Morphology of the distal thoracic duct and the right lymphatic duct in different head and neck pathologies: an imaging based study

Background: Excessive use of smartphones may be associated with behavioral and physical health changes and might cause musculoskeletal alterations in the head and neck region. Objective: To evaluate the prevalence of smartphone addiction in college students and its correlation with symptoms of head and neck pain and masticatory and trapezius muscle activity while resting, before and after smartphone use. Methods: Twenty university students participated in the study. They answered the Smartphone Addiction Scale and the Fonseca Anamnestic Index. Next, the participants were seated and prepared for electromyography through the placement of surface electrodes on the masseter, temporal, and trapezius muscles. Rest condition data were collected for 10 seconds before and after 30 minutes of smartphone use. Results: The results showed that 35% of the evaluated individuals were classified as smartphone addicted and 35% reported no head or neck pain in the previous 30 days. There was no association between smartphone use and head and neck pain. In the electromyography, there was an increase in RMS values after smartphone use in the right and left masseter muscles and the left trapezius. Conclusion: College students presented a high prevalence of smartphone addiction and head and neck pain, but these were not statistically associated. There was a change in muscle activity only in the right trapezius muscles before and after 30 minutes of smartphone use. These findings are contrary to the current belief that the use of smartphones correlates with pain in the neck region and changes in the electrical muscle activity, leading to fatigue in the cervical muscles.

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THE ABSORPTION OF PROTEIN SOLUTIONS FROM THE PULMONARY ALVEOLI

Journal of Experimental Medicine ◽

10.1084/jem.66.4.449 ◽

1937 ◽

Vol 66 (4) ◽

pp. 449-458 ◽

Cited By ~ 8

Author(s):

Cecil K. Drinker ◽

Madeleine Field Warren ◽

Margaret MacLanahan

Keyword(s):

Thoracic Duct ◽

Horse Serum ◽

Molecular Size ◽

The Other ◽

Immunological Methods ◽

Protein Solutions ◽

Blood Capillaries ◽

Egg Albumin ◽

Pulmonary Alveoli ◽

The Right

Horse serum, crystallized hemoglobin, and crystallized egg albumin have been injected into the lung alveoli of dogs in which the entrances of the right lymphatics have been tied and the thoracic duct cannulated. Samples of blood and lymph have been taken following this injection. Only after several hours in the case of the horse serum and hemoglobin have these proteins been detected by immunological methods and invariably they have appeared first in the blood. Egg albumin also enters the blood capillaries, but much more rapidly than the other two proteins, due probably to the smaller molecular size.

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Primary cutaneous nocardiosis of the head and neck in an immunocompetent patient

BMJ Case Reports ◽

10.1136/bcr-2020-241217 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241217

Author(s):

Claudio Tirso Acevedo ◽

Frank Imkamp ◽

Ewerton Marques Maggio ◽

Silvio Daniel Brugger

Keyword(s):

Head And Neck ◽

Skin Lesions ◽

Immunocompetent Patient ◽

Rrna Gene ◽

Gene Sequence Analysis ◽

Rare Manifestation ◽

Life Threatening ◽

Amoxicillin Clavulanic Acid ◽

Disseminated Nocardiosis ◽

The Right

Nocardiosis is known to be an opportunistic infection most commonly affecting immunocompromised patients that can lead to life-threatening conditions. Primary cutaneous disease remains a rare manifestation and unlike pulmonary or disseminated nocardiosis, it usually affects immunocompetent individuals. We present a case of a primary cutaneous nocardiosis of the head and neck after an insect bite in a healthy 50-year-old woman who had recently travelled from Greece. She presented with a painful right-sided swelling of her face and neck and an ulcerated plaque over the right temple. Biopsy of the plaque revealed inflammation with abscess formation indicating underlying infection. Culture from the biopsy showed growth of Nocardia spp and 16S rRNA gene sequence analysis identified Nocardia brasiliensis. The patient was treated with trimethoprim/sulfamethoxazole and subsequently switched to amoxicillin/clavulanic acid due to a drug eruption. Antibiotic therapy was continued for a total of 3 months with complete resolution of the skin lesions.

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Is GRADE the Right Choice for Clinical Practice Guidelines Developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation?

