RESUMEN
Children with lymphangiomatous macroglossia often have difficulty eating and talking, and their airways may be compromised because of bleeding and infection, especially when extensive cervicomediastinal cystic hygromas are present. We report a case of lymphangiomatous macroglossia associated with extensive cystic hygromas in the cervicomediastinal region. The 3-year-old girl was treated with anterior wedge reduction of the tongue, needle aspiration of the cervicomediastinal cystic hygromas, and systemic steroids and antibiotics. The extensive cystic cervicomediastinal hygromas spontaneously regressed, and further surgery was not needed until 4 years later. Surprisingly, subtotal or partial lymphatic malformation removal improved the complicated lymphatic malformation.
Asunto(s)
Neoplasias de Cabeza y Cuello/complicaciones , Linfangioma Quístico/complicaciones , Linfangioma/complicaciones , Macroglosia/complicaciones , Neoplasias del Mediastino/complicaciones , Neoplasias de la Lengua/complicaciones , Preescolar , Femenino , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Linfangioma Quístico/cirugía , Macroglosia/terapia , Neoplasias del Mediastino/cirugíaRESUMEN
Both carotid canal dehiscence (CCD) and high jugular bulb (HJB) are thought to increase the potential for disastrous consequences during middle ear surgery. Clinical co-presentation of these two great vessel variants has not yet been described. This study aims to determine the relationship between CCD and HJB based on a computed tomographic (CT) temporal bone evaluation. High-resolution CT scans of 408 temporal bones obtained from 208 adults were recruited. Carotid canal integrity, jugular bulb position, petrous apex pneumatization and the minimal thickness of the carotid canal wall (TCW) facing the tympanic cavity were examined and measured for the incidence of CCD and/or HJB. Other variables including gender, age, laterality and the presence of otitis media or mastoiditis were also collected for analysis. CCD was found in 28 ears (6.9%); 19 of these were found to also have HJB (67.9%). The presence of CCD was significantly correlated with HJB presentation. The minimal TCW in HJB ears was significantly thinner than that of normally positioned jugular bulbs. Moreover, after controlling for other candidate variables, the independent factors of age (younger or older than 50 years) and jugular bulb position (high vs. normal) were found to predict the presence of CCD. In conclusion, HJB tends to coexist with a thinner carotid canal wall. This finding emphasizes the need to be watchful for the coexistence of these two great vessel anomalies when surgeons encounter an aged patient presenting either CCD or HJB during middle ear surgery.
Asunto(s)
Oído Medio/cirugía , Complicaciones Intraoperatorias/diagnóstico por imagen , Venas Yugulares/anomalías , Venas Yugulares/diagnóstico por imagen , Dehiscencia de la Herida Operatoria/diagnóstico por imagen , Adulto , Anciano , Arterias Carótidas/diagnóstico por imagen , Oído Medio/diagnóstico por imagen , Femenino , Humanos , Incidencia , Complicaciones Intraoperatorias/epidemiología , Complicaciones Intraoperatorias/prevención & control , Modelos Logísticos , Masculino , Mastoiditis/diagnóstico por imagen , Mastoiditis/epidemiología , Persona de Mediana Edad , Análisis Multivariante , Otitis Media/diagnóstico por imagen , Otitis Media/epidemiología , Hueso Petroso/diagnóstico por imagen , Valor Predictivo de las Pruebas , Cuidados Preoperatorios , Estudios Retrospectivos , Dehiscencia de la Herida Operatoria/epidemiología , Dehiscencia de la Herida Operatoria/prevención & control , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
BACKGROUND: The purpose of this study was to identify and describe the knowledge and attitudes of cigarette smoking that are associated with smoking habits among young military conscripts in Taiwan. METHODS: We conducted a cross-sectional survey of young conscripts in southern and eastern Taiwan between August 1 and December 31, 2001. We selected 3,249 young military conscripts who had served more than 1 month in the military, based on specific criteria. We used a standard structured questionnaire to collect information about the respondents' sociodemographic characteristics, lifestyle, knowledge, attitude, and cigarette smoking practices. RESULTS: Our findings showed that among smoking young military conscripts, knowledge about smoking was lower and attitudes toward smoking were more negative when compared with the non-smokers. Knowledge and attitudes about smoking varied with sociodemographic characteristics (age, education level, residential area) and lifestyle (cigarette smoking, betel nut chewing, alcohol drinking), all p < 0.05. Subjects with greater knowledge about smoking had a lower risk of smoking (odds ratio, 0.88; 95% confidence interval, 0.86-0.91). But this characteristic diminished after being adjusted for potential confounders. In addition, subjects with a higher attitude score about smoking had relatively lower risk for cigarette smoking when compared to those with a lower attitude score, even after adjusting for potential confounders (odds ratio, 0.93; 95% confidence interval, 0.91-0.94). CONCLUSION: Knowledge and attitudes about smoking are significantly associated with the status of cigarette smoking. These findings can help public health professionals develop effective policies and smoking prevention and cessation programs among young military conscripts in Taiwan.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Personal Militar , Fumar/psicología , Adulto , Estudios Transversales , Humanos , Modelos Logísticos , Masculino , Adulto JovenRESUMEN
