<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, absces...<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, abscess, or as fistula. Several studies have been conducted across the world, but the literature is scarce on its presentation and complications in the Middle East. This indexing study aims to report a 10-year experience with thyroglossal duct cyst (TGDC) presentation, excision, and recurrence at a teaching hospital in Saudi Arabia (KSA). <strong>Methods:</strong> A retrospective chart review was conducted at the Armed Forces Hospital Southern Region, KSA from December 2008 to December 2018. Data were retrieved from the electronic medical record system of the hospital and validated with the histopathology records. A total of 48 patients diagnosed as TGDC, sinus or fistula were identified. Stata ver. 16.1 was used to analyze the data and results formulated using regression model and Pearson’s chi-square test. <strong>Results:</strong> The majority of our patients were female (60.4%), and the most common presentation was a midline neck swelling which moved with tongue protrusion. Surgical excision via Complete Sistrunk procedure was the operation of choice in 60.5% followed by excision of the cyst with tract and sinus tract. Previous infection and surgical history contributed to complications in our patients, but no association of age or gender was observed. Patients presenting with infected and discharging cysts were found to be much more likely to develop a recurrence (9 patients). Cysts deep to the hyoid showed more recurrence [n = 7 (78%)] compared to superficial cysts [n = 2 (22%)] and posterior and multi-tract lesions also showed significant recurrence. <strong>Conclusion:</strong> Despite being a common cause of neck swelling, thyroglossal duct cyst is often missed on physical exams. To reduce complications, timely diagnosis and treatment are necessary.展开更多
Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Alle...Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients. Functional endoscopic sinus surgery (FESS) is the mainstay of surgical treatment for patients and improves QOL of patients. This subjective assessment of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose. Prospective study was done on 54 patients. Data were collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st, 3rd, 6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Out of 54 patients, 59.3% were males, mean age was 35.98, 29.6% were in CRS without polyp group, 44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%, revision surgery required in 3.7% while 22.2% had history of asthma. Paired sample t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Thus FESS provides significant improvement in QOL of patients in chronic rhinosinusitis.展开更多
Spindle cell carcinoma also known as sarcomatoid carcinoma is a rare highly aggressive tumor which is histologically different from squamous cell ca and mesenchymal cancers. Only hands full of cases have been reported...Spindle cell carcinoma also known as sarcomatoid carcinoma is a rare highly aggressive tumor which is histologically different from squamous cell ca and mesenchymal cancers. Only hands full of cases have been reported in literature since 1957 and hence no proper treatment protocol has been devised yet. We present such a case of thirty-four-year-old female who presented with spindle cell carcinoma of the maxilla at our department and was treated with extensive surgery followed by chemotherapy and radiation therapy. Spindle cell carcinoma is generally associated with poor prognosis and hence literature supports use of post operative Chemo and Radiotherapy for better result and decrease chance of local recurrence.展开更多
文摘<strong>Introduction:</strong> Thyroglossal duct cyst is a well-recognized congenital midline neck swelling observed in early childhood and rarely in adults. It may reveal itself as a painless cyst, abscess, or as fistula. Several studies have been conducted across the world, but the literature is scarce on its presentation and complications in the Middle East. This indexing study aims to report a 10-year experience with thyroglossal duct cyst (TGDC) presentation, excision, and recurrence at a teaching hospital in Saudi Arabia (KSA). <strong>Methods:</strong> A retrospective chart review was conducted at the Armed Forces Hospital Southern Region, KSA from December 2008 to December 2018. Data were retrieved from the electronic medical record system of the hospital and validated with the histopathology records. A total of 48 patients diagnosed as TGDC, sinus or fistula were identified. Stata ver. 16.1 was used to analyze the data and results formulated using regression model and Pearson’s chi-square test. <strong>Results:</strong> The majority of our patients were female (60.4%), and the most common presentation was a midline neck swelling which moved with tongue protrusion. Surgical excision via Complete Sistrunk procedure was the operation of choice in 60.5% followed by excision of the cyst with tract and sinus tract. Previous infection and surgical history contributed to complications in our patients, but no association of age or gender was observed. Patients presenting with infected and discharging cysts were found to be much more likely to develop a recurrence (9 patients). Cysts deep to the hyoid showed more recurrence [n = 7 (78%)] compared to superficial cysts [n = 2 (22%)] and posterior and multi-tract lesions also showed significant recurrence. <strong>Conclusion:</strong> Despite being a common cause of neck swelling, thyroglossal duct cyst is often missed on physical exams. To reduce complications, timely diagnosis and treatment are necessary.
文摘Chronic Rhinosinusitis (CRS) is a group of disorders characterized by the inflammation of mucosa of the nasal passages and paranasal sinuses. It includes chronic rhinosinusitis with polyps, CRS without polyps and Allergic Fungal Sinusitis (AFS). This debilitating disease causes negative impact on quality of life (QOL) of patients. Functional endoscopic sinus surgery (FESS) is the mainstay of surgical treatment for patients and improves QOL of patients. This subjective assessment of QOL can be measured by disease specific questionnaires. SNOT-22 questionnaire is widely used and validated questionnaire for this purpose. Prospective study was done on 54 patients. Data were collected using SNOT-22 questionnaire and filled in pre-operative period then in post-operative follow-up visits on 1st, 3rd, 6th and 12th months. Paired sample t-test was used to compare pre-operative and post-operative SNOT scores and multivariate generalized linear model was used to estimate regression parameters for SNOT scores in CRS with polyp and AFS in comparison of CRS without polyps. Out of 54 patients, 59.3% were males, mean age was 35.98, 29.6% were in CRS without polyp group, 44.4% and 25.9% were in CRS with polyps and AFS group. Recurrence occurred in 7.4%, revision surgery required in 3.7% while 22.2% had history of asthma. Paired sample t-test showed statistical significant reduction in post-operative SNOT scores. Linear model results showed SNOT scores in CRS with polyp group was significantly reduced. Thus FESS provides significant improvement in QOL of patients in chronic rhinosinusitis.
文摘Spindle cell carcinoma also known as sarcomatoid carcinoma is a rare highly aggressive tumor which is histologically different from squamous cell ca and mesenchymal cancers. Only hands full of cases have been reported in literature since 1957 and hence no proper treatment protocol has been devised yet. We present such a case of thirty-four-year-old female who presented with spindle cell carcinoma of the maxilla at our department and was treated with extensive surgery followed by chemotherapy and radiation therapy. Spindle cell carcinoma is generally associated with poor prognosis and hence literature supports use of post operative Chemo and Radiotherapy for better result and decrease chance of local recurrence.
