BackgroundA limited number of single institutions have published retrospective cohort studies on transoral laser microsurgery for supraglottic laryngectomy (TLM-SGL). These studies have shown that the oncologic outcomes of TLM-SGL are comparable to those of open SGL. However, there is limited information available regarding swallowing rehabilitation and quality of life (QoL).Patients and methodsSUPRATOL is a prospective, multicenter trial assessing the functional outcomes of TLM-SGL +/− adjuvant radio-(chemo)-therapy. The primary endpoint was aspiration-free swallowing at 12 months, as established using fibreoptic endoscopic evaluation of swallowing (FEES) and defined as a grade < 6 on the penetration–aspiration scale. Secondary endpoints were swallowing- and voice-related QoL, the prevalence of temporary and permanent tracheostomy and percutaneous gastrostomy, local control, laryngectomy-free survival, overall survival, and disease-free survival, as well as the influence of treatment centers on outcomes.ResultsFrom April 2015 to February 2018, 102 patients were recruited from 26 German Otorhinolaryngology (ORL) hospitals. All patients had TLM-SGL and 96.1% underwent uni- or bilateral, mostly selective neck dissection. To 47.0% of patients, adjuvant radio-(chemo)-therapy (R(C)T) was administered. The median follow-up period was 24.1 months. At 12-month follow-up, completed by 84.3% of patients, 98.2%, 95.5%, and 98.8% were free of aspiration when tested with saliva, liquid, or pulp. Adjuvant R(C)T, pT category, and type of resection had no significant influence on swallowing rehabilitation. A total of 40.2% of patients had been tracheotomized, and in 46.1% of patients, a PEG tube was inserted. At the 24-month follow-up, 5.3% of patients still required a tracheostomy, and 8.0% continued to use a percutaneous endoscopic gastrostomy (PEG) tube. Deterioration of swallowing- and voice-related QoL was observed immediately after treatment, but patients recovered, and baseline values were reached again. The Kaplan–Meier 2-year rates for local control, laryngectomy-free survival, overall survival, and disease-free survival were 88%, 92%, 93%, and 82%, respectively.ConclusionsOur prospective multicenter trial shows that, at 12 months post-TLM-SGL +/− R(C)T, 95.5%–98.8% of patients achieved aspiration-free swallowing. Morbidity was higher than previously reported. The rates of permanent tracheostomy and gastrostomy tube placement correspond to previous cohort studies. The 2-year oncologic outcomes are within the reported range.Clinical trial registrationhttps://drks.de/search/en/trial/DRKS00004641, identifier (DRKS00004641).

Einleitung Bei einem in der Paukenhöhle lokalisierten Tumor, der durch das Trommelfell Pulsationen erkennen lässt, handelt es sich meistens um ein Paragangliom. Differentialdiagnostisch können aber auch Gefäßanomalien oder andere Tumoren vorliegen.

Introduction Parinaud's oculoglandular syndrome is characterized by unilateral granulomatous conjunctivitis accompanied by locoregional lymphadenopathy (LAP). It is a rare manifestation of cat scratch disease, tularemia and many other infectious diseases.

Introduction A middle ear tumor that shows a pulsating movement through the tympanic membrane is usually a paraganglioma. However, vascular anomalies or other tumors should also be included in the differential diagnosis.

Hintergrund Das okuloglanduläre Parinaud-Syndrom ist ein seltenes Krankheitsbild, das durch eine unilaterale Konjunktivitis und Lymphadenopathie (LAP) auffällt. Infektiöse Auslöser sind u.a. Bartonella henselae (Katzenkratzkrankheit) und Francisella tularensis (Tularämie).

Other Supporting Colleagues from Clinical Predictors for Germline Mutations in Head and Neck Paraganglioma Patients: Cost Reduction Strategy in Genetic Diagnostic Process as Fall-Out

Supplementary Table 2 from Clinical Predictors for Germline Mutations in Head and Neck Paraganglioma Patients: Cost Reduction Strategy in Genetic Diagnostic Process as Fall-Out

Supplementary Table 1 from Clinical Predictors for Germline Mutations in Head and Neck Paraganglioma Patients: Cost Reduction Strategy in Genetic Diagnostic Process as Fall-Out

