and Objectives: Hypocalcemia is a commonly reported complication after thyroid surgery. Many possible risk factors have been identified. The purpose of this study is to analyze various risk factors ...possibly associated with development of postoperative hypocalcemia after thyroid surgery by dividing the sample population into postoperative hypocalcemia and normal calcium groups.
Retrospective.
Multiple centers in the Makkah region of Saudi Arabia.
Risk factors for postoperative hypocalcemia that were obtained for analysis include patient factors, perioperative blood parameters factors, disease-related factors, and surgical factors. Postoperative hypocalcemia was defined as a reduction of the total calcium level to <8.0 mg/dL. Hypocalcemic and normocalcemic patients were compared by multivariate logistic regression.
Distinguish independent risk factors for postoperative hypocalcemia after thyroidectomy.
215 patients.
The incidence of hypocalcemia was 52.1% (112 of 215 patients). According to multivariate analysis, statistically significant risk factors for predicting postoperative hypocalcemia included postoperative parathyroid hormone level <10 pg/dL, inadvertent parathyroid gland resection, and neck dissection surgeries.
The causes of postoperative hypocalcemia are multi-factorial. Because many of these factors are modifiable, they should be identified postoperatively to distinguish high-risk groups and implement early preventive measures.
Retrospective with a relatively small size. We encourage additional prospective studies with a larger sample size in multiple regions of the country, which might reveal further significant results.
Dysphagia is a common adverse event among head and neck (H&N) cancer patients. We aimed, for the first time, to validate the Arabic version of the MD Anderson Dysphagia Inventory (MDADI) among 82 ...Saudi Arabian patients with H&N cancer. We followed established validation guidelines and translated the 20-item MDADI using the forward–backward method. Our results revealed 100% feasibility. Test–retest reliability demonstrated acceptable interclass correlation coefficients (ICC) for the subscale domains (emotional = 0.973, physical = 0.971, and functional = 0.956) and composite score (ICC = 0.984). The Cronbach’s alpha coefficients for the emotional, functional, and physical subscales were 0.937, 0.825, and 0.945, respectively (composite score = 0.975). We confirmed concurrent validity by demonstrating significant correlations between the domains of the Arabic MDADI and European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Head and Neck Module (QLQ-H&N35). Our study validated the Arabic version of the MDADI among H&N cancer patients from Saudi Arabia.
The COVID-19 pandemic has necessitated temporary modifications in the current head and neck oncology treatment paradigm. Till date, no definite treatment for COVID-19 has been discovered. Considering ...the situation of the global COVID-19 outbreak, methods that minimize patient visits with no compromise in efficacy should be considered. The optimal method for tongue reconstruction has not been determined yet. The artificial bilayer membrane has been used as mucosal substitute in few cases of tongue reconstruction with promising results.
We present two cases of tongue reconstruction with acellular dermal matrix post partial glossectomy for tongue carcinoma during the COVID-19 pandemic. Both patients showed good recovery and healing, and no side effects and/or complications were reported.
The acellular dermal matrix is not a standard technique for tongue reconstruction but one of the available options. The few reported cases in literature showed promising results in regard of function and healing.
We believe the use of acellular dermal matrix can help in preventing the spread of COVID-19 because of the absence of donor morbidity, decreasing post-operative hospital stay and visits.
•ADM is a useful alternative for tongue reconstruction instead of skin graft.•ADM use in reconstruction will avoid skin graft doner site morbidity.•ADM is safe to be used in oral cavity after partial glossectomy.•ADM maybe better than skin graft further study need to be follow.
Papillary thyroid carcinoma (PTC) is the most prevalent type of thyroid cancer. It is one of the most common types of malignancy of the thyroid that spreads to cervical lymph nodes. Lymph node ...metastasis (LNM) is an important factor when determining recurrence risk, and determining the extent of lymph node involvement can guide treatment. Our main objective is to evaluate the association between the size of the tumor and the number of lymph node metastases in patients with PTC. Methods: We conducted an electronic retrospective chart review of 125 patients with PTC followed in the Head and Neck Department at KAMC from 2009 to 2020. Twenty-two patients included in our study were pathologically and clinically diagnosed and confirmed to have LNM of PTC. Results: The study included 22 PTC patients who had undergone lymph node dissections. Patients had a median age of 38.8 years (IQR = 32.2–54.5), and the median tumor size was 20.5 mm. The most commonly affected level of the neck was IV (76.2%). Distant metastasis M1 was seen in only two patients (9.1%). Tumors sizes >30mm (75%) had ≥5 LNM. Most cases were the classic subtype PTC. For the site of the tumor, the site had a significant impact on the number of LNM (p = 0.004). Multifocality had a high impact on LNM (p = 0.019). Conclusions: This study showed no association between the size of PTC and the number of LNMs. The bilaterality of PTC was significantly associated with a high number of LNMs.
•Lymph nodes in level IV were the most common metastasis site for PTC.•Bilateral and multifocal PTC were significantly associated with a higher number of lymph nodes metastasis.•The size of the tumor was not significantly related to the number of lymph node metastasis.
