ABSTRACT
This cross-sectional study evaluates the concordance on treatment and diagnostic recommendations between clinicians at 2 collaborating health systems.
Subject(s)
Head and Neck Neoplasms , Humans , Head and Neck Neoplasms/therapy , SpecializationABSTRACT
OBJECTIVES/HYPOTHESIS: To review the literature on neck recurrence in esthesioneuroblastoma. STUDY DESIGN: PubMed database. METHODS: A PubMed database search was performed using keywords "esthesioneuroblastoma," "olfactory neuroblastoma," and "esthesioneuroblastoma neck metastasis." Articles written in English with greater than 10 subjects that had data regarding the association of neck recurrence and mortality and/or the association of neck recurrence with Kadish stage were included for analysis. RESULTS: Thirteen studies met inclusion criteria with information regarding the association of neck recurrence and mortality, and 15 studies had data associating neck recurrence and Kadish stage. The neck recurrence rate was 14.1% in studies analyzing mortality. Among those patients who developed regional metastases, mortality was 60%. Of patients without regional recurrence, the mortality rate from disease was 26% (P < 0.0001) and overall mortality was 32% (P < 0.0001). The rate of neck recurrence within each Kadish stage was 0%, 11%, 21%, and 18% for Kadish stages A, B, C, and D, respectively. The trend toward an increased incidence of neck recurrence from stage A to stage D is statistically significant, with P value 0.003. CONCLUSION: The rate of neck recurrence in esthesioneuroblastoma is close to 15%. There is a strong association of recurrence with Kadish stage B and C. Mortality from disease in patients with recurrence in cervical lymph nodes is significant when compared to those who never develop neck disease. Prospective studies are needed to evaluate a potential role for elective neck dissection versus elective neck radiation for patients with esthesioneuroblastoma. LEVEL OF EVIDENCE: N/A. Laryngoscope, 126:1373-1379, 2016.
Subject(s)
Esthesioneuroblastoma, Olfactory/pathology , Head and Neck Neoplasms/pathology , Nasal Cavity/pathology , Neck/pathology , Neoplasm Recurrence, Local/pathology , Nose Neoplasms/pathology , Esthesioneuroblastoma, Olfactory/mortality , Head and Neck Neoplasms/mortality , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Neoplasm Recurrence, Local/mortality , Nose Neoplasms/mortalityABSTRACT
The most common of the lesions in the carotid space are discussed in relation to their radiographic diagnosis and clinical implications. The appearance of tumors and lesions on computed tomography or magnetic resonance imaging is presented, and their differential diagnosis is discussed. The image of each carotid disease is presented, and the discussion concludes with treatment recommendations and considerations.
Subject(s)
Diagnostic Imaging , Fascia/anatomy & histology , Neck/anatomy & histology , Aortic Dissection/diagnosis , Aneurysm, False/diagnostic imaging , Carotid Artery Diseases/diagnosis , Carotid Artery Diseases/diagnostic imaging , Carotid Artery, Internal/diagnostic imaging , Carotid Body Tumor/diagnosis , Humans , Jugular Veins , Lemierre Syndrome/diagnosis , Magnetic Resonance Imaging , Neck/blood supply , Neck/innervation , Thrombophlebitis/diagnostic imaging , Tomography, X-Ray Computed , Vascular Diseases/diagnosisABSTRACT
The head and pinna shape the sound reaching the tympanum. We explored this signal transformation in humans and a mini basketball for different sound locations in an anechoic chamber. For humans, we embedded microphones in ear molds that were custom fitted to the subject's ear canal. For the ball, the microphones were flush with the surface at +/- 90 degrees azimuths on the equator. Sounds were generated with a custom point source. In the ball, the signal level was nearly flat across frequency, with no gains. In contrast, in the ears, signal level changed in a complex way across frequency, with considerable gains. For frequencies < 2 kHz, the interaural level difference (ILD) increased with decreasing distance similarly in the human ears and ball. For frequencies > 4 kHz, ILDs in the human ears were larger and more complex than those in the ball such that the human ILDs were nonmonotonic with distance whereas the ball ILDs were monotonic with distance.
