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Sample records for neck space infections

  1. Deep space infections of neck.

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    Kaluskar, S; Bajaj, P; Bane, P

    2007-03-01

    A retrospective study was performed on fourteen cases of deep cervical space infections in the neck admitted for diagnosis and treatment to the ENT Department, during a period of seven years from 1989-1997. Of the fourteen, four patients had Ludwig's angina and of the fourteen, one had a very serious complication resulting in death. Early diagnosis and adequate treatment were of paramount importance. The role of tracheostomy and management of airway in deep cervical space infections of the neck is discussed to gether with bacteriology, antibiotic treatment and surgical management.

  2. Deep-neck space infections - a diagnostic dilemma!

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    Jain, Shraddha; Kumar, Sunil; Kumar, Nishant; Puttewar, M P; Nagpure, P S

    2008-12-01

    Deep Neck Space Infections (DNI) are a potentially life threatening condition. This paper highlights the importance of their early diagnosis and early intervention. The deep-neck space infections may be odontogenic in origin. The severe airway compromise caused by them may make diagnosis difficult. Suspicion of simultaneous occurrence of tetanus and retropharyngeal space infection in a child can further increase the dilemma.

  3. Deep Neck Space Infection Caused by Keratocystic Odontogenic Tumor.

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    Oh, Ji-Su; Kim, Su-Gwan; You, Jae-Seek; Min, Hong-Gi; Kim, Ji-Won; Kim, Eun-Sik; Kim, Cheol-Man; Lim, Kyung-Seop

    2014-03-01

    Keratocystic odontogenic tumor (KCOT) is a benign cystic intraosseous tumor of odontogenic origin. An infection of a KCOT is not common because KCOT is a benign developmental neoplasm. Moreover, a severe deep neck space infection with compromised airway caused by infected KCOT is rare. This report presents a 60-year-old male patient with a severe deep neck space infection related to an infected KCOT due to cortical bone perforation and rupture of the exudate. Treatment of the deep neck space infection and KCOT are reported.

  4. Wound botulism presenting as a deep neck space infection.

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    Gouveia, Christopher; Mookherjee, Somnath; Russell, Matthew S

    2012-12-01

    Otolaryngologists commonly evaluate patients with findings suspicious for deep space soft tissue infections of the neck. In this case, a woman with a history of injection drug use (IDU) presented with dysphagia, odynophagia, and neck pain. Multiple neck abscesses, too small to drain, were seen on imaging. Despite broad-spectrum intravenous antibiotics, she unexpectedly and rapidly developed respiratory failure requiring intubation. Further work-up diagnosed wound botulism (WB). To our knowledge, this is the first report of WB presenting as a deep neck space infection, and illustrates the importance of considering this deadly diagnosis in patients with IDU history and bulbar symptoms.

  5. Odontogenic versus nonodontogenic deep neck space infections: CT manifestations

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    Kim, Hyung Jin; Park, Eui Dong; Kim, Jung Hee; Kim, Jae Hyoung; Hwang, Eui Gee; Chung, Sung Hoon [Gyeongsan National University Hospital, Jinju (Korea, Republic of)

    1995-10-15

    The purpose of this study was to evaluate computed tomographic (CT) findings of deep neck space infection (DNSI) with particular attention to the differences in the spaces involved and in complications between odontogenic and nonodontogenic groups. Forty-four patients (21 odontogenic and 23 nonodontogenic) were included in this study. Among odontogenic DNSIs, 15 had the dental infection in the second or third mandibular molar. We compared the CT features between odontogenic and nonodontogenic DNSIs with special emphasis on the differences in the spaces involved and in the rate and type of complications. In all patients, CT clearly differentiated abscess from cellulitis. The most common spaces involved in 21 patients with odontogenic DNSI were the parapharyngeal (n = 18), the submandibular (n = 18), the anterior visceral (n = 13), the masticator (n = 9), and the sublingual (n 7) spaces. In contrast, in 23 patients with nonodontogenic DNSI, the anterior visceral space (n = 14) was most frequently involved. The parapharyngeal, the submandibular, and the masticator spaces were statistically more frequently involved in odontogenic than in nonodontogenic DNSI ({rho} < .05). Twenty-two patients had one or more complications shown by CT, of which airway compromise was more frequent and severe in odontogenic than in nonodontogenic DNSI. We conclude that the parapharyngeal, the submandibular, and the masticator spaces are more significantly vulnerable in odontogenic DNSI than in nonodontogenic DNSI. The predilection for certain spaces of the neck in odontogenic DNSI seems to originate from the intimate relationship of the mandibular molars to the adjacent deep neck spaces.

  6. Emergency imaging assessment of deep neck space infections.

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    Maroldi, Roberto; Farina, Davide; Ravanelli, Marco; Lombardi, Davide; Nicolai, Piero

    2012-10-01

    Deep neck space infection may lead to severe and potentially life-threatening complications, such as airway obstruction, mediastinitis, septic embolization, dural sinus thrombosis, and intracranial abscess. The clinical presentation is widely variable, and often early symptoms do not reflect the disease severity. The complication risk depends on the extent and anatomical site: diseases that transgress fascial boundaries and spread along vertically oriented spaces (parapharyngeal, retropharyngeal, and paravertebral space) have a higher risk of complications and require a more aggressive treatment compared with those confined within a nonvertically oriented space (peritonsillar, sublingual, submandibular, parotid, and masticator space). Imaging has 5 crucial roles: (1) confirm the suspected clinical diagnosis, (2) define the precise extent of the disease, (3) identify complications, (4) distinguish between drainable abscesses and cellulitis, and (5) monitor deep neck space infection progression. Ultrasonography is the gold standard to differentiate abscesses from cellulitis, for the diagnosis of lymphadenitis. and to identify internal jugular thrombophlebitis in the infrahyoid neck. However, field-of-view limitation and poor anatomical information confine the use of ultrasonography to the evaluation of superficial lesions and to image-guided aspiration or drainage. Computed tomography (CT) combines fast image acquisition and precise anatomical information without field-of-view limitations. For these reasons, it is the most reliable technique for the evaluation of deep and multicompartment lesions and for the identification of mediastinal and intracranial complications. Contrast agent administration enhances the capability to differentiate fluid collections from cellulitis and allows the detection of vascular complications. Magnetic resonance imaging is more time-consuming than CT, limiting its use to selected indications. It is the technique of choice for assessing

  7. Life-threatening complications of deep neck space infections.

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    Dalla Torre, Daniel; Brunold, Silvia; Kisielewsky, Irene; Kloss, Frank R; Burtscher, Doris

    2013-11-01

    Odontogenic infections represented a challenge for every craniomaxillofacial surgeon in the pre-antibiotic era, not least due to the frequent association with septic complications and lethal consequences. Nowadays, the incidences of serious infection-related complications are less frequent thanks to the medical progress. Nevertheless, the development of severe infections is still hard to foresee. The following analysis provides an overview of four patients with severe, life-threatening odontogenic deep neck space infections treated at the University Clinic for Oral and Maxillofacial Surgery in Innsbruck and describes the etiology, therapy, and outcome for each patient while analyzing differences between the single cases. Crucial aspects in origin, progression, and treatment of DNIs are highlighted, comparing the results with the international literature.

  8. Deep Neck Space Infections: A Study of 76 Cases

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    Gaurav Kataria

    2015-07-01

    Full Text Available Introduction: Deep neck space infections (DNSI are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are dental infections, tonsillar and salivary gland infections, malignancies, and foreign bodies. With widespread use of antibiotics, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, presentation, sites involved, bacteriology, and management and complications of DNSI.   Materials and Methods: This retrospective study was performed from October 2010 to January 2013, and included 76 patients with DNSI. Patients of all age groups and gender were included. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and required interventions were studied.   Results: In our study, the majority of patients were in the 31–50-year age group. Males accounted for 55.26% of the sample and females for 44.74%, with a male:female ratio of 1.23. Most of the patients were from a rural background. Diabetes was found as a co-morbid condition in 10.52% cases. Neck pain was the most common symptom, identified in 89.47% cases. The most common etiological factor was odontogenic infection (34.21%, followed by tonsillar and pharyngeal infection (27.63%. The most common presentation was Ludwig’s angina (28.94%, followed by peritonsillar abscess and submandibular abscess. In 50% of cases, Streptococcus and Staphylococcus were found in the culture. Surgical intervention was carried out in 89.47% cases. Emergency tracheotomy was required in 5.26% cases.   Conclusion:  DNSI can be life-threatening in diabetic patients, the immunocompromised, and elderly patients, and special attention should therefore be given

  9. A pain in the neck--a review of deep space neck infections in the emergency department.

    Science.gov (United States)

    Harney, T; Mullarkey, C; O'Donnell, J

    2012-01-01

    We report a case of prevertebral abscess in a 37-year-old male, presenting with a 2-day history of neck pain radiating to the right shoulder. We also review the current literature relating to the presentation and the emergency management of deep neck space infections.

  10. Odontogenic deep neck space infection as life-threatening condition in pregnancy.

    Science.gov (United States)

    Dalla Torre, D; Burtscher, D; Höfer, D; Kloss, F R

    2014-09-01

    Odontogenic deep neck space infections represent a severe disease with possible life-threatening complications. Despite knowledge of these infectious diseases, treatment remains a challenge for every maxillofacial surgeon. Therapy of severe neck infections is even more crucial during pregnancy because of the possible life-threatening situation for both the mother and the foetus. The possible compromise of oral health during pregnancy is well known, however severe odontogenic infections are rarely considered in the literature. The following case report describes the dramatic course of a deep neck space infection in a pregnant patient, commencing with typical symptoms of localized odontogenic infection and ending in a critical, life-threatening condition for the patient and a lethal condition for the foetus. The case represents the first description of intrauterine, foetal death caused by a deep neck space infection. Implications for dental and medical treatment during pregnancy, especially regarding odontogenic infections, are presented and discussed with findings in the international literature.

  11. Bilateral deep neck space infection in pediatric patients: review of literature and report of a case.

    Science.gov (United States)

    Raghani, Manish J; Raghani, Nisha

    2015-01-01

    The diagnosis and treatment of deep neck infections is still an enigma for surgeons and physicians. Because of the complexity and the deep location of this region, the diagnosis and treatment in this area is difficult. The anatomy of deep neck spaces is highly complex and therefore precise localization of infections in this region is very difficult. The diagnoses of deep neck space infection (DNSI) are difficult because of the deep location of these spaces and are usually covered by substantial amount of normal superficial soft tissue. Access: To gain surgical access to the deep neck spaces, the superficial tissues must be crossed with the risk of injury to the neurovascular structures in the neck. Neural dysfunction, vascular erosion or thrombosis, and osteomyelitis are some of the complications of DNSI because of the proximity of nerves, vessels, bones, and other soft tissues. Deep neck spaces are communicated with each other and infections from one space can spread to adjacent space. DNSI, if not diagnosed early and promptly, may result in serious consequences even mortality. The treatment of DNSI with antibiotic therapy and drainage is most often definitive and recurrence of these cases is rare.

  12. Relationship between Neutrophil-to-Lymphocyte Ratio and Prognosis in Patients with Deep Neck Space Infection

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    Engin Şengül

    2016-03-01

    Full Text Available Objective: The aim of this study was to demonstrate if there is any relation between the neutrophil-to-lym­phocyte ratio and prognosis in patients with deep neck space infections Methods: One hundred eight patients who were interned and treated due to deep neck infection in department of otolaryngology between January 2010 and January 2015 were analyzed. Demographics, clini­cal data, complications and treatment results of patients were evaluated. Pediatric patients between the age of 0 and 14, the patients who had only peritonsillary abscess, infection secondary to trauma were excluded from study. During follow-up and treatment duration the patients with deep neck infections were divided into two groups ac­cording to whether they had any complication (group 1 or not (group 2. Results: Fourteen (13% patients with deep neck in­fections had life-threatening complications whereas 94 (87% did not have any complication during follow-up and treatment duration. The mean neutrophil-to-lymphocyte ratio in patients with complications was significantly high­er than the patients without any complications (p0.05. Conclusion: This study showed that the neutrophil-to-lymphocyte ratio can be used as a cheap, easily obtained and predictive prognostic factor in patients with deep neck infections.

  13. Bilateral deep neck space infection in the paediatric age group: a case report and review of the literature.

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    Songu, M; Demiray, U; Adibelli, Z H; Adibelli, H

    2011-06-01

    Deep neck space infections can occur at any age but require more intimate management in the paediatric age group because of their rapidly progressive nature. Concurrent abscess in distinct neck spaces has rarely been reported in healthy children. Herewith, a rare case of bilateral neck abscess is reported in a 16-month-old female and the clinical presentation and management are discussed with a review of the literature.

  14. Internal carotid artery pseudoaneurysm with life-threatening epistaxis as a complication of deep neck space infection.

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    da Silva, Paulo Sérgio Lucas; Waisberg, Daniel Reis

    2011-05-01

    Pseudoaneurysm of the cervical internal carotid artery is a very rare, potentially fatal complication of a neck space infection in children associated with high mortality and morbidity. A 3-year-old boy presented with spontaneous massive epistaxis 45 days after a deep neck space infection caused by a peritonsillar abscess. During nasopharyngeal packing, he evolved with cardiac arrest. Intra-arterial angiography was then performed that revealed a large pseudoaneurysm. Endovascular treatment using detachable balloons achieved complete exclusion of the pseudoaneurysm. The child made an uneventful recovery and was discharged with mild left hemiparesis and no deficit of sensory or cognitive functions. Pseudoaneurysms of the internal carotid artery after a deep neck space infection can be associated with delayed and potentially fatal massive epistaxis. Furthermore, a regional (ie, extranasal) blood vessel should be promptly investigated when there are signs of hypovolemic shock. A high level of suspicion and definitive treatment are essential for successful management of these patients.

  15. DEEP NECK INFECTION AFTER THIRD MOLAR EXTRACTION*

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    Seda YILMAZ

    2015-04-01

    Full Text Available Odontogenic and oropharyngeal infections are relatively common in the cervicofacial region. In rare cases, odontogenic or peritonsillar abscesses may spread through the deep fascial cervical spaces and cause life-threatening complications. Odontogenic infection is the most common cause of deep neck infections and it accounts for 43% of the cases. Early diagnosis, immediate antibiotic treatment, and surgical drainage are the basis of therapeutic success. Deep neck infections are potentially life threatening complications if they are not diagnosed in time and treated quickly. This case report presents clinical, radiological features and treatment of the spread of abscesses through cervical spaces of an unusual case of deep neck infection that was caused by the secondary infection of the root remnants after extraction.

  16. Fusobacterial head and neck infections in children.

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    Brook, Itzhak

    2015-07-01

    Fusobacterium species are increasingly recognized as a cause of head and neck infections in children. These infections include acute and chronic otitis, sinusitis, mastoiditis, and tonsillitis; peritonsillar and retropharyngeal abscesses; Lemierre syndrome; post-anginal cervical lymphadenitis; and periodontitis. They can also be involved in brain abscess and bacteremia associated with head and neck infections. This review describes the clinical spectrum of head and neck fusobacterial infection in children and their management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Lack of Association of Tumor Necrosis Factor-α G-308A and Transforming Growth Factor-β1 C-509T Polymorphisms in Patients with Deep Neck Space Infections.

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    Jevtović-Stoimenov, T; Despotović, M; Pešić, Z; Cosić, A

    2013-12-01

    Deep neck space infections are defined as infections that spread along the fascial planes and spaces of the head and neck. Even in the era of antibiotics, these infections can and have been potentially life-threatening conditions. The role of single nucleotide polymorphisms (SNPs) of tumor necrosis factor-α (TNF-α) and transforming growth factor-β1 (TGF-β1) genes in deep neck infections has not been studied. Thus, the aim of this study was to investigate the distribution of the TNF-α G-308A and TGF-β1 C-509T polymorphisms in patients suffering from infections of deep neck spaces and to determine the correlation of these polymorphisms with the values of inflammation markers [C-reactive protein (CRP) and white blood cell (WBC) count]. A total of 41 patients with infections of deep neck spaces and 44 healthy controls were screened for TNF-α G-308A and TGF-β1 C-509T polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. The distribution of the TNF-α G-308A genotype in patients did not reveal statistically significant correlation compared to con-trols (p = 0.483, χ(2) = 0.491) as well as the distribution of the TGF-β1 C-509T genotypes (p = 0.644, χ(2) = 0.725). The distribution of TNF-α -308 and TGF-β1 -509 alleles was not significantly different in patients compared to controls. Moreover, CRP levels and WBC counts were not associated with TNF-α G-308A and TGF-β1 C-509T promoter polymorphisms in patients with deep neck infections. In conclusion, our study suggests that the TNF-α G-308A and TGF-β1 C-509T polymorphisms are not associated with infections of deep neck spaces.

  18. CT diagnosis of interfascial space infections in maxillofacial and neck part%颌面部颈部筋膜间隙感染的 CT 诊断

    Institute of Scientific and Technical Information of China (English)

    王镇; 邹真; 杨君

    2015-01-01

    OBJECTIVE To investigate nosocomial infections of interfascial space in maxillofacial and neck part and diagnostic significance of multi - slice spiral CT to provide reference for clinical diagnosis and treatment . METHODS Totally 52 patients with interfascial space infections in maxillofacial and neck part admitted and treated in the hospital during Jul .2009 to Mar .2014 were enrolled and their drainage pus after operation was collected for bacterial culture and simultaneously anaerobic culture .The performance of multi‐slice spiral CT diagnosis and the spread ways were observed .The software SPSS19 .0 was used for data analysis .RESULTS The 52 cases of patients with nosocomial infections had 59 strains of pathogens cultured from the specimens with pathogens ranking the top three including 13 strains of K lebsiella pneumoniae accounting for 22 .03% ,16 strains of Streptococcus pyogenes accounting for 27 .11% ,and 8 strains of Streptococcus anginosus accounting for 13 .56% .Multi‐slice spiral CT diagnosed that the 52 patients were infected with cellulitis or abscess .CT of abscess showed abscess wall ring enhancement ,with low density of vomicae .CT of cellular inflammation showed thickening and swelling of the affected muscles with fuzzy boundaries and the skin of affected parts had edema and thickness and the fat in fascial space disappeared .The 52 patients with interfascial space infection included 27 patients with masseteric space infection ,12 patients with mouth floor space infection ,10 patients with infection of carotid space abscess ,and 3 patients with space infection around tonsil .CONCLUSION Multi‐slice spiral CT has high accuracy for diagnosis of interfascial space infection in maxillofacial and neck part ,and the diagnostic CT can display spread ways ,which has important clinical value .%目的:探讨颌面部颈部筋膜间隙医院感染及多层螺旋 CT诊断意义,为临床诊断治疗提供参考。方法选择2009年7月-2014年3

  19. Clinical Versus Computed Tomography Evaluation In The Diagnosis And Management Of Deep Neck Infection.

    OpenAIRE

    Agricio Nubiato Crespo; Carlos Takahiro Chone; Adriano Santana Fonseca; Maria Carolina Montenegro; Rodrigo Pereira; João Altemani Milani

    2015-01-01

    CONTEXT: Deep neck infections have high potential for severe complications and even death, if not properly managed. The difference between clinical and computed tomography findings may demonstrate that clinical evaluation alone underestimates disease extent, which may lead to conservative treatment with worse prognosis. OBJECTIVE: To compare clinical and computed tomography findings from neck spaces affected by deep neck infections and to determine the main clinical and radiological features ...

  20. Imaging Aspect of Fasciae and Spaces of the Neck

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    Malekmaryam Afkar

    2010-05-01

    Full Text Available The importance of the fasciae of the neck is their ability to define spaces, which may limit to some degree the spread of most infections and some tumors. "nFascia has been variously described in the literature as a collection of fat and fibrous tissue that seems to equate with a "fat layer" a thin but firm well-defined layer of fibrous tissue such as an aponeurosis. "nThe interest in the fasciae and spaces of the neck stems from early anatomic investigations was pe-formed by surgeons who were seeking ways to pre-dict the spread of infection. "nThey believed correctly that knowledge of such routes of spread would allow them to approach and drain abscesses more effectively. "nWith the utilization of CT and MR imaging, it has been noted that the growth of some tumors appears to be restricted by certain fasciae and knowledge of the anatomy of these fasciae allows one to predict such growth patterns. "nOnce the often complex anatomy of these fasciae is mastered, one can achieve a better understanding of the spread of both infections and some tumors in the neck.

  1. Serious soft tissue infections of the head and neck

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    Herr, R.D.; Murdock, R.T.; Davis, R.K. (University of Utah School of Medicine, Salt Lake City (USA))

    1991-09-01

    The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage. 25 references.

  2. Infections of the neck leading to descending necrotizing mediastinitis: Role of multi-detector row computed tomography

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    Pinto, Antonio [Department of Diagnostic Imaging, A. Cardarelli Hospital, 80131 Naples (Italy)], E-mail: antopin1968@libero.it; Scaglione, Mariano; Scuderi, Maria Giuseppina; Tortora, Giovanni; Daniele, Stefania; Romano, Luigia [Department of Diagnostic Imaging, A. Cardarelli Hospital, 80131 Naples (Italy)

    2008-03-15

    Descending necrotizing mediastinitis is an acute, polymicrobial infection of the mediastinum, originating from odontogenic, oropharyngeal and cervical infections. Anatomical continuity of the fascial spaces between the neck and the mediastinum leads to an occasional mediastinal extension of deep neck infection as a serious sequela. An understanding of the anatomy of the deep spaces of the neck and familiarity with the imaging findings in descending necrotizing mediastinitis may allow rapid diagnosis and treatment of this rare and life-threatening complication of deep neck space infection. In this article, we discuss the current role of radiology in diagnosing descending necrotizing mediastinitis, in determining the level of infection and the pathways of spread of infections from the neck to the mediastinum and in planning a successful treatment.

  3. Os espaços cervicais profundos e seu interesse nas infecções da região Deep neck spaces and their interest in cervical infections

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    M.D. Durazzo

    1997-06-01

    Full Text Available As infecções dos espaços cervicais profundos, embora raras, associam-se a alta morbi-mortalidade. A abordagem cirúrgica faz-se necessária na maioria dos casos e se baseia no conhecimento da complexa anatomia das fáscias cervicais e dos espaços cervicais profundos. OBJETIVO. Apresentar considerações anatômicas de interesse prático sobre fáscias e espaços do pescoço, sua conceituação e nomenclatura, relatando, a título de exemplo, quatro casos de infecções dos espaços cervicais profundos. MATERIAL E MÉTODO. São apresentados um caso de angina de Ludwig complicada com mediastinite, pericardite, pneumonia, empiema pleural, fístula esofágica e choque séptico, um caso de abscesso cervical espontâneo em paciente diabético, um caso de abscesso de loja submandibular e um caso de abscesso parafaríngeo iniciado após manipulação dentária. Nos quatro casos, a documentação imagenológica é rica e, em dois deles, evidencia o comprometimento de mais de um espaço profundo do pescoço. CONCLUSÕES. A literatura enfatiza morbidade e mortalidade elevadas, etiologia diversificada (infecções dentárias, uso de drogas endovenosas, infecções do trato aerodigestivo alto e outras, a necessidade de traqueostomia em cerca de 50% dos casos e o emprego da terapêutica combinada (antibioticoterapia e abordagem cirúrgica do pescoço. Os métodos imagenológicos, como a tomografia computadorizada, são imprescindíveis no estudo de infecções dos espaços profundos do pescoço, tanto para a avaliação do sítio e extensão da afecção, como para o planejamento terapêutico.BACKGROUND. Although rare, deep neck space infections are associated with high morbidity and mortality rates. The surgical approach is necessary in the majority of the cases, and the surgeon must know the complex anatomy of the cervical fasciae and deep neck spaces. PURPOSE. The anatomy of the cervical fasciae and deep neck spaces is reviewed. As an illustration, a

  4. Nursing care of patient with odontogenic deep neck space infections and secondary mediastinal abscess%牙源性颈深间隙广泛感染并发纵隔脓肿患者的护理

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    李少云; 安卫红; 李宇轩; 张会芝

    2015-01-01

    A report of one case of severe dental deep neck space abscess complicated with extensive mediastinal ab-scess,after operation and nursing discharge. Early tracheotomy,ensure the ventilation function, paying attention to o-ral care and twice airway management; assessment and preparation to the floor of the mouth, neck and chest incision drainage of pus preoperative,monitoring signs of postoperative infection, wound and drainage management; reasonable arrangements for antibiotic input, ensure the stable blood drug level; strengthen psychological counseling for patients and family members.%报告1例重症牙源性颈深间隙广泛脓肿形成并发纵隔脓肿、两次手术排脓患者的护理经过。早期气管切开,保证通气功能,重视口腔护理及气道管理;做好口底和颈部及胸部切开排脓术前的评估及准备、术后感染征象的监测、创面及引流管的管理;合理安排抗生素输入,保证稳定的血药浓度;加强对患者及家属的心理疏导。

  5. Computed Tomography Findings in Deep Neck Infections in Children

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    Ayşe Seçil Ekşioğlu

    2014-03-01

    Full Text Available Aim: This study aims to review the computed tomography (CT findings in children with deep neck infections. The crucial role of CT in the diagnosis is emphasized. Methods: Contrast enhanced CT images and medical records of twelve children (4 girls, 8 boys, age range: 1-14 years, mean age: 9 diagnosed with deep neck infection were retrospectively evaluated. Positive CT findings of deep neck infection were: cellulitis, increased fatty tissue echogenicity, loss of soft tissue planes, myositis, and necrotic lymphadenopathy; presence of phlegmon, peritonsillar, retropharyngeal or parapharyngeal abscess. The first four findings were considered as ‘early findings’ while the presence of an abscess indicated advanced infection and was solely enough to make a diagnosis. Results: 42% of the children with deep neck infections had necrotic cervical lymphadenopathies. 5 children (52% had cellulitis, 11 (92% had increased fatty tissue dansity, and 6 (50% children had myositis. Deep neck abscesses (3 retropharyngeal, 4 parapharyngeal, 2 peritonsillar were depicted in 7 children and phlegmon in one child. 2 patients had combined parapharyngeal/retropharyngeal abscesses. The most frequent type was parapharyngeal abcess. Conclusion: CT imaging has a crucial role in the diagnosis and follow-up of deep neck infections in children and is the preferred modality of choice. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 34-8

  6. Application of radiographic images in diagnosis and treatment of deep neck infections with necrotizing fasciitis: a case report

    OpenAIRE

    2011-01-01

    The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We success...

  7. Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

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    Cemal Hacı

    2016-09-01

    Full Text Available Aim: In our study, we assessed symptoms and treatment outcomes in patients with deep neck infections (DNI. It often has a rapid onset and can cause lethal complications. Methods: A retrospective designed study of 85 patients diagnosed with DNI such as peritonsillar, parapharyngeal, and submandibular abscesses. Results: A total of 85 patients were diagnosed with DNI. 33 of the 85 patients were younger than 18 (group of children, and 52 were older than 18 years of age (group of adults. The mean age of the patients was 24.109±14.003 (4-54 years. Trismus, fever, odynophagia and pain were the most common complaints in both groups. In the adults group, the peritonsillar space was the most common site of infection (49%. In children group, the parapharyngeal space was the most common site of infection (35%. All patients were given intravenous antibiotic therapy and additional drainage of the abscess was also carried out for some of the patients. Most frequently, intravenous ampicillin-sulbactam alone or in combination with metronidazole was administrated to the patients. Conclusion: Most of the cases of DNI can be treated with intravenous antibiotics in spite of the fact that if there is no clinical healing, drainage is needed.

  8. CT differentiation of abscess and non-infected fluid in the postoperative neck

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    Yoon, Soo Jeong; Yoon, Dae Young [Dept. of Radiology, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)], e-mail: evee0914@chollian.net; Kim, Sam Soo [Dept. of Radiology, Kangwon National Univ. Coll. of Medicine, Kangwon-do (Korea, Republic of); Rho, Young-Soo; Chung, Eun-Jae [Dept. of Otorhinolaryngology, Ilsong Memorial Inst. of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of); Eom, Joong Sik; Lee, Jin Seo [Dept. of Internal Medicine, Div. of infectious disease, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)

    2013-02-15

    Background: Differentiation of postoperative neck abscess from non-infected fluid is important because the treatment is different. Purpose: To determine specific CT findings that might help to differentiate abscesses from non-infected fluid collections in the postoperative neck. Material and Methods: We retrospectively reviewed CT scans of 50 patients (43 men and 7 women; mean age, 62.5 {+-} 8.9 years) who had postoperative fluid collections in the neck (26 abscesses and 24 non-infected fluid collections). Diagnosis of an abscess was determined by a positive bacteria culture from the fluid collection. Diagnoses were correlated with the following CT findings: anatomic spaces involved, the maximum transverse diameter, margin, attenuation, rim enhancement, gas bubbles, and manifestations of soft tissue adjacent to a fluid collection. Results: Rim enhancement pattern and soft tissue manifestations showed significant differences between abscess and non-infected fluid. The reliable CT findings for abscess were: (i) rim enhancement > 50% of the circumference, 54% sensitive, 71% specific, and 62% accurate; and (ii) severe soft tissue manifestations, 39% sensitive, 92% specific, and 64% accurate. There were no significant differences in the anatomic spaces involved, the maximum transverse diameter, margin, attenuation, and gas bubbles between abscess and non-infected fluid. Conclusion: CT findings that may help differentiate postoperative neck abscess from non-infected fluid were rim enhancement > 50% of the circumference and severe soft tissue manifestations.

  9. Airway management in patients with deep neck infections

    Science.gov (United States)

    Cho, Soo Young; Woo, Jae Hee; Kim, Yoon Jin; Chun, Eun Hee; Han, Jong In; Kim, Dong Yeon; Baik, Hee Jung; Chung, Rack Kyung

    2016-01-01

    Abstract Securing the airway in patients undergoing surgical intervention to control a deep neck infection (DNI) is challenging for anesthesiologists due to the distorted airway anatomy, limited mouth opening, tissue edema, and immobility. It is critical to assess the risk of a potential difficult airway and prepare the most appropriate airway management method. We reviewed our anesthetic experiences managing patients with DNIs, focusing on the need for video-laryngoscope or awake fiberoptic intubation beyond a standard intubation from the anesthesiologist's perspective. When patients had infections in the masticatory space, mouth of floor, oropharyngeal mucosal space, or laryngopharynx, their airways tended to be managed using methods requiring more effort by the anesthesiologists, and more extensive equipment preparation, compared with use of a standard laryngoscope. The degree to which the main lesion influenced the airway anatomy, especially at the level of epiglottis and aryepiglottic fold was related to the airway management method selected. When managing the airways of patients undergoing surgery for DNIs under general anesthesia, anesthesiologists should use imaging with computed tomography to evaluate the preoperative airway status and a comprehensive understanding of radiological findings, comorbidities, and patients’ symptoms is needed. PMID:27399122

  10. INVASIVE FUNGAL INFECTIONS OF HEAD AND NECK: A RETROSPECTIVE STUDY

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    Somu

    2015-08-01

    Full Text Available Invasive fungal infection of the head and neck is an emerging problem with diverse presentation. It has recently gained clinical importance as it causes considerable morbidity and mortality. It is more common in patients with diabetics, chronic renal disease, patients undergoing chemotherapy etc. Early recognition of this entity will enable treating surgeon to institute appropriate treatment. AIM OF THE STUDY: To review the microbiological and clinicopathological profile of patients diagn osed as invasive fungal infections of the head and neck in a tertiary referral hospital. METHODOLOGY: In this retrospective study we reviewed the clinical data ( M icrobiology, clinical manifestations, radiological investigation, diagnosis, therapy and histolopathology of 25 patients diagnosed and treated for invasive fungal infection of the head and neck in our unit in a tertiary care hospital. The period of study was July 2006 to July 2010 (4 years. All cases with a diagnosis of invasive fungal infection of the head and neck region, confirmed either by fungal smear, culture or histopathological examination were included in the study. RESULTS: In this study, Of the 25 patients, majority had invasive fungal rhinosinusitis (52%, mucormycosis (32% and zygomycotic necrotizing fasciitis (12%. One patient had invasive subcutaneous aspergillosis. Most of the patients presented in the fifth decade of life, 86% of these patients had uncontrolled diabetes. The commonest presentation in mucormycosis was head ache or facial pain (100% along with ptosis (88%. Fungal smear was positive in 81%, fungi were isolated in culture in 54% and histopathological study was positive for fungal hyphae in all these patients (100%. Though all these patients had florid fungal infection of the head and neck only one patient had clinical and radiological evidence of cervical lymphadenitis. CONCLUSION: A clinical suspicion of mucormycosis should be kept in mind in an immunocompromised patient

  11. Application of radiographic images in diagnosis and treatment of deep neck infections with necrotizing fasciitis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Joo; Kim, Ju Dong; Ryu, Hye In; Cho, Yeon Hee; Kong, Jun Ha; Ohe, Joo Young; Kwon, Yong Dae; Choi, Byung Joon; Kim, Gyu Tae [School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2011-12-15

    The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

  12. Deep Neck Infections: A Retrospective Analysis of Eighty Five Cases

    OpenAIRE

    2016-01-01

    Aim: In our study, we assessed symptoms and treatment outcomes in patients with deep neck infections (DNI). It often has a rapid onset and can cause lethal complications. Methods: A retrospective designed study of 85 patients diagnosed with DNI such as peritonsillar, parapharyngeal, and submandibular abscesses. Results: A total of 85 patients were diagnosed with DNI. 33 of the 85 patients were younger than 18 (group of children), and 52 were older than 18 years of age (group of adults)....

  13. Thoracic complications of deeply situated serous neck infections.

    Science.gov (United States)

    Colmenero Ruiz, C; Labajo, A D; Yañez Vilas, I; Paniagua, J

    1993-03-01

    Nine cases of complicated deep neck infections, occurring during a period of twelve years are presented. Complications observed were cervico-thoracic necrotizing fasciitis in 3 cases, purulent pleural effusion in 6 cases, pericardial effusion in 2, mediastinitis in 8 cases, jugular vein thrombosis and rupture of the innominate artery in one case each. Although 2 cases were managed initially with blind endotracheal intubation, all cases finally required tracheostomy. A cervico-mediastinal approach was useful for the early mediastinal involvement. Two patients died because of inadequacy of the multiple surgical procedures resulting in persistent infection and multi-organ failure and one because of uncontrollable bleeding after innominate artery rupture.

  14. Predisposing Factors of Complicated Deep Neck Infection: An Analysis of 158 Cases

    OpenAIRE

    Lee, Joon-Kyoo; Kim, Hee-Dae; Lim, Sang-Chul

    2007-01-01

    Both the introduction of antibiotics and improvements in oral hygiene have made deep neck infections occur less frequently today than in the past. Nevertheless, the complications from these infections are often life-threatening. The purpose of this article was to review the clinical findings of deep neck infections and identify the predisposing factors of these complications. The present study reviewed 158 cases of deep neck infections between the years of 1995 to 2004, 23 of which had life-t...

  15. Intraoperative hypotension associated with massive deep space neck abscesses in a 9-month old: A case report.

    Science.gov (United States)

    Plum, Ann; Sobin, Lindsay; Tatum, Sherard

    2016-04-01

    The neck is divided into multiple compartments by cervical fasciae. The deep space compartments, which all have a potential for becoming infected, are interconnected, providing a mechanism for the spread of infections. Thus, infections of the deep spaces can lead to devastating consequences, especially when there is extension to the mediastinum. Here we report a case of intraoperative hypotension in a 9-month-old child with extensive bilateral parapharyngeal and retropharyngeal abscesses with mediastinal extension with a focus on when hemodynamic monitoring should be considered.

  16. Head and neck fascia and compartments: no space for spaces.

    Science.gov (United States)

    Guidera, Alice K; Dawes, Patrick J D; Fong, Amy; Stringer, Mark D

    2014-07-01

    An accurate understanding of the arrangement of cervical fascia and its associated compartments is essential for differential diagnosis, predicting the spread of disease, and surgical management. The purpose of this detailed review is to summarize the anatomic, clinical, and radiological literature to determine what is known about the arrangement of cervical fascia and to highlight controversies and consensus. The current terminology used to describe cervical fascia and compartments is replete with confusing synonyms and inconsistencies, creating important interdisciplinary differences in understanding. The term "spaces" is inappropriate. A modified nomenclature underpinned by evidence-based anatomic and radiologic findings is proposed. This should not only enhance our understanding of cervical anatomy but also facilitate clearer interdisciplinary communication. Copyright © 2014 Wiley Periodicals, Inc.

  17. Head and neck cancers masquerading as deep neck abscesses.

    Science.gov (United States)

    Soon, Sue Rene; Kanagalingam, Jeevendra; Johari, Shirish; Yuen, Heng Wai

    2012-12-01

    Deep neck space abscesses are common otolaryngological emergencies, and prompt incision and drainage is the treatment of choice. Head and neck cancers often present with cervical metastases that may become secondarily infected. Clinical presentation is similar to a deep neck abscess. Surgical drainage of such collections has implications on subsequent treatment. In this case series, we describe six cases with this unusual presentation that were subsequently found to have a head and neck malignancy, and where three patients had their abscesses treated surgically. We aim to raise awareness of this unusual presentation of a head and neck carcinoma, and to avoid a potential pitfall in the management of deep neck abscess.

  18. Characteristics of Deep Neck Infection in Children According to Weight Percentile

    OpenAIRE

    2014-01-01

    Objectives To evaluate the effect of weight percentile on deep neck infections in children. Methods A retrospective evaluation of 79 patients who were treated for deep neck infections. The patients were divided into six groups according to weight percentile. Patients who had systemic and/or congenital disease were excluded. Their demographics, etiology, localization, laboratory, and treatment results were reviewed. Results In total, 79 pediatric patients were recorded: 48.1% were females and ...

  19. Anaerobic bacteria in upper respiratory tract and head and neck infections: microbiology and treatment.

    Science.gov (United States)

    Brook, Itzhak

    2012-04-01

    Anaerobes are the predominant components of oropharyngeal mucous membranes bacterial flora, and are therefore a common cause of bacterial infections of endogenous origin of upper respiratory tract and head and neck. This review summarizes the aerobic and anaerobic microbiology and antimicrobials therapy of these infections. These include acute and chronic otitis media, mastoiditis and sinusitis, pharyngo-tonsillitis, peritonsillar, retropharyngeal and parapharyngeal abscesses, suppurative thyroiditis, cervical lymphadenitis, parotitis, siliadenitis, and deep neck infections including Lemierre Syndrome. The recovery from these infections depends on prompt and proper medical and when indicated also surgical management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. A pain in the neck-Imaging in neck sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Lyle, N.J., E-mail: nickylyle@doctors.org.uk [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom); Rutherford, E.E.; Batty, V.B. [Department of Diagnostic Imaging, Southampton General Hospital, Southampton (United Kingdom)

    2011-09-15

    Deep neck infection has a high morbidity and mortality and the extent of infection is often difficult to estimate clinically. The complex anatomy and the communication between neck spaces means that infection can spread along fascial planes leading to life-threatening complications such as airway compromise, vascular erosion/thrombosis, neural dysfunction, and ultimately descending necrotizing mediastinitis. Imaging has an important role to play in identifying the extent of infection and the presence of complications.

  1. Otitis media and a neck lump--current diagnostic challenges for Paragonimus-like trematode infections.

    Science.gov (United States)

    Schuster, H; Agada, F O; Anderson, A R; Jackson, R S; Blair, D; McGann, H; Kelly, G

    2007-02-01

    A 29 year-old Nigerian studying in the UK presented with a neck lump and otitis media. Paragonimus-like trematode eggs were found in the neck lump aspirate. Morphologically these eggs resembled Paragonimus uterobilateralis or Achillurbainia congolensis. We favoured the diagnosis of achillurbainiasis over extrapulmonary paragonimiasis on the basis of clinical features and because we could not amplify DNA sequences using PCR primers specific for Paragonimus species. We discuss current diagnostic challenges for this rare parasitic infection.

  2. A retrospective analysis of deep neck infections at Royal perth hospital.

    Science.gov (United States)

    Matzelle, S J; Heard, A M B; Khong, G L S; Riley, R H; Eakins, P D

    2009-07-01

    Serious deep neck infections may result in life-threatening airway complications. The aim of this study was to review the management of patients requiring surgical drainage with deep neck infections and to identify possible factors that may predict a greater risk of airway complications. In this study the authors reviewed the notes of patients requiring surgical drainage of deep neck infections who were admitted to Royal Perth Hospital over a seven-year period (2000 to 2007). One hundred and twenty-nine suitable patients were identified, of whom 15.5% encountered airway complications including one death due to airway obstruction. Airway complications were more common if there was no consultant anaesthetist present (odds ratio 4.01 [confidence interval 1.20 to 13.46], P = 0.02). Deep neck infections are still relatively common and are associated with significant morbidity and mortality. Patients with deep neck infections represent an anaesthetic challenge which should be managed by those with an appropriate level of experience.

  3. Orofacial Space Infection Due to Faulty Prosthesis

    OpenAIRE

    Pramod Krishna, B.; Batra, Ranmeet; Chopra, Sumit; Sethi, Nitin

    2011-01-01

    Orofacial space infections are commonly treated by oral and maxillofacial surgeons, even in the post antibiotic era. Pre existing systemic conditions such as diabetes mellitus makes a person more vulnerable to space infection. A prosthesis which is poorly designed often jeopardises the oral health and makes a person susceptible to ulcers of mucosa, which can result in necrosis of mucosa. The sequel of such ulcerations and necrosis would be life threatening Orofacial space infections in medica...

  4. Tonsillectomy and the risk for deep neck infection-a nationwide cohort study.

    Directory of Open Access Journals (Sweden)

    Ying-Piao Wang

    Full Text Available Although the tonsils contribute to first line immunity against foreign pathogens in the upper aero-digestive tract, the association of tonsillectomy with the risk of deep neck infection remains unclear. The aim of this study was to assess the incidence rate and risk of deep neck infection among patients who had undergone a tonsillectomy.This retrospective cohort study evaluated all patients who had undergone tonsillectomy between 2001 and 2009 as identified from the Taiwan National Health Insurance Research Database. For each post-tonsillectomy patient, 10 age-, sex-, and index date-matched controls without a history of tonsillectomy were randomly selected. Cox Proportional hazard model and propensity score model were performed to evaluate the association between tonsillectomy and deep neck infection after adjusting for demographic and clinical data.There were 34 (71.6 cases per 100,000 person-years and 174 (36.6 cases per 100,000 person-years patients that developed deep neck infection in the tonsillectomized and comparison cohorts, respectively. After adjusting for covariates, patients who had undergone a tonsillectomy had a 1.71-fold greater risk of deep neck infection by both Cox proportional hazard model (95% confidence interval, 1.13-2.59 and propensity score model (95% confidence interval, 1.10-2.66. This association was not altered regardless of the indication for tonsillectomy (i.e. chronic/recurrent tonsillitis or sleep apnea/hypertrophy of tonsil (p = 0.9797.Based on our review of a nationwide cohort study we identified that the risk of deep neck infection is significantly increased among patients who have undergone a tonsillectomy. Additional research is needed to explore the possible mechanisms behind these findings.

  5. Deep neck infections - classification in levels of severity

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    Coelho, Marina Serrato

    2009-06-01

    Full Text Available Introduction: The cervical spaces infections compose severe pictures and result in a high degree of mortality when they evolve with complications. Objective: To set up a graduation protocol of the cervical abscesses and organize a sequence to treat these patients. Method: We carried out a retrospective study of 150 patients with cervical abscess in which we evaluated the clinical impression, general state, respiratory state, locoregional state, antibiotics used and comorbidity. Then we organized a classification with severity levels. Results: The mean age was of 31 years old and in 37% of the cases the origin was dental. In the locoregional evaluation in 67% the affection expanded up to level I and II. According to the severity, the patients were classified as follows: Level I (46%, II (36%, III (15% and IV (3%. Only antibiotic therapy was used in 27% of the cases. The association with surgery occurred in 73% Conclusion: The therapeutic procedure standardization and its classification in severity is essential for the service systematization and reduction of morbimortality.

  6. Submasseteric Infection: A Rare, Deep Space Cheek Infection Causing Trismus.

    Science.gov (United States)

    Schwartz, Richard H; Bahadori, Robert S; Willis, Andrea

    2015-11-01

    Submasseteric space infections are rare at any age but particularly so in primary school children. The origin of the infection is usually odontogenic, from pericoronitis in a third molar. Submasseteric inflammation is a deep facial space inflammation, often progressing to mature abscess, and usually misdiagnosed as staphylococcal or streptococcal lymphadenitis or pyogenic parotitis. The hallmark of a masticatory space infection is trismus. The cardinal signs of this infection include a firm mass in the body of the masseter muscle with overlying cellulitis with trismus.

  7. Infecções cervicais profundas: análise de 80 casos Deep neck infection: analysis of 80 cases

    Directory of Open Access Journals (Sweden)

    Alexandre Babá Suehara

    2008-04-01

    Full Text Available As infecções cervicais profundas são afecções graves que acometem os diversos espaços do pescoço. A mais temível complicação é a mediastinite necrosante descendente, que necessita de diagnóstico precoce e tratamento, por vezes, agressivo. OBJETIVOS: Analisar os 80 casos tratados de infecção cervical profunda e propor uma diretriz de conduta. MATERIAL E MÉTODO: Os autores realizaram um estudo retrospectivo de 80 casos de infecções cervicais profundas tratados no período de junho de 1997 a junho de 2003. RESULTADOS: As causas odontogênicas e amigdalianas foram as mais comumente encontradas. Os espaços mais acometidos foram o submandibular e parafaríngeo. Os principais microorganismos envolvidos foram o Staphylococcus aureus e o Streptococcus sp. CONCLUSÃO: O manejo da via aérea difícil nas infecções cervicais profundas deve ter cuidado especial, quando da indicação cirúrgica, de preferência com intubação sob visão endoscópica e sem uso de miorrelaxantes. Drenagem cirúrgica ampla permanece o tratamento padrão das infecções cervicais profundas. A tomografia computadorizada é o exame de escolha para o diagnóstico das infecções cervicais profundas. Essas infecções apresentam alta morbimortalidade, quando associada ao choque séptico e à mediastinite. Nossa mortalidade foi de 11,2% e dos cinco doentes com mediastinite apenas um sobreviveu.Deep neck infections are serious diseases that involve several spaces in the neck. The most dreadful complication is descending necrotizing fasciitis, which needs early diagnosis and aggressive treatment. AIM: To analyze 80 treated cases of deep neck infection and propose a schematic guideline for managing this disease. METHOD: The authors present a retrospective analysis of 80 treated cases of deep neck infection, from June 1997 to June 2003. RESULTS: Odontogenic and tonsilar causes were the more frequent ones. Submandibular and parapharyngeal spaces were the most frequent

  8. Extensive deep neck space abscess due to B-Haemolytic group G Streptococci-A case report

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    Malini A

    2004-01-01

    Full Text Available Beta haemolytic phenotype of group G streptococci was isolated from the pus obtained from a patient with extensive deep neck space abscess. Patient was immunocompetent and made complete recovery after surgical drainage and administration of amoxycillin with clavulanic acid, amikacin and metronidazole. To our knowledge, this is the first report of deep neck space abscess due to group G streptococci.

  9. Neck stiffness in Guillaine-Barre syndrome subsequent to cytomegalovirus infection

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    İbrahim Etem Pişkin

    2011-03-01

    Full Text Available Guillain-Barre syndrome is an acute inflammatory demyelinating polyradiculoneuropathy that can be seen at any age. The classic symptoms such as flaccid paralysis and areflexia are not always predominant in children. In this study, we presented a 3-year-old girl with Guillain-Barre syndrome associated with cytomegalovirus infection who referred with showed atypical symptoms including neck stiffness.

  10. An Unusual Case of Loffler Endomyocarditis after Takotsubo Cardiomyopathy Induced by Deep Neck Infection

    Science.gov (United States)

    Kundi, Harun; Cetin, Mustafa; Kızıltunç, Emrullah; Cetin, Zehra Guven; Çiçekçioğlu, Hülya; Ornek, Ender

    2015-01-01

    In this case, we herein have described a 72-year-old female patient with deep neck infection induced Takotsubo cardiomyopathy and idiopathic hypereosinophilic syndrome with Loffler endocarditis characterized by right atrial thrombus and right ventricular fibrothrombotic obliteration within two months. PMID:27122907

  11. Throat infection, neck and chest pain and cardiac response: a persistent infection-related clinical syndrome.

    Science.gov (United States)

    Zhou, Changqing; Fu, Xiangning; Yan, Jiangtao; Fan, Qiao; Li, Zhuoya; Cianflone, Katherine; Wang, Daowen

    2009-02-01

    Dizziness, chest discomfort, chest depression and dyspnea are a group of symptoms that are common complaints in clinical practice. Patients with these symptoms are usually informed that while neurosis consequent to coronary heart disease is excluded nonetheless they remain unhealthy with no rational explanation or treatment. 165 cases of these symptoms and 85 control subjects were reviewed and underwent further medical history inquiry, routine EKG test and cardiac ultrasound examination. Thirty-five patients received coronary artery angiography to exclude coronary heart disease. Serum myocardial autoantibodies against beta(1)-adrenoceptor, alpha-myosin heavy chain, M(2)-muscarinic receptor and adenine-nucleotide translocator were tested, and inflammatory cytokines and high sensitivity C-reaction protein were measured and lymphocyte subclass was assayed by flow cytometry. All patients had a complex of four symptoms or tetralogy: (1) persistent throat or upper respiratory tract infection, (2) neck pain, (3) chest pain and (4) chest depression or dyspnea, some of them with anxiety. Anti-myocardial autoantibodies (AMCAs) were present in all patients vs. 8% in controls. TNF-alpha, IL-1 and IL-6 were significantly higher in patients than in controls (Prib cartilage inflammation, symptoms of cardiac depression and dyspnea with or without anxiety.

  12. 持续负压引流术治疗严重颌面颈部间隙感染的探讨%Sustained negative pressure drainage for treatment of severe maxillofacial and neck space infection

    Institute of Scientific and Technical Information of China (English)

    章功杰; 陈松军; 郑珉; 吴晓立; 俞洁

    2015-01-01

    目的:  应用持续的负压引流术治疗严重颌面颈部间隙感染,观察其疗效。方法  采用持续负压引流术治疗18例严重颌面颈部间隙感染患者。在患者感染部位肿胀最明显或波动处用小切口切开引流,放置负压引流装置,同时缝合封闭创口,持续负压引流。结果  18例患者中,14例患者经持续负压引流至肿胀及疼痛消退,然后拔除引流管;4例患者术后创口破溃,负压消失而拔除引流管,改用其他无负压引流方法。所有患者术后肿胀疼痛未加重,无窒息、感染性休克、纵膈脓肿等并发症发生,均痊愈出院。结论  持续负压引流术为治疗严重颌面颈部间隙感染的方法多了一种选择,该方法改变了传统的脓肿切开引流的治疗方式,减少了患者的痛苦,同时也减轻了医生的工作负担。%Objective  This study observed the curative effect of sustained negative pressure drainage application on treat-ment of severe maxillofacial and neck space infection. Methods  Incision and drainage were performed to treat 18 patients with severe maxillofacial and neck space infection. A small incision was made on the site of the most obvious swelling or fluc-tuations, and localized negative pressure was applied with a drainage device on the wound during suturing. Results  Among the 18 patients, 14 were healed, whereas 4 underwent dehiscence of the wound after the operation. Negative pressure was lost as the drainage tubes were removed, and non-negative pressure drainage method was used instead. During the negative pressure treatment, swelling and pain did not increase after the operation. Other complications, such as asphyxia

  13. Infections of Head and Neck Soft Tissues – A Statistical Study over a 10-year Period

    Directory of Open Access Journals (Sweden)

    Amorin-Remus POPA

    2010-09-01

    Full Text Available Aim: A statistical analysis of the epidemiology of head and neck soft tissues conditions was carried out. Material and Method: The patients with head and neck infections who received treatment at Ist Oral and Maxillofacial Surgery Clinics of Cluj-Napoca between January 2000 and December 2009 inclusively were included in this study. Results: 1008 patients accomplished the inclusion criteria. The starting point of the head and neck inflammatory conditions was represented mainly by dental-periodontal lesions (79.66%. Most of the infections were localized at the level of a single cavity (81.85%; when more than one cavity was affected the patients were had also systemic conditions. When septic metastases spread the most affected side was the mediastinal structures. All patients included in this study received surgical treatment, most frequently two surgical interventions being necessary (50.20%. The post-surgical evolution was favorable for 1005 patients with an average of hospitalization period of 6.11 days, the hospitalization stay being also influenced by the presence or absence of the systemic immunodepression. Conclusion: The present research identified that the inflammatory conditions of the head and neck have as major starting point the dental-periodontal inflammatory conditions. The surgical treatment is the best choice for curing these affections.

  14. Edema in the retropharyngeal space associated with head and neck tumors: CT imaging characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Kurihara, Noriko; Nakamura, Mamoru; Tsuda, Masashi; Saito, Haruo [National Hospital Organization Sendai Medical Center, Department of Radiology, Sendai, Miyagi (Japan); Takahashi, Shoki; Higano, Shuichi [Tohoku University, Department of Diagnostic Radiology, Sendai, Miyagi (Japan)

    2005-08-01

    To determine computed tomographic (CT) imaging characteristics of retropharygeal edema, we reviewed CT images in 18 patients with head and neck tumors. Retropharyngeal edema spread craniocaudally between soft palate and upper half of thyroid cartilage in all patients. No edema fluid extended above soft palate and below thyroid cartilage. Horizontally, it spread symmetrically in ten and asymmetrically in eight patients. Predominance in asymmetrical retropharyngeal edema was found on the same side as that of unilateral predominance both in lymph nodes enlargement and jugular vein stenosis/occlusion. All patients had edema also in other cervical spaces. Edema of retropharyngeal and other spaces fluctuated synchronously. In 14 patients, as primary lesion and/or cervical lymph nodes regressed, retropharyngeal edema disappeared or decreased. Retropharyngeal edema had some imaging characteristics. With knowledge of that, we could avoid diagnostic confusion when evaluating head and neck CT images. (orig.)

  15. Differential Diagnosis of Lymphadenopathy in the Neck Spaces in a CT Perfusion Study

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Hong, Hyun Sook; Lee, Eun Hye; Lee, Min Hee [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Science, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2011-11-15

    To evaluate the CT perfusion parameters for differentiating between a benign and malignant lymphadenopathy in the neck spaces. Seventeen patients with cervical lymphadenopathy underwent perfusion CT. Perfusion parameters, including blood flow (BF), blood volume (BV), permeability index (PI), and mean transit time, were calculated at the regions of interest in the enlarged lymph nodes (LNs). The enlarged LNs were diagnosed by fine needle aspiration, surgical excision, and clinical follow-up. The LNs were classified as either reactive hyperplasia (n = 26), metastatic LNs (n = 11), or LNs of lymphoma (n = 14). Significant differences were found for BF, BV, and PI among the three groups (p < 0.05). Reactive hyperplasia had a significantly higher BF than metastatic LN (p < 0.0167). The LNs of lymphoma had a significantly lower BF, BV, and PI than reactive hyperplasia (p < 0.0167). No significant difference was observed between the metastatic LNs of the head and neck cancer and LNs of lymphoma for all perfusion parameters. In patients with head and neck cancer, perfusion CT is not useful for differentiating between metastatic LNs and inflammatory reactive hyperplasia. However, perfusion CT can be useful for differentiating between LNs of lymphoma and reactive hyperplasia.

  16. Deep neck space abscesses of dental origin: the impact of Streptococcus group Milleri.

    Science.gov (United States)

    Terzic, Andrej; Scolozzi, Paolo

    2014-10-01

    In recent years, there has been rising interest in Streptococcus group Milleri (SM) because high mortality rates have been related to it. In case of deep neck infections (DNI), whatever the origin, mortality rates as high as 26% were reported. But there are no data available for DNI with SM of purely dental origin. The aim of our article was to describe and analyse DNI of purely dental origin involving on one hand SM and on the other hand infections without presence of SM. We compared these two groups and statistically investigated if there were differences in clinical presentation (age, mouth opening, length of hospital stay, laboratory parameters) or clinical behaviour (re-operation, re-hospitalisation, secondary osteomyelitis, stay at intensive care, length of antibiotic treatment, presence of resistances against antibiotics, incapacity to work). For this, we retrospectively searched medical records of our institution for all purulent DNI treated from 2004 till 2012. We found 81 patients meeting all inclusion criteria. Thirty-four patients had involvement of SM, 47 did not. The only statistically significant difference between the SM group and the non-SM group was the length of incapacity to work. All other parameters were non-significant. Furthermore, there were no fatalities. In conclusion, the clinical importance of this article is that patients with deep neck abscesses of purely dental origin involving SM do not need more or different care when compared to all other DNI of dental origin.

