Adenoid

腺样体
  • 文章类型: Journal Article
    简介:牙源性肿瘤包括一组异质性病变,范围从错构瘤性病变到恶性肿瘤。组织学表现的显着变化可能会误导其准确的诊断和分类。成釉细胞瘤通常很容易理解并且易于诊断,但是自从Broca在1867年对牙源性肿瘤进行分类以来,分类系统一直在变化。多年来,它已被世界卫生组织修改,有许多补充和遗漏。这种动态变化是基于分子和遗传研究的结果和结论,最后一次修改是在2017年。病例报告:我们介绍了2例32岁和60岁女性报告面部肿胀,显示存在明显的组织病理学发现,并被诊断为成釉细胞瘤伴有牙样或腺样成釉细胞瘤。文献检索显示缺乏不同形式的成釉细胞瘤,这些成釉细胞瘤显示形成导管样结构和牙质。结论:由于缺乏相关研究和对患者的随访,生物学行为仍未被探索,因此强调此类病例很有趣。了解新实体的发病机制和组织病理学特征将有助于及时诊断,治疗计划和扩大病变范围。
    在线版本包含补充材料,可在10.1007/s12070-023-03534-6获得。
    Introduction: Odontogenic tumors encompass a heterogeneous group of lesions that range from hamartomatous lesions to malignancy. Considerable variation in histologic presentation can mislead their accurate diagnosis and categorization. Ameloblastoma is generally well understood and is easy to diagnose but there has been a constant change in the classification systems ever since Broca classified odontogenic tumors in the year 1867. Over the years, it has been modified by the World Health Organization with many additions and omissions. This dynamic change is based on the result and conclusions of molecular and genetic studies with the last modification in 2017. Case Report: We present two cases of females aged 32 and 60 years who reported with facial swellings, revealed the presence of distinct histopathological findings and were diagnosed as ameloblastoma with dentinoid or adenoid ameloblastoma. Literature search revealed dearth of distinct forms of ameloblastoma that show the formation of duct like structures and dentinoid. Conclusion: It is interesting to highlight such cases as the biological behavior is still unexplored due to paucity of relevant studies and follow up of patients. Understanding the pathogenesis and the histopathological characteristics of the newer entities will enable the prompt diagnosis, treatment plan and expanding the spectrum of the lesions.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-03534-6.
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  • 文章类型: Journal Article
    OBJECTIVE: Clinical guidelines suggest adenoidectomy when enlarged adenoids are associated with nasal obstruction and other symptoms. Given that nasal obstruction is the leading symptom of adenoid hypertrophy, it should be thoroughly explored. However, there is no consensus regarding what could be the best approach. This systematic review is designed with the objective of exploring the extent to which adenoidectomy can decrease nasal resistance through rhinomanometry.
    METHODS: 3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing the change in nasal resistance and/or nasal airflow in rhinomanometry after adenoidectomy in pediatric patients.
    RESULTS: A total of 9 studies with a total population of 423 participants (323 patients excluding healthy controls) met the inclusion criteria. All of them found decreased nasal resistance after adenoidectomy. 5 studies could be combined in a metanalysis, which revealed a statistically significant difference of 0.52 Pa in basal conditions, and 0.64 Pa in rhinomanometry under nasal decongestion. 4 authors explored changes in nasal airflow. All of them found a statistically significant increase in nasal airflow after adenoidectomy. However, their results could not be merged in a meta-analysis.
    CONCLUSIONS: This systematic review and meta-analysis demonstrated the existence of a systematic decrease in nasal resistance and increase in nasal airflow with and without nasal decongestant after adenoidectomy. The available evidence suggests that rhinomanometry with nasal decongestant could help in intermediate cases of adenoid hypertrophy, in order to identify the presence of nasal obstruction and, when present, the possibility of other causes for it rather than enlarged adenoids, mainly turbinate hypertrophy.
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  • 文章类型: Journal Article
    OBJECTIVE: adenoidectomy is one of the most common surgical procedure in pediatric otolaryngology practice. Clinical guidelines (such as the Spanish or American) suggest adenoidectomy when the enlargement of the adenoids is associated with nasal obstruction. Nasal endoscopy and cephalograms are adequate methods to estimate the size of the adenoids. However, they do not measure nasal patency. This systematic review is designed with the objective of exploring the relationship between adenoid size and nasal ventilation through rhinomanometry.
    METHODS: 3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing both nasal resistance and/or nasal airflow in rhinomanometry and adenoid size by any method (endoscopy, cephalogram, direct examination).
