Clinicopathological determinants of positron emission tomography computed tomography fluorodeoxyglucose standardised uptake value in head and neck carcinoma.

BACKGROUND: Although positron emission tomography computed tomography has proven diagnostic and staging value in head and neck carcinoma, it does not have optimal sensitivity or specificity. The positron emission tomography computed tomography fluorodeoxyglucose standardised uptake value has been shown to be associated with carcinoma stage. This study evaluated the impact of major clinicopathological factors on the standardised uptake value at the primary site and at neck lymph node metastases. SUBJECTS AND METHODS: Two hundred and forty-three oral cavity and laryngopharyngeal carcinoma patients who underwent positron emission tomography computed tomography were included. Correlation between the positron emission tomography computed tomography standardised uptake value and various clinicopathological factors was analysed. RESULTS: A positive correlation was found between the standardised uptake value and the size and depth of tumour infiltration, and lymph node positivity. Higher standardised uptake values were seen for more advanced tumour stages. The presence of perineural invasion, lymphatic invasion and extracapsular spread were all associated with increased standardised uptake values. CONCLUSION: Most of the clinicopathological features of head and neck carcinoma which are well known to be poor prognostic factors have a significant impact on positron emission tomography computed tomography fluorodeoxyglucose standardised uptake value.

Improvement in quality of life by adenotonsillectomy in children with adenotonsillar disease.

OBJECTIVES: To evaluate the effect of adenotonsillectomy on quality of life of children with adenotonsillar disease and to evaluate the basal differences and post-surgical changes of life quality in children with different disease severity. STUDY DESIGN: Prospective, case - controlled study. SETTING: Tertiary referral center. PARTICIPANTS AND MAIN OUTCOME MEASURES: Preoperative and postoperative quality of life of 40 children with adenotonsillar disease were determined by pedsQL™, and disease severity was assessed in terms of a score obtained by tonsil and adenoid health status instrument (TAHSI). These children comprised the study group. Median of scores of study group was 31. Twenty-one children with a score less than 31 comprised the study subgroup I, while 19 children with a score bigger than 31 comprised the study subgroup II. Thirty normal children comprised the control group. Comparisons of data obtained from affected and healthy children and their parents were made. RESULTS: The mean preoperative physical, emotional, social, school and total quality of life scores of the study group were 64.81, 49.62, 76.37, 66.62 and 64.41; postoperatively 83.67, 75.75, 85.75, 87.25, 83.18; and control group were 82.21, 77.50, 92.50, 90.50, 85.40, respectively. There was highly statistically significant difference between all preoperative and postoperative scores of the study group. There was highly statistically significant difference between all preoperative scores of the study and control group. There was no statistically significant difference in preoperative and postoperative scores between the study subgroups. The improvement after surgery was not statistically significant between mild and severe group except for emotional scale. CONCLUSION: Children with adenotonsillar disease showed significant improvements in disease-specific and global quality of life after adenotonsillectomy as measured by TAHSI and PedsQL. Preoperative and postoperative life quality does not differ according to severity of the disease. The improvement provided by adenotonsillectomy in the children with mild disease is statistically not different from the severely affected children in overall life quality.

Laryngocoele as an unusual complication of supracricoid partial laryngectomy: evaluation of 62 cases.

BACKGROUND: This study sought to evaluate the incidence, aetiology, clinical features and treatment modalities for laryngocoele formation after supracricoid partial laryngectomy. METHODS: The medical charts of 62 patients who had undergone supracricoid partial laryngectomy were reviewed. RESULTS: Three patients developed laryngocoele, giving an incidence of 4.8 per cent. Two of these patients presented with a cervical mass, dyspnoea and fever. The mobility of the arytenoids was disturbed on the involved side. The third patient was admitted complaining only of a compressible cervical mass. In all patients, diagnosis was made by computed tomography scan. The transcervical surgical approach was preferred for resection. CONCLUSION: Laryngocoele can occur as a late complication of supracricoid partial laryngectomy. Remnants of the laryngeal ventricle may be the cause of laryngocoele formation. The integrity of the laryngeal ventricle in the resected specimen should be routinely checked in order to avoid this rare complication. Clinicians should be aware that, following supracricoid partial laryngectomy, a cervical mass presenting with dyspnoea and disturbance of arytenoid mobility does not always indicate tumour recurrence.

Effect of nasolacrimal duct obstruction on nasal mucociliary transport.

BACKGROUND: Most patients with nasolacrimal duct obstruction have dry, crusty nasal mucosa. Mucociliary clearance is modulated by the amount and biochemical composition of nasal mucus. Nasolacrimal duct obstruction disturbs the drainage of tears into the nasal cavity. OBJECTIVE: We examined the effect of nasolacrimal duct obstruction on the mucociliary transport of nasal mucosa, by comparing saccharine test results for epiphora patients versus healthy volunteers. STUDY DESIGN: Prospective, randomised, clinical trial. METHODS: Eight patients with bilateral epiphora and 10 patients with unilateral epiphora were included in the study group. Complete nasolacrimal duct obstruction was demonstrated by studying irrigation of the nasolacrimal system, and by fluorescein dye study. The control group comprised 20 healthy volunteers. Mucociliary transport was assessed by the saccharine test in both the study and control groups. The saccharine transit times of 26 impaired nasal cavities were compared with those of 20 healthy nasal cavities of controls. Also, the saccharine transit times of the healthy nasal cavities of the 10 patients with unilateral epiphora were compared with those of their diseased sides, and also with those of healthy volunteers. RESULTS: The saccharine transit times of the epiphora patients were statistically significantly greater than those of the control group. Also, there was a statistically significant difference in saccharine transit times, comparing the healthy and impaired nasal cavities of patients with unilateral epiphora. CONCLUSION: Nasolacrimal duct obstruction has a negative effect on nasal mucociliary clearance. This may be related to changes in the amount and biochemical composition of nasal mucus.