Oral propranolol therapy for benign capillary hemangiomas in a series of adult and pediatric patients

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe outcomes of oral propranolol therapy in a series of adult and pediatric patients diagnosed with benign capillary hemangioma of the head and neck.<br /><strong>METHODS:</strong><br /><strong>Design:</strong> Prospective Case Series<br /><strong>Setting:</strong> Tertiary Government Teaching Hospital<br /><strong>Participants:</strong> Ten (10) patients representing all patients clinically diagnosed with benign capillary hemangioma of the head and neck enrolled in the study from 2012 to 2015.<br /><strong>RESULTS:</strong> Two (2) adults and eight (8) children were enrolled in the study. Although a decrease in lesion size was observed in half of the participants starting at three months, only one (1) attained complete resolution of the lesion-- a 12-year-old girl with hemangioma of the right parotid gland that attained clinical resolution of symptoms after four months of treatment. The remaining nine out of ten (9/10) participants did not attain complete clinical resolution; but there was a decrease in lesion size in four (4) of these participants. For the remaining five (5) participants, there was neither a decrease nor an increase in lesion size. Altogether, of the two adult participants, only one responded to therapy while only 4 out of 8 pediatric participants responded to therapy. There were no noticeable differences between adult and pediatric patients in terms of resolution and plateau. Aside from mild bradycardia expected with propranolol, no adverse reactions were observed during the course of treatment.<br /><strong>CONCLUSIONS:</strong> Although half of our participants responded to oral propranolol therapy whether these observations may be attributable to oral propranolol alone cannot be concluded.</p>

Animated demonstration of selected ORLHNS concepts and surgeries: A potential adjunct to learning

@#OBJECTIVE: To create visual animated demonstrations of certain otorhinolaryngologic concepts and surgeries that can aid learning of students and ORL residents.METHODS: Several otorhinolaryngologic surgical procedures and pathophysiologic concepts were represented through two dimensional images. For every concept or procedure, a series of images was drawn and manipulated using the software Adobe Photoshop CS4. The series of images were then put into animation using the software Morpheus Photo Animation Suite v3.15.RESULT: The end results were demonstrations of otorhinolaryngologic concepts and surgical procedures in movie (.AVI) format.CONCLUSION: Concepts and surgeries in the field of otorhinolaryngology are usually explained or documented using texts or simple images. The generated animated demonstration of these ideas can aid in the learning of the ORL specialist.

Glottal function index and GRBAS scale of patients undergoing vocal cord medialization: A series of five patients

@#<p><strong>OBJECTIVE: </strong>Vocal cord paralysis or immobility is debilitating condition that may result from neural or mechanical fixation of the vocal cord (VC). When permanent, therapy is aimed at improving closure by modifying the position of the vocal cord. Whatever surgical intervention is chosen, pre-and post-operative voice evaluation is important. This study aimed to investigate the usefulness of the Glottal Function Index (GFI) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) Scale in the evaluation of treatment outcomes in patients with unilateral vocal cord paralysis (UVCP) who underwent medialization thyroplasty type 1 with a modified lock-in soft silicone implant.<br /><br /><strong>METHODS:<br />Design:</strong> Descriptive Case Series<br /><strong>Setting:</strong> Tertiary Government Hospital<br /><strong>Patient:</strong> Five<br /><br /><strong>RESULTS:</strong> Five patients (3 females, 2 males) consulted due to hoarness underwent rigid endoscopy. Four (2 right, 2 left) had unilateral paramedian VC paralysis while one had bilateral paresis with bowing of the left vocal cord. One of those with left VC paralysis was diagnosed as idiopathic; the four were iatrogenic (3 form thyroid surgery, 1 from multiple surgical procedures). All patients underwent medialization thyroplasty type 1 using locked-in soft silicone implant. The GFI and GRBAS scale were utilized for pre-operative and post-operative perceptual evaluation of voice. The GFI showed severe glottic insufficiency among all five patients prior to surgery with improvement of the subjective symptoms one day and one week post-surgery in four patients. Likewise, the Hirano GRBAS scale showed improvement of voice quality and correlated the improvement of the patient's subjective symptoms from the from GFI scores. However, 5 cases with bilateral vocal cord paresis, showed no improvement of voice quality despite recovery from subjective symptoms.<br /><br /><strong>CONCLUSIONS:</strong> For glottal insufficiency, perceptual voice evaluation using self-administered GFI and GRBAS scale assessment are important parameters in determining the quality of life among patients with glottal insufficiency undergoing medialization laryngoplasty.</p>

Cavernous hemangioma of the mandible

Objective: To report a case of hemangioma arising from the mandible and its clinical presentation; describe the similarities with which mandibular hemangioma may mimic odontogenic and non-odontogenic lesions; and identify diagnostic and treatment modalities employed in these patients. Methods: Design: Case Report Setting: Tertiary Public Hospital Patient: One Results: A 12-year-old male with intractable gum bleeding exacerbated by intraoperative manipulation of a loose first premolar and uncontrolled by left external carotid ligation, underwent segmental mandibulectomy. The resected segment revealed multiple porosities and a hollow blood-filled cavity. Histopathology confirmed the diagnosis of cavernous hemangioma. Conclusion: Though rare, mandibular hemangiomas should be considered in lesions involving the mandible. Diagnosis is difficult with an array of lesions that may appear clinically and radiographically similar. The non-specific signs and symptoms of mandibular hemangioma could lead to exsanguinating hemorrhage if not attended to promptly.