BACKGROUND: The purpose of this study was to identify the most important risk factors that influence cigarette smoking among young adult military conscripts in Taiwan. METHODS: A cross-sectional survey was conducted among young conscripts (19-25 years old) in Taiwan from August to December 2001. A total of 3,569 conscripts who had served more than 1 month in the military were chosen. Information regarding cigarette smoking and other factors was collected using a standard structured questionnaire. RESULTS: Subjects whose lifestyles included betel-nut chewing (OR, 16.81; 95% CI, 11.35-25.91) and alcohol drinking (OR, 2.11; 95% CI, 1.54-2.90) were more likely to smoke compared to subjects without these adverse behaviors. Subjects whose education stopped at junior high school or before were more likely to smoke compared to those with a university degree (OR, 5.36; 95% CI, 3.77-7.69). Subjects who had a higher proportion of peers who smoked were more likely to smoke compared to those with no peers who smoked (OR, 3.16; 95% CI, 2.42-4.15). Subjects whose parents and peers approved of smoking were also at a higher risk for smoking compared with those whose parents and peers disapproved (father's approval---OR, 3.28 and 95% CI, 2.02-5.43; mother's approval---OR, 3.11 and 95% CI, 1.47-7.12; peer approval---OR, 2.27 and 95% CI, 1.60-3.22). CONCLUSION: From this study, we found that education level, betel-nut chewing, alcohol intake, smoking behavior of peers, and the attitudes of parents and peers toward smoking are all associated with the risk of a young adult conscripts becoming a habitual cigarette smoker. These results provide insight for targeting critical risk factors in helping these individuals control or cease their cigarette smoking habit in the future.
Asunto(s)
Personal Militar , Fumar , Estudios Transversales , Humanos , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Taiwán , Adulto JovenRESUMEN
BACKGROUND: Recurrent laryngeal papillomatosis is caused by the human papilloma virus and characterized by multiple exophytic lesions of the vocal tract; it is a benign disease, but one that tends to recur after removal of growths. Due to the nature of the disease, alternative treatment strategies have focused on antiviral injection at lesion sites that eliminate repeated surgical procedures. The purpose of this study was to evaluate the efficacy of cidofovir injection following initial papilloma excision with a microdebrider. METHODS: Cidofovir injections (at a concentration of 7.5 mg/mL) were conducted in 5 patients (1 child; 4 adults). The injection number per patient varied from 2 mL to 6 mL. Repeated cidofovir injections were indicated only if recurrent or newly grown lesions were found in any of 3-week follow-up visits. RESULTS: Short-term complete remission was observed with different duration, from 11 to 21 weeks, following initial 2 to 3 cidofovir injections. All patients relapsed eventually, and their recurrent lesions were not successfully eradicated by repeated cidofovir injection. One patient's prognosis was complicated by scarring of both vocal cords. CONCLUSION: Surgical excision combined with cidofovir injection failed to prevent relapsing laryngeal papillomatosis. Once lesions recurred, repeated cidofovir injections alone were not able to achieve complete remission, although these procedures might be helpful in lessening the severity of the clinical course. Further studies in determining the dosage, duration of injection, and more long-term follow-up are required to clarify the efficacy of cidofovir for the treatment of recurrent laryngeal papillomatosis.
Asunto(s)
Antineoplásicos/uso terapéutico , Citosina/análogos & derivados , Neoplasias Laríngeas/tratamiento farmacológico , Recurrencia Local de Neoplasia/tratamiento farmacológico , Organofosfonatos/uso terapéutico , Papiloma/tratamiento farmacológico , Adulto , Niño , Cidofovir , Citosina/administración & dosificación , Citosina/uso terapéutico , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Organofosfonatos/administración & dosificaciónAsunto(s)
Tumores de Células Gigantes/diagnóstico , Neoplasias Laríngeas/diagnóstico , Biopsia , Diagnóstico Diferencial , Estudios de Seguimiento , Tumores de Células Gigantes/cirugía , Humanos , Neoplasias Laríngeas/cirugía , Laringectomía/métodos , Laringoscopía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Rayos XRESUMEN
Tonsillectomy is one of the most common operations performed by otolaryngologists. Sore throat, otalgia, fever, dehydration, uvular edema, and tonsillar hemorrhage are common complications. Hematoma of the mouth floor, an unusual complication, was reported. A 21-year-old man presented with a soft, dark-red swelling of the mouth floor three days after undergoing tonsillectomy. The hematoma of the mouth floor subsided spontaneously 2 weeks later. The complication in this case was most likely caused by the blood vessel insult, which resulted from suspension of the mouth with tongue retraction during surgery. This procedure should be done carefully to prevent this complication. Hematoma of the mouth floor can cause airway obstruction, and if present, health providers should be alert to the possibility of airway compromise.