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Objective:  To identify risk factors associated with disease recurrence among Filipinos with papillary thyroid carcinoma (PTC). Methods: Design:           Retrospective cohort study Setting:           Tertiary National University Hospital Participants: 76 patients diagnosed with papillary thyroid carcinoma, classified as low and low-to-intermediate risk (2015 ATA classification) that underwent total thyroidectomy with or without neck dissection from 2010-2014 and were followed up from 10 months to 5 years. Log rank and Cox regression analyses were used to determine significant risk factors for recurrence. Results:  29 (38.15%) had recurrence.  On univariate analysis, age, tumor size, multifocality, extrathyroidal extension, presence of lateral neck nodes and RAI therapy were statistically associated with recurrence.  However, on multivariate analysis, no clinicopathologic factor was statistically associated with recurrence. Conclusion: Age of >45 years, female sex, tumor size of >2 cm, multifocality, presence of microscopic extrathyroidal extension, and lymph node metastasis might contribute to the recurrence of papillary thyroid cancer while post-operative radioactive ablation may have some protective effect.  However, this study suggests that other factors must be included in the model to better understand the relationship between these factors and recurrence.   Keywords: papillary thyroid cancer, thyroid neoplasm, recurrence

Objective:       To report a case of extragnathic sinonasal ameloblastoma and discuss its clinical features, approach to diagnosis, pathology, and management.   Methods: Study Design:             Case report Setting:                       Tertiary government university hospital Subject:                      One   Results:  A 40-year-old female consulted for a rapidly enlarging right intranasal mass of 4 months duration associated with recurrent profuse epistaxis and nasal obstruction.  Previous specimens of the mass were histopathologically interpreted as ameloblastoma versus craniopharyngioma.  Examination revealed a pink, fleshy, smooth right intranasal mass with associated nasomaxillary bulge and supero-lateral displacement of the right eye.  Computed tomography (CT) scan and magnetic resonance imaging (MRI) of the nasal cavity and paranasal sinuses demonstrated a soft-tissue density occupying the entire nasal cavity with erosion but no invasion of the maxillary sinus and no intracranial extension despite erosion of the skull base.  The mass was completely excised via lateral rhinotomy and the final histopathologic diagnosis was ameloblastoma.   Conclusion:    Extragnathic sinonasal ameloblastoma is a benign but locally aggressive variant of ameloblastoma involving the nasal cavity and/or paranasal sinuses often mimicking malignant tumors.  Diagnosis is primarily based on histopathology but radiologic and intraoperative findings help distinguish it from differentials.  Complete surgical excision remains the treatment of choice, and coupled with good follow up, may improve the prognosis of patients.   Keywords: sinonasal ameloblastoma, extragnathic, craniopharyngioma

Introduction Allergic rhinitis is a common disease entity that may be easily misdiagnosed and mistreated. It is a global concern, affecting 10% to 25% of the population worldwide, that has to be controlled since it can be disabling affecting the quality of life of patients. The Philippine Society of OtolaryngologyHead and Neck Surgery is currently updating its 2006 guideline on Allergic Rhinitis. The Section of Rhinology, Department of Otorhinolaryngology together with the Section of Allergy and Immunology, Departments of Pediatrics and Internal Medicine, came up with practice parameters in the diagnosis and management of adult and pediatric patients suspected to have allergic rhinitis to guide clinicians in managing these patients. Locally, it is the first collaboration of otorhinolaryngologists and allergists. Scope of the Guideline This practice parameter was developed to guide general physicians, otorhinolaryngologists and allergists in the diagnosis and management of adult and pediatric patients with allergic rhinitis in an ambulatory care setting. Objectives This guideline aims to (1) assist general physicians, otorhinolaryngologists and allergists diagnose true allergic rhinitis; (2) evaluate current techniques and practices in diagnosing allergic rhinitis; and (3) describe treatment and management options for allergic rhinitis. Development process The Section of Rhinology of the Department of Otorhinolaryngology and Section of Allergy and Immunology of the Departments of Pediatrics and Internal Medicine of the UP-Philippine General Hospital convened a working group to create a consensus document to be used primarily for the Allergic Rhinitis Clinic, a joint clinic of the aforementioned sections in the Out-Patient Department of the UP-PGH, and to serve as a guide to general physicians, otorhinolaryngologists and allergists. The working group agreed to come up with an algorithm for the diagnosis and management of a patient with allergic rhinitis. Clinical questions were subsequently formulated based on the algorithm. The members then searched for relevant literature (including clinical practice guidelines, systematic reviews) in the National Library of Medicine’s PubMed database, Herdin database and unpublished local articles on allergic rhinitis. Appraisal of literature was done by an epidemiologist and evidence was presented and discussed within the working group. Applicability and availability of the diagnostic tests and therapeutic interventions were considered. All materials were assessed for relevance and further classified according to levels of evidence and grades of evidence based on guidelines. Recommendations were based on nominal approval of the working group. The document was then presented to stakeholders--consultants and residents of four clinical departments (Family Medicine, Internal Medicine, Otorhinolaryngology, Pediatrics), medical interns, medical students, nurses and patients. The opinions of the stakeholders were considered in the final draft.