Otolaryngology ◽

10.1177/0194599819846458 ◽

2019 ◽

Vol 161 (1) ◽

pp. 3-5

Author(s):

Andrés M. Bur ◽

Richard M. Rosenfeld

Keyword(s):

Clinical Practice ◽

American Academy ◽

Head And Neck ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Current Knowledge ◽

Clinical Care ◽

Neck Surgery ◽

Head And Neck Surgery ◽

The Right

Clinical practice guidelines (CPGs), developed to inform clinicians, patients, and policy makers about what constitutes optimal clinical care, are one way of increasing implementation of evidence into clinical practice. Many factors must be considered by multidisciplinary guideline panels, including strength of available evidence, limitations of current knowledge, risks/benefits of interventions, patient values, and limited resources. Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a framework for summarizing evidence that has been endorsed by many national and international organizations for developing CPGs. But is GRADE the right choice for CPGs developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF)? In this commentary, we will introduce GRADE, discuss its strengths and limitations, and address the question of what potential benefits GRADE might offer beyond existing methodology used by the AAO-HNSF in developing CPGs.

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An isolated pilomatricoma of the leg: a rare location – A Case Study

American Journal of Orthopedic Research and Reviews ◽

10.28933/ajorr-2021-05-2605 ◽

2021 ◽

pp. 28

Keyword(s):

Head And Neck ◽

Lower Limbs ◽

Surgical Removal ◽

Skin Tumour ◽

Postoperative Course ◽

Hair Matrix ◽

Rare Location ◽

The Right

Pilomatricoma is a rare, benign skin tumour arising from the hair matrix. The usual locations are the head and neck. Localization in the lower limbs is exceptional. The diagnosis of certainty is histological. Treatment is complete surgical removal to avoid recurrence. We report in this article the case of a rare localization of a pilomatricoma on the right leg, in a 25-year-old patient operated with complete surgical removal. The postoperative course was simple and without recurrence after 2 months of follow-up.

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TMJ pain as a presentation of metastatic breast cancer to the right mandibular condyle

BMJ Case Reports ◽

10.1136/bcr-2021-241601 ◽

2021 ◽

Vol 14 (3) ◽

pp. e241601

Author(s):

Victor Ken On Chang ◽

Samuel Thambar

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Head And Neck ◽

Cancer Metastasis ◽

Mandibular Condyle ◽

Metastatic Breast ◽

Neck Region ◽

Head And Neck Region ◽

History Of ◽

The Right

Cancer metastasis to the oral and maxillofacial region is uncommon, and metastasis to the mandibular condyle is considered rare. We present a case of a 56-year-old woman with a history of invasive ductal cell carcinoma of the right breast, 10 years in remission, presenting with a 6-month history of symptoms typical of temporomandibular joint (TMJ) dysfunction. Imaging revealed an osteolytic lesion of her right TMJ and subsequent open biopsy confirmed the diagnosis of metastatic breast cancer. Despite the rarity of metastatic cancer to the head and neck region, it is still important for clinicians from both medical and dental backgrounds to consider this differential diagnosis, particularly in patients with a history of hormonal positive subtype of breast cancer. Given that bony metastasis can manifest even 10 years after initial diagnosis, surveillance which includes examination of the head and neck region is important, and may include routine plain-film imaging surveillance with an orthopantomogram (OPG).

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BIOPSY OF THE SCALENE LYMPH NODES AND THE RIGHT THORACIC DUCT LYMPH NODE FOR THE DIAGNOSIS OF PULMONARY DISEASE

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)33577-9 ◽

1964 ◽

Vol 47 (4) ◽

pp. 438-445 ◽

Cited By ~ 11

Author(s):

James V. Maloney ◽

Robert Franks ◽

Dwight Makoff ◽

Paul H. Sherman

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Pulmonary Disease ◽

Thoracic Duct ◽

Thoracic Duct Lymph ◽

Duct Lymph ◽

The Right

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Tinnitus With Unexpected Spanish Roots: Head and Neck Paragangliomas Caused by SDHAF2 Mutation

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa016 ◽

2020 ◽

Vol 4 (3) ◽

Author(s):

Laura Maria Roose ◽

Niels J Rupp ◽

Christof Röösli ◽

Nadejda Valcheva ◽

Achim Weber ◽

...