  17. Surgical vs ultrasound-guided drainage of deep neck space abscesses: a randomized controlled trial: surgical vs ultrasound drainage

    OpenAIRE

    2013-01-01

    Introduction Deep neck space abscesses (DNAs) are relatively common otolaryngology-head and neck surgery emergencies and can result in significant morbidity with potential mortality. Traditionally, surgical incision and drainage (I&D) with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound-guided drainage (USD) is a less invasive and effective alternative in select cases. Objectives To compare I&D vs USD of well-defined DNAs, using a randomized control...

  18. Is ultrasonography-guided drainage a safe and effective alternative to incision and drainage for deep neck space abscesses?

    Science.gov (United States)

    Dabirmoghaddam, P; Mohseni, A; Navvabi, Z; Sharifi, A; Bastaninezhad, S; Safaei, A

    2017-03-01

    Deep neck space abscesses are common head and neck surgery emergencies. Traditionally, surgical incision and drainage has been the main treatment for deep neck abscesses. Recently, it has been suggested that ultrasound-guided drainage of neck abscesses can be an effective and less invasive alternative to incision and drainage. Patients with deep neck space abscesses referred to the emergency department of Amiralam Hospital were assessed and enrolled to the study if they met the inclusion criteria. Patients were randomly assigned to incision and drainage or ultrasound-guided drainage groups using sealed envelopes. Sixty patients were evaluated, with 30 patients in each group. There was a significant difference (p < 0.001) in mean length of hospital stay between patients who underwent ultrasound-guided drainage (5.47 days) and those who underwent incision and drainage (9.70 days). Ultrasound-guided drainage is an effective and safe procedure, leading to shorter hospital stay, and thus may be a suitable alternative to incision and drainage of deep neck abscesses.

  19. Human papillomavirus infection on initiating synchronous esophageal neoplasia in patients with head and neck cancer.

    Science.gov (United States)

    Wang, Wen-Lun; Wang, Yu-Chi; Chang, Chi-Yang; Lo, Jo-Lin; Kuo, Yao-Hung; Hwang, Tzer-Zen; Wang, Chih-Chun; Mo, Lein-Ray; Lin, Jaw-Town; Lee, Ching-Tai

    2016-05-01

    Human papillomavirus (HPV) is a risk factor for head and neck squamous cell carcinoma (HNSCC) as well as esophageal squamous cell carcinoma (ESCC). We aimed to investigate whether HPV infection underlies the field cancerization phenomenon over upper aerodigestive tract to develop synchronous multiple cancers. A case control study. The presence and subtype of HPV-DNA sequence in cancers were examined by polymerase chain reaction and sequencing in a prospective cohort with 100 HNSCCs, 50 of which had synchronous ESCCs. The clinicopathologic characteristics were further analyzed according to the presence of HPV. Twelve patients were HPV-positive, of which 11 were positive for HPV-16. The prevalence of HPV infection were not different between the synchronous and HNSCC alone groups (P = 0.357). Testing for HPV in paired HNSCC and ESCC tissues from the same patient revealed that none were concomitantly HPV-positive. Multivariate logistic regression showed drinking alcohol (odds ratio [OR], 18.75; P = 0.030), alcohol flushing (OR, 2.53; P = 0.041), and body mass index (OR, 0.77; P = 0.001) but not HPV infection were independent risk factors for synchronous phenotype. The patients with synchronous ESCCs had significantly poorer survival than those with HNSCC alone (5-year overall survival: 30% vs. 70%; log-rank P infection plays little role in field cancerization phenomenon to initiate synchronous SCC. The synchronous HNSCC and ESCC from the same patients had no clonal relationship. Routine endoscopic examination of the esophagus should be recommended for patients with risk factors identified. NA. Laryngoscope, 126:1097-1102, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Epstein-Barr virus and human papillomavirus infections and genotype distribution in head and neck cancers.

    Directory of Open Access Journals (Sweden)

    Zeyi Deng

    Full Text Available To investigate the prevalence, genotypes, and prognostic values of Epstein-Barr virus (EBV and human papillomavirus (HPV infections in Japanese patients with different types of head and neck cancer (HNC.HPV and EBV DNA, EBV genotypes and LMP-1 variants, and HPV mRNA expression were detected by PCR from fresh-frozen HNC samples. HPV genotypes were determined by direct sequencing, and EBV encoded RNA (EBER was examined by in situ hybridization.Of the 209 HNC patients, 63 (30.1% had HPV infection, and HPV-16 was the most common subtype (86.9%. HPV E6/E7 mRNA expression was found in 23 of 60 (38.3% HPV DNA-positive cases detected. The site of highest prevalence of HPV was the oropharynx (45.9%. Among 146 (69.9% HNCs in which EBV DNA was identified, 107 (73.3% and 27 (18.5% contained types A and B, respectively, and 124 (84.9% showed the existence of del-LMP-1. However, only 13 (6.2% HNCs were positive for EBER, 12 (92.3% of which derived from the nasopharynx. Co-infection of HPV and EBER was found in only 1.0% of HNCs and 10.0% of NPCs. Kaplan-Meier survival analysis showed significantly better disease-specific and overall survival in the HPV DNA+/mRNA+ oropharyngeal squamous cell carcinoma (OPC patients than in the other OPC patients (P = 0.027 and 0.017, respectively. Multivariate analysis showed that stage T1-3 (P = 0.002 and HPV mRNA-positive status (P = 0.061 independently predicted better disease-specific survival. No significant difference in disease-specific survival was found between the EBER-positive and -negative NPC patients (P = 0.155.Our findings indicate that co-infection with HPV and EBV is rare in HNC. Oropharyngeal SCC with active HPV infection was related to a highly favorable outcome, while EBV status was not prognostic in the NPC cohort.

  1. Epstein-Barr virus and human papillomavirus infections and genotype distribution in head and neck cancers.

    Science.gov (United States)

    Deng, Zeyi; Uehara, Takayuki; Maeda, Hiroyuki; Hasegawa, Masahiro; Matayoshi, Sen; Kiyuna, Asanori; Agena, Shinya; Pan, Xiaoli; Zhang, Chunlin; Yamashita, Yukashi; Xie, Minqiang; Suzuki, Mikio

    2014-01-01

    To investigate the prevalence, genotypes, and prognostic values of Epstein-Barr virus (EBV) and human papillomavirus (HPV) infections in Japanese patients with different types of head and neck cancer (HNC). HPV and EBV DNA, EBV genotypes and LMP-1 variants, and HPV mRNA expression were detected by PCR from fresh-frozen HNC samples. HPV genotypes were determined by direct sequencing, and EBV encoded RNA (EBER) was examined by in situ hybridization. Of the 209 HNC patients, 63 (30.1%) had HPV infection, and HPV-16 was the most common subtype (86.9%). HPV E6/E7 mRNA expression was found in 23 of 60 (38.3%) HPV DNA-positive cases detected. The site of highest prevalence of HPV was the oropharynx (45.9%). Among 146 (69.9%) HNCs in which EBV DNA was identified, 107 (73.3%) and 27 (18.5%) contained types A and B, respectively, and 124 (84.9%) showed the existence of del-LMP-1. However, only 13 (6.2%) HNCs were positive for EBER, 12 (92.3%) of which derived from the nasopharynx. Co-infection of HPV and EBER was found in only 1.0% of HNCs and 10.0% of NPCs. Kaplan-Meier survival analysis showed significantly better disease-specific and overall survival in the HPV DNA+/mRNA+ oropharyngeal squamous cell carcinoma (OPC) patients than in the other OPC patients (P = 0.027 and 0.017, respectively). Multivariate analysis showed that stage T1-3 (P = 0.002) and HPV mRNA-positive status (P = 0.061) independently predicted better disease-specific survival. No significant difference in disease-specific survival was found between the EBER-positive and -negative NPC patients (P = 0.155). Our findings indicate that co-infection with HPV and EBV is rare in HNC. Oropharyngeal SCC with active HPV infection was related to a highly favorable outcome, while EBV status was not prognostic in the NPC cohort.

  2. Role of culture of postoperative drainage fluid in the prediction of infection of the surgical site after major oncological operations of the head and neck.

    Science.gov (United States)

    Candau-Alvarez, A; Linares-Sicilia, M J; Dean-Ferrer, A; Pérez-Navero, J L

    2015-02-01

    Infection of the surgical site after major oncological operations of the head and neck increases mortality and morbidity. The aim of this prospective pilot study was to assess the efficacy of culturing the exudate from the drain after cervical neck dissection to see if it predicted such infection. We studied 40/112 patients with squamous cell cancer of the head and neck who were treated during the last two years and met our inclusion criteria. Six patients developed infections (15%). Reconstruction with pedicled rather than local or microvascular flaps, duration of operation of over 7 hours, the presence of a tracheostomy, and bilateral neck dissection were considered risk factors (p=0.01). Culture of drainage fluid on postoperative day 3 that grew no pathogens predicted that the site would not become infected, with a negative predictive value of 96%. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Pericoronitis, deep fascial space infections, and the impacted third molar.

    Science.gov (United States)

    Litonjua, L S

    1996-01-01

    Patients consulting the Philippine General Hospital Dentistry Department for management of impacted mandibular third molars were studied for the presence of pericoronits and deep fascial space infections. 18% of total cases presented an infection, while 13% presented with pericoronitis. 11% presented with deep fascial infection of which 72% were secondary to pericoronitis. A radiographic evaluation showed the vertical angulation (68%) with the highest portion at or above the occlusal level (70%) associated the most with pericoronits. The potential of pericoronitis developing to a deep space infection should always be considered.

  4. Otolaryngological, head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa.

    Science.gov (United States)

    Tshifularo, M; Govender, L; Monama, G

    2013-05-16

    Sub-Saharan Africa has the highest incidence of HIV infection. According to recent census statistics, 5.6 million people in South Africa (SA) are HIV-positive, the highest number of infected individuals worldwide. Over 80% of HIV-infected individuals will present with ear, nose and throat (ENT) manifestations. Previous studies show that oral diseases seem to be the most common ENT-related manifestation, reported in about 40 - 50% of HIV-infected patients. In SA, there is lack of local information regarding the otolaryngological and head and neck manifestations in HIV-infected individuals. To ascertain our local trends of ENT and head and neck manifestations in HIV-infected patients seen at our specialised ENT-HIV Clinic, Steve Biko Academic Hospital, Pretoria, Gauteng Province, SA. A 1-year prospective study involving 153 HIV-infected patients was conducted in the clinic from January to December 2011. Patient history was taken and examinations were performed based on the World Health Organization (WHO) HIV/AIDS classification system. Data analysis was performed using Epi Info 7 software. The most common manifestations were adenoid hypertrophy/hyperplasia followed by cervical lymphadenopathy, chronic suppurative otitis media, otitis media with effusion and sensory-neural hearing loss. Patients typically presented with early manifestations during symptomatic WHO stages I and II in contrast to results reported in similar developing world studies from Iran, Nigeria and India. A possible explanation may lie in the SA government HIV Counselling and Testing campaign and the antiretroviral rollout programme, the effectiveness of which is becoming evident.

  5. Descriptive Study on Influence of Systemic Conditions on Head and Neck Infections

    Directory of Open Access Journals (Sweden)

    Mihai JUNCAR

    2011-03-01

    Full Text Available Aim: The aim of the present research was to conduct a descriptive study about the role of systemic conditions, other than diabetes, in the occurrence and evolution of neck and head suppurations. Material and Method: For this purpose, we selected the sick people hospitalized in the Ist Oral and Maxillofacial Surgery Clinics of Cluj-Napoca who presented suppurations of the head and neck and chronic systemic conditions. Results: One hundred and thirteen patients accomplished the inclusion criteria. The most frequent systemic conditions identified at patients with head and neck suppurations were the cardio-vascular diseases (48%, followed by hepatic diseases (19%. Head and neck suppurations proved to affect only one cavity in 75.22% of cases. The septic metastasis process was present in case of 3 patients, the mediastine being the most frequently affected organ by the presence of the septic process. The post-surgical evolution was favorable in case of 112 patients, the only death being noticed in the case of a woman suffering from decompensated leukemia. The mean of hospitalization days proved to be statistically significant higher when patients presented more than one affected cavity compared to patients with one affected cavity (p = 0.0030. Conclusion: Immuno-depressing systemic conditions may influence in an unfavourable way the evolution of head and neck suppurations. The surgical treatment has been proved to be efficient in curing the suppurations of the patients suffering from diverse chronic systemic conditions.

  6. Tracking Resilience to Infections by Mapping Disease Space.

    Directory of Open Access Journals (Sweden)

    Brenda Y Torres

    2016-04-01

    Full Text Available Infected hosts differ in their responses to pathogens; some hosts are resilient and recover their original health, whereas others follow a divergent path and die. To quantitate these differences, we propose mapping the routes infected individuals take through "disease space." We find that when plotting physiological parameters against each other, many pairs have hysteretic relationships that identify the current location of the host and predict the future route of the infection. These maps can readily be constructed from experimental longitudinal data, and we provide two methods to generate the maps from the cross-sectional data that is commonly gathered in field trials. We hypothesize that resilient hosts tend to take small loops through disease space, whereas nonresilient individuals take large loops. We support this hypothesis with experimental data in mice infected with Plasmodium chabaudi, finding that dying mice trace a large arc in red blood cells (RBCs by reticulocyte space as compared to surviving mice. We find that human malaria patients who are heterozygous for sickle cell hemoglobin occupy a small area of RBCs by reticulocyte space, suggesting this approach can be used to distinguish resilience in human populations. This technique should be broadly useful in describing the in-host dynamics of infections in both model hosts and patients at both population and individual levels.

  7. 颈深部感染95例临床分析%Deep neck infection:clinical analyses of 95 cases

    Institute of Scientific and Technical Information of China (English)

    程泽星; 余爵波; 肖路; 练状; 魏毅玲; 汪俊峰

    2015-01-01

    Objective To review the recent diagnosis and treatment experience with deep neck infection and emphasize the importance of radiologic evaluation,microbiology and appropriate treatment selection in these patients.Methods A respective review was conducted in 95 cases who were diagnosed as having deep neck from Jan.2006 to March 2015.Results The primary diseases in 95 patients with deep neck infection were acute tonsillitis or acute laryngitis (27 cases),infection of upper respiratory tract (23 cases),odontogenic infection or oral inflammation (16 cases),foreign bodies in esophagus(9 cases),acute cervical lymphadenitis (5 cases) and cause uncertain (15 cases).Computed tomography was performed in all of patients to identify the location,extent,and character (cellulitis in 47 cases or abscesses in 48 cases) of the infections.The locations of abscess were parapharyngeal abscess (25 cases),retropharyngeal abscess (9 cases),submaxillary space abscess (6 cases),pretracheal space abscess (5 cases) and esophageal abscess (3 cases).Complications:mediastinitis (2 cases),pericarditis (1 case),bilateral pneumothorax (2 cases),and upper digestive tract (1 case).Bacterial cultivation performed in 35 patients and positive results were detected in 21.All patients were given intravenous antibiotic therapy.Tracheotomy was performed in 4 cases.Preoperative contrast enhanced CT was performed in 42 patients and indicated the formation of abscess.Three cases with the symptoms of septic shock were transferred to ICU and one was cured.All the patients were cured except two who died of massive hemorrhage of upper digestive tract and septic shock.Conclusions The airway patency in patients with deep neck infections must be ensured.Drainage may be mandatory in selected cases at presentation or in cases who fail to respond to parenteral antibiotics within the first 24-48 hours.Imaging evaluation plays a significant role in the diagnosis and rational therapeutic management in deep neck infection

  8. Variation of HPV Subtypes with Focus on HPV-Infection and Cancer in the Head and Neck Region.

    Science.gov (United States)

    Wichmann, Gunnar

    The human papillomavirus (HPV) comprises a heterogeneous group of double-strand DNA viruses with variable potential to infect human epithelial cells and trigger neoplastic transformation. Its 8 kb genome encodes proteins required for virus replication and self-organized formation of infectious particles but also for early proteins E6 and E7 able to trigger neoplastic transformation. E6 and E7 of high-risk (HR) HPV subtypes can bind to p53 or release E2F and abrogate replication control. Due to variable amino acid sequence (AAS) in the binding sites of E6 and E7 particular HR-HPV variants within subtypes are essentially heterogeneous in efficacy triggering neoplastic transformation and cancer development. This could explain differences in the clinical course of HPV-driven head and neck cancer.

  9. Infecções dos espaços cervicais: estudo prospectivo de 57 casos Deep neck infections: prospective study of 57 patients

    Directory of Open Access Journals (Sweden)

    Luiz Ubirajara Sennes

    2002-05-01

    Full Text Available Objetivo: apesar da antibioticoterapia, as infecções dos espaços cervicais profundos continuam a ter grande importância, tanto por sua alta incidência, como pelo risco de complicações. Forma de estudo: clínico, prospectivo. Material e método: descrevem-se neste estudo 57 casos de pacientes com diagnóstico de infecção cervical (celulite, abscesso e fasceíte necrotizante internados na Enfermaria de Otorrinolaringologia do Hospital das Clínicas da Faculdade de Medicina da USP entre janeiro de 1999 e janeiro de 2001. Cinqüenta pacientes (87,7% apresentavam abscesso cervical, cinco (8,8%, celulite e dois pacientes (3,5%, fasceíte necrotizante. A infecção odontogênica foi o foco de origem mais prevalente, responsável por 24 casos (42%, seguida das amigdalites (17,5% e linfadenites (15,8%. Os espaços cervicais mais acometidos foram o submandibular (57,9%, o sublingual (26,3% e o parafaríngeo (24,6%. Em 53 pacientes realizaram-se culturas das quais 71,7% foram positivas, sendo que 20,8% destas apresentaram flora mista. Os microorganismos mais prevalentes dentre os aeróbicos foi o Streptococcus viridans (41,5% e, dentre os anaeróbios, Peptostreptococcus micros e Peptostreptococcus sp (5,7% e 3,8%, respectivamente. A associação entre penicilina cristalina e metronidazol foi o tratamento preconizado em 31 pacientes (54,3%. Nos demais, diversos antibióticos como clindamicina, cefalosporinas de terceira geração, cloranfenicol e oxacilina foram utilizados. Cinqüenta e quatro pacientes (94,7% evoluíram satisfatoriamente, dois (3,5% apresentaram deiscência da ferida cirúrgica e um (1,7% foi a óbito por mediastinite. Conclusão: os abscessos cervicais ainda configuram uma importante causa de morbidade em nossa população e suas complicações requerem vigilância para a prevenção e abordagem oportunas, especialmente pelo tratamento mais adequado.Aim: Since the development of penicillin, the head and neck space infections have

  10. Streptococcal toxic shock syndrome secondary to a deep neck space infection presenting with no throat or neck symptoms

    OpenAIRE

    2013-01-01

    A previously fit and well 44-year-old gentleman was admitted with a 3-week history of parotid swelling, malaise and feeling generally unwell. His only medical history was α-thalassaemia trait. Initial ear, nose and throat examination was unremarkable. Routine observations highlighted tachycardia, hypotension and a raised respiratory rate. Despite fluid resuscitation, his hypotension failed to resolve and he was admitted to intensive care for inotropic support. He was started on broad spectrum...

  11. [Guidelines: Antibiotic treatment of infections of the head and neck: consensus report on behalf of the presidency of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery edited by P. Federspil, Homburg/Saar].

    Science.gov (United States)

    Federspil, P

    2009-04-01

    In 1999 the following guidelines were elaborated by a consensus conference of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery with delegates of 10 further societies and complemented by a Delphi procedure. In 2002 and 2008 up-dates were performed by the members of the consensus conference, the chair of the study group of ENT infectiology of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery and the presidency of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. The guidelines concern the antibiotic treatment of bacterial infections of the ears, nose and throat, taking the expected spectrum of pathogens, the microbiological and clinical efficacy and the containment of costs into consideration. After specification of the basic principles, the various infections with their causative pathogens and the antibiotics coming into question for therapy are tabulated and a differentiation is made between the antibiotic or the antibiotics of first choice and alternatives. The different dosages of oral and parenteral antibiotics for adults and children are indicated. In the appendix the different groups of antibiotics are characterized concerning their antibacterial spectrum and pharmacokinetics and in particular the differences between the older and newer representatives of the groups are pointed out.

  12. Infection prevention and control during prolonged human space travel.

    Science.gov (United States)

    Mermel, Leonard A

    2013-01-01

    Prolonged human spaceflight to another planet or an asteroid will introduce unique challenges of mitigating the risk of infection. During space travel, exposure to microgravity, radiation, and stress alter human immunoregulatory responses, which can in turn impact an astronaut's ability to prevent acquisition of infectious agents or reactivation of latent infection. In addition, microgravity affects virulence, growth kinetics, and biofilm formation of potential microbial pathogens. These interactions occur in a confined space in microgravity, providing ample opportunity for heavy microbial contamination of the environment. In addition, there is the persistence of aerosolized, microbe-containing particles. Any mission involving prolonged human spaceflight must be carefully planned to minimize vulnerabilities and maximize the likelihood of success.

  13. A rare case of extracranial meningioma in parapharyngeal space presented as a neck mass

    Directory of Open Access Journals (Sweden)

    Nader Albsoul

    2015-01-01

    Conclusion: Extracranial meningiomas are quite rare. The diagnosis of these types of tumors is challenging due to the non specific nature of the symptoms. The anatomic complexity of the region of parapharyngeal space also makes their detection difficult. Imaging modalities can aid in the diagnosis, but pathological examinations are essential in confirming a definite diagnosis.

  14. Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries

    Science.gov (United States)

    2011-08-01

    immobilization , and primary clo- sure with drainage are important to prevent infection. 38 However, there is no consensus regarding the optimal management...esophageal suture line for further protection. If an extensive esophageal injury is present, a lateral cervical esophagostomy should be created and

  15. Towards rational treatment of bacterial infections during extended space travel.

    Science.gov (United States)

    Taylor, Peter W; Sommer, Andrei P

    2005-09-01

    In the next 15-30 years, manned space flight to Mars, our planetary neighbour, will become a reality and astronauts are likely to spend at least 2-3 years away from Earth. Time spent in such extreme environments will result in a diminution of immune status and profound changes in the human bacterial microflora. In microgravity, the efficacy of antibiotics is reduced and microbial mutation rates increase dramatically. These factors will impinge on the capacity to treat effectively the infections that will doubtless arise during such long and stressful endeavour. We highlight new rationales for the treatment of infectious disease that may be applicable to therapy in extreme environments such as deep space.

  16. Imaging analyses of odontogenic infection involving the maxillofacial fascial spaces, with special emphasis on the parapharyngeal space

    Energy Technology Data Exchange (ETDEWEB)

    Ariji, Yoshiko; Gotoh, Masakazu; Izumi, Masahiro; Naitoh, Munetaka; Kurita, Kenichi; Natsume, Nagato; Ariji, Eiichiro [Aichi-Gakuin Univ., Nisshin (Japan). School of Dentistry

    2002-01-01

    The purpose of this study was to investigate odontogenic infection pathways into the maxillofacial fascial spaces, especially into the parapharyngeal space, in relation to causal tooth and clinical symptoms. CT and MR images were retrospectively investigated in 47 patients with spread of odontogenic infection into the maxillofacial spaces. The involvement of spaces was evaluated based on lateral asymmetry of their shapes and density on CT images or intensity on MR images. Involvement on images was observed in 70%, 49%, and 30% of the submandibular, the masticator, and the parapharyngeal spaces, respectively. Patients with submandibular space involvement often had spontaneous pain. Of 14 patients with parapharyngeal space involvement, 8 patients showed dysphagia and/or fever, and 13 patients showed involvement of the mandibular molar as a cause of infection. All of these 14 patients also had submandibular space involvement, while only 7 patients (50%) showed changes in the medial pterygoid muscle. The fat layer between the medial pterygoid muscle and parapharyngeal space was maintained in 11 of 14 (79%) patients with parapharyngeal involvement. CT and MR images clearly demonstrated the spread of odontogenic infection into the maxillofacial spaces. Involvement of the parapharyngeal space was mostly caused by infection originating in the mandibular molar, and was considered to be secondary spread from the submandibular space and/or medial pterygoid muscle. (author)

  17. Dislocation and spontaneous reduction of the femoral implant against the femoral neck in an infected metal on metal hip resurfacing with complex collection

    Energy Technology Data Exchange (ETDEWEB)

    Tins, Bernhard, E-mail: Bernhard.Tins@rjah.nhs.uk [Department of Radiology, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY 107 AG (United Kingdom)

    2011-07-15

    Metal on metal resurfacing hip implants are known to have complications unique to this type of implant. The case presented adds a further previously not described complication, the dislocation and spontaneous reduction of the pin of the femoral component against the femoral neck. The radiographic and CT findings are demonstrated. The dislocation was aided by bone loss due to an infection with a large periarticular collection. Periarticular collections in hip resurfacings are often due to a hypersensitivity type reaction to metal debris. However in the case presented it was due to infection. MRI was not able to discern the infection from a sterile collection. CT demonstrated bone loss and periosteal reaction suggestive of infection. In addition calcification of the pseudocapsule was seen, this is not a recognized feature of sterile collections.

  18. Neck Pain

    Science.gov (United States)

    ... antidepressants for pain relief. Therapy Physical therapy. A physical therapist can teach you correct posture, alignment and neck- ... therapy, under supervision of a medical professional and physical therapist, may provide relief of some neck pain, especially ...

  19. Magnetic resonance imaging of disc space infection revisited: temporal changes

    Institute of Scientific and Technical Information of China (English)

    Duan Shaoyin; Xu Bingqiang; Gina Di Primio; Cheemun Lum; Mark E Schweitzer

    2014-01-01

    Background Magnetic resonance imaging (MRI) has advantages in showing pathologic changes of disc space infection,which is important in clinical treatment.The purpose of this study was to describe the MRI findings of disc space infections in relation to chronicity.Methods MRI of 60 patients from January 1,2002 to April 30,2012 in Ottawa Hospital were retrospectively evaluated by two radiologists blindly.All patients had histological confirmation,with 55 having microbiological confirmation as well.These patients were divided into acute (n=18),subacute (n=21) and chronic (n=21) based on histological findings.The following potential signs of MRI finding were assessed:marrow edema,endplate erosions,disk fluid and height change,paraspinal mass,epidural collection,facet fluid and enhancement in the marrow,disc,paraspinal mass,and epidural involvement.Statistical analysis consisted of t-or F-tests and chi-square test.Results In the 60 patients,83 infected discs (single disc in 45 patients,2-4 discs in 15 patients) were found,including 22 discs in the acute group,30 discs in the subacute group,and 31 discs in the chronic group.There was a significant difference in the extent of marrow edema between the acute,subacute and chronic groups (P <0.05),with a gradually increasing extent from acute to chronic.The extent of endplate erosions increased with chronicity,but was not statistically significant.There were significant differences in the disc fluid,epidural collection,and disc enhancement among the acute,subacute and chronic groups,as well as the facet fluid between acute and chronic groups (P <0.05).There were no significant differences in the present probability of disc height loss,paraspinal mass,and marrow enhancement among the three groups (P >0.05).Conclusions From acute to chronic infections,the extent of marrow edema and endplate erosions appeared to gradually increase.Epidural collections and facet fluid are most frequently found in the acute group,while disc

  20. Deep neck abscesses: the Singapore experience.

    Science.gov (United States)

    Lee, Yan Qing; Kanagalingam, Jeevendra

    2011-04-01

    This study aims to review our experience with deep neck abscesses, identify key trends, and improve the management of this condition. This is a retrospective chart review of patients diagnosed with deep neck abscesses in the Department of ENT (Otorhinolaryngology) at Tan Tock Seng Hospital, Singapore between 2004 and 2009. Patient demographics, etiology, bacteriology, systemic disease, radiology, treatment, complications, duration of hospitalization, and outcomes were reviewed. 131 patients were included (64.9% male, 35.1% female) with a median age of 51.0 years. 54 (41.2%) patients had diabetes mellitus. The parapharyngeal space (23.7%) was the most commonly involved space. Odontogenic and upper airway infections were the leading causes of deep neck abscesses (28.0% each). Klebsiella pneumoniae (27.1%) was the most commonly cultured organism in this study and among the diabetic patients (50.0%). 108 (82.4%) patients underwent surgical drainage. 42 patients suffered complications. All 19 patients, who had upper airway obstruction, had either a tracheostomy or intubation. Patients with multi-space abscesses, diabetes mellitus, and complications had prolonged hospitalizations. Old age and diabetes are risk factors for developing deep neck abscesses and their sequelae. The empiric choice of antibiotics should recognize that a dental source is likely, and that Klebsiella is most common in diabetics. Surgical drainage and adequate antibiotic coverage remains the cornerstone of treatment of deep neck abscesses. Therapeutic needle aspiration may successfully replace surgical drainage, if the abscesses are small and no complications are imminent. Airway obstruction should be anticipated in multi-space and floor of mouth abscesses.

  1. Neck pain

    OpenAIRE

    2002-01-01

    Non-specific neck pain has a postural or mechanical basis, and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but becomes chronic in about 10% of people.Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident.

  2. Neck lump

    Science.gov (United States)

    ... the neck lump treated. When to Contact a Medical Professional Call your health care provider if you have an abnormal neck swelling or ... to Expect at Your Office Visit The health care provider will take your medical history and do a physical exam. You may ...

  3. A case of brain abscess extended from deep fascial space infection.

    Science.gov (United States)

    Sakamoto, Haruo; Karakida, Kazunari; Otsuru, Mitsunobu; Arai, Masayuki; Shimoda, Masami

    2009-09-01

    A case of brain abscess in the temporal lobe caused by direct intracranial extension of deep neck abscess is described. The abscess also spread to the orbital cavity through infraorbital fissure. The possible etiology of this case might be dental surgery. The diagnostic imaging clearly showed the routes of intracranial and -orbital extension of parapharyngeal and masticator space abscesses. From the abscess specimens, oral streptococci, anaerobic streptococci, and anaerobic gram-negative bacilli were isolated. Antimicrobial susceptibility testing of isolates showed that some Prevotella and Fusobacterium strains had decreased susceptibility to penicillin, and these bacteria produced beta-lactamase. The bacteria from the deep neck abscess were consistent with those detected from the brain abscess. Proper diagnosis, aggressive surgical intervention, and antibiotics chemotherapy saved the patient from this life-threatening condition.

  4. Neck dissection - discharge

    Science.gov (United States)

    Radical neck dissection - discharge; Modified radical neck dissection - discharge; Selective neck dissection - discharge ... 659-665. Robbins KT, Samant S, Ronen O. Neck dissection. In: Flint PW, Haughey BH, Lund V, et ...

  5. Keeping nanobacterial infections at bay during space travel.

    Science.gov (United States)

    Sommer, Andrei P; Wickramasinghe, N Chandra

    2004-12-01

    In January 2004, President George W. Bush unveiled plans to send astronauts to the Moon in 2015 and shortly thereafter to Mars. With the prospect of manned exploration of the planets drawing ever closer, the new discipline of Space Medicine is destined to come to the fore. Moreover, investigations of how human beings function under space conditions could provide important new insights into fundamental questions of human physiology and disease. We draw attention here to one such instance of a disease process that can be provoked by extended periods of exposure to low gravity.

  6. Rhinovirus Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  7. Eye Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  8. Campylobacter Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  9. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    OpenAIRE

    2014-01-01

    Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were reco...

  10. Variations of dendritic cell-specific intercellualar adhesion molecule-3-grabing nonintegrin neck region in HIV infected individuals

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ Dendritic ceils(DCs)play a critical role in initiating the immune response by virtue of their ability to capture and present antigens to T cells.1 Although the precise mechanism by which DCs acquire human immunodeficiency virus (HIV-1) is not completely understood,migration of DCs from the periphery to the draining lymph nodes may enable CD4+ T cells to become infected.2

  11. Ludwig’s Angina: The Importance of Oral Cavity Examination in Patients with a Neck Mass

    Directory of Open Access Journals (Sweden)

    Mohamad I

    2012-12-01

    Full Text Available neck mass is a common condition in primary care. the most common affected area is the cervical lymph node. the neck region is also prone infection as structurally the nodes and spaces are in close contact with the upper respiratory tract and the alimentary tract. oral cavity is one of the most common route for harbouring infection. Poor oral hygeine and periapical dental problems are the main causes. thus, it is important to perform a complete oral cavity examination even when trismus is present. Besides dental caries, floor of the mouth should be inspected for oedema that may impose threat to the upper airway. We report a case of Ludwig’s angina originating from a periapical lesion of the lower molar stressing the importance of oral examination in patient with neck mass.

  12. Evaluation of Ultrasonography as a Diagnostic Tool in Maxillofacial Space Infections

    Directory of Open Access Journals (Sweden)

    Praveen Kumar Pandey

    2011-11-01

    Full Text Available Objectives: The purpose of the study was to establish the role of ultrasonography in determining the involvement of specific fascial spaces in maxillofacial region and the stage of infection, in indicating the appropriate time for surgical intervention and to compare clinical and ultrasonographic findings.Material and Methods: Twenty five patients with fascial space infection in maxillofacial region were subjected to ultrasonographic examination following a detailed clinical and radiological examination. Ultrasonography guided needle aspiration was performed. Based on the findings, patients diagnosed with abscess were subjected to incision and drainage and those with cellulitis were subjected to medical line of treatment.Results: More than one fascial space was involved in all patients. On clinical examination 64 spaces were involved, of them 34 spaces had abscess formation and 30 spaces were in the stage of cellulitis. On ultrasonography examination, 28 spaces were reported to have abscess formation and 36 spaces were diagnosed to be in the stage of cellulitis. On comparative analysis of both clinical and ultrasonographic findings, ultrasonography was found to be sensitive in 65% of the cases and having specificity of 80%. It was registered statistically significant (P < 0.001 agreement between these two methods of assessment (kappa index = 0.814.Conclusions: Ultrasonography is a quick, widely available, relatively inexpensive, and painless procedure and can be repeated as often as necessary without risk to the patient. Thus ultrasonography is a valuable diagnostic aid to the oral and maxillofacial surgeon for early and accurate diagnosis of fascial space infection, their appropriate treatment and to limit their further spread.

  13. Anaerobic Infections

    Science.gov (United States)

    ... on the face and neck, sometimes after a dental infection or procedure such as a tooth extraction or ... adults of all ages. The most common are dental infections, inflammation of the abdominal lining (peritonitis), and abscesses ...

  14. CT findings of palpable neck masses in children

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Sup; Chung, Won Mo; Seok, Eul Hye; Suh, Chang Hae; Chung, Won Kyun [College of Medicine, Inha University, Incheon (Korea, Republic of)

    1994-12-15

    We performed this study to assess the value of CT in the differential diagnosis of palpable neck masses in children. We retrospectively reviewed the CT scans of the palpable neck masses in 30 children. The masses were proved histopathologically and classified into cystic, solid, and inflammatory mass and their CT findings were analyzed. Twelve cases were cystic masses, 4 were solid masses, and 14 were inflammatory lesions. Cystic masses included cystic lymphangiomas (n=6), branchial cleft cysts (n=3), thyroglossal duct cysts (n=2), and ranula (n=1). Cystic lymphangiomas showed insinuating appearances into adjacent structures and 4 cases occurred in the posterior cervical space. All branchial cleft cysts were round cystic masses with smooth wall and displaced the submandibular gland anteriorly and the sternocleidomastoid muscle posteriorly. Two thyroglossal duct cysts occurred centrally adjacent to the hyoid bone and 1 ranula in the submental area. Solid masses were juvenile hemangioma, pleomorphic adenoma in submandibular gland, neurilemmoma, and fibromatosis colli. Juvenile hemangioma showed well-enhancing mass with indistinct margin and the other solid masses had well-defined margin with their characteristic location. Inflammatory lesions were abscess (n=4), deep neck infections with lymphadenopathy (n=4), submandibular gland inflammation (n=3), and tuberculous lymphadenitis (n=3) and they showed strand-like enhancement in adjacent subcutaneous tissues. Tuberculous lymphadenitis had multiple lymph node enlargement with internal low attenuation areas and showed less surrounding strand-like enhancement than suppurative lymphadenopathies. Most neck masses in infants and children were of congenital or inflammatory origin. CT is useful for the evaluation of the child presenting with a neck mass, because it can differentiate various forms of neck masses and is able to reveal the relationship of the masses to the adjacent structures with their characteristic location.

  15. Neck Injuries and Disorders

    Science.gov (United States)

    ... or upper arms. Muscle strain or tension often causes neck pain. The problem is usually overuse, such as from ... or accidents, including car accidents, are another common cause of neck pain. Whiplash, a soft tissue injury to the neck, ...

  16. Atypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.

    LENUS (Irish Health Repository)

    Uzomefuna, Vincent

    2012-02-01

    Retropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. While older children may have specific complaints referable to the pharynx, infants and young children may present with vague symptoms. To date, a lot of emphasis continues to be placed on the importance of lateral soft tissue neck X-ray in the diagnosis and management of patients with suspected retropharyngeal abscesses; and lateral neck X-ray has been cited as the most useful radiological view of the laryngopharynx. While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.

  17. Inter-vertebral flexibility of the ostrich neck: implications for estimating sauropod neck flexibility.

    Directory of Open Access Journals (Sweden)

    Matthew J Cobley

    Full Text Available The flexibility and posture of the neck in sauropod dinosaurs has long been contentious. Improved constraints on sauropod neck function will have major implications for what we know of their foraging strategies, ecology and overall biology. Several hypotheses have been proposed, based primarily on osteological data, suggesting different degrees of neck flexibility. This study attempts to assess the effects of reconstructed soft tissues on sauropod neck flexibility through systematic removal of muscle groups and measures of flexibility of the neck in a living analogue, the ostrich (Struthio camelus. The possible effect of cartilage on flexibility is also examined, as this was previously overlooked in osteological estimates of sauropod neck function. These comparisons show that soft tissues are likely to have limited the flexibility of the neck beyond the limits suggested by osteology alone. In addition, the inferred presence of cartilage, and varying the inter-vertebral spacing within the synovial capsule, also affect neck flexibility. One hypothesis proposed that flexibility is constrained by requiring a minimum overlap between successive zygapophyses equivalent to 50% of zygapophyseal articular surface length (ONP50. This assumption is tested by comparing the maximum flexibility of the articulated cervical column in ONP50 and the flexibility of the complete neck with all tissues intact. It is found that this model does not adequately convey the pattern of flexibility in the ostrich neck, suggesting that the ONP50 model may not be useful in determining neck function if considered in isolation from myological and other soft tissue data.

  18. Neck Pain

    Science.gov (United States)

    ... Call for Letters of Interest Call for Topics Axial Spondyloarthritis Glucocorticoid-Induced Osteoporosis Gout Juvenile Idiopathic Arthritis ... with systemic illnesses, such as polymyalgia rheumatica , ankylosing spondylitis , rheumatoid arthritis , tumors and infections. The common mechanical ...

  19. Odontogenic infection involving the secondary fascial space in diabetic and non-diabetic patients: a clinical comparative study

    OpenAIRE

    Chang, Je-Shin; Yoo, Kil-Hwa; Yoon, Sung Hwan; Ha, Jiwon; JUNG, Seunggon; Kook, Min-Suk; Park, Hong-Ju; Ryu, Sun-Youl; Oh, Hee-Kyun

    2013-01-01

    Objectives This retrospective study was performed to evaluate the clinical impact of diabetes mellitus on the prognosis in secondary space infection. Materials and Methods Medical records, radiographic images, computed tomography, and microbial studies of 51 patients (25 diabetic patients and 26 non-diabetic patients) were reviewed. Patients were diagnosed as secondary fascial space infections with odontogenic origin and underwent treatment at Chonnam National University Hospital, in Departme...

  20. Neck x-ray

    Science.gov (United States)

    X-ray - neck; Cervical spine x-ray; Lateral neck x-ray ... There is low radiation exposure. X-rays are monitored so that the lowest amount of radiation is used to produce the image. Pregnant women and ...

  1. A Prognostic Scoring Tool for Cesarean Organ/Space Surgical Site Infections: Derivation and Internal Validation.

    Science.gov (United States)

    Assawapalanggool, Srisuda; Kasatpibal, Nongyao; Sirichotiyakul, Supatra; Arora, Rajin; Suntornlimsiri, Watcharin

    Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool. The likelihood ratio of positive for each risk category and the area under receiver operating characteristic (AUROC) curves were analyzed on total scores. Internal validation using bootstrap re-sampling was tested for reproducibility. The predictors of 243 organ/space SSIs from 4,988 eligible cesarean delivery cases comprised the presence of foul-smelling amniotic fluid (four points), vaginal examination five or more times before incision (two points), wound class III or greater (two points), being referred from local setting (two points), hemoglobin less than 11 g/dL (one point), and ethnic minorities (one point). The likelihood ratio of cesarean organ/space SSIs with 95% confidence interval among low (total score of 0-1 point), medium (total score of 2-5 points), and high risk (total score of ≥6 points) categories were 0.11 (0.07-0.19), 1.03 (0.89-1.18), and 13.25 (10.87-16.14), respectively. Both AUROCs of the derivation and validation data were comparable (87.57% versus 86.08%; p = 0.418). This scoring tool showed a high predictive ability regarding cesarean organ/space SSIs on the derivation data and reproducibility was demonstrated on internal validation. It could assist practitioners prioritize patient care and management depending on risk category and decrease SSI rates in cesarean deliveries.

  2. The use of ultrasonography in diagnosis and management of superficial fascial space infections

    Directory of Open Access Journals (Sweden)

    Pravin U Mukhi

    2012-01-01

    Materials and Methods: a total of 26 patients with acute facial swellings were included in the study. Clinical examination confirmed the presence of space infection. Ultrasonographic examination of the swelling was then performed. If ultrasound images showed no collection and only thickness of subcutaneous tissue and muscle involved were increased, then the diagnosis was made as cellulitis. When collection was identified, diagnosis was made as abscess. Dimensions of abscess cavity, amount of pus collected, and depth of the center of the abscess cavity from the skin surface were recorded. Pus evacuation was then prime consideration either by needle aspiration or by incision and drainage. The amount of collection recorded on ultrasonography was compared with that drained at the time of surgery. Results: of 26 patients, 14 patients were diagnosed with cellulitis and the remaining 12 patients with abscesses in the maxillofacial region. Five of 12 cases of abscess were managed with ultrasound-guided needle aspiration; rest seven cases underwent the incision and drainage procedure. Clinical specificity (69.23% was found to be poorer than ultrasound specificity (100 %, both clinical and ultrasound showed the same percentage of sensitivity (92.30% Conclusions: from our experience we can conclude that ultrasonography is an inexpensive and non-invasive diagnostic technique that should be used to supplement clinical examination in patients with superficial fascial space infection.

  3. Mycoplasma pneumoniae Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  4. Arcanobacterium Haemolyticum Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  5. Helicobacter Pylori Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  6. Importance of ultrasonography and magnetic resonance imaging in diagnosis of cysticercosis of temporalis muscle mimicking temporal space infection

    Directory of Open Access Journals (Sweden)

    Sameer Rastogi

    2013-01-01

    Full Text Available Cysticercosis cellulosae, caused by the larval stage of Taenia solium is a common parasitic infection in Indian subcontinent. Although cysticercosis is common in other parts of the human body, its involvement with temporalis muscle is an extremely rare entity and demands documentation. This paper reports a case of cysticercosis cellulosae in a 35-year-old male patient within the temporalis muscle mimicking temporal space infection; due to the presence of concomitant dental infection, which was diagnosed with the help of high resolution ultrasonography and magnetic resonance imaging and managed conservatively using oral antiparasitic medication. Here, in this case report, we are emphasizing the importance of imaging modalities in diagnosing space infection and cysticercosis.

  7. Forgotten triangles of neck.

    Science.gov (United States)

    Singh, Manpreet; Vashistha, Arpit; Chaudhary, Manoj; Kaur, Gagandeep

    2016-01-01

    The purpose of this manuscript is to add some more information in the present scientific literature on these nearly forgotten triangles of surgical importance. The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well-known, yet, some have been nearly forgotten, i.e., Lesser's triangle, Farabeuf triangle, Pirogoff's triangle, and Beclard's triangle. From the anatomic and surgical point of view, the neck is an amazingly interesting place. It is like a connection where crucial functional units meet and pass. Added surgical landmarks are always helpful to the surgeon while dealing with the neck. Described triangles of neck in this article are always reliable and constant landmarks for head and neck surgeons.

  8. The operative treatment of maxillofacial and deep neck infection on minimally invasive technique assisted by vacuum aspiration drainage method%颌面颈部深部化脓性感染的微创负压引流方法研究

    Institute of Scientific and Technical Information of China (English)

    董青山; 郭家平; 李志进; 王翔; 侯君; 孙传孔; 唐建军; 黄实华

    2014-01-01

    目的:评估颌面颈部深部化脓性感染的微创手术加负压引流的临床效果。方法:2009年1月~2013年12月颌面颈部深部化脓性感染病例87例,其中淋巴结坏死形成的脓肿32例、囊肿伴感染21例、间隙感染24例、化脓性颌下腺炎10例。所有病变在全麻下微创切口,行脓肿切开及包块的整体切除,伤口内放置持续负压引流管,严密关闭创口。术后次日开始药物和生理盐水冲洗,配合常规抗炎、支持和对症处理。结果:87例患者术后全身发热、不适等症状明显好转,局部炎症反应基本在1~3天内控制,伤口大部分可以一期愈合,创面小而美观。合并有糖尿病、艾滋病等疾病时,伤口愈合延迟。结论:颌面颈部深部化脓性炎症大部分可以一期切除,脓肿行微创切口,并严密关闭伤口,伤口通过负压引流结合冲洗,是取得良好治疗效果的保证。%Objective:To evaluate the minimally invasive operative principles and effects of maxillofacial and deep neck infection assisted by vacuum aspiration drainage method. Method:There were 87 patients of maxillofacial and deep neck infection in Wuhan General Hospital from January 2009 to December 2013. Among them,32 cases were abscess from necrotizing lymph nodes,21 cases were cyst affiliated with infection,24 cases were maxillofacial space infection,10 cases were acute submaxillaritis. These cases were treated by general massive resection of abscess and tumors,and closed the wounds assisted by vacuum aspiration drainage. From the second day,the patients were received anti-inflammatory treatment and washed by sodium chloride or antibiotics. Result:After these treatments,the symptoms of patient general fever and dis-comfort were clearly better. The local inflammatory reaction was controlled within 1 to 3 days,and the wounds were most pri-mary healing in 7 days. But the wound in those patients accompanied diabetes and AIDS

  9. Head and Neck

    DEFF Research Database (Denmark)

    Højgaard, Liselotte; Berthelsen, Anne Kiil; Loft, Annika

    2014-01-01

    Positron emission tomography (PET)/computed tomography with FDG of the head and neck region is mainly used for the diagnosis of head and neck cancer, for staging, treatment evaluation, relapse, and planning of surgery and radio therapy. This article is a practical guide of imaging techniques......, including a detailed protocol for FDG PET in head and neck imaging, physiologic findings, and pitfalls in selected case stories....

  10. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

  11. Diagnosis and treatment of fungal infections in head and neck cancer with radiotherapy%头颈部肿瘤放疗中真菌感染的诊治

    Institute of Scientific and Technical Information of China (English)

    唐曦; 胡娅; 徐炎华

    2011-01-01

    目的 探讨头颈部肿瘤放疗中真菌感染的诊治疗效.方法回顾性分析14例头颈部肿瘤真菌感染病例的诊治过程及治疗方法.结果 8例患者均在接受治疗2~3 d后症状即有减轻、体温下降,7~10 d后症状基本消失,体温恢复正常,维持治疗1~3周后停药,随访2~6个月无复发;1例伴糖尿病、高血压者,在接受治疗的同时控制血糖、血压;2例在治疗前肝功能检查:谷丙转氨酶、谷草转氨酶均偏高,治疗后第2周后复查转氨酶有逐渐增高趋势,考虑患者临床上已基本痊愈,即予停药.结论真菌感染的治疗以抗真菌为主,可选用抗菌谱广、不良反应小的氟康唑、伊曲康唑等治疗.%OBJECTIVE To discuss the effect of diagnosis and treatment of fungal infections in head and neck cancer by radiotherapy. METHODS The diagnosis and the treatment were retrospectively analyzed in 14 patients with head and neck cancer fungal infections cases. RESULTS Totally 8 patients were treated after 2~3 d to reduce the symptoms that, the temperature droped, 7~10 d after the symptoms disappeared, the body temperature returned to normal, maintained the therapy for 1 to 3 weeks after the withdrawal, followed up for 2 to 6 months without recurrence. 1 case with diabetes, hypertension, while receiving treatment in internal medicine to help control blood sugar and blood pressure. 2 patients were performed the liver function tests before the treatment: alanine aminotransferase, aspartate aminotransferase are high, the first 2 weeks after treatment has gradually increased after the review of aminotransferase trend has been basically considered clinically cured patients, withdrawal verdict. CONCLUSION The antifungal treatment is mainly the choice for fungal infection. Fluconazole and itraconazole, which are with broad antibacterial spectrum and less side effects, can be selected.

  12. Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

    Directory of Open Access Journals (Sweden)

    Melisa Lim Seer Yee

    2014-01-01

    Full Text Available Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were recorded. 75 patients were diagnosed as having neck abscess on CECT; out of those 71 patients were found to have pus. Overall CECT findings were found to have a high sensitivity (98.6% and positive predictive value (PPV (94.7% but lower specificity (67.2% in diagnosing neck abscess. The CECT diagnostic criterion with the highest PPV is the presence of rim irregularity (96%. The most common deep neck space involved is the submandibular compartment, which correlates with the finding that odontogenic cause was the most common identifiable cause of abscess in the study population. Thus, in a patient clinically suspected of having neck abscess, CECT findings of a hypodense mass with rim irregularity are helpful in confirming the diagnosis and guiding clinical management.

  13. Risk factors of nosocomial infections in patients with head and neck cancer during radiotherapy%头颈部恶性肿瘤患者放疗期间发生医院感染的危险因素

    Institute of Scientific and Technical Information of China (English)

    张海兵; 许建伟; 郑少俊; 茹利新; 俞根华; 纪鹏天

    2016-01-01

    目的:分析头颈部恶性肿瘤患者放疗期间发生医院感染的相关危险因素。方法回顾性分析2011年8月至2014年12月湖州市中心医院189例头颈部恶性肿瘤接受放射治疗患者的临床资料,对可能影响医院感染的危险因素进行单因素χ2检验和多因素logistic回归分析。结果189例患者中,64例并发医院感染,医院感染发生率为33.86%。单因素分析结果显示,口咽部黏膜炎(χ2=11.47,P<0.01)、有基础疾病(χ2=6.59,P<0.05)、肿瘤分期Ⅲ~Ⅳ(χ2=4.36,P<0.05)、照射范围为全面颈(χ2=7.64,P<0.05)、照射剂量≥50 Gy(χ2=8.92,P<0.05)、合并化疗(χ2=6.53, P<0.01)、侵入性操作(χ2=4.21,P<0.05)、PS评分=1(χ2=3.58,P<0.05)及体质指数偏低(χ2=9.56,P<0.05)是医院感染的相关危险因素。多因素Logistic 回归分析结果显示,口咽部黏膜炎(OR=3.46,χ2=8.72,P <0.01)、有基础疾病(OR =1.91,χ2=4.66,P <0.05)、肿瘤分期Ⅲ~Ⅳ(OR=2.01,χ2=5.22,P<0.05)、照射范围为全面颈( OR=1.78,χ2=4.89,P<0.05)、照射剂量≥50 Gy(OR=1.69,χ2=3.25,P<0.05)、合并化疗(OR=1.84,χ2=6.91,P<0.05)及体质指数偏低(OR=1.53,χ2=2.59,P<0.05)是引起医院感染的独立危险因素。结论头颈部恶性肿瘤患者放疗期间医院感染发生率较高。放疗期间口咽部黏膜炎、基础疾病、肿瘤分期、照射范围、照射剂量、合并化疗及营养状态可能影响医院感染的发生。%Objective To investigate the risk factors of nosocomial infections in patients with head and neck cancer during radiotherapy .Methods Clinical data of 189 patients with head and neck cancer receiving radiotherapy in Huzhou Central Hospital during August 2011 and December 2014 were retrospectively studied .Chi-square test and multivariate

  14. Surgical site infection after caesarean section: space for post-discharge surveillance improvements and reliable comparisons.

    Science.gov (United States)

    Ferraro, Federica; Piselli, Pierluca; Pittalis, Silvia; Ruscitti, Luca E; Cimaglia, Claudia; Ippolito, Giuseppe; Puro, Vincenzo

    2016-04-01

    Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive.

  15. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of se

  16. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of

  17. Medications for Sexually Transmitted Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  18. Thrush and Other Candida Infections

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  19. 头颈部肿瘤患者口腔真菌感染耐药性分析%Drug resistance of fungi causing oral infections in patients with head and neck cancer

    Institute of Scientific and Technical Information of China (English)

    郑晓珍; 郑勤红; 邹燕; 吕珍; 王丹丹

    2014-01-01

    OBJECTIVE To analyze the drug resistance of the fungi causing oral infections in head and neck cancer patients undergoing radiochemotherapy so as to provide guidance for clinical treatment .METHODS A total of 605 patients with head and neck cancer ,who underwent the radiochemotherapy from Jan 2009 to Sep 2013 ,were en-rolled in the study ,then the throat swab samples were collected from the patients with infections ,the drug resist-ance of isolated fungi was analyzed ;the statistical analysis was performed with the use of SPSS 17 .0 software ,the measurement data were defined as mean ± standard deviation and analyzed by using the t-test ,and the count data were analyzed by means of the chi-square test .RESULTS Among the 605 head and neck cancer patients undergoing radiochemotherapy ,the oral infections occurred in 63 cases with the infection rate of 10 .41% .Totally 125 strains of pathogens have been isolated ,including 61 (48 .80% ) strains of bacteria and 64 (51 .20% ) strains of fungi;the Candida albicans was dominant among the fungi ,accounting for 24 .80% (31 strains ) .The main species of fungi were highly resistant to econazole and ketoconazole ,but the drug resistance rates to fluconazole ,5-flucytosine , and amphotericin B were low ,and the strains were most susceptible to amphotericin B ,with the drug resistance rate no more than 3 .23% .CONCLUSION The incidence of fungal infections is high in the head and neck cancer pa-tients undergoing radiochemotherapy ,and the C .albicans is the predominant species of fungi .Fluconazole can achieve significant effect on treatment of the fungal infections ,meanwhile ,flucytosine and amphotericin B can also be applied in the hospital .%目的:针对头颈部肿瘤放化疗患者口腔感染及真菌耐药性进行分析,为临床治疗提供参考依据。方法对2009年1月-2013年9月收治的605例头颈部肿瘤放化疗患者口腔咽拭子样本进行感染分析,并对检出真菌进

  20. Multidisciplinary treatment of the neck

    NARCIS (Netherlands)

    de Bree, Remco; Langendijk, Johannes A.; Leemans, C. R.

    2016-01-01

    Since lymph node metastases are one of the most important prognostic factors, treatment of the neck is challenging. In clinically N0 neck, (super)selective neck dissection is indicated, whereas a more extensive neck dissection with preservation of important structures is performed in N2-N3 disease.

  1. Carotid sheath abscess caused by a tooth decay infection on the opposite side.

    Science.gov (United States)

    Tuncturk, F Ruya; Uzun, Lokman; Kalcioglu, M Tayyar; Egilmez, Oguz Kadir; Timurlenk, Emine; Erguven, Muferet

    2015-01-01

    Deep neck infections are mortal diseases that need emergency treatment. It can occur at any age but usually in pediatric ages. In this report, a left cervical carotid space abscess of a pediatric patient was discussed. It was interesting that the only origin of the left carotid sheath abscess was right inferior first molar tooth decay. Right neck spaces were all clean. Patient had no immunosupression and also there were no congenital masses such as branchial cleft cysts, foreign bodies, or masses suspicious for malignancies in cervical ultrasound and MRI. We discussed this rare condition under the light of the literature.

  2. Melanoma - neck (image)

    Science.gov (United States)

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  3. Head and neck teratomas

    OpenAIRE

    Shah, Ajaz; Latoo, Suhail; Ahmed, Irshad; Malik, Altaf H

    2009-01-01

    Teratomas are complex lesions composed of diverse tissues from all 3 germinal cell layers and may exhibit variable levels of maturity. Head and neck teratomas are most commonly cervical with the oropharynx (epignathus) being the second commonest location. In this article, clinical presentation, behaviour and associated significance of head and neck teratomas have been highlightened. Because of their obscure origin, bizarre microscopic appearance, unpredictable behaviour and often dramatic cli...

  4. A CALCULUS CHOLECYSTITIS PERFORATING AT THE NECK

    Directory of Open Access Journals (Sweden)

    Jayashri

    2014-08-01

    Full Text Available Gallbladder perforation is a rare complication of cholecystitis and cholelithiasis. The high morbidity and mortality rates associated with this condition are due to delays in diagnosis and treatment since signs and symptoms of perforation do not differ significantly from those of uncomplicated cholecystitis. We report a case of 17 year old boy who presented with perforation at the neck of gall bladder with extrusion of a stone. It was associated with bile infected with S. typhi.

