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Preoperative Selective Venous Sampling for Localization of Parathyroid Adenoma
P154
Otolaryngology– Head and Neck Surgery August 2005
Research Posters
tween 1998 and 2004. On-protocol patients were six months to 18 years of age and had macrocystic LM (cysts 2 cc) or mixed macrocystic-microcystic (cysts 2 cc) LM of the head and/or neck. Treatment consisted of a four dose injection series of OK-432 sclerotherapy at eight-week intervals. Control subjects were observed for spontaneous regression for six months prior to OK-432 sclerotherapy. Reduction in lesion volume was measured radiographically and graded as complete (90-100%), substantial (60-80%), intermediate (20-50%), or none (20%). Results: A substantial or complete response was seen in 85% of macrocystic LM, 58% of mixed macrocystic-microcystic LM, and 0% of microcystic LM. Spontaneous resolution was less than 3%. Major adverse effects included upper airway obstruction necessitating tracheostomy. Minor and expected adverse effects included temporary edema, pain, low-grade fever, and malaise. No deaths or cranial neuropathies were related to OK-432 treatment. Conclusion: OK-432 sclerotherapy is a more effective and safer alternative to surgery in the treatment of macrocystic cervicofacial LM. It is ineffective in the treatment of microcystic LM. Significance: This study was undertaken to determine the efficacy and safety of OK-432 sclerotherapy as a treatment alternative in the management of pediatric cervicofacial LM. OK-432 sclerotherapy is a more effective and safer alternative to surgery in the treatment of macrocystic cervicofacial LM.
underwent SVS prior to surgery and four patients underwent a four gland neck exploration without preoperative SVS. The two groups were then assessed for accuracy of the SVS in localizing the adenoma, operative time, length of hospitalization, and complications. Results: All of the patients in the study underwent successful uncomplicated surgical parathyroidectomy. The SVS proved accurate in preoperatively localizing the adenoma in 7 of 8 patients and all the cases in the SVS group were ambulatory while 33% of the control group patients were admitted overnight. The operative time was a mean of 33 minutes for the SVS group and a mean of 67 minutes in the non-SVS group. None of the patients who underwent SVS experienced procedural complications. Conclusion: This study demonstrates that preoperative selective venous sampling may represent a safe and effective method of preoperatively localizing the non-localized parathyroid adenoma. Significance: In cases where conventional radiological techniques fail to localize an adenoma, SVS may obviate the need for a four gland exploration.”
R577 The Presence of Female Hormone Receptors in the Nasal Mucosa Charlotte R. Wolstenholme, MRCSEd (presenter); Dominik C.
Preoperative Selective Venous Sampling for Localization of Parathyroid Adenoma Jean Anderson Eloy, MD (presenter); Eric M Genden, MD; Harlod Mitty, MD; Edward J Shin, MD; Adam Saul Jacobson, MD New York NY; New York NY; New York NY; New York NY; New York NY
Problem: Preoperative parathyroid adenoma localization allows for a minimally invasive surgical approach, a reduced risk of surgical complications, and improved surgical success. Ultrasonography and sestamibi scanning represent the most common modalities for adenoma localization however computed tomography and magnetic resonance imaging (MRI) may prove helpful when the adenoma remains non-localized. When an adenoma is not identified following a complete radiological work up, the surgeon is faced with a four gland exploration. Selective venous sampling (SVS) has been described as a safe and clinically effective method to localize a parathyroid adenoma following failed exploration. The purpose of this study was to evaluate the efficacy of SVS as a primary localization technique in cases where conventional localization techniques have failed. Methods: Fourteen patients with non-localizing parathyroid adenomas following ultrasonography, sestamibi scanning, and MRI were retrospectively reviewed. Eight patients
Wild; George E Murty, MD PhD FRCS Leicester United Kingdom; Leicester United Kingdom; Kirby Muxloe United Kingdom
Problem: The aim is to identify female hormone receptor positive cells in the nasal mucosa and to determine whether or not there is a significant difference in the number of positive cells between sexes, ages and those with rhinitic symptoms. Methods: Ethical committee approval was granted. 26 patients over the age of 18 attending a university hospital for routine elective ENT procedures under general anaesthetic were recruited pre-operatively. Background information about each participant was recorded. Biopsies were taken from the inferior turbinates. These were analysed using immunohistochemistry techniques to assess for the presence of Progesterone, Oestrogen-a (ERa) and Oestrogen-b (ERb) receptors. Results: All nasal biopsies were negative for progesterone and oestrogen-a receptors. Oestrogen-b receptors were present in 25 out of the 26 biopsies. Using paired t-test to compare the sexes, smoking history, atopic history and female hormone status no statistical difference was shown between any of these groups (p ⬍ 0.05). However, the rhinitis quality of life questionnaire score and the mean number of Eraˆ receptor positive cells per biopsy showed a positive correlation (Pearson correlation of 0.4, p⬍0.05).
