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Chronic submucosal fungal epiglottitis
OtolaryngologyHead and Neck Surgery
Scientific Posters P207
Volume 121 Number 2
18 Chronic Submucosal Fungal Epiglottitis MAHMOUD EL-SHERIFM AMMAR MD; SOLY BAREDESMD; GUSTAVO DE LA ROZA MD; KAPILA RAJENDRA MD; Hackensack NJ; Newark NJ; Santa Clara CA; Newark NJ
Objectives: Fungal infections of the larynx include candidiasis, histoplasmosis, blastomycosis, cryptococcosis, aspergillosis, and coccidiomycosis. Isolated fungal infections of the larynx are rare. Such infections are usually seen as part of a broader involvement of the respiratory system, usually in an immunocompromised host. Our objective is to report the first case of chronic submucosal fungal disease of the larynx in an immunocompetent host. Methods: Case report and literature review. Results: We report a case of a 33-year-old immunocompetent woman who presented with a 2-week history of a foreign body sensation when she swallowed and occasional mild respiratory difficulty. Head and neck examination (and CT scan) were only remarkable for symmetrical thickening of the epiglottis with normal mucosa. This thickening persisted despite antibiotics and oral steroids. Biopsy 1 month later showed noncaseating submucosal granulomas containing fungal hyphae. The hyphae could not be classified, but cultures grew Penicillium, Paecilomyces, and Trichoderma species sensitive to itraconazole. Despite itraconazole treatment, the thickness of the epiglottis and the foreign body sensation chronically persist. The patient has remained otherwise in good health. Conclusion: Fungal epiglottitis is rare and is most commonly caused by Candida albicans in patients with predisposing factors such as immunosuppression, severe bums, and antibiotic use. These cases typically have mucosal manifestations of disease, including erythema, edema, thick white exudates or plaques, and necrosis. We are reporting the first case of chronic submucosal fungal disease of the epiglottis in an immunocompetent individual. 19 Publication Rate of Abstracts Presented at the AAO-HNSF Annual Meeting ALl R NAMAZIE MD; KEITH E BLACKWELL MD; MARILENE B WANG MD; MAZDA AGHAMOHAMMADI MD; NEEMA AGHAMOHAMMADI BS; Los Angeles CA
Objectives: The publication rates of oral presentations at national meetings have been extensively reviewed in other fields. These reviews furnish information regarding the quality of data and the average time to publication of presented work. These studies permit comparison of publication rates with meetings from other fields. The purpose of this study was to examine the publication status of the podium presentations at the annual meeting of American Academy of Otolaryngology-Head and Neck Surgery.
Methods: All papers listed in the 1992, 1993, and 1994 AAO-HNS meeting programs were included in the study. A search was conducted for each of the papers using the computerized database Melvyl Medline Plus with Premedline at the National Computing Biotechnology Information (NCBI) website. Rigorous criteria established in previous studies were followed. Results: There were a total of 1305 papers presented at the 1992 (n = 412), 1993 (n = 428), and 1994 (n = 465) annual meetings of the AAO-HNS. A total of 385 abstracts were published by December 31, 1998. The percentage of abstracts published for each individual year ranged from 28.6% to 32.4%. The percentage of abstracts published in different journals and categories, as defined by the AAO-HNS, was examined. The median time to and the rate of publication for each category and year presented were reviewed. Conclusion: Papers in the Basic Science category had a higher likelihood of acceptance. Feedback from the national forum may have led to the revision of up to 40% of studies prior to their acceptance for publication. The acceptance rate of abstracts at the AAO-HNS meeting and the criteria for presentation appears to be consistent with that of other national medical meetings. 2O Radiation Therapy in Head and Neck Malignancies with Perineural Skull Base Extension JAMES W MIMS MD; J DALE BROWNE MD; Winston-Salem NC
Objective: To demonstrate the complication, diagnosis, and therapy of radionecrosis of brain parenchyma following treatment of head and neck malignancies with perineural extension involving the skull base. Methods/Measures: A retrospective review of 2 patients with radionecrosis of the brain stem following combined surgical and radiation therapy for head and neck malignancies. Clinical course, surgical therapy, radiation portals, and radiologic findings were reviewed. Results: One patient underwent therapy for adenoid cystic carcinoma of the hard palate minor salivary glands; the second patient was treated for cutaneous squamous cell carcinoma with perineural extension. Both lesions were well demonstrated by MRI. The patient with dysphagia died of progressive brain stem necrosis. Conclusions: The development of this potentially devastating side effect of curative radiation generally occurs well after the completion of all therapy, and the otolaryngologist should be aware of the representative symptoms and care of the patient with this iatrogenic disease. Clinical Significance of Study: While important to control of disease, radiation therapy is not without devastating complications that should be considered in the follow-up of those patients with head and neck malignancies involvingthe cranial base,
Scientific Posters P207
Volume 121 Number 2
18 Chronic Submucosal Fungal Epiglottitis MAHMOUD EL-SHERIFM AMMAR MD; SOLY BAREDESMD; GUSTAVO DE LA ROZA MD; KAPILA RAJENDRA MD; Hackensack NJ; Newark NJ; Santa Clara CA; Newark NJ
Objectives: Fungal infections of the larynx include candidiasis, histoplasmosis, blastomycosis, cryptococcosis, aspergillosis, and coccidiomycosis. Isolated fungal infections of the larynx are rare. Such infections are usually seen as part of a broader involvement of the respiratory system, usually in an immunocompromised host. Our objective is to report the first case of chronic submucosal fungal disease of the larynx in an immunocompetent host. Methods: Case report and literature review. Results: We report a case of a 33-year-old immunocompetent woman who presented with a 2-week history of a foreign body sensation when she swallowed and occasional mild respiratory difficulty. Head and neck examination (and CT scan) were only remarkable for symmetrical thickening of the epiglottis with normal mucosa. This thickening persisted despite antibiotics and oral steroids. Biopsy 1 month later showed noncaseating submucosal granulomas containing fungal hyphae. The hyphae could not be classified, but cultures grew Penicillium, Paecilomyces, and Trichoderma species sensitive to itraconazole. Despite itraconazole treatment, the thickness of the epiglottis and the foreign body sensation chronically persist. The patient has remained otherwise in good health. Conclusion: Fungal epiglottitis is rare and is most commonly caused by Candida albicans in patients with predisposing factors such as immunosuppression, severe bums, and antibiotic use. These cases typically have mucosal manifestations of disease, including erythema, edema, thick white exudates or plaques, and necrosis. We are reporting the first case of chronic submucosal fungal disease of the epiglottis in an immunocompetent individual. 19 Publication Rate of Abstracts Presented at the AAO-HNSF Annual Meeting ALl R NAMAZIE MD; KEITH E BLACKWELL MD; MARILENE B WANG MD; MAZDA AGHAMOHAMMADI MD; NEEMA AGHAMOHAMMADI BS; Los Angeles CA
Objectives: The publication rates of oral presentations at national meetings have been extensively reviewed in other fields. These reviews furnish information regarding the quality of data and the average time to publication of presented work. These studies permit comparison of publication rates with meetings from other fields. The purpose of this study was to examine the publication status of the podium presentations at the annual meeting of American Academy of Otolaryngology-Head and Neck Surgery.
Methods: All papers listed in the 1992, 1993, and 1994 AAO-HNS meeting programs were included in the study. A search was conducted for each of the papers using the computerized database Melvyl Medline Plus with Premedline at the National Computing Biotechnology Information (NCBI) website. Rigorous criteria established in previous studies were followed. Results: There were a total of 1305 papers presented at the 1992 (n = 412), 1993 (n = 428), and 1994 (n = 465) annual meetings of the AAO-HNS. A total of 385 abstracts were published by December 31, 1998. The percentage of abstracts published for each individual year ranged from 28.6% to 32.4%. The percentage of abstracts published in different journals and categories, as defined by the AAO-HNS, was examined. The median time to and the rate of publication for each category and year presented were reviewed. Conclusion: Papers in the Basic Science category had a higher likelihood of acceptance. Feedback from the national forum may have led to the revision of up to 40% of studies prior to their acceptance for publication. The acceptance rate of abstracts at the AAO-HNS meeting and the criteria for presentation appears to be consistent with that of other national medical meetings. 2O Radiation Therapy in Head and Neck Malignancies with Perineural Skull Base Extension JAMES W MIMS MD; J DALE BROWNE MD; Winston-Salem NC
Objective: To demonstrate the complication, diagnosis, and therapy of radionecrosis of brain parenchyma following treatment of head and neck malignancies with perineural extension involving the skull base. Methods/Measures: A retrospective review of 2 patients with radionecrosis of the brain stem following combined surgical and radiation therapy for head and neck malignancies. Clinical course, surgical therapy, radiation portals, and radiologic findings were reviewed. Results: One patient underwent therapy for adenoid cystic carcinoma of the hard palate minor salivary glands; the second patient was treated for cutaneous squamous cell carcinoma with perineural extension. Both lesions were well demonstrated by MRI. The patient with dysphagia died of progressive brain stem necrosis. Conclusions: The development of this potentially devastating side effect of curative radiation generally occurs well after the completion of all therapy, and the otolaryngologist should be aware of the representative symptoms and care of the patient with this iatrogenic disease. Clinical Significance of Study: While important to control of disease, radiation therapy is not without devastating complications that should be considered in the follow-up of those patients with head and neck malignancies involvingthe cranial base,