  5. Pediatric Neck Mass

    Directory of Open Access Journals (Sweden)

    Guilherme Machado de Carvalho

    2015-11-01

    Full Text Available Introduction  Neck masses include a wide variety of diagnostic possibilities, with more than 60 etiologies that depend on clinical aspects such as age, location and time of disease progression. The interview and physical examination guide research that cross the neck masses in pediatric patients in 3 groups: infectious / inflammatory, and neoplastic embryonic remnants. The aim of this study was to present a protocol for evaluation of neck masses in the pediatric age group, based on a review of literature on the subject and experience of this service. Materials and Methods Survey of literature data from PubMed / Medline, Google Scholar and Scopus Database without language restriction, since 1980 sources, with the MeSH term "Pediatric neck mass".  Results Prepared flowchart guidelines to be followed according with diagnostic suspicions. Patients were divided into 3 groups according to the initial clinical manifestations and according to etiological hypotheses formulated recommend evaluations protocols.  Conclusion The standardization of the evaluation of neck masses in children proves valuable and can help in the differential diagnosis of different etiologies involved.

  6. Malakoplakia of the neck.

    Science.gov (United States)

    Schmerber, Sebastien; Lantuejoul, Sylvie; Lavieille, Jean-Pierre; Reyt, Emile

    2003-11-01

    Malakoplakia that presents in the head and neck is very rare. We describe a 76-year-old man who presented with an inflammatory mass in the lateral aspect of the neck that clinically mimicked a tumoral expansion and was consistent with a cervical malakoplakia. To our knowledge, this is the second case reported with manifestations of this chronic inflammatory disease localized in the neck. Malakoplakia is a rare granulomatous disease that most frequently involves the genitourinary tract and occurs in an immunodeficient host. The symptoms are nonspecific and the diagnosis is based on the histologic findings. In the present case, the biopsy specimen of the cervical mass revealed a collection of numerous von Hansemann cells containing Michaelis-Gutmann bodies, which are pathognomonic of malakoplakia. Bacteriologic analysis identified Escherichia coli. The evolution was favorable after surgical excision and prolonged antibiotic therapy with fluoroquinolones.

  7. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... oncologist will listen to the history of your problem and perform a physical examination. Consultations with other members of the head and neck team, such as the head and neck surgeon, pathologist, ...

  8. Infections

    Science.gov (United States)

    ... Does My Child Need? How to Safely Give Acetaminophen Is It a Cold or the Flu? Is the Flu Vaccine a Good Idea for Your Family? Too Late for the Flu Vaccine? Common Childhood Infections Can Chronic Ear Infections Cause Long-Term Hearing Loss? Chickenpox Cold Sores Common Cold Diarrhea Fever and ...

  9. Biomechanics of Head, Neck, and Chest Injury Prevention for Soldiers

    Science.gov (United States)

    2011-03-01

    magnitude filter was applied to the images. Bones with small articular spaces (such as cervical vertebra ) were manually separated. The polygon surfaces...the neck. Cervical vertebrae 1 through 7, the hyoid bone, the C2 cartilage, spinal cord, 52 muscles of the neck (listed in Figure 12 and Figure 13...studies of the cervical spine is provided in place the head supported mass analysis (Task 2.1/2.2), as agreed upon with USAARL. Task 3 includes the finite

  10. Developmental biomechanics of neck musculature.

    Science.gov (United States)

    Lavallee, Amy V; Ching, Randal P; Nuckley, David J

    2013-02-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6-23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects' ability to maintain 70% of peak force over 30s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (pNeck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions.

  11. Lipoblastoma of the neck

    DEFF Research Database (Denmark)

    Lorenzen, Jacob C; Godballe, Christian; Kerndrup, Gitte B

    2005-01-01

    with lipoblastomatous tumours in the neck is presented. A 6-year-old boy with complains of stridorous respiration and significant reduction in physical capacity was referred to the ENT Department, Odense University Hospital, Denmark. He was treated with total surgical resection of a soft and slowly growing tumour...

  12. Detection of Tuberculosis Infection Hotspots Using Activity Spaces Based Spatial Approach in an Urban Tokyo, from 2003 to 2011.

    Directory of Open Access Journals (Sweden)

    Kiyohiko Izumi

    Full Text Available Identifying ongoing tuberculosis infection sites is crucial for breaking chains of transmission in tuberculosis-prevalent urban areas. Previous studies have pointed out that detection of local accumulation of tuberculosis patients based on their residential addresses may be limited by a lack of matching between residences and tuberculosis infection sites. This study aimed to identify possible tuberculosis hotspots using TB genotype clustering statuses and a concept of "activity space", a place where patients spend most of their waking hours. We further compared the spatial distribution by different residential statuses and describe urban environmental features of the detected hotspots.Culture-positive tuberculosis patients notified to Shinjuku city from 2003 to 2011 were enrolled in this case-based cross-sectional study, and their demographic and clinical information, TB genotype clustering statuses, and activity space were collected. Spatial statistics (Global Moran's I and Getis-Ord Gi* statistics identified significant hotspots in 152 census tracts, and urban environmental features and tuberculosis patients' characteristics in these hotspots were assessed.Of the enrolled 643 culture-positive tuberculosis patients, 416 (64.2% were general inhabitants, 42 (6.5% were foreign-born people, and 184 were homeless people (28.6%. The percentage of overall genotype clustering was 43.7%. Genotype-clustered general inhabitants and homeless people formed significant hotspots around a major railway station, whereas the non-clustered general inhabitants formed no hotspots. This suggested the detected hotspots of activity spaces may reflect ongoing tuberculosis transmission sites and were characterized by smaller residential floor size and a higher proportion of non-working households.Activity space-based spatial analysis suggested possible TB transmission sites around the major railway station and it can assist in further comprehension of TB transmission

  13. Neck swelling from a retropharyngeal abscess caused by penicillin-resistant Streptococcus pneumoniae: a case report

    OpenAIRE

    2014-01-01

    Background In small children, retropharyngeal abscesses usually occur after upper respiratory tract infections. Unlike in adults, these abscesses are difficult to diagnose in small children, and can rapidly develop into deep neck or mediastinal abscesses. Case presentation A 2-year-old Japanese boy recently presented to our department with a chief complaint of neck swelling. Physical examination revealed bilateral tonsillitis and swelling of the left posterior pharyngeal wall. Emergency neck ...

  14. Anatomy of lithosphere necking during orthogonal rifting

    Science.gov (United States)

    Nestola, Yago; Cavozzi, Cristian; Storti, Fabrizio

    2013-04-01

    The evolution of lithosphere necking is a fundamental parameter controlling the structural architecture and thermal-state of rifted margin. The necking shape depends on several parameters, including the extensional strain-rate and thermal layering of the lithosphere. Despite a large number of analogue and numerical modelling studies on lithosphere extension, a quantitative description of the evolution of necking through time is still lacking. We used analogue modelling to simulate in three-dimension the progression of lithosphere thinning and necking during orthogonal rifting. In our models we simulated a typical "cold and young" 4-layer lithosphere stratigraphy: brittle upper crust (loose quartz sand), ductile lower crust (silicon-barite mixture), brittle upper mantle (loose quartz sand), and ductile lower mantle (silicon-barite mixture). The experimental lithosphere rested on a glucose syrup asthenosphere. We monitored model evolution by periodic and coeval laser scanning of both the surface topography and the lithosphere base. After model completion, each of the four layers was removed and the top of the underlying layer was scanned. This technical approach allowed us to quantify the evolution in space and time of the thinning factors for both the whole lithosphere (βz) and the crust (γ). The area of incremental effective stretching (βy) parallel to the extensional direction was obtained from the βz maps.

  15. Neck muscle fatigue alters upper limb proprioception.

    Science.gov (United States)

    Zabihhosseinian, Mahboobeh; Holmes, Michael W R; Murphy, Bernadette

    2015-05-01

    Limb proprioception is an awareness by the central nervous system (CNS) of the location of a limb in three-dimensional space and is essential for movement and postural control. The CNS uses the position of the head and neck when interpreting the position of the upper limb, and altered input from neck muscles may affect the sensory inputs to the CNS and consequently may impair the awareness of upper limb joint position. The purpose of this study was to determine whether fatigue of the cervical extensors muscles (CEM) using a submaximal fatigue protocol alters the ability to recreate a previously presented elbow angle with the head in a neutral position. Twelve healthy individuals participated. CEM activity was examined bilaterally using surface electromyography, and kinematics of the elbow joint was measured. The fatigue protocol included an isometric neck extension task at 70 % of maximum until failure. Joint position error increased following fatigue, demonstrating a significant main effect of time (F 2, 18 = 19.41, p ≤ 0.0001) for absolute error. No significant differences were found for variable error (F 2, 18 = 0.27, p = 0.76) or constant error (F 2, 18 = 1.16 of time, p ≤ 0.33). This study confirms that fatigue of the CEM can reduce the accuracy of elbow joint position matching. This suggests that altered afferent input from the neck subsequent to fatigue may impair upper limb proprioception.

  16. Developmental biomechanics of neck musculature

    OpenAIRE

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A fa...

  17. Streptococcal Infections: Not A or B

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  18. Safety and Efficacy of Intrapleural Tissue Plasminogen Activator and DNase during Extended Use in Complicated Pleural Space Infections

    Science.gov (United States)

    McClune, Jason R.; Wilshire, Candice L.; Gorden, Jed A.; Louie, Brian E.; Farviar, Alexander S.; Stefanski, Michael J.; Vallieres, Eric; Aye, Ralph W.

    2016-01-01

    The use of intrapleural therapy with tissue plasminogen activator and DNase improves outcomes in patients with complicated pleural space infections. However, little data exists for the use of combination intrapleural therapy after the initial dosing period of six doses. We sought to describe the safety profile and outcomes of intrapleural therapy beyond this standard dosing. A retrospective review of patients receiving intrapleural therapy with tissue plasminogen activator and DNase was performed at two institutions. We identified 101 patients from January 2013 to August 2015 receiving intrapleural therapy for complicated pleural space infection. The extended use of intrapleural tissue plasminogen activator and DNase therapy beyond six doses was utilized in 20% (20/101) of patients. The mean number of doses in those undergoing extended dosing was 9.8 (range of 7–16). Within the population studied there appears to be no statistically significant increased risk of complications, need for surgical referral, or outcome differences when comparing those receiving standard or extended dosing intrapleural therapy. Future prospective study of intrapleural therapy as an alternative option for patients who fail initial pleural drainage and are unable to tolerate/accept a surgical intervention appears a potential area of study. PMID:27445574

  19. Safety and Efficacy of Intrapleural Tissue Plasminogen Activator and DNase during Extended Use in Complicated Pleural Space Infections

    Directory of Open Access Journals (Sweden)

    Jason R. McClune

    2016-01-01

    Full Text Available The use of intrapleural therapy with tissue plasminogen activator and DNase improves outcomes in patients with complicated pleural space infections. However, little data exists for the use of combination intrapleural therapy after the initial dosing period of six doses. We sought to describe the safety profile and outcomes of intrapleural therapy beyond this standard dosing. A retrospective review of patients receiving intrapleural therapy with tissue plasminogen activator and DNase was performed at two institutions. We identified 101 patients from January 2013 to August 2015 receiving intrapleural therapy for complicated pleural space infection. The extended use of intrapleural tissue plasminogen activator and DNase therapy beyond six doses was utilized in 20% (20/101 of patients. The mean number of doses in those undergoing extended dosing was 9.8 (range of 7–16. Within the population studied there appears to be no statistically significant increased risk of complications, need for surgical referral, or outcome differences when comparing those receiving standard or extended dosing intrapleural therapy. Future prospective study of intrapleural therapy as an alternative option for patients who fail initial pleural drainage and are unable to tolerate/accept a surgical intervention appears a potential area of study.

  20. High dead-space syringes and the risk of HIV and HCV infection among injecting drug users.

    Science.gov (United States)

    Zule, William A; Bobashev, Georgiy

    2009-03-01

    This study examines the association between using and sharing high dead-space syringes (HDSSs)--which retain over 1000 times more blood after rinsing than low dead-space syringes (LDSSs)--and prevalent HIV and hepatitis C virus (HCV) infections among injecting drug users (IDUs). A sample of 851 out-of-treatment IDUs was recruited in Raleigh-Durham, North Carolina, between 2003 and 2005. Participants were tested for HIV and HCV antibodies. Demographic, drug use, and injection practice data were collected via interviews. Data were analyzed using multiple logistic regression analysis. Participants had a mean age of 40 years and 74% are male, 63% are African American, 29% are non-Hispanic white, and 8% are of other race/ethnicity. Overall, 42% of participants had ever used an HDSS and 12% had shared one. HIV prevalence was 5% among IDUs who had never used an HDSS compared with 16% among IDUs who had shared one. The HIV model used a propensity score approach to adjust for differences between IDUs who had used an HDSS and those who had never used one. The HCV models included all potential confounders as covariates. A history of sharing HDSSs was associated with prevalent HIV (odds ratio=2.50; 95% confidence interval=1.01, 6.15). Use and sharing of HDSSs were also associated with increased odds of HCV infection. Prospective studies are needed to determine if sharing HDSSs is associated with increased HIV and HCV incidence among IDUs.

  1. Advances in otolaryngology-Head and neck surgery. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Myers, E.N. (Univ. of Pittsburgh School of Medicine, Pittsburgh, PA (US)); Bluestone, C.D. (Univ. of Pittsburgh, Pittsburgh, PA (US))

    1987-01-01

    This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery.

  2. Spaces

    Directory of Open Access Journals (Sweden)

    Maziar Nekovee

    2010-01-01

    Full Text Available Cognitive radio is being intensively researched as the enabling technology for license-exempt access to the so-called TV White Spaces (TVWS, large portions of spectrum in the UHF/VHF bands which become available on a geographical basis after digital switchover. Both in the US, and more recently, in the UK the regulators have given conditional endorsement to this new mode of access. This paper reviews the state-of-the-art in technology, regulation, and standardisation of cognitive access to TVWS. It examines the spectrum opportunity and commercial use cases associated with this form of secondary access.

  3. Group size and nest spacing affect Buggy Creek virus (Togaviridae: Alphavirus infection in nestling house sparrows.

    Directory of Open Access Journals (Sweden)

    Valerie A O'Brien

    Full Text Available The transmission of parasites and pathogens among vertebrates often depends on host population size, host species diversity, and the extent of crowding among potential hosts, but little is known about how these variables apply to most vector-borne pathogens such as the arboviruses (arthropod-borne viruses. Buggy Creek virus (BCRV; Togaviridae: Alphavirus is an RNA arbovirus transmitted by the swallow bug (Oeciacus vicarius to the cliff swallow (Petrochelidon pyrrhonota and the introduced house sparrow (Passer domesticus that has recently invaded swallow nesting colonies. The virus has little impact on cliff swallows, but house sparrows are seriously affected by BCRV. For house sparrows occupying swallow nesting colonies in western Nebraska, USA, the prevalence of BCRV in nestling sparrows increased with sparrow colony size at a site but decreased with the number of cliff swallows present. If one nestling in a nest was infected with the virus, there was a greater likelihood that one or more of its nest-mates would also be infected than nestlings chosen at random. The closer a nest was to another nest containing infected nestlings, the greater the likelihood that some of the nestlings in the focal nest would be BCRV-positive. These results illustrate that BCRV represents a cost of coloniality for a vertebrate host (the house sparrow, perhaps the first such demonstration for an arbovirus, and that virus infection is spatially clustered within nests and within colonies. The decreased incidence of BCRV in sparrows as cliff swallows at a site increased reflects the "dilution effect," in which virus transmission is reduced when a vector switches to feeding on a less competent vertebrate host.

  4. Group size and nest spacing affect Buggy Creek virus (Togaviridae: Alphavirus) infection in nestling house sparrows.

    Science.gov (United States)

    O'Brien, Valerie A; Brown, Charles R

    2011-01-01

    The transmission of parasites and pathogens among vertebrates often depends on host population size, host species diversity, and the extent of crowding among potential hosts, but little is known about how these variables apply to most vector-borne pathogens such as the arboviruses (arthropod-borne viruses). Buggy Creek virus (BCRV; Togaviridae: Alphavirus) is an RNA arbovirus transmitted by the swallow bug (Oeciacus vicarius) to the cliff swallow (Petrochelidon pyrrhonota) and the introduced house sparrow (Passer domesticus) that has recently invaded swallow nesting colonies. The virus has little impact on cliff swallows, but house sparrows are seriously affected by BCRV. For house sparrows occupying swallow nesting colonies in western Nebraska, USA, the prevalence of BCRV in nestling sparrows increased with sparrow colony size at a site but decreased with the number of cliff swallows present. If one nestling in a nest was infected with the virus, there was a greater likelihood that one or more of its nest-mates would also be infected than nestlings chosen at random. The closer a nest was to another nest containing infected nestlings, the greater the likelihood that some of the nestlings in the focal nest would be BCRV-positive. These results illustrate that BCRV represents a cost of coloniality for a vertebrate host (the house sparrow), perhaps the first such demonstration for an arbovirus, and that virus infection is spatially clustered within nests and within colonies. The decreased incidence of BCRV in sparrows as cliff swallows at a site increased reflects the "dilution effect," in which virus transmission is reduced when a vector switches to feeding on a less competent vertebrate host.

  5. Evaluation of antibiotic releasing porous polymethylmethacrylate space maintainers in an infected composite tissue defect model

    NARCIS (Netherlands)

    Spicer, P.P.; Shah, S.R.; Henslee, A.M.; Watson, B.M.; Kinard, L.A.; Kretlow, J.D.; Bevil, K.; Kattchee, L.; Bennett, G.N.; Demian, N.; Mende, K.; Murray, C.K.; Jansen, J.A.; Wong, M.E.; Mikos, A.G.; Kasper, F.K.

    2013-01-01

    This study evaluated the in vitro and in vivo performance of antibiotic-releasing porous polymethylmethacrylate (PMMA)-based space maintainers comprising a gelatin hydrogel porogen and a poly(dl-lactic-co-glycolic acid) (PLGA) particulate carrier for antibiotic delivery. Colistin was released in vit

  6. Evaluation of antibiotic releasing porous polymethylmethacrylate space maintainers in an infected composite tissue defect model

    NARCIS (Netherlands)

    Spicer, P.P.; Shah, S.R.; Henslee, A.M.; Watson, B.M.; Kinard, L.A.; Kretlow, J.D.; Bevil, K.; Kattchee, L.; Bennett, G.N.; Demian, N.; Mende, K.; Murray, C.K.; Jansen, J.A.; Wong, M.E.; Mikos, A.G.; Kasper, F.K.

    2013-01-01

    This study evaluated the in vitro and in vivo performance of antibiotic-releasing porous polymethylmethacrylate (PMMA)-based space maintainers comprising a gelatin hydrogel porogen and a poly(dl-lactic-co-glycolic acid) (PLGA) particulate carrier for antibiotic delivery. Colistin was released in

  7. Infections

    Directory of Open Access Journals (Sweden)

    Virginia Vanzzini Zago

    2012-01-01

    Full Text Available This is a retrospective, and descriptive study about the support that the laboratory of microbiology aids can provide in the diagnosis of ocular infections in patients whom were attended a tertiary-care hospital in México City in a 10-year-time period. We describe the microbiological diagnosis in palpebral mycose; in keratitis caused by Fusarium, Aspergillus, Candida, and melanized fungi; endophthalmitis; one Histoplasma scleritis and one mucormycosis. Nowadays, ocular fungal infections are more often diagnosed, because there is more clinical suspicion and there are easy laboratory confirmations. Correct diagnosis is important because an early medical treatment gives a better prognosis for visual acuity. In some cases, fungal infections are misdiagnosed and the antifungal treatment is delayed.

  8. Sepsis in head and neck cancer patients treated with chemotherapy and radiation: literature review and consensus

    NARCIS (Netherlands)

    A. Mirabile; G. Numico; E.G. Russi; P. Bossi; F. Crippa; A. Bacigalupo; V. De Sanctis; S. Musso; A. Merlotti; M.G. Ghi; M.C. Merlano; L. Licitra; F. Moretto; N. Denaro; O. Caspiani; M. Buglione; S. Pergolizzi; A. Cascio; J. Bernier; J. Raber-Durlacher; J.B. Vermorken; B. Murphy; M.V. Ranieri; R.P. Dellinger

    2015-01-01

    The reporting of infection/sepsis in chemo/radiation-treated head and neck cancer patients is sparse and the problem is underestimated. A multidisciplinary group of head and neck cancer specialists from Italy met with the aim of reaching a consensus on a clinical definition and management of infecti

  9. Imaging of head and neck venous malformations

    Energy Technology Data Exchange (ETDEWEB)

    Flis, Christine M.; Connor, Stephen E. [King' s College Hospital, Neuroradiology Department, London (United Kingdom)

    2005-10-01

    Venous malformations (VMs) are non proliferative lesions that consist of dysplastic venous channels. The aim of imaging is to characterise the lesion and define its anatomic extent. We will describe the plain film, ultrasound (US) (including colour and duplex Doppler), computed tomography (CT), magnetic resonance imaging (MRI), conventional angiographic and direct phlebographic appearances of venous malformations. They will be illustrated at a number of head and neck locations, including orbit, oral cavity, superficial and deep facial space, supraglottic and intramuscular. An understanding of the classification of such vascular anomalies is required to define the correct therapeutic procedure to employ. Image-guided sclerotherapy alone or in combination with surgery is now the first line treatment option in many cases of head and neck venous malformations, so the radiologist is now an integral part of the multidisciplinary management team. (orig.)

  10. Infection

    Science.gov (United States)

    2010-09-01

    Interactions between biofilms and the environment. FEMS Microbiol Rev. 1997;20:291–303. 4. Webb LX, Wagner W, Carroll D, et al. Osteomyelitis and...treatment of osteomyelitis . Biomed Mater. 2008;3: 034114. 6. Gristina AG. Biomaterial-centered infection: microbial adhesion versus tissue integration...vertebral osteomyelitis . Spine. 2007;32: 2996–3006. 15. Beckham JD, Tuttle K, Tyler KL. Reovirus activates transforming growth factor ß and bone

  11. Neck pain in different cephalalgias

    OpenAIRE

    E. A. Chechet; G. R. Tabeeva

    2014-01-01

    The paper reviews the literature related to the investigations of neck pain (cervicalgia) in patients with headache (cephalalgia). Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cer...

  12. Periodontal disease, atherosclerosis, adverse pregnancy outcomes, and head-and-neck cancer

    NARCIS (Netherlands)

    Han, Y.W.; Houcken, W.; Loos, B.G.; Schenkein, H.A.; Tezal, M.

    2014-01-01

    Interrelationships between periodontal infection and systemic conditions such as cardiovascular disease, adverse pregnancy outcomes, and head-and-neck cancer have become increasingly appreciated in recent years. Periodontitis is associated with cardiovascular disease (CVD) and, experimentally, with

  13. Dynamic head-neck stabilization and modulation with perturbation bandwidth investigated using a multisegment neuromuscular model

    NARCIS (Netherlands)

    Happee, R. (Riender); de Bruijn, E. (Edo); Forbes, P.A. (Patrick A.); F.C.T. van der Helm (Frans C.)

    2017-01-01

    textabstractThe human head-neck system requires continuous stabilization in the presence of gravity and trunk motion. We investigated contributions of the vestibulocollic reflex (VCR), the cervicocollic reflex (CCR), and neck muscle co-contraction to head-in-space and head-on-trunk stabilization,

  14. Interventional radiology neck procedures.

    Science.gov (United States)

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation.

  15. Aggressive Fibromatosis in Neck.

    Directory of Open Access Journals (Sweden)

    Namita Kabdwal

    2013-01-01

    Full Text Available Aggressive fibromatosis (AF is a locally aggressive infiltrative low-grade benign tumor that accounts for approximately less than 3% of all soft tissue tumors. In the head and neck region this tumor tends to be more aggressive and associated with significant morbidity. Aggressive surgery is a viable management option and may be successfully used as a single modality treatment, or in combination with radiotherapy. We report a rare case of AF in a 38 year old female, who presented with a painless mass over the left supraclavicular fossa, extending inferiorly into the thoracic inlet, which was excised successfully in toto with the help of cardiothoracic vascular surgeon (CTVS.

  16. [Necrotizing fasciitis of the neck].

    Science.gov (United States)

    Kovacić, Marijan; Kovacić, Ivan; Delalija, Boris

    2013-03-01

    Necrotizing fasciitis is a rare and rapidly progressive infection characterized by necrosis of the superficial fascia and spread on the surrounding skin or muscles, which can be fatal. It usually occurs in the limbs, abdominal wall and perineum. In this retrospective review, the authors present 15 patients with cervical necrotizing fasciitis. The patient mean age was 54.7 years and they had one or more comorbid health problems. Five of them had descending necrotizing mediastinitis and three had progressive sepsis with toxic shock syndrome. Broad-spectrum intravenous antibiotic therapy was administered to all patients immediately, and in three of them we used five-day intravenous immunoglobulin therapy for the signs of toxic shock syndrome. After positive computed tomography imaging for necrotizing fasciitis, we used surgical exploration and debridement of necrotic tissue. In five patients, the initial surgery also included mediastinal transcervical drainage. Preoperative tracheotomy was performed in six patients and delayed tracheotomy in one patient. Histopathologically, all cases showed extensive necrosis of debrided fascia and vascular thrombosis of the neck soft tissue. The mortality rate was 6.7% (1/15). The authors point to the importance of early diagnosis and timely surgical management, broad-spectrum antibiotics and intravenous immunoglobulin therapy when patients are too unstable to undergo surgery.

  17. Evaluation of antibiotic releasing porous polymethylmethacrylate space maintainers in an infected composite tissue defect model.

    Science.gov (United States)

    Spicer, Patrick P; Shah, Sarita R; Henslee, Allan M; Watson, Brendan M; Kinard, Lucas A; Kretlow, James D; Bevil, Kristin; Kattchee, Lauren; Bennett, George N; Demian, Nagi; Mende, Katrin; Murray, Clinton K; Jansen, John A; Wong, Mark E; Mikos, Antonios G; Kasper, F Kurtis

    2013-11-01

    This study evaluated the in vitro and in vivo performance of antibiotic-releasing porous polymethylmethacrylate (PMMA)-based space maintainers comprising a gelatin hydrogel porogen and a poly(dl-lactic-co-glycolic acid) (PLGA) particulate carrier for antibiotic delivery. Colistin was released in vitro from either gelatin or PLGA microparticle loaded PMMA constructs, with gelatin-loaded constructs releasing colistin over approximately 7 days and PLGA microparticle-loaded constructs releasing colistin for up to 8 weeks. Three formulations with either burst release or extended release at different doses were tested in a rabbit mandibular defect inoculated with Acinetobacter baumannii (2×10(7) colony forming units ml(-1)). In addition, one material control that released antibiotic but was not inoculated with A. baumannii was tested. A. baumannii was not detectable in any animal after 12 weeks on culture of the defect, saliva, or blood. Defects with high dose extended release implants had greater soft tissue healing compared with defects with burst release implants, with 8 of 10 animals showing healed mucosae compared with 2 of 10 respectively. Extended release of locally delivered colistin via a PLGA microparticle carrier improved soft tissue healing compared with implants with burst release of colistin from a gelatin carrier. Copyright © 2013 Acta Materialia Inc. All rights reserved.

  18. CT angiography - head and neck

    Science.gov (United States)

    ... often on the face or scalp Swallowing problems Stroke Transient ischemic attack (TIA) Weakness in one part of your body CTA of the neck may also be done: After trauma to the neck to look for damage to blood vessels For planning before carotid artery ...

  19. Neck dissection: then and now.

    NARCIS (Netherlands)

    Ferlito, A.; Rinaldo, A.; Silver, C.E.; Shah, J.P.; Suarez, C.; Medina, J.E.; Kowalski, L.P.; Johnson, J.T.; Strome, M.; Rodrigo, J.P.; Werner, J.A.; Takes, R.P.; Towpik, E.; Robbins, K.T.; Leemans, C.R.; Herranz, J.; Gavilan, J.; Shaha, A.R.; Wei, W.I.

    2006-01-01

    The significance of metastatic disease in the lymph nodes of the neck as a critical independent prognostic factor in head and neck cancer has long been appreciated. Although 19th century surgeons attempted to remove involved cervical lymph nodes at the time of resection of the primary cancer, a syst

  20. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  1. Neck pain causes respiratory dysfunction.

    Science.gov (United States)

    Kapreli, Eleni; Vourazanis, Evangelos; Strimpakos, Nikolaos

    2008-01-01

    This paper describes a presumptive mechanism for the development of changes in respiratory function due to chronic neck pain. The patient with neck pain presents a number of factors that could constitute a predisposition of leading to a respiratory dysfunction: (a) the decreased strength of deep neck flexors and extensors, (b) the hyperactivity and increased fatigability of superficial neck flexors, (c) the limitation of range of motion, (d) the decrease in proprioception and disturbances in neuromuscular control, (e) the existence of pain and (f) the psychosocial influence of dysfunction. The possible connection of neck pain and respiratory function could have a great impact on various clinical aspects notably patient assessment, rehabilitation and pharmacological prescription.

  2. Pleomorphic Adenomas of the Parapharyngeal Space

    Directory of Open Access Journals (Sweden)

    İstemihan Akın

    2014-01-01

    Full Text Available Background. Parapharyngeal space is one of potential facial planes for neoplasms and infections and represents less than 1% of all head and neck tumours. Occurrence of the pleomorphic adenoma in the parapharyngeal space is a rarity. Case Presentation. Here, three giant pleomorphic adenomas of different sizes occupying the parapharyngeal space in three patients are reported. Extensive preoperative diagnostic workup was done in order to verify the nature and size of the tumour and the proximity to the large vessels. Review of the literature, clinical features, pathology, radiological findings, and treatment of these tumours are discussed. Conclusion. The excision of the tumor through submandibular transcervical approach, without cutting the mandible, turned out to be a safe and radical approach in all three cases.

  3. Medicolegal aspects of necrotizing fasciitis of the neck.

    Science.gov (United States)

    Sperry, K; McFeeley, P J

    1987-01-01

    Necrotizing fasciitis of the neck (NFN) is a relatively rare, fulminating infectious process of the cervicofacial tissues which may cause sudden and unexpected death. Although often the result of a dental infection, injuries of the soft tissues of the neck may also initiate rampant cellulitis, and recognition of the underlying etiology of such cases is necessary to determine properly the manner of death. Five cases of NFN are presented with a review of the causative factors and usual bacteriology, and specific factors of medicolegal interest are addressed.

  4. 老年患者股骨颈骨折术后肺部感染的临床分析及干预对策%Clinical analysis and intervention strategies of pulmonary infection after surgery in elderly patients with femoral neck fracture

    Institute of Scientific and Technical Information of China (English)

    邓月华

    2015-01-01

    目的:分析老年患者股骨颈骨折术后并发肺部感染的危险因素,提出针对性的预防护理干预对策,以降低感染率。方法收集本科室2008年1月至2013年12月病历齐全的老年股骨颈骨折176例患者资料,根据是否发生肺部感染分为两组(即感染组和非感染组),比较两组患者感染的高危因素。结果高龄、早期缺乏活动、合并糖尿病、慢性支气管炎、长期反复使用抗菌药物、营养状况差、长期吸烟等因素可增加肺部感染的发生率,以上指标均具有统计学意义(P均<0.05)。感染组42例患者经积极治疗后感染于7~14 d得到控制。结论针对上述因素,积极干预,鼓励患者早期活动,彻底吸痰、加强肺功能锻炼、体位干预、饮食干预及加强基础护理,积极治疗原发病等措施,可以降低老年患者股骨颈骨折术后肺部感染的发生率。%Objectives To analyze the risk factors of pulmonary infection after surgery in elderly patients with femoral neck fracture, to propose targeted prevention and nursing intervention strategies, and to reduce the infection rates. Methods The clinical date of 176 elderly patients with femoral neck fracture were collected from January 2008 to December 2013 in our department, and those cases were divided into two groups (the infected group and the non-infected group) depending on whether they had pulmonary infection, then compared and summarized risk factors of infection. Results Advanced age, early lack of activity, diabetes, chronic bronchitis, long-term repeated use of antibiotics, poor nutritional status and long-term smoking could increase the incidence of pulmonary infection, all the indicators mentioned-above had significant differences (P all < 0.05). There were 42 cases with severe infetion in the infected group were treated within 7-14 d. Conclusions In response to these factors, doctors and nurses should take active intervention

  5. Infrahyoid spread of deep neck abscess: anatomical consideration.

    Science.gov (United States)

    Ojiri, H; Tada, S; Ujita, M; Ariizumi, M; Ishii, C; Mizunuma, K; Fukuda, K

    1998-01-01

    The aim of this study was to determine the pathway of infrahyoid extension of the oropharyngeal abscess considering the anatomy of the fascial spaces by cross-sectional imaging. CT scans and MR images were retrospectively reviewed in ten patients with known infrahyoid extension of oropharyngeal abscesses (eight with acute tonsillitis, two with acute phlegmonous oropharyngitis). In seven of eight patients tonsillar abscesses descended along the deep cervical fascia converging on the hyoid bone and further accumulated in the anterior cervical space through which extension to the mediastinum took place in four patients. In seven patients the abscesses involved the retropharyngeal space at the infrahyoid neck. In two of these seven patients the abscesses directly extended down into the upper mediastinum through the retropharyngeal space. In one patients of the seven mediastinal spread of an abscess occurred through the posterior cervical space, not through the retropharyngeal space. Cross-sectional imaging is valuable in the evaluation of deep neck abscesses and the pathway of spread. The anterior cervical space in the infrahyoid neck is important for mediastinal extension of pharyngeal abscesses.

  6. Masticator space abscess in a 47-day-old infant

    Directory of Open Access Journals (Sweden)

    Eunhee Kim

    2011-08-01

    Full Text Available A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about 2.0¡¿1.5 cm that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

  7. Variation in infectivity and aggressiveness in space and time in wild host-pathogen systems: causes and consequences.

    Science.gov (United States)

    Tack, A J M; Thrall, P H; Barrett, L G; Burdon, J J; Laine, A-L

    2012-10-01

    Variation in host resistance and in the ability of pathogens to infect and grow (i.e. pathogenicity) is important as it provides the raw material for antagonistic (co)evolution and therefore underlies risks of disease spread, disease evolution and host shifts. Moreover, the distribution of this variation in space and time may inform us about the mode of coevolutionary selection (arms race vs. fluctuating selection dynamics) and the relative roles of G × G interactions, gene flow, selection and genetic drift in shaping coevolutionary processes. Although variation in host resistance has recently been reviewed, little is known about overall patterns in the frequency and scale of variation in pathogenicity, particularly in natural systems. Using 48 studies from 30 distinct host-pathogen systems, this review demonstrates that variation in pathogenicity is ubiquitous across multiple spatial and temporal scales. Quantitative analysis of a subset of extensively studied plant-pathogen systems shows that the magnitude of within-population variation in pathogenicity is large relative to among-population variation and that the distribution of pathogenicity partly mirrors the distribution of host resistance. At least part of the variation in pathogenicity found at a given spatial scale is adaptive, as evidenced by studies that have examined local adaptation at scales ranging from single hosts through metapopulations to entire continents and - to a lesser extent - by comparisons of pathogenicity with neutral genetic variation. Together, these results support coevolutionary selection through fluctuating selection dynamics. We end by outlining several promising directions for future research.

  8. E-Coli Infection: Not Just from Food

    Science.gov (United States)

    ... Genitals and Urinary Tract Glands & Growth Head Neck & Nervous System Heart Infections Learning Disabilities Obesity Orthopedic Prevention Sexually Transmitted Skin Tobacco Treatments Injuries & ...

  9. Head, Neck, and Oral Cancer

    Science.gov (United States)

    ... a bright light and a mirror: Remove any dentures Look and feel inside the lips and the ... Early treatment may well be the key to complete recovery. Head, Neck & Oral Cancer Facts The information ...

  10. Spontaneous emphysema of the neck.

    Science.gov (United States)

    El-Ghazali, A M

    1983-04-01

    A case of spontaneous emphysema in the neck in a 17-year-old male was reported. Pathogenesis and management are discussed. Although it is a benign and self-limiting condition, it may carry a potential for serious complications.

  11. Neck pain in different cephalalgias

    Directory of Open Access Journals (Sweden)

    E. A. Chechet

    2014-01-01

    Full Text Available The paper reviews the literature related to the investigations of neck pain (cervicalgia in patients with headache (cephalalgia. Neck pain is second to lower back pain as a reason for considerable socioeconomic damage to society. The prevalence of cervicalgia in the population ranges from 5.9 to 38%; the annual incidence is 10.4–21.3%; 14.2 to 71% of people report to have neck pain at some time in their lifetime. Neck pain is concurrent with cephalalgia in 70% of cases. In patients with cervicalgia, the prevalence of headache is 20–40% higher than in those with musculoskeletal pain at another site. Neck pain is as a major risk factor for migraine and tension headache (TH. Neck pain in TH progresses with the increased intensity, frequency, and strength of headache. There is a direct relationship of the quality of life worsening associated withcervicalgia to the frequency of migraine attacks and the risk of its chronization. Neck pain is noted in cervicogenic headache belonging to secondary headaches. The identification of mixed headache in a patient with cervicalgia allows the prescription of a treatment option that may be effective in relieving both headache and neck pain. The paper discusses the causes and pathogenesis of cervicalgia in patients with headache, examination methods, and main approaches to drug and nondrug therapies in relation to the leading pathophysiological mechanism, as well as new possibilities for the effective and safe relief of pain syndrome in this category of patients. Nonsteroidal anti-inflammatory drugs, myorelaxants,and their combination are observed to be effective in treating patients with cervicalgia and cephalalgia.

  12. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    OpenAIRE

    Han Suk Lee; Hyung Kuk Chung; Sun Wook Park

    2015-01-01

    Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation...

  13. Does the use of laminar flow and space suits reduce early deep infection after total hip and knee replacement?: the ten-year results of the New Zealand Joint Registry.

    Science.gov (United States)

    Hooper, G J; Rothwell, A G; Frampton, C; Wyatt, M C

    2011-01-01

    We have investigated whether the use of laminar-flow theatres and space suits reduced the rate of revision for early deep infection after total hip (THR) and knee (TKR) replacement by reviewing the results of the New Zealand Joint Registry at ten years. Of the 51 485 primary THRs and 36 826 primary TKRs analysed, laminar-flow theatres were used in 35.5% and space suits in 23.5%. For THR there was a significant increase in early infection in those procedures performed with the use of a space suit compared with those without (p space suit (p space suit (p space suits were used in those theatres (p deep infection has not been reduced by using laminar flow and space suits. Our results question the rationale for their increasing use in routine joint replacement, where the added cost to the health system seems to be unjustified.

  14. Photodynamic therapy in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Kamil H Nelke

    2014-02-01

    Full Text Available Photodynamic therapy (PDT is a special type of treatment involving the use of a photosensitizer or a photosensitizing agent along with a special type of light, which, combined together, induces production of a form of oxygen that is used to kill surrounding cells in different areas of the human body. Specification of the head and neck region requires different approaches due to the surrounding of vital structures. PDT can also be used to treat cells invaded with infections such as fungi, bacteria and viruses. The light beam placed in tumor sites activates locally applied drugs and kills the cancer cells. Many studies are taking place in order to invent better photosensitizers, working on a larger scale and to treat deeply placed and larger tumors. It seems that PDT could be used as an alternative surgical treatment in some tumor types; however, all clinicians should be aware that the surgical approach is still the treatment of choice. PDT is a very accurate and effective therapy, especially in early stages of head and neck squamous cell carcinomas (HNSCC, and can greatly affect surgical outcomes in cancerous patients. We present a detailed review about photosensitizers, their use, and therapeutic advantages and disadvantages.

  15. Photodynamic therapy in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Kamil H Nelke

    2014-02-01

    Full Text Available Photodynamic therapy (PDT is a special type of treatment involving the use of a photosensitizer or a photosensitizing agent along with a special type of light, which, combined together, induces production of a form of oxygen that is used to kill surrounding cells in different areas of the human body. Specification of the head and neck region requires different approaches due to the surrounding of vital structures. PDT can also be used to treat cells invaded with infections such as fungi, bacteria and viruses. The light beam placed in tumor sites activates locally applied drugs and kills the cancer cells. Many studies are taking place in order to invent better photosensitizers, working on a larger scale and to treat deeply placed and larger tumors. It seems that PDT could be used as an alternative surgical treatment in some tumor types; however, all clinicians should be aware that the surgical approach is still the treatment of choice. PDT is a very accurate and effective therapy, especially in early stages of head and neck squamous cell carcinomas (HNSCC, and can greatly affect surgical outcomes in cancerous patients. We present a detailed review about photosensitizers, their use, and therapeutic advantages and disadvantages.

  16. Imaging appearance of granulomatous lesions of head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Abdel Razek, Ahmed Abdel Khalek, E-mail: arazek@mans.eun.e [Diagnostic Radiology Department, Mansoura Faculty of Medicine, 62 ElNokrsi Street-Meet Hadr, Mansoura (Egypt); Castillo, Mauricio [Department of Radiology, University of North Carolina, Chapel Hill, NC (United States)

    2010-10-15

    We aim to review the imaging appearance of granulomatous lesions of the head and neck. Granulomatous lesions are seen in different regions of the head and neck and a difficult diagnostic challenge for the radiologist. Infective granulomas may be due to bacterial or fungal agents. Non-infective granulomas are Wegener's granulomatosis, sarcoidosis, amyloidosis, chemical granuloma and reparative giant cell granuloma. Familiarity with the clinical presentation and imaging features of these lesions can suggest diagnosis in some cases. CT and MR imaging demonstrate the exact location, extension and effect on surrounding structures. A thorough knowledge of age, gender, common location, clinical features and imaging appearance of granulomatous lesions are important for diagnosis.

  17. Congenital piriform fossa sinus tract presenting as an asymptomatic neck mass in an infant

    Energy Technology Data Exchange (ETDEWEB)

    Bloom, David A. [Department of Pediatric Imaging, Children' s Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48201 (United States); Adler, Brent H. [Department of Radiology, Children' s Radiological Institute, Columbus Children' s Hospital, Columbus, Ohio (United States); Forsythe, Robert C. [Department of Pediatrics, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States); Mutabagani, Khaled; Teich, Steven [Department of Surgery, Columbus Children' s Hospital, Ohio State University Medical Center, Columbus, Ohio (United States)

    2003-05-01

    A 5-month-old girl with an asymptomatic left-sided neck mass was demonstrated by ultrasound and upper gastrointestinal series (UGI), and confirmed at surgery, to have a congenital piriform fossa sinus tract (CPFST) that communicated with an intrathyroidal cyst. To demonstrate a case of CPFST presenting as an asymptomatic neck mass. Nearly all cases of CPFST present with infection or pain, making this case unique. Case report and review of the literature. CPFST with an associated cyst should be added to the differential diagnosis of asymptomatic cystic neck masses in infants, especially if the cyst is intrathyroidal by ultrasound. (orig.)

  18. The transcervical approach for parapharyngeal space pleomorphic adenomas: indications and technique.

    Directory of Open Access Journals (Sweden)

    Gilad Horowitz

    Full Text Available BACKGROUND: Head and Neck Parapharyngeal space tumors are rare. Pleomorphic Adenomas are the most common Parapharyngeal space tumors. The purpose of this study was to define preoperative criteria for enabling full extirpation of parapharyngeal space pleomorphic adenomas via the transcervical approach while minimizing functional and cosmetic morbidity. METHODS: The surgical records and medical charts of 19 females and 10 males with parapharyngeal space pleomorphic adenomas operated between 1993 and 2012 were reviewed. RESULTS: Fifteen patients were operated by a simple transcervical approach, 13 by a transparotid transcervical approach, and one by a transmandibular transcervical approach. Complications included facial nerve paralysis, infection, hemorrhage and first bite syndrome. There were three recurrences, but neither recurrence nor complications were associated with the type of surgical approach. CONCLUSION: A simple transcervical approach is preferred for parapharyngeal space pleomorphic adenomas with narrow attachments to the deep lobe of the parotid gland and for pleomorphic adenomas originating in a minor salivary gland within the parapharyngeal space.

  19. Association of neck pain, disability and neck pain during maximal effort with neck muscle strength and range of movement in women with chronic non-specific neck pain.

    Science.gov (United States)

    Ylinen, Jari; Takala, Esa-Pekka; Kautiainen, Hannu; Nykänen, Matti; Häkkinen, Arja; Pohjolainen, Timo; Karppi, Sirkka-Liisa; Airaksinen, Olavi

    2004-10-01

    Several studies have reported lower neck muscle strength in patients with chronic neck pain compared to healthy controls. The aim of the present study was to evaluate the association between the severity of neck pain and disability with neck strength and range of movement in women suffering from chronic neck pain. One hundred and seventy-nine female office workers with chronic neck pain were selected to the study. The outcome was assessed by the self-rating questionnaires on neck pain (visual analogue scale, Vernon's disability index, Neck pain and disability index) and by measures of the passive range of movement (ROM) and maximal isometric neck muscle strength. No statistically significant correlation was found between perceived neck pain and the disability indices and the maximal isometric neck strength and ROM measures. However, the pain values reported during the strength tests were inversely correlated with the results of strength tests (r=-0.24 to -0.46), showing that pain was associated with decreased force production. About two-thirds of the patients felt pain during test efforts. Pain may prevent full effort during strength tests and hence the production of maximal force. Thus in patients with chronic neck pain the results do not always describe true maximal strength, but rather the patients' ability to bear strain, which may be considerably influenced by their painful condition. The results of the present study suggest that rehabilitation in cases of chronic neck pain should aim at raising tolerance to mechanical strain.

  20. 探讨口腔颌面部多间隙感染患者病原菌情况%Discussion of Oral Multiple Space Pathogen Infection

    Institute of Scientific and Technical Information of China (English)

    苗丽丽

    2015-01-01

    Objective To analyze the oral and maxillofacial space infection in patients with multiple pathogens, initiation site, routes of infection. To investigate effective preventive measures to reduce infection rates. Methods January 2012 to January 2014, oral and maxillofacial hospital 120 patients infected with more space. The clinical data were retrospectively analyzed 120 patients analyzed initiation site of pathogen infection, infection route, detect pathogens. Results 120 patients pathogen initiation site submandibular space 71 cases, accounting for 59.17%, parapharyngeal space 8 cases, accounting for 6.67%, masseteric gap 21 cases, accounting for 17.50%; submental space 7 cases, accounting for 5.83%, wing jaw gap 5 cases, accounting for 4.17%; sublingual space 4 cases, accounting for 3.33%, buccal space 4 cases, accounting for 3.33%. 120 cases of patients, 71 cases of odontogenic infection, accounting for 59.17%, adenovirus-borne infection in 42 cases, accounting for 35.00%, seven cases of nosocomial infection, accounting for 5.83%. Odontogenic infection is the main route of infection, iatrogenic infection at least, the difference was statistically significant (χ2=77.40, P<0.05). Oral maxillofacial space infection pathogens gram-positive bacteria dominated, of 102 cases, accounting for 85.00% of the total, 14 cases of gram-negative bacteria, accounting for 11.67%, Candida albicans 4 cases, accounting for 3.33% total. The top three pathogens are Staphylococcus aureus, accounting for 15.84 percent, followed by Streptococcus constellation, accounting for 15.00%. And F streptococci, accounting for 13.33%. The most common Gram-negative bacteria Klebsiella pneumoniae, accounting for 7.50%. Conclusion Oral and maxillofacial multiple space Pathogens wide range of pathogenic bacteria in the case of effective treatment measures to promote the recovery of the patient's health is important.%目的:分析口腔颌面部多间隙感染患者的病原菌种类、起始部位

  1. AN APPROACH TO THE NECK MASS

    African Journals Online (AJOL)

    Enrique

    The neck mass is often surrounded by mystique — in arriving at a diagnosis as ... and Neck Surgery at. Groote Schuur ... picious features include lymph nodes ..... Blood investigations can often exclude ... after treatment with antibiotics, referral.

  2. Neck Circumference and Cardio- Metabolic Syndrome

    OpenAIRE

    Kumar, Nagendran Vijaya; Ismail, Mohammed H.; P, Mahesha; M, Girish; Tripathy, Monica

    2014-01-01

    Background: Only few studies about neck circumference (NC) as a measure of cardio metabolic syndrome available from India. Study was conducted to establish an association between neck circumference and cardio metabolic syndrome.

  3. Space space space

    CERN Document Server

    Trembach, Vera

    2014-01-01

    Space is an introduction to the mysteries of the Universe. Included are Task Cards for independent learning, Journal Word Cards for creative writing, and Hands-On Activities for reinforcing skills in Math and Language Arts. Space is a perfect introduction to further research of the Solar System.

  4. Head and Neck Soft Tissue Sarcoma

    OpenAIRE

    Aljabab, A. S.; Nason, R. W.; Kazi, R; Pathak, K. A.

    2011-01-01

    Sarcomas are malignant neoplasms originating from mesodermal tissues and constitute less than 1% of body’s tumors, including those of the head and neck region. 5–15% of adult sarcomas are in the head and neck region (20% from bones and cartilages and 80% in soft tissues). Commonly encountered sarcomas in the head and neck region are - osteosarcoma, rhabdomyosarcoma, malignant fibrous histiocytoma, fibrosarcoma and angiosarcoma. This article reviews the available literature on head and neck sa...

  5. X-Ray Exam: Neck (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Neck KidsHealth > For Parents > X-Ray Exam: Neck A A A What's in ... español Radiografía: cuello What It Is A neck X-ray is a safe and painless test that ...

  6. Pleural effusion adenosine deaminase: a candidate biomarker to discriminate between Gram-negative and Gram-positive bacterial infections of the pleural space

    Directory of Open Access Journals (Sweden)

    Ruolin Li

    2016-05-01

    Full Text Available OBJECTIVES: Delay in the treatment of pleural infection may contribute to its high mortality. In this retrospective study, we aimed to evaluate the diagnostic accuracy of pleural adenosine deaminase in discrimination between Gram-negative and Gram-positive bacterial infections of the pleural space prior to selecting antibiotics. METHODS: A total of 76 patients were enrolled and grouped into subgroups according to Gram staining: 1 patients with Gram-negative bacterial infections, aged 53.2±18.6 years old, of whom 44.7% had empyemas and 2 patients with Gram-positive bacterial infections, aged 53.5±21.5 years old, of whom 63.1% had empyemas. The pleural effusion was sampled by thoracocentesis and then sent for adenosine deaminase testing, biochemical testing and microbiological culture. The Mann-Whitney U test was used to examine the differences in adenosine deaminase levels between the groups. Correlations between adenosine deaminase and specified variables were also quantified using Spearman’s correlation coefficient. Moreover, receiver operator characteristic analysis was performed to evaluate the diagnostic accuracy of pleural effusion adenosine deaminase. RESULTS: Mean pleural adenosine deaminase levels differed significantly between Gram-negative and Gram-positive bacterial infections of the pleural space (191.8±32.1 U/L vs 81.0±16.9 U/L, p<0.01. The area under the receiver operator characteristic curve was 0.689 (95% confidence interval: 0.570, 0.792, p<0.01 at the cutoff value of 86 U/L. Additionally, pleural adenosine deaminase had a sensitivity of 63.2% (46.0-78.2%; a specificity of 73.7% (56.9-86.6%; positive and negative likelihood ratios of 2.18 and 0.50, respectively; and positive and negative predictive values of 70.6% and 66.7%, respectively. CONCLUSIONS: Pleural effusion adenosine deaminase is a helpful alternative biomarker for early and quick discrimination of Gram-negative from Gram-positive bacterial infections of the

  7. Planned Neck Dissection Following Radiation Treatment for Head and Neck Malignancy

    Directory of Open Access Journals (Sweden)

    J. F. Dautremont

    2012-01-01

    Full Text Available Introduction. Optimal therapy for patients with metastatic neck disease remains controversial. Neck dissection following radiotherapy has traditionally been used to improve locoregional control. Methods. A retrospective review of 28 patients with node-positive head and neck malignancy treated with planned neck dissection following radiotherapy between January 2002 and December 2005 was performed to assess treatment outcomes. Results. Median interval to neck dissection was 9.6 weeks with a median number of 21 + 9 lymph nodes per specimen. Ten of 31 (32% neck dissection specimens demonstrated evidence of residual carcinoma. Overall survival at two years was 85%; five-year overall survival was 65%. Concurrent chemotherapy did not impact the presence of residual neck disease. Conclusion. Based on the frequency of residual malignancy in the neck of patients treated with primary radiotherapy, a planned, postradiotherapy neck dissection should be strongly advocated for all patients with advanced-stage neck disease.

  8. Ear Infection (Middle Ear)

    Science.gov (United States)

    Ear infection (middle ear) Overview By Mayo Clinic Staff An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that ...

  9. From Space to the Patient: A New Cytokine Release Assay to Monitor the Immune Status of HIV Infected Patients and Sepsis Patients

    Science.gov (United States)

    Kaufmann, I.; Draenert, R.; Gruber, M.; Feuerecker, M.; Crucian, B. E.; Mehta, S. L.; Roider, J.; Pierson, D. L.; Briegel, J. M.; Schelling, G.; Sams, C. F.; Chouker, A.

    2013-01-01

    Monitoring of humans either in the healthy men under extreme environmental stress like space flight, in human immunodeficiency virus (HIV) infected patients or in sepsis is of critical importance with regard to the timing of adequate therapeutic (counter-)measures. The in vivo skin delayed-type hypersensitivity test (DTH) served for many years as a tool to evaluate cell mediated immunity. However, this standardised in vivo test was removed from the market in 2002 due to the risk of antigen stabilization. To the best of our knowledge an alternative test as monitoring tool to determine cell mediated immunity is not available so far. For this purpose we tested a new alternative assay using elements of the skin DTH which is based on an ex vivo cytokine release from whole blood and asked if it is suitable and applicable to monitor immune changes in HIV infected patients and in patients with septic shock.

  10. Jugular neck dissection for NO neck supraglottic carcinoma

    Directory of Open Access Journals (Sweden)

    Petrović Željko

    2004-01-01

    Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO. Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%. Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72 of cases, and in 17% (21/121 patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2 yielded occult metastases in 33% (5/15, and 24% (6/25 of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult

  11. [Spinal accessory nerve and lymphatic neck dissection].

    Science.gov (United States)

    Pinsolle, V; Michelet, V; Majoufre, C; Caix, P; Siberchicot, F; Pinsolle, J

    1997-09-01

    Radical neck dissection was the golden standard of treatment for cervical nodes in head and neck tumors. From the seventies, the preservation of the spinal accessory nerve has become increasingly popular in order to improve the functional result of the neck dissections. The aim of this study was to assess the degree of functional disability associated with each type of neck dissection and the value of anatomical references for dissection of the spinal accessory nerve. One hundred twenty seven patients were evaluated 1 month and 1 year after radical, functional or supraomohyoid neck dissection with a questionnaire and a physical examination. Anatomical measurements of the spinal accessory nerve were performed in 20 patients. We found considerable or severe shoulder dysfunction in 7%, 34% and 51% respectively of patients in whom supraomohyoid, functional and radical neck dissections were performed. Furthermore 49% of patients having undergone a radical neck dissection had little or no symptoms. Sacrifice of the spinal accessory nerve in radical neck dissection may lead to shoulder dysfunction. A functional disability may also be associated, although in a less extent, with any neck dissection in which the spinal accessory nerve is dissected and placed in traction. There is a large variation in the degree of functional disability and pain in patients with similar neck dissections. The course of the spinal accessory nerve in the neck makes it particularly vulnerable to injury during the dissection near the sternocleidomastoid muscle and in the posterior cervical triangle.

  12. Neck muscle function in violinists/violists with and without neck pain.

    Science.gov (United States)

    Steinmetz, Anke; Claus, Andrew; Hodges, Paul W; Jull, Gwendolen A

    2016-04-01

    Neck pain is associated with changes in neuromuscular control of cervical muscles. Violin and viola playing requires good function of the flexor muscles to stabilize the instrument. This study investigated the flexor muscle behaviour in violin/viola players with and without neck pain using the craniocervical flexion test (CCFT). In total, 12 violin/viola players with neck pain, 21 violin/viola players without neck pain in the preceding 12 weeks and 21 pain-free non-musicians were included. Activity of the sternocleidomastoid muscles (SCM) was measured with surface electromyography (EMG) during the CCFT. Violin/viola players with neck pain displayed greater normalised SCM EMG amplitudes during CCFT than the pain-free musicians and non-musicians (P neck pain in violinists/violists is associated with altered behaviour of the superficial neck flexor muscles consistent with neck pain, despite the specific use of the deep and superficial neck flexors during violin playing.

  13. Common oral lesions associated with HIV infection.

    Science.gov (United States)

    Navazesh, M; Lucatorto, F

    1993-09-01

    More than 40 different lesions involving head and neck areas have been associated with HIV infection. The oral cavity may manifest the first sign of HIV infection. Early detection of these conditions can lead to early diagnosis of HIV infection and subsequent appropriate management. Signs, symptoms and management of the most common HIV-associated oral lesions are discussed.

