ABSTRACT
The case records of 213 fine-needle aspiration biopsies (FNAB) of head and neck masses performed on 209 patients over a 3-year period were reviewed to assess the diagnostic accuracy and safety of this technique in comparison with surgical histologic examination. Cytologic diagnoses based on FNAB were compared with histologic diagnoses in 110 patients who underwent surgery. Based on cytology alone, 40.3% of the lesions were reported as malignant, 45.1% as benign, and 14.6% as indeterminant. A specific cytologic diagnosis was made in 85.5% of the cases. Cytologic diagnoses concurred with surgical histologic diagnoses 90% of the time. Fine-needle aspiration biopsy was found to have a false-positive rate of 0.5% and a false-negative rate of 2.3%. The sensitivity and specificity of FNAB in determining a malignant diagnosis were 81.1% and 99%, respectively. Positive and negative predictive values were calculated at 98.9% and 82.8%, respectively. Diagnostic rate, sensitivity, and negative predictive value increased consistently throughout the study period, indicating that the diagnostic accuracy of FNAB improved with experience.
Subject(s)
Biopsy, Needle , Head and Neck Neoplasms/pathology , Head , Neck/pathology , Biopsy, Needle/instrumentation , Biopsy, Needle/methods , Cytodiagnosis , Diagnosis, Differential , Histological Techniques , Humans , Mouth Diseases/pathology , Needles , Parotid Diseases/pathology , Retrospective Studies , Scalp/pathology , Sensitivity and Specificity , Thyroid Diseases/pathologyABSTRACT
Nitrous oxide is an important and widely used anesthetic agent. However, during lengthy surgical procedures, significant amounts of nitrous oxide diffuse into the endotracheal tube cuff, causing sequelae that may include increased cuff pressures, tracheal trauma, increased postoperative discomfort, and cuff rupture. In this paper, two cases are presented in which the endotracheal tube cuff used to deliver this anesthetic agent ruptured after more than four hours of surgery. Two simple means of limiting the diffusion of nitrous oxide into the cuff and thus preventing this occurrence are described.
Subject(s)
Anesthesia, Inhalation , Intubation, Intratracheal/instrumentation , Nitrous Oxide , Adult , Equipment Failure , Humans , Intubation, Intratracheal/adverse effects , Male , PressureABSTRACT
Ibuprofen is a frequently used medication, and possible drug reactions should be familiar to the clinician. Because oral manifestations of thrombocytopenia are often the initial finding and possibly represent the only clinical evidence of this disease, the dentist should be able to recognize the significance of these lesions and refer the patient for appropriate evaluation and therapy.