POSTERS
R576
Otolaryngology– Head and Neck Surgery August 2005
Research Posters
tween 1998 and 2004. On-protocol patients were six months to 18 years of age and had macrocystic LM (cysts 2 cc) or mixed macrocystic-microcystic (cysts 2 cc) LM of the head and/or neck. Treatment consisted of a four dose injection series of OK-432 sclerotherapy at eight-week intervals. Control subjects were observed for spontaneous regression for six months prior to OK-432 sclerotherapy. Reduction in lesion volume was measured radiographically and graded as complete (90-100%), substantial (60-80%), intermediate (20-50%), or none (20%). Results: A substantial or complete response was seen in 85% of macrocystic LM, 58% of mixed macrocystic-microcystic LM, and 0% of microcystic LM. Spontaneous resolution was less than 3%. Major adverse effects included upper airway obstruction necessitating tracheostomy. Minor and expected adverse effects included temporary edema, pain, low-grade fever, and malaise. No deaths or cranial neuropathies were related to OK-432 treatment. Conclusion: OK-432 sclerotherapy is a more effective and safer alternative to surgery in the treatment of macrocystic cervicofacial LM. It is ineffective in the treatment of microcystic LM. Significance: This study was undertaken to determine the efficacy and safety of OK-432 sclerotherapy as a treatment alternative in the management of pediatric cervicofacial LM. OK-432 sclerotherapy is a more effective and safer alternative to surgery in the treatment of macrocystic cervicofacial LM.
underwent SVS prior to surgery and four patients underwent a four gland neck exploration without preoperative SVS. The two groups were then assessed for accuracy of the SVS in localizing the adenoma, operative time, length of hospitalization, and complications. Results: All of the patients in the study underwent successful uncomplicated surgical parathyroidectomy. The SVS proved accurate in preoperatively localizing the adenoma in 7 of 8 patients and all the cases in the SVS group were ambulatory while 33% of the control group patients were admitted overnight. The operative time was a mean of 33 minutes for the SVS group and a mean of 67 minutes in the non-SVS group. None of the patients who underwent SVS experienced procedural complications. Conclusion: This study demonstrates that preoperative selective venous sampling may represent a safe and effective method of preoperatively localizing the non-localized parathyroid adenoma. Significance: In cases where conventional radiological techniques fail to localize an adenoma, SVS may obviate the need for a four gland exploration.”
R577 The Presence of Female Hormone Receptors in the Nasal Mucosa Charlotte R. Wolstenholme, MRCSEd (presenter); Dominik C.
Preoperative Selective Venous Sampling for Localization of Parathyroid Adenoma Jean Anderson Eloy, MD (presenter); Eric M Genden, MD; Harlod Mitty, MD; Edward J Shin, MD; Adam Saul Jacobson, MD New York NY; New York NY; New York NY; New York NY; New York NY
Problem: Preoperative parathyroid adenoma localization allows for a minimally invasive surgical approach, a reduced risk of surgical complications, and improved surgical success. Ultrasonography and sestamibi scanning represent the most common modalities for adenoma localization however computed tomography and magnetic resonance imaging (MRI) may prove helpful when the adenoma remains non-localized. When an adenoma is not identified following a complete radiological work up, the surgeon is faced with a four gland exploration. Selective venous sampling (SVS) has been described as a safe and clinically effective method to localize a parathyroid adenoma following failed exploration. The purpose of this study was to evaluate the efficacy of SVS as a primary localization technique in cases where conventional localization techniques have failed. Methods: Fourteen patients with non-localizing parathyroid adenomas following ultrasonography, sestamibi scanning, and MRI were retrospectively reviewed. Eight patients
Wild; George E Murty, MD PhD FRCS Leicester United Kingdom; Leicester United Kingdom; Kirby Muxloe United Kingdom
Problem: The aim is to identify female hormone receptor positive cells in the nasal mucosa and to determine whether or not there is a significant difference in the number of positive cells between sexes, ages and those with rhinitic symptoms. Methods: Ethical committee approval was granted. 26 patients over the age of 18 attending a university hospital for routine elective ENT procedures under general anaesthetic were recruited pre-operatively. Background information about each participant was recorded. Biopsies were taken from the inferior turbinates. These were analysed using immunohistochemistry techniques to assess for the presence of Progesterone, Oestrogen-a (ERa) and Oestrogen-b (ERb) receptors. Results: All nasal biopsies were negative for progesterone and oestrogen-a receptors. Oestrogen-b receptors were present in 25 out of the 26 biopsies. Using paired t-test to compare the sexes, smoking history, atopic history and female hormone status no statistical difference was shown between any of these groups (p ⬍ 0.05). However, the rhinitis quality of life questionnaire score and the mean number of Eraˆ receptor positive cells per biopsy showed a positive correlation (Pearson correlation of 0.4, p⬍0.05).
POSTERS
R576