  14. Head and neck position sense.

    Science.gov (United States)

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  15. Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer.

    Science.gov (United States)

    Honda, Keigo; Asato, Ryo; Tsuji, Jun; Miyazaki, Masakazu; Kada, Shinpei; Tsujimura, Takashi; Kataoka, Michiko

    2017-09-01

    Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation. A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed. A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides. Preserving cervical nerves in neck dissection is oncologically safe in selected cases. © 2017 Wiley Periodicals, Inc.

  16. Increased neck muscle activity and impaired balance among females with whiplash-related chronic neck pain

    DEFF Research Database (Denmark)

    Juul-Kristensen, Birgit; Clausen, Brian; Ris Hansen, Inge

    2013-01-01

    To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls.......To investigate neck muscle activity and postural control in patients with whiplash-associated disorder compared with healthy controls....

  17. Speciation of Black-necked Crane

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Based on the concepts of species and speciation,the speciation of Black-necked Grane(Grus nigricollis) was discussed using bio-geographic principles and some evidences suggest that Black-necked Grane had a close relationship with Red-crowned Crane(Grus japonensis).The Qinghai-Tibetan Plateau uplift may be the most important factor in allopatric speciation for Black-necked Crane.

  18. Migraine and neck pain: Mechanisms of comorbidity

    Directory of Open Access Journals (Sweden)

    A. S. Zenkevich

    2016-01-01

    Full Text Available Neck pain and migraine are common diseases. Neck pain seldom occurs in a patient with migraine. However, the relationship between migraine and neck pain has been inadequately investigated.Objective: to analyze neck pain in patients with migraine to determine possible comorbidity mechanisms of these diseases.Patients and methods. The investigation enrolled 63 patients with chronic migraine (CM and 40 with episodic migraine (EM diagnosed in accordance with the International Classification of Headache Disorders, 3rd edition (ICHD-3. Winking reflex (WR and nociceptive flexion reflex (NFR were examined to evaluate the function of antinociceptive systems.Results. In the patients with CM, neck pain was more common than in those with EM (53.03% versus 14.02%; and panful tenderness, sensitivity, and tension of neck muscles were more marked. There was also a significant reduction in WR and NFR thresholds. Neck pain was noted to be an integral component of the pathogenesis of CM in a large number of patients with this condition. The authors proposed several pathophysiological mechanisms of a relationship between migraine and neck pain. Neck muscles and craniovertebral junction areas serve as a source for the arrival of nociceptive pain pulses in the central nervous system (peripheral sensitization, promoting pain chronization. Muscle dysfunction in this area may be, in turn, a reflection of central sensitization and impaired descending pain control.

  19. [Update on current care guidelines. Neck pain].

    Science.gov (United States)

    2009-01-01

    Neck pain is very common. Age, female gender, obesity, and several physical and psychological work related factors increase the risk while physical activity appears to decrease it. Non-specific neck pain is most common but serious or specific illness must be ruled out and neural compression identified. Patients are encouraged to remain active and improve their ergonomics. Acute neck pain often disappears without any special treatment. Paracetamol is the primary pain medication. Multidisciplinary treatment is recommended if disabling pain has lasted for two months, and intensive muscle exercises in chronic neck pain. Progressive muscle weakness and myelopathy indicate a surgical assessment.

  20. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    Science.gov (United States)

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  1. Effects of anticoagulants on outcome of femoral neck fracture surgery.

    Science.gov (United States)

    Ginsel, Bastiaan L; Taher, Ahmad; Whitehouse, Sarah L; Bell, Jack J; Pulle, Chrys R; Crawford, Ross W

    2015-04-01

    To review records of 330 patients who underwent surgery for femoral neck fractures with or without preoperative anticoagulation therapy. Medical records of 235 women and 95 men aged 48 to 103 years (mean, 81.6; standard deviation [SD], 13.1) who underwent surgery for femoral neck fractures with or without preoperative anticoagulation therapy were reviewed. 30 patients were on warfarin, 105 on aspirin, 28 on clopidogrel, and 167 were controls. The latter 3 groups were combined as the non-warfarin group and compared with the warfarin group. Hospital mortality, time from admission to surgery, length of hospital stay, return to theatre, and postoperative complications (wound infection, deep vein thrombosis, and pulmonary embolism) were assessed. The warfarin and control groups were significantly younger than the clopidogrel and aspirin groups (80.8 vs. 80.0 vs. 84.2 vs. 83.7 years, respectively, preturned to theatre for surgery: one in the warfarin group for washout of a haematoma, 2 in the aspirin group for repositioning of a mal-fixation and for debridement of wound infection, and one in the control group for debridement of wound infection. The warfarin group did not differ significantly from non-warfarin group in terms of postoperative complication rate (6.7% vs. 2.7%, p=0.228) and the rate of return to theatre (3.3% vs. 1%, p=0.318). It is safe to continue aspirin and clopidogrel prior to surgical treatment for femoral neck fracture. The risk of delaying surgery outweighs the peri-operative bleeding risk.

  2. Imaging diagnosis of venous malformation in head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Ha, Doo Hoe; Kim, Dong Ik; Suh, Jung Ho; Jung, Tae Sub [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    1992-11-15

    The venous malformation in head and neck is a development vascular disease which arises from the arrest in the certain stage of vascular embryogenesis. However, the lesion extends along the fascia and has a tendency to recur after incomplete therapy. Retrospectively, the authors reviewed radiologic studies of 20 patients diagnosed as venous malformation during the last 5 years. The diagnosis was verified by histopathology (5 patients) and direct puncture angiography (15 patients). The radiologic studies included. CT with intravenous contrast injection (20 patients), RI angiography with 99mTc-pyrophosphate (6 patients), and direct puncture angiography (15 patients). Multiplicity of venous malformation was noted in 9 patients. On CT scan, the lesions had lobulated irregular shape, with heterogeneous appearance, showed delayed enhancing characteristics, and had the phleboliths (21 lesions). The venous malformations were located at the masticator space (including masseter muscle) (n = 12), retrobulbar space (n 6), submandibular space (n = 4), paravertebral space (n = 3) and so on. In two cases, the lesions were very extensive involving entire neck and parapharynx. On RI angiography using {sup 99m}Tc-pyrophosphate, all of the lesions showed persistent and delayed uptake. With direct puncture angiography the lesions could be classified as acinar pattern (n = 17) and mixed pattern (acinar and saccular) (n = 2). Venous connections were noted in 10 lesions. In conclusion, if a soft tissue mass on head and neck shows a heterogeneous attenuation density with or without calcified phlebolith on CT scan, RI angiography is recommended as a next diagnostic study. If it shows delayed persistent uptake, venous malformation can be suspected. Finally direct puncture angiography can verify the nature and extent of the lesion.

  3. Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index

    NARCIS (Netherlands)

    Reneman, Michiel F.; Geertzen, Jan H. B.; Jorritsma, Wim; Knol-de Vries, Grietje; Dijkstra, Pieter U.

    2012-01-01

    To investigate relevant change on the Neck Pain and Disability Scale (NPAD) and Neck Disability Index (NDI) and which questionnaire is the most responsive in patients with non-specific chronic neck pain (CNP). Seventy-six patients with non-specific CNP in an outpatient tertiary rehabilitation settin

  4. CT findings and differential diagnosis of cystic neck masses

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ji Yeon; Lee, Kil Jun; Jeong, Seong Ki; Han, Seong Nim; Tae, Seok; Shin, Kyoung Ja; Lee, Sang Chun [Seoul Red Cross Hospital, Seoul (Korea, Republic of)

    1995-10-15

    The purpose of this study is to analyze the CT features of the cystic masses in the neck and to review differential diagnosis. We retrospectively reviewed and analyzed the CT findings of 22 histopathologically proved, cystic neck masses in regard to the location in fascial plane and relationship with adjacent organ. Of 22 cases, ten congenital cysts two ranulas, seven inflammatory lesions, and three solid tumors were included. Ten congenital cystic masses were located in typical locations as branchial cleft cyst (5) in mandibular angle, thyroglossal duct cyst (3) in visceral space embeded within the strap muscles, cystic hygroma (1) and cavernous hemangioma (1) in posterior cervical space with insinuating appearance. Two cases of ranula included one simple ranula localized in sublingual space and a plunging ranula extending to adjacent submandibular space. Seven cases of inflammatory lesions were characterized by multispatial locations and good contrast-enhancement of walls and adjacent tissue. Solid masses of low density mimicking cyst were two pleomorphic adenomas of submandibular gland and one neurilemmoma. It is considered that thorough analysis of the CT findings with attention to typical location, CT appearance, and the relationship with the adjacent structures usually leads to the correct diagnosis.

  5. Use of next generation sequencing in head and neck squamous cell carcinomas

    DEFF Research Database (Denmark)

    Tabatabaeifar, Siavosh; Kruse, Torben A; Thomassen, Mads

    2014-01-01

    Head and neck squamous cell carcinoma (HNSCC) can primarily be attributed to alcohol consumption, tobacco use and infection with human papilloma virus. The heterogeneous nature of HNSCC has exposed a lack of tools for clinicians to provide more accurate prognosis. There is a need for biomarkers...

  6. Cooccurrence of Metastatic Papillary Thyroid Carcinoma and Salmonella Induced Neck Abscess in a Cervical Lymph Node

    Science.gov (United States)

    Kim, Jae-Myung; Jung, Eun Jung; Song, Eun Jin; Kim, Dong Chul; Jeong, Chi-Young; Ju, Young-Tae; Lee, Young-Joon; Hong, Soon-Chan; Choi, Sang-Kyung; Ha, Woo-Song

    2017-01-01

    Cervical lymph node metastasis is common in patients with papillary thyroid carcinoma (PTC). Salmonella species are rarely reported as causative agents in focal infections of the head and neck. The cooccurrence of lymph node metastasis from PTC and a bacterial infection is rare. This report describes a 76-year-old woman with a cervical lymph node metastasis from PTC and Salmonella infection of the same lymph node. The patient presented with painful swelling in her left lateral neck region for 15 days, and neck ultrasonography and computed tomography showed a cystic mass along left levels II–IV. The cystic mass was suspected of being a metastatic lymph node; modified radical neck dissection was performed. Histopathological examination confirmed the presence of PTC in the resected node and laboratory examination of the combined abscess cavity confirmed the presence of Salmonella Typhi. Following antibiotic sensitivity testing of the cultured Salmonella Typhi, she was treated with proper antibiotics. Cystic lesions in lymph nodes with metastatic cancer may indicate the presence of cooccurring bacterial infection. Thus, culturing of specimen can be option to make accurate diagnosis and to provide proper postoperative management. PMID:28261270

  7. Epstein-Barr virus (EBV)-associated lymphoid lesions of the head and neck.

    Science.gov (United States)

    Auerbach, Aaron; Aguilera, Nadine S

    2015-01-01

    Epstein Barr virus (EBV)-related lymphoproliferative processes occur in the head and neck ranging from reactive processes such as infectious mononucleosis to high grade malignant lymphomas. EBV is a ubiquitous herpes virus that infects more than 90% of adults worldwide, and is generally transferred though saliva. Primary infection can occur throughout life. EBV is the first virus linked to malignancies, both epithelial and lymphoid. Both T and B cell lymphomas can be associated with EBV and evidence shows that an individual's response to the acute EBV infection may be critical in the development of subsequent lymphoma. Currently, in situ hybridization for EBER is the most sensitive available test to detect EBV and should be routinely performed in lymphoproliferative lesions of the head and neck. Immunohistochemistry for EBV related proteins, such as LMP1, is much less sensitive than EBER in situ hybridization, but can help determine latency patterns of EBV infection. Although relatively rare, primary EBV-related lymphomas must be considered in the differential of atypical lymphoid proliferations in the head and neck. We present selected EBV-related disorders of the head and neck discussing etiology as well as differential diagnosis.

  8. ASSOCIATION OF EPSTEIN BARR VIRUS WITH MUCOSAL SQUAMOUS CELL CANCERS OF HEAD AND NECK

    Directory of Open Access Journals (Sweden)

    Saquib

    2015-10-01

    Full Text Available Head and neck cancer is the commonest cancer in India and consists of about one-third of all cancers. Among viral infections, Epstein Barr virus (EBV has been implicated in the association of many head and neck cancers. Role of EBV as etiological factor in our population remains unknown. AIMS & OBJECTIVES: To determine the EBV related etiology of mucosal Head and Neck Squamous Cell Carcinoma (HNSCC in Kashmir Valley and if positive to define sub-typing of EBV and to find a correlation between the burden of EBV and disease status. MATERIAL METHODS: Observational single centre retrospective –prospective study. The study included 53 tissue samples from patients with Squamous Cell carcinoma of Head and Neck region. An equal number of blood samples were taken from healthy volunteers as a control for the reaction process. Sample collection and storage was done as per standard protocol. DNA amplification was done by Polymerase chain reaction. RESULTS: We did not observe any sample which tested positive for EBV. All samples were negative for EBV DNA. CONCLUSION: EBV has no role in the pathogenesis of Head and Neck Cancers in Kashmiri ethnic population of India. Different Genetic makeup of our population may be responsible for it. Further studies are needed to elucidate the etiology of head and neck Carcinoma in our population.

  9. Perforating oesophageal carcinoma presenting as necrotizing fasciitis of the neck.

    Science.gov (United States)

    Francque, S M; Van Laer, C; Struyf, N; Vermeulen, P; Corthouts, B; Jorens, P G

    2001-10-01

    A patient with a history of schizophrenia was admitted to our hospital in an already severe stage of necrotizing fasciitis of the neck, complicated with mediastinitis and gangrene. Later on, he also developed a vena cava superior syndrome and sepsis. In the few cases and small series described in the literature, necrotizing fasciitis of the neck is usually associated with surgery or trauma. Less frequently, an orodental or pharyngeal infection, often innocuous, is the underlying cause. None of these causes could be identified in our patient. Initially, on computer-assisted tomography (CT) scan, a tracheal rupture was suspected, but this diagnosis could not be confirmed on bronchoscopic examination. On gastroscopy, a stenotic oesophageal segment was discovered. Biopsy of this segment showed a poorly differentiated squamous cell carcinoma. The patient died in sepsis. Autopsy confirmed the presence of a large proximal oesophageal tumour with perforation. As far as we know, no case of a necrotizing fasciitis of the neck caused by perforation of a formerly unknown oesophageal carcinoma has been reported. Even mediastinitis, with or without gangrene, is rarely associated with oesophageal cancer, and in the few cases reported it is always due to fistulization after surgery.

  10. HPV Associated Head and Neck Cancer.

    Science.gov (United States)

    Spence, Tara; Bruce, Jeff; Yip, Kenneth W; Liu, Fei-Fei

    2016-08-05

    Head and neck cancers (HNCs) are a highly heterogeneous group of tumours that are associated with diverse clinical outcomes. Recent evidence has demonstrated that human papillomavirus (HPV) is involved in up to 25% of HNCs; particularly in the oropharyngeal carcinoma (OPC) subtype where it can account for up to 60% of such cases. HPVs are double-stranded DNA viruses that infect epithelial cells; numerous HPV subtypes, including 16, 18, 31, 33, and 35, drive epithelial cell transformation and tumourigenesis. HPV positive (HPV+) HNC represents a distinct molecular and clinical entity from HPV negative (HPV-) disease; the biological basis for which remains to be fully elucidated. HPV positivity is strongly correlated with a significantly superior outcome; indicating that such tumours should have a distinct management approach. This review focuses on the recent scientific and clinical investigation of HPV+ HNC. In particular, we discuss the importance of molecular and clinical evidence for defining the role of HPV in HNC, and the clinical impact of HPV status as a biomarker for HNC.

  11. American Academy of Otolaryngology--Head and Neck Surgery

    Science.gov (United States)

    ... Neck Mass in Adults is now available in Otolaryngology–Head and Neck Surgery. The guideline addresses the ... Interested in systematic review training? SAGE, publisher of Otolaryngology—Head and Neck Surgery , will offer three grants ...

  12. Adjuvant Intraoperative Photodynamic Therapy in Head and Neck Cancer

    Science.gov (United States)

    Rigual, Nestor R.; Shafirstein, Gal; Frustino, Jennifer; Seshadri, Mukund; Cooper, Michele; Wilding, Gregory; Sullivan, Maureen A.; Henderson, Barbara

    2015-01-01

    IMPORTANCE There is an immediate need to develop local intraoperative adjuvant treatment strategies to improve outcomes in patients with cancer who undergo head and neck surgery. OBJECTIVES To determine the safety of photodynamic therapy with 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH) in combination with surgery in patients with head and neck squamous cell carcinoma. DESIGN, SETTING, AND PARTICIPANTS Nonrandomized, single-arm, single-site, phase 1 study at a comprehensive cancer center among 16 adult patients (median age, 65 years) with biopsy-proved primary or recurrent resectable head and neck squamous cell carcinoma. INTERVENTIONS Intravenous injection of HPPH (4.0 mg/m2), followed by activation with 665-nm laser light in the surgical bed immediately after tumor resection. MAIN OUTCOMES AND MEASURES Adverse events and highest laser light dose. RESULTS Fifteen patients received the full course of treatment, and 1 patient received HPPH without intraoperative laser light because of an unrelated myocardial infarction. Disease sites included larynx (7 patients), oral cavity (6 patients), skin (1 patient), ear canal (1 patient), and oropharynx (1 patient, who received HPPH only). The most frequent adverse events related to photodynamic therapy were mild to moderate edema (9 patients) and pain (3 patients). One patient developed a grade 3 fistula after salvage laryngectomy, and another patient developed a grade 3 wound infection and mandibular fracture. Phototoxicity reactions included 1 moderate photophobia and 2 mild to moderate skin burns (2 due to operating room spotlights and 1 due to the pulse oximeter). The highest laser light dose was 75 J/cm2. CONCLUSIONS AND RELEVANCE The adjuvant use of HPPH-photodynamic therapy and surgery for head and neck squamous cell carcinoma seems safe and deserves further study. PMID:23868427

  13. Non-specific neck pain in preadolescent to adolescent populations

    OpenAIRE

    2014-01-01

    Neck pain is a common health problem globally. In addition to individual suffering, it causes a huge burden on societies. Some evidence suggests that neck pain in adolescence predicts frequent neck symptoms also in adulthood. A steady increase in prevalence of frequent and persistent neck pain among Finnish adolescents was observed in the 1990s, which might predict an increasing amount of adults with chronic neck pain in the near future. Thus, better understanding neck pain in children and ad...

  14. Preventing head and neck injury.

    Science.gov (United States)

    McIntosh, A S; McCrory, P

    2005-06-01

    A wide range of head and neck injury risks are present in sport, including catastrophic injury. The literature since 1980 on prevention of head and neck injury in sport was reviewed, focusing on catastrophic and brain injury and identifying the range of injury prevention methods in use. There have been few formal evaluations of injury prevention methods. Approaches that are considered, or have been proven, to be successful in preventing injury include: modification of the baseball; implementation of helmet standards in ice hockey and American football and increased wearing rates; use of full faceguards in ice hockey; changes in rules associated with body contact; implementation of rules to reduce the impact forces in rugby scrums. Helmets and other devices have been shown to reduce the risk of severe head and facial injury, but current designs appear to make little difference to rates of concussion. Research methods involving epidemiological, medical, and human factors are required in combination with biomechanical and technological approaches to reduce further injury risks in sport.

  15. Initial conformation of kinesin's neck linker

    CERN Document Server

    Geng, Yi-Zhao; Liu, Shu-Xia; Yan, Shiwei

    2013-01-01

    How ATP binding initiates the docking process of kinesin's neck linker is a key question in understanding kinesin mechanism. It is believed that the formation of an extra turn structure by the first three amino acids of neck linker (LYS325, THR326, ILE327 in 2KIN) is crucial for initiating the docking process. But the initial conformation of neck linker (specially the three amino acids of the extra turn) and the neck linker docking initiation mechanism remain unclear. By using molecular dynamics method, we investigate the initial conformation of kinesin's neck linker in the docking process. We find that, in the initial state of NL docking process, NL still has interactions with {\\beta}0 and forms a conformation similar to the "cover-neck bundle" structure proposed by Hwang et al. [Structure 2008, 16(1): 62-71]. From this initial structure, the docking of the "cover-neck bundle" structure can be achieved. The motor head provides a forward force on the initial cover-neck bundle structure through ATP-induced rot...

  16. Evaluation of head and neck postures

    NARCIS (Netherlands)

    Delleman, N.J.

    2000-01-01

    This paper describes the literature and two experiments on the evaluation of head and neck postures. It is concluded that health and safety professiona1s and ergonomists during posture evaluation should consider neck flexion/extension (head vs. trunk), besides the traditionally used inclination of t

  17. Acute Neck Pain in General Practice

    NARCIS (Netherlands)

    C.J. Vos (Kees)

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered quest

  18. Nodal yield in selective neck dissection

    DEFF Research Database (Denmark)

    Norling, Rikke; Therkildsen, Marianne H; Bradley, Patrick J

    2013-01-01

    The total lymph node yield in neck dissection is highly variable and depends on anatomical, surgical and pathological parameters. A minimum yield of six lymph nodes for a selective neck dissection (SND) as recommended in guidelines lies in the lower range of the reported clinical nodal yields...

  19. Ultrasound examination of the head and neck

    NARCIS (Netherlands)

    R.J. Baatenburg de Jong (Robert Jan); R.J. Rongen (Robert Jan)

    1990-01-01

    textabstractStructure of this thesis Part I deals with basic bio-physics and bio-effects of clinical ultrasound of the head and neck. Furthermore, the ultrasound anatomy of the head and neck is described and illustrated. In addition, the technique of ultrasound guided fine needle aspiration biopsy (

  20. Evaluation of head and neck postures

    NARCIS (Netherlands)

    Delleman, N.J.

    2000-01-01

    This paper describes the literature and two experiments on the evaluation of head and neck postures. It is concluded that health and safety professiona1s and ergonomists during posture evaluation should consider neck flexion/extension (head vs. trunk), besides the traditionally used inclination of

  1. Nonsurgical treatment of aggressive fibromatosis in the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    West, C.B. Jr.; Shagets, F.W.; Mansfield, M.J. (Wilford Hall USAF Medical Center, Lackland Air Force Base, TX (USA))

    1989-09-01

    Aggressive fibromatosis is a poorly defined, locally aggressive, yet histologically benign fibroblastic proliferative lesion that may occur in the head and neck. The lesion is highly cellular and locally infiltrative and has a propensity to invade and erode bone, compromising vital structures within the head and neck. However, it is not a true malignancy because it does not have malignant cytologic characteristics nor does it metastasize. We present two cases of aggressive fibromatosis occurring in young adult men. The first case involved a rapidly enlarging mass of the anterior maxilla that involved the upper lip, nasal alae, nasal septum, inferior turbinates, and hard palate. The patient underwent incisional biopsy to confirm the diagnosis. Because of difficulty in determining the actual margins of this extensive lesion and the significant morbidity that would have resulted from surgical resection, we elected to treat this patient with chemotherapy and radiation therapy. The second case was an extensive lesion involving the right temporal bone, pterygomaxillary space, and infratemporal, temporal, and middle cranial fossae. Incisional biopsy confirmed the diagnosis. Because of the lack of functional and cosmetic deficits and the unavoidable morbidity of a surgical resection, this patient was treated with radiation therapy. Although wide field resection is the most satisfactory form of treatment, in situations in which this modality would result in unacceptable morbidity or if surgical margins are positive, then radiation therapy and chemotherapy should be considered. Support for these therapeutic modalities is found in larger series of cases outside the head and neck.

  2. Public knowledge of head and neck cancer.

    LENUS (Irish Health Repository)

    O'Connor, T E

    2010-04-01

    Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

  3. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    OpenAIRE

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were eval...

  4. Spread of odontogenic infections: a retrospective analysis and review of the literature

    NARCIS (Netherlands)

    Moghimi, M.; Baart, J.A.; Karagozoglu, K.H.; Forouzanfar, T.

    2013-01-01

    Objective: To provide an empirical description of the relationship between the spread of head and neck infections, and the causal tooth. Method and Materials: The hospital records of 155 patients presenting with odontogenic head and neck infections due to a single identifiable tooth from January 200

  5. Chronic Neck Pain and Cervicogenic Headaches.

    Science.gov (United States)

    Feng, Frank L.; Schofferman, Jerome

    2003-11-01

    Chronic axial neck pain and cervicogenic headache are common problems, and there have been significant advances in the understanding of the etiology and treatment of each. The severity and duration of pain drives the process. For patients who have had slight to moderate pain that has been present for less than 6 months and have no significant motor loss, strength training of anterior, posterior, and interscapular muscle groups coupled with body mechanics training is prescribed. After 8 weeks, if the patient is better, exercises are continued at home or in a gym. If the patient is not better, physical therapy is continued for up to 8 more weeks. In patients with motor loss or severe pain, radiographs and magnetic resonance imaging (MRI) should be ordered at the initial visit. In patients with slight to moderate pain who are not better by 4 to 6 months, plain radiographs of the neck and MRI should be ordered. Based on the results, a spinal injection is usually prescribed. If MRI reveals spinal stenosis of the central or lateral canal, or a disc herniation, an epidural corticosteroid injection should be ordered. If the epidural provides good relief, the patient can be referred for more aggressive physical therapy and repeat the epidural as needed up to a maximum of three times. If there is no pathology within the canal, medial branch blocks and intra-articular steroid injections can be ordered based on the joints that are most tender or where disc space narrowing is greatest, or MRI or radiographs are recommended. If there is excellent relief from the medial branch block and joint injections, repeat when the steroids wear off. If there is good relief again, but pain recurs, medial branch radiofrequency neurotomy is recommended. For patients with one or two level disc degeneration that has not responded, a psychologic evaluation and discography is recommended. If there are no significant psychologic abnormalities, and one or two (rarely three) painful discs, surgical

  6. A rare gigantic solitary cysticercosis pseudotumour of the neck

    Directory of Open Access Journals (Sweden)

    Seif J Uledi

    2010-11-01

    Full Text Available Cysticercosis is one of the ancient parasitic infections and endemic in many parts of the developing world. Humans acquire cysticercosis when they ingest pork tapeworm eggs either through faecal-oral route by eating faecally contaminated food or by auto infection.The clinical picture largely depends on the location of larval encystment. Neurocysticercosis is the most common form of presentation. Solitary extra neural lesions are quite rare and fairly small in size.We present a very unique case of 56 year old Malawian female with a very rare, long standing gigantic solitary cysticercosis pseudo tumour of the neck. By far, there is no documented report on incorrigible cysticercosis lesion with such a sheer size.Solitary extraneural cysticercosis lesions may mimic other soft tissue masses; therefore it is important for clinicians working in endemic regions to consider cysticercosis as a differential diagnosis when evaluating patients with soft tissue lesions.

  7. MALLASEZIA FOLLICULITIS ON THE NECK

    Directory of Open Access Journals (Sweden)

    Brzeziński Piotr

    2010-10-01

    Full Text Available Folliculitis caused by Malassezia spp. classified as yeasts in our climate (Poland is fairly rare disease . MF is most commonly found on the chest, back, upper arms, and less frequently on the face. Permanent symptom is persistent itching. The favorable external conditions, which are largely due to high temperature and humidity, and endogenous factors, such as immunosuppression, there is a lipophilic yeast multiplication in the hair follicles. The aim of this article is presentation of the patient with Malassezia Folliculitis on the neck. Patient age 33 with 1- to 2-mm monomorphic papules and pustules on chest. Skin lesions accompanied by itching. In the treatment used topical: ketoconazole containing shampoo, 1% clindamycin cream, 0,5% hydrocortisonum cream, fluconazole 400 mg once p.o.

  8. Neck pain: causes, diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Aleksey Ivanovich Isaikin

    2011-01-01

    Full Text Available Neck pain is frequently encountered in clinical practice. In most cases, it is unassociated with a serious problem and ends with complete recovery. Nonspecific (mechanical, axial pain is most common; posttraumatic pain associated with whiplash injury is less frequently encountered; compression (radicular and myelopathic syndromes are much less frequent. Analysis of complaints and medical histories and neuroorthopedic and neurological examinations allow one to define the major source of pain. Additional studies are indicated in cases of suspected serious pathology, ineffective standard medical therapy, elective manual therapy or neurosurgery. Paracetamol, nonsteroidal anti-inflammatory agents, and myelorelaxants are the drugs of choice in treating acute pain. If these are ineffective, blocks with local anesthetics and glucocorticoids, including diprospan, are used. Early activation and manual therapy are effective. Psychotherapy, therapeutic exercises, manual therapy, and the use of antidepressants and anticonvulsants are indicated for chronic pain. Surgical treatment has limited indications.

  9. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    Directory of Open Access Journals (Sweden)

    Han Suk Lee

    2015-01-01

    Full Text Available Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP. Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman’s rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p<0.05. If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p=0.026. However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP.

  10. The Incidence of Dislocation Utilizing a Neck Sparing Stem in Primary THA in Community Based Practices with the Posterior Approach

    Directory of Open Access Journals (Sweden)

    McPherson E

    2015-07-01

    Full Text Available This study retrospectively reviews the clinical results of a novel proximal neck-sparing cementless prosthesis for primary Total Hip Arthroplasty (THA. This neck-sparing prosthesis preserves the entire circumference of the femoral neck. The porous coated surface is located only within the femoral neck region. This study group included 338 primary THA’s from three institutions. All approaches and techniques were similar, using a postero-lateral approach in all cases. Average follow-up was 38 months (range 12-56 months. There were five stem revisions (1.5% in this group. Two stems were revised for aseptic loosening, two were revised for recurrent dislocation, and one was revised for a chronic periprosthetic infection employing a two-stage protocol. We had 3 dislocations (0.88% and all three had re-operations. The neck sparing prosthesis is alluring as it saves almost the entire femoral neck and requires minimal deep posterior soft tissue releases. Our dislocation rate in this series was low. Insertion of a neck sparing prosthesis requires fastidious preparation and gentle insertion, but we find this design to provide reliable clinical function at short-term follow-up.

  11. 颈深部合并上纵隔感染的临床诊疗分析%The clinical analysis of infection of the deep neck space with superior mediastinal abscess

    Institute of Scientific and Technical Information of China (English)

    倪茂美; 杨秀海

    2016-01-01

    目的:探讨颈深部合并上纵隔感染的病因及发病特点、诊断方法及治疗原则,为临床诊疗提供借鉴.方法:对我院2011-01-2015-06期间收治的15例颈深部合并上纵隔感染的患者临床资料进行回顾性分析和总结,分别对其临床特征、全身系统检查、实验室检查、影像学特征及微生物学检查进行整理分析,归纳病因,并追踪临床诊疗和预后.结果:15例患者中7例因“食管异物”、3例因“扁桃体周围脓肿”、2例因“拔牙”、3例不明原因导致感染.2例拔牙患者中均有糖尿病,且血糖控制不佳.患者入院时C反应蛋白(CRP)平均值为(151.82±22.12)mg/L,CRP值降至正常范围所需时间为(15.3±2.1)d,与住院时间(23.8±4.1)d呈正相关(r=0.79,P<0.01).7例患者细菌培养阳性(阳性率为46.67%),其中肺炎克雷伯菌肺炎亚种2例,其中1例合并大肠埃希菌感染,草绿色链球菌2例,溶血性链球菌非A群和B群2例,金黄色葡萄球菌1例.在针对病因治疗同时,对于脓肿形成的患者行颈深部脓肿及纵隔脓肿切开引流术,结合药物敏感试验,给予相应的抗生素抗感染治疗,若细菌培养阴性的患者,给予经验抗生素治疗.经过积极的综合治疗后,15例患者中死亡4例,其中2例为糖尿病患者(死亡率为26.67%),痊愈11例(有效率为73.33%).结论:颈深部间隙感染并发纵隔感染起病急,进程快,合并糖尿病者预后差.临床诊治上应详细分析病史及临床表现,结合影像学检查、细菌培养及药物敏感试验等检查,以明确诊断,及时使用有效抗生素,并积极给予外科干预.

  12. A painful stiff neck following an ear, nose, and throat surgical procedure: case report.

    Science.gov (United States)

    Pavlidis, Elena; Copioli, Cristiana; Spagnoli, Carlotta; Mazzotta, Silvia; Ormitti, Francesca; Crisi, Girolamo; Pisani, Francesco

    2015-02-01

    Grisel syndrome is a rare, nontraumatic atlantoaxial subluxation, typical of developmental ages and characterized by head flexion/rotation and painful fixation. Neurological symptoms may occur. It is secondary to head/neck infections and ear, nose, and throat surgery (adenoidectomy, tonsillectomy, and mastoidectomy). Here, we report the case of a child who presented a painful stiff neck following an adenotonsillectomy, with imaging evidencing an atlantoaxial subluxation. The child showed improvement in his condition following a conservative treatment with antibiotics, anti-inflammatory, and analgesic therapy and cervical collar. We believe it is of great significance for clinicians taking into account this peculiar condition in the differential diagnosis of a stiff neck in pediatric patients, thus avoiding misdiagnosis and delays. Indeed, its diagnosis is mainly based on a focused anamnesis associated with the detection of the typical neuroradiological findings.

  13. Trans-tragal incision for improved exposure of diacapitular and condylar neck fractures.

    Science.gov (United States)

    Pau, M; Feichtinger, M; Reinbacher, K E; Ivancic, P; Kärcher, H

    2012-01-01

    The authors present a modification of the preauricular approach that improves the exposure of the condyle whilst reducing diacapitular and condylar neck fractures. The incision is a combination of the hockey-stick and endaural incisions. Its inferior part runs within the ear on the posterior face of the tragus; the tragal cartilage is transected together with the retrotragal skin and included in the anterior skin flap. Between May 2009 and December 2010, 16 patients with diacapitular or condylar neck fractures were treated with this approach. All patients showed good occlusion postoperatively and satisfactory aesthetic results. No infection or cartilage necrosis was observed in this series. This approach improves the exposure of the condylar head during the reduction of diacapitular and condylar neck fractures, ensuring easier internal fixation and good cosmetic results.

  14. Spinal accessory nerve function following neck dissection.

    Science.gov (United States)

    Zibordi, F; Baiocco, F; Bascelli, C; Bini, A; Canepa, A

    1988-01-01

    Spinal accessory nerve (SAN) function was evaluated by electromyography (EMG) and muscle testing in 36 patients who underwent neck dissection with SAN preservation. The results emphasized that SAN function was relatively good after conservative neck surgery. Muscle testing findings showed better function than did EMG findings. After surgery the trapezius muscle functioned more efficiently than the sternocleidomastoid (SCM) muscle probably because of the more traumatic surgical handling of both the SCM muscle and its SAN branch. In order to obtain the functional advantages of SAN preservation, the authors suggest that the conservative procedure in radical neck dissection be used whenever warranted by oncologic diagnosis.

  15. Management of patients with neck pain

    OpenAIRE

    E. A. Chechet; V. A. Parfenov

    2016-01-01

    Neck pain (cervicalgia) occupies one of the leading places among the reasons for outpatient visits, 75% of people have experienced neck pain at least once in their lives. In most cases, neck pain regresses; however, it recurs in almost one half of patients. The paper gives data on the risk factors, mechanisms, course, and prognosis of cervicalgia. It discusses the issues of differential diagnosis, examination, and approaches to treating this condition in these patients. Nonsteroidal anti-infl...

  16. Human Papillomavirus Induced Transformation in Cervical and Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Allie K. [Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229 (United States); Wise-Draper, Trisha M. [Division of Hematology/Oncology, University of Cincinnati Medical Center, University of Cincinnati, Cincinnati, OH 45229 (United States); Wells, Susanne I., E-mail: Susanne.Wells@cchmc.org [Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229 (United States)

    2014-09-15

    Human papillomavirus (HPV) is one of the most widely publicized and researched pathogenic DNA viruses. For decades, HPV research has focused on transforming viral activities in cervical cancer. During the past 15 years, however, HPV has also emerged as a major etiological agent in cancers of the head and neck, in particular squamous cell carcinoma. Even with significant strides achieved towards the screening and treatment of cervical cancer, and preventive vaccines, cervical cancer remains the leading cause of cancer-associated deaths for women in developing countries. Furthermore, routine screens are not available for those at risk of head and neck cancer. The current expectation is that HPV vaccination will prevent not only cervical, but also head and neck cancers. In order to determine if previous cervical cancer models for HPV infection and transformation are directly applicable to head and neck cancer, clinical and molecular disease aspects must be carefully compared. In this review, we briefly discuss the cervical and head and neck cancer literature to highlight clinical and genomic commonalities. Differences in prognosis, staging and treatment, as well as comparisons of mutational profiles, viral integration patterns, and alterations in gene expression will be addressed.

  17. Human Papillomavirus Induced Transformation in Cervical and Head and Neck Cancers

    Directory of Open Access Journals (Sweden)

    Allie K. Adams

    2014-09-01

    Full Text Available Human papillomavirus (HPV is one of the most widely publicized and researched pathogenic DNA viruses. For decades, HPV research has focused on transforming viral activities in cervical cancer. During the past 15 years, however, HPV has also emerged as a major etiological agent in cancers of the head and neck, in particular squamous cell carcinoma. Even with significant strides achieved towards the screening and treatment of cervical cancer, and preventive vaccines, cervical cancer remains the leading cause of cancer-associated deaths for women in developing countries. Furthermore, routine screens are not available for those at risk of head and neck cancer. The current expectation is that HPV vaccination will prevent not only cervical, but also head and neck cancers. In order to determine if previous cervical cancer models for HPV infection and transformation are directly applicable to head and neck cancer, clinical and molecular disease aspects must be carefully compared. In this review, we briefly discuss the cervical and head and neck cancer literature to highlight clinical and genomic commonalities. Differences in prognosis, staging and treatment, as well as comparisons of mutational profiles, viral integration patterns, and alterations in gene expression will be addressed.

  18. Diagnostic imaging of benign and malignant neck masses in children—a pictorial review

    Science.gov (United States)

    Harave, Srikrishna

    2016-01-01

    Neck masses are frequently encountered in pediatric medicine, and can present a diagnostic dilemma for the clinicians involved. There are several means by which neck masses in children can be subdivided, for example by age at presentation, anatomical location including compartments and fascia of the neck, their classical appearance when imaged, or by etiology. When imaging children the clinicians must be mindful of radiation exposure and as such ultrasound (US) is often attempted first. Cross sectional imaging can be helpful for problem solving with CT being particularly useful for assessing the patient in more acute scenarios, for example when there is airway compromise. Nuclear medicine scintigraphy has a role in specific circumstances and can aid in staging in the presence of malignancy. If required, additional acquisition by means of magnetic resonance imaging (MRI) and computed tomography (CT) can be considered. This pictorial review describe the diagnostic imaging of (I) congenital and Developmental Pathologies, including thyroglossal duct cyst, branchial cleft cyst, cystic hygroma, dermoid cyst, thymic cyst and ectopic thymus; (II) neoplastic lesions, including hemangiomas and vascular malformations, pilomatrixoma, neurofibroma, neuroblastoma, rhabdomyosarcoma, papillary thyroid cancer, lymphoma & leukemia; (III) neck masses of Infective causes, including lymphadenitis, retropharyngeal and peritonsilar abscess, salivary gland inflammation; and (IV) other miscellaneous lesions, including ranula, sternocleidomastoid fibromatosis coli, and goiter. Neck masses are common in the pediatric population with a broad and varied differential; malignant etiologies are less frequently encountered when compared with adults but an awareness of its potential is important when reviewing imaging. PMID:27942480

  19. Reconstruction of the Head and Neck Region Using Lower Trapezius Musculocutaneous Flaps

    Directory of Open Access Journals (Sweden)

    Soo Kwang Yoon

    2012-11-01

    Full Text Available Background Recent literature has indicated that free flaps are currently considered thepreferred choice for head and neck reconstruction. However, head and neck cancer patients arefrequently treated with chemoradiotherapy, which is often associated with a poor general andlocal condition, and thus, such patients are ineligible for free flap reconstruction. Therefore,other reconstruction modalities should be considered.Methods We used lower trapezius musculocutaneous (LTMC flap based on the dorsal scapularartery to reconstruct head and neck defects that arose from head and neck cancer in 8 patients.All of the patients had undergone preoperative chemoradiotherapy.Results There were no complications except one case of partial flap necrosis; it was treatedwith secondary intention. Healing in the remaining patients was uneventful without hematoma,seroma, or infection. The donor sites were closed primarily.Conclusions The LTMC flap is the preferred flap for a simple, reliable, large flap with a widearc of rotation and minor donor-site morbidity. The authors recommend this versatile islandflap as an alternative to microvascular free tissue transfer for the reconstruction of defects inthe head and neck region, for patients that have undergone preoperative chemoradiotherapy.

  20. Acute Raoultella planticola cystitis in a child with rhabdomyosarcoma of the bladder neck.

    Science.gov (United States)

    Yoon, Jong Hyung; Ahn, Yo Han; Chun, Jong In; Park, Hyeon Jin; Park, Byung-Kiu

    2015-10-01

    Raoultella planticola is a Gram-negative, non-motile, aerobic bacillus. It is an environmental bacteria found in soil and water, and a very rare cause of local or systemic infection in humans. Although some adult cases of R. planticola infection have been reported, childhood local or systemic infection caused by R. planticola is very rare. Reported herein is a rare case of acute cystitis due to R. planticola in a 16-month-old boy with rhabdomyosarcoma of the bladder neck, and a review of the literature.

  1. Three-dimensional measurement of femoral neck anteversion and neck shaft angle.

    Science.gov (United States)

    Sangeux, Morgan; Pascoe, Jessica; Graham, H Kerr; Ramanauskas, Fiona; Cain, Tim

    2015-01-01

    We present a three-dimensional measurement technique for femoral neck anteversion and neck shaft angles which do not require alignment of the femoral and scanner axes. Two assessors performed the measurements on 11 patients (22 femurs). Repeatability between assessors was 2.7 degrees for femoral neck anteversion and 4.8 degrees for neck shaft angle. Measurements compared with an alternative single slice method were different by 2 degrees (3 degrees) in average. The method was repeatable and appropriate for clinical practice.

  2. Recurrence and survival after neck dissections in cutaneous head and neck melanoma

    DEFF Research Database (Denmark)

    Andersen, Peter Stemann; Chakera, Annette Hougaard; Thamsborg, Andreas Key Milan

    2014-01-01

    INTRODUCTION: An important prognostic factor in head and neck melanoma is the status of the regional lymph nodes since the presence of metastatic disease in the nodes greatly aggravates the prognosis. There is no consensus on the surgical treatment algorithm for this group. Our aim was to study...... if there is a difference in nodal recurrence and survival after radical, modified or selective neck dissection. METHODS: A total of 57 patients treated for regional meta-stases of head and neck melanoma were analysed retrospectively with respect to type of neck dissection, use of sentinel node biopsy, nodal recurrence...

  3. Stiff Neck, Torticollis, and Pseudotumor Cerebri

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-05-01

    Full Text Available Three prepubertal children diagnosed with pseudotumor cerebri and presenting with stiff neck and torticollis are reported from Schneider Children’s Medical Center, Sackler School of Medicine, Tel Aviv, Israel.

  4. Drugs Approved for Head and Neck Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for head and neck cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  5. Neck Muscle Fatigue Resulting from Prolonged Wear of Weighted Helmets

    Science.gov (United States)

    2008-06-01

    documented neck injury rates of 50% or higher ranging from minor neck strain to cervical vertebral fracture3,11-14,17. Lighter helmets were developed...greater neck fatigue and susceptibility to neck injury. There may be an increase in cervical loads during aircraft ejections (catapult, windblast...and compromised effectiveness for long missions. The neck load limits ( flexion , extension, and rotation) under operational conditions are

  6. Acupuncture for patients with chronic neck pain.

    Science.gov (United States)

    Witt, Claudia M; Jena, Susanne; Brinkhaus, Benno; Liecker, Bodo; Wegscheider, Karl; Willich, Stefan N

    2006-11-01

    Acupuncture is widely used by patients with neck pain, but there is a lack of information about its effectiveness in routine medical care. The aim was to investigate the effectiveness of acupuncture in addition to routine care in patients with chronic neck pain compared to treatment with routine care alone. We performed a randomized controlled multicentre trial plus non-randomized cohort in general practices in Germany. 14,161 patients with chronic neck pain (duration >6 months). Patients were randomly allocated to an acupuncture group or a control group receiving no acupuncture. Patients in the acupuncture group received up to 15 acupuncture sessions over three months. Patients who did not consent to randomization received acupuncture treatment. All subjects were allowed to receive usual medical care in addition to study treatment. Neck pain and disability (NPAD Scale by Wheeler) after three months. Of 14,161 patients (mean age 50.9+/-13.1 years, 68% female) 1880 were randomized to acupuncture and 1886 to control, and 10,395 included into the non-randomized acupuncture group. At three months, neck pain and disability improved by 16.2 (SE: 0.4) to 38.3 (SE: 0.4); and by 3.9 (SE: 0.4) to 50.5 (SE: 0.4), difference 12.3 (pacupuncture and control group, respectively. Treatment success was essentially maintained through six months. Non-randomized patients had more severe symptoms at baseline and showed higher neck pain and disability improvement compared to randomized patients. Treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

  7. Schwannomas of the head and neck

    Directory of Open Access Journals (Sweden)

    Anastasios Kanatas

    2011-12-01

    Full Text Available Schwannomas are benign encapsulated nerve sheath tumors composed of Schwann cells. Malignant change in head and neck schwannomas is rare, with the incidence varying between 8 and 13.9%. In this review, we discuss the presentation and the management of head and neck schwannomas. The issues and difficulties based on our own experience as well as the experience of published reports from the literature are presented.

  8. Prevalence of neck pain in computer operators

    OpenAIRE

    2015-01-01

    Abstract Introduction: Persisting neck pain is common in society, especially in office-workers. Although, neck pain is common source of disability, little is known about its prevalence and course. The bulk of literature available on this problem is in west with few studies done in an Indian setup. India is a middle-income developing country. The importance of this kind of studies becomes more obvious when it is considered that some reports indicate that...

  9. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  10. Rational radical neck dissection for oral cancer

    Institute of Scientific and Technical Information of China (English)

    李龙江; 温玉明; 王昌美; 王莉娟

    2003-01-01

    Lymphatic metastasis is the most commonly seen route for the spread of malignant epithelial tumors. Oral cancers derived from epithelial tissue occur more often in the head and neck regions with a high lymphatic metastasis rate. According to reports from Chinese researchers, the lymphatic metastasis rate of oral cancer could be as high as 40%, and clearing those involved lymph nodes in neck is one of the most important methods to treat the disease.

  11. Anchoretic Infection

    Directory of Open Access Journals (Sweden)

    S. Gokkulakrishnan

    2012-01-01

    Full Text Available Active and passive mouth opening exercises are a very common practice in oral and maxillofacial surgery especially for various conditions causing limited mouth opening like space infections, trauma, and ankylosis. But most of the practitioners do not follow basic principles while advocating these active mouth opening exercises and also take it for granted that it would benefit the patient in the long run. Because of this, the mouth opening physiotherapy by itself can at times lead to unwanted complications. We report a case wherein due to active physiotherapy, the patient had complications leading to persistent temporal space infection which required surgical intervention and hospitalization. This could have been because of hematoma formation during physiotherapy which got infected due to anchoretic infection of unknown etiology and resulted in temporal space infection. Hence, our conclusion is that whenever mouth opening exercises are initiated, it should be done gradually under good antibiotic coverage to avoid any untoward complications and for optimum results. According to the current English literature, such a complication has not been documented before.

  12. PATTERN OF OROFACIAL BACTERIAL INFECTIONS IN A TERTIARY HOSPITAL IN SOUTHWEST, NIGERIA.

    Science.gov (United States)

    Ibiyemi, S T; Okoje-Adesomoju, V N; Dada-Adegbola, H O; Arotiba, J T

    2014-01-01

    Orofacial bacterial infections present in diverse patterns due to the anatomical complexity of the area. The likelihood of spread from the initial area of infection is also high because of the presence of contiguous spaces in the head and neck region. To determine the pattern and management outcome of orofacial bacterial infections in Southwest Nigeria. A prospective study. University College Hospital, Ibadan, Nigeria. A prospective study on 102 patients with orofacial bacterial infections seen between June and December, 2011 was carried out. The information collected with data sheet included socio- demographic data, clinical history and examination, treatment and outcome. Frequencies, means, medians and diagrams of relevant variable generated. Chi square test was used to test association between categorical variables at porofacial bacterial infection and presentation for treatment was 7 (range 3-90) days. Sixty seven (65.7%) patients presented to hospital within 7 days of the onset of symptoms of infection. Pain was the common symptom 100 (98.04%), followed by sleep disturbance 71 (69.6%) while the least common symptom was dyspnea 18 (17.7%). Most of the early presenters had complaint of sleep disturbance (67.6%) while most of the late presenters had dyspnea (44.4%). Positive medical history including diabetes mellitus was reported by 28 patients (27.6%). Sixty seven (65.7%) had fascial space involvement, of which the majority 38 (56.7%) had multiple space involvement. Eight (21%) of those with multiple space involvement had submental, bilateral sublingual and submandibular spaces (Ludwig's angina).The majority 12 (41.4%) of those with single space infection had it in submandibular space. The majority 35 (45%) of the patients with odontogenic infections had it in right posterior mandible. All the patients had antibiotics prescribed for them and also had one form of surgical treatment or the other which included extraction, incision and draina cge with extraction

  13. Chronic neck pain and masticatory dysfunction.

    Science.gov (United States)

    Catanzariti, Jean-François; Debuse, Thierry; Duquesnoy, Bernard

    2005-12-01

    Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain.

  14. Modeling neck mobility in fossil turtles.

    Science.gov (United States)

    Werneburg, Ingmar; Hinz, Juliane K; Gumpenberger, Michaela; Volpato, Virginie; Natchev, Nikolay; Joyce, Walter G

    2015-05-01

    Turtles have the unparalleled ability to retract their heads and necks within their shell but little is known about the evolution of this trait. Extensive analysis of neck mobility in turtles using radiographs, CT scans, and morphometry reveals that basal turtles possessed less mobility in the neck relative to their extant relatives, although the anatomical prerequisites for modern mobility were already established. Many extant turtles are able to achieve hypermobility by dislocating the central articulations, which raises cautions about reconstructing the mobility of fossil vertebrates. A 3D-model of the Late Triassic turtle Proganochelys quenstedti reveals that this early stem turtle was able to retract its head by tucking it sideways below the shell. The simple ventrolateral bend seen in this stem turtle, however, contrasts with the complex double-bend of extant turtles. The initial evolution of neck retraction therefore occurred in a near-synchrony with the origin of the turtle shell as a place to hide the unprotected neck. In this early, simplified retraction mode, the conical osteoderms on the neck provided further protection. © 2014 Wiley Periodicals, Inc.

  15. Maternal Obesity and Neck Circumference.

    Science.gov (United States)

    Anglim, B; O'Higgins, A; Daly, N; Farren, M; Turner, M J

    2015-06-01

    Obese women are more likely to require general anaesthesia for an obstetric intervention than non-obese. Difficult tracheal intubation and oxygen desaturation is more common in pregnancy. Failed tracheal intubation has been associated with an increase in neck circumference (NC). We studied the relationship between maternal obesity and NC as pregnancy advanced in women attending a standard antenatal clinic. Of the 96 women recruited, 13.5% were obese. The mean NC was 36.8cm (SD 1.9) in the obese women compared with 31.5cm (SD 1.6) in women with a normal BMI (p < 0.001) at 18-22 weeks gestation. In the obese women it increased on average by 1.5cm by 36-40 weeks compared with an increase of 1.6 cm in women with a normal BMI. The antenatal measurement of NC is a simple, inexpensive tool that is potentially useful for screening obese women who may benefit from an antenatal anaesthetic assessment.

  16. Effects of neck pain on reaching overhead and reading: a case–control study of long and short neck flexion

    OpenAIRE

    Constand, Marissa K; MacDermid, Joy C

    2013-01-01

    Background Reaching overhead and reading are tasks that many individuals encounter daily. The level of difficulty of these tasks increases if an individual has neck pain. This study determined the neck movement patterns during these two tasks by comparing neck flexion of individuals with and without neck pain. Methods This case control study used the portable video technology, Dartfish ProSuite 5.5 Video Software, to analyse neck flexion movement patterns. Healthy individuals and individuals ...

  17. Spindle cell lipoma of the head and neck: CT and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Wook [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Ajou University School of Medicine, Department of Radiology, Suwon (Korea, Republic of); Kim, Hyung-Jin; Kim, Hye Jung; Cha, Ji Hoon; Kim, Sung Tae [Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Kim, Jinna [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2013-01-15

    Spindle cell lipoma (SCL) is an uncommon benign lipomatous tumor, most commonly occurring in the posterior neck and shoulder. The purpose of this study was to investigate the CT and MR imaging features of SCL in the head and neck. CT (n = 5) and MR (n = 3) images of seven patients (five men and two women; mean age, 54 years) with surgically proven SCL in the head and neck were retrospectively reviewed. The location and morphologic characteristics of SCL were documented as well. Six lesions were well-defined and located in the subcutaneous fat of the posterior neck (n = 4), anterior neck (n = 1), and buccal space (n = 1). One lesion was ill-defined and located deeply in the supraclavicular fossa, infiltrating the adjacent shoulder muscles. Intratumoral fat was identified in five lesions in various amounts. Compared with the adjacent subcutaneous fat, intratumoral fat was slightly hyperattenuated on CT scans and slightly hypointense on T1-weighted MR images. In five of six lesions in which postcontrast CT and/or MR images were obtained, significant enhancement was seen in the nonadipose component of the lesion. Various components of the adipose and nonadipose tissues may cause difficulty differentiating between SCL and other adipocytic tumors including liposarcoma radiologically. Although nonspecific, the radiologist should know the various imaging features of SCL, because the tumor can be cured by simple excision. (orig.)

  18. Predisposing Factors for the Complications of Deep Neck Infection

    Directory of Open Access Journals (Sweden)

    Hassan Abshirini

    2010-07-01

    Full Text Available Introduction: Cerumen is known as ear wax, produced regularly by cerumen and lipid secretary glands. Regarding the effect of Mazandaran province's humid weather on the prevalence of pathogenic microorganisms, this study was performed to determine the bacterial flora of the ear in patients with acute otitis externa and its comparison with healthy subjects. Materials and Methods: In this case-control study, cerumen was collected and cultured from 40 patients with clinically diagnosed acute otitis externa and 80 healthy controls. The data were finally analyzed using SPSS. Results: In the study group, Staphylococcus aureus (20.8%, Bacillus (18.9% and Pseudomonas (11.3% and in the control group Staphylococcus epidermidis (38.7% and Diphtheroid (22.4% were the most common bacteria, respectively. Conclusion: The isolated bacteria from cerumen of healthy subjects were totally different from those of acute otitis externa patients.

  19. Comparison of electromyographic activity and range of neck motion in violin students with and without neck pain during playing.

    Science.gov (United States)

    Park, Kyue-nam; Kwon, Oh-yun; Ha, Sung-min; Kim, Su-jung; Choi, Hyun-jung; Weon, Jong-hyuck

    2012-12-01

    Neck pain is common in violin students during a musical performance. The purpose of this study was to compare electromyographic (EMG) activity in superficial neck muscles with neck motion when playing the violin as well as neck range of motion (ROM) at rest, between violin students with and without neck pain. Nine violin students with neck pain and nine age- and gender-matched subjects without neck pain were recruited. Muscle activity of the bilateral upper trapezius, sternocleidomastoid, and superficial cervical extensor muscles was measured using surface EMG. Kinematic data on neck motion while playing and active neck ROM were also measured using a three-dimensional motion analysis system. Independent t-tests were used to compare EMG activity with kinematic data between groups. These analyses revealed that while playing, both the angle of left lateral bending and leftward rotation of the cervical spine were significantly greater in the neck pain group than among those without neck pain. Similarly, EMG activity of the left upper trapezius, both cervical extensors, and both sternocleidomastoid muscles were significantly greater in the neck pain group. The active ROM of left axial rotation was significantly lower in the neck pain group. These results suggest that an asymmetric playing posture and the associated increased muscle activity as well as decreased neck axial rotation may contribute to neck pain in violin students.

  20. Neck Pain and Disability Scale and Neck Disability Index : validity of Dutch language versions

    NARCIS (Netherlands)

    Jorritsma, Wim; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Knol-de Vries, Grietje; Reneman, Michiel F.

