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tonsillar pillar

Johan Fehrm, Pia Nerfeldt, Joar Sundman, Danielle Friberg
Importance: Adenotonsillectomy (ATE) is the primary surgical method for treating obstructive sleep apnea (OSA) in children. However, children with severe OSA have an increased risk for residual OSA after ATE. Previous studies indicate that adenopharyngoplasty (APP), a modified ATE with closure of the tonsillar pillars, might improve the surgical outcome, but the overall evidence is weak. Objective: To determine whether APP is more effective than ATE for treating severe OSA in otherwise healthy children...
May 31, 2018: JAMA Otolaryngology—Head & Neck Surgery
Amarbir Gill, Nilesh Vasan, Babak Givi, Arjun Joshi
Oral cavity squamous cell carcinoma (OCSCC) is the most common nonmelanoma head and neck cancer in the world, with an estimated 405 000 new cases expected each year. Subsites of the oral cavity include the alveolar ridge, buccal mucosa, anterior tongue, tonsillar pillar, retromolar trigone, hard palate, gingiva, and floor of the mouth. In this issue of the AHNS "Do you know your guidelines?" series, we review the evidence-based approach to the management of oral cavity carcinomas based on the framework provided by the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology...
February 2018: Head & Neck
Patrick Carpenter, Daniel Hall, Jeremy D Meier
PURPOSE OF REVIEW: The purpose of this review is to evaluate the current literature regarding postoperative management after tonsillectomy in children. RECENT FINDINGS: Controversy remains regarding the ideal medication regimen to manage pain after tonsillectomy. Acetaminophen and ibuprofen are routinely used, although concerns of more severe postoperative hemorrhage with ibuprofen remain. Narcotics are prescribed commonly, but with extreme caution in children with severe obstructive sleep apnea...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
Blanca Pilar Galindo Torres, Félix De Miguel García, Jaime Whyte Orozco
OBJECTIVE: Tonsillectomy is one of the surgical techniques most practiced by otolaryngologists, and despite being a relatively simple technique; it presents a considerable percentage of complications, such as postoperative bleeding. The aim of this study is to describe the surgical indications and most frequent complications, analyze whether surgical suture of the tonsillar pillars has an influence on bleeding, and study the data of hospital stay and its importance for the control of complications...
June 2018: Auris, Nasus, Larynx
Robert J Mann, Andrew L O'Brien, Nicholas S Adams, John A Girotto, John W Polley
Oropharyngeal stenosis (OPS) is a rare postoperative complication of adenotonsillectomy that can be a source of considerable patient distress and morbidity. Circumferential scarring of the soft palate and tonsillar pillars leads to narrowing of the oropharyngeal aperture. This case report describes the novel use of bilateral buccal myomucosal flaps for the repair of postoperative OPS in a 20-year-old woman presenting with dysphagia, odynophagia, dyspnea, and intermittent hypernasal speech. Postoperatively, the patient noted immediate improvement of her symptoms...
August 2017: Annals of Plastic Surgery
Gamal Abdel-Fattah
OBJECTIVE: Rarely the tonsillar pillars and the soft palate became adherent to the posterior nasopharyngeal wall by strong fibrous tissue due to excessive dissection and cauterization during surgery leading to nasopharyngeal stenosis. Therefore, many treatment modalities are being tried to cure this problem. The aim of this study is to explore our results of modifying the basic technique to accommodate those patients with combined nasopharyngeal stenosis and tonsillar pillars adhesions in one stage...
November 2016: International Journal of Pediatric Otorhinolaryngology
Taneeru Sravya, Guttikonda Venkateswara Rao, Manchikatla Praveen Kumar, K Sudheerkanth
Adenosquamous carcinoma (ASC) of the head and neck (H and N) is an aggressive variant of squamous cell carcinoma (SCC). They are described as SCC subtype with high infiltrative capacity and also presents with dual histomorphology, having both squamous and glandular cell components. ASC of the H and N region is considered as a controversial tumor, as it is similar to salivary gland mucoepidermoid carcinoma. It has been described in a variety of body sites, including uterine cervix, lung and pancreas. ASC rarely develops in the upper aerodigestive tract, particularly in the oral cavity...
