Botulinum toxin injection remains the gold-standard treatment for ASD in our center. Potential patients for type II thyroplasty need to be carefully selected and counseled by a multidisciplinary team of otolaryngologists, neurologists, and speech pathologists.
Our treatment outcomes, particularly those in the group receiving postoperative radiotherapy, were similar to other studies. The prognosis of N3 neck disease was poor but improved with radiotherapy, particularly postoperative radiotherapy. The role of definitive chemotherapy and/or radiotherapy and salvage surgery is difficult to evaluate as the results are inconsistent and the available data are limited. Future studies in particular with quality of life assessment are needed to evaluate the management of N3 head and neck cancer.
A 27‐year‐old woman presented with metastatic follicular carcinoma of thyroid cell type. Assessment was complicated by recent surgery for “benign” struma ovarii. She underwent total thyroidectomy which failed to show a neoplasm, leaving the struma ovarii as the likely source of the metastasis.
Thyroid incidentaloma detected on FDG-PET scan has been reported repeatedly in the last several years, though conflicting data are reported. Our aim is to identify the incidence and outcome of incidental FDG-PET detected thyroid lesions in patients undergoing FDG-PET scan for other primary malignancies and to suggest a management algorithm. This is a retrospective review of all patients who had a FDG-PET detected incidental thyroid lesion between January 2002 and December 2009 at Peter MacCallum Cancer Center. Demographics, data relating to PET scan findings, FNA diagnoses, operative details, and histopathology were reviewed. Of the 1,034 subjects who underwent the FDG-PET study, 51 (4.9%) were identified as having thyroid incidentaloma, 31 females and 20 males with a mean age of 60 years. Thyroid malignancy was noted in 39.5% (19/48 patients) who underwent FNAB. Sixteen underwent thyroidectomy. The histopathology revealed 12 patients with papillary carcinoma, 5 with follicular carcinoma and 2 with medullary carcinoma. The high rates are in concordance with analysis of the rates published in the literature. In patients with thyroid PET incidentaloma, the incidence of primary thyroid malignancy is very high as reported in our study and based on analysis of published data, necessitating further investigation. If assessment of these incidentalomas suggests malignancy, then appropriate surgical management may be warranted according to the patient's medical condition.
A reduction in conversion rates, operating time, morbidity and length of stay was realized during the learning curve of implementing laparoscopic splenectomy by adopting a standardized technique. This technique involved hilar dissection using the ultrasonic shears, two experienced laparoscopic surgeons performing the surgery, dedicated equipment and trained staff using the checklist approach. We recommend such a standardized technique in performing laparoscopic splenectomy.
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