    2012-01-01

    To investigate the validity of the Neck Pain and Disability Scale Dutch Language Version (NPAD-DLV) and the Neck Disability Index (NDI)-DLV. NPAD-DLV, NDI-DLV, Short-Form-36 Health Survey (SF-36)-DLV, visual analog scale (VAS)(pain) and VAS(disability) were administered to 112 patients with non-spec

  1. Neck Pain and Disability Scale and the Neck Disability Index : reproducibility of the Dutch Language Versions

    NARCIS (Netherlands)

    Jorritsma, W; Knol-de Vries, Grietje; Geertzen, J.H.B.; Dijkstra, P.U.; Reneman, M.F

    2010-01-01

    The first aim of this study was to translate the Neck Pain and Disability Scale (NPAD) from English into Dutch producing the NPAD-Dutch Language Version (DLV). The second aim was to analyze test-retest reliability and agreement of the NPAD-DLV and the Neck Disability Index (NDI)-DLV. The NPAD was tr

  2. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

  3. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how th

  4. Respiratory weakness in patients with chronic neck pain.

    Science.gov (United States)

    Dimitriadis, Zacharias; Kapreli, Eleni; Strimpakos, Nikolaos; Oldham, Jacqueline

    2013-06-01

    Respiratory muscle strength is one parameter that is currently proposed to be affected in patients with chronic neck pain. This study was aimed at examining whether patients with chronic neck pain have reduced respiratory strength and with which neck pain problems their respiratory strength is associated. In this controlled cross-sectional study, 45 patients with chronic neck pain and 45 healthy well-matched controls were recruited. Respiratory muscle strength was assessed through maximal mouth pressures. The subjects were additionally assessed for their pain intensity and disability, neck muscle strength, endurance of deep neck flexors, neck range of movement, forward head posture and psychological states. Paired t-tests showed that patients with chronic neck pain have reduced Maximal Inspiratory (MIP) (r = 0.35) and Maximal Expiratory Pressures (MEP) (r = 0.39) (P Neck muscle strength (r > 0.5), kinesiophobia (r neck pain and disability (r Neck muscle strength was the only predictor that remained as significant into the prediction models of MIP and MEP. It can be concluded that patients with chronic neck pain present weakness of their respiratory muscles. This weakness seems to be a result of the impaired global and local muscle system of neck pain patients, and psychological states also appear to have an additional contribution. Clinicians are advised to consider the respiratory system of patients with chronic neck pain during their usual assessment and appropriately address their treatment.

  5. Surgical correction of the webbed neck: an alternative lateral approach

    Directory of Open Access Journals (Sweden)

    Mehri Turki, Imen

    2017-03-01

    Full Text Available Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor. Various but rare surgical approaches have been described to correct this deformity. We reviewed our experience with the surgical correction of the pterygium colli.Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline. Results: No postoperative wound infection occurred. No recurrence was observed through 24 months. Three patients developed hypertrophic scars.Conclusion: The lateral approach associated with an advanced flap and a Z-plasty is an effective technique for correction of this neck deformity. The presence of a multidisciplinary team, formed with maxillofacial and plastic surgeons, endocrinologists and psychologists, is required to treat these patients allowing reintegration into society and family.

  6. Surgical correction of the webbed neck: an alternative lateral approach

    Science.gov (United States)

    Mehri Turki, Imen

    2017-01-01

    Objective: The webbed neck deformity or pterygium colli is the number one symptom of the Turner syndrome that leads the patient to consult a doctor. Various but rare surgical approaches have been described to correct this deformity. We reviewed our experience with the surgical correction of the pterygium colli. Methods: Through five clinical cases, we describe the surgical technique with a lateral approach which provides a better control of the operative site, allows for the excision of the underlying trapezial fascial web, thus preventing recurrence seen in the posterior approach, and restores a normal hairline. Results: No postoperative wound infection occurred. No recurrence was observed through 24 months. Three patients developed hypertrophic scars. Conclusion: The lateral approach associated with an advanced flap and a Z-plasty is an effective technique for correction of this neck deformity. The presence of a multidisciplinary team, formed with maxillofacial and plastic surgeons, endocrinologists and psychologists, is required to treat these patients allowing reintegration into society and family.

  7. PRIMARY MULTILOCULAR HYDATID CYST OF NECK : A RARE CASE REPORT

    Directory of Open Access Journals (Sweden)

    Deepak Ramraj

    2015-02-01

    Full Text Available Hydatid disease, also known as echinococcosis or hydatidosis , is an infectious disease caused by Echinococcus. Echinococcus granulosus is the most common Echinococcus species affecting human beings. It may affect any organ and tissue in the body, in particular the liver and lung. Musculoskeletal or soft tissue hyda tidosis accounts for about 0.5% 5% of all echinococcal infections in endemic areas, and is almost always secondary to the hepatic or pulmonary disease. Even in regions where echinococcosis is endemic, hydatidosis of cervicofacial region is extremely rare. Herein, we present exceptionally rare case in a 55 year old female with an unusual localization of primary multilocular hydatid cyst in the right supraclavicular region of the neck. A high index of suspicion is required to diagnose hydatid cyst in rare loc ations like this. Hydatid cyst should be considered in differential diagnosis of benign swellings of head and neck region, so that it can be managed during surgery to prevent acute anaphylaxis

  8. Elective Neck Dissection in Patients With Head and Neck Adenoid Cystic Carcinoma

    DEFF Research Database (Denmark)

    Amit, Moran; Na'ara, Shorook; Sharma, Kanika

    2015-01-01

    BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC. METHODS: This retros......BACKGROUND: Adenoid cystic carcinoma (ACC) accounts for 3-5 % of all head and neck malignancies. Investigations of outcomes from elective neck dissection (END) for patients with ACC are sparse. This study aimed to assess the impact of END on the survival of patients with ACC. METHODS......: This retrospective multicentered study investigated 270 patients who underwent neck dissection. A multivariate analysis assessed associations of clinical and histopathologic characteristics with survival outcomes. RESULTS: The primary tumor sites included the oral cavity in 250 patients (55 %), the major salivary...

  9. Resection of recurrent neck cancer with carotid artery replacement.

    Science.gov (United States)

    Illuminati, Giulio; Schneider, Fabrice; Minni, Antonio; Calio, Francesco G; Pizzardi, Giulia; Ricco, Jean-Baptiste

    2016-05-01

    The management of patients with recurrent neck cancer invading the carotid artery is controversial. The purpose of this study was to evaluate overall survival rate, primary patency of vascular reconstructions, and quality-adjusted life-years (QALYs) after en bloc resection of the carotid artery and tumor with in-line polytetrafluoroethylene (PTFE) carotid grafting, followed by radiotherapy. From 2000 to 2014, 31 consecutive patients with recurrent neck cancer invading the carotid artery underwent en bloc resection and simultaneous carotid artery reconstruction with a PTFE graft, which was associated in 18 cases with a myocutaneous flap. The primary tumor was a squamous cell carcinoma of the larynx in 17 patients and of the hypopharynx in 7, an undifferentiated carcinoma of unknown origin in 4, and an anaplastic carcinoma of the thyroid in 3. All of the patients underwent postoperative radiotherapy (50-70 Gy), and 10 of them also underwent chemotherapy (doxorubicin and cisplatin). None of the patients died or sustained a stroke during the first 30 days after the index procedure. Postoperative morbidity consisted of 6 transitory dysphagias, 3 vocal cord palsies, 2 wound dehiscences, 1 transitory mandibular claudication, and 1 partial myocutaneous flap necrosis. No graft infection occurred during follow-up. Fifteen patients (48%) died from metastatic cancer during a mean follow-up of 45.4 months (range, 8-175 months). None of the patients showed evidence of local recurrence, stroke, or thrombosis of the carotid reconstruction. The 5-year survival rate was 49 ± 10%. The overall number of QALYs was 3.12 (95% confidence interval, 1.87-4.37) with a significant difference between patients without metastasis at the time of redo surgery (n = 26; QALYs, 3.74) and those with metastasis (n = 5; QALYs, 0.56; P = .005). QALYs were also significantly improved in patients with cancer of the larynx (n = 17; QALYs, 4.69) compared to patients presenting with other types of

  10. A phase II study using vinorelbine and continuous 5-fluorouracil in patients with advanced head and neck cancer

    DEFF Research Database (Denmark)

    Larsen, Susanne; Serup-Hansen, Eva; Andersen, Lisbeth J

    2007-01-01

    Seventy patients with advanced head and neck cancer were treated with vinorelbine and continuous 5-FU administered in a central venous catheter. Over all response was 36% with 9% complete responses. The most common grade 3 and 4 toxicities were stomatitis (13), infection (5), pain related...

  11. Epidemiology, diagnosis, and treatment of neck pain.

    Science.gov (United States)

    Cohen, Steven P

    2015-02-01

    Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%. Most episodes of acute neck pain will resolve with or without treatment, but nearly 50% of individuals will continue to experience some degree of pain or frequent occurrences. History and physical examination can provide important clues as to whether the pain is neuropathic or mechanical and can also be used to identify "red flags" that may signify serious pathology, such as myelopathy, atlantoaxial subluxation, and metastases. Magnetic resonance imaging is characterized by a high prevalence of abnormal findings in asymptomatic individuals but should be considered for cases involving focal neurologic symptoms, pain refractory to conventional treatment, and when referring a patient for interventional treatment. Few clinical trials have evaluated treatments for neck pain. Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation. In patients with radiculopathy or myelopathy, surgery appears to be more effective than nonsurgical therapy in the short term but not in the long term for most people.

  12. Prevalence of neck pain in computer operators

    Directory of Open Access Journals (Sweden)

    S A Shah

    2015-01-01

    Full Text Available Abstract Introduction: Persisting neck pain is common in society, especially in office-workers. Although, neck pain is common source of disability, little is known about its prevalence and course. The bulk of literature available on this problem is in west with few studies done in an Indian setup. India is a middle-income developing country. The importance of this kind of studies becomes more obvious when it is considered that some reports indicate that the greatest increase in the prevalence of musculo-skeletal disorders in the next decade will be in middle-/low-income countries. Aims & objectives: The Primary aim of this research was to study the prevalence of neck pain in computer operators. Methodology: Study design: Cross Sectional Study. Sampling technique: Simple Random Sampling. Study subject: They should be working on computer for at least 3 hours / day or 15 hours/week, in current job for at least past 6 months & should be willing to participate in the study. Technique: Study was approved from the Institutional Ethics Committee. Informed consent was taken prior to data collection. Data were collected from 700 subjects via structured mailed questionnaire which included individual variables & work related variables. Conclusions: Prevalence of neck pain was found to be 47%. The study shows that neck pain is affected by individual variables and work related variables.

  13. Integrative Medicine in Head and Neck Cancer.

    Science.gov (United States)

    Matovina, Chloe; Birkeland, Andrew C; Zick, Suzanna; Shuman, Andrew G

    2017-02-01

    Objective Complementary and alternative medicine, or integrative medicine, has become increasingly popular among patients with head and neck cancer. Despite its increasing prevalence, many patients feel uncomfortable discussing such therapies with their physicians, and many physicians are unaware and underequipped to evaluate or discuss their use with patients. The aim of this article is to use recent data to outline the decision making inherent to integrative medicine utilization among patients with head and neck cancer, to discuss the ethical implications inherent to balancing integrative and conventional approaches to treatment, and to highlight available resources to enhance head and neck cancer providers' understanding of integrative medicine. Data Sources Randomized controlled trials involving integrative medicine or complementary and alternative medicine treatment for cancer patients. Review Methods Trials were drawn from a systematic PubMed database search categorized into cancer prevention, treatment, and symptom management. Conclusions Integrative medicine is gaining popularity for the management of cancer and is most commonly used for symptom management. A number of randomized controlled trials provide data to support integrative therapies, yet physicians who treat head and neck cancer may be faced with ethical dilemmas and practical barriers surrounding incorporation of integrative medicine. Implications for Practice In the management of head and neck cancer, there is an increasing demand for awareness of, dialogue about, and research evaluating integrative medicine therapies. It is important for otolaryngologists to become aware of integrative therapy options, their risks and benefits, and resources for further information to effectively counsel their patients.

  14. Early result of hemiarthroplasty in elderly patients with fracture neck of femur

    Directory of Open Access Journals (Sweden)

    Mue Daniel

    2015-01-01

    Full Text Available Background: Fractured neck of femur is a frequent and severe injury in elderly patients with consequent high morbidity and mortality. Hemiarthroplasty is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60 years. This study analysed the early functional outcome and complications of Austin Moore endoprosthesis in elderly patients above 60 years with fractured neck of femur. Materials and Methods: Retrospective data were obtained over a 5 year period from January 2007 to December 2012. Thirty-five elderly patients of 60 years and above with displaced intracapsular fracture neck of femur treated with hemiarthroplasty using Austin Moore endoprosthesis were included. Data were analysed using SPSS version 21. Results: A total of 35 patients were involved. The age-range was 60-90 years with mean age of 69.7 ΁ 7 years. The predominant mechanism of injury was trivial falls in 18 (66.7% patients. The commonest complication was pressure sore in 2 (5.7% patients, followed by surgical site infection in 1 (2.9% patient and periprosthetic fracture in 1 (2.9% patients. Early post-operative mortality was 2.9%. Post-operative hip functional status according to Postel and Merle d Aubigne revealed that majority (66.6% of patients had satisfactory hip function. Conclusion: Functional outcome of Austin Moore in elderly patients above 60 years with fracture neck of femur was satisfactory in most of the cases with minimal morbidity. Careful patient selection for hemiarthroplasty is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures.

  15. Lithosphere continental rifting and necking in 3D analogue experiments: role of plate divergence rate.

    Science.gov (United States)

    Nestola, Y.; Storti, F.; Cavozzi, C.

    2014-12-01

    The evolution of lithosphere necking is a fundamental parameter controlling the structural architecture and thermal state of rifted margins. Despite a large number of analogue and numerical modelling studies on lithosphere extension are available in the literature, a quantitative experimental description of lithosphere necking evolution is still lacking. Extensional strain rate and thermal layering of the lithosphere exert a fundamental control on necking shape and evolution. We focused our experimental work on the former parameter and simulated the progression of lithosphere thinning and necking during asymmetric orthogonal rifting at different plate divergence rates. Our models involve a 4-layer mechanical continental lithosphere, which rests on a glucose syrup asthenosphere. Both the topography and the base of the lithosphere were monitored by time-lapse laser scanning. This technical approach allowed us to quantify the evolution in space and time of the thinning factors for the crust, mantle, and lithosphere as a whole. Laser-scanning monitoring provided also a detailed picture of the evolving neck shape, which shows a strong dependency on the strain-rate. At low strain-rates, necking is "boxed" with steep flanks and a flat-lying roof, and few deep basins develop at surface. At high strain-rates, more distributed thinning occurs and isolates portions of less deformed mantle. More distributed deformation affects the model topography. Despite large differences in shape, the aspect ratio (amplitude/wavelength) of the cross-sectional neck shapes converges towards very similar values at the end of the experiments.The significant differences and evolutionary pathways produced by the plate divergence rate on the lithosphere necking profile, suggest that this parameter exert a fundamental control on localization vs. distribution of deformation in the crust as in the whole mechanical lithosphere. Furthermore, it can exert a fundamental control on the time and space

  16. Imaging of connective tissue diseases of the head and neck.

    Science.gov (United States)

    Abdel Razek, Ahmed Abdel Khalek

    2016-06-01

    We review the imaging appearance of connective tissue diseases of the head and neck. Bilateral sialadenitis and dacryoadenitis are seen in Sjögren's syndrome; ankylosis of the temporo-mandibular joint with sclerosis of the crico-arytenoid joint are reported in rheumatoid arthritis and lupus panniculitis with atypical infection are reported in patients with systemic lupus erythematosus. Relapsing polychondritis shows subglottic stenosis, prominent ear and saddle nose; progressive systemic sclerosis shows osteolysis of the mandible, fibrosis of the masseter muscle with calcinosis of the subcutaneous tissue and dermatomyositis/polymyositis shows condylar erosions and autoimmune thyroiditis. Vascular thrombosis is reported in antiphospholipid antibodies syndrome; cervical lymphadenopathy is seen in adult-onset Still's disease, and neuropathy with thyroiditis reported in mixed connective tissue disorder. Imaging is important to detect associated malignancy with connective tissue disorders. Correlation of the imaging findings with demographic data and clinical findings are important for the diagnosis of connective tissue disorders.

  17. Prevalence of human papillomaviruses in patients with head and neck squamous cell carcinoma in Lithuania and Belarus.

    Science.gov (United States)

    Gudleviciene, Zivile; Didziapetriene, Janina; Mackeviciene, Irina; Cicenas, Saulius; Smolyakova, Raisa; Zhukavetc, Aliaksandr; Zivile, Gudleviciene; Janina, Didziapetriene; Irina, Mackeviciene; Saulius, Cicenas; Raisa, Smolyakova; Aliaksandr, Zhukavetc

    2014-03-01

    Overall, head and neck sqamous cell carcinoma accounts for more than 550,000 cases annually worldwide. It is well known that human papillomavirus (HPV) is the main risk factor for cervical cancer development. As the incidence and the mortality of cervical cancer are closely related to the HPV prevalence, we hypothesized that there is the same association between HPV prevalence and head and neck squamous cell carcinoma. Therefore we performed the study aiming to compare the level of HPV infection and HPV type distribution between two groups of Lithuanian and Belarusian patients with head and neck sqamous cell carcinoma. One hundred ninety head and neck sqamous cell carcinoma patients were included in the study, 75 from Lithuania and 115 from Belarus. PCR was used for HPV detection and typing. The distribution of HPV infection among head and neck sqamous cell carcinoma patients was similar in the Lithuanian (20.0%) and Belarusian (18.3%) patient groups, however differences were found in the distribution of HPV types.

  18. TO COMPARE THE EFFECTS OF DEEP NECK FLEXORS STRENGHTNING EXERCISE AND McKENZIE NECK EXERCISE IN SUBJECTS WITH FORWARD NECK POSTURE: A RANDOMISED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Vijay Kage

    2016-04-01

    Full Text Available Background: Forward Neck Posture also called as Protracted neck, is one in which the head is positioned anteriorly and the normal anterior cervical convexity is increased with the apex of the lordotic cervical curve at a considerable distance from the LOG in comparison with optimal posture.Nowadays texting may play a significant role in forward neck posture. According to Wellness Centre “It is the repetition of forward head movements combined with poor ergonomic postures and/or trauma that causes the body to adapt to forward head posture. Purpose: To compare effects of deep flexor strengthening exercises and McKenzie neck exercises in subjects with forward neck posture. Materials and Methods: 30 Subjects clinically diagnosed with FNP meeting the inclusion criteria were randomly assigned into three groups. Group A received McKenzie neck exercises, Group B received Deep Neck Flexor Strengthening Exercises and both the groups commonly went for pectoralis minor stretching respectively for once daily for a total of 6 sessions. Results: The results suggested that all the outcome measure i.e Forward Neck Posture, flexibility of pectoralis minor and CROM values showed significant differences among both the groups. Conclusion: The present study concluded that the comparison of McKenzie neck Exercises and Deep Neck Flexor Strengthening Exercises revealed no statistically significant differences, However each group showed improvement in cervical range of motion and forward neck posture with increase in the pectoralis minor flexibility.

  19. The Danish Head and Neck Cancer database

    DEFF Research Database (Denmark)

    Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian

    2016-01-01

    ) of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01-C.11, C.30-C.32, C.73, and C.80). MAIN VARIABLES: The main variables used in the study were symptoms and the duration of the symptoms......AIM OF THE DATABASE: The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck...... cancer in Denmark and to create a basis for clinical trials. STUDY POPULATION: The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma...

  20. Perfusion CT of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Razek, Ahmed Abdel Khalek Abdel, E-mail: arazek@mans.edu.eg; Tawfik, Ahmed Mohamed, E-mail: ahm_m_tawfik@hotmail.com; Elsorogy, Lamiaa Galal Ali, E-mail: lamia2elsorogy@hotmail.com; Soliman, Nermin Yehia, E-mail: nermin_eid@hotmail.com

    2014-03-15

    We aim to review the technique and clinical applications of perfusion CT (PCT) of head and neck cancer. The clinical value of PCT in the head and neck includes detection of head and neck squamous cell carcinoma (HNSCC) as it allows differentiation of HNSCC from normal muscles, demarcation of tumor boundaries and tumor local extension, evaluation of metastatic cervical lymph nodes as well as determination of the viable tumor portions as target for imaging-guided biopsy. PCT has been used for prediction of treatment outcome, differentiation between post-therapeutic changes and tumor recurrence as well as monitoring patient after radiotherapy and/or chemotherapy. PCT has a role in cervical lymphoma as it may help in detection of response to chemotherapy and early diagnosis of relapsing tumors.

  1. Management of patients with neck pain

    Directory of Open Access Journals (Sweden)

    E. A. Chechet

    2016-01-01

    Full Text Available Neck pain (cervicalgia occupies one of the leading places among the reasons for outpatient visits, 75% of people have experienced neck pain at least once in their lives. In most cases, neck pain regresses; however, it recurs in almost one half of patients. The paper gives data on the risk factors, mechanisms, course, and prognosis of cervicalgia. It discusses the issues of differential diagnosis, examination, and approaches to treating this condition in these patients. Nonsteroidal anti-inflammatory drugs are most effective in treating patients with acute cervicalgia. Therapeutic exercises and manual therapy are indicated in patients with chronic cervicalgia. There is evidence on the efficacy and safety of meloxicam for the management of acute and chronic cervicalgia.

  2. Psychometric properties of the Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short form-36 (SF-36) were evaluated in patients with neck pain

    DEFF Research Database (Denmark)

    Sørensen, Tina Juul; Søgaard, Karen; Davis, Aileen M;

    2016-01-01

    OBJECTIVE: To assess reliability, construct validity, responsiveness and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short-form-36 (SF-36) in neck pain patients. STUDY DESIGN AND SETTING: Internal consistency was assessed by Cronbach's alpha. Test-retest reliab......OBJECTIVE: To assess reliability, construct validity, responsiveness and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI) and Short-form-36 (SF-36) in neck pain patients. STUDY DESIGN AND SETTING: Internal consistency was assessed by Cronbach's alpha. Test......, valid and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI....

  3. 20例老年糖尿病患者合并口腔颌面间隙感染的护理体会%Nursing experience of 20 diabetic patients with oral and maxillofacial space infection in elderly patients

    Institute of Scientific and Technical Information of China (English)

    李红梅

    2012-01-01

    目的:探讨老年糖尿病患者合并口腔颌面间隙感染者的护理措施.方法:回顾性分析我科2009年1月-2012年1月共收治老年糖尿病患者合并口腔颌面间隙感染20例.结果:20例患者均创口愈合,治愈率达100%.结论:老年糖尿病患者合并口腔颌面间隙感染在血糖控制平稳的情况下,采用全身加局部的治疗方法和全方位的护理,效果满意.%Objective:To explore appropriate nursing methods for elderly patients with diabetes combined with spaces infection.Methods:A retrospectively review was performed for 20 cases of elderly diabetes patients hospitalized for space infections in maxillofacial area from January 2009 to January 2012.Results:Complete healing was achieved in all the patients with 100% curative ratio.Conclusions:Besides appropriate treatment and nursing,more attention must be paid to blood glucose control in order to achieve satisfying results for elderly diabetes patients with spaces infection.

  4. Prediction of Neck Dissection Requirement After Definitive Radiotherapy for Head-and-Neck Squamous Cell Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Thariat, Juliette [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Radiation Oncology/IBDC CNRS UMR, Cancer Center Antoine-Lacassagne, University Nice Sophia-Antipolis, Nice, Cedex 2 (France); Ang, K. Kian; Allen, Pamela K. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ahamad, Anesa [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); University of the West Indies, St. Augustine (Trinidad and Tobago); Williams, Michelle D. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Myers, Jeffrey N. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Department of Cancer Biology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Ginsberg, Lawrence E. [Department of Diagnostic Radiology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Morrison, William H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Garden, Adam S., E-mail: agarden@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-03-01

    Background: This analysis was undertaken to assess the need for planned neck dissection in patients with a complete response (CR) of involved nodes after irradiation and to determine the benefit of a neck dissection in those with less than CR by tumor site. Methods: Our cohort included 880 patients with T1-4, N1-3M0 squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received treatment between 1994 and 2004. Survival curves were calculated by the Kaplan-Meier Method, comparisons of rates with the log-rank test and prognostic factors by Cox's proportional hazard model. Results: Nodal CR occurred in 377 (43%) patients, of whom 365 patients did not undergo nodal dissection. The 5-year actuarial regional control rate of patients with CR was 92%. Two hundred sixty-eight of the remaining patients (53%) underwent neck dissections. The 5-year actuarial regional control rate for patients without a CR was 84%. Those who had a neck dissection fared better with 5-year actuarial regional control rates of 90% and 76% for those operated and those not operated (p < 0.001). Variables associated with poorer regional control rates included higher T and N stage, non-oropharynx cancers, non-CR, both clinical and pathological. Conclusions: With 92% 5-year neck control rate without neck dissection after CR, there is little justification for systematic neck dissection. The addition of a neck dissection resulted in higher neck control after partial response though patients with viable tumor on pathology specimens had poorer outcomes. The identification of that subgroup that benefits from additional treatment remains a challenge.

  5. INTRAOPERATIVE NEUROMONITORING DURING HEAD AND NECK SURGERY

    Directory of Open Access Journals (Sweden)

    P. O. Rumyantsev

    2012-01-01

    Full Text Available This clinical trial comparatively analyzed the frequency of postoperative neurological complications due to damage to motor (facial, recurrent, laryngeal, and accessory nerves after head and neck operations using the traditional procedure or intraoperative neuromonitoring. Neuromonitoring made during operations on the thyroid and level VI central neck could reduce the rate of recurrent laryngeal nerve paralysis by more than twice (OR = 0.32; 95 % CI 0.11–0.86; p = 0.028. The author considers the absolute indication for intraoperative neuromonitoring to be high-risk surgery for nondeliberate damage to the motor nerves and impossibility of their visual detection.

  6. [Unilateral atypical neck pain in Eagle syndrome].

    Science.gov (United States)

    Lonka, Matilde Mia; Schousboe, Lars Peter

    2012-04-30

    This article is an introduction to Eagle syndrome as a differential diagnosis in patients with lateral neck pain, a symptom, which is often difficult to diagnose and where the accepted treatment covers a variety of forms. This was the case for a 51 year-old man with lateral neck pain and a crunchy sensation/sound when he turned his head. After years of pain, the right examination and a computed tomography finally suggested Eagle syndrome. The patient had severe symptoms and was treated with an operation by which part of the ossificated stylohyoid ligament was removed. The operation relieved him of all his symptoms.

  7. Acute Neck Pain in General Practice

    OpenAIRE

    2006-01-01

    textabstractWe performed a prospective cohort study with one-year follow-up of patients with acute neck pain in general practice. Patients above 18 years of age consulting their GP for non-specific acute neck pain lasting no longer than six weeks were invited to participate. Self-administered questionnaires were collected from patients at baseline and after 6, 12, 26 and 52 weeks. 187 patients were included and we have follow-up data of 138 patients (74%). After one-year 47% still reported ne...

  8. Nonunion of paediatric talar neck fracture

    Directory of Open Access Journals (Sweden)

    Jindal Nipun

    2014-02-01

    Full Text Available 【Abstract】Fractures of the paediatric talus are infrequent injuries, most complicated by posttraumatic arthrosis and avascular necrosis in the course of treatment. Non- union in children has not been reported before in literature. We report a case of a 12-year-old boy who had a nonunion of Hawkins type II fracture of talar neck. The nonunion was treated surgically with a good clinical outcome. The goals of management in nonunion of paediatric talar neck fracture are different from those in fresh fractures. A suboptimal reduction should be acceptable without trying a radical surgery which may cause further impairment.

  9. Penetrating wounds of the head and neck.

    Science.gov (United States)

    Jahrsdoerfer, R A; Johns, M E; Cantrell, R W

    1979-12-01

    Wounding capability of bullets is primarily releated to velocity. Bullet mass and shape, and specific gravity of body tissues being struck by the missile, are lesser factors. Seventy cases of penetrating wounds of the head and neck were treated during a six-year period. Vascular injuries were more common with neck wounds, while face and head injuries (extracranial) were similar to maxillofacial trauma. It is recognized that hemorrhage at the base of the skull is difficult to treat, and contemporary training in temporal bone and base of skull surgery is mandatory for the critical management of these wounds.

  10. Congenital neck masses: embryological and anatomical perspectives

    Directory of Open Access Journals (Sweden)

    Zahida Rasool

    2013-08-01

    Full Text Available Neck masses are a common problem in paediatric age group. They tend to occur frequently and pose a diagnostic dilemma to the ENT surgeons. Although the midline and lateral neck masses differ considerably in their texture and presentation but the embryological perspective of these masses is not mostly understood along with the fundamental anatomical knowledge. The article tries to correlate the embryological, anatomical and clinical perspectives for the same. [Int J Res Med Sci 2013; 1(4.000: 329-332

  11. Delays in diagnosis, referral and management of head and neck ...

    African Journals Online (AJOL)

    Delays in diagnosis, referral and management of head and neck cancer presenting at Kenyatta National ... Background: The most important prognostic factor in head and neck cancer is the stage of the disease at presentation. ... Article Metrics.

  12. PET-CT–Guided Surveillance of Head and Neck Cancers

    Science.gov (United States)

    Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

  13. Physiotherapy for Chronic Neck Pain: Evaluation of a biopsychosocial approach

    OpenAIRE

    2010-01-01

    markdownabstract__Abstract__ Neck pain is a common complaint that causes substantial morbidity in western countries. Reported prevalence in the general population ranges from 9.5% to 22%, and the 12-month (point) prevalence estimates ranges from 30% to 50%. It is suggested that two thirds of individuals may at least once in their lifetime experience neck pain; it is more often reported by women than men. Patients with neck complaints generally also complain of neck stiffness and reduced mobil...

  14. Masticator space abscess derived from odontogenic infection: imaging manifestation and pathways of extension depicted by CT and MR in 30 patients

    Energy Technology Data Exchange (ETDEWEB)

    Schuknecht, B. [Medizinisch Radiologisches Institut, Section Neuroradiology, Zurich (Switzerland); MRI, Zurich (Switzerland); Stergiou, G.; Graetz, K. [University Hospital of Zurich Switzerland, Department of Cranio-Maxillofacial Surgery, Zurich (Switzerland)

    2008-09-15

    Propagation of odontogenic masticator space abscesses is insufficiently understood. The purpose was to analyse pathways of spread in 30 patients with odontogenic masticator space abscess. The imaging findings in 30 patients (CT in 30, MR in 16 patients) were retrospectively analysed. CT and MR imaging depicted a masticator space abscess within: medial pterygoid muscle in 13 patients (43.3%), lateral masseter and/or pterygoid muscle in 14 (46.7%) and superficial temporal muscle in 3 patients (10%). In the lateral masticator space intra-spatial abscess extension occurred in 7 of 14 patients (50%). The sub-masseteric space provided a pathway in seven (70%). Extra-spatial extension involved the submandibular space only in 3 of 14 patients (21.4%). Medial masticator space abscesses exhibited extra-spatial spread only. Extension affected the parapharyngeal space and/or soft palate in 7 of 13 lesions (53.8%). MR imaging in comparison to CT increased the number of abscess locations from 18 to 23 (27.8%) and regions affected by a cellular infiltrate from 12 to 16 (33.3%). The sub-masseteric space served as a previously underestimated pathway for intra-spatial propagation of lateral masticator abscesses. Medial masticator space abscesses tend to display early extra-spatial parapharyngeal space and/or soft palate extension. (orig.)

  15. Weakness of the neck extensors, possible causes and relation to adolescent idiopathic cervical kyphosis.

    Science.gov (United States)

    Xiaolong, Shen; Xuhui, Zhou; Jian, Chen; Ye, Tian; Wen, Yuan

    2011-09-01

    Cervical kyphosis may be congenital, or occur as a result of laminectomy, post-traumatic deformity, infection, neuromuscular disorders such as muscular dystrophies, motor neuron disorders such as amyotrophic lateral sclerosis, tumor, and inflammation such as ankylosing spondylitis. Furthermore, adolescent idiopathic cervical kyphosis was defined as cervical kyphotic deformity of adolescent patient without any cause such as those previously described. As no standard values for "cervical kyphosis" could be found in the literature, many reported studies only report a subjective classification, "kyphotic, straight or lordotic". But this method had proven to be unreliable. Grob et al. defined "straight" for the global curvature as +4° to -4°, and lordotic and kyphotic as +4°, respectively. The etiology and pathogenesis of adolescent idiopathic cervical kyphosis remain little understood. Weakness of the neck extensors can result in "dropped head syndrome", a rare disorder characterized by weakness of neck extensor muscles causing an inability to extend the neck and resulting in a chin-on-chest deformity. The purpose of this paper is to propose a possible mechanical cause leading to the kyphotic deformity. We hypothesize that weakness of the neck extensors could be the initiating factor for adolescent idiopathic cervical kyphosis.

  16. Characterization of HPV and host genome interactions in primary head and neck cancers

    Science.gov (United States)

    Parfenov, Michael; Pedamallu, Chandra Sekhar; Gehlenborg, Nils; Freeman, Samuel S.; Danilova, Ludmila; Bristow, Christopher A.; Lee, Semin; Hadjipanayis, Angela G.; Ivanova, Elena V.; Wilkerson, Matthew D.; Protopopov, Alexei; Yang, Lixing; Seth, Sahil; Song, Xingzhi; Tang, Jiabin; Ren, Xiaojia; Zhang, Jianhua; Pantazi, Angeliki; Santoso, Netty; Xu, Andrew W.; Mahadeshwar, Harshad; Wheeler, David A.; Haddad, Robert I.; Jung, Joonil; Ojesina, Akinyemi I.; Issaeva, Natalia; Yarbrough, Wendell G.; Hayes, D. Neil; Grandis, Jennifer R.; El-Naggar, Adel K.; Meyerson, Matthew; Park, Peter J.; Chin, Lynda; Seidman, J. G.; Hammerman, Peter S.; Kucherlapati, Raju; Ally, Adrian; Balasundaram, Miruna; Birol, Inanc; Bowlby, Reanne; Butterfield, Yaron S.N.; Carlsen, Rebecca; Cheng, Dean; Chu, Andy; Dhalla, Noreen; Guin, Ranabir; Holt, Robert A.; Jones, Steven J.M.; Lee, Darlene; Li, Haiyan I.; Marra, Marco A.; Mayo, Michael; Moore, Richard A.; Mungall, Andrew J.; Robertson, A. Gordon; Schein, Jacqueline E.; Sipahimalani, Payal; Tam, Angela; Thiessen, Nina; Wong, Tina; Protopopov, Alexei; Santoso, Netty; Lee, Semin; Parfenov, Michael; Zhang, Jianhua; Mahadeshwar, Harshad S.; Tang, Jiabin; Ren, Xiaojia; Seth, Sahil; Haseley, Psalm; Zeng, Dong; Yang, Lixing; Xu, Andrew W.; Song, Xingzhi; Pantazi, Angeliki; Bristow, Christopher; Hadjipanayis, Angela; Seidman, Jonathan; Chin, Lynda; Park, Peter J.; Kucherlapati, Raju; Akbani, Rehan; Casasent, Tod; Liu, Wenbin; Lu, Yiling; Mills, Gordon; Motter, Thomas; Weinstein, John; Diao, Lixia; Wang, Jing; Fan, You Hong; Liu, Jinze; Wang, Kai; Auman, J. Todd; Balu, Saianand; Bodenheimer, Tom; Buda, Elizabeth; Hayes, D. Neil; Hoadley, Katherine A.; Hoyle, Alan P.; Jefferys, Stuart R.; Jones, Corbin D.; Kimes, Patrick K.; Marron, J.S.; Meng, Shaowu; Mieczkowski, Piotr A.; Mose, Lisle E.; Parker, Joel S.; Perou, Charles M.; Prins, Jan F.; Roach, Jeffrey; Shi, Yan; Simons, Janae V.; Singh, Darshan; Soloway, Mathew G.; Tan, Donghui; Veluvolu, Umadevi; Walter, Vonn; Waring, Scot; Wilkerson, Matthew D.; Wu, Junyuan; Zhao, Ni; Cherniack, Andrew D.; Hammerman, Peter S.; Tward, Aaron D.; Pedamallu, Chandra Sekhar; Saksena, Gordon; Jung, Joonil; Ojesina, Akinyemi I.; Carter, Scott L.; Zack, Travis I.; Schumacher, Steven E.; Beroukhim, Rameen; Freeman, Samuel S.; Meyerson, Matthew; Cho, Juok; Chin, Lynda; Getz, Gad; Noble, Michael S.; DiCara, Daniel; Zhang, Hailei; Heiman, David I.; Gehlenborg, Nils; Voet, Doug; Lin, Pei; Frazer, Scott; Stojanov, Petar; Liu, Yingchun; Zou, Lihua; Kim, Jaegil; Lawrence, Michael S.; Sougnez, Carrie; Lichtenstein, Lee; Cibulskis, Kristian; Lander, Eric; Gabriel, Stacey B.; Muzny, Donna; Doddapaneni, HarshaVardhan; Kovar, Christie; Reid, Jeff; Morton, Donna; Han, Yi; Hale, Walker; Chao, Hsu; Chang, Kyle; Drummond, Jennifer A.; Gibbs, Richard A.; Kakkar, Nipun; Wheeler, David; Xi, Liu; Ciriello, Giovanni; Ladanyi, Marc; Lee, William; Ramirez, Ricardo; Sander, Chris; Shen, Ronglai; Sinha, Rileen; Weinhold, Nils; Taylor, Barry S.; Aksoy, B. Arman; Dresdner, Gideon; Gao, Jianjiong; Gross, Benjamin; Jacobsen, Anders; Reva, Boris; Schultz, Nikolaus; Sumer, S. Onur; Sun, Yichao; Chan, Timothy; Morris, Luc; Stuart, Joshua; Benz, Stephen; Ng, Sam; Benz, Christopher; Yau, Christina; Baylin, Stephen B.; Cope, Leslie; Danilova, Ludmila; Herman, James G.; Bootwalla, Moiz; Maglinte, Dennis T.; Laird, Peter W.; Triche, Timothy; Weisenberger, Daniel J.; Van Den Berg, David J.; Agrawal, Nishant; Bishop, Justin; Boutros, Paul C.; Bruce, Jeff P; Byers, Lauren Averett; Califano, Joseph; Carey, Thomas E.; Chen, Zhong; Cheng, Hui; Chiosea, Simion I.; Cohen, Ezra; Diergaarde, Brenda; Egloff, Ann Marie; El-Naggar, Adel K.; Ferris, Robert L.; Frederick, Mitchell J.; Grandis, Jennifer R.; Guo, Yan; Haddad, Robert I.; Hammerman, Peter S.; Harris, Thomas; Hayes, D. Neil; Hui, Angela BY; Lee, J. Jack; Lippman, Scott M.; Liu, Fei-Fei; McHugh, Jonathan B.; Myers, Jeff; Ng, Patrick Kwok Shing; Perez-Ordonez, Bayardo; Pickering, Curtis R.; Prystowsky, Michael; Romkes, Marjorie; Saleh, Anthony D.; Sartor, Maureen A.; Seethala, Raja; Seiwert, Tanguy Y.; Si, Han; Tward, Aaron D.; Van Waes, Carter; Waggott, Daryl M.; Wiznerowicz, Maciej; Yarbrough, Wendell; Zhang, Jiexin; Zuo, Zhixiang; Burnett, Ken; Crain, Daniel; Gardner, Johanna; Lau, Kevin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Penny, Robert; Shelton, Candance; Shelton, Troy; Sherman, Mark; Yena, Peggy; Black, Aaron D.; Bowen, Jay; Frick, Jessica; Gastier-Foster, Julie M.; Harper, Hollie A.; Lichtenberg, Tara M.; Ramirez, Nilsa C.; Wise, Lisa; Zmuda, Erik; Baboud, Julien; Jensen, Mark A.; Kahn, Ari B.; Pihl, Todd D.; Pot, David A.; Srinivasan, Deepak; Walton, Jessica S.; Wan, Yunhu; Burton, Robert; Davidsen, Tanja; Demchok, John A.; Eley, Greg; Ferguson, Martin L.; Shaw, Kenna R. Mills; Ozenberger, Bradley A.; Sheth, Margi; Sofia, Heidi J.; Tarnuzzer, Roy; Wang, Zhining; Yang, Liming; Zenklusen, Jean Claude; Saller, Charles; Tarvin, Katherine; Chen, Chu; Bollag, Roni; Weinberger, Paul; Golusiński, Wojciech; Golusiński, Paweł; Ibbs, Matthiew; Korski, Konstanty; Mackiewicz, Andrzej; Suchorska, Wiktoria; Szybiak, Bartosz; Wiznerowicz, Maciej; Burnett, Ken; Curley, Erin; Gardner, Johanna; Mallery, David; Penny, Robert; Shelton, Troy; Yena, Peggy; Beard, Christina; Mitchell, Colleen; Sandusky, George; Agrawal, Nishant; Ahn, Julie; Bishop, Justin; Califano, Joseph; Khan, Zubair; Bruce, Jeff P; Hui, Angela BY; Irish, Jonathan; Liu, Fei-Fei; Perez-Ordonez, Bayardo; Waldron, John; Boutros, Paul C.; Waggott, Daryl M.; Myers, Jeff; Lippman, Scott M.; Egea, Sophie; Gomez-Fernandez, Carmen; Herbert, Lynn; Bradford, Carol R.; Carey, Thomas E.; Chepeha, Douglas B.; Haddad, Andrea S.; Jones, Tamara R.; Komarck, Christine M.; Malakh, Mayya; McHugh, Jonathan B.; Moyer, Jeffrey S.; Nguyen, Ariane; Peterson, Lisa A.; Prince, Mark E.; Rozek, Laura S.; Sartor, Maureen A.; Taylor, Evan G.; Walline, Heather M.; Wolf, Gregory T.; Boice, Lori; Chera, Bhishamjit S.; Funkhouser, William K.; Gulley, Margaret L.; Hackman, Trevor G.; Hayes, D. Neil; Hayward, Michele C.; Huang, Mei; Rathmell, W. Kimryn; Salazar, Ashley H.; Shockley, William W.; Shores, Carol G.; Thorne, Leigh; Weissler, Mark C.; Wrenn, Sylvia; Zanation, Adam M.; Chiosea, Simion I.; Diergaarde, Brenda; Egloff, Ann Marie; Ferris, Robert L.; Romkes, Marjorie; Seethala, Raja; Brown, Brandee T.; Guo, Yan; Pham, Michelle; Yarbrough, Wendell G.

    2014-01-01

    Previous studies have established that a subset of head and neck tumors contains human papillomavirus (HPV) sequences and that HPV-driven head and neck cancers display distinct biological and clinical features. HPV is known to drive cancer by the actions of the E6 and E7 oncoproteins, but the molecular architecture of HPV infection and its interaction with the host genome in head and neck cancers have not been comprehensively described. We profiled a cohort of 279 head and neck cancers with next generation RNA and DNA sequencing and show that 35 (12.5%) tumors displayed evidence of high-risk HPV types 16, 33, or 35. Twenty-five cases had integration of the viral genome into one or more locations in the human genome with statistical enrichment for genic regions. Integrations had a marked impact on the human genome and were associated with alterations in DNA copy number, mRNA transcript abundance and splicing, and both inter- and intrachromosomal rearrangements. Many of these events involved genes with documented roles in cancer. Cancers with integrated vs. nonintegrated HPV displayed different patterns of DNA methylation and both human and viral gene expressions. Together, these data provide insight into the mechanisms by which HPV interacts with the human genome beyond expression of viral oncoproteins and suggest that specific integration events are an integral component of viral oncogenesis. PMID:25313082

  17. Management of complications and compromised free flaps following major head and neck surgery.

    Science.gov (United States)

    Kucur, Cuneyt; Durmus, Kasim; Uysal, Ismail O; Old, Matthew; Agrawal, Amit; Arshad, Hassan; Teknos, Theodoros N; Ozer, Enver

    2016-01-01

    Microvascular free flaps are preferred for most major head and neck reconstruction surgeries because of better functional outcomes, improved esthetics, and generally higher success rates. Numerous studies have investigated measures to prevent flap loss, but few have evaluated the optimal treatment for free flap complications. This study aimed to determine the complication rate after free flap reconstructions and discusses our management strategies. Medical records of 260 consecutive patients who underwent free flap reconstructions for head and neck defects between July 2006 and June 2010 were retrospectively reviewed for patient and surgical characteristics and postoperative complications. The results revealed that microvascular free flaps were extremely reliable, with a 3.5 % incidence of flap failure. There were 78 surgical site complications. The most common complication was neck wound infection, followed by dehiscence, vascular congestion, abscess, flap necrosis, hematoma, osteoradionecrosis, and brisk bleeding. Twenty patients with poor wound healing received hyperbaric oxygen therapy, which was ineffective in three patients who eventually experienced complete flap loss. Eleven patients with vascular congestion underwent medicinal leech therapy, which was effective. Among the 78 patients with complications, 44 required repeat surgery, which was performed for postoperative brisk bleeding in three. Eventually, ten patients experienced partial flap loss and nine experienced complete flap loss, with the latter requiring subsequent pectoralis major flap reconstruction. Microvascular free flap reconstruction represents an essential and reliable technique for head and neck defects and allows surgeons to perform radical resection with satisfactory functional results and acceptable complication rates.

  18. A 66-year-old man with neck pain.

    Science.gov (United States)

    Jaynstein, Dayna

    2017-03-01

    Neck pain is a fairly common complaint among patients in the ED. The differential diagnosis is broad, from musculoskeletal causes to potentially life-threatening causes. Providers need to have a good understanding of when the complaint of neck pain requires more diagnostic investigation, even in a patient with chronic neck pain.

  19. Prevention of flight-related neck pain in military aircrew

    NARCIS (Netherlands)

    van den Oord, M.H.A.H.

    2012-01-01

    Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance. I

  20. Prevention of flight-related neck pain in military aircrew

    NARCIS (Netherlands)

    van den Oord, M.H.A.H.

    2012-01-01

    Military pilots and rear aircrew members are occupations with several occupational exposures that might cause neck pain. In addition to the negative impact of neck pain on health, safety is one of the main concerns for the military aviation, because neck pain may interfere with flying performance.

  1. Neck sprain after motor vehicle accidents in drivers and passengers

    NARCIS (Netherlands)

    Versteegen, GJ; Kingma, J; Meijler, WJ; ten Duis, HJ

    2000-01-01

    Neck sprain is a general term denoting a soft tissue injury of the neck, which seldom causes major disability but is considered a modem epidemic. The purpose of the present study was to determine the prevalence of sprain of the neck injury due to motor vehicle accidents (MVAs) in both drivers and pa

  2. A new methodology for biofidelic head-neck postural control

    NARCIS (Netherlands)

    Nemirovsky, N.; Rooij, L. van

    2010-01-01

    Active safety systems require accurate modelling of human behaviour. The effect of bracing, together with an appropriate human head/neck stability control are essential in the study of pre-crash behaviour and neck injury, since they can account for changes in apparent joint stiffness in the neck. In

  3. Postural Correction in Persons with Neck Pain (II. Integrated Electromyography of the Upper Trapezius in Three Simulated Neck Positions).

    Science.gov (United States)

    Enwemeka, C S; Bonet, I M; Ingle, J A; Prudhithumrong, S; Ogbahon, F E; Gbenedio, N A

    1986-01-01

    In the previous paper (Enwemeka, Bonet, Ingle, et al. 8:235-239, 1986) we showed that patients with neck pain and spasm of the upper trapezius often assume a forward head position, and that two neck positions, axial extension, and neutral neck position are frequently used by physical therapists to correct this faulty neck posture. Because there is no scientific basis for recommending either of the two corrective neck positions, we simulated the three neck positions in 10 normal adults and compared the integrated electromyography (IEMG) of the upper trapezius to determine if the muscle shows less activity in any of the two corrective positions. The results showed significantly less IEMG of the upper trapezius in each of the two corrective neck positions than in the faulty neck position (p 0.10). The implications and limitations of these findings are discussed along with suggestions for future studies. J Orthop Sports Phys Ther 1986;8(5):240-242.

  4. The variation of the strength of neck extensor muscles and semispinalis capitis muscle size with head and neck position.

    Science.gov (United States)

    Rezasoltani, A; Nasiri, R; Faizei, A M; Zaafari, G; Mirshahvelayati, A S; Bakhshidarabad, L

    2013-04-01

    Semispinalis capitis muscle (SECM) is a massive and long cervico-thoracic muscle which functions as a main head and neck extensor muscle. The aim of this study was to detect the effect of head and neck positions on the strength of neck extensor muscles and size of SECM in healthy subjects. Thirty healthy women students voluntarily participated in this study. An ultrasonography apparatus (Hitachi EUB 525) and a system of tension-meter were used to scan the right SECM at the level of third cervical spine and to measure the strength of neck extensor muscles at three head and neck positions. Neck extensor muscles were stronger in neutral than flexion or than extension positions while the size of SECM was larger in extension than neutral or than flexion position. The force generation capacity of the main neck extensor muscle was lower at two head and neck flexion and extension positions than neutral position. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. A Comparative Study of Deep Neck Abscess with Regards to Anatomical Location and Age Groups Using CT and Clinical Data

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chan Ho; Han, Jong Kyu; Kim, Young Tong; Shin, Hyeong Cheol; Kim, Hyung Hwan; Jou, Sung Shick [Dept. of Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan (Korea, Republic of)

    2012-04-15

    To evaluate differences anatomical location and age groups on CT and clinical data in deep neck abscess. This study included 200 patients who underwent CT and were diagnosed with a deep neck abscess, from December 2005 to July 2010. Patients were divided into four groups by age (children, adolescent, adult, elderly). Next, the anatomic location, location multiplicity and clinical data regarding the deep neck abscesses were analyzed retrospectively. The deep neck abscesses observed were defined as superficial or deep and partitioned into sub-groups, with further analysis of their clinical data. The incidence of the parapharyngeal abscess was more frequent in children and elderly groups (p < 0.05). The masticator abscess was only observed among patients in the elderly group (p < 0.05). Multiple locations were observed with increased frequency in children and elderly groups (p < 0.05). Swelling in the neck was more frequently observed in children and elderly groups (p < 0.05), cervical lymphadenitis was frequently seen in children and adolescent groups (p < 0.05), and the incidence of symptoms including sore throat were significantly increased in adolescent and adult groups (p < 0.05). Location multiplicity was significantly higher in parapharyngeal, retropharyngeal, submandibular, danger, visceral and masticator spaces than other spaces (p < 0.05). With regards to anatomic location, neck swelling was more frequent in superficial group and sore throat was more frequent in deep group (p < 0.05). Deep neck abscess would show significant differences with regards to the abscess location, location multiplicity, and clinical symptoms according to age. The clinical symptoms observed are dependent on the anatomic location as defined by a superficial or deep abscess.

  6. HPV in Head and Neck Cancer-30 Years of History.

    Science.gov (United States)

    Syrjänen, Stina; Rautava, Jaana; Syrjänen, Kari

    The interesting history of papillomavirus (PV) research has been reviewed before. The history of human papillomavirus (HPV) in head and neck region starts in 1901 when the contagious transmission of warty lesions into the mouth via oral sex was described, although the confirmation of their viral etiology had to wait until 1907. Ullman was the first to associate the human wart virus with laryngeal warts. Parsons and Kidd described the natural history of oral PV infections in rabbits already in 1942, but these findings were corroborated in humans only recently. Koilocytotic atypia described by Koss and Durfee in 1956 was recognized as a sign of HPV infection in cervical precancer lesions only in 1976-1977 (Meisels and Fortin; Purola and Savia). This prompted systematic surveys of head and neck lesions for the detection of koilocytosis since the late 1970s, and the authors of this communication were the first to propose the HPV involvement in a subgroup of head and neck cancers. Brandsma and Abramson demonstrated HPV16 DNA in tonsillar SCCs in 1989. Since the early 2000s, HPV research of head and neck squamous cell carcinomas (HNSCC) has made impressive progress, confirming that the specific anatomic site plays a key role in determining the susceptibility to HPV infection. The most likely cancer sites associated with HPV are the base of the tongue and palatine tonsils, followed by oral cavity, larynx, and sinonasal mucosa. There is substantial geographic variation in HPV association with HNSCC. Patients with HPV-associated HNSCC are younger, and survival is better than in the absence of HPV.

  7. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

    NARCIS (Netherlands)

    Coskun, H.H.; Medina, J.E.; Robbins, K.T.; Silver, C.E.; Strojan, P.; Teymoortash, A.; Pellitteri, P.K.; Rodrigo, J.P.; Stoeckli, S.J.; Shaha, A.R.; Suarez, C.; Hartl, D.M.; Bree, R. de; Takes, R.P.; Hamoir, M.; Pitman, K.T.; Rinaldo, A.; Ferlito, A.

    2015-01-01

    Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore,

  8. Neck pain and disability due to neck pain: what is the relation?

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan

    2008-01-01

    Pain and disability are interrelated, but the relationship between pain and disability is not straightforward. The objective of this study was to investigate the relationship between neck pain (NP) intensity, NP duration, and disability based on the population-based 'Funen Neck and Chest Pain......' study. Pain intensity was measured using 11-box numerical rating scales, pain duration was measured using the Standardized Nordic Questionnaire, and disability was measured by the Copenhagen Neck Functional Disability Scale. Spearman rank correlation coefficients and logistic regression analyses were...... used to measure correlations and strength of associations between pain intensity, pain duration, and disability given domain specific characteristics (socioeconomic, health and physical, comorbidity, and variables related to consequences of NP). Neck pain was very common, but mainly mild and did...

  9. Malignant triton tumor (MTT) of the neck

    DEFF Research Database (Denmark)

    Sørensen, Kristine Bjørndal; Godballe, Christian; Krogdahl, Annelise

    2006-01-01

    Malignant Triton Tumor (MTT) is a rare, malignant periphere nerve sheath tumor with rhabdomyoblastic differentiation. One third of described MTT's were located at the head and neck region. One third of these are associated with neurofibromatosis type 1. MTT most often appears in the third decade...

  10. Manipulation or Mobilisation for Neck Pain

    NARCIS (Netherlands)

    A. Gross; J. Miller; J. D'Sylva; S.J. Burnie; C.H. Goldsmith; N. Graham; T. Haines; G. Brønfort; J.L. Hoving

    2010-01-01

    Background Manipulation and mobilisation are often used, either alone or combined with other treatment approaches, to treat neck pain. Objectives To assess if manipulation or mobilisation improves pain, function/disability, patient satisfaction, quality of life, and global perceived effect in adults

  11. Sex differences in heritability of neck Pain

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    Experimental studies have suggested biological factors as a possible explanation for gender disparities in perception of pain. Recently, heritability of liability to neck pain (NP) has been found to be statistically significantly larger in women compared to men. However, no studies have been cond...

  12. Malignant neoplasms of the head and neck.

    Science.gov (United States)

    Dickson, Paxton V; Davidoff, Andrew M

    2006-05-01

    Head and neck masses represent a common clinical entity in children. In general, these masses are classified as developmental, inflammatory, or neoplastic. Having a working knowledge of lesions within this region and conducting a thorough history and physical examination generally enables the clinician to facilitate an appropriate workup and establish a diagnosis. The differential diagnosis is broad, and expeditiously distinguishing benign from malignant masses is critical for instituting a timely multidisciplinary approach to the management of malignant lesions. Neoplasms of the head and neck account for approximately 5% of all childhood malignancies. A diagnosis of malignancy may represent a primary tumor or metastatic foci to cervical nodes. In this review, we discuss the general approach to evaluating suspicious masses and adenopathy in the head and neck region and summarize the most common malignant neoplasms of the head and neck with regard to their incidence, clinical presentation, diagnostic evaluation, staging, and management. Thyroid, parathyroid, and salivary gland tumors are discussed elsewhere in this issue of Seminars in Pediatric Surgery.

  13. Chronic calcific tendinitis of the neck

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, H.; Zee, C.S.; Frankel, P.; Robinson, A.; Blau, L.; Gans, D.C.

    1981-12-01

    The authors present the first three cases of chronic calcific tendinits of the neck. This condition is diagnosed radiologically by the presence of calcification located just inferior to the anterior tubercle of C1. The calcification is at the insertion of the longus colli muscle. No soft tissue swelling is present and the patients are asymptomatic.

  14. INDICATIONS FOR RADIOTHERAPY AFTER NECK DISSECTION

    NARCIS (Netherlands)

    Strojan, Primoz; Ferlito, Alfio; Langendijk, Johannes A.; Silver, Carl E.

    Up-front surgery and postoperative radiotherapy constitute a well-recognized treatment concept for locally or regionally advanced squamous cell carcinoma of the head and neck. This "treatment package" is further intensified with the concomitant application of chemotherapy during irradiation when

  15. Oral sequelae of head and neck radiotherapy

    NARCIS (Netherlands)

    Vissink, A; Jansma, J; Spijkervet, FKL; Burlage, FR; Coppes, RP

    In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e. g., salivary glands, oral mucosa, bone, dentition,

  16. The Funen Neck and Chest Pain study

    DEFF Research Database (Denmark)

    Fejer, René; Hartvigsen, Jan; Kyvik, Kirsten Ohm

    2006-01-01

    OBJECTIVE: To describe the Funen Neck and Chest Pain (FNCP) study and carry out a comprehensive non-response analysis of the quality of the survey. METHODS: The FNCP questionnaire was sent out to 7000 randomly selected individuals aged 20-71 years living in Funen County, Denmark. A full description...