    RESULTS: A total of 10 studies with a total population of 969 participants met the inclusion criteria. 5 authors explored the size of the adenoids through endoscopy. 4 authors explored the adenoids through lateral cephalograms. Finally, a further 2 authors explored adenoid size studying the resected tissue. Five studies explored the correlation between adenoid size and nasal resistance in rhinomanometry, which ranged from 0.20 to 0.84. Finally, 5 studies used nasal decongestant. It was found higher sensitivity and specificity, a higher area under the curve for the receiver operating characteristic curve, and higher correlation with adenoid size for rhinomanometry under nasal decongestion.
    CONCLUSIONS: Up to now, there is no ideal diagnostic method for adenoid hypertrophy. Therefore, it seems prudent to use a combination of all currently available tools, as they provide complementary, rather than supplementary information. Available evidence suggests that rhinomanometry combined with nasal decongestant could help to elucidate the existence of nasal obstruction in intermediate cases of adenoid hypertrophy, as well as throw light on other possible causes for nasal obstruction, mainly turbinate hypertrophy.
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  • 文章类型: Journal Article
    背景:过敏可能是儿童腺体扁桃体病的重要危险因素,尽管文献中报道了相互矛盾的结果。在以前的文章中,作者通常无法区分腺扁桃体肥大和复发性扁桃体炎,也无法区分孤立或合并的腺样体和扁桃体肥大。
    目的:评估将变态反应与不同表型的腺扁桃体病联系起来的临床证据和生物标志物。此外,我们质疑抗过敏治疗是否可以预防腺扁桃体疾病的发生或改善其特异性治疗。
    方法:我们的系统评价,根据系统评价和荟萃分析(PRISMA)流程的首选报告项目,最终筛选出1010篇文章。这导致了21个全文被纳入定性分析。
    结果:文献数据支持变态反应与合并的腺扁桃体肥大和孤立的腺样体肥大之间的关联,而描述过敏和孤立的扁桃体肥大之间的主要负相关。本综述的结果表明,局部过敏性炎症可能在腺扁桃体肥大中起作用。与细菌性复发性扁桃体炎和过敏相关的数据很少,尽管来自实验室的证据表明,过敏可能通过降低抗微生物蛋白水平来抑制扁桃体组织的先天免疫。
    结论:根据我们的定性分析,合并腺样体肥大或孤立性腺样体肥大的儿童不应误诊过敏,而证据不支持过敏和孤立的扁桃体肥大之间的联系。最后,一些数据支持变态反应和复发性腺扁桃体感染之间的联系,尽管需要未来的研究来证实这一数据.我们在一个实际算法中总结了我们的结论。
    BACKGROUND: allergy may be an important risk factor for adenotonsillar disease in children, although conflicting results have been reported in the literature. In previous articles, authors often failed in distinguishing between adeno-tonsillar hypertrophy and recurrent tonsillitis and in not discriminating between isolated or combined adenoid and tonsillar hypertrophy.
    OBJECTIVE: to evaluate clinical evidence and biomarkers linking allergy to different phenotypes of adeno-tonsillar disease. Furthermore, we questioned whether anti-allergy treatment might prevent occurrence of adeno-tonsillar disease or improve its specific management.
    METHODS: our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1010 articles finally screened. This resulted in 21 full texts that were included in a qualitative analysis.
    RESULTS: literature data support the association between allergy and combined adeno-tonsillar hypertrophy and isolated adenoid hypertrophy, whereas describe a mainly negative correlation between allergy and isolated tonsillar hypertrophy. The results of this review suggest that local allergic inflammation may play a role in adeno-tonsillar hypertrophy. Data correlating bacterial recurrent tonsillitis and allergy are few, although evidence from the lab revealed that allergy might suppress innate immunity in tonsillar tissue by reducing levels of anti-microbial proteins.
    CONCLUSIONS: basing on our qualitative analyses allergy should not be misdiagnosed in children with combined adenotonsillar hypertrophy or isolated adenoid hypertrophy, whereas evidence do not support a link between allergy and isolated tonsil hypertrophy. Finally, some data support a link between allergy and recurrent adeno-tonsillar infection although future studies are required to confirm this data. We summarized our conclusions in a practical algorithm.
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  • 文章类型: Journal Article
    Introduction Risk of surgical intervention for post-adenoidectomy haemorrhage can be assessed with the analysis of the Hospital Episode Statistics (HES) data. Materials and methods HES data for England from 2012 to 2019 were analysed comparing the coded number of adenoidectomy procedures to the number of surgical arrests of post-adenoidectomy haemorrhage in adolescents/adults and children. Results Between April 2012 and April 2019, of 47,597 procedures, 52 (0.11%) patients required surgical arrest of post-adenoidectomy haemorrhage. In adults (n = 5,379), 11 patients returned to theatre for control of post-operative bleeding, whereas 41 children (n = 42,218) required this intervention. The total number of adenoidectomies was 3.7 times higher in children; however, adults were statistically two times more likely to require further surgical intervention for arrest of post-adenoidectomy haemorrhage (two-tailed p-value = 0.0031). Conclusion Children are more likely to return to theatre for surgical arrest of post-adenoidectomy haemorrhage, with p-values indicating the difference between the incidence of adults and children returning to theatre to be very statistically significant.