Introduction: CeFCiD was a multicenter phase II study comparing the efficacy of cetuximab (C), 5-flourouracil, and cisplatin with the same regimen adding docetaxel (D) in recurrent/metastatic head and neck cancer. The primary analysis trial did not demonstrate survival benefit from therapy intensification in first-line recurrent and/or metastatic squamous cell carcinoma of the head and neck (SCCHN). The current analysis of the trial assessed the impact of treatment on quality of life (QoL). Methods: The European Organization for Research and Treatment of Cancer Quality of life Questionnaire QLQ-C30 and the tumor-specific module for head and neck cancer (QLQ-H&N35) were used to assess QoL at baseline (visit 1), after 2 (visit 3), 4 (visit 5), and 6 (visit 7) cycles of chemotherapy. Results: Of 180 patients included in this study, 86 patients (47.8%) completed the questionnaires at baseline. Considering selected scores over treatment time, there was no difference in global QoL, dyspnea, swallowing, and speech between the treatment arms in the course. For fatigue, a significant increase from baseline to visit 3 (p = 0.02), visit 5 (p = 0.002), and to visit 7 (p = 0.003) was observed for patients receiving D, cisplatin or carboplatin (P), 5-fluorouracil (F), and C. At the end of chemotherapy, the manifestation of fatigue was similar compared in the 2 treatment arms. Discussion/Conclusion: Therapy intensification not adversely affects selected scores of QoL of patients with recurrent and/or metastatic SCCHN. Nevertheless, fatigue seems to be pronounced in patients treated with D.

Zusammenfassung Einseitige Erkrankungen der Kieferhöhle zählen zu den häufigsten rhinologischen Diagnosen. Die Vielfalt dieser Erkrankungen kann eine potenzielle Herausforderung für den behandelnden Arzt werden. Das Spektrum der Diagnosen erstreckt sich von harmlosen Kieferhöhlenzysten, die selten eine Therapie benötigen, bis zu hoch aggressiven Malignomen. Von großer Bedeutung sind die Diagnose und Therapie des invertierten Papilloms. Das Besondere dieses benignen Tumors sind die hohen Rezidivraten und eine mögliche maligne Entartung. Der Schlüssel zur Vermeidung eines Rezidivs ist eine gezielte Operation. Weitere Erkrankungen wie der Antrochoanalpolyp und der Pilzball (Aspergillom) der Kieferhöhle werden ausführlich diskutiert.

Unilateral diseases of the maxillary sinus are among the most common rhinologic diagnoses. The diversity of these diseases can represent a challenge for the treating physician. The spectrum ranges from harmless maxillary sinus cysts that seldom require treatment, to highly aggressive malignant tumors. Special attention should be given to the management of inverted papilloma. These benign tumors are characterized by high recurrence rates and the potential for malignant transformation. The key to minimizing recurrence is precise surgical intervention. Other unilateral maxillary sinus diseases such as the antrochoanal polyp and the fungus ball (aspergilloma) are also discussed in depth.

Wir berichten über 2 Kinder, die in kurzem Zeitabstand mit identischer Erkrankung behandelt wurden. Bei einem 7-jährigen Mädchen (Patient 1) sowie einem 5-jährigen Mädchen (Patient 2) bestand eine solitäre, indolente, prall-elastische, livid-rote Hautveränderung an der Helixkante und am Ohrläppchen des linken bzw. rechten Ohrs (▶ Abb. 1, 2). Anamnestisch bestand ein Trauma nach Ohrlochstechen einige Monate vorher. Ein Zeckenbiss war nicht erinnerlich (Patient 1). Auf Nachfrage gab Patient 2 einen Zeckenbiss bei einem Auslandsaufenthalt vor einigen Monaten an.

Epistaxis ist ein Symptom, ausgehend von multifaktoriellen Ursachen, und ein häufiger Konsultationsgrund der Akutmedizin.

Solitär fibröse Tumore (auch Hämangioperizytom) gehören mit ca. 0.6% zu einer seltenen Untergruppe von gutartigen Weichteiltumoren. Sie sind im Thoraxbereich (Pleura) bekannt, wurden aber auch in verschiedenen anderen Lokalisationen beschrieben.

A 30-year-old male from India presented with lockjar, dysphagia and night sweats. Clinical examination showed an extensive tumor of the right cheek infiltrating the vestibular fold as well as the ascending lower jawbranch and pterygopalatine fossa.

Solitary fibrous tumors (also called hemangiopericytoma) are with about 0.6% to a rare mostly benign subgroup of soft tissue tumors. They are mainly known in the thoracic region (pleura), but have also been described in various other localizations.