E-Book, Englisch, 456 Seiten, ePub
Carlson / Van Abel / Archibald Otolaryngology--Head and Neck Surgery
1. Auflage 2014
ISBN: 978-1-63853-032-9
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
Rapid Clinical and Board Review
E-Book, Englisch, 456 Seiten, ePub
ISBN: 978-1-63853-032-9
Verlag: Thieme
Format: EPUB
Kopierschutz: 6 - ePub Watermark
A concise, high-yield otolaryngology text for rapid review
This well-organized text for rapid clinical and board review contains high-yield facts using a question and answer format that covers all subspecialty topics in otolaryngology. It combines clinically relevant facts with hard-to-remember, commonly tested details and presents them in an easy-to-follow layout that allows clinicians to quickly review large amounts of information.
Key Features:
• More than 9,000 high-yield questions and answers, half provided in the book and the other half online
• Portable for quick reference during downtimes such as before morning rounds, in between OR cases or while traveling
• Clinical pearls on patient evaluation and management
This review book is a must-have for residents preparing for in-service exams or initial board certification exams as well as seasoned clinicians studying for their MOC Part III re-certification exams.
This print book includes complimentary access to a digital copy on https://medone.thieme.com.
Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product.
Autoren/Hrsg.
Fachgebiete
Weitere Infos & Material
Chapter 1: Pediatric Otolaryngology–Head and Neck Surgery
Chapter 2: Pediatric Malignancies
Chapter 3: Rhinology, Allergy, and Immunology
Chapter 4: General Otolaryngology
Chapter 5: Laryngology
Chapter 6: Otology, Neurotology, and Lateral Skull Base Surgery
Chapter 7: Head and Neck Surgical Oncology
Chapter 8: Cutaneous Malignancies
Chapter 9: Facial Plastic and Reconstructive Surgery
Chapter 10: Facial Trauma
Chapter 11: Salivary Gland Disorders
Chapter 12: Endocrine Disorders
Chapter 13: Odontogenic Disorders
2 Pediatric Malignancies
Kathryn M. Van Abel, Ashley G. O'Reilly, and Rajanya S. Petersson Rhabdomyosarcomas
1 Second to accidents, what is the most common cause of death in children between 1 and 14 years of age? Malignancy 2 What is the most common sarcoma of childhood? Rhabdomyosarcoma. Up to 35% are found in the head and neck. 3 Which cell type gives rise to rhabdomyosarcoma, and what major histologic variants are described? Primitive skeletal muscle cells (small, round blue cell tumor of childhood): embryonal, botryoid, alveolar, undifferentiated. Some include anaplastic. Embryonal and alveolar are the most common types, and embryonal type carries the best prognosis. 4 Where does pediatric head and neck rhabdomyosarcoma most commonly occur? Parameningeal (50%): Paranasal sinuses, nasopharynx, nasal cavity, middle ear, mastoid, infratemporal fossa (5-year survival: 49%; considered high risk) Orbit (25%) (5-year survival: 84%) Nonorbital, nonparameningeal (25%): Scalp, parotid, oral cavity, pharynx, thyroid, parathyroid, neck (5-year survival: 70%) 5 What are the common initial symptoms associated with head and neck pediatric rhabdomyosarcoma? Symptoms are due to progressive mass effect, local swelling, neurologic sequelae, or tissue necrosis. Bone marrow involvement can manifest as hematologic concerns. 6 What are the most important negative prognostic factors associated with pediatric rhabdomyosarcoma? Diagnosis during infancy or adolescence; metastatic disease at diagnosis; alveolar histology; disease identified in a parameningeal location (risk for intracranial spread), in the extremities, or in the retroperitoneum or trunk; recurrence or progression during therapy 7 What diagnostic techniques are required to evaluate the primary tumor in rhabdomyosarcoma? Biopsy: Open biopsy is done to ensure adequate tissue unless the lesion is small and difficult to access, in which case, needle biopsy may be acceptable. Imaging: CT scan and magnetic resonance imaging (MRI) to evaluate extent of disease 8 What diagnostic techniques are required to evaluate locoregional and/or distant metastases in rhabdomyosarcoma? Laboratory work (complete blood count [CBC], electrolytes, liver function, coagulation studies, renal function tests) Technetium-99 bone scan CT chest Positron emission tomography (PET)/CT scan Aspiration/biopsy of iliac bone marrow. Distant metastases are more commonly found in the brain, lung, bone, and bone marrow. 