  17. Anatomy of neck configuration in fission decay

    CERN Document Server

    Patra, S K; Satpathy, L

    2010-01-01

    The anatomy of neck configuration in the fission decay of Uranium and Thorium isotopes is investigated in a microscopic study using Relativistic mean field theory. The study includes $^{236}U$ and $^{232}Th$ in the valley of stability and exotic neutron rich isotopes $^{250}U$, $^{256}U$, $^{260}U$, $^{240}Th$, $^{250}Th$, $^{256}Th$ likely to play important role in the r-process nucleosynthesis in stellar evolution. Following the static fission path, the neck configurations are generated and their composition in terms of the number of neutrons and protons are obtained showing the progressive rise in the neutron component with the increase of mass number. Strong correlation between the neutron multiplicity in the fission decay and the number of neutrons in the neck is seen. The maximum neutron-proton ratio is about 5 for $^{260}$U and $^{256}$Th suggestive of the break down of liquid-drop picture and inhibition of the fission decay in still heavier isotopes. Neck as precursor of a new mode of fission decay li...

  18. Nodular Fasciitis of Neck in Childhood.

    Directory of Open Access Journals (Sweden)

    Saurabh Varshney

    2013-01-01

    Full Text Available Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which is frequently misinterpreted as sarcoma, both clinically and microscopically. It is a reactive lesion composed of fibroblasts/myofibroblasts and most commonly found in extremities and trunk. NF has been described in the head and neck region in 10-20% of cases. Many pathologists do not consider NF in the differential diagnosis of soft tissue masses arising in the Head neck region. NF that occurs in otherwise healthy individuals usually presents with a history of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. It has a confirmed perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is the treatment of choice. A case of NF over the neck in a 05-year-old female not associated with trauma who presented with a localized mass over her left neck is presented.

  19. [Photodynamic therapy for head and neck cancer

    DEFF Research Database (Denmark)

    Lajer, C.B.; Specht, Lena; Kirkegaard, J.

    2006-01-01

    Photodynamic therapy (PDT) is a new treatment for head and neck cancer. The principle of the treatment is a photochemical reaction initiated by light activation of a photosensitizer, which causes the death of the exposed tissue. This article presents the modes of action of PDT and the techniques...

  20. Application of enhanced computed tomography in oral and maxillofacial and cervical multi-space infection%增强CT在口腔颌面颈部多间隙感染中的应用评价

    Institute of Scientific and Technical Information of China (English)

    姜滨; 蔡协艺; 张伟杰; 浦益萍; 杨驰; 王婧; 厉婕嫣

    2013-01-01

    PURPOSE: To summarize the imaging features of enhanced computed tomography of oral and maxillofacial and cervical multi-space infection, and to evaluate the effect of enhanced CT for diagnosis and treatment. METHODS: Two hundred and twenty -seven consecutive cases of oral and maxillofacial and cervical multi -space infection were collected from December 2005 to December 2011, the resource of infection, CT findings, involved space, treatment outcomes and follow-up CT findings were retrospectively analyzed. RESULTS: Odontogenic and gland-borne infection was most frequent, with 167 cases and 33 cases respectively. Infection on enhanced CT showed abscess, gas bubble and cellulitis. Submandibular space was involved most frequently in 145 cases, followed by masticator space in 73 cases, pterygomandibular space in 50 cases and sublingual space in 48 cases; respiratory obstruction was found in 15 cases and descending mediastinitis was found in 11 cases; 214 cases were cured, 8 were lost to follow-up and 5 cases died. CONCLUSION: Enhanced CT should be used as preferred radiographic method of oral and maxillofacial and cervical multi-space infection. It is effective in diagnosis, guiding therapy and evaluating prognosis. Supported by Research Fund of Science and Technology Commission of Shanghai Municipality (08DZ2271100) and Research Fund of Health Bureau of Shanghai Municipality (2012Y046).%目的:总结口腔颌面颈部多间隙感染在增强CT上的影像学特点,并评估其对诊断和治疗的应用价值.方法:收集2005年12月-2011年12月口腔颌面颈部多间隙感染并行增强CT检查的连续病例227例,对其发病原因、CT表现、累及间隙、治疗结果、随访CT表现进行回顾分析.结果:病因多为牙源性和腺源性,分别有167例和33例;CT主要表现为脓肿、气体积聚和蜂窝织炎;下颌下间隙累及频率最高,为145例,其次为咬肌间隙(73例)、翼颌间隙(50例)和舌下间隙(48

  1. Noninvasive analysis of human neck muscle function

    Science.gov (United States)

    Conley, M. S.; Meyer, R. A.; Bloomberg, J. J.; Feeback, D. L.; Dudley, G. A.

    1995-01-01

    STUDY DESIGN. Muscle use evoked by exercise was determined by quantifying shifts in signal relaxation times of T2-weighted magnetic resonance images. Images were collected at rest and after exercise at each of two intensities (moderate and intense) for each of four head movements: 1) extension, 2) flexion, 3) rotation, and 4) lateral flexion. OBJECTIVE. This study examined the intensity and pattern of neck muscle use evoked by various movements of the head. The results will help elucidate the pathophysiology, and thus methods for treating disorders of the cervical musculoskeletal system. SUMMARY OF BACKGROUND DATA. Exercise-induced contrast shifts in T2 has been shown to indicate muscle use during the activity. The noninvasive nature of magnetic resonance imaging appears to make it an ideal approach for studying the function of the complex neuromuscular system of the neck. METHODS. The extent of T2 increase was examined to gauge how intensely nine different neck muscles or muscle pairs were used in seven subjects. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation was assessed to infer the pattern of use among and within individual neck muscles or muscle pairs. RESULTS. Signal relaxation increased with exercise intensity for each head movement. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation also increased with exercise load. Neck muscles or muscle pairs extensively used to perform each head movement were: extension--semispinalis capitis and cervicis and splenius capitis; flexion--sternocleidomastoid and longus capitis and colli; rotation--splenius capitis, levator scapulae, scalenus, semispinalis capitis ipsilateral to the rotation, and sternocleidomastoid contralateral; and lateral flexion--sternocleidomastoid CONCLUSION. The results of this study, in part, agree with the purported functions of neck muscles derived from anatomic location. This also was true for the few

  2. Quantitative Ultrasonic Nakagami Imaging of Neck Fibrosis After Head and Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiaofeng [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Yoshida, Emi [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California (United States); Cassidy, Richard J.; Beitler, Jonathan J.; Yu, David S.; Curran, Walter J. [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: tliu34@emory.edu [Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2015-06-01

    Purpose: To investigate the feasibility of ultrasound Nakagami imaging to quantitatively assess radiation-induced neck fibrosis, a common sequela of radiation therapy (RT) to the head and neck. Methods and Materials: In a pilot study, 40 study participants were enrolled and classified into 3 subgroups: (1) a control group of 12 healthy volunteers; (2) an asymptomatic group of 11 patients who had received intensity modulated RT for head and neck cancer and had experienced no neck fibrosis; and (3) a symptomatic group of 17 post-RT patients with neck fibrosis. Each study participant underwent 1 ultrasound study in which scans were performed in the longitudinal orientation of the bilateral neck. Three Nakagami parameters were calculated to quantify radiation-induced tissue injury: Nakagami probability distribution function, shape, and scaling parameters. Physician-based assessments of the neck fibrosis were performed according to the Radiation Therapy Oncology Group late morbidity scoring scheme, and patient-based fibrosis assessments were rated based on symptoms such as pain and stiffness. Results: Major discrepancies existed between physician-based and patient-based assessments of radiation-induced fibrosis. Significant differences in all Nakagami parameters were observed between the control group and 2 post-RT groups. Moreover, significant differences in Nakagami shape and scaling parameters were observed among asymptomatic and symptomatic groups. Compared with the control group, the average Nakagami shape parameter value increased by 32.1% (P<.001), and the average Nakagami scaling parameter increased by 55.7% (P<.001) for the asymptomatic group, whereas the Nakagami shape parameter increased by 74.1% (P<.001) and the Nakagami scaling parameter increased by 83.5% (P<.001) for the symptomatic group. Conclusions: Ultrasonic Nakagami imaging is a potential quantitative tool to characterize radiation-induced asymptomatic and symptomatic neck fibrosis.

  3. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    OpenAIRE

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how these outcomes compared between patients who had undergone surgery and a control group. Methods. We analyzed physical symptoms, psychological symptoms, and social and functional well-being at least 1...

  4. Are People With Whiplash-Associated Neck Pain Different from People With Nonspecific Neck Pain?

    DEFF Research Database (Denmark)

    Anstey, Ricci; Kongsted, Alice; Kamper, Steven

    2016-01-01

    -specific neck pain. Conclusion People referred to secondary care with WAD were typically more severely affected on self-reported health than those with non-specific neck pain, and also experienced worse outcomes. Caution is required interpreting the longitudinal outcomes due to lower than optimal follow......-up rates. Level of Evidence Prognosis, level 2. J Orthop Sports Phys Ther, Epub 3 Sep 2016. doi:10.2519/jospt.2016.6588....

  5. Why sauropods had long necks; and why giraffes have short necks

    Science.gov (United States)

    Wedel, Mathew J.

    2013-01-01

    The necks of the sauropod dinosaurs reached 15 m in length: six times longer than that of the world record giraffe and five times longer than those of all other terrestrial animals. Several anatomical features enabled this extreme elongation, including: absolutely large body size and quadrupedal stance providing a stable platform for a long neck; a small, light head that did not orally process food; cervical vertebrae that were both numerous and individually elongate; an efficient air-sac-based respiratory system; and distinctive cervical architecture. Relevant features of sauropod cervical vertebrae include: pneumatic chambers that enabled the bone to be positioned in a mechanically efficient way within the envelope; and muscular attachments of varying importance to the neural spines, epipophyses and cervical ribs. Other long-necked tetrapods lacked important features of sauropods, preventing the evolution of longer necks: for example, giraffes have relatively small torsos and large, heavy heads, share the usual mammalian constraint of only seven cervical vertebrae, and lack an air-sac system and pneumatic bones. Among non-sauropods, their saurischian relatives the theropod dinosaurs seem to have been best placed to evolve long necks, and indeed their necks probably surpassed those of giraffes. But 150 million years of evolution did not suffice for them to exceed a relatively modest 2.5 m. PMID:23638372

  6. Are major reductions in new HIV infections possible with people who inject drugs? The case for low dead-space syringes in highly affected countries.

    Science.gov (United States)

    Zule, William A; Cross, Harry E; Stover, John; Pretorius, Carel

    2013-01-01

    Circumstantial evidence from laboratory studies, mathematical models, ecological studies and bio behavioural surveys, suggests that injection-related HIV epidemics may be averted or reversed if people who inject drugs (PWID) switch from using high dead-space to using low dead-space syringes. In laboratory experiments that simulated the injection process and rinsing with water, low dead space syringes retained 1000 times less blood than high dead space syringes. In mathematical models, switching PWID from high dead space to low dead space syringes prevents or reverses injection-related HIV epidemics. No one knows if such an intervention is feasible or what effect it would have on HIV transmission among PWID. Feasibility studies and randomized controlled trials (RCTs) will be needed to answer these questions definitively, but these studies will be very expensive and take years to complete. Rather than waiting for them to be completed, we argue for an approach similar to that used with needle and syringe programs (NSP), which were promoted and implemented before being tested more rigorously. Before implementation, rapid assessments that involve PWID will need to be conducted to ensure buy-in from PWID and other local stakeholders. This commentary summarizes the existing evidence regarding the protective effects of low dead space syringes and estimates potential impacts on HIV transmission; it describes potential barriers to transitioning PWID from high dead space to low dead space needles and syringes; and it presents strategies for overcoming these barriers.

  7. Neurilemmoma of Masseteric Space

    Directory of Open Access Journals (Sweden)

    Admaja K Nair

    2014-01-01

    Full Text Available A neurilemmoma, also called schwannoma, is a benign, encapsulated, slow growing tumor arising from the neural sheath’s Schwann cells of the peripheral, cranial or autonomic nerves. Clinically, a schwannoma is indistinguishable from other benign tumors. The etiology is unknown, there is no gender preference and the tumors occur most commonly between the ages of 20 and 50 years. Approximately 25 to 48% of these tumors occur in the head and neck region, with only 1% occurring in the mouth. The present article reports a case of masseteric space neurilemmoma, which demonstrates a remarkable presentation for this benign neural tumo

  8. An Overview of the Relationship Between Helicobacter Pylori Infection and Otolaryngology Head and Neck Surgery Diseases%幽门螺旋杆菌感染与耳鼻咽喉头颈外科疾病关系研究综述

    Institute of Scientific and Technical Information of China (English)

    杜芬

    2012-01-01

    Helicobacter pylori is closely related to diseases like chronic gastritis and peptic ulcer, but recent studies show that there is also some connection with certain diseases concerning otolaryngology head and neck surgery. This paper begins with the de scription about helicobacter pylori biology, diagnosis, epidemiology and anti helicobacter pylori treatment and comprehensively states the relationship between helicobacter pylori and diseases concerning otolaryngology head and neck surgery in the hope providing a new perspective for the research of diseases connected with otolaryngology head and neck surgery.%幽门螺旋杆菌与慢性胃炎及消化性溃疡密切相关,但最近研究发现与某些耳鼻咽喉头颈外科疾病亦有一定关系。本文从阐述幽门螺旋杆菌的生物学性状、诊断技术、流行病学及抗幽门螺旋杆菌治疗入手,综述了幽门螺旋杆菌与耳鼻咽喉头颈外科疾病的关系,为从系统因素出发研究耳鼻咽喉头颈外科疾病提供新思路。

  9. MRI sequences in head and neck radiology. State of the art

    Energy Technology Data Exchange (ETDEWEB)

    Widmann, Gerlig; Henninger, Benjamin; Kremser, Christian; Jaschke, Werner [Medical Univ. of Innsbruck (Austria). Dept. of Radiology

    2017-05-15

    Magnetic resonance imaging (MRI) has become an essential imaging modality for the evaluation of head and neck pathologies. However, the diagnostic power of MRI is strongly related to the appropriate selection and interpretation of imaging protocols and sequences. The aim of this article is to review state-of-the-art sequences for the clinical routine in head and neck MRI and to describe the evidence for which medical question these sequences and techniques are useful. Literature review of state-of-the-art sequences in head and neck MRI. Basic sequences (T1w, T2w, T1wC+) and fat suppression techniques (TIRM/STIR, Dixon, Spectral Fat sat) are important tools in the diagnostic workup of inflammation, congenital lesions and tumors including staging. Additional sequences (SSFP (CISS, FIESTA), SPACE, VISTA, 3D-FLAIR) are used for pathologies of the cranial nerves, labyrinth and evaluation of endolymphatic hydrops in Meniere's disease. Vessel and perfusion sequences (3D-TOF, TWIST/TRICKS angiography, DCE) are used in vascular contact syndromes, vascular malformations and analysis of microvascular parameters of tissue perfusion. Diffusion-weighted imaging (EPI-DWI, non-EPI-DWI, RESOLVE) is helpful in cholesteatoma imaging, estimation of malignancy, and evaluation of treatment response and posttreatment recurrence in head and neck cancer. Understanding of MRI sequences and close collaboration with referring physicians improves the diagnostic confidence of MRI in the daily routine and drives further research in this fascinating image modality.

  10. Functional cervicothoracic boundary modified by anatomical shifts in the neck of giraffes

    Science.gov (United States)

    Gunji, Megu; Endo, Hideki

    2016-01-01

    Here we examined the kinematic function of the morpho- logically unique first thoracic vertebra in giraffes. The first thoracic vertebra of the giraffe displayed similar shape to the seventh cervical vertebra in general ruminants. The flexion experiment using giraffe carcasses demonstrated that the first thoracic vertebra exhibited a higher dorsoventral mobility than other thoracic vertebrae. Despite the presence of costovertebral joints, restriction in the intervertebral movement imposed by ribs is minimized around the first thoracic vertebra by subtle changes of the articular system between the vertebra and ribs. The attachment area of musculus longus colli, mainly responsible for ventral flexion of the neck, is partly shifted posteriorly in the giraffe so that the force generated by muscles is exerted on the cervical vertebrae and on the first thoracic vertebra. These anatomical modifications allow the first thoracic vertebra to adopt the kinematic function of a cervical vertebra in giraffes. The novel movable articulation in the thorax functions as a fulcrum of neck movement and results in a large displacement of reachable space in the cranial end of the neck. The unique first thoracic vertebra in giraffes provides higher flexibility to the neck and may provide advantages for high browsing and/or male competition behaviours specific to giraffes. PMID:26998330

  11. Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Kilian Kreutzer

    2014-01-01

    Full Text Available Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.

  12. Short Term Effects of Mobilization Techniques on Neck Pain and Deep Neck Flexor Muscle Endurance in Patients with Mechanical Chronic Neck Pain

    Science.gov (United States)

    Kılınç, Hasan Erkan; Harput, Gülcan; Baltacı, Gül; İnce, Deniz İnal

    2014-01-01

    Objectives: The aim of the study was to investigate short term effects of cervical and scapular mobilization techniques on neck pain and deep cervical muscles endurance in chronical mechanical neck pain patients. Methods: 22 chronical mechanic neck pain patients four male 18 female (mean age: mean±sd 35.59± 15.85) were included. Before treatment, neck pain level (visual analog scale) and deep neck flexor muscles endurance (in supine position with digital chronometer) of all patients were evaluated. Cyriax cervical mobilization for 10 minutes and scapular mobilization for 10 repetition 10 sets were performed to patients as treatment protocol. After treatment, 24 hours after and a week after evaluations of neck pain and deep cervical muscles endurance were repeated. Results: Before treatment Neck pain Visual Analog Scale scores was 5.78±1.43 point, 2.80±1.99 point after treatment, 24 hours later 3.36±2.12 point, one week later 3.91±2.24 point. This alteration was found significant statistically (p<0.01). Before treatment deep cervical flexor muscle endurance score was 27.25±17.74 sec, after treatment 39.46±25.20 sec, 24 hours later 38.67±28.43 and one week later 40.11±27.82 sec. This alteration was also found significant statistically (p=0.01). Conclusion: Initially neck pain scores in our subjects decreased quickly, after 24 hours these scores increased but last scores were below first neck pain level in a week follow-up. Deep neck cervical flexor muscles test scores also increased quickly, after 24 hours later this scores were stable along a week. Mobilization techniques are effective methods on neck pain and endurance in chronical mechanic neck pain patients.

  13. Silver nitrate mimicking a foreign body in the pharyngeal mucosal space

    Institute of Scientific and Technical Information of China (English)

    Devon; Livingstone; Yazeed; Alghonaim; Nathan; Jowett; Eyal; Sela; Alex; Mlynarek; Reza; Forghani

    2015-01-01

    Silver nitrate is sometimes used as a means of chemicalcauterization for control of minor bleeding and management of hypergranulation tissue following bedside head and neck procedures. There are only few reports available on the imaging appearance of silver nitrate and its potential to mimic a foreign body. We report a case of a patient presenting with dysphagia, odynophagia, and fever following dental work who had a peritonsillar incision and drainage for treatment of a deep neck space infection. During the procedure, silver nitrate was applied to halt the bleeding. Patient was subsequently transferred to another institution. Since the patient was not showing significant clinical improvement on antibiotic therapy, a computed tomography(CT) scan was performed demonstrating a hyperdense structure lodged in the pharyngeal mucosal space in the oropharynx and soft palate that was mistaken for a foreign body such as bone. Silver nitrate can have density similar to bone but does not have the normal architecture of bone with cortex and marrow on CT. Familiarity with the appearance of silver nitrate on CT, lack of bone architecture, and proper documentation and communication of the use of silver nitrate to the consultant radiologist and medical personnel could help avoid misdiagnosis and potentially unnecessary surgical exploration.

  14. Isolated pulmonic valve endocarditis presenting as neck pain

    Directory of Open Access Journals (Sweden)

    Aditya Goud

    2015-12-01

    Full Text Available We discuss a unique case of a 52-year-old man with no history of intravenous drug use or dental procedures who presented with neck pain, 2 weeks of fevers, chills, night sweats, cough, and dyspnea found to have isolated pulmonic valve (PV endocarditis. The patient did not have an associated murmur, which is commonly seen in right-sided infectious endocarditis. A transthoracic echocardiogram showed a thickened PV leaflet, with subsequent transesophageal echocardiogram showing a PV mass. Speciation of blood cultures revealed Streptococcus oralis. In right-sided infective endocarditis, usually the tricuspid valve is involved; however, in our case the tricuspid valve was free of any mass or vegetation. The patient did meet Duke criteria and was thus started on long-term intravenous antibiotics for infectious endocarditis. The patient's symptoms quickly improved with antibiotics. A careful history and evaluating the patient's risk factors are key in earlier detection of infective endocarditis (IE. Because of early detection and a high index of suspicion, the patient had no further complications and did not require any surgery. In conclusion, clinical suspicion of right-sided IE should be high in patients who present with persistent fevers and pulmonary symptoms in order to reduce the risk of complications, and to improve outcomes.

  15. Paediatric neck masses at a University teaching hospital in northwestern Tanzania: a prospective analysis of 148 cases.

    Science.gov (United States)

    Lucumay, Elibariki M; Gilyoma, Japhet M; Rambau, Peter F; Chalya, Phillipo L

    2014-11-03

    Pediatric neck masses are one of the common surgical conditions presenting to the pediatric surgical wards and clinics in many centers worldwide. There is paucity of published information regarding pediatric neck masses in Tanzania and the study area in particular. This study determines the etiology, clinico-histopathological patterns and treatment outcome of pediatric neck masses and to identify predictors of outcome in our local setting. This was a prospective cross-sectional hospital based study done in children aged ten years and below with neck masses for a five months period. Statistical data analysis was done using SPSS version 17.0. A total of 148 patients were studied. Their ages ranged from 2 months to 10 years (median 3 years). The male to female ratio was 2.5:1. Inflammatory lesions were the most frequent cause of neck masses accounting for 43.9% of cases. The median duration of illness was 2 years. Except for the neck mass, 72 (48.6%) of the children had clinically stable health condition on presentation. The posterior triangle was commonly involved in 118 (79.7%) patients. eight (5.4%) were HIV positive. The majority of patients (95.9%) were treated surgically. Postoperative complication rate was 30.4% and surgical site infection was the most frequent complication in 37.5% of cases. The median length of hospital stay was 10 days and was significantly longer in patients with malignant masses and those with surgical site infection (p <0.001). The overall mortality rate in this study was 8.1% and it was significantly associated with malignant masses, associated pre-existing illness, late presentation, HIV positivity, low CD 4 count, high ASA class and presence of surgical site infections (p <0.001). The outcome of patients on discharge was excellent as more than 90% of patients were successfully treated and discharged well. Pediatric neck masses are among the most common causes of paediatric surgical admissions and pose a diagnostic and therapeutic

  16. Acute neck pain in the ED: Consider longus colli calcific tendinitis vs meningitis.

    Science.gov (United States)

    Patel, Tyag K; Weis, James C

    2017-06-01

    Presented here is a rare cause of severe neck pain - acute longus colli calcific tendinitis - in a 54year old man who presented to the emergency department. The neck pain is due to inflammation caused by calcium hydroxyapatite crystal deposition in the tendons on the longus colli muscles. This is non-infectious. The gold standard for diagnosis is a CT neck which best shows the calcifications in the anterior vertebral column of C1-C4, where the tendons of these muscles insert bilaterally. Longus colli calcific tendinitis is not life-threatening and patients will make a full recovery after treatment with NSAIDs. However, this condition is often confused with life-threatening conditions such as infection (meningitis or retropharyngeal abscess), intracranial hemorrhage, trauma, herniation of cervical discs, or malignancy (Estimable et al. (2015) [1]). Symptoms associated with calcific tendinitis of the longus colli muscle are non-specific and include mild fever, moderate-severe headache, neck pain, and drastically reduced range of motion of the neck. More specific symptoms are the presence of dysphagia and odynophagia. Lab findings usually are significant for mild leukocytosis, and elevated ESR and CRP. Awareness of this condition by E.D. physicians can avoid unnecessary invasive interventions, increased costs, and delays that result from incorrect diagnosis and treatment. This is a unique case in which a patient who was afebrile with a normal ESR was worked up for meningitis and an intracranial process, and also empirically treated for meningitis before finally being diagnosed with acute calcific tendinitis of the longus colli muscle in the E.D. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  18. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  19. Human papillomavirus infections in laryngeal cancer

    NARCIS (Netherlands)

    Torrente, M.C.; Rodrigo, J.P.; Haigentz Jr., M.; Dikkers, F.G.; Rinaldo, A.; Takes, R.P.; Olofsson, J.; Ferlito, A.

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we revie

  20. Human papillomavirus infections in laryngeal cancer

    NARCIS (Netherlands)

    Torrente, M.C.; Rodrigo, J.P.; Haigentz Jr., M.; Dikkers, F.G.; Rinaldo, A.; Takes, R.P.; Olofsson, J.; Ferlito, A.

    2011-01-01

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we

  1. HUMAN PAPILLOMAVIRUS INFECTIONS IN LARYNGEAL CANCER

    NARCIS (Netherlands)

    Torrente, Mariela C.; Rodrigo, Juan P.; Haigentz, Missak; Dikkers, Frederik G.; Rinaldo, Alessandra; Takes, Robert P.; Olofsson, Jan; Ferlito, Alfio

    Although the association and clinical significance of human papillomavirus (HPV) infections with a subset of head and neck cancers, particularly for oropharyngeal carcinoma, has recently been well documented, the involvement of HPV in laryngeal cancer has been inadequately evaluated. Herein we

  2. Atlanto-axial infection after acupuncture.

    Science.gov (United States)

    Robinson, A; Lind, C R P; Smith, R J; Kodali, V

    2015-12-11

    A 67-year-old man presented with neck cellulitis following acupuncture for cervical spondylosis. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. Increased neck pain and bacteraemia prompted MRI, which showed atlanto-axial septic arthritis without signs of infection of the tissues between the superficial cellulitic area and the atlanto-axial joint, thus making direct extension of infection unlikely. It is more likely that haematogenous spread of infection resulted in seeding in the atlanto-axial joint, with the proximity of the arthritis and acupuncture site being coincidental. Acupuncture is a treatment option for some indolent pain conditions. As such, acupuncture services are likely to be more frequently utilised. A history of acupuncture is rarely requested by the admitting doctor and seldom offered voluntarily by the patient, especially where the site of infection due to haematogenous spread is distant from the needling location. Awareness of infectious complications following acupuncture can reduce morbidity through early intervention.

  3. How common is hypothyroidism after external radiotherapy to neck in head and neck cancer patients?

    Directory of Open Access Journals (Sweden)

    Nirmala Srikantia

    2011-01-01

    Full Text Available Purpose: To identify the occurrence of clinical and subclinical hypothyroidism among head and neck cancer patients receiving radiation to the neck and to justify routine performing of thyroid function tests during follow-up. Materials and Methods: This is a prospective nonrandomized study of 45 patients of head and neck cancer, receiving radiotherapy (RT. Thyroid stimulating hormone and T4 estimations were done at baseline and at 4 months and 9 months following RT. Results: Of the 45 patients, 37(82.2 % were males and eight (17.8 % were females. All patients received radiation to the neck to a dose of >40Gy. 35.6% received concurrent chemotherapy. Two patients underwent prior neck dissection. Fourteen patients (31.1% were found to have clinical hypothyroidism (P value of 0.01. Five (11.1% patients were found to have subclinical hypothyroidism with a total 19 of 45 (42.2% patients developing radiation-induced hypothyroidism. Nine of 14 patients with clinical hypothyroidism were in the age group of 51 to 60 years (P=0.0522. Five of 16 patients who received chemoradiation and nine of 29 who received RT alone developed clinical hypothyroidism. Above 40 Gy radiation dose was not a relevant risk factor for hypothyroidism. Conclusion: Hypothyroidism (clinical or subclinical is an under-recognized morbidity of external radiation to the neck which is seen following a minimum dose of 40 Gy to neck. Recognizing hypothyroidism (clinical or subclinical early and treating it prevents associated complications. Hence, thyroid function tests should be made routine during follow-up.

  4. Radiotherapy complications and their possible management in the head and neck region

    Directory of Open Access Journals (Sweden)

    Pankaj Agarwal

    2012-01-01

    Full Text Available Oral complications from radiation to the head and neck or chemotherapy for any malignancy can compromise patients′ health and quality of life and affect their ability to complete planned cancer treatment. For some patients the complications can be so debilitating that they may tolerate only lower doses of therapy, postpone scheduled treatments, or discontinue treatment entirely. Oral complications can also lead to serious systemic infections. Medically necessary oral care before, during, and after cancer treatment can prevent or reduce the incidence and severity of oral complications, enhancing both patient survival and quality of life. In the present article we present an overview of oral complications, and their possible management, after radiation therapy in the head-and-neck region.

  5. Hidradenitis suppurativa presenting with a posterior neck mass: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Young; Jeon, Min Hee; Bae, Il Heon; Han, Gi Seok; Cha, Sang Hoo; Kim, Sung Jin; Park, Kil Sun [Chungbuk National University Hospital, Cheongju (Korea, Republic of)

    2007-06-15

    Hidradenitis suppurativa is a rare disorder that is characterized by recurrent chronic skin infections and the formation of sinus tracts and considerable scaring. A 37-year-old man presented with a hard posterior neck mass. Multiple pus-producing sinuses were detected in the skin covering the mass. MRI demonstrated an ill-defined, soft tissue mass with multiple variable sized cystic lesions. The soft tissue mass measured 12 x 10 x 4 cm in the subcutaneous fat layer, it contained multifocal cystic lesions that revealed higher signal intensity on both the T1-and T2-weighted images, as compared with the adjacent neck muscles. The mass was not enhanced on the post-contrast T1 weighted images. Some of the cystic lesions extended to the skin. The mass was removed surgically and confirmed to be hidradenitis suppurativa.

  6. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-12-15

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

  7. Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber's Glands Infection?

    Science.gov (United States)

    Klug, Tejs Ehlers; Rusan, Maria; Fuursted, Kurt; Ovesen, Therese

    2016-08-01

    To review the literature concerning the 2 primary hypotheses put forth to explain the pathogenesis of peritonsillar abscess: "the acute tonsillitis hypothesis" (peritonsillar abscess is a complication of acute tonsillitis) and "the Weber gland hypothesis" (peritonsillar abscess is an infection of Weber's glands). PubMed, EMBASE. Data supporting or negating one hypothesis or the other were elicited from the literature. Several findings support the acute tonsillitis hypothesis. First, the 2 main pathogens in peritonsillar abscess have been recovered from pus aspirates and bilateral tonsillar tissues with high concordance rates, suggesting that both tonsils are infected in patients with peritonsillar abscess. Second, studies report signs of acute tonsillitis in the days prior to and at the time of peritonsillar abscess. Third, antibiotic treatment reduces the risk of abscess development in patients with acute tonsillitis. However, some findings suggest involvement of the Weber's glands in peritonsillar abscess pathogenesis. First, high amylase levels have been found in peritonsillar pus. Second, the majority of peritonsillar abscesses are located at the superior tonsillar pole in proximity of the Weber's glands. We propose a unified hypothesis whereby bacteria initially infect the tonsillar mucosa and spread via the salivary duct system to the peritonsillar space, where an abscess is formed. Our findings support the rationale for antibiotic treatment of patients with severe acute tonsillitis to reduce the risk of abscess development. Improved understanding of peritonsillar abscess pathogenesis is important for the development of efficient prevention strategies. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  8. Role of infectious agents in the carcinogenesis of brain and head and neck cancers

    Directory of Open Access Journals (Sweden)

    Alibek Kenneth

    2013-02-01

    Full Text Available Abstract This review concentrates on tumours that are anatomically localised in head and neck regions. Brain cancers and head and neck cancers together account for more than 873,000 cases annually worldwide, with an increasing incidence each year. With poor survival rates at late stages, brain and head and neck cancers represent serious conditions. Carcinogenesis is a multi-step process and the role of infectious agents in this progression has not been fully identified. A major problem with such research is that the role of many infectious agents may be underestimated due to the lack of or inconsistency in experimental data obtained globally. In the case of brain cancer, no infection has been accepted as directly oncogenic, although a number of viruses and parasites are associated with the malignancy. Our analysis of the literature showed the presence of human cytomegalovirus (HCMV in distinct types of brain tumour, namely glioblastoma multiforme (GBM and medulloblastoma. In particular, there are reports of viral protein in up to 100% of GBM specimens. Several epidemiological studies reported associations of brain cancer and toxoplasmosis seropositivity. In head and neck cancers, there is a distinct correlation between Epstein-Barr virus (EBV and nasopharyngeal carcinoma (NPC. Considering that almost every undifferentiated NPC is EBV-positive, virus titer levels can be measured to screen high-risk populations. In addition there is an apparent association between human papilloma virus (HPV and head and neck squamous cell carcinoma (HNSCC; specifically, 26% of HNSCCs are positive for HPV. HPV type 16 was the most common type detected in HNSCCs (90% and its dominance is even greater than that reported in cervical carcinoma. Although there are many studies showing an association of infectious agents with cancer, with various levels of involvement and either a direct or indirect causative effect, there is a scarcity of articles covering the role of

  9. Complications in head and neck surgery.

    Science.gov (United States)

    Christison-Lagay, Emily

    2016-12-01

    Head and neck anatomy is topographically complex and the region is densely populated by vital nerves and vascular and lymphatic structures. Injury to many of these structures is associated with significant morbidity and may even be fatal. A thorough knowledge of regional anatomy is imperative and complications need to be managed in a thoughtful directed manner. The pediatric surgeon may be called upon to address both congenital and acquired conditions and should be prepared to encounter reoperative fields after failed initial surgery. This review summarizes the current literature on four frequently encountered surgical conditions of the head and neck: branchial cleft anomalies, thyroglossal duct cyst, thyroid disease, and lymphatic malformations, with a focus on the prevention and treatment of complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Cutaneous angiosarcoma of head and neck

    Directory of Open Access Journals (Sweden)

    Rita Vora

    2014-01-01

    Full Text Available Cutaneous angiosarcoma is a rare aggressive tumor of capillary and lymphatic endothelial cell origin. Cutaneous angiosarcoma of the head and neck regions seems to be a distinctive neoplasm with characteristic clinicopathologic features that differ from angiosarcoma in other anatomic locations. Angiosarcoma, regardless of their setting, has a bad prognosis. We presented here a case of 80 years old male, with multiple nontender grouped purple to red hemorrhagic vesicular and bullous lesions over left lower cheek and upper neck area, with bilateral cervical lymph nodes since 1 month. Computed tomography thorax showed nodular opacities in the right upper and midzones. Excisional biopsy showed characterstic "dissection of collagen" with mild nuclear atypia. Immunohistochemistry showed tumor cell positive for CD-31 and Fli-1. Patient died within 1 month of presentation.

  11. Hidden Beauty in Twisted Viking Neck Rings

    CERN Document Server

    Olsen, Kasper

    2010-01-01

    Many hoards found in Ireland, Scotland, Orkney Islands, and Scandinavia demonstrate the vikings ability to fabricate beautiful arm and neck rings of twisted silver and gold rods. Characteristic for such rings is the uniform appearance of the twisted pattern along the length of the arm ring, as well as from one arm ring to another, also when found at distant geographical locations. How can the appearance of the twisted wires be so perfectly repetitive? We demonstrate that the answer is that the vikings utilized a self-forming motif: The pattern arises from a twisting of the wires to a maximally rotated configuration. That is why the twist patterns in these arm and neck rings are beautiful, repetitive, and universal.

  12. Spine neck plasticity regulates compartmentalization of synapses.

    Science.gov (United States)

    Tønnesen, Jan; Katona, Gergely; Rózsa, Balázs; Nägerl, U Valentin

    2014-05-01

    Dendritic spines have been proposed to transform synaptic signals through chemical and electrical compartmentalization. However, the quantitative contribution of spine morphology to synapse compartmentalization and its dynamic regulation are still poorly understood. We used time-lapse super-resolution stimulated emission depletion (STED) imaging in combination with fluorescence recovery after photobleaching (FRAP) measurements, two-photon glutamate uncaging, electrophysiology and simulations to investigate the dynamic link between nanoscale anatomy and compartmentalization in live spines of CA1 neurons in mouse brain slices. We report a diversity of spine morphologies that argues against common categorization schemes and establish a close link between compartmentalization and spine morphology, wherein spine neck width is the most critical morphological parameter. We demonstrate that spine necks are plastic structures that become wider and shorter after long-term potentiation. These morphological changes are predicted to lead to a substantial drop in spine head excitatory postsynaptic potential (EPSP) while preserving overall biochemical compartmentalization.

  13. SBRT for recurrent head and neck cancer

    Science.gov (United States)

    Garg, M.; Kabarriti, R.; Baliga, S.; Guha, C.; Tome, W.; Kalnicki, S.

    2017-01-01

    The management of patients with recurrent head and neck cancers is complex. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab.

  14. Malnutrition associated with head and neck cancers

    Directory of Open Access Journals (Sweden)

    Sharifeh Haghjoo

    2015-01-01

    Full Text Available Cancerous patients, under the chemotherapy or radiotherapy, are at high risk of malnutrition due to the associated complications with the treatment procedures such as chewing problems, dysphagia, nausea etc. Considering the patients’ history of alcohol consumption, smoking or any other diseases and performing several physical examinations are essential in early identification of high-risk patients for nutritional complications, losing unintentional weight and fat free mass. In this review, we tried to briefly explain the risk of malnutrition in patients with head and neck cancers who are undergoing surgery, chemotherapy and radiotherapy. Oral nutrition, nasogastric tube and percutaneous endoscopic gastrostomy  are different methods of nutritional interventions, which have been compared due to their efficacy in maintaining the patients’ weight. In this study, we reviewed the results obtained in clinical trials about the efficacy of intense nutritional intervention on limiting the chemoradiotherapy-associated complications in patients with head and neck cancers.

  15. What is normal bladder neck anatomy?

    Science.gov (United States)

    Naranjo-Ortiz, Cristina; Shek, Ka Lai; Martin, Andrew James; Dietz, Hans Peter

    2016-06-01

    Functional anatomy of the bladder neck and proximal urethra has been studied extensively because of the belief that it is important for urinary continence. The aim of this study was to explore the limits of normality for pelvic floor ultrasound parameters of bladder neck and urethral mobility associated with stress urinary incontinence (SUI) and urodynamic stress incontinence (USI). A retrospective study was conducted on 589 women seen for urodynamic testing in a tertiary urogynaecology clinic. All women were assessed following a protocol including interview, clinical examination, flowmetry, urodynamic testing and 4D pelvic floor ultrasound. Volume data sets were analysed offline to assess for bladder neck descent (BND), urethral rotation and the retrovesical angle (RVA) on maximal Valsalva. After excluding women with previous incontinence or prolapse surgery, 429 datasets were available. SI was significantly associated with the RVA (p = 0.033) and BND (p = 0.036); USI was associated with urethral rotation (p = 0.021) and BND (p < 0.001). On multivariate logistic regression analysis, controlling for confounders including age, BMI, parity, previous hysterectomy and maximal urethral pressure, the association between SUI and BND remained significant (OR [per 10 mm] = 1.23; 95 % CI: 1.01 to 1.51; p = 0.043), as did the association between USI and BND (OR [per 10 mm] = 1.58; 95 % CI: 1.3 to 1.91; p < 0.001). ROC statistics for BND suggested a cut-off of 25 mm in describing the limit of normality. Measures of functional bladder neck anatomy are weakly associated with SUI and USI (with association between BND and USI being the strongest). It is suggested that a BND of 25 mm or higher be defined as abnormal ("hypermobile") on the basis of its association with USI.

  16. Cutaneous Angiosarcoma of Head and Neck

    OpenAIRE

    Rita Vora; Gopikrishnan Anjaneyan; Rajat Gupta

    2014-01-01

    Cutaneous angiosarcoma is a rare aggressive tumor of capillary and lymphatic endothelial cell origin. Cutaneous angiosarcoma of the head and neck regions seems to be a distinctive neoplasm with characteristic clinicopathologic features that differ from angiosarcoma in other anatomic locations. Angiosarcoma, regardless of their setting, has a bad prognosis. We presented here a case of 80 years old male, with multiple nontender grouped purple to red hemorrhagic vesicular and bullous lesions ove...

  17. Skin Cancer of the Head and Neck

    OpenAIRE

    Ouyang, Yun-Hsuan

    2010-01-01

    The majority of skin cancers of the head and neck are nonmelanoma skin cancers (NMSC). Basal cell carcinoma and squamous cell carcinoma are the most frequent types of NMSC. Malignant melanoma is an aggressive neoplasm of skin, and the ideal adjuvant therapy has not yet been found, although various options for treatment of skin cancer are available to the patient and physician, allowing high cure rate and excellent functional and cosmetic outcomes. Sunscreen protection and early evaluation of ...

  18. The Indications and Clinical Curative Effects of Modified Neck Dissection in Head and Neck Cancers

    Institute of Scientific and Technical Information of China (English)

    GuohaoWu; WeiweiUu; FujinChen; ZongyuanZeng; HaoLi; MingSong; MaowenWei; QuanZhang; AnkuiYang; WenkuanChen

    2004-01-01

    OBJECTIVE Functional neck dissection was first described by Bocca and Pignataro in 1967. It has been used in clinical practice for years, but remains controversial among neck-surgery experts. This study was designed to evaluate indications and curative effects of functional-neck dissection (FND). METHODS One hundred and fifty-two cases which underwent FND were reviewed with an analysis of pathological specimens and follow-up datas. RESULTS The series of FND included 20 cases of tongue carcinoma, 23 cases of larynx carcinoma, 96 cases of thyroid papillary adenocarcinoma, 9 cases of follicular adenocarcinoma and 4 cases of medullary adenocarcinoma; the five-year recurrence rate for tongue carcinoma was 12.5%, 14.3%, 40.0% and for a larynx carcinoma was 20.0%, 16.7%, 50.0% in N0 stage, N1 stage, N2a stage, respectively. The 5-year recurrence rate of thyroid papillary adenocarcinoma was 6.5%, 7.1% in N1a, N1b, respectively. CONCLUSION Functional neck dissection is indicated in early and low malignant head and neck neoplasms and results in satisfactory curative effects.

  19. Effects of neck exercise on high-school students' neck-shoulder posture.

    Science.gov (United States)

    Lee, Myoung-Hyo; Park, Su-Jin; Kim, Jin-Sang

    2013-05-01

    [Purpose] This study examined the effects of deep flexor muscle-strengthening exercise on the neck-shoulder posture, and the strength and endurance of the deep flexor muscles of high-school students. [Subjects] The subjects were 30 seventeen-year-old female high-school students who complained about bad posture and chronic neck-shoulder pain. They were randomly divided into an experimental group of 15 subjects, who performed a deep flexor muscle-strengthening exercise and a control group of 15 subjects, who performed a basic stretching exercise. [Methods] The experimental group of 15 subjects performed a deep flexor muscle-strengthening exercise consisting of low-load training of the cranio-cervical flexor muscle, and the control group of 15 subjects performed a basic stretching exercise consisting of seven motions. [Results] The experimental group showed statistically significant changes in head tilt angle, neck flexion angle, forward shoulder angle, and the result of the cranio-cervical flexion test after the training. In contrast, the control group showed no statistically significant changes in these measures following the training. When the results of the groups were compared, statistically significant differences were found for all items between the experimental group and the control group. [Conclusion] Strengthening cranio-cervical flexor muscles is important for the adjustment of neck posture, and maintaining their stability is required to improve neck-shoulder posture.

  20. Accessible or Inaccessible? Diagnostic Efficacy of CT-Guided Core Biopsies of Head and Neck Masses

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, Jane D., E-mail: janecunningham0708@gmail.com; McCusker, Mark W.; Power, Sarah; PearlyTi, Joanna; Thornton, John; Brennan, Paul; Lee, Michael J.; O’Hare, Alan; Looby, Seamus [Beaumont Hospital, Department of Radiology (Ireland)

    2015-04-15

    PurposeTissue sampling of lesions in the head and neck is challenging due to complex regional anatomy and sometimes necessitates open surgical biopsy. However, many patients are poor surgical candidates due to comorbidity. Thus, we evaluated the use of CT guidance for establishing histopathological diagnosis of head and neck masses.MethodsAll consecutive patients (n = 22) who underwent CT-guided core biopsy of head or neck masses between April 2009 and August 2012 were retrospectively reviewed using the departmental CT interventional procedures database. The indication for each biopsy performed was to establish or exclude a diagnosis of neoplasia in patients with suspicious head or neck lesions found on clinical examination or imaging studies. Patients received conscious sedation and 18 G, semiautomated core needle biopsies were performed by experienced neuroradiologists using 16-slice multidetector row CT imaging guidance (Somatom Definition Siemens Medical Solutions, Germany). Histopathology results of each biopsy were analysed.ResultsSixteen of 22 biopsies that were performed (73 %) yielded a pathological diagnosis. Anatomic locations biopsied included: masticator (n = 7), parapharyngeal (n = 3), parotid (n = 3), carotid (n = 3), perivertebral (n = 3), pharyngeal (n = 2), and retropharyngeal (n = 1) spaces. Six biopsies (27 %) were nondiagnostic due to inadequate tissue sampling, particularly small biopsy sample size and failure to biopsy the true sampling site due to extensive necrosis. No major complications were encountered.ConclusionsThe use of CT guidance to perform core biopsies of head and neck masses is an effective means of establishing histopathological diagnosis and reduces the need for diagnostic open surgical biopsy and general anaesthesia.

  1. Quality of life and neck pain in nurses

    Directory of Open Access Journals (Sweden)

    Lucy Joslin

    2014-04-01

    Full Text Available Objectives: To investigate the association between neck pain and psychological stress in nurses. Material and Methods: Nurses from the Avon Orthopaedic Centre completed 2 questionnaires: the Short Form-36 (SF-36 and 1 exploring neck pain and associated psychological stress. Results: Thirty four nurses entered the study (68% response. Twelve (35.3% had current neck pain, 13 (38.2% reported neck pain within the past year and 9 (26.5% had no neck pain. Subjects with current neck pain had significantly lower mental health (47.1 vs. 70.4; p = 0.002, physical health (60.8 vs. 76.8; p = 0.010 and overall SF-36 scores (56.8 vs. 74.9; p = 0.003. Five (41.7% subjects with current neck pain and 5 (38.5% subjects with neck pain in the previous year attributed it to psychological stress. Conclusions: Over 1/3 of nurses have symptomatic neck pain and significantly lower mental and physical health scores. Managing psychological stress may reduce neck pain, leading to improved quality of life for nurses, financial benefits for the NHS, and improved patient care.

  2. ASCO highlights podcast: head and neck cancers.

    Science.gov (United States)

    Merlano, Marco

    2016-01-01

    A critical review of the head and neck cancer research highlights of the American Society of Clinical Oncology (ASCO) meeting 2016, held in June 2016 in Chicago, is presented in this podcast. Considering the most interesting and practice-changing trials reported at the meeting, the key trial comparing gemcitabine plus cisplatin against 5-FU (5-fluorouracil) plus cisplatin in the treatment of nasopharyngeal carcinoma is highlighted. The GORTEC2007-02 trial comparing induction docetaxel/platinum/5-FU followed by cetuximab-radiotherapy against concurrent chemo-radiotherapy for N2b/c-N3 non operated stage III-IV squamous cell cancer of the head and neck is also discussed. An overview of the research reported using immunotherapy in head and neck cancer is also given, considering maturing data and particularly in relapsing patients, where response rates, though low, are better than with current therapies, and the responses are long lasting. Future developments are also considered, again with a focus on immunotherapy, but also considering combination with radiotherapy and chemoradiation.

  3. Experimental Injury Biomechanics of the Pediatric Neck

    Science.gov (United States)

    Nightingale, Roger W.; Luck, Jason F.

    Motor vehicle related crashes rank as the most common cause of spinal related injuries in the pediatric population (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Eleraky et al. 2000; Hamilton and Myles 1992a; Bonadio 1993; Babcock 1975). Pediatric spinal related trauma accounts for between 1 and 12 % of all spinal related injuries (Hamilton and Myles 1992a; Hadley et al. 1988; Aufdermaur 1974). Cervical spine trauma in children accounts for approximately 2 % of all cervical spinal injuries (Henrys et al. 1977). Approximately 1-2 % of all children admitted for traumatic injury are related to injuries to the cervical spine (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Orenstein et al. 1994; Rachesky et al. 1987). Overall, pediatric neck injury rates are significantly lower than adult rates; however, the neck injury rate in children between the ages of 11 and 15 years approaches the adult rate of 18.8 per 100,000 (McGrory et al 1993; Myers and Winkelstein 1995). For children less than 11 years of age, neck injuries are relatively rare (1.2 per 100,000), but have particularly devastating consequences (McGrory et al. 1993). The overall mortality rate amongst victims of pediatric spinal trauma is approximately 16-41 % but considerably higher for the youngest ages (Platzer et al. 2007; Brown et al. 2001; Kokoska et al. 2001; Eleraky et al. 2000; Givens et al. 1996; Orenstein et al. 1994; Hamilton and Myles 1992b).

  4. MR imaging of solitary fibrous tumors in the head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jeong [The Catholic University, Daejeon (Korea, Republic of); Lee, Ho Kyu; Shin, Ji Hoon; Lee, Jeong Hyun [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Seo, Jeong Jin [Chonnam National University Medical School, Kwangju (Korea, Republic of); Kim, Hyung Jim [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Jeong, Ae Kyung [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2005-09-15

    Solitary fibrous tumor (SFT) is a very rare tumor. The purpose of this study is to determine the MR imaging features of SFT in the intracranial and extracranial head and neck regions. We retrospectively reviewed six MR images and two CT images of six histologically proven cases of SFT that occurred in four men and two women, and their ages ranged from 46 to 59 years. These imaging findings were correlated with the microscopic findings of their surgical specimens. Six SFTs arose in the meninges (the petrous ridge and the pituitary fossa), the parotid gland, the parapharyngeal space, the buccal space and the maxillary sinus. On the MR images, SFTs in the intracranial and extracranial head and neck regions were mostly isointense to the muscle on the T1-weighted images, they were hyperintense on the T2-weighted images and they all had intense enhancement. On the T1- and T2-weighted images, hypointense lines were observed within in five SFTs. On the CT images, the SFTs were hypodense to the muscle on the unenhanced images and they were heterogeneously enhanced on the contrast-enhanced images. An exceptional case of pituitary SFT was hypointense on the T2-weighted images and it was hyperdense on the unenhanced CT images, which correlated with the increased collagenous component and the cellular compactness. The imaging features of SFT are nonspecific; however, SFT should be included in the differential diagnosis of masses involving the intracranial and extracranial head and neck regions.

  5. Spinal infections

    Energy Technology Data Exchange (ETDEWEB)

    Tali, E. Turgut E-mail: turguttali@gazi.edu.tr

    2004-05-01

    Spinal infections can be thought of as a spectrum of disease comprising spondylitis, discitis, spondylodiscitis, pyogenic facet arthropathy, epidural infections, meningitis, polyradiculopathy and myelitis. Radiological evaluations have gained importance in the diagnosis, treatment planning, treatment and treatment monitoring of the spinal infections. Conventional radiographs are usually the initial imaging study. The sensitivity and specificity of the plain radiographs are very low. The sensitivity of CT is higher while it lacks of specificity. Conventional CT has played minor role for the diagnosis of early spondylitis and disc space infection and for follow-up, researches are going on the value of MDCT. MRI is as sensitive, specific and accurate as combined nuclear medicine studies and the method of choice for the spondylitis. Low signal areas of the vertebral body, loss of definition of the end plates and interruption of the cortical continuity, destruction of the cortical margins are typical on T1WI whereas high signal of affected areas of the vertebral body and disc is typical on T2WI. Contrast is mandatory and increases conspicuity, specificity, and observer confidence in the diagnosis and facilitates the treatment planning. Contrast enhancement is the earliest sign and pathognomonic in the acute inflammatory episode and even in the subtle infection then persists to a varying degree for several weeks or months. The outcome of the treatment is influenced by the type of infection and by the degree of neurologic compromise before treatment. There is an increasing move away from surgical intervention towards conservative therapy, percutaneous drainage of abscess or both. It is therefore critical to monitor treatment response, particularly in the immuno-deficient population.

  6. Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Koc, M.; Aktas, E. [Ataturk Univ., Erzurum (Turkey). Medical School

    2003-02-01

    Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

  7. Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

    NARCIS (Netherlands)

    Wilgen, Cornelis Paul van

    2004-01-01

    In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain

  8. Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

    NARCIS (Netherlands)

    Wilgen, Cornelis Paul van

    2004-01-01

    In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain me

  9. Spatial and taxonomical overlap of fungi on phylloplanes and invasive alien ladybirds with fungal infections in tree crowns of urban green spaces

    DEFF Research Database (Denmark)

    Howe, Andrew Gordon; Ravn, Hans Peter; Jensen, Annette Bruun

    2016-01-01

    Occurrence of entomopathogenic fungi on phylloplanes in Tilia x europaea crowns between 1 - 13m was assessed in urban parks. Prevalence of fungal infections in ladybirds (Coleoptera: Coccinellidae) collected from T. x europaea was assessed to determine whether fungi found on phylloplanes also...

  10. UNILATERAL BIG HOCKEY STICK INCISION FOR NECK DISSECTION IN HEAD AND NECK CARCINOMA

    Institute of Scientific and Technical Information of China (English)

    刘宝国; 赵振生; 李明强; 陈荣鋭; 王建军; 张乃嵩

    2004-01-01

    Objective: To investigate for the feasibility and advantages performed by the unilateral big hockey stick incision (BHSI) in head and neck carcinoma. Methods: Neck dissection by using the unilateral big hockey stick incision (BHSI) was performed on 93 patients with head and neck carcinoma. Results: The big hockey stick incision has a cosmetic scar and not scar contraction and is barely visible and easily covered in hair and clothing; sufficient exposure of the operation field; a small area of marginal necrosis was occasionally seen at the apex of the skin flap due to having preoperative radiotherapy. Conclusion: The unilateral big hockey stick incision has adequate surgical access, good healing of skin flaps, and a good cosmetic result.

  11. Fibular grafting with cannulated hip screw fixation in late femoral neck fracture in young adults

    Directory of Open Access Journals (Sweden)

    Goyal R

    2006-01-01

    Full Text Available Background: We reviewed the operative results of fibular bone graft with cannulated hip screw fixation in femoral neck fracture in young adults. Method: Sixteen young adults with femoral neck fracture were treated by fibular bone graft with cannulated hip screw fixation. All the fractures were more than 3 weeks old. Results: Results were assessed in 15 patients while one patient died due to complications not related to surgery. Union occurred in all 15 patients. One patient had intra-operative complication in the form of screw cut out with graft in the joint space. The average fallow up was 24.4 months. Out of 15 patients assessed clinico-radiologically 11 showed good results, 3 had fair while 1 had poor result. Conclusion: We conclude that this is a simple and cost effective procedure for late femoral fleck fracture in young adults with good results.

  12. microRNA evaluation of unknown primary lesions in the head and neck

    Directory of Open Access Journals (Sweden)

    Xu Wei

    2009-12-01

    Full Text Available Abstract Unknown primary malignancy in the head and neck is not an infrequent diagnosis for patients with metastatic cervical lymph nodes. Although linked with a relatively good prognosis following radiation treatment, widespread radiation is coupled with significant morbidity. Altered microRNA (miRNA expression has been associated with both cancer progression and metastasis. We sought to determine whether miRNA expression analysis could be used as a diagnostic tool to discover the primary site of malignancy, within the head and neck. We used quantitative real-time PCR to identify miRNA expression profiles of squamous cell carcinoma of the tonsil, base of tongue and post-nasal space, as well as their corresponding metastatic lymph nodes, from 6 patients. Our results revealed that each cancer maintained its expression profile between the primary site and the nodal metastasis (r = 0.82, p

  13. Rejuvenation of the neck with liposuction and ancillary techniques.

    Science.gov (United States)

    Stebbins, William G; Hanke, C William

    2011-01-01

    An aesthetically pleasing neck is an important component of physical appearance and a frequently targeted area for a variety of rejuvenative procedures. In appropriately selected patients, liposuction of the neck using tumescent local anesthesia can effectively render a more youthful appearance to the anterior and lateral neck by removing superficial adipose tissue and redraping the skin. This article will review all aspects of neck liposuction, including neck and lower face anatomy, proper patient selection and evaluation, necessary equipment, as well as all peri-procedural management. An in-depth discussion of administration of tumescent local anesthesia and proper liposuction technique is also included. Lastly, a number of ancillary techniques to further enhance the appearance of the neck including laser lipolysis, fractional ablative CO(2) resurfacing, and treatment of platysmal banding will be briefly discussed. © 2011 Wiley Periodicals, Inc.

