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Rossi Johnson posted an update 1 week ago
Aural fistula developed posteriorly is very rare, and it mimicked a temporal tumor or mastoiditis with a protruding auricle. Careful observation of the skin and consideration from developmental aspects are needed for an accurate diagnosis.Sinonasal inverted papilloma (SIP) is a benign tumor originating from the nasal cavity and paranasal sinuses. Sinonasal inverted papilloma is characterized by local infiltration, high recurrence, and malignant transformation, and its associated dysplasia ranges from mild, moderate, severe, carcinoma in situ (CIS) to invasive squamous cell carcinoma. Sinonasal inverted papilloma with carcinoma in situ (IPwCIS) is the highest degree of dysplasia, which is a stage of malignant transformation of IP. Surgical excision and proper adjuvant therapy can help reduce recurrence rates and suppress further deterioration. In this study, we present a patient with IPwCIS who developed 3 recurrences with a multifocal attachment pattern in less than 18 months. We report the clinical manifestations, development, and treatment process in detail. We also performed a literature review to analyze the characteristics of the disease. Despite comprehensive treatment methods, tumor recurrence and further deterioration of IPwCIS persist.
Extirpation of multiple head and neck paragangliomas carries challenge due to close anatomic relationships with critical neurovascular bundles.
This study aims to assess whether the application of 3-D models can assist with surgical planning and treatment of these paragangliomas, decrease surgically related morbidity and mortality.
Fourteen patients undergoing surgical resection of multiple head and neck paragangliomas were enrolled in this study. A preoperative 3-D model was created based on radiologic data, and relevant critical anatomic relationships were preoperatively assessed and intraoperatively validated.
All 14 patients presented with multiple head and neck paragangliomas, including bilateral carotid body tumors (CBT, n = 9), concurrent CBT with glomus jugulare tumors (GJT, n = 4), and multiple vagal paragangliomas (n = 1). Ten patients underwent genomic analysis and all harbored succinate dehydrogenase complex subunit D (SDHD) mutations. Under guidance of the 3-D model, the internal carotid artery (ICA) was circumferentially encased by tumor on 5 of the operated sides, in 4 (80%) of which the tumor was successfully dissected out from the ICA, whereas ICA reconstruction was required on one side (20%). Following removal of CBT, anterior rerouting of the facial nerve was avoided in 3 (75%) of 4 patients during the extirpation of GJT with assistance of a 3-D model. Two patients developed permanent postoperative vocal cord paralysis. There was no vessel rupture or mortality in this study cohort.
The 3-D model is beneficial for establishment of a preoperative strategy, as well as planning and guiding the intraoperative procedure for resection of multiple head and neck paragangliomas.
The 3-D model is beneficial for establishment of a preoperative strategy, as well as planning and guiding the intraoperative procedure for resection of multiple head and neck paragangliomas.When fitting hearing aids, patients are required to make an earmold impression material for device fixation. It usually causes no problems, although in rare cases, the earmold passes through the middle ear through tympanic membrane perforations.1-3 Foreign bodies may cause a delayed inflammatory reaction and deterioration of aeration, especially in the Eustachian tube. Herein, we report a rare case of earmold impression material as a foreign body in the middle ear that required surgical removal.Head and neck tumors are rare in pediatric patients but should be kept in the differential when a patient presents with a new swelling or mass. One of these tumors is a myxoma, which is an insidiously growing, benign mass originating from the mesenchyme. They most commonly arise in the myocardium but can also develop in facial structures, particularly in the maxilla and mandible. When arising in facial structures, ocular, respiratory, and digestive systems can be affected based on local invasion. Complete surgical resection is curative but can lead to significant morbidity as well. Here, we present a case of a 15-month-old toddler presenting with a paranasal mass, which was ultimately diagnosed as a maxillary myxoma. This tumor is very rare in the pediatric population, especially in the toddler age-group, reminding clinicians to broaden the differential diagnosis when a patient’s course is atypical.Nodular fasciitis (NF) has a low incidence, many classification subtypes and large histological variations. We describe a 17-month-old child who presented with a mass in the right cavity of auricular concha that was successfully cured by 2 procedures. In pediatric patients with fibroproliferative lesions, the possibility of NF should be excluded to avoid misdiagnosis and overtreatment.Health literacy is an amenable factor that can improve screening uptake. However, associations between the multidimensional health literacy domains and cervical cancer screening nonadherence are not known and should be considered to improve screening rates. this website The current quantitative study assessed the associations of multiple health literacy domains with cervical cancer screening nonadherence. Women aged 30 to 65 years without a hysterectomy were surveyed online (N = 812). Assessing, understanding, and appraising measures from the European Health Literacy Survey Questionnaire were adapted for cervical cancer screening. The outcome variable measured the application of cervical cancer information regarding adherence to the 2012 cervical cancer screening guidelines (yes/no). Adjusted logistic regression odds ratios (aORs) estimated nonadherence. Most of the women were non-Hispanic (81.4%) or White (68.1%), and aged 30 to 39 years (40%). The majority of the women (71%) were adherent to screening recommendations. The model with all domains of health literacy had the best model fit statistics compared with other models with different health literacy components. Older age and lack of insurance were statistically significant for screening nonadherence. Difficulty understanding health information (aOR = 3.15; 95% confidence interval [CI; 1.80, 5.51]) and less worry about cervical cancer (aOR = 1.74; 95% CI [1.03, 2.94]) were associated with higher odds of nonadherence. Higher cervical cancer knowledge (aOR = 0.93; 95% CI [0.87, 0.98]) and Hispanic ethnicity (aOR = 0.36; 95% CI [0.21, 0.61)] were associated with lower odds of nonadherence. Incorporating a multidimensional health literacy framework may better inform the need to develop easily understood interventions that address cervical cancer perceived vulnerability and acknowledge systemic sociodemographic influences on screening perceptions.