ABSTRACT
BACKGROUND: Hyperparathyroidism is a frequent affection. Therapeutic management is based on surgical removal of pathological glands. Therapeutic results are ameliorated thanks to preoperative imaging approach. AIM: To evaluate performances of different imaging investigations and scintigraphy for preoperative parathyroid localization. METHODS: Retrospective study about 26 patients with confirmed hyperparathyroidism. RESULTS: After radio-surgical and histological correlation, scintigraphy showed the best rate of sensitivity (92.3%), compared to other morphologic imaging (ultrasonography: 66.6%, CT-scan: 33.3% and MRI: 66.6%). The specificity was the same (100 %). No difference was obseved for both scintigraphic modalities. CONCLUSION: Our results compared to the literature showed that scintigraphy is the most satisfying for preoperative localization of abnormal parathyroid glands in hyperparathyroïdism.
Subject(s)
Hyperparathyroidism/diagnostic imaging , Diagnostic Imaging/methods , Diagnostic Imaging/standards , Efficiency , Female , Humans , Hyperparathyroidism/surgery , Limit of Detection , Magnetic Resonance Imaging , Male , Middle Aged , Predictive Value of Tests , Preoperative Period , Radiography , Retrospective Studies , Tomography, Emission-Computed , UltrasonographyABSTRACT
BACKGROUND: Gastroesophageal reflux is a frequent and benign affection. It represents an etiopathological entity in otorhinolaryngology; that may occasion a large variety of ENT manifestations. AIM: To evaluate clinical and pHmetric impact of gastro esophageal reflux on upper airways in adult. METHODS: Prospective study about 95 cases diagnosed and treated at the ENT department of military hospital of Tunis. Clinical features, pH metric profiles and therapeutic approach are reported and compared to the literature. RESULTS: The mean age was 37 years old. Sex ratio was 1.16. Pharyngolaryngeal symptoms dominated ENT manifestations (41 cases). Laryngeal dyspnea, cough and dysphonia were predictive of danger. Positive pH metric rate collated to posterior laryngitis and pharyngitis were respectively 81.2% and 79.1%. Posterior laryngitis, dental erosion and chronic sinusitis, seem to have pejorative significance. CONCLUSION: Otorhinolaryngologist must think about asymptomatic reflux every time when chronic or recurrent ENT affection remain unexplained after complete clinical investigations. PH monitoring confirms gastroesophageal reflux disease.
Subject(s)
Gastroesophageal Reflux/diagnosis , Gastroesophageal Reflux/physiopathology , Respiratory System/metabolism , Respiratory System/physiopathology , Adolescent , Adult , Aged , Cohort Studies , Esophageal pH Monitoring , Female , Gastroesophageal Reflux/epidemiology , Gastroesophageal Reflux/metabolism , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Prognosis , Respiratory Mucosa/chemistry , Respiratory Mucosa/metabolism , Respiratory Mucosa/physiopathology , Respiratory System/pathology , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/etiology , Young AdultABSTRACT
BACKGROUND: Thyroid microcarcinoma is defined as a tumour of one centimeter or less in its greater diameter. Prognoses and therapeutic modalities remain controversial therapeutic guidelines for surgical treatment. AIM: To analyse the anatomical and clinical characteristics and discuss the modalities of care and therapeutic indications of these microcarcinoma. METHODS: We report a retrospective study concerning 13 cases of thyroid microcarcinoma, diagnosted and treated at the ENT department of Military Hospital of Tunis from 1998 to 2007. RESULTS: The mean age was 41 years and sex-ratio was 0.18. Clinical investigation by cervical ultrasonography found an isolated nodule in 30.7% and a multinodal goiter in 69.2%. Lymph node metastasis was precessiving in two cases. Five patients underwent loboisthmectomy and higt patients had a total thyroidectomy. Surgical lymph node removal was practiced for both cases with preceding cervical node involvement. Iodine 131 ablation was necessary every time when total thyroidectomy was practiced. A six years mean follow-up revealed no recurrence or death. CONCLUSION: Thyroid microcarcinoma is favorable long-term prognosis. Therapeutic modalities are closely depending on risk factors such as histology type, tumor size, lymph node involvement and extra thyroid extension.