  14. ASSESSMENT OF RELATIONSHIP BETWEEN NECK SHAFT ANGLE AND NECK LENGTH WITH INTEREPICONDYLAR DISTANCE IN FEMUR

    Directory of Open Access Journals (Sweden)

    Ishita Ghosh

    2015-12-01

    Full Text Available Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°-known as angle of inclination or neck shaft angle (NSA; this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side are: - a Neck shaft angle of femur, b Neck length of femur, c Neck circumference of femur, d Inter-epicondylar distance of femur, e Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s. Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could

  15. Transoral endoscopic thyroidectomy with central neck dissection:experimental studies on human cadavers

    Institute of Scientific and Technical Information of China (English)

    Guo Peiyi; Tang Zhiping; Ding Zihai; Chu Guoliang; Yao Huosheng; Pan Tao; Wang Huaqiao

    2014-01-01

    Background With the development of natural orifice trans-luminal endoscopic surgery,studies on transoral video-assisted thymidectomy in preclinical experiments (e.g.,human anatomy and animal trials) were progressing gradually.From 2009 to 2011,embalmed human cadavers were dissected to define the anatomical location,surgical planes,and related neural and vascular structures to create a safe transoral access to the front cervical spaces.Recently,experimental transoral endoscopic thyroidectomy was performed to verify the feasibility of this approach on 15 fresh specimens.Methods Fifteen specimens were placed in the supine position with slight neck extension.Endoscopic incision was made on the midline between the Wharton's duct papillae and two other incisions were made on mandibular first premolar buccal mucosa.Sublingual combined bilateral vestibular tunnels were created from oral cavity to the cervical region.The neck subplatysmal working space was insufflated with CO2 at 6-8 mmHg.The bilateral thyroid lobes and central lymph nodes were dissected under craniocaudal view.Results Three incisions were made in the oral cavity without any incisions on the body surfaces.The distance from the oral cavity to front neck region was the shortest.Bilateral thyroid lobes and central neck region were fully resected via transoral approach.This approach provided a craniocaudal view,in which retrosternal thyroid gland and lymph nodes were easily accessible.The recurrent laryngeal nerve could be identified safely on the inferior cornu of the thyroid cartilage.The only structure at risk was the mental nerve.Camera motion was somewhat limited by the maxillary dentition.The volume of harvested thyroid nodule through sublingual tunnel in the fifteen human cadavers was (40±15) cm3.Conclusion The transoral procedure is progressive and innovative which not only gives the best cosmetic result and minimal access trauma but also provides a craniocaudal view.

  16. Evaluation of the dynamic and kinematic performance of the THOR dummy: neck performance

    NARCIS (Netherlands)

    Hoofman, M.; Ratingen, M.R. van; Wismans, J.S.H.M.

    1998-01-01

    The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III-neck system on a HyGe

  17. Evaluation of the dynamic and kinematic performance of the THOR dummy: neck performance

    NARCIS (Netherlands)

    Hoofman, M.; Ratingen, M.R. van; Wismans, J.S.H.M.

    1998-01-01

    The objective of this study is to evaluate the frontal head-neck performance of the THOR neck with respect to the human frontal head-neck performance and the Hybrid-III frontal head-neck performance. For this purpose, tests were carried out with an isolated THOR and Hybrid-III-neck system on a HyGe

  18. DOES ELECTROMYOGRAPHY BIOFEEDBACK TRAINING REDUCE WORK-RELATED NECK PAIN?

    OpenAIRE

    2014-01-01

    Purpose: The purpose of this study is to investigate the use of Electromyography (EMG) biofeedback training in dental professionals to reduce upper trapezius muscle tension and thereby to reduce the work related neck pain. By reducing muscle activity in the neck and shoulder postural stabilizing muscles, EMG biofeedback training would be an effective mode of treatment in dental professionals for the management of work related neck pain. Subjects and Methods: This RCT included a total of 50...

  19. Superficial Head and Neck Anatomy for Dermatologic Surgery: Critical Concepts.

    Science.gov (United States)

    Chow, Steven; Bennett, Richard G

    2015-10-01

    Thorough understanding of head and neck anatomy is useful and necessary for dermatologic surgery. To highlight pertinent head and neck anatomic structures that are encountered during dermatologic surgery and correlate these with common surgical problems. Important anatomic structures and regional cutaneous anatomy are discussed and illustrated. Several important anatomic structures exist within the head and neck that can influence surgical outcomes. Anatomic knowledge is helpful to the dermatologic surgeon to optimize reconstructive outcomes.

  20. Pathological and morphological features of bladder neck sclerosis

    OpenAIRE

    Klochay V.V.; Krupin V.N.; Nashivochnikova N.A.; Artifeksova A.A.

    2011-01-01

    The research goal is to estimate a condition of microcirculation in a bladder neck in patients with benign prostatic hyperplasia (BPH) and its value in pathogenesis of bladder neck sclerosis. Materials and methods: Work basis included the analysis of treatment results of 1171 patients with BPH who carried complex examination, operative treatment and further supervision. The basic group was made up of 182 patients with BPH who developed bladder neck sclerosis in the postoperative period. The c...

  1. Transparotid approach for mandibular condylar neck and subcondylar fractures

    OpenAIRE

    Croce, A; Moretti, A.; Vitullo, F.; CASTRIOTTA, A.; M. Rosa; Citraro, L

    2010-01-01

    SUMMARY Mandibular condylar neck fractures and subcondylar fractures represent, respectively, 19-29% and 62-70% of all mandibular fractures; treatment involves some problems, common to both, concerning the choice of an adequate approach. Herewith, personal experience is reported related to the surgical treatment of some cases of mandibular condylar neck and subcondylar fractures by transparotid approaches with partial parotidectomy, removing the salivary tissue overlying the condylar neck and...

  2. Cervical vertebral realignment when voluntarily adopting a protective neck posture.

    Science.gov (United States)

    Newell, Robyn S; Siegmund, Gunter P; Blouin, Jean-Sébastien; Street, John; Cripton, Peter A

    2014-07-01

    In vivo human volunteer study of the intervertebral postural changes and muscle activity levels while tensing the neck muscles. To determine if actively tensing the neck muscles changes the posture of the cervical spine and, because axial impact neck injury often occurs while inverted, whether these changes exist both upright and upside down. Rollover accidents are dynamic and complex events in which head contacts with the vehicle interior can cause catastrophic neck injuries. Computational modeling has suggested that active neck muscles may increase the risk of cervical spine fracture in a rollover crash. Cadaver testing has also demonstrated that overall neck alignment and curvature are key to understanding and preventing catastrophic neck injuries. Although muscle activity and neck posture affects the resulting injury, there are currently no in vivo data describing how tensing the neck muscles influences intervertebral posture. Eleven human subjects (6 females, 5 males) actively tensed their neck muscles while seated upright and inverted. Vertebral alignment was measured using fluoroscopy and muscle activity was recorded using surface and indwelling electrodes in 8 neck muscles. On average, tensed muscles increased cervical spine curvature and anterior motion of the cervical vertebrae relative to the torso. These changes, which were magnified by inversion, indicate that cervical intervertebral posture differs considerably between the relaxed and tensed states. Active muscle contraction can change the vertebral alignment in upright and inverted postures. This change in posture may alter the load path and injury mechanics during an axial head impact and may help explain the disparity between the neck injuries observed in real-world rollover accidents and ex vivo cadaver experiments. N/A.

  3. Space of Spaces

    CERN Document Server

    Anderson, Edward

    2014-01-01

    Wheeler emphasized the study of Superspace - the space of 3-geometries on a spatial manifold of fixed topology. This is a configuration space for GR; knowledge of configuration spaces is useful as regards dynamics and QM.In this Article I consider furthmore generalized configuration spaces to all levels within the conventional `equipped sets' paradigm of mathematical structure used in fundamental Theoretical Physics. This covers A) the more familiar issue of topology change in the sense of topological manifolds (tied to cobordisms), including via pinched manifolds. B) The less familiar issue of not regarding as fixed the yet deeper levels of structure: topological spaces themselves (and their metric space subcase), collections of subsets and sets. Isham has previously presented quantization schemes for a number of these. I consider some classical preliminaries for this program, aside from the most obvious (classical dynamics for each). Rather, I provide I) to all levels Relational and Background Independence ...

  4. Responses of Myosin Heavy Chain Phenotypes and Gene Expressions in Neck Muscle to Micro- an Hyper-Gravity in Mice

    Science.gov (United States)

    Ohira, Tomotaka; Ohira, Takashi; Kawano, F.; Shibaguchi, T.; Okabe, H.; Ohno, Y.; Nakai, N.; Ochiai, T.; Goto, K.; Ohira, Y.

    2013-02-01

    Neck muscles are known to play important roles in the maintenance of head posture against gravity. However, it is not known how the properties of neck muscle are influenced by gravity. Therefore, the current study was performed to investigate the responses of neck muscle (rhomboideus capitis) in mice to inhibition of gravity and/or increase to 2-G for 3 months to test the hypothesis that the properties of neck muscles are regulated in response to the level of mechanical load applied by the gravitational load. Three male wild type C57BL/10J mice (8 weeks old) were launched by space shuttle Discovery (STS-128) and housed in Japanese Experimental Module “KIBO” on the International Space Station in mouse drawer system (MDS) project, which was organized by Italian Space Agency. Only 1 mouse returned to the Earth alive after 3 months by space shuttle Atlantis (STS-129). Neck muscles were sampled from both sides within 3 hours after landing. Cage and laboratory control experiments were also performed on the ground. Further, 3-month ground-based control experiments were performed with 6 groups, i.e. pre-experiment, 3-month hindlimb suspension, 2-G exposure by using animal centrifuge, and vivarium control (n=5 each group). Five mice were allowed to recover from hindlimb suspension (including 5 cage control) for 3 months in the cage. Neck muscles were sampled bilaterally before and after 3-month suspension and 2-G exposure, and at the end of 3-month ambulation recovery. Spaceflight-associated shift of myosin heavy chain phenotype from type I to II and atrophy of type I fibers were observed. In response to spaceflight, 17 genes were up-regulated and 13 genes were down-regulated vs. those in the laboratory control. Expression of 6 genes were up-regulated and that of 88 genes were down-regulated by 3-month exposure to 2-G vs. the age-matched cage control. In response to chronic hindlimb suspension, 4 and 20 genes were up- or down-regulated. Further, 98 genes responded

  5. Spatial and taxonomical overlap of fungi on phylloplanes and invasive alien ladybirds with fungal infections in tree crowns of urban green spaces

    DEFF Research Database (Denmark)

    Howe, Andrew Gordon; Ravn, Hans Peter; Jensen, Annette Bruun;

    2016-01-01

    ), Lecanicillium spp. (13.6% H. axyridis; 4.8% natives), with fewer Beauveria spp. infections (2.6% H. axyridis). Molecular identification revealed B. bassiana, B. pseudobassiana, I. farinosa and L. muscarium among isolates of both tree and ladybird origin. Tilia x europaea phylloplanes support a diverse...... occurred as infections in ladybirds. Isaria spp. was most abundant on phylloplanes (mean colony forming units (CFU) per leaf ± SE, 0.33 ± 0.03) followed by Beauveria spp. (0.22 ± 0.02 CFU per leaf) and Lecanicillium spp. (0.19 ± 0.02 CFU per leaf). Densities of inoculum were higher in inner crowns...... and decreased with height, although Lecanicillium spp. peaked at 5 – 7m. Upper phylloplane surfaces harboured higher densities of Isaria spp. and Beauveria spp. than lower surfaces, whereas Lecanicillium spp. was equally distributed. Most prevalent on ladybirds were Isaria spp. (20. 6% H. axyridis; 4.8% natives...

  6. Ipsilateral Acetabular and Femoral Neck and Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Hideto Irifune

    2015-01-01

    Full Text Available Floating hip injuries and ipsilateral femoral neck and shaft fractures are rare. Additionally, the simultaneous occurrence of these injuries is extremely rare, and only one case report of the simultaneous occurrence of these injuries has been published. Here, we report the case of a patient with ipsilateral acetabular and femoral neck and shaft fractures following a suicide attempt. The patient experienced nonunion of the femoral neck and shaft after the initial operation and therefore underwent reconstruction using a femoral head prosthesis with a long stem and interlocking screws. Our procedure may be used in primary and/or secondary reconstruction for ipsilateral acetabular and femoral neck and shaft fractures.

  7. Digital subtraction angiography in head and neck radiology

    Energy Technology Data Exchange (ETDEWEB)

    Carmody, R.F.; Seeger, J.F.; Smith, R.L.; Horsley, W.W.; Miller, R.W.

    1984-07-01

    Intravenous digital subtraction angiography (IVDSA) was used to evaluate 44 patients with suspected otolaryngologic abnormalities. Sixteen had IVDSA for pulsatile tinnitus or suspected glomus tumor of the petrous bone. Nine patients were evaluated because of pulsatile neck masses, and 12 others had suspected tumors of the neck, face, and paranasal sinuses. Seven had IVDSA following head and neck trauma. The technique of examination is described. The current indications of IVDSA in head and neck radiology are discussed. It is concluded that IVDSA is a suitable substitute for conventional angiography for many otolaryngologic conditions and, because of its safety, can be used more liberally.

  8. Basilar artery aneurysm case presented with neck pain

    Directory of Open Access Journals (Sweden)

    Uygar Utku

    2013-04-01

    Full Text Available Neck pain related with disorders of the brain and neck vascular structures is not rare but importance was attached to a condition that is often overlooked. Tension as a sudden onset, radiating to the nape, the neck pain becomes unbearable and within seconds the raging 51-year-old female patient with aneurysm at the distal end of basilar artery was found. Case, the only sign of neck pain with unruptured basilar artery aneurysm is presented in terms of raising awareness on the subject.

  9. Neck Pain in Primary Care: Prognosis and methodology

    OpenAIRE

    2011-01-01

    textabstractNeck pain is one of the most common musculoskeletal complaints in adults in the general population, with an estimated point prevalence of 20.6-22.2% and a 1-year prevalence of 31.4-35.6%. About half of those who experience neck pain consult their general practitioner (GP) for this complaint. In daily practice this means that a GP is consulted about five times a week for an episode of neck pain. The risk of developing neck pain is highest in women and in people of middle age (40-49...

  10. Head-Neck Biomechanics in Simulated Rear Impact

    OpenAIRE

    Yoganandan, Narayan; Pintar, Frank A.; Cusick, Joseph F.; Kleinberger, Michael

    1998-01-01

    The first objective of this study is to present an overview of the human cadaver studies aimed to determine the biomechanics of the head-neck in a simulated rear crash. The need for kinematic studies to better understand the mechanisms of load transfer to the human head-neck complex is emphasized. Based on this need, a methodology is developed to delineate the dynamic kinematics of the human head-neck complex. Intact human cadaver head-neck complexes were subjected to postero-anterior impact ...

  11. Unusual head and neck injury in elevator: autopsy study.

    Science.gov (United States)

    Eren, B; Türkmen, N; Dokgöz, H

    2012-10-01

    Industrial injuries related to auto-load-carrying vehicles were not frequently reported in the literature. Presented case was, 31-year-old male furniture worker. Deceased was found in awkward position in furniture workshop. Victim was observed on his knees in front of the elevator, head and neck lodged within openings of the elevator, and head and neck structures compressed-guillotined by the lower platform of the elevator were detected. We presented rare case of head and neck compression by elevator. Key words: head - neck - accidents - elevator - autopsy.

  12. Cervicopectoral flap in head and neck cancer surgery

    Directory of Open Access Journals (Sweden)

    Sivrioglu Nazan S

    2003-12-01

    Full Text Available Abstract Background Reconstruction of the head and neck after adequate resection of primary tumor and neck dissection is a challenge. It should be performed at one sitting in advanced tumors. Defects caused by the resection should be closed with flaps which match in color, texture and hair bearing characteristics with the face. Cervicopectoral flap is a one such flap from chest and neck skin mainly used to cover the cheek defects. Methods This study included twelve patients presenting with cancer of the head and neck to Izmir Ataturk Training Hospital and Adnan Menderes University Hospital. Tumor resection and neck dissection was performed in one session by the same surgeon. A single incision was made and a medially based cervicopectoral fascio-cutaneous flap was used for surgical exposure in neck dissection and for closure of defects after tumor resection. Results There was no major complication. Two flaps had partial superficial epidermolysis at the suture line. Good aesthetic and functional results were achieved. Conclusion The cervicopectoral flap is an excellent alternative for the reconstruction of head and neck. Harvesting and application of the flap is rapid and safe. Only a single incision is sufficient for dissection and flap elevation. This flap achieves perfect surgical exposure, makes neck dissection easy and allows one to perform both tumor resection and neck dissection in one session.

  13. Karakteristik Abses Leher Dalam Di SMF THT-KL RSUP. H. Adam Malik Medan Tahun 2006-2012.

    OpenAIRE

    2015-01-01

    Introduction: A deep neck infection is a neck infection at the space (a potential) between the fascia of the neck, consists of peritonsil, parapharynx, retropharynx and submandibular abscesses. Currently, the case of deep neck infection is rarely found since the discovering of antibiotics. Deep neck infection is still a case of emergency in ENT-HNS cause resulting a fatal complications. Purpose: To identify the characteristic of deep neck infection at H. Adam Malik General Hospital Medan ...

  14. Treatment of neck laxity with a Gore-Tex cervical sling for patients with heavy neck tissues.

    Science.gov (United States)

    Beaty, M M

    2001-05-01

    Treatment of neck laxity is a challenging problem for facial plastic surgeons. Many factors may contribute to this problem, including relaxation of the SMAS- platysma complex, excess submental adipose tissue, loss of skin elasticity, and anatomic factors such as hyoid position. Patients with heavy tissues in the neck area are more likely to have disappointing or short-lived results from neck rejuvenation surgery. Placement of an expanded-polytetrafluoroethylene (Gore-Tex) cervical sling provides additional support to the soft tissues of the neck, improving both initial and long-term cervical contours. This method is used in our practice for most patients with heavy neck tissues undergoing lower facial rejuvenation procedures. The cervical sling is well tolerated and provides the additional benefit of easy adjustability should the soft tissues of the neck further relax.

  15. Corrosion behavior of tantalum-coated cobalt-chromium modular necks compared to titanium modular necks in a simulator test.

    Science.gov (United States)

    Dorn, Ulrich; Neumann, Daniel; Frank, Mario

    2014-04-01

    This study compared the corrosion behavior of tantalum-coated cobalt-chromium modular necks with that of titanium alloy modular necks at their junction to titanium-alloy femoral stem. Tests were performed in a dry assembly and two wet assemblies, one contaminated with calf serum and the other contaminated with calf serum and bone particles. Whereas the titanium modular neck tested in the dry assembly showed no signs of corrosion, the titanium modular necks tested in both wet assemblies showed marked depositions and corrosive attacks. By contrast, the tantalum-coated cobalt-chromium modular necks showed no traces of corrosion or chemical attack in any of the three assemblies. This study confirms the protective effect of tantalum coating the taper region of cobalt-chromium modular neck components, suggesting that the use of tantalum may reduce the risk of implant failure due to corrosion.

  16. A Case of Pyriform Sinus Fistula Infection with Double Tracts

    Directory of Open Access Journals (Sweden)

    Masato Shino

    2014-01-01

    Full Text Available Pyriform sinus fistula is a rare clinical entity and the precise origin remains controversial. The fistula is discovered among patients with acute suppurative thyroiditis or deep neck infection of the left side of the neck and is usually located in the left pyriform sinus. To the best of our knowledge, only a single tract has been reported to be responsible for pyriform sinus fistula infection. We present a case of a 13-year-old female patient with a pyriform sinus fistula that caused a deep infection of the left side of the neck and showed double-tract involvement discovered during surgical resection of the entire fistula. Both tracts arose around the pyriform sinus and terminated at the upper portion of the left lobe of the thyroid.

  17. Ultrasound-guided surgical drainage of face and neck abscesses.

    Science.gov (United States)

    Yusa, H; Yoshida, H; Ueno, E; Onizawa, K; Yanagawa, T

    2002-06-01

    An ultrasound-guided surgical drainage technique in which grey-scale and colour Doppler ultrasonography were combined is described. The technique was performed for eight deep subcutaneous abscesses subsequent to odontogenic infection, and provided easy detection and accurate, reliable penetration of abscesses that were difficult to locate by physical examination. Colour Doppler ultrasonography is particularly useful for differentiating blood vessels from the static space of abscesses.

  18. The burden of neck pain: its meaning for persons with neck pain and healthcare providers, explored by concept mapping

    OpenAIRE

    2015-01-01

    Purpose To empirically define the concept of burden of neck pain. The lack of a clear understanding of this construct from the perspective of persons with neck pain and care providers hampers adequate measurement of this burden. An additional aim was to compare the conceptual model obtained with the frequently used Neck Disability Index (NDI). Methods Concept mapping, combining qualitative (nominal group technique and group consensus) and quantitative research methods (cluster analysis and mu...

  19. On neck load among helicopter pilots : Effects of head worn equipment, whole body vibration and neck position

    OpenAIRE

    Thuresson, Marcus

    2005-01-01

    Introduction: Helicopter pilots complain of pain originating from the neck region. The causes are still basically unknown, but the ergonomic situation when flying a helicopter, with unfavorable load caused by static neck and body positions, whole-body vibration and heavy head-worn equipment, has been suggested as a risk factor. Aim: The aim of the work reported in this thesis was to quantify the effects of external loads on helicopter pilots necks, and to evaluate diffe...

  20. Einfluss der prophylaktischen Gabe von Faktor XIII auf die Wundheilung nach Neck Dissection bei Patienten mit chronischem Alkoholkonsum

    OpenAIRE

    Asmussen, Marie

    2016-01-01

    Wound healing disorders are a common complication in patients with Alcohol Use Disorder (AUD) after neck dissection. They can be differentiated into haematomas, seromas, wound dehiscences and wound infections. Important for wound healing are blood coagulation, an adequate immune response and tissue reformation. Factor XIII (FXIII) stabilises fibrin as well as collagene and supports fibroblasts and angiogenesis amongst others. Patients with AUD probably have a reduced level of FXlll. In thi...

  1. Refractory metabolic acidosis in patients with sepsis following hemiarthroplasty for femoral neck fracture: a causative role for paracetamol and flucloxacillin?

    OpenAIRE

    2011-01-01

    The authors report two cases of pyroglutamic acidosis as a result of paracetamol and flucloxacillin therapy in patients with prosthesis infection following hemiarthroplasty for neck of femur fractures. Pyroglutamic acidosis is an important and often unrecognised cause of refractory metabolic acidosis that disproportionately affects older women, and can be caused by drugs such as paracetamol and flucloxacillin in the setting of sepsis, renal failure and malnutrition. Although relatively rare, ...

  2. Parapharyngeal space primary tumours.

    Science.gov (United States)

    Grilli, Gianluigi; Suarez, Vanessa; Muñoz, María Gabriela; Costales, María; Llorente, José Luis

    The aim of this study is to present our experience with the diagnostic and therapeutic approaches for parapharyngeal space tumours. This study is a retrospective review of 90 patients diagnosed with tumours of the parapharyngeal space and treated surgically between 1984 and 2015. Patients whose tumours were not primary but invaded the parapharyngeal space expanding from another region, tumours originating in the deep lobe of the parotid gland and head and neck metastasis were excluded from this study. 74% percent of the parapharyngeal space neoplasms were benign and 26% were malignant. Pleomorphic adenoma was the most common neoplasm (27%), followed by paragangliomas (25%), miscellaneous malignant tumours (16%), neurogenic tumours (12%), miscellaneous benign tumours (10%), and malignant salivary gland tumours (10%). The transcervical approach was used in 56 cases, cervical-transparotid approach in 15 cases, type A infratemporal fossa approach in 13 cases, transmandibular approach in 4 cases and transoral approach in 2 cases. The most common complications were those deriving from nervous injuries. Most parapharyngeal space tumours can be removed surgically with a low rate of complications and recurrence. The transcervical approach is the most frequently used. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  3. Preoperative Use of Clopidogrel Does Not Affect Outcomes for Femoral Neck Fractures Treated With Hemiarthroplasty.

    Science.gov (United States)

    Ghanem, Elie S; Richard, Raveesh D; Wingert, Nathaniel C H; Gotoff, James R; Graham, Jove H; Bowen, Thomas R

    2017-07-01

    The antiplatelet effect of clopidogrel on blood loss and perioperative complications after surgical intervention remains ambiguous. The purpose of this study was to determine if patients on clopidogrel before hemiarthroplasty for femoral neck fracture are predisposed to greater surgical bleeding and perioperative complications compared with those not taking clopidogrel before surgery. We conducted a review of our electronic medical record from 2006-2013 and identified 602 patients who underwent 623 hemiarthroplasty procedures for displaced femoral neck fracture, of which 54 cases (9%) were taking clopidogrel before hospital admission. Patient demographics and comorbidities, operative and surgical variables, and perioperative complications at 90 days were compared between the clopidogrel and nonclopidogrel user groups. The 2 groups of patients had similar baseline characteristics, but patients taking clopidogrel preoperatively were sicker with higher American Society of Anesthesiologists scores (P = .049) and age-adjusted Charlson index (P = .001). They also had a greater incidence of cerebrovascular disease (P = .01), chronic obstructive pulmonary disease (P = .03), diabetes (0.03), and malignancy (P postoperative medical readmissions (P = .85), surgical readmissions (P = .26), infection (P = .99), and mortality (P = .89). Patients taking clopidogrel who present with a displaced femoral neck fracture can safely undergo a hemiarthroplasty while actively on clopidogrel without an increase in medical or surgical complications and mortality. We do not recommend delaying surgical intervention until the antiplatelet effects of clopidogrel subside. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Advancements in the Management of HPV-Associated Head and Neck Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Ross Zeitlin

    2015-04-01

    Full Text Available Head and neck carcinomas have long been linked to alcohol and tobacco abuse; however, within the last two decades, the human papillomavirus (HPV has emerged as a third etiology and is specifically associated with head and neck squamous cell carcinomas (HNSCC. In this anatomical region, the oncogenic HPV-16 mediates transformation and immortalization of epithelium, most commonly in the oropharynx. Nevertheless, the recent identification of novel HPV mechanisms thought to be specific to oropharyngeal carcinogenesis has coincided with observations that HPV-associated HNSCC has differing clinical behavior—in terms of natural history, therapeutic response, and prognosis—than HPV-negative head and neck tumors. Taken together with the growing incidence of HPV transmission in younger populations, these discoveries have sparked a rapid expansion in both laboratory and clinical studies on the infection and disease. Herein, we review the clinical characteristics of HPV-associated HNSCC, with particular emphasis on recent advancements in our understanding of the management of this infectious malignancy.

  5. Results of cemented bipolar hemiarthroplasty for fracture of the femoral neck - 10 year study

    Directory of Open Access Journals (Sweden)

    Maini P

    2006-01-01

    Full Text Available Background : One of the most common treatments of displaced fracture of femoral neck in elderly is bipolar hemiarthroplasty. Method : Two hundred and seventy patients of displaced fracture of femoral neck were treated by bipolar hemiarthroplasty. The Mean age of the patients at the time of surgery was 69.80 years. Results : Follow up ranged between 12 months and 120 months. There were 8 cases each of acetabular erosion and protrusion with 10 cases of femoral stem loosening. Eight cases had post operative dislocation requiring open reduction. Eighteen patients got revision surgery to total hip replacement. The overall incidence of DVT/PE was 9.9% which declined after regular use of low molecular weight heparin. Eleven patients had post operative infection. There were 54.2 % excellent results, 21.0 % good results, 10.7 % fair and 3.7% poor results. Conclusion : Elderly patients with displaced fracture of neck femur are able to ambulate early after Cemented bipolar hemi arthroplasty. The complication rate is low, the component survival long and pre injury functional status is restored in majority of patients.

  6. Impact of genetic targets on therapy in head and neck squamous cell carcinoma.

    Science.gov (United States)

    Chaikhoutdinov, Irina; Goldenberg, David

    2013-01-01

    Despite advances in surgical technique, radiation therapy and chemotherapy, the mortality from head and neck squamous cell carcinoma (HNSCC) has not improved significantly. Squamous cell carcinoma is caused by tobacco use, alcohol consumption and infection with high-risk types of human papillomavirus. It is the 6th most common cancer in the world, with upwards of 45,000 new cases reported yearly in the United States alone.In recent years, there has been a significant increase in the understanding of the molecular and genetic pathogenesis of head and neck cancer, shedding light on the unexpected heterogeneity of the disease. Genetic analysis has led to new classification schemes for HNSCC, with different subgroups exhibiting different prognoses. In addition, multiple targets in aberrant signaling pathways have been identified using increasingly sophisticated bio-informatics tools. Advances in technology have allowed for novel delivery mechanisms to introduce genetic material into cells to produce a therapeutic effect by targeting cancer cells via a number of different approaches.A pressing need to develop novel therapies to augment current treatment modalities has led to a number of translational studies involving gene therapy in the treatment of HNSCC. This article will focus on a review of the most recent developments in molecular biology of head and neck squamous cell carcinoma in regards to possible targets for gene therapy, as well as the array of novel therapeutic strategies directed at these targets.

  7. Neck Kinematics in Rear-End Impacts

    Directory of Open Access Journals (Sweden)

    King H Yang

    2003-01-01

    Full Text Available The purpose of this study was to document the kinematics of the neck during low-speed rear-end impacts. In a series of experiments reported by Deng et al (2000, a pneumatically driven mini-sled was used to study cervical spine motion using six cadavers instrumented with metallic markers at each cervical level, a 9-accelerometer mount on the head, and a tri-axial accelerometers on the thorax. A 250-Hz x-ray system was used to record marker motion while acceleration data were digitized at 10,000 Hz. Results show that, in the global coordinate system, the head and all cervical vertebrae were primarily in extension during the entire period of x-ray data collection. In local coordinate systems, upper cervical segments were initially in relative flexion while lower segments were in extension. Facet joint capsular stretch ranged from 17 to 97%. In the vertical direction, the head and T1 accelerated upward almost instantaneously after impact initiation while there was delay for the head in the horizontal direction. This combination was the result of a force vector which was pointed in the forward and upward direction to generate an extension moment. Upward ramping of the torso was larger in tests with a 20-deg seatback angle. The study concluded that the kinematics of the neck is rather complicated and greatly influenced by the large rotations of the thoracic spine. Significant posterior shear deformation was found, as evidenced by the large facet capsular stretch. Although the neck forms a 'mild' S-shaped curve during whiplash, using its shape as an injury mechanism can be misleading because the source of pain is likely to be located in the facet capsules.

  8. Treatment of 10 cases of trismus resulting from head and neck radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Wakamatsu, Keita; Harashina, Takao [Saitama Medical School, Kawagoe (Japan). Saitama Medical Center; Tsuchiya, Yuichi; Ohtsuru, Hiroshi

    2001-07-01

    Ten cases of trismus following irradiation of head and neck cancer are reported. The patients were 4 males and 6 females with a mean age of 54.2 years. We preformed 2 arthroplasties, and used 4 scapular flaps, 2 groin flaps, 1 omental flap, and 1 latissimus dorsi flap. The maximum mouth opening in each patient improved, and all patients were able to open past 2 finger breadth after treatment. Use of vascularized tissue is important to prevent atrophy of transferred bone and other soft tissues, and infection. In addition, even if trismus is improved after surgery, mouth opening exercises are needed to prevent recurrence of trismus. (author)

  9. Anatomic Eponyms in Neuroradiology: Head and Neck.

    Science.gov (United States)

    Bunch, Paul M

    2016-10-01

    In medicine, an eponym is a word-typically referring to an anatomic structure, disease, or syndrome-that is derived from a person's name. Medical eponyms are ubiquitous and numerous. They are also at times controversial. Eponyms reflect medicine's rich and colorful history and can be useful for concisely conveying complex concepts. Familiarity with eponyms facilitates correct usage and accurate communication. In this article, 22 eponyms used to describe anatomic structures of the head and neck are discussed. For each structure, the author first provides a biographical account of the individual for whom the structure is named. An anatomic description and brief discussion of the structure's clinical relevance follow.

  10. Novel Immunotherapeutic Approaches for Head and Neck Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Darrin V. Bann

    2016-09-01

    Full Text Available The immune system plays a key role in preventing tumor formation by recognizing and destroying malignant cells. For over a century, researchers have attempted to harness the immune response as a cancer treatment, although this approach has only recently achieved clinical success. Head and neck squamous cell carcinoma (HNSCC is the sixth most common cancer worldwide and is associated with cigarette smoking, alcohol consumption, betel nut use, and human papillomavirus infection. Unfortunately, worldwide mortality from HNSCC remains high, partially due to limits on therapy secondary to the significant morbidity associated with current treatments. Therefore, immunotherapeutic approaches to HNSCC treatment are attractive for their potential to reduce morbidity while improving survival. However, the application of immunotherapies to this disease has been challenging because HNSCC is profoundly immunosuppressive, resulting in decreased absolute lymphocyte counts, impaired natural killer cell function, reduced antigen-presenting cell function, and a tumor-permissive cytokine profile. Despite these challenges, numerous clinical trials testing the safety and efficacy of immunotherapeutic approaches to HNSCC treatment are currently underway, many of which have produced promising results. This review will summarize immunotherapeutic approaches to HNSCC that are currently undergoing clinical trials.

  11. Prevalence of neck pain among cabin crew of Saudi Airlines.

    Science.gov (United States)

    Ezzat, Hesham M; Al-Sultan, Alanood; Al-Shammari, Anwar; Alyousef, Dana; Al-Hamidi, Hager; Al-Dossary, Nafla; Al-Zahrani, Nuha; Al-Abdulqader, Wala

    2015-01-01

    Neck pain is considered to be a major health problem in modern societies. Many previous studies found that certain occupations are related to this problem or are associated with the risk of developing it in future. Although the pain is caused by mechanical factors, it may progress to a serious problem and give rise to other abnormal symptoms such as vertigo, headache, or migraine. To investigate the prevalence of neck pain among the cabin crew of Saudi Airlines. A cross-sectional study was carried out on the available Saudi Airlines cabin crews in King Fahad Airport during our visits, using questionnaires and measurements of several parameters. Neck Pain Questionnaires were distributed to the cabin crews on Saudi Airlines and assessment sheets were completed by all participants of the study to evaluate the prevalence and distribution of neck pain. Physical therapy examination of neck motions in different directions and specific tests were performed by all the participants to identify any symptoms. Using these data the prevalence of neck pain among the cabin crews was calculated. Collected data were analyzed statistically using SPSS software calculating the mean, median, and score of the questionnaire. According to the scoring system of the study, 31 (30.09%) of 105 cabin crew staff of Saudi Airlines had neck pain. Our study confirmed a positive correlation between this occupation and neck pain, and in fact found that according to the results of logistic regression analysis, this occupation is the only significant factor that affects the positive compression test. The prevalence of neck pain among the cabin crews of Saudi Airlines was emphasized. The results show a high prevalence of neck pain in the participants of the study, with most cases appearing to run a chronic - episodic course. Further research is needed to help us understand more about the long-term course of neck pain and its broader outcomes and impacts.

  12. Neck Pain Occurrence and Characteristics in Nigerian University Undergraduates

    Directory of Open Access Journals (Sweden)

    Olufunke Patience Iroko

    2010-06-01

    Full Text Available AIM: University students seem to be a high risk group for neck pain which often leads to diminished concentration and academic performance among them. This study examined the occurrence and characteristics of neck pain in undergraduate students from the University of Ibadan, Nigeria. METHOD: One thousand and sixty nine (512 male and 557 female undergraduate students with the mean age of 23.49 ± 2.54 years responded in this cross-sectional survey. An adapted questionnaire that sought information on demographics, occurrence, characteristics and the consequence of neck pain on activities of daily living served as the survey instrument. Data were summarized using descriptive statistics. RESULTS: Lifetime prevalence and current frequency of neck pain among the respondents was 34.9% and 9.8% respectively. Female students had a higher preponderance of lifetime neck pain prevalence than their male counterparts (52.8 vs. 47.2%. There was higher frequency of neck pain after admission into the university than before (68.6 vs. 28.7%. Neck pain increased according to level of study and commoner among clinical students. 20% of the respondents reported chronic neck pain and was commoner in males than females (13% vs. 7% females. Seats without back supports used during lectures (48.0%, long reading hours (31.4%, poor self perpetuating posture (16.6%, and types of pillow used when sleeping (14.2% were the most implicated predisposing factors to neck pain. Reading (49.7% and concentration on school work (27.9% were the most limited activities of daily living. CONCLUSION: Neck pain is common among Nigerian university undergraduate students and affects females than males. The prevalence increased with higher level of study and commoner among clinical students. Neck pain mostly affects reading and concentration on school work among university undergraduate students. [TAF Prev Med Bull 2010; 9(3.000: 167-174

  13. Postoperative antibiotic prophylaxis in clean-contaminated head and neck oncologic surgery: a retrospective cohort study.

    Science.gov (United States)

    Busch, C-J; Knecht, R; Münscher, A; Matern, J; Dalchow, C; Lörincz, B B

    2016-09-01

    Antibiotic prophylaxis is commonly used in head and neck oncologic surgery, due to the clean-contaminated nature of these procedures. There is a wide variety in the use of prophylactic antibiotics regarding the duration of application and the choice of agent. The purpose of this study was to determine whether short-term or long-term antibiotic prophylaxis has an impact on the development of head and neck surgical wound infection (SWI). Retrospective chart review was carried out in 418 clean-contaminated head and neck surgical oncology cases at our department. More than 50 variables including tumour type and stage, type of surgical treatment, co-morbidities, duration and choice of antibiotic prophylaxis, and the incidence of SWI were analysed. Following descriptive data analysis, Chi square test by Pearson and Fisher's exact test were used for statistical evaluation. Fifty-eight of the 418 patients (13.9 %) developed SWI. Patients with advanced disease and tracheotomy showed a significantly higher rate of SWI than those with early stage disease and without tracheotomy (p = 0.012 and p = 0.00017, respectively). However, there was no significant difference between the SWI rates in the short term and long term treatment groups (14.6 and 13.2 %, respectively; p = 0.689). Diabetes and body weight were not found to be risk factors for SWI. Long-term antibiotic prophylaxis was not associated with a decrease in SWI in the entire cohort of patients undergoing clean-contaminated major head and neck oncologic surgery. Our data confirmed the extent of surgery and tracheotomy as being risk factors for postoperative SWI.

  14. A rare differential diagnosis to occupational neck pain: bilateral stylohyoid syndrome

    OpenAIRE

    2006-01-01

    Abstract Chronic neck pain is widely prevalent and a common source of disability in the working-age population. Etiology of chronic neck pain includes neck sprain, mechanical or muscular neck pain, myofascial pain syndrome, postural neck pain as well as pain due to degenerative changes. We report the case of a 42 year old secretary, complaining about a longer history of neck pain and limited movement of the cervical spine. Surprisingly, the adequate radiologic examination revealed a bilateral...

  15. Clinical Pearls in pediatric infections.

    Science.gov (United States)

    Singhi, Sunit; Mathew, Joseph; Jindal, Atul; Verma, Sanjay

    2011-12-01

    This series of Clinical Pearls presents four cases presenting with infection. Each of these cases had clinical clues to the correct diagnosis, which could be picked up on meticulous history, clinical examination, or basic laboratory investigations. The authors highlight the important lessons to be learnt from each case. The first is a 7 year old boy with recurrent respiratory tract infections since early life. Clinical examination revealed the presence of dextrocardia and situs inversus and bronchiectasis leading to a diagnosis of Primary Ciliary Dyskinesia. The second case is a 1.5-month-old infant who presented with meningitis and increasing head size since birth. CSF examination and CT scanning led to the correct diagnosis of congenital Toxoplasmosis. The next case is an infant with high grade fever and neck swelling. He had the rare Lemierre's syndrome comprising of oro-pharyngeal infection, suppurative thrompbophlebitis of the internal jugular vein and systemic dissemination of septic emboli. The fourth case is a 2-year-old infant with recurrent respiratory tract infections and discharging neck swellings from early life. Repeated testing for tuberculosis was negative. The diagnosis was Chronic granulomatous disease. The authors describe the clinical approach and investigations in these cases; along with an outline of the management.

  16. Manual of head and neck imaging

    Energy Technology Data Exchange (ETDEWEB)

    Raghavan, Prashant [Maryland University School of Medicine, Baltimore, MD (United States). Div. of Neuroradiology; Mukherjee, Sugoto [Virginia University Health System, Charlottesville, VA (United States). Div. of Neuroradiology; Jameson, Mark J. [Virginia University Health System, Charlottesville, VA (United States). Div. of Head and Neck Surgical Oncology; Wintermark, Max [Virginia University Health System, Charlottesville, VA (United States). Dept. of Radiology and Medical Imaging

    2014-06-01

    Easy-to-read short chapters. Tables, checklists, and algorithms to assist in arriving at a quick diagnosis. Clinical pearls that will enable the radiologist to issue a relevant report. One-stop resource when preparing for radiology and otolaryngology exams. Line diagrams to illustrate key concepts. This book is designed as an easily readable manual that will be of great practical value for radiology and otolaryngology residents during their clinical rotations. Key facts on head and neck imaging are presented in short chapters written in an easily readable style. Line drawings are used to illustrate key concepts, and tables, checklists, and algorithms will enable the readers to arrive at a quick diagnosis. In addition, emphasis is placed on clinical pearls that will assist them in preparing suitable reports. The Manual of Head and Neck Imaging is sized to allow residents to read it completely within a matter of days, and it will also serve as an ideal quick reference guide as different clinical situations arise.

  17. Giant Arteriovenous Malformation of the Neck

    Directory of Open Access Journals (Sweden)

    P. A. Dieng

    2015-01-01

    Full Text Available Arteriovenous malformations (AVM have a wide range of clinical presentations. Operative bleeding is one of the most hazardous complications in the surgical management of high-flow vascular malformations. In the cervical region, the presence of vital vascular structures, such as the carotid artery and jugular vein, may increase this risk. This is a case of massive arteriovenous malformation deforming the neck and the face aspect of this aged lady and growing for several years. A giant mass of the left neck occupied the carotid region and the subclavian region. The AVM was developed between the carotid arteries, jugular veins, and vertebral and subclavian vessels, with arterial and venous flux. The patient underwent surgery twice for the cure of that AVM. The first step was the ligation of the external carotid. Seven days later, the excision of the mass was done. In postoperative period the patient presented a peripheral facial paralysis which completely decreased within 10 days. The first ligation of the external carotid reduces significantly the blood flow into the AVM. It permitted secondarily the complete ablation of the AVM without major bleeding even though multiple ligations were done.

  18. Mucosal melanoma of the head and neck.

    Science.gov (United States)

    Ascierto, Paolo Antonio; Accorona, Remo; Botti, Gerardo; Farina, Davide; Fossati, Piero; Gatta, Gemma; Gogas, Helen; Lombardi, Davide; Maroldi, Roberto; Nicolai, Piero; Ravanelli, Marco; Vanella, Vito

    2017-04-01

    Mucosal melanoma of the head and neck is a very rare and aggressive malignancy with a very poor prognosis. The nasal cavity, paranasal sinuses, and oral cavity are the most common locations. One-, 3- and 5-year survival rates between 2000 and 2007 were 63%, 30% and 20%, respectively. Cigarette smoking seems to be a risk factor even though the evidence for this is very low. Clinical signs and symptoms are usually nonspecific. While surgery is considered the mainstay of treatment for most mucosal melanomas of the head and neck region, radiotherapy has a role in local control of the disease after surgery. Many new treatment options in the last years, in particular targeted therapies (i.e. inhibitors of c-KIT, NRAS/MEK or BRAF) and immunotherapies (anti CTLA-4 and anti PD-1/PD-L1 antibodies), have changed the history of cutaneous melanoma. Despite the different biology, mucosal melanoma is currently treated in the same way as cutaneous melanoma; however, patients with mucosal melanoma were excluded from the majority of recent clinical trials. Recent molecular findings offer new hope for the development of more effective systemic therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Group B and F Beta Streptococcus Necrotizing Infection-Surgical Challenges with a Deep Central Plantar Space Abscess A Diabetic Limb Salvage Case Report.

    Science.gov (United States)

    Mendivil, Jason M; Jolley, David; Walters, Jodi; Dancho, Jim; Martin, Billy

    2016-05-01

    We present the case of a 66-year-old, type II diabetic male with a deep wound to the plantar-lateral aspect of his right hallux. On examination, the central plantar compartment of his right foot was moderately erythematous and tender on palpation. After obtaining a deep wound culture, treatment was complicated by a progression of a group B and F beta streptococcus, necrotizing infection. The patient underwent a right hallux amputation, followed by a plantar medial incision for drainage of an abscess to the medial and central plantar compartments of the foot. Due to the extent and limb threat of the infection, the patient ultimately underwent a transmetatarsal amputation. Advanced healing modalities were also employed to decrease wound healing times, which allowed the patient to achieve early weightbearing and return to activities of daily living. This study depicts how the astute podiatric surgeon needs to make a decision in a timely manner to surgically debride all nonviable and necrotic tissue in order to minimize further amputation and preserve foot function.

  20. Central line infections - hospitals

    Science.gov (United States)

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  1. Neck Pain in Primary Care: Prognosis and methodology

    NARCIS (Netherlands)

    J.M. Schellingerhout (Jasper Mattijs)

    2011-01-01

    textabstractNeck pain is one of the most common musculoskeletal complaints in adults in the general population, with an estimated point prevalence of 20.6-22.2% and a 1-year prevalence of 31.4-35.6%. About half of those who experience neck pain consult their general practitioner (GP) for this compla

  2. Gravitational demand on the neck musculature during tablet computer use.

    Science.gov (United States)

    Vasavada, Anita N; Nevins, Derek D; Monda, Steven M; Hughes, Ellis; Lin, David C

    2015-01-01

    Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head-neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3-5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 quantitative data about mechanical requirements on the neck musculature during tablet computer use and are important for developing ergonomics guidelines. Practitioner Summary: Flexed head and neck postures occur during tablet computer use and are implicated in neck pain. The mechanical demand on the neck muscles was estimated to increase 3-5 times during seated tablet computer use versus seated neutral posture, with the lowest demand in a high propped tablet position but few differences in other conditions.

  3. Survival of head and neck cancer in Greenland

    DEFF Research Database (Denmark)

    Jensen, Ramon Gordon; Friborg, Jeppe; Rosborg, Jørn

    2010-01-01

    Head and neck cancer is frequent in the Inuit population of Greenland and is characterized by a very high incidence of Epstein-Barr virus associated nasopharyngeal carcinoma (NPC). However, information on the treatment and survival of Inuit head and neck cancer patients is practically non-existen...

  4. Exercise therapy for trismus in head and neck cancer

    NARCIS (Netherlands)

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F.K.L.; Roodenburg, J.L.N.; Pater, R.

    2007-01-01

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of p

  5. HEADS UP: Sensorimotor control of the head-neck system

    NARCIS (Netherlands)

    Forbes, P.A.

    2014-01-01

    Head-neck stabilization is inherently challenging even when stationary, requiring constant vigilance to counter the downward pull of gravity. It involves a highly complex biomechanical system comprised of a large mass (the head) balanced on top of seven vertebrae (the neck), that are in turn connect

  6. Variation of neck muscle strength along the human cervical spine.

    Science.gov (United States)

    Oi, Nelson; Pandy, Marcus G; Myers, Barry S; Nightingale, Roger W; Chancey, Valeta Carol

    2004-11-01

    The aim of this study was to describe and explain the variation of neck muscle strength along the cervical spine. A three-dimensional model of the head-neck complex was developed to test the hypothesis that the moment-generating capacity of the neck musculature is lower in the upper cervical spine than in the lower cervical spine. The model calculations suggest that the neck muscles can protect the lower cervical spine from injury during extension and lateral bending. The maximum flexor moment developed in the lower cervical spine was 2 times higher than that developed in the upper spine. The model also predicted that the neck musculature is 30% stronger in the lower cervical spine during lateral bending. Peak compressive forces (up to 3 times body weight) were higher in the lower cervical spine. These results are consistent with the clinical finding that extension loading of the neck often leads to injuries in the upper cervical spine. Analysis of the model results showed that neck flexor strength was greater in the lower cervical spine because of the relatively large size of the sternocleidomastoid muscle. The hyoid muscles developed significant flexor moments about the joints of the upper cervical spine, as these muscles had relatively large flexor moment arms; however, this effect was offset by the action of the sternocleidomastoid, which exerted a large extensor moment in the upper spine. Lateral bending strength of the neck muscles was governed by geometry (i.e., moment arms) rather than by muscle size.

  7. Exercise therapy for trismus in head and neck cancer

    NARCIS (Netherlands)

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F.K.L.; Roodenburg, J.L.N.; Pater, R.

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of

  8. Exercise therapy for trismus in head and neck cancer

    NARCIS (Netherlands)

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F.K.L.; Roodenburg, J.L.N.; Pater, R.

    2007-01-01

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of p

  9. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    OpenAIRE

    Radha; Ravi Shankar; Naveen; Roopa

    2015-01-01

    BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to ...

  10. Resonance and Neck Length for a Spherical Resonator

    Directory of Open Access Journals (Sweden)

    Emily Corning

    2011-06-01

    Full Text Available The relationship between the neck length of a spherical resonator and its period of fundamental resonance was investigated. This was done by measuring the frequency of fundamental resonance of the resonator at 6 different neck lengths. It was found that its resonance resembled Helmholtz resonance but was not that of ideal Helmholtz resonance.

  11. Sagittal alignment of the cervical spine after neck injury.

    Science.gov (United States)

    Beltsios, Michail; Savvidou, Olga; Mitsiokapa, Evanthia A; Mavrogenis, Andreas F; Kaspiris, Angelos; Efstathopoulos, Nikolaos; Papagelopoulos, Panayiotis J

    2013-07-01

    The normal sagittal alignment of the cervical spine is lordotic and is affected by the posture of the head and neck. The question of whether loss of cervical lordosis is the result of muscle spasm after injury or a normal variation, and the clinical significance of such changes in sagittal profile of the cervical spine has been an issue of several studies. The purpose of this paper is to study the incidence of normal cervical lordosis and its changes after neck injury compared to the healthy population. We studied the lateral radiographs of the cervical spine of 60 patients with neck injury compared to 100 patients without a neck injury. Lateral radiographs were obtained in the standing or sitting position, and the curvature of the cervical spine was measured using the angle formed between the inferior end plates of the C2 and C7 vertebrae. In the patients without neck injury, lordotic and straight cervical spine sagittal alignment was observed in 36.5% each, double curvature in 17%, and kyphotic in 10%. In the patients with neck injury, lordotic sagittal alignment was observed in 36%, straight in 34%, double curvature in 26% and kyphotic in 4%. No significant difference between the two groups regarding all types of sagittal alignment of the cervical spine was found (p > 0.100). The alterations in normal cervical lordosis in patients with neck injury must be considered coincidental. These alterations should not be associated with muscle spasm caused by neck pain.

  12. 33 CFR 117.800 - Mill Neck Creek.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Mill Neck Creek. 117.800 Section 117.800 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements New York § 117.800 Mill Neck Creek. The draw of...

  13. Endotracheal tube positioning during neck extension in thyroidectomy.

    Science.gov (United States)

    Sharma, S D; Kumar, G; Kanona, H; Jovaisa, T; Kaddour, H

    2015-10-01

    To evaluate the effect of body mass index and neck length on endotracheal tube movement during neck extension in thyroidectomy. A prospective study was conducted of 30 patients undergoing thyroidectomy during an 8-month period. Patient characteristics were recorded and endotracheal tube displacement was determined. Mean body mass index was 27.8 kg/m2 (range, 17.5-34.7 kg/m2) and mean neck circumference was 43.2 cm (range, 28-56 cm). The mean (± standard deviation) upward displacement of the endotracheal tube during neck extension was 7.17 ± 5.87 mm. Patients with a larger body mass index had a significantly greater amount of tube displacement (R2 = 0.67, p endotracheal tube. The amount of displacement is significantly higher in patients with a larger body mass index or shorter neck length. This has particular relevance for nerve monitoring in thyroidectomy.

  14. Free Flap Procedures for Reconstruction After Head and Neck Cancer.

    Science.gov (United States)

    Kini, Erin

    2015-12-01

    Patients with head and neck cancer are seeking improved surgical procedures to avoid severe defects that result from head and neck cancer resection. Free flap reconstruction provides vascularized tissue that has been transferred from a distant donor site on a patient's body to a recipient site, markedly improving wound closure and protecting structures of the head and neck. This article discusses free flap procedures for reconstruction after head and neck cancer resection, including the following procedure phases: airway protection and neck dissections, tumor resection, flap harvest, microvascular anastomosis of the flap, and reconstruction and closure. The article also explains specific risk factors for patients undergoing free flap procedures that have been identified in the literature and include procedure length, hypothermia, and pressure injuries. Each of these factors is discussed regarding its specific effect on this patient population, and the nursing interventions to reduce these risks are identified.

  15. Hookworm infection

    Science.gov (United States)

    Hookworm disease; Ground itch; Ancylostoma duodenale infection; Necator americanus infection; Parasitic infection - hookworm ... The infection is caused by infestation with any of the following ... Ancylostoma duodenale Ancylostoma ceylanicum Ancylostoma ...

  16. Kidney Infection

    Science.gov (United States)

    ... X-ray called a voiding cystourethrogram. Antibiotics for kidney infections Antibiotics are the first line of treatment ... the infection is completely eliminated. Hospitalization for severe kidney infections For a severe kidney infection, your doctor ...

  17. Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu [Kyungpook National Yonsei University School of Medicine, Daegu (Korea, Republic of); Yea, Ji Woon [Dongguk University Gyeongju Hospital, Gyeongju (Korea, Republic of)

    2010-11-15

    The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

  18. How does the neck flexion affect the cervical MRI features of Hirayama disease?

    Science.gov (United States)

    Hou, Chao; Han, Hongbin; Yang, Xiaohong; Xu, Xiaojuan; Gao, Hui; Fan, Dongsheng; Fu, Yu; Sun, Yu; Liu, Bo

    2012-10-01

    Although flexion cervical MRI has been recommended for the diagnosis of Hirayama disease (HD), no study focused on the MR features at different neck flexion angles. Moreover, no uniform flexion angle has been confirmed in clinical practice. The purpose of this study is to quantitatively investigate the MRI typical signs of HD patients in different neck flexion degree and gives a suggestion to the MR scanning. Cervical MRI in neutral and different flexion positions (cervical flexion angle 20°, 25°, 30°, 35°, and 40°) were performed in 45 HD patients. Three MRI features including anterior shifting of the posterior wall of the cervical dural canal (ASD), widening of cervical epidural space, and epidural flow voids (EFV) at each flexed position were summarized. To evaluate ASD quantitatively, the widest cervical epidural space with the maximum sagittal diameters (d) and cervical canal sagittal diameter (D) at the same level were measured. The d/D values at different angles were calculated and compared. ASD was demonstrated in 34 out of 45 cases (75.6%) at 20° and in all cases (100%) at other 4 angles (χ (2) = 25.728, P flexion angles have effects on ASD, widening of cervical epidural space and EFV. 25° is recommended as the least effective diagnostic flexion angle for MRI diagnosis of HD, and 35° may be the best one.

  19. Free fibular strut graft in neglected femoral neck fractures in adult

    Directory of Open Access Journals (Sweden)

    Azam Md Quamar

    2009-01-01

    Full Text Available Background: Neglected femoral neck fracture in adults still poses a formidable challenge. Existing treatment options varies from osteotomy (with or without graft to osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularized, and nonvascularized fibula. The aim of this study was to assess outcome of nonvascularized fibular strut graft and cancellous screw fixation in neglected femoral neck fractures in the younger age group. Materials and Methods: Medical records of 32 patients of neglected femoral neck fracture, in the age group of 22-45 years (mean 37.8 years, operated between May 1994 to December 2001, were retrospectively reviewed. After the application of inclusion and exclusion criteria, 28 patients having three years minimum follow-up (mean 4.6 years were included. Delay between injury and operation varied from four weeks to 42 weeks (mean 16.4 weeks. Closed reduction was achieved in 17 patients; open reduction through Watson-Jones anterolateral approach was performed in the remaining 15 patients in whom closed reduction failed. The fracture was transfixed with three parallel guide wires. Appropriate sized cannulated lag screw (7 mm was then inserted in two of the wires. Selection of the third guide wire for fibula depended on the space available in both anteroposterior and lateral view. Results: Satisfactory bony union was obtained in 25 patients, of whom in four cases, the union occurred in 10-20° (mean 15° of varus. Nonunion occurred in three patients (9.37%, and aseptic necrosis occurred in another six patients (18.75%. Of the 25 patients where union was achieved, five patients showed excellent results; 14 good and six had poor functional result, as evaluated using modified Anglen criteria. Conclusion: Nonvascularized fibular strut graft along with cancellous screws provides a dependable and technically less-demanding alternative procedure for neglected femoral neck fractures in young adults. Fibula

  20. Sub-specialty training in head and neck surgical oncology in the European Union.

    Science.gov (United States)

    Manganaris, Argyris; Black, Myles; Balfour, Alistair; Hartley, Christopher; Jeannon, Jean-Pierre; Simo, Ricard

    2009-07-01

    Sub-specialty training in otorhinolaryngology and head and neck surgery (ORL-HNS) is not standardised across European Union (EU) states and remains diverse. The objective of this study was to assess the current status of sub-specialty training programmes in head and neck surgical oncology within the European Union (EU-15). A postal questionnaire was distributed to 41 representative members of the European Federation of Otorhinolaryngological Societies (EUFOS) in the specialty of ORL-HNS in 15 EU states. The questionnaire included questions regarding the sub-specialty practice, structure, length, access, examination procedures and certification, future developments and also a space for individual comments. Thirty-one respondents (75.6%) from major training centres in 15 different European countries replied. Overall, the data revealed major diversity for all aspects analysed, between and within the different European countries. Only four EU states had formal sub-specialty training in head and neck surgical oncology. This includes Finland, Germany, The Netherlands, and the United Kingdom. In the rest of EU states, the last year of residency programmes is often spent as an introduction to one of the sub-specialties. Sub-specialty training in head and neck surgical oncology within the EU at present is clearly underdeveloped. Issuing a European diploma in ORL-HNS could be an initial step towards assessing the skills acquired during specialist training within the different European countries and formalising specialist training. This would establish a uniform measure for evaluating candidacy for sub-specialty training both across the EU and for USA, Canada or Australia.