September 2016: Journal of Oral and Maxillofacial Pathology: JOMFP
Mary Lauren Neel, Jeremy Kern, Tova Ronis
A 3-day-old girl was referred from her pediatrician for oral ulcerations. The patient was otherwise well appearing and afebrile. Her prenatal and antenatal courses were unremarkable, except for a failed routine hearing screen. The patient's examination was notable for several yellowish ulcers on erythematous bases located on her anterior tonsillar pillars. The patient also had a right coloboma and a II/VI systolic ejection murmur. Laboratory analyses revealed a traumatic lumbar puncture with 182 000 red blood cells and 808 white blood cells, as well as a complete blood count that showed thrombocytopenia and leukocytosis...
September 2016: Pediatrics
Devon Greer, Kathryn E Marshall, Scott Bevans, Aurora Standlee, Patricia McAdams, Wayne Harsha
OBJECTIVES: Reports of patient injuries associated with videolaryngoscopy are increasing in the literature. There are a wide variety of opinions regarding both safe use of the device and patient care following aerodigestive tract injury. We have seen an increase in videolaryngoscopy-associated injuries in recent years at our institution. Because of this, we wanted to determine if video-assisted laryngoscopy presents a greater risk of injury compared with direct laryngoscopy. Furthermore, we wanted to determine if there were patient and/or surgical factors that could contribute to patient injuries following videolaryngoscopy...
February 2017: Laryngoscope
Raymond K Tsang, F Christopher Holsinger
OBJECTIVES/HYPOTHESIS: To determine the feasibility of transoral endoscopic nasopharyngectomy without division of the soft plate using a flexible, next-generation robotic surgical system. STUDY DESIGN: Preclinical anatomic study using four human cadavers. METHODS: Transoral resection of the nasopharyngeal wall with en-bloc resection of the cartilaginous Eustachian tube and dissection of the parapharyngeal fat space. RESULTS: The first flexible robotic surgical system has recently been described...
October 2016: Laryngoscope
William R Kennedy, Michael P Herman, Rohan L Deraniyagala, Robert J Amdur, John W Werning, Peter Dziegielewski, Jessica Kirwan, Christopher G Morris, William M Mendenhall
This study is aimed at updating our institution's experience with definitive radiotherapy (RT) for squamous cell carcinoma of the tonsil. We reviewed 531 patients treated between 1983 and 2012 with definitive RT for squamous cell carcinoma of the tonsil. Of these, 179 patients were treated with either induction (n = 19) or concomitant (n = 160) chemotherapy. Planned neck dissection was performed on 217 patients: unilaterally in 199 and bilaterally in 18 patients. Median follow-up was 5.2 years for all patients (range 0...
August 2016: European Archives of Oto-rhino-laryngology
Ahmed Mohamed Mohyee Eldin Elbassiouny
BACKGROUND: The soft palate and the lateral pharyngeal walls contribute to the collapse of the upper airway in patients with snoring and obstructive sleep apnea. In this study, the original soft palatal webbing flap palatopharyngoplasty for both soft palatal and oropharyngeal lateral wall collapse has been modified to include all tonsil grades and to apply the barbed suture technique. METHODS: Twenty-one adults with significant soft palatal webbing, lateral pharyngeal wall collapse, and tonsil hypertrophy of any grade were selected for the study with a minimum follow-up period of 6 months...
May 2016: Sleep & Breathing, Schlaf & Atmung
Carlos Omaña-Cepeda, Andrea Martínez-Valverde, María del Mar Sabater-Recolons, Enric Jané-Salas, Antonio Marí-Roig, José López-López
BACKGROUND: To report an uncommon case of hand, foot and mouth disease, (HFMD) in an immunocompetent adult; a highly infectious disease, characterized by the appearance of vesicles on the mouth, hands and feet, associated with coxsackieviruses and enteroviruses; including a literature review. CASE REPORT: A 23 year Caucasian male with no medical or surgical history, no allergies, was not taking any medication and smoked ten cigarettes a day, suffering from discomfort in the oral cavity; itching, burning and pain when swallowing associated with small erythematous lesions located on the hard palate, and small ulcers in tonsillar pillars and right buccal mucosa...
March 15, 2016: BMC Research Notes
Matthew E Spector, Steven B Chinn, Emily Bellile, K Kelly Gallagher, Stephen Y Kang, Jeffrey S Moyer, Mark E Prince, Gregory T Wolf, Carol R Bradford, Jonathan B McHugh, Thomas E Carey, Francis P Worden, Avraham Eisbruch, Mohannad Ibrahim, Douglas B Chepeha
IMPORTANCE: Understanding the drainage patterns to the retropharyngeal lymph nodes is an important consideration in oropharyngeal squamous cell carcinoma (OPSCC) because treatment of these nodes is related to increased morbidity. Prediction of these drainage patterns could not only help minimize treatment morbidity but also prevent failures in at-risk patients as deintensification trials are under way for this disease. OBJECTIVE: To evaluate the prevalence of pathologic retropharyngeal adenopathy (RPA) in OPSCC relative to involvement of the oropharyngeal subsite, number of metastatic neck nodes, T classification, and N classification...