9 Which group is credited with increasing the survival rate for patients with rhabdomyosarcoma from 30 to 70% since the 1970s? The Intergroup Rhabdomyosarcoma Study Committee (now the Soft Tissue Sarcoma Committee of the Children's Oncology Group) 10 What is the clinical grouping or surgical pathologic staging system commonly used for staging rhabdomyosarcoma? ( Table 2.1) Table 2.1 Surgical-Histopathologic Clinical Grouping System for the Intergroup Rhabdomyosarcoma Study Stage Description Group I Localized disease, completely resected A Confined to organ or muscle of origin B Invasion outside organ/muscle of origin; regional nodes not involved Group II Compromised or regional resection including A Grossly resected tumors with microscopic residual tumor B Regional disease, completely resected, in which nodes may be involved and/or tumor extends into an adjacent organ C Regional disease with involved nodes, grossly resected, but with evidence of microscopic residual Group III Incomplete resection or biopsy with gross residual disease Group IV Distant metastases, present at onset Data from Crist WM, Garnsey L, Beltangady MS, et al. Prognosis in children with rhabdomyosarcoma: a report of the intergroup rhabdomyosarcoma studies I and II (Intergroup Rhabdomyosarcoma Committee). J Clin Oncol. 1990 Mar;8 (3):443–52. 11 What is the tumor, node, and metastases (TNM) staging system for rhabdomyosarcoma introduced by the Intergroup Rhabdomyosarcoma Study IV? ( Table 2.2) Table 2.2 TNM staging system for rhabdomyosarcoma introduced by the Intergroup Rhabdomyosarcoma Study IV. Stage Description T1 Confined to the anatomical site or origin T2 Extension beyond site of origin A: = 5 cm in diameter B: > 5 cm in diameter N0 No clinically involved lymph nodes N1 Clinically involved lymph nodes NX Clinical status unknown M0 No distant metastasis M1 Distant metastasis MX Distant metastasis unknown Data from Neville HL, Andrassy RJ, Lobe TE, et al. Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdomyosarcoma Study IV (1991–1997). J Pediatr Surg. 2000 Feb;35(2):317–21. 12 Describe the staging system for rhabdomyosarcoma that combines the TNM and clinicopathologic groups to provide both prognostic and therapeutic recommendations. Rhabdomyosarcoma prognostic stratification and standard treatment assignment (Prognosis, Event-Free Survival): Excellent (> 85%) Very good (75 to 85%) Good (50 to 70%) Poor (< 30%) This system allows for risk-directed therapy. 13 Describe the favorable and unfavorable locations for head and neck rhabdomyosarcoma. Favorable: Orbit and eyelid Unfavorable: Parameningeal 14 True or False. In a patient with localized nonorbital, nonparameningeal head and neck embryonal rhabdomyosarcoma, if complete surgical excision can be achieved, radiation therapy may be avoided. True. However, chemotherapy is recommended for all patients with rhabdomyosarcoma. 15 Is elective neck dissection for clinically negative necks recommended in patients with nonparameningeal rhabdomyosarcoma of the head and neck? No 16 What are the most commonly used chemotherapeutic agents for treatment of rhabdomyosarcoma? Vincristine, actinomycin D, cyclophosphamide 17 What are the most common late complications in patients treated for rhabdomyosarcoma of the head and neck? Short stature, regional tissue hypoplasia, poor dentition, malformed teeth, impaired vision, decreased hearing, and learning disorders 18 What is the most common fibrous tumor of infancy? Infