Vestibular migraine (VM) is characterized by recurrent, episodic vertigo associated with migrainous headache. These symptoms are similar to those of Meniere's disease (MD), which often coexists with VM. The term "VM/MD overlapping syndrome (VMOS)" has been suggested for the clinical syndrome characterized by simultaneous occurrence of different types of vertigo associated with VM and MD. Diagnosis of VM is often missed in patients presenting with vertigo, because it is still not well-recognized by otorhinolaryngologists. The medical records of 29 patients diagnosed as having VM at the Department of Otorhinolaryngology of our hospital were reviewed retrospectively to evaluate the diagnostic steps. These 29 patients accounted for 4.3 of all patients who visited our hospital with the chief complaint of vertigo over a 32-month period. Of the 29 patients, while 19 primarily had VM or VMOS (primary VM group), 10 developed VM or VMOS subsequently, during follow-up for MD or benign paroxysmal positional vertigo ("subsequent" VM group). Significantly fewer patients with "subsequent" VM, as compared to primary VM, complained of concomitant headache (Fisher's exact test, p 0.03); in total, 14 and 3 patients in the primary and "subsequent" VM groups, respectively, complained of headache without being prompted, whereas the remaining patients of both groups answered "yes" only when they were asked if they suffered from headache. Furthermore, significantly fewer patients with differing onset times in life of their vertigo and headache complained of headache unless they were asked the leading question by the doctor (Fisher's exact test, p 0.02). These results indicate the importance of asking patients with recurrent vertigo if they also suffer from headache. Vertigo patients are less likely to complain of headache spontaneously Cases of vestibular migraine seen in the field of otorhinolaryngology:
We investigated the clinical characteristics and preoperative diagnosis rate of Warthin's tumor (WT) of the parotid gland. The subjects were 189 patients who underwent surgery at the Department of Otolaryngology, Head and Neck Surgery in Osaka Medical College between September 1999 and April 2017. We compared the date of the189 patients with 466 cases of pleomorphic adenoma (PA) of the parotid gland seen during the same period. Among the 189 patients with WT, there were 163 males and 26 females, with a median age of 62 years. The sites of origin of the tumors in the parotid gland were distributed as follows: superficial lobe, 64 cases; deep lobe, 14 cases; and lower pole, 111 cases. The median maximum diameter of the tumor was 30 mm. The median operative time and the median operative blood loss were 120 minutes and 20 mL, respectively. The diagnosis had been made accurately prior to the surgery in 72% of the patients, by the fine needle aspiration cytology. Postoperative facial nerve dysfunction occurred in 39 cases (20.6%); however, it was transient in all cases. The transient facial nerve dysfunction recovered within 2 months in 50% of all cases, within 6 months in 90%, and within 1 year in 100% of cases. The features that were especially frequently encountered in the cases with postoperative facial dysfunction were origin of the tumor in the deep lobe of the parotid and large size of the tumor; furthermore, these cases also required a longer operative time. As compared with PA, WT occurred more often in male patients. WTs occurred more often in the lower pole and they were larger in size. The operative blood loss was greater. There were no significant differences with regards to the incidence of postoperative facial nerve dysfunction and the operative time.
To compare the clinical features and treatments of laryngeal cancer patients by age group, We analyzed the data of 400 patients of laryngeal cancer who received the initial treatment at the Department of Otorhinolaryngology and Head and Neck Surgery, Osaka Medical College, from September 1999 to December 2017. We defined patients under 64 years of age as middle aged patients, patients between 65 and 74 years of age as early stage elderly patients, and patients over 75 years of age as late stage elderly patients. The clinical features disease stage, treatment, and outcome were compared among the three age groups. In addition, data of the 200 cases seen in the first half of the study period were compared with those of the 200 cases seen in the latter half of the study period. There was no differences among the age groups in the stage distribution of glottic cancer, whereas in the cases of supraglottic cancer, the number of N cases was significantly higher in elderly patients as compared to the middle aged patients. In both cases of glottic cancer and supraglottic cancer, there number of cases that received RT alone was higher in the late elderly patients as compared to the other age groups. There were no differences in the treatment outcomes among the age groups. The incidence of BSC was significantly higher in the early stage and late stage elderly patients, and higher in women than in men. In the 200 patients seen in the latter half of the study period, the average age was 3.1 years higher than that in the 200 patients seen in the first half of the study period. In regard to the treatment plan, in the middle aged patients, total laryngectomy tended to shift to CDDPRT, and in the elderly patients, RT alone was the most frequently adopted treatment and the frequency of total laryngectomy was lower. However, the 200 patients seen in the first half and second half of the study period had similar survival curves. The average age of patients with laryngeal cancer has increased, and treatment has shifted to laryngeal preservation in all patients of all age groups. However, there has been no change in the disease specific survival rate. The health status of elderly cancer patients varies, and it is necessary to take into account not only the stage of the disease, but also the general condition of the patient when selecting the appropriate treatment plan, including best supportive care.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.