  1. Management of the clinically negative neck in early-stage head and neck cancers after transoral resection

    NARCIS (Netherlands)

    Rodrigo, J.P.; Shah, J.P.; Silver, C.E.; Medina, J.E.; Takes, R.P.; Robbins, K.T.; Rinaldo, A.; Werner, J.A.; Ferlito, A.

    2011-01-01

    The decision regarding treatment of the clinically negative neck has been debated extensively. This is particularly true with early-stage tumors for which surgery is the treatment of choice, and the tumor has been resected transorally without a cervical incision. Elective neck dissection in this

  2. Morbidity after neck dissection in head and neck cancer patients: a study describing shoulder and neck complaints, and quality of life

    OpenAIRE

    2004-01-01

    In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain mechanisms, range of motion, and loss of sensation. The consequences of dysfunction such as shoulder disability and activities of daily living, but also psychological problems (depression) and qualit...

  3. Neck injuries in young pediatric homicide victims.

    Science.gov (United States)

    Brennan, Laura K; Rubin, David; Christian, Cindy W; Duhaime, Ann-Christine; Mirchandani, Haresh G; Rorke-Adams, Lucy B

    2009-03-01

    In this study, the authors estimate the prevalence of injuries to the soft tissue of the neck, cervical vertebrae, and cervical spinal cord among victims of abusive head trauma to better understand these injuries and their relationship to other pathophysiological findings commonly found in children with fatal abusive head trauma. The population included all homicide victims 2 years of age and younger from the city of Philadelphia, Pennyslvania, who underwent a comprehensive postmortem examination at the Office of the Medical Examiner between 1995 and 2003. A retrospective review of all available postmortem records was performed, and data regarding numerous pathological findings, as well as the patient's clinical history and demographic information, were abstracted. Data were described using means and standard deviations for continuous variables, and frequency and ranges for categorical variables. Chi-square analyses were used to test for the association of neck injuries with different types of brain injury. The sample included 52 children, 41 (79%) of whom died of abusive head trauma. Of these, 29 (71%) had primary cervical cord injuries: in 21 there were parenchymal injuries, in 24 meningeal hemorrhages, and in 16, nerve root avulsion/dorsal root ganglion hemorrhage were evident. Six children with abusive head trauma had no evidence of an impact to the head, and all 6 had primary cervical spinal cord injury (SCI). No child had a spinal fracture. Six of 29 children (21%) with primary cervical SCIs had soft-tissue (ligamentous or muscular) injuries to the neck, and 14 (48%) had brainstem injuries. There was a significant association of primary cervical SCI with cerebral edema (p = 0.036) but not with hypoxia-ischemia, infarction, or herniation. Cervical SCI is a frequent but not universal finding in young children with fatal abusive head trauma. In the present study, parenchymal and/or root injury usually occurred without evidence of muscular or ligamentous damage

  4. The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled Trial.

    Science.gov (United States)

    Lauche, Romy; Stumpe, Christoph; Fehr, Johannes; Cramer, Holger; Cheng, Ying Wu; Wayne, Peter M; Rampp, Thomas; Langhorst, Jost; Dobos, Gustav

    2016-09-01

    This study aimed to test the efficacy of Tai Chi for treating chronic neck pain. Subjects with chronic nonspecific neck pain were randomly assigned to 12 weeks of group Tai Chi or conventional neck exercises with weekly sessions of 75 to 90 minutes, or a wait-list control. The primary outcome measure was pain intensity (visual analogue scale). Secondary outcomes included pain on movement, functional disability, quality of life, well-being and perceived stress, postural and interoceptive awareness, satisfaction, and safety. Altogether, 114 participants were included (91 women, 49.4 ± 11.7 years of age). After 12 weeks Tai Chi participants reported significantly less pain compared with the wait list group (average difference in mm on the visual analogue scale: -10.5; 95% confidence interval, -20.3 to -.9; P = .033). Group differences were also found for pain on movement, functional disability, and quality of life compared with the wait list group. No differences were found for Tai Chi compared with neck exercises. Patients' satisfaction with both exercise interventions was high, and only minor side effects were observed. Tai Chi was more effective than no treatment in improving pain in subjects with chronic nonspecific neck pain. Because Tai Chi is probably as effective as neck exercises it may be considered a suitable alternative to conventional exercises for those with a preference toward Tai Chi. This article presents results of a randomized controlled trial comparing Tai Chi, conventional neck exercises, and no treatment for chronic nonspecific neck pain. Results indicate that Tai Chi exercises and conventional neck exercises are equally effective in improving pain and quality of life therefore representing beneficial interventions for neck pain. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  5. A rare case of neck pain: acute longus colli calcific tendinitis in a possibly immunocompromised individual.

    Science.gov (United States)

    Estimable, Kerlie; Rizk, Cynthia; Pujalte, George G A

    2015-01-01

    We present a rare case of severe neck pain in a 45-year-old man with severe hidradenitis suppurativa who was participating in a study involving adalimumab. The neck pain was associated with acute longus colli calcific tendinitis, which is a noninfectious inflammatory response in the longus colli tendons secondary to deposition of calcium hydroxyapatite crystal. The diagnosis was made by computed tomography, which showed calcifications and deposits, and magnetic resonance imaging, which showed a retropharyngeal effusion. Ears, Nose, and Throat Services performed a fiberoptic scope examination, which revealed a patent airway and no drainable abscess. Nonsteroidal anti-inflammatory drugs resulted in a dramatic improvement in the patient's clinical symptoms. In acute longus colli tendinitis, differentiating retropharyngeal aseptic effusion from infection is important. Of note, the confounding factor in this case was that the patient was blinded to whether he was receiving the placebo or adalimumab, so whether the patient was immunosuppressed and at risk for infection was unknown. Clinician familiarity and education concerning acute calcific longus colli tendinitis may lead to decreased costs stemming from incorrect diagnosis and unnecessary treatment. © Copyright 2015 by the American Board of Family Medicine.

  6. Proteomic Study of HPV-Positive Head and Neck Cancers: Preliminary Results

    Directory of Open Access Journals (Sweden)

    Géraldine Descamps

    2014-01-01

    Full Text Available Human papillomavirus (HPV was recently recognized as a new risk factor for head and neck squamous cell carcinoma. For oropharyngeal cancers, an HPV+ status is associated with better prognosis in a subgroup of nonsmokers and nondrinkers. However, HPV infection is also involved in the biology of head and neck carcinoma (HNC in patients with a history of tobacco use and/or alcohol consumption. Thus, the involvement of HPV infection in HN carcinogenesis remains unclear, and further studies are needed to identify and analyze HPV-specific pathways that are involved in this process. Using a quantitative proteomics-based approach, we compared the protein expression profiles of two HPV+ HNC cell lines and one HPV− HNC cell line. We identified 155 proteins that are differentially expressed (P<0.01 in these three lines. Among the identified proteins, prostate stem cell antigen (PSCA was upregulated and eukaryotic elongation factor 1 alpha (EEF1α was downregulated in the HPV+ cell lines. Immunofluorescence and western blotting analyses confirmed these results. Moreover, PSCA and EEF1α were differentially expressed in two clinical series of 50 HPV+ and 50 HPV− oral cavity carcinomas. Thus, our study reveals for the first time that PSCA and EEF1α are associated with the HPV-status, suggesting that these proteins could be involved in HPV-associated carcinogenesis.

  7. Neck biomechanics indicate that giant Transylvanian azhdarchid pterosaurs were short-necked arch predators.

    Science.gov (United States)

    Naish, Darren; Witton, Mark P

    2017-01-01

    Azhdarchid pterosaurs include the largest animals to ever take to the skies with some species exceeding 10 metres in wingspan and 220 kg in mass. Associated skeletons show that azhdarchids were long-necked, long-jawed predators that combined a wing planform suited for soaring with limb adaptations indicative of quadrupedal terrestrial foraging. The postcranial proportions of the group have been regarded as uniform overall, irrespective of their overall size, notwithstanding suggestions that minor variation may have been present. Here, we discuss a recently discovered giant azhdarchid neck vertebra referable to Hatzegopteryx from the Maastrichtian Sebeş Formation of the Transylvanian Basin, Romania, which shows how some azhdarchids departed markedly from conventional views on their proportions. This vertebra, which we consider a cervical VII, is 240 mm long as preserved and almost as wide. Among azhdarchid cervicals, it is remarkable for the thickness of its cortex (4-6 mm along its ventral wall) and robust proportions. By comparing its dimensions to other giant azhdarchid cervicals and to the more completely known necks of smaller taxa, we argue that Hatzegopteryx had a proportionally short, stocky neck highly resistant to torsion and compression. This specimen is one of several hinting at greater disparity within Azhdarchidae than previously considered, but is the first to demonstrate such proportional differences within giant taxa. On the assumption that other aspects of Hatzegopteryx functional anatomy were similar to those of other azhdarchids, and with reference to the absence of large terrestrial predators in the Maastrichtian of Transylvania, we suggest that this pterosaur played a dominant predatory role among the unusual palaeofauna of ancient Haţeg.

  8. Neck biomechanics indicate that giant Transylvanian azhdarchid pterosaurs were short-necked arch predators

    Directory of Open Access Journals (Sweden)

    Darren Naish

    2017-01-01

    Full Text Available Azhdarchid pterosaurs include the largest animals to ever take to the skies with some species exceeding 10 metres in wingspan and 220 kg in mass. Associated skeletons show that azhdarchids were long-necked, long-jawed predators that combined a wing planform suited for soaring with limb adaptations indicative of quadrupedal terrestrial foraging. The postcranial proportions of the group have been regarded as uniform overall, irrespective of their overall size, notwithstanding suggestions that minor variation may have been present. Here, we discuss a recently discovered giant azhdarchid neck vertebra referable to Hatzegopteryx from the Maastrichtian Sebeş Formation of the Transylvanian Basin, Romania, which shows how some azhdarchids departed markedly from conventional views on their proportions. This vertebra, which we consider a cervical VII, is 240 mm long as preserved and almost as wide. Among azhdarchid cervicals, it is remarkable for the thickness of its cortex (4–6 mm along its ventral wall and robust proportions. By comparing its dimensions to other giant azhdarchid cervicals and to the more completely known necks of smaller taxa, we argue that Hatzegopteryx had a proportionally short, stocky neck highly resistant to torsion and compression. This specimen is one of several hinting at greater disparity within Azhdarchidae than previously considered, but is the first to demonstrate such proportional differences within giant taxa. On the assumption that other aspects of Hatzegopteryx functional anatomy were similar to those of other azhdarchids, and with reference to the absence of large terrestrial predators in the Maastrichtian of Transylvania, we suggest that this pterosaur played a dominant predatory role among the unusual palaeofauna of ancient Haţeg.

  9. Neck biomechanics indicate that giant Transylvanian azhdarchid pterosaurs were short-necked arch predators

    Science.gov (United States)

    2017-01-01

    Azhdarchid pterosaurs include the largest animals to ever take to the skies with some species exceeding 10 metres in wingspan and 220 kg in mass. Associated skeletons show that azhdarchids were long-necked, long-jawed predators that combined a wing planform suited for soaring with limb adaptations indicative of quadrupedal terrestrial foraging. The postcranial proportions of the group have been regarded as uniform overall, irrespective of their overall size, notwithstanding suggestions that minor variation may have been present. Here, we discuss a recently discovered giant azhdarchid neck vertebra referable to Hatzegopteryx from the Maastrichtian Sebeş Formation of the Transylvanian Basin, Romania, which shows how some azhdarchids departed markedly from conventional views on their proportions. This vertebra, which we consider a cervical VII, is 240 mm long as preserved and almost as wide. Among azhdarchid cervicals, it is remarkable for the thickness of its cortex (4–6 mm along its ventral wall) and robust proportions. By comparing its dimensions to other giant azhdarchid cervicals and to the more completely known necks of smaller taxa, we argue that Hatzegopteryx had a proportionally short, stocky neck highly resistant to torsion and compression. This specimen is one of several hinting at greater disparity within Azhdarchidae than previously considered, but is the first to demonstrate such proportional differences within giant taxa. On the assumption that other aspects of Hatzegopteryx functional anatomy were similar to those of other azhdarchids, and with reference to the absence of large terrestrial predators in the Maastrichtian of Transylvania, we suggest that this pterosaur played a dominant predatory role among the unusual palaeofauna of ancient Haţeg. PMID:28133577

  10. Intrathyroidal Parathyroid Cyst: An Unusual Neck Mass

    Directory of Open Access Journals (Sweden)

    Maswood M Ahmad

    2017-03-01

    Full Text Available Parathyroid cyst (PC is a very rare condition. A case of intrathyroidal PC is being reported here in a 53-year-old woman who presented to the endocrine clinic with slowly progressive painless left anterior neck swelling for 1 year with no symptoms of thyroid or parathyroid dysfunction and no compressive symptoms. Ultrasound of the thyroid showed a well-defined cystic lesion measuring 4.7 × 3.6 cm in maximum diameter with internal echoes within the cyst located in the left lobe of the thyroid gland. Fine needle aspiration revealed colorless clear fluid with a high concentration of parathyroid hormone. The patient underwent left hemithyroidectomy at her request. Histopathology revealed parathyroid tissue with unilocular cyst and thyroid tissue with goitrous changes. She was in remission, and there was no evidence of thyroid or parathyroid dysfunction after surgery.

  11. Neurogenic sarcomas of the neck in neurofibromatosis.

    Science.gov (United States)

    Martin, G; Kleinsasser, O

    1981-01-01

    Based on two observations and a review of the literature, the pathological and clinical findings in sarcomas of the neck in patients with neurofibromatosis are described. Histologically these neurogenic tumours show a manifold picture; in addition to spindle-cell sarcomas pleomorphic structures are to be found, which can be similar to rhabdomyo-, lipo-, chondro-, angio-, or osteogenic sarcomas so that a histological diagnosis of a neurogenic sarcoma cannot always be made without clinical details. Up to the present surgical treatment is preferred; the value of cytostatic therapy and irradiation is controversial. The results of treating these tumours are unsatisfactory. Of 29 cases reported in the literature, only two could be found in which the patient survived without a recurrence for more than five years.

  12. Recurrent plunging ranula of the neck.

    Science.gov (United States)

    Al Ruhaimi, Khalid A

    2013-03-01

    The reported case describes a mismanaged extensive recurrent plunging ranula that occupied a large portion of the neck. The ranula is usually clinically diagnosed. However, absence of visible intra-oral signs may mislead the diagnosis and leads to improper surgical management. Presence of amylase in the aspirated fluids is an important aid in the differential diagnosis. Thereby confirming the salivary origin of the fluids and thus avoiding extensive investigations. The recurrence rate varies according to the procedure performed. Diverse methods of treating ranula have been reported in the literature with variable results. These include marsuplization, excision of the ranula, incision of the ranula and drainage of the contents, excision of the sublingual gland and drainage. The successful procedure to treat plunging ranula depends on complete excision of the affected sublingual gland and drainage of its contents. In this paper, the useful diagnostic investigations and the recommended surgical intervention procedure were described.

  13. [Plasmacytomas of the head and neck].

    Science.gov (United States)

    Marzetti, E; Marzetti, A; Palma, O; Pezzuto, R W

    1996-02-01

    Neoplastic proliferation of plasma cells results in a population of immunologically homogeneous cells that can produce diffuse (multiple myeloma) or localized (extramedullary plasmacytomas and solitary plasmacytoma of bone) disease. In otorhinolaryngologic literature these neoplasms are rarely described and their nosological arrangement is often confused. The presence of a plasma cell neoplasm can be a surprise and sometimes a diagnostic challenge to the head and neck surgeon. Proper management of such lesions needs to be individualized according to their expected biologic behaviour. The recent observation of a case of maxillary sinus plasmacytoma suggested the Authors to carefully review the literature, drawing their attention mainly on the current histogenetic hypotheses and their consequences in therapeutic strategy. The correct diagnostic procedure is also explained, highlighting the difficulties due to both the protean nature of the disease and the still existing nosological confusion. The possibility of a plasma cell tumour should be never forgotten in presence of an head and neck neoplasm. Because these neoplasms may signal the presence of multiple mieloma, full evaluation is required to exclude disseminated disease. In light of recent histogenetic acquisitions it is suggested that extramedullary plasmacytomas can be classified among the so-called "mucosa-associated" lymphomas. Possible following differences in therapeutic approach and long-term follow-up are also indicated, stressing the role of surgery in managing these disorders. Surgical excision of extramedullary plasmacytomas followed by complementary radiotherapy on the site of tumour is proposed as the best treatment for these kind of neoplasms. This is in opposition with "classical" statement considering radiotherapy the only treatment for this kind of disorders.

  14. Clinical Study of Tuina for Stiff Neck

    Institute of Scientific and Technical Information of China (English)

    吴耀持; 张峻峰; 汪崇淼; 王健雄; 张沈煜

    2009-01-01

    Objective: To observe the clinical effect of Tuina for stiffneck. Methods: All of 216 cases with stiff neck were randomly allocated into a tuina group (110 cases) and a control group (106 cases). The patients in the tuina group were treated with "Three Parts, Four Points,Five Manipulation" tuina therapy, while those in the control group were treated with pucturing Wailaogong (Ex-UE 8), Houxi (SI 3), Jianjing (GB 21) and Ashi points in the affected side,Once a day, and 3 times constitute one treatment course. The effect was observed after 2-course treatments. Result: The effective rate in the tuina group and the control group was 93.64% and 83.02%, respectively, and there was statistical difference between the two groups (P < 0.05).Conclusion: The tuina therapy of "Three Parts, Four Points, Five Manipulations" is better than simple acupuncture therapy in treating stiff neck.%目的:观察推拿治疗落枕的临床疗效.方法:将216例落枕患者随机分为推拿组110例和对照组106例,推拿组用"三部四穴五法"推拿法治疗,对照组针刺患侧外劳宫、后溪、肩井和阿是穴.每日1次,3次为1个疗程;治疗2个疗程后观察疗效. 结果:推拿组有效率为93.64%,对照组为83.02%,两者比较有统计学意义(P<0.05)结论:"三部四穴五法"推拿法治疗落枕明显优于单纯针刺疗法.

  15. Perioperative Allogeneic Blood Transfusion Is Associated With Surgical Site Infection After Abdominoperineal Resection-a Space for the Implementation of Patient Blood Management Strategies.

    Science.gov (United States)

    Kaneko, Kensuke; Kawai, Kazushige; Tsuno, Nelson H; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Watanabe, Toshiaki

    2015-05-01

    Allogeneic blood transfusion (ABT) has been reported as a major risk factor for surgical site infection (SSI) in patients undergoing colorectal surgery. However, the association of ABT with SSI in patients undergoing abdominoperineal resection (APR) and total pelvic exenteration (TPE) still remains to be evaluated. Here, we aim to elucidate this association. The medical records of all patients undergoing APR and TPE at our institution in the period between January 2000 and December 2012 were reviewed. Patients without SSI (no SSI group) were compared with patients who developed SSI (SSI group), in terms of clinicopathologic features, including ABT. In addition, data for 262 patients who underwent transabdominal rectal resection at our institution in the same period were also enrolled, and their data on differential leukocyte counts were evaluated. Multivariate analysis showed that intraoperative transfusion was an independent predictive factor for SSI after APR and TPE (P = 0.004). In addition, the first-operative day lymphocyte count of patients undergoing APR, TPE, and transabdominal rectal resection was significantly higher in nontransfusion patients compared with transfusion ones (P = 0.026). ABT in the perioperative period of APR and TPE may have an important immunomodulatory effect, leading to an increased incidence of SSI. This fact should be carefully considered, and efforts to avoid allogeneic blood exposure while still achieving adequate patient blood management would be very important for patients undergoing APR and TPE as well.

  16. Change in neck circumference after shoulder arthroscopy: An observational study

    Directory of Open Access Journals (Sweden)

    Shrividya Chellam

    2015-01-01

    Full Text Available Background and Aims: Shoulder arthroscopy requires fluid irrigation, which causes soft-tissue oedema around chest, neck, and arm intraoperatively, leading to postoperative airway complications. We decided to study the incidence of increase in the neck circumference in shoulder arthroscopy and its effects on the airway. Methods: We studied 32 cases of shoulder arthroscopies over a period of 1-year, performed under general anaesthesia with interscalene block. The neck circumference of patients before and after the procedure was measured along with other parameters. The endotracheal tube cuff was deflated at the end of surgery to determine air leak around the tube. The negative leak test suggested airway oedema. Results: Thirty out of 32 patients showed positive air leak test. The average change in neck circumference was 1.17 ± 1.16 cm and all could be extubated uneventfully. Two showed negative leak test with an increase in neck circumference by 4.5 and 6.4 cm and were not extubated. Multiple regression analysis for risk factors showed intraoperative hypertension as a single predictor for an increase in neck circumference. Conclusion: Change in the neck circumference beyond 4 cm may suggest airway compromise and below 4 cm, airway compromise is unlikely even in the presence of extensive soft-tissue oedema around the shoulder, upper arm and chest.

  17. Characteristics of a new episode of neck pain.

    Science.gov (United States)

    Leaver, Andrew M; Maher, Christopher G; McAuley, James H; Jull, Gwendolen A; Refshauge, Kathryn M

    2013-06-01

    We report on the demographic and clinical characteristics of patients seeking manual therapy care for a new episode of non-specific neck pain and report on characteristics associated with higher levels of pain and disability in these patients. Demographic and clinical data were collected from patients who enrolled in a clinical trial of manipulation for neck pain. A profile of these patients was formulated using descriptive statistics. Multivariate linear regression models were used to describe the relationship between patient characteristics and severity of pain and disability. Patients with a new episode of non-specific neck pain reported pain intensity of 6.1 ± 2.0 (mean ± SD) on a 0-10 numerical scale and disability scores of 15.7 ± 7.4 (Neck Disability Index/50). Sixty-three percent had a prior history of neck pain. Concomitant symptoms were highly prevalent including upper limb pain (80%), headache (65%), upper back pain (64%), lower back pain (39%), dizziness (31%) and nausea (23%). There was a strong association between pain intensity and disability (p pain was also associated with not having concomitant back pain (p = 0.01) More severe disability was also associated with poor general health (p neck pain, and deemed suitable for treatment with neck manipulation reported moderately high intensity pain and disability with widespread and frequent concomitant symptoms.

  18. EVALUATION OF NECK SHAFT ANGLE OF FEMUR ON DRY BONES

    Directory of Open Access Journals (Sweden)

    Radha

    2015-04-01

    Full Text Available BACKGROUND: Evaluation of the neck shaft angle of femur helps to understand clinical relevance in bio mechanics of the hip joint. It helps for the better treatment of different pathological conditions of hip and femur and also to design prosthesis. Femoral neck shaft angle is important to convey the information regarding the race to which they belong. Hence the present study was under taken to determine the neck shaft angle of femur in humans. OBJECTIVE: 1. To correct the different types of deformity and to have a normal good walking Mechanism. 2. To know the recent methodology and attempt to evaluate the range of normal Angles of femora and their sex differences. METHODS: ANTHROPOMETRIC: 100 Adult dry bones were studied and analyzed . The neck shaft angle of femur was measured by tracing outlines of contours of all femora. RESULTS: The neck shaft angle of the femur have revealed that there is no much difference in between males and females. There was slightly higher 0.2° in females. INTERPRETATION & CONCLUSION: There was no significant gender difference in neck shaft angle. The Knowledge of knowing the neck shaft angle helps to understand the Biomechanics of the hip joint and also for better treatment of pathological condition of hip and femur.

  19. Relationship between neck disability and mandibular range of motion.

    Science.gov (United States)

    Packer, Amanda Carine; Dibai-Filho, Almir Vieira; de Souza Costa, Ana Cláudia; dos Santos Berni, Kelly Cristina; Rodrigues-Bigaton, Delaine

    2014-01-01

    There is a close interaction between the mandibular and cervical systems due to the existing neurological and biomechanical communications. This study aimed to evaluate the relationship between neck disability and mandibular range of motion (ROM). Fifty-two women aged between 18 and 40 years were recruited and allocated to four groups using two outcome measures: the Neck Disability Index (NDI) and the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): Group I (n=13), healthy volunteers; Group II (n=13), volunteers with TMD and neck disability; Group III (n=13), volunteers with TMD and without neck disability; and Group IV (n=13), volunteers with neck disability and without TMD. Mandibular ROM was evaluated as part of the RDC/TMD clinical examination. Statistical analysis involved one-way ANOVA followed by Tukey's test for comparisons between groups. Spearman's correlation coefficients were calculated to determined correlations among the variables. Significant differences were found in the mandibular ROM of functional opening in the comparisons between Groups I and III (p=0.009) and between Groups III and IV (p=0.024). No significant association was found between mandibular ROM and the NDI score (p > 0.05). Based on the methodology employed, there is no association between mandibular ROM and neck disability in university women. In this sense, clinical interventions focusing on the flexibility of the temporomandibular joint does not have repercussions on the neck disability and vice versa.

  20. Lateral lower face and neck contouring following burn injury.

    Directory of Open Access Journals (Sweden)

    Sadrollah Motamed

    2015-04-01

    Full Text Available The neck is normally a concave and highly mobile structure. Facial and cervical skin is prone to burn scar contracture because of its thin nature. The goal of treatment is to reconstruct this region to achieve a good aesthetic outcome and also normal neck and chin mobilization. This study was conducted to compare the effect of one row of suture and three rows of suture in critical points of the neck to recreate cervicomandibular angle for better contouring of the neck. A cross-sectional study was performed from July 2006 until August 2010. A total of 65 patients underwent lower lateral face and neck burn scar contracture reconstruction. The mean age of participants was 25.5 years old. After designing a local flap, in 31 patients we applied one row of suture. In 34 patients, we used three rows of suture on each side of the neck incorporation with  the recipient bed and the flap dermis or capsule to recreate a natural lower lateral face and neck contour (P<0.001. The standard deviation in hospitalization was 7 ± 2 days for group A and 6 ± 1 days for group B. In a two years follow-up, no blunting of cervicomandibular angle occurred and three rows of suture were superior according to present findings.

  1. The Articulation of Sauropod Necks: Methodology and Mythology

    Science.gov (United States)

    Stevens, Kent A.

    2013-01-01

    Sauropods are often imagined to have held their heads high atop necks that ascended in a sweeping curve that was formed either intrinsically because of the shape of their vertebrae, or behaviorally by lifting the head, or both. Their necks are also popularly depicted in life with poses suggesting avian flexibility. The grounds for such interpretations are examined in terms of vertebral osteology, inferences about missing soft tissues, intervertebral flexibility, and behavior. Osteologically, the pronounced opisthocoely and conformal central and zygapophyseal articular surfaces strongly constrain the reconstruction of the cervical vertebral column. The sauropod cervico-dorsal vertebral column is essentially straight, in contrast to the curvature exhibited in those extant vertebrates that naturally hold their heads above rising necks. Regarding flexibility, extant vertebrates with homologous articular geometries preserve a degree of zygapophyseal overlap at the limits of deflection, a constraint that is further restricted by soft tissues. Sauropod necks, if similarly constrained, were capable of sweeping out large feeding surfaces, yet much less capable of retracting the head to explore the enclosed volume in an avian manner. Behaviorally, modern vertebrates generally assume characteristic neck postures which are close to the intrinsic curvature of the undeflected neck. With the exception of some vertebrates that can retract their heads to balance above their shoulders at rest (e.g., felids, lagomorphs, and some ratites), the undeflected neck generally predicts the default head height at rest and during locomotion. PMID:24205266

  2. Neck masses: diagnostic analysis of 630 cases in Turkish population.

    Science.gov (United States)

    Balikci, H H; Gurdal, M M; Ozkul, M H; Karakas, M; Uvacin, O; Kara, N; Alp, A; Ozbay, I

    2013-11-01

    Neck masses can be classified into three main categories: congenital, inflammatory and neoplastic. Our aim was to determine the distribution of diagnosis in patients who were followed-up for a neck mass and had undergone surgery for diagnostic indications. Six hundred and thirty cases referred to the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital between January 2005 and February 2012 with a neck mass who underwent excisional or incisional biopsy to establish a histopathologic diagnosis were retrospectively evaluated. Patients with a diagnosis of upper aerodigestive tract malignancy were excluded from the study. As well as the patients with thyroid masses were excluded. Only unknown primary neck masses were included in the study. The neck masses were categorized as inflammatory (33.49 %), congenital (18.9 %) or neoplastic (47.6 %). Neoplastic masses were either benign (51 %) or malignant (49 %) tumors. The most common causes were tuberculous lymphadenitis (40.28 %) among inflammatory masses, thyroglossal duct cysts (32.77 %) among congenital masses, pleomorphic adenoma (22.33 %) among benign neoplastic masses, and lymphoma (20 %) among malignant neoplastic masses. The most common types of mass were congenital in the 0-20 year age group, benign neoplastic in 21-40-year-old and malignant neoplastic in the >40-year group. Any neck mass, especially in an elderly patient, should be managed with caution as a considerable proportion may be malignant. In children and adolescents, a neck mass requiring surgery is most likely to be congenital. Tuberculosis should be considered as a cause of a neck mass due to a long-term inflammatory process in a developing country.

  3. Sauropod necks: are they really for heat loss?

    Directory of Open Access Journals (Sweden)

    Donald M Henderson

    Full Text Available Three-dimensional digital models of 16 different sauropods were used to examine the scaling relationship between metabolism and surface areas of the whole body, the neck, and the tail in an attempt to see if the necks could have functioned as radiators for the elimination of excess body heat. The sauropod taxa sample ranged in body mass from a 639 kg juvenile Camarasaurus to a 25 t adult Brachiosaurus. Metabolism was assumed to be directly proportional to body mass raised to the ¾ power, and estimates of body mass accounted for the presence of lungs and systems of air sacs in the trunk and neck. Surface areas were determined by decomposing the model surfaces into triangles and their areas being computed by vector methods. It was found that total body surface area was almost isometric with body mass, and that it showed negative allometry when plotted against metabolic rate. In contrast, neck area showed positive allometry when plotted against metabolic rate. Tail area show negative allometry with respect to metabolic rate. The many uncertainties about the biology of sauropods, and the variety of environmental conditions that different species experienced during the groups 150 million years of existence, make it difficult to be absolutely certain about the function of the neck as a radiator. However, the functional combination of the allometric increase of neck area, the systems of air sacs in the neck and trunk, the active control of blood flow between the core and surface of the body, changing skin color, and strategic orientation of the neck with respect to wind, make it plausible that the neck could have functioned as a radiator to avoid over-heating.

  4. Characteristics of visual disturbances reported by subjects with neck pain.

    Science.gov (United States)

    Treleaven, Julia; Takasaki, Hiroshi

    2014-06-01

    Visual symptoms are often reported by patients with neck pain. The aim of the study was to report on the prevalence and most troublesome visual disturbances in subjects with neck pain. Seventy subjects with neck pain and seventy healthy control subjects answered questions about the presence and magnitude (/12) - product of frequency (0-4) and intensity (0-3) of each of 16 visual symptoms noted to be associated with neck pain and other possible causes. A visual complaint index (VCI) (/168) was generated from the sum of the magnitude rating of 14 significant symptoms. The neck pain group had significantly (P > 0.05) greater prevalence and magnitude of 14/16 visual complaints and VCI (mean 27.4) compared to control subjects (mean 6.2). The most prevalent symptoms were 'need to concentrate to read' (70%) and 'sensitivity to light' (58.6%). The least prevalent were 'double vision' (28.6%) and 'dizzy reading' (38.6%). The most troublesome symptoms (greatest magnitude) were 'need to concentrate to read' (3.4/12), 'visual fatigue' (3/12), 'difficulty judging distances' (2.1/12) and 'sensitivity to light' (2.1/12) while the least troublesome complaints were 'double vision' (0.5/12), 'red eyes' (1/12) and 'spots and words moving' (1/12). The characteristics of the visual symptoms were mostly consistent for those previously associated with neck pain. Subjects with traumatic neck pain had a significantly higher VCI compared to those with idiopathic neck pain. The results could help with differential diagnosis. The visual symptoms might be related to eye movement control disturbances in neck pain, however further research is required.

  5. Radiotherapy of Neck Node Metastases from an Unknown Primary Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun [Kyungpook National University School of Medicine, Daegu (Korea, Republic of)

    2007-12-15

    Purpose: The aim of this retrospective analysis was to analyze the results of radiotherapy administered to patients with neck node metastases from an unknown primary cancer, with or without neck dissection. Materials and Methods: From January 1986 to December 2005, 88 patients with neck node metastases from an unknown primary cancer were treated with curative intent. The age of the patients ranged from 35 to 74 years (median age, 59 years). There were 74 male and 14 female patients. Distribution of patients by N status was as follows: N1, 4 patients; N2a, 10 patients; N2b, 48 patients; N2c, 8 patients; N3, 18 patients. Fifty-one patients underwent neck dissection and 37 patients had only a biopsy (31 patients had fine-needle aspiration and 6 patients had an excisional biopsy). All patients received radiotherapy. The follow-up time ranged from 1 to 154 months, with a median time of 32 months. Results: The overall survival (OS) and disease-free survival (DFS) rate at 5 years were 43.9% and 41.7%, respectively. The factors associated with the OS rate were neck dissection, and a subsequent primary tumor. Factors associated with the DFS rate were N stage, neck dissection, and a subsequent primary tumor. Neck failure was noted in 15 patients, distant metastases in 18 patients, and a subsequent primary tumor in 8 patients. Conclusion: With comprehensive radiotherapy given to the bilateral neck and the potential mucosal sites, good survival rates can be obtained in patients with neck node metastases from an unknown primary cancer. However, considering the side effects, a randomized trial is required to determine the optimal radiotherapy volume.

  6. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

    Science.gov (United States)

    Heck, Julia E; Berthiller, Julien; Vaccarella, Salvatore; Winn, Deborah M; Smith, Elaine M; Shan'gina, Oxana; Schwartz, Stephen M; Purdue, Mark P; Pilarska, Agnieszka; Eluf-Neto, Jose; Menezes, Ana; McClean, Michael D; Matos, Elena; Koifman, Sergio; Kelsey, Karl T; Herrero, Rolando; Hayes, Richard B; Franceschi, Silvia; Wünsch-Filho, Victor; Fernández, Leticia; Daudt, Alexander W; Curado, Maria Paula; Chen, Chu; Castellsagué, Xavier; Ferro, Gilles; Brennan, Paul; Boffetta, Paolo; Hashibe, Mia

    2010-01-01

    Background Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV). Methods We undertook a pooled analysis of four population-based and four hospital-based case–control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral–anal contact. Findings were stratified by sex and disease subsite. Results Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09, 2.33) and with an earlier age at sexual debut (OR = 2.36, 95% CI 1.37, 5.05). Cancer of the base of the tongue was associated with ever having oral sex among women (OR = 4.32, 95% CI 1.06, 17.6), having two sexual partners in comparison with only one (OR = 2.02, 95% CI 1.19, 3.46) and, among men, with a history of same-sex sexual contact (OR = 8.89, 95% CI 2.14, 36.8). Conclusions Sexual behaviours are associated with cancer risk at the head and neck cancer subsites that have previously been associated with HPV infection. PMID:20022926

  7. Chronic expanding hematoma of thorax extended to the neck.

    Science.gov (United States)

    Ueda, Hitoshi; Baba, Hiromitsu; Ondo, Kaoru

    2014-01-01

    We report a rare case of chronic expanding hematoma of thorax extended to the neck. An 83-year-old man with a history of Lucite ball plombage and thoracoplasty of bilateral thorax was admitted with numbness of left upper extremity. In 6 months, left supraclavicular fossa was gradually bulged like tumor. The lesion was diagnosed as chronic expanding hematoma. Surgically, Lucite balls were removed with surrounding hematoma debris and fluid, and neck hematoma, which was slightly communicated to the thorax, was extirpated. We discussed the genesis of this hematoma and its extension to the neck.

  8. Fenestrated internal jugular vein: a rare finding in neck dissection.

    Science.gov (United States)

    Moreno-Sánchez, M; Hernández Vila, C; González-García, R; Monje, F

    2015-09-01

    Fenestration of the internal jugular vein (IJV) is an extremely rare phenomenon. An 85-year-old woman was referred to our department with T2N0M0 squamous cell carcinoma of the right floor of the mouth. The patient underwent local resection, an ipsilateral modified type 3 radical neck dissection, and microsurgical reconstruction. During neck dissection, a fenestration was observed in the middle of the IJV. No structure passed through the fenestration. Such anatomical variations are rare, but clinicians and surgeons should be aware of them in order to avoid damage to the important vascular structures, especially if a neck dissection is performed.

  9. Unusual presentation of a radial neck fracture in a child

    Directory of Open Access Journals (Sweden)

    Murali Poduval

    2013-01-01

    Full Text Available Fracture of the radial neck are uncommon injuries. In children, they may present as radial neck fractures, a components of forearm fracture dislocations, or as isolated fracture dislocations. Here, we present an unusual and previously undescribed variant of radial neck fracture with dislocation of the radial head to the medial side and ulnar nerve injury. The fracture dislocation was openly reduced and fixed with a small fragment plate. The fracture healed with some loss of rotational movements. At short followup of 6 months patient had useful elbow function but ulnar nerve did not recover.

  10. Bilateral impacted femoral neck fracture in a renal disease patient

    Directory of Open Access Journals (Sweden)

    Pramod Devkota

    2013-01-01

    Full Text Available Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  11. Exercise therapy for trismus in head and neck cancer

    OpenAIRE

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F K L; Roodenburg, J.L.N.; Pater, R.

    2007-01-01

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of physical therapy with the diagnosis trismus were retrieved and analyzed. Data of 27 patients with trismus related to head and neck cancer and data of eight patients with trismus not related to cance...

  12. Bilateral nonunited femoral neck fracture in a child with osteopetrosis.

    Science.gov (United States)

    Steinwender, G; Hosny, G A; Koch, S; Grill, F

    1995-01-01

    We report a case of osteopetrosis with bilateral nonunited femoral neck and coxa vara in a 7-year-old boy. There was a history of traumatic transcervical left femoral neck fracture unsuccessfully treated by internal fixation. We performed a bilateral subtrochanteric valgus osteotomy. K-Wire fixation failed on the right side due to hardness of the bone. Finally, internal fixation with an angular plate after predrilling of the femoral neck offered stability. Bone union was achieved on both sides, resulting in full recovery of normal physical activity.

  13. Primary bladder neck obstruction may be determined by postural imbalances.

    Science.gov (United States)

    Camerota, Tommaso Ciro; Zago, Matteo; Pisu, Stefano; Ciprandi, Daniela; Sforza, Chiarella

    2016-12-01

    Primary bladder neck obstruction (PBNO) is a frequent under-investigated urological condition in which the bladder neck fails to open adequately during voiding. In the majority of cases no known etiological factor can be found. In this study we propose a new hypothesis to explain the origin of the disease in young male patients with no neurological disorders. We suggest a possible role of an unbalanced biomechanics of the pelvis on urethral sphincters activity and on functional bladder capacity. To support the proposed hypothesis, we present pilot gait analysis data of young male patients with primary bladder neck obstruction.

  14. Examination of the patient with head and neck cancer.

    Science.gov (United States)

    Georgopoulos, Rachel; Liu, Jeffrey C

    2015-07-01

    Head and neck cancer typically refers to epithelial malignancies of the upper aerodigestive tract and may include neoplasms of the thyroid, salivary glands, and soft tissue, bone sarcomas, and skin cancers. Two-thirds of patients present with advanced disease involving regional lymph nodes at the time of diagnosis. A thorough history and detailed examination are integral to oncologic staging and treatment planning. This article begins with an overview of the head and neck examination (with special attention to detailed findings with clinical implications), followed by a discussion of the major head and neck subsites, and clinical pearls surrounding the examination.

  15. Relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability.

    Science.gov (United States)

    Lau, Kwok Tung; Cheung, Ka Yuen; Chan, Kwok Bun; Chan, Man Him; Lo, King Yuen; Chiu, Thomas Tai Wing

    2010-10-01

    This was a cross-sectional correlation study to explore the relationships between sagittal postures of thoracic and cervical spine, presence of neck pain, neck pain severity and disability. Moreover, the reliability of the photographic measurement of the sagittal posture of thoracic and cervical spine was investigated. Forty-five subjects without neck pain and forty-seven subjects with neck pain were recruited. Using a photographic method, the sagittal thoracic and cervical postures were measured by the upper thoracic and the craniovertebral (CV) angles respectively. The Numeric Pain Rating Scale (NPRS) and Chinese version Northwick Park Neck Pain Questionnaire (NPQ) were used to assess neck pain severity and disability. The upper thoracic angle was positively correlated (r(s) = 0.63, p angle was negatively correlated (r(s) = -0.56, p upper thoracic angle was negatively correlated with the CV angles (r(s) = -0.62, p angle, the upper thoracic angle was moderately correlated with the neck pain severity (r(s) = 0.43, p = 0.01) and disability (r(s) = 0.44, p = 0.02). The upper thoracic angle (OR = 1.37, p angle (OR = 0.86, p = 0.04).

  16. Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain

    DEFF Research Database (Denmark)

    Gross, Anita R; Kaplan, Faith; Huang, Stacey

    2013-01-01

    To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain.......To conduct an overview on psychological interventions, orthoses, patient education, ergonomics, and 1⁰/2⁰ neck pain prevention for adults with acute-chronic neck pain....

  17. Role of human papillomavirus and its detection in potentially malignant and malignant head and neck lesions: updated review.

    Science.gov (United States)

    Chaudhary, Ajay Kumar; Singh, Mamta; Sundaram, Shanthy; Mehrotra, Ravi

    2009-06-25

    Head and neck malignancies are characterized by a multiphasic and multifactorial etiopathogenesis. Tobacco and alcohol consumption are the most common risk factors for head and neck malignancy. Other factors, including DNA viruses, especially human papilloma virus (HPV), may also play a role in the initiation or development of these lesions. The pathways of HPV transmission in the head and neck mucosal lesions include oral-genital contact, more than one sexual partner and perinatal transmission of HPV to the neonatal child. The increase in prevalence of HPV infection in these lesions may be due to wider acceptance of oral sex among teenagers and adults as this is perceived to be a form of safe sex. The prevalence of HPV in benign lesions as well as malignancies has been assessed by many techniques. Among these, the polymerase chain reaction is the most sensitive method. Review of literature reveals that HPV may be a risk factor for malignancies, but not in all cases. For confirmation of the role of HPV in head and neck squamous cell carcinoma, large population studies are necessary in an assortment of clinical settings. Prophylactic vaccination against high-risk HPV types eventually may prevent a significant number of cervical carcinomas. Of the two vaccines currently available, Gardasil (Merck & Co., Inc.) protects against HPV types 6, 11, 16 and 18, while the other vaccine, Cervarix (GlaxoSmithKline, Rixensart, Belgium) protects against HPV types 16 and 18 only. However, the HPV vaccine has, to the best of our knowledge, not been tried in head and neck carcinoma. The role of HPV in etiopathogenesis, prevalence in benign and malignant lesions of this area and vaccination strategies are briefly reviewed here.

  18. Neck motion kinematics: an inter-tester reliability study using an interactive neck VR assessment in asymptomatic individuals.

    Science.gov (United States)

    Sarig Bahat, Hilla; Sprecher, Elliot; Sela, Itamar; Treleaven, Julia

    2016-07-01

    The use of virtual reality (VR) for assessment and intervention of neck pain has previously been used and shown reliable for cervical range of motion measures. Neck VR enables analysis of task-oriented neck movement by stimulating responsive movements to external stimuli. Therefore, the purpose of this study was to establish inter-tester reliability of neck kinematic measures so that it can be used as a reliable assessment and treatment tool between clinicians. This reliability study included 46 asymptomatic participants, who were assessed using the neck VR system which displayed an interactive VR scenario via a head-mounted device, controlled by neck movements. The objective of the interactive assessment was to hit 16 targets, randomly appearing in four directions, as fast as possible. Each participant was tested twice by two different testers. Good reliability was found of neck motion kinematic measures in flexion, extension, and rotation (0.64-0.93 inter-class correlation). High reliability was shown for peak velocity globally (0.93), in left rotation (0.9), right rotation and extension (0.88), and flexion (0.86). Mean velocity had a good global reliability (0.84), except for left rotation directed movement with moderate reliability (0.68). Minimal detectable change for peak velocity ranged from 41 to 53 °/s, while mean velocity ranged from 20 to 25 °/s. The results suggest high reliability for peak and mean velocity as measured by the interactive Neck VR assessment of neck motion kinematics. VR appears to provide a reliable and more ecologically valid method of cervical motion evaluation than previous conventional methodologies.

  19. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study.

    Science.gov (United States)

    Bragatto, M M; Bevilaqua-Grossi, D; Regalo, S C H; Sousa, J D; Chaves, T C

    2016-05-01

    Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty-two female computer workers who were divided into two groups: (i) those with self-reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self-reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ(2) = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work-related factors to be good predictors of disability (R(2) = 0·93, P neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain-related disability.

  20. Persistent fever, neck swelling, and small vessel vasculitis following tonsillectomy in a patient with Behçet’s disease: a case report

    Directory of Open Access Journals (Sweden)

    Wagner Claudia

    2012-10-01

    Full Text Available Abstract Introduction Behçet’s disease commonly presents with recurrent oral and genital mucocutaneous ulcerations, uveitis and various skin manifestations. Other clinical symptoms include gastrointestinal ulcerations, arthritis, venous thrombosis, arterial aneurysms and central nervous system affection. Vasculitis underlies most clinical symptoms of Behçet’s disease. Case presentation We report the case of a 62-year-old European Caucasian woman with Behçet’s disease who presented with persistent fever and neck soft-tissue swelling, despite broad antibiotic treatment, two weeks after acute tonsillitis and a tonsillectomy. Diffuse epi- and mesopharyngeal swelling shown on a computed tomography scan of her neck and persistently elevated serum markers of inflammation initially prompted suspicion of an infectious etiology. Magnet resonance imaging of her neck and a neck tissue biopsy finally confirmed small vessel vasculitis involving skin, subcutaneous tissue and muscle. Considering the clinical presentation, past medical history and histological findings, we interpreted our patient’s symptoms as a flare of Behçet’s disease. Immunosuppressive treatment led to rapid clinical improvement. Conclusion A patient with Behçet’s disease developed small vessel vasculitis of the soft tissue of her neck after tonsillitis and a tonsillectomy. Infection and surgery probably triggered a flare of Behçet’s disease.

  1. Pretreatment performance status and nutrition are associated with early mortality of locally advanced head and neck cancer patients undergoing concurrent chemoradiation.

    Science.gov (United States)

    Chang, Pei-Hung; Yeh, Kun-Yun; Huang, Jen-Seng; Lai, Chien-Hong; Wu, Tsung-Han; Lan, Yii-Jenq; Tsai, Jason Chien-Sheng; Chen, Eric Yen-Chao; Yang, Shih-Wei; Wang, Cheng-Hsu

    2013-05-01

    Unexpected fatal events in patients with head and neck cancers undergoing concurrent chemoradiation therapy are a clinical concern. Malnutrition, which is reported frequently in head and neck cancer patients, are associated with immunity derangement. The purpose of this study was to identify risk factors for early death of patients undergoing chemoradiation. We retrospectively analyzed the records of 194 stage III, IVA, and IVB head and neck cancer patients who were treated with chemoradiation between 2007 and 2009. We defined early death as death while receiving chemoradiation or within 60 days of treatment completion. Risk factors for early death were tested using univariate and multivariate analyses. Fourteen patients (7.2 %) experienced early death, 78.6 % of whom died of infection. Univariate analysis revealed significant correlations between early death and several pretreatment variables, including Eastern Cooperative Oncology Group performance status (PS) >1, hemoglobin total lymphocyte count 1, BMI total lymphocyte count malnutrition before chemoradiation independently predict early death in locally advanced head and neck cancer patients undergoing chemoradiation. Cautious management of head and neck cancer patients with these risk factors is required throughout chemoradiation period.

  2. Neck Emission of Intermediate Mass Fragments During Fission

    Science.gov (United States)

    de Souza, R. T.; Chen, S. L.; Cornell, E. W.; Davin, B.; Hamilton, T. M.; Hulburt, D.; Kwiatkowski, K.; Lou, Y.; Viola, V. E.; Wile, J. L.; Korteling, R.

    1996-05-01

    Ternary fission of heavy nuclei provides a unique opportunity to constrain models of the dissipative forces which occur during fission. We have measured neck emission of Intermediate mass fragments (IMF:3 model are made.

  3. Introduction to the Points Singly Used for Stiff Neck

    Institute of Scientific and Technical Information of China (English)

    李鸿超; 余光辉

    2004-01-01

    @@ In acupuncture treatment of stiff neck, based on the patients' individual conditions, flexible application of different single points can quickly bring about good therapeutic results. The following is a collection of the points singly used for stiffneck.

  4. 50 Facts about Oral, Head and Neck Cancer

    Science.gov (United States)

    ... nutritionists, and speech therapists. About half of throat cancers occur in the larynx (voice box). Because of the location of head and neck cancer, it often affects breathing, eating, drinking, voice, speaking, ...

  5. Hip Hemiarthroplasty for Femoral Neck Fractures Using the Modified ...

    African Journals Online (AJOL)

    The patients had good hip abduction postoperatively. In addition ... Key words: Femoral neck fractures, hip hemiarthroplasty, ... the overall blood loss at surgery and morbidity after surgery, ... Their clinical and demographic features were noted.

  6. The Trail Inventory of Mason Neck NWR [Cycle 2

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this report is to create a baseline inventory of all non-motorized trails on Mason Neck National Wildlife Refuge. Trails in this inventory are...

  7. Neck masses in children: Etiopathology in a tertiary center

    African Journals Online (AJOL)

    2011-02-15

    Feb 15, 2011 ... chemo and/or radiotherapy, with two (5.7%) mortality recorded due ... surgical consultation and thorough histopathologic analysis of neck masses in children in our subregion. ... Anorexia, weight loss, failure to thrive, anemia,.

  8. Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

    Science.gov (United States)

    Lim, Dong C.; Gagnon, Patrick J.; Meranvil, Sophia; Kaurin, Darryl; Lipp, Linda; Holland, John M.

    2010-01-01

    Background. Lhermitte's sign (LS) is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT) for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS. PMID:20628529

  9. Myxoid liposarcoma presenting like a cystic neck swelling

    Directory of Open Access Journals (Sweden)

    Harmeet Sahni

    2015-05-01

    Full Text Available Soft tissue sarcomas are rare and unusual neoplasm's, accounting for approximately 1% of adult human cancers and 15% of pediatric malignancies. Most liposarcomas occur in deep soft tissues of the extremities and retroperitoneum; only a very small percentage (as low as 2% occurs in the head and neck. Here we present a case of a 48yr old male with a painless mass in the neck clinically presenting as a cystic swelling. The CT neck was suggestive of cystic lesion in the neck representing benign cystic lesion. The swelling was excised and sent for histopathology which was suggestive of myxoid liposarcoma. The patient was planned for wide excision of the edges and scar and adjuvant chemo and radio therapy. [Int J Res Med Sci 2015; 3(5.000: 1281-1284

  10. Mason Neck National Wildlife Refuge: Narrative report: 1971

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Mason Neck NWR outlines Refuge accomplishments during the 1971 calendar year. The report begins by summarizing the weather...

  11. The diagnosis and treatment of nonspecific neck pain and whiplash.

    Science.gov (United States)

    Binder, A

    2007-03-01

    Nonspecific (simple) neck pain is the commonest cause of neck symptoms and results from postural and mechanical causes. It includes pain following whiplash injury provided there is no bony injury or objective neurological deficit. The anatomy of the cervical spine is described, with the degenerative changes that are seen in patients with nonspecific neck pain, but also occur with ageing. The poor correlation between the degree of degeneration and presence and severity of symptoms is noted. A lack of specific pathology is also a feature of whiplash. The epidemiology, clinical presentation, investigation, and complications of nonspecific neck pain are described with a discussion of the controversial aspects of natural history, prognosis and therapy. Chronic whiplash is very common in some countries, but nonexistent in other countries and the factors which might explain this difference are considered. There is a great need for better quality studies to explore pathogenesis, natural history and factors including therapy that influence outcome.

  12. The Trail Inventory of Harris Neck NWR [Cycle 2

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this report is to create a baseline inventory of all non-motorized trails on Harris Neck National Wildlife Refuge. Trails in this inventory are...

  13. Mason Neck National Wildlife Refuge: Narrative report: FY 1975

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Mason Neck National Wildlife Refuge outlines Refuge accomplishments during the 1975 fiscal year. The report begins by summarizing...

  14. Head and neck malignancies in Croatian renal transplant recipients

    National Research Council Canada - National Science Library

    Basić-Jukić, Nikolina; Bubić-Filipi, Ljubica; Prgomet, Drago; Djanić Hadzibegović, Ana; Bilić, Mario; Kovac, Lana; Kastelan, Zeljko; Pasini, Josip; Mokos, Ivica; Basić-Koretić, Martina; Kes, Petar

    2010-01-01

    Renal transplantation is associated with increased incidence of cancer. We reviewed a large series of renal transplant recipients to determine the incidence and outcome of patients with malignant changes located at the head and neck...

  15. A case report of missed femoral neck stress fracture

    Directory of Open Access Journals (Sweden)

    Onibere Oruaro Adebayo

    2015-01-01

    Full Text Available Femoral neck stress fracture (FNSF is an uncommon but potentially serious orthopaedic problem. This is a case report on missed femoral neck stress fracture in a 62-year-old female who was initially treated as early-onset coxarthrosis. She later presented to us with a displaced intra-capsular neck of left femur fracture and underwent total hip replacement. This case illustrates that causes other than osteoarthritis should be taken into consideration in patients presenting with anterior hip pain where symptoms are disproportionate to clinical and radiological findings. More advanced investigations such as MRI scan or regular follow up with plain radiographs should be performed. A delay in diagnosis can lead to secondary displacement of the femoral neck stress fracture.

  16. Identifying and treating the causes of neck pain.

    Science.gov (United States)

    Evans, Ginger

    2014-05-01

    Future studies are needed to further understand the pathophysiology of mechanical neck pain. Robust scientific evidence is sparse on which noninvasive treatments are the most beneficial and how to better select patients for particular noninvasive or invasive treatments.

  17. Eastern Neck National Wildlife Refuge Narrative report calendar year 1971

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This annual narrative report for Eastern Neck National Wildlife Refuge outlines Refuge accomplishments during the 1971 calendar year. The report begins by...

  18. Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Dong C. Lim

    2010-01-01

    Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

  19. Atraumatic femoral neck fracture secondary to prolonged lactation induced osteomalacia

    Directory of Open Access Journals (Sweden)

    Dhammapal Sahebrao Bhamare

    2013-01-01

    Full Text Available Presenting a case of atraumatic fracture neck femur secondary to 2 years of prolonged lactation. A 26-year-old lactating mother presented with pain in left hip from last 12 months. She was apparently alright before and during pregnancy. Plain radiograph showed a complete undisplaced fracture of femoral neck. Osteomalacia was diagnosed by radiological and serological investigations. The fracture was fixed using AO type cannulated cancellous screws. The fracture showed good clinical and radiological union at 3 months. Literature review shows that this is a first case of atraumatic fracture of neck femur due to prolonged lactational osteomalacia. It showed that even apparently healthy Indians are susceptible to osteomalacia, more so during pregnancy and lactation and can be presented as atraumatic fracture. Although considered relatively stable, a compression type incomplete fracture neck femur may progress to a complete fracture if not treated in time.

  20. Productive performance of naked neck, frizzle and dwarf laying hens ...

    African Journals Online (AJOL)

    Unknown

    various natural climates and two nutritional treatments ... improved egg production or feed efficiency, although the naked neck (Na) ... pullets were moved to a tiered system of individual cages in a laying house with ..... nutrients for production.