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Concept: Otolaryngology


Introduction and objectives: Behçet disease (BD) is a systemic immune-mediated vasculitis of unknown origin characterised by recurrent orogenital ulceration, ocular inflammation and skin lesions. The aim of our study was to identify ear, nose and throat (ENT) manifestations associated with BD.

Concepts: Inflammation, Rheumatoid arthritis, Tinnitus, Otolaryngology


Dizziness is a common symptom in daily clinical practice. Dizziness and vertigo affect the quality of life as they are associated with the risk of falls leading to limited ability of independent locomotion and thus to a reduction in social contact. The source of problems with dizziness is localized in the area of visual, somatosensory and vestibular sense inputs. The ear nose and throat (ENT) specialist is involved in an interdisciplinary context to elucidate and treat peripheral vestibular disorders. The subjective symptoms of dizziness have to be clarified by taking a careful patient history. By means of objective tests (cVEMP, oVEMP, video-head impulse test) the ENT specialist is able to selectively analyze the function of the five vestibular receptors; therefore, a topological assignment in peripheral vestibulopathy is possible. The exact diagnosis is a prerequisite for a specific therapy and many diseases can be evidence-based, safe and effectively treated.

Concepts: Medicine, Disease, Greek loanwords, Sensory system, Otology, Ménière's disease, Otolaryngology, Otoplasty


Carcinomas arising in the thyroglossal duct cysts are rare, accounting only for about 0.7-1.5 % of all thyroglossal duct cysts.1 (-) 3 Synchronous occurrence of thyroglossal duct carcinoma and thyroid carcinoma is reported to be even rarer.4 Traditionally, surgical treatments of such coexisting thyroglossal duct cyst carcinoma (TGDCa) and papillary thyroid carcinoma (PTC) were typically performed through a single transverse or double incisions on the overlying skin. A longer, extended cervical incision might be required if neck dissection is necessary. Though this method provides the operator with the optimal surgical view, the detrimental cosmetic effect on the patient of possessing a scar cannot be avoided, despite the effort of the surgeon to camouflage the scar by placing the incision in natural skin creases. Recently, the authors have previously reported the feasibility of robot-assisted neck dissections via a transaxillary and retroauricular (“TARA”) approach or modified face-lift approach in early head and neck cancers.5 (,) 6 On the basis of the forementioned surgical technique, we demonstrate our novel technique for robot-assisted Sistrunk’s operation via retroauricular approach as well as robot-assisted neck dissection with total thyroidectomy via transaxillary approach.

Concepts: Head and neck, Surgery, Epithelium, Thyroid disease, Al-Andalus, Surgical oncology, Otolaryngology, Thyroglossal cyst


Balloon dilation technology (BDT), also known as balloon sinuplasty, has been in clinical use since September, 2005. Prior to BDT, surgeons performed a procedure called FESS, or functional endoscopic sinus surgery, for patients with chronic sinusitis. As is true with any new technology or procedure in medicine, a debate often ensues between early adopters and mainstream practitioners. Over the past 7 years, much has been discussed, debated, and learned about BDT. What follows is a review of the origins of the BDT: the theory, technology, indications and applications; and a review of the pertinent outcomes literature. Independent of how one feels about BDT, the evidence strongly supports its safety, efficacy, and growing popularity among patients and physicians alike.

Concepts: Medicine, Hospital, Surgery, Sinusitis, Physician, Otolaryngology, Functional Endoscopic Sinus Surgery, Rhinology


Septoplasty is a frequently performed operation by otolaryngologists to relieve nasal obstruction complaints. When objective measurements tools are not available, preoperative decision-making is based on careful clinical examination. Our aim was to evaluate the relationship between type and severity of septal deviation and patient-reported nasal obstruction.

Concepts: Degree of a polynomial, Objective pronoun, Otolaryngology


The effectiveness of tonsillectomy or adenotonsillectomy (“tonsillectomy”) for recurrent throat infection compared with watchful waiting is uncertain.

Concepts: Infectious diseases, Otolaryngology


Everolimus, an inhibitor of the mammalian target of rapamycin (mTOR), is effective in treating tumors harboring alterations in the mTOR pathway. Mechanisms of resistance to everolimus remain undefined. Resistance developed in a patient with metastatic anaplastic thyroid carcinoma after an extraordinary 18-month response. Whole-exome sequencing of pretreatment and drug-resistant tumors revealed a nonsense mutation in TSC2, a negative regulator of mTOR, suggesting a mechanism for exquisite sensitivity to everolimus. The resistant tumor also harbored a mutation in MTOR that confers resistance to allosteric mTOR inhibition. The mutation remains sensitive to mTOR kinase inhibitors.

Concepts: Cancer, Mutation, Oncology, Types of cancer, Thyroid disease, Inhibitor, Mammalian target of rapamycin, Otolaryngology


Fat grafting can be used to improve the results of face lifting. The extent to which plastic surgeons use fat grafting in their face-lift practices is unknown. The goals of this study were to understand the current use of fat grafting during facial rejuvenation surgery and identify the most common techniques used.

Concepts: Hospital, Surgery, Plastic surgery, Reconstructive surgery, General surgery, Oral and maxillofacial surgery, Otolaryngology, Rhytidectomy


Lower lid blepharoplasty is one of the most complex procedures performed by plastic surgeons and may cause significant long-term sequelae, including inadequate aesthetic outcomes if not performed with a thorough understanding of anatomy and proper technique. The authors' practice is consistently evolving to deliver the highest quality results for their patients. The purpose of this article is to introduce an additional sixth step to the lower lid blepharoplasty procedure involving the targeted injection of fractionated fat to better blend the lid-cheek junction. This added step will enhance overall facial rejuvenation, is reproducible, and will provide patients with exceptional outcomes.

Concepts: Hospital, Surgery, Physician, Plastic surgery, Rejuvenation, Blepharoplasty, Otolaryngology, Blend


The 2013 discovery of TERT promoter mutations chr5, 1,295,228 C>T (C228T) and 1,295,250 C>T (C250T) in thyroid cancer represents an important event in the thyroid cancer field and much progress has occurred since then. This article provides a comprehensive review of this exciting new thyroid cancer field. The oncogenic role of TERT promoter mutations involves their creation of consensus binding sites for ETS transcriptional factors. TERT C228T is far more common than TERT C250T and their collective prevalence is, on average, 0%, 11.3%, 17.1%, 43.2%, and 40.1% in benign thyroid tumors, papillary thyroid cancer (PTC), follicular thyroid cancer, poorly differentiated thyroid cancer, and anaplastic thyroid cancer, respectively, displaying an association with aggressive types of thyroid cancer. TERT promoter mutations are associated with aggressive thyroid tumor characteristics, tumor recurrence, and patient mortality as well as BRAF V600E mutation. Coexisting BRAF V600E and TERT promoter mutations have a robust synergistic impact on the aggressiveness of PTC, including a sharply increased tumor recurrence and patient mortality, while either mutation alone has a modest impact. Thus, TERT with promoter mutations represents a prominent new oncogene in thyroid cancer and the mutations are promising new diagnostic and prognostic genetic markers for thyroid cancer, which, in combination with BRAF V600E mutation or other genetic markers (e.g., RAS mutations), are proving to be clinically useful for the management of thyroid cancer. Future studies will specifically define such clinical utilities, elucidate the biological mechanisms, and explore the potential as therapeutic targets of TERT promoter mutations in thyroid cancer.

Concepts: DNA, Genetics, Cancer, Oncology, Types of cancer, Benign tumor, Thyroid disease, Otolaryngology