RESUMO
AIMS: To evaluate the efficacy and clinical impact of FDG-PET in patients with suspected recurrent laryngeal carcinoma. MATERIALS AND METHODS: 15 patients, with suspicion of recurrent laryngeal carcinoma and ambiguous conventional imaging modalities. In all patients a whole body scan was performed with FDG-PET in fasting patients following i.v. administration of 370-444 MBq FDG. The results were confirmed by histology and clinical evolution (follow-up period > 12 months). RESULTS: Prevalence of recurrence was 86.6%. FDG-PET was positive in 13 patients, with confirmation in all cases, and 2 were true negative (TN). Overall sensitivity, specificity, PPV, NPV and accuracy were 100%. FDG-PET changed the modality of treatment in 10 patients (clinical impact 63.3%). CONCLUSIONS: FDG-PET has high clinical impact in patients with a suspicion of recurrent laryngeal carcinoma, and should be incorporated to the diagnostic protocols before making a therapy decision.
Assuntos
Carcinoma/diagnóstico por imagem , Fluordesoxiglucose F18 , Neoplasias Laríngeas/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
The normal inner ear contains different elements belonging to the immune system. Some pathology of the inner ear has been attributed to autoimmune mechanisms, both humoral and cellular. Melatonin, the principal hormone of the pineal gland, modulates the immune system, is involved in autoimmune processes, and mediates free-radical and interleukine production. In a study of the presence of melatonin in rat cochlea, a day-night rhythm of melatonin in cochlea was observed. Melatonin levels are high during dark periods and low during light periods. This rhythm is synchronic with peripheral melatonin circulation. More work, both experimental and clinical, is needed to determine the role of melatonin in the inner ear and its therapeutic usefulness.
Assuntos
Ritmo Circadiano , Cóclea/química , Melatonina/análise , Glândula Pineal/fisiologia , Animais , Feminino , Masculino , Melatonina/metabolismo , Glândula Pineal/metabolismo , Ratos , Ratos WistarRESUMO
Tonsils are a point of contact between the environment and the immune system. The pineal hormone melatonin is influenced by environmental dark-light variations and modulates the immune system. We measured the amount of melatonin present in pediatric tonsillar infectious and obstructive processes. The highest levels of tonsillar melatonin were found in tonsillar hypertrophy and the lowest levels in recurrent acute tonsillitis, with or without hypertrophy. Melatonin has an immunostimulative function and an antiapoptotic effect. The relationship between low tonsillar melatonin concentrations and infection, as well as high melatonin levels and increased tonsillar size is discussed.
Assuntos
Melatonina/análise , Tonsila Palatina/química , Tonsila Palatina/patologia , Tonsilite/imunologia , Tonsilite/patologia , Doença Aguda , Criança , Pré-Escolar , Feminino , Humanos , Hipertrofia/patologia , Masculino , Recidiva , Síndromes da Apneia do Sono/diagnóstico , Síndromes da Apneia do Sono/etiologia , Tonsilite/complicaçõesAssuntos
Corticosteroides/uso terapêutico , Hemangioma/tratamento farmacológico , Hemangioma/patologia , Neoplasias Laríngeas/tratamento farmacológico , Neoplasias Laríngeas/patologia , Laringe/patologia , Corticosteroides/administração & dosagem , Feminino , Hemangioma/diagnóstico , Humanos , Lactente , Neoplasias Laríngeas/diagnóstico , MasculinoRESUMO
We have studied during 1991 a randomized group of 25 cystic fibrosis children whose ages were between 1 and 18 years, analyzing the disease's ENT signs. We have found polyps in the 20% of the patients points up for its high incidence, and the practical absence of otologic, pharyngeal and laryngeal processes.
Assuntos
Fibrose Cística/complicações , Otorrinolaringopatias/etiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Masculino , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/epidemiologia , Pólipos Nasais/etiologia , Otorrinolaringopatias/diagnóstico por imagem , Neoplasias dos Seios Paranasais/diagnóstico por imagem , Neoplasias dos Seios Paranasais/epidemiologia , Neoplasias dos Seios Paranasais/etiologia , Pólipos/diagnóstico por imagem , Pólipos/epidemiologia , Pólipos/etiologia , Estudos Prospectivos , RadiografiaRESUMO
In this study we presents: 6 subglottic stenosis, 2 subglottic hemangiomas, 2 laryngeal webs, 2 laryngeal cysts and 1 laryngoesophageal cleft. Were diagnosed during laryngotracheobronchoscopies performed to 220 newborns and small children that showed as main finding: stridor, voice change or aspiration syndrome. The stenosis, hemangiomas and cleft were resolved spontaneously. In the webs and cysts surgical correction was required. Here we will expound upon clinical, diagnostical and therapeutic aspects of these rare congenital laryngeal anomalies.
Assuntos
Doenças da Laringe/congênito , Laringe/anormalidades , Anormalidades Congênitas/terapia , Feminino , Humanos , Recém-Nascido , Doenças da Laringe/terapia , MasculinoRESUMO
Four cases of Histiocytosis X are presented here, with symptoms otorhinolaryngologic. The evolution has been good, so they have been without disease for three of four years. We are presenting the problem of differential diagnosis of this disease for ENT specialists and the delay in the diagnosis. All our cases were diagnosed after one year of the beginning of symptoms.
Assuntos
Histiocitose de Células de Langerhans/complicações , Otorrinolaringopatias/etiologia , Pré-Escolar , Diagnóstico Diferencial , Feminino , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/diagnóstico por imagem , Humanos , Lactente , Otorrinolaringopatias/diagnóstico , RadiografiaRESUMO
Relapsing polychondritis is not a very frequent systemic disease. Nevertheless, it has to be borne in mind since very often the first symptoms appear in the sphere of otorhinolaryngology. We are faced with the problem of differential diagnosis in a case which in the beginning seemed to be a neurological pattern. The definitive diagnosis was not established until 15 months after the appearance of the symptoms when, after several outbreaks, the clinical pattern was clearer. As we have to deal with a recurrent and systemic pathology whose diagnosis is eminently clinical, long-term pursuit and valuation are necessary to allow us to know the natural history of the disease as well as the reaction to the treatment.