April 2016: JAMA Otolaryngology—Head & Neck Surgery
Rūta Pribuišienė, Valdas Šarauskas, Alina Kuzminienė, Virgilijus Uloza
OBJECTIVE: The aim of the study was to evaluate correlations between throat-related symptoms and histological findings in adults with chronic tonsillitis. MATERIALS AND METHODS: A prospective cohort study was carried out. Throat-related symptoms (complaints, tonsillitis rate, and pharyngeal findings) of 81 adults with histologically proven chronic tonsillitis followed by tonsillectomy were analyzed. Four types of histological changes in removed tonsils were determined: (1) pure hyperplasia, (2) chronic inflammation, (3) chronic inflammation with hyperplasia, (4) chronic inflammation with scarring/fibrosis...
November 2015: Medicina
William R Kennedy, Michael P Herman, Rohan L Deraniyagala, Robert J Amdur, John W Werning, Peter T Dziegielewski, Christopher G Morris, William M Mendenhall
The purpose of this study is to update our institution's experience with ipsilateral radiation therapy (RT) for squamous cell carcinoma of the tonsillar area. Outcome study of 76 patients treated between 1984 and 2012 with ipsilateral RT for squamous cell carcinoma of the tonsil. Patients had either cT1 (n = 41, 54 %) or cT2 (n = 35, 46 %) primaries and cN0 (n = 27, 36 %), cN1 (n = 15, 20 %), cN2a (n = 8, 11 %), or cN2b (n = 26, 34 %) nodal disease. Of these, 32 (42 %) patients underwent a planned neck dissection and 21 (28 %) patients received concomitant chemotherapy...
August 2016: European Archives of Oto-rhino-laryngology
Giselle Cuestas, Agustín Martínez Font, María Victoria Demarchi, María Pía Martínez Corvalán, Hernán García Rivello, Ana Morandi, Juan Razetti, Carlos Boccio
Tonsil malignancy is uncommon in children. Tonsillar asymmetry is usually secondary to a benign process, either inflammatory conditions, differences in the tonsillar fossa depth or anterior pillar asymmetry. However, it may indicate a serious underlying disorder such as lymphoma. Lymphoma is the most common childhood malignancy in the head and neck. Approximately, 15% of the cases affect the Waldeyer's ring. The most common clinical manifestations of palatine tonsils lymphoma are unilateral tonsillar hypertrophy, alteration in the appearance of the mucosa and ipsilateral cervical lymphadenopathy...
August 2015: Archivos Argentinos de Pediatría
Jared J Tompkins, Cory A Vaughn, Faisal A Shaikh, Rose Mary Stocks, Jerome W Thompson
Oropharyngeal stenosis is rare, but known complication from tonsillectomy procedure. A 15-year-old female presented with refractory dyspnea, mild obstructive sleep apnea, and dysphagia. She underwent tonsillectomy 3 years prior. Severe cicatricial oropharyngeal scar involving soft palate, anterior tonsillar pillars, and base of tongue, resulted in 1-cm(2) airway. Case report describing lysis of severe palatopharyngeal scar bands from tonsillectomy misadventure with immediate buccal mucosal grafts to repair resultant oropharyngeal defects...
September 2015: International Journal of Pediatric Otorhinolaryngology
Christopher H Rassekh, Ken Kazahaya, Virginia A Livolsi, Laurie A Loevner, Andy T Cowan, Gregory S Weinstein
BACKGROUND: Congenital cervical salivary duct fistulae are rare entities and can mimic branchial cleft fistulae. Ectopic salivary tissue associated with these pharyngocervical tracts may have malignant potential. METHODS AND RESULTS: We present a case report of a novel surgical approach and review of the literature. A 27-year-old man presented with complaint of drainage from the right side of his neck since early childhood. A tract was found from the posterior tonsillar pillar into the neck and ectopic salivary tissue was found along the tract...
February 2016: Head & Neck
Willis S Tsang, John K Woo, C Andrew van Hasselt
The most common sites of fish bone impaction are the tonsils, tonsillar pillars, tongue base, valleculae, and piriform fossa. Impaction in the supraglottic area is extremely uncommon.
October 2014: Ear, Nose, & Throat Journal
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