Keyword(s):

Genetic Testing ◽

Head And Neck ◽

Carotid Body ◽

Loss Of Function ◽

Negative Family History ◽

Paraganglioma Syndrome ◽

Plasma Free Metanephrines ◽

The Right ◽

Head And Neck Paragangliomas

Abstract It is estimated that up to 40% of all head and neck paragangliomas (HNPGL) have a hereditary background with the most common mutations being found in the succinate dehydrogenase (SDH) genes. SDHAF2 mutation leads to the rare paraganglioma syndrome 2. The authors present the case of a 15-year-old male patient with 2, non-secretory HNPGLs, presenting with left-sided, pulsatile tinnitus, and hearing loss. Imaging led to the suspicion of a jugulotympanic paraganglioma on the left, as well as a carotid body tumor on the right. After resection of the jugulotympanic tumor, histology confirmed the presence of a paraganglioma; immunohistochemistry furthermore suggested a loss of SDHB expression. Genetic testing revealed a rare germline, loss-of-function mutation in the SDHAF2 gene, previously described to cause hereditary paraganglioma syndrome 2. Twenty months after the first operation, the patient underwent a resection of the right carotid body paraganglioma. Plasma-free metanephrines/catecholamines always remained within the reference range; the patient is under regular follow-up, and his relatives will be screened. Our findings emphasize the relevance of genetic testing in patients with HNPGL, also with negative family history, especially when the patients present at a young age and with multiple lesions.

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Melanotic neuroectodermal tumour of infancy presenting as a lytic lesion in femur: a rare tumour at a rare site with an unusual behaviour

BMJ Case Reports ◽

10.1136/bcr-2019-231959 ◽

2019 ◽

Vol 12 (10) ◽

pp. e231959

Author(s):

Nishu Bhardwaj ◽

Rajni Yadav ◽

Venkatesan Sampath Kumar ◽

Shah Alam Khan

Keyword(s):

Head And Neck ◽

Spontaneous Regression ◽

Benign Lesion ◽

Osteolytic Lesion ◽

Lytic Lesion ◽

Rare Tumour ◽

Neuroectodermal Tumour ◽

Rare Site ◽

The Right

Melanotic neuroectodermal tumour of infancy (MNTI) is an uncommon tumour, predominantly occurring in head and neck, mostly maxilla, but also in skull and mandible. Although a benign lesion, it is known to recur in 15%–27% of cases, and rarely, may undergo malignant transformation. We present a case of a 5-month-old female patient, who presented with a gradually progressive swelling in the right thigh. On imaging, an osteolytic lesion was seen, involving the metadiaphysis of shaft of right femur. A biopsy was performed, on which diagnosis of MNTI was made. MNTI is rarely seen in extremities. To the best of our knowledge, only six cases have been reported in femur, the present case being the seventh. The tumour showed spontaneous regression on follow-up in our patient, which has rarely been described. A knowledge of characteristic morphology and immunohistochemistry is the key to differentiate it from other tumours.

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Perineural Invasion of Squamous Cell Carcinoma of the Lip with Occult Involvement of the Infra-orbital Nerve Detected by PET-CT and Treated with MRI-based IMRT: A Case Report

Technology in Cancer Research & Treatment ◽

10.1177/153303460500400304 ◽

2005 ◽

Vol 4 (3) ◽

pp. 251-253 ◽

Cited By ~ 11

Author(s):

Ajay K. Bhatnagar ◽

Dwight E. Heron ◽

Barry Schaitkin

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Perineural Invasion ◽

Infraorbital Nerve ◽

Upper Lip ◽

Pet Ct ◽

Facial Numbness ◽

The Right

A 51 year old male with a history of right facial numbness developed progressive upper lip swelling for one year, but an MRI of the head was unremarkable. A wide local excision of the upper lip was performed and pathology revealed a 1.7 cm mass, poorly differentiated squamous cell carcinoma with perineural invasion. Surgical margins were free of tumor. Two months postoperatively, a hybrid PET-CT of the whole body was performed due to the persistent right facial numbness. The CT portion identified an equivocal lesion at the base of the right orbit correlating to the right infraorbital nerve. However, the PET-CT image revealed avid uptake in this location suggesting perineural invasion which was confirmed with biopsy of the right infraorbital nerve demonstrating carcinoma. Subsequently, the patient was treated with Intensity Modulation Radiation Therapy (IMRT) using MRI fusion for proper delineation of the right infraorbital nerve to its origin in the base of skull. This case exemplifies the superiority of hybrid PET-CT over CT or MRI alone in head and neck imaging which can lead to significant impact on management for patients with head and neck cancer.

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