Incidence of Surgical Site Infections after Transcervical Thyroidectomy in Patients Given Antibiotics versus those without Antibiotics in a Government Hospital in the Philippines.

Background and Objectives: Surgical site infection (SSI) makes up the largest single group of postoperative infective complications. For surgeries classified as clean surgeries of the head and neck, such as a thyroidectomy, the routine administration of antimicrobial prophylaxis is not recommended. Despite this, extended usage of antibiotics is common in developing countries. This study evaluated the need for antibiotics in elective transcervical thyroidectomy for the prevention of SSI in a tertiary government hospital in a developing country. Methods: This is a retrospective cohort study that included patients who have undergone elective transcervical thyroidectomy at the Department of Otolaryngology - Head and Neck Surgery (ORL-HNS) of the University of the Philippines - Philippine General (UP-PGH) Hospital from August 1, 2020 to June 30, 2022. Data collection was conducted through review of both in-patient and out-patient records. Results: The data of 58 patients were analyzed. The mean (±SD) age was 42.5±14.5 years, with approximately 2:27 male to female ratio. Of the 58 patients, 26 were given postoperative antibiotics while 32 did not receive postoperative antibiotics. None of the 58 were noted to have SSI on the 3rd postoperative day. Only 54 patients completed the 7-day follow-up of the study and their data were further analyzed. One patient had SSI. There was no significant difference between the presence and absence of postoperative antibiotics in relation to SSI (p-value>0.05). Conclusion: This study shows that in patients undergoing transcervical thyroidectomies, there is no significant difference in the occurrence of SSI among patients who received and did not receive postoperative antibiotics. Therefore, there is no need to administer postoperative antibiotics, as long as a sterile surgical technique is ensured.

Combined external and endoscopic transnasal approach with use of a diamond burr in the removal of a fishing harpoon hook traversing bilateral sphenoid sinuses in a 22-year-old man.

A 22-year old construction worker was shot with a fishing harpoon gun on the left side of his face. He consulted at the emergency room 12 days postinjury, stable but with blurring of vision on the right. The shaft of the harpoon was protruding at the left preauricular area; the tip was neither visible nor palpable. Craniofacial CT scan and skull anteroposterolateral radiographs revealed the tip of the harpoon to be at the right orbital apex. A hook attached 1 cm from the tip was lodged in the sphenoid sinus. The hook was dismantled from the shaft via a combined external and endoscopic transnasal approach, enabling the shaft to be gently pulled. The hook, together with the tip, were removed endoscopically. The patient's visual acuity improved. He was discharged after 2 days on oral antibiotics with no deficits on follow-up.

Temporal Bone Chondroblastoma: Systematic Review of Clinical Features and Outcomes.

OBJECTIVE: Chondroblastoma is an uncommon benign neoplasm of cartilaginous origin usually involving the long bones. The temporal bone is a rare location for this tumor. The clinical profile, optimal medical and surgical management, and outcomes of treatment for temporal bone chondroblastoma remain unknown. METHODS: We performed a systematic review of the SCOPUS, PubMed, and CENTRAL databases for case reports and case series on patients with histopathologically proven temporal bone chondroblastoma. Data on demographics, clinical manifestation, surgical management, adjuvant treatment, and outcome on last follow-up were collected. RESULTS: A total of 100 cases were reported in the literature, including one described in the current study. The mean age of patients was 42.3 years (range, 2-85 years), with a slight male predilection (1.3:1). The most common clinical manifestations were otologic symptoms (e.g., hearing loss [65%], tinnitus, and otalgia) and a palpable mass. Surgical excision was performed in all cases, with gross total excision achieved in 58%. Radiation therapy was performed in 18% of cases, mostly as adjuvant treatment after subtotal excision. There were no deaths at a median follow-up of 2 years. Among the patients with detailed status on follow-up, 58% had complete neurologic recovery, 38% had partial recovery, and 4% had progression of symptoms as a result of tumor recurrence. CONCLUSIONS: Temporal bone chondroblastoma has a distinct clinical profile from chondroblastoma of long bones. Surgery is the mainstay of treatment, and radiation therapy may be given after subtotal excision. Outcomes are generally favorable after treatment.

