.
Lemierre syndrome is a rare but serious illness that associates throat infection and thrombosis of the internal jugular vein (IJV) or one of its tributaries with subsequent distant septic emboli. The purpose of our study was to review the pathogenesis, clinical presentation, and treatment of this disease. ⋯ Treatment with broad-spectrum antibiotics is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation.
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Given emerging demographic trends, many more elderly patients are being diagnosed with head and neck cancers. The surgical care paradigm for this cohort of patients must take into account specific challenges inherent to geriatric perioperative management. ⋯ The involvement of geriatricians and of patients' primary care providers may be invaluable in assisting in complex perioperative decision-making and in participating in longitudinal management. Preoperative risk stratification and assessment of medical, social, and functional variables are critical for appropriate decision-making in this challenging patient population.