Non-melanoma skin cancer of the auricle is treated according to national guidelines.

INTRODUCTION: Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are non-melanoma skin cancers (NMSCs) and are the most common malignancies in Caucasians. The purpose of our study was to examine the frequency of the histological types of NMSC located on the auricle, and to determine whether national and international guidelines on NMSC treatment were followed in our ear, nose, and throat (ENT) department. MATERIAL AND METHODS: The present study is a retrospective and descriptive cohort study of patients treated from 1996 to 2011 at the ENT department of The Regional Hospital Viborg. National guidelines issued in 2008 were compared with the given treatment. RESULTS: A total of 54 patients were included in the study, 48 (89%) males and six (11%) females. BCC on the auricle was observed in 26 patients (48%) and SCC in 28 patients (52%). Six females and 20 males were in the BCC group; and only males were in the SCC group. National and international guidelines were followed sufficiently with respect to the treatment of choice - surgery and excision margins. These data were specified in half of the journals and they ranged from six to 20 mm. Not all patients were followed-up sufficiently according to the guidelines. CONCLUSION: BCC and SCC were observed equally on the auricle in our study. This confirms that BCC and SCC of the auricle are represented differently than on the other parts of the body. The national and international guidelines on NMSCs are sufficiently followed with regard to treatment of choice and excision margins; however, the follow-up should be more precise. FUNDING: not relevant. TRIAL REGISTRATION: This study was registered with and approved by the Danish Data Protection Agency (Datatilsynet).

Cervicofacial nontuberculous mycobacterial lymphadenitis in children.

INTRODUCTION: Nontuberculous mycobacteria are ubiquitous organisms readily isolated from natural waters, drinking water systems and soil. They form a continuous challenge to the human immune system which becomes apparent in patients with impaired immunity. However, most infections occur in seemingly healthy children. The clinical presentation consists of a unilateral, non-tender, persistent, cervical lymphadenopathy without systemic illness. Fistula formation may occur. MATERIAL AND METHODS: Patients were included if one or more of the following were positive; 1) mycobacterial culture, 2) acid-fast microscopy, 3) polymerase chain reaction and/or 4) granulomatous inflammation. RESULTS: On the basis of operative management, two distinct groups were established. Group 1 had an excision of all pathological tissue performed and Group 2 was treated with incision and drainage. There was a difference between the two groups in regard to the risk of developing a postoperative fistula. In Group 1, 50% developed a fistula compared with 91% in Group 2 (p = 0.06). CONCLUSION: Surgical treatment is generally advocated as the treatment of choice. Antibiotic treatment is associated with adverse effects and avoidance of surgery does not justify the inferior results related to antibiotics. A watch-and-wait strategy or antibiotic therapy may be considered when surgical excision carries a high risk of facial nerve injury. Although the lymph nodes may persist for months, spontaneous regression may occur and the children remain systemically well. FUNDING: not relevant. TRIAL REGISTRATION: not relevant.

[Laryngomalacia treated with CO2 laser]. / Laryngomalaci behandlet med CO2-laser.

Laryngomalacia is the most common laryngeal anomaly which causes inspiratory stridor in newborns. The disease is usually self-limiting and resolves before the age of two years. We present a case of severe laryngomalacia with feeding disorder and airway obstruction which needed surgical management--supraglottoplasty. The shortened aryepiglottic folds were incised using CO(2) laser and jet ventilation. The patient was observed at the hospital for one week after surgery and discharged. Four weeks after treatment, the patient was free of airway obstruction and feeding problems.

Post-thyroidectomy hemorrhage: a national study of patients treated at the Danish departments of ENT Head and Neck Surgery.

As bleeding in the neck region is a potentially life-threatening complication, we found it imperative to concretize the frequency and to identify possible reasons for this complication. A national database of all thyroid surgery performed inside the specialty of ENT Head and Neck Surgery (THYKIR) was established in January 2001. This nationwide cohort study represents 5,490 patients included until December 2007. Overall hemorrhage frequency was 4.2% with a wide variation among departments. Multiple regression analysis identified age, male gender, malignant histology and extent of surgery as independent risk factors for hemorrhage. Increased hospital stay and infection rates were found in patients treated with drainage. The median time for onset of postoperative hemorrhage was 3 h (range 0-105). Compared with international literature our incidence of post-thyroidectomy hemorrhage is relatively high. Improvement might be reached by the exchange of experience between departments with focus on adequate surgical technique and careful hemostasis.

[Treatment of Frey syndrome with intracutaneous injections of botulinum toxin]. / Behandling af Freys syndrom med intrakutane injektioner af botulinumtoksin.

In a prospective study, we have examined the efficacy of intracutaneous injections of botulinum toxin in Frey's syndrome. In a controlled study, the long term results after surgical treatment for parotid tumors were investigated in 98 consecutive patients. Patients, who reacted positive by Minor's iodine-starch test, and who had subjective complaints too, were offered treatment. A total of four patients entered the study. The affected area was visualised by Minor's iodine-starch test. The coloured areas were injected with botulinum toxin (Botox) 2.5 U/0.1 ml. We injected 0.5 U/cm2. The distance between each injections points was 1 cm. All patients became free of symptoms. The injections were given with little discomfort to the patients and no side effects. At the control one year after the injections three patients had minor recurrent complaints, which were treated successfully by reinjections. Botulinum toxin injections are thus safe and effective in the treatment of FS.