Development and validation of a thyroid cancer-specific health-related quality of life questionnaire for adult Filipinos with differentiated thyroid cancer / Journal of the ASEAN Federation of Endocrine Societies

@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> The study aims to develop and validate a health-related quality of life (HRQoL) questionnaire for adult Filipinos with differentiated thyroid cancer (DTC) that can be used in combination with the European Organization for Research and Treatment of Cancer QLQ-C30 Questionnaire.<br /><strong>METHODOLOGY:</strong> The study had 4 phases. Phase I involved generation of HRQoL issues from literature review, focus group discussions with 6 DTC patients and 5 health care professionals (HCP). Subsequent assessment for relevance and importance of the HRQoL issues by 20 patients and HCP panel was done. Phase II was formulation of the HRQoL issues into questionnaire and subsequent translation into Filipino. Phase III was pilot testing of the questionnaire in 15 patients. Phase IV was validation of the pre-final questionnaire in 231 patients.<br /><strong>RESULTS:</strong> In Phase I, 28 HRQoL issues were generated. In Phase II, a 28-item Filipino questionnaire was created. In Phase III, 22 items that were not upsetting or confusing to patients and with good range of responses were retained. After Phase IV, a 22-item questionnaire with 5 conceptual scales (perceived fears, psychological distress/anxiety, functionality, voice complaints, neck complaints) was created.<br /><strong>CONCLUSIONS:</strong> The developed and validated 22-item questionnaire can be used to assess HRQoL issues in adult Filipinos with DTC.</p>

Tumoral calcinosis in secondary hyperparathyroidism

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To  report  a  case  of  tumoral  calcinosis  from  secondary hyperparathyroidism  and  to describe its surgical management.<br /><strong>METHODS:</strong><br /><strong> Design:</strong> Case Report<br /> <strong>Setting:</strong> Tertiary Public University Hospital<br /> <strong>Patient:</strong> One<br /><strong>RESULTS:</strong> A 34-year-old woman presented with progressively-enlarging bilateral upper extremity masses. Diagnostic tests revealed hyperfunctioning parathyroid glands. The patient underwent subtotal  parathyroidectomy,  right  thyroid  lobectomy  with  isthmusectomy,  and  transcervical thymectomy.    Follow-up  revealed  marked  decrease  in  parathyroid  hormone,  and  progressive resolution of the tumoral calcinosis.<br /><strong>CONCLUSION:</strong> Subtotal  parathyroidectomy  and  transcervical  thymectomy  have  a  role  in  the management  of  tumoral  calcinosis,  and  in  this  case  led  to  excellent  post-operative  results. The rare  presentation  of  secondary  hyperparathyroidism  and  intervention  in  this  patient  may  have potential lessons for future management of similar cases.</p>

Primary hyperparathyroidism due to an intrathyroidal parathyroid adenoma associated with chronic lymphocytic thyroiditis.

This is a case of a 44-year-old woman with an anterior neck mass and hypothyroidism who presented with an incidental finding of an elevated serum calcium level and was found to have primary hyperparathyroidism and osteoporosis. During surgical exploration no parathyroid adenoma was found, although a nodule was palpated within the right thyroid lobe. Examination of the excised right thyroid lobe revealed an intrathyroidal parathyroid adenoma and chronic lymphocytic thyroiditis. After surgery, she did not develop severe hypocalcaemia and this was attributed to preoperative treatment with pamidronate. In the months following surgery, parathyroid hormone remained undetectable.

Oncocytic carcinoma of the nasal septum, a rare cause of unilateral epistaxis

A case of a 74-year-old male with unilateral nasal obstruction, recurrent epistaxis and a right intranasal mass is presented. It was initially diagnosed as hemangioma but final histopathology report revealed oncocytic carcinoma. Oncocytic carcinoma is a rare tumor of the salivary glands with very few reported cases, most of which involve the parotid gland. It has a tendency to recur with inadequate excision. Diagnosis is histopathologic. It is to be emphasized that adequate tissue samples should be taken in order to provide a definite diagnosis from biopsy, and subsequently institute proper definitive management.