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  • 文章类型: Journal Article
    UNASSIGNED: Adenoid cystic carcinoma (AdCC) of the larynx is an uncommon malignancy of the head and neck with very little literature discussing treatment paradigms and prognostic factors influencing survival.
    UNASSIGNED: This retrospective cohort study uses data obtained from the Surveillance, Epidemiology and End Result database comprising of patients diagnosed with laryngeal AdCC from 1978 to 2016.
    UNASSIGNED: A total of 89 records were analyzed. High histologic grade was a significant negative prognostic factor compared to low histologic grade disease for overall survival (OS; 5-year OS: 35.7% vs 90.5%, P < .005) and disease-specific survival (DSS; 5-year DSS: 38.7% vs 95.2%, P < .005). No differences in OS (5-year OS: 88.9% vs 76.4%, P = .287) or DSS (5-year DSS: 100% vs 79.1%, P = .159) were noted between patients with early versus late American Joint Committee on Cancer (AJCC) stage disease. No differences in DSS was noted in cohorts treated with just definitive surgery versus surgery and adjuvant radiation (5-year DSS: 92.9% vs 74.3%, P = .140) even when stratified for late stage disease (5-year DSS: 100% vs 78.6%, P = .290) or high-grade histology (5-year DSS: 100% vs 83.3%, P = .773).
    UNASSIGNED: Histologic grade may be a more significant prognostic factor than AJCC stage for survival in laryngeal AdCC. Treatment with surgery and radiation may provide no additional survival advantage compared to just definitive surgery in these patients, although further study is warranted.
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  • 文章类型: Case Reports
    Primary tumors of the brachial plexus are rare. Most are benign and characterized as Schwannoma and neurofibroma, whereas malignant peripheral nerve sheath tumors are less common. Here, we report a rare case of primary embryonal carcinoma in the brachial plexus.
    A 17-yr-old male presented with a 3-mo history of a mass growing in the left supraclavicular region over the middle part of the clavicle. Magnetic resonance imaging revealed a well-defined mass (diameter 2.5 cm) straddling the brachial plexus. After surgical resection, and the mass was histologically confirmed to be an embryonal carcinoma.
    Primary embryonal carcinoma in the brachial plexus has not been reported previously. This case highlights the importance of considering the possibility that some primary brachial plexus tumors may be malignant and should be treated promptly.
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  • 文章类型: Journal Article
    Acantholytic squamous cell carcinoma (acantholytic SCC) is a variant of SCC in which acantholysis develops owing to the loss of desmosomal adhesion proteins. This loss of cell-cell adhesion leads to morphologic changes that have the potential to mimic other tumor types, such as angiosarcoma or signet ring cell adenocarcinoma. Acantholytic SCC characteristically occurs in sun-exposed skin of elderly patients; however, it can occur in nondermal locations. We present a review of the literature describing cases of nondermal acantholytic SCC.
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  • 文章类型: Journal Article
    OBJECTIVE: To study and review the short- and long-term effects of intranasal steroids on obstructive adenoids.
    METHODS: In this prospective cohort study, 19 children previously treated with mometasone furoate for 3 months were contacted at 3, 6 and 12 months after cessation of treatment. Main outcome measures included: change in severity of nasal obstruction, allergic rhinitis and obstructive symptoms. A systematic review of literature was also performed.
    RESULTS: By one year, 25 per cent of patients required adenoidectomy; the remaining children had no significant change in clinical score (p = 0.464), obstruction severity (p = 0.191) or allergic symptoms (p = 0.284). Fourteen pertinent studies were identified; all but one study showed improvement in the patients\' symptoms and/or degree of obstruction. Two studies with follow up reaching 25 months showed positive effects.
    CONCLUSIONS: The short-term positive effect of some intranasal steroids on obstructive adenoids seems to persist in a significant number of patients after the cessation of treatment.
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  • 文章类型: Case Reports
    We present the case of a 51-year-old patient with sinonasal adenoid cystic carcinoma (SACC). Computed tomography (CT) and magnetic resonance imaging (MRI) exams revealed an expansive process in the right nostril accompanied with perineural spread and invasion to the floor of the middle cranial fossa. Due to the size of the tumor and brain involvement, the Head and Neck Tumor Board (HNTB) recommended radiochemotherapy treatment to decrease the size of the lesion. Presently, the patient is undergoing treatment without major complications.
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