ABSTRACT
Introduction Thyroid cancer incidence has increased in the previous 2 decades. Preoperative identification of lymph node metastasis is a suggested risk factor associated with recurrence following thyroidectomy. Objectives We aimed to evaluate the accuracy of preoperative radiologic investigations of nodal status in determining the postoperative risk of regional nodal recurrence in cases of well-differentiated thyroid cancer. Methods This is a case series. We retrospectively reviewed data, including preoperative ultrasonography and/or computed tomography results, on patients who underwent total thyroidectomy for thyroid cancer at our hospital between 2006 and 2012. Prognostic factors for predicting recurrence, including age, sex, tumor diameter, and nodal diameter, were evaluated. Results Total thyroidectomy was performed on 24 male and 74 female patients (median age, 43 years). The median follow-up time was 21 months. Sixty-eight patients had papillary thyroid cancer, and 30 had follicular cancer. Nodal recurrence was evident in 30% of patients, and 4% of patients died. Identification of lymph node involvement during preoperative radiologic investigations was strongly prognostic for recurrence: 35.3% of patients with positive preoperative ultrasonography findings and 62.5% of those with positive preoperative computed tomography findings had recurrence (p = 0.01). Conclusions Preoperative identification of lymph node metastasis on radiologic studies was correlated with an increased risk of regional nodal recurrence in well-differentiated thyroid cancer. Computed tomography was superior to ultrasonography in detecting metastatic nodal involvement preoperatively and is therefore recommended for preoperative assessment and postoperative follow-up. .
Subject(s)
Animals , Humans , Hematopoiesis/genetics , Leukemia, Myeloid, Acute/genetics , Zebrafish Proteins/physiology , Zebrafish/physiology , /physiology , Amino Acid Sequence , Animals, Genetically Modified , Conserved Sequence , Embryo, Nonmammalian , Molecular Sequence Data , Protein Structure, Tertiary/genetics , Sequence Homology, Amino Acid , Tandem Repeat Sequences , Transcriptome , Zebrafish Proteins/chemistry , Zebrafish/embryology , /chemistryABSTRACT
Introduction Thyroid cancer incidence has increased in the previous 2 decades. Preoperative identification of lymph node metastasis is a suggested risk factor associated with recurrence following thyroidectomy. Objectives We aimed to evaluate the accuracy of preoperative radiologic investigations of nodal status in determining the postoperative risk of regional nodal recurrence in cases of well-differentiated thyroid cancer. Methods This is a case series. We retrospectively reviewed data, including preoperative ultrasonography and/or computed tomography results, on patients who underwent total thyroidectomy for thyroid cancer at our hospital between 2006 and 2012. Prognostic factors for predicting recurrence, including age, sex, tumor diameter, and nodal diameter, were evaluated. Results Total thyroidectomy was performed on 24 male and 74 female patients (median age, 43 years). The median follow-up time was 21 months. Sixty-eight patients had papillary thyroid cancer, and 30 had follicular cancer. Nodal recurrence was evident in 30% of patients, and 4% of patients died. Identification of lymph node involvement during preoperative radiologic investigations was strongly prognostic for recurrence: 35.3% of patients with positive preoperative ultrasonography findings and 62.5% of those with positive preoperative computed tomography findings had recurrence (p = 0.01). Conclusions Preoperative identification of lymph node metastasis on radiologic studies was correlated with an increased risk of regional nodal recurrence in well-differentiated thyroid cancer. Computed tomography was superior to ultrasonography in detecting metastatic nodal involvement preoperatively and is therefore recommended for preoperative assessment and postoperative follow-up.
ABSTRACT
OBJECTIVE: To compare hearing impairment and audiometric shapes associated with type 2 diabetes mellitus (T2DM) with an age-matched control group in the Saudi population. METHODS: This is an observational case-control study at a tertiary academic referral center. We recruited 196 individuals (age; 29-69 years) attending the Department of Otolaryngology, King Abdulaziz University Hospital between January 2005 to December 2009, and grouped them into T2DM (n=109) and control (n=87) groups. We excluded patients with a history of noise exposure, conductive hearing loss, ototoxic medications, and a positive family history of hearing impairment. Age, gender, family history, duration of T2DM, current treatment, and presence of diabetic complications were noted. Pure tone hearing (in decibels [dB])was recorded. Data were statistically analyzed against the matched control group. RESULTS: We identified a strong relationship between T2DM and low and mid frequencies hearing loss than the matched controls. A flat audiogram was the most common audiometric shape observed. Patients with associated diabetic complications were at a higher risk of hearing loss, while hyperglycemic control by insulin was also observed to be a risk factor for hearing loss. CONCLUSION: The T2DM is strongly associated with hearing loss especially in the low and mid frequencies. Several factors including age, diabetes control by insulin, and presence of complications, may be risk factors for hearing loss in DM patients.