This report presents a case of primary non-keratinizing, undifferentiated nasopharyngeal cancer and an oncocytic (Hurthle cell) thyroid carcinoma developing simultaneously. The patient was diagnosed ...in August 2022 with nasopharyngeal carcinoma. After the staging process and before starting treatment for the patient, he was diagnosed with oncocytic (Hurthle cell) thyroid carcinoma on October 2022. Synchronous primary head and neck malignancies are well-known in the medical field. However, this is a rare case of two primary tumors of mucosal and non-mucosal carcinomas, highlighting the importance of discussing head and neck malignant cases in the multidisciplinary team meeting and performing frequent imaging and endoscopic examination for suspicious cases, especially in elderly patients. This case report describes the cases, the management modalities, and the outcomes, informing clinicians of the importance of considering the possibility of multiple primary malignancies when evaluating patients with head and neck tumors and a better approach to this rare and challenging case to ensure successful management.
Renal cell carcinoma is known to cause metastasis to unusual sites, but metastasis to the thyroid gland is a rare occurrence, not only that, but 20 years after complete recovery is almost ...nonexistent.
We are presenting here a case of 79-year-old female who presented to us for asymptomatic progressive thyroid nodule. She had history of right nephrectomy for renal cell carcinoma 20 years ago. Ultrasound guided fine needle aspiration biopsy (FNAB) of the thyroid was non-diagnostic. Total thyroidectomy of the patient was performed, and histopathological evaluation of the specimen revealed the swelling to be of metastatic in nature secondary to renal cell carcinoma.
Despite thyroid metastasis being rare, FNAB can prove to be useful tool for diagnosis of thyroid tumors and metastases and can be inconclusive in some cases. Therefore, immunohistochemistry can prove beneficial in diagnosis such cases.
The diagnosis of renal cell carcinoma metastasis is made after immunohistochemical evaluation of the thyroidectomy specimen with thyroidectomy proving to be the modality of treatment for such cases with no further radiation therapy and a yearly follow up plan to screen for other lesions.
•Renal cell carcinoma is one of the most common malignany to metastasize to thyroid.•Metastatic etiology should always be considered in thyroid nodule patient with history of renal cell carcinoma.•Diagnosis is mainly by immunohistochemical analysis.•Surgery has a significant mortality benefit.
To evaluate the accuracy and e cacy of ne-needle aspiration cytology (FNAC) in diagnosing thyroid nodules, correlating it with the histopathological findings.
A retrospective evaluation of 314 ...patients was undertaken at a tertiary referral center of King Abdullah Medical City (KAMC), Makkah, Kingdom of Saudi Arabia, between 2010-2019. Patients who presented with thyroid swellings underwent ultrasonography and FNAC. If indicated, surgery was performed. The FNAC findings were compared to the final histopathological reports.
The findings for FNAC from our data set of 314 patients showed a sensitivity value of 79.8%, specificity of 82.1%, accuracy of 74.8%, positive predictive value of 74.8%, and negative predictive value of 85.9%. Conclusion: Our study showed that FNAC has high sensitivity and speci city in the initial evaluation of patients with thyroid nodules. When guided by ultrasonography, the accuracy can be markedly improved. Molecular markers once widely available can improve the diagnostic power of FNAC to be no less than the histopathologic evaluation of thyroid tissue.
To improve our local data and demographics of thyroid neoplasm in Makkah region, Kingdom of Saudi Arabia and provide some basic statistics for future studies in our local community. Methods: A ...record based retrospective epidemiological study was conducted and included 314 thyroid disease patients who were presented to our centers at Makkah region, Kingdom of Saudi Arabia between December 2009 and December 2019. Results: A descriptive statistical analysis was carried out. The average age was 42.77 years, with a female-to-male ratio of 3:1, and most of the patients were Saudi (77%). Fifty-seven percent of cases were benign, while in malignant cases, 33.4% were papillary thyroid carcinoma. The mean follow-up time was 15.44 months, with excellent compliance in 39.4% of the patients. Conclusion: Thyroid tumors have a leading incidence in head and neck tumors in Makkah, Kingdom of Saudi Arabia, mandating further studies to determine the causes and distribution in other regions of the country.
Abstract
Dermatofibrosarcoma protuberans is a rare, locally aggressive cutaneous malignancy with a high rate of recurrence if the head-and-neck region is involved. Treatment is challenging as it is ...difficult to avoid poor aesthetic and functional outcomes using the standard approach of complete resection with negative margins and subsequent reconstruction. This is especially challenging in cases where the face is involved and the defect is large after resection. There have been few cases of reconstruction using different flaps reported. We present the case of a young lady with a large cheek tumor, which was reconstructed using an anterolateral thigh flap. Excellent functional and aesthetic outcomes were achieved.
•Sarcoidosis is a chronic multisystemic granulomatous disease with unknown etiology.•Sarcoidosis affects the head and neck region in only 10%–15% of cases.•Larynx with turban-like thickening should ...raise high suspicions of laryngeal sarcoidosis.•Sarcoidosis is diagnosed after laboratory, endoscopic, and histopathology findings exclude other differentials.•Isolated laryngeal sarcoidosis is rare, making early diagnosis challenging and rising misdiagnosis.
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