Facial nerve palsy: an unusual presenting feature of small cell lung cancer.

Lung cancer is the second most common type of cancer in the world and is the most common cause of cancer-related death in men and women; it is responsible for 1.3 million deaths annually worldwide. It can metastasize to any organ. The most common site of metastasis in the head and neck region is the brain; however, it can also metastasize to the oral cavity, gingiva, tongue, parotid gland and lymph nodes. This article reports a case of small cell lung cancer presenting with metastasis to the facial nerve.

Serum paraoxonase activity and oxidative DNA damage in patients with laryngeal squamous cell carcinoma.

OBJECTIVES: To determine the possible role of oxidants and antioxidants in the pathogenesis of in laryngeal squamous cell carcinoma. DESIGN AND SETTING: Our study involved patients with newly diagnosed laryngeal cancer (n = 29) and same age- and sex-matched healthy individuals (n = 21). Serum malondialdehyde (MDA) and paraoxonase (PON1) levels were measured by colorimetric methods and 8-hydroxy-2'-deoxyguanosine (8-OH-dG) was measured using enzyme-linked immunosorbent assay in fasting blood samples of participants. RESULTS: The levels of 8-OH-dG (control, 4.61 ± 1.27 ng/mL; patient, 11.70 ± 2.44 ng/mL; P < 0.001) and MDA (control, 4.16 ± 1.02 nmol/mL; patient, 8.74 ± 1.65 nmol/mL; P < 0.001) were significantly higher, and those of PON1 (control, 170.86 ± 72.46 U/mL; patient, 80.44 ± 29.81 U/mL; P < 0.001) were significantly lower in patients. There were no statistically significant differences in the 8-OH-dG, MDA levels, and PON1 activity in relation to T (tumor) staging of differentiation and different smoking/drinking status. There was a statistically significant difference in MDA levels (10.24 ± 0.64 nmol/mL) only in stage II laryngeal cancer. There were a statistically significant positive correlation between serum MDA and 8-OH-dG (r = 0.887, P < 0.001), a statistically significant negative correlation between serum MDA and serum PON1 (r = -0.477, P < 0.01), and a statistically significant negative correlation between serum 8-OH-dG and serum PON1 in patients (r = -0.420, P < 0.05). CONCLUSIONS: We conclude that, in patients with laryngeal squamous cell carcinoma, the oxidant/antioxidant balance was impaired in favor of lipid peroxidation and DNA damage.

Modified midfacial degloving approach for sinonasal tumors.

A perfect surgical approach to nasal cavity and paranasal sinus tumors should provide a broad exposition preserving the important structures with no cosmetic defect. Midfacial degloving (MD) technique provides good exposure without incisions and scars in the face. Classic MD technique includes rhinoplasty incisions. However, combination of the facial plastic skills of the rhinoplasty techniques with an oncologic approach limits its popularity. We modified the classic technique, which is performed without classic rhinoplasty incisions. The surgical approaches to 55 patients with benign and malignant sinonasal neoplasms are reviewed, and the modification of MD technique performed without rhinoplasty incisions is described. The study includes 41 male and 13 female patients with both benign and malignant sinonasal neoplasms. The ages of the patients were between 9 and 78 years with a mean age of 41.15 years. Follow-up of the patients ranged from 2 to 96 months with a mean of 31.7 months. Most of the cases were angiofibroma and inverted papilloma. Modified MD approach was used for all patients, and in 6 cases, the technique was combined with subcranial approach. We successfully resected the tumors in all of the patients. The most frequently encountered complaint in the postoperative period was temporary nasal crusting and epistaxis. An important complication was the rupture of subpetrous part of the internal carotid artery in one patient and also a temporary facial palsy in another one. Palatal dysfunction, oroantral fistula, or vestibular stenosis, which are significant complications of MD, were not observed in any of our cases. In this modified technique, rhinoplasty incisions are not used; therefore, the duration of operation is shortened, the technique becomes easier, and the incisions of the rhinoplasty procedure, which could cause circular stenosis, are avoided.

Diagnostic value of peripheral lymph node biopsy in sarcoidosis: a report of 67 cases.

A peripheral lymph node (PLN) 1 cm or greater was found in 79 of 546 sarcoidosis patients (14.5%) between 1972 and 2005. Seventy-two of the 79 sarcoidosis patients had a lymph node biopsy performed. Sixty-seven of these biopsy specimens were histologically diagnosed as sarcoidosis, whereas five patients had a reactive adenopathy. For patients with histological diagnosis of sarcoidosis, localizations of the biopsies were as follows: cervical (n=21), supraclavicular (n=20), inguinal (n=11), axillary (n=8), epitrochlear (n=5) and submandibular (n=2). At the time of biopsy, 12 patients had stage 0 disease, 37 patients had stage I disease, 14 patients had stage II disease and four patients had stage III disease. Skin involvement (16.4%) was the most frequently observed type of organ involvement in patients who had enlarged PLNs due to sarcoidosis. In the presence of an enlarged PLN in sarcoidosis, biopsy had a greater diagnostic value compared with other methods, as well as having a relatively low cost (approximately US$120) in Turkey. No procedure-related complications were observed. In conclusion, it is recommended that PLNs be thoroughly examined when sarcoidosis is suspected. If an enlarged PLN is found, biopsy should be routinely performed because it is an easy, convenient and practical method, with a low complication risk and a high sensitivity.

Upper respiratory tract involvement of sarcoidosis in the Turkish population.

PRINCIPLES AND METHODS: Upper respiratory tract (URT) involvement is rare in sarcoidosis. In this descriptive study, we retrospectively evaluated the clinical and demographic features of 12 (2.19%) patients with URT involvement out of the 546 sarcoidosis patients with follow-up visits at our center within the last 40-year period. RESULTS: Out of the 546 patients, 12 (2.19%) had upper respiratory tract involvement, 5 (0.91%) had laryngeal involvement, 4 (0.73%) had sinonasal tract involvement, 2 (0.36) patients had salivary gland involvement, and 1 patient had tonsillary involvement. The number of stage 0 subjects among other sarcoidosis patients was significantly lower than that among those with URT involvement. CONCLUSIONS: URT involvement is rarely diagnosed in patients with systemic sarcoidosis. The most common site for URT involvement among the Turkish population is the larynx, followed by the sinonasal tract. EBM RATING: C-4.

Laryngeal chondroma presenting as a laryngopyocele.

The abnormal dilatation of saccules in direct communication with the laryngeal lumen is termed laryngocele. A simple laryngocele is an air-filled dilatation of the saccule and is mostly asymptomatic. When the neck of the laryngocele is obstructed, the laryngocele becomes filled with mucus. If a mucus-filled laryngocele is infected, it is called a laryngopyocele. The etiology of laryngoceles is not well understood. However, there is an association between laryngoceles and carcinoma of the supraglottic larynx. The main reasons are probably obstruction and mucosal retention of the saccule, increasing intralaryngeal pressure due to airway obstruction or abnormal contraction of the involved laryngeal muscles due to tumoral spreading. We present a patient with laryngopyocele that arose because of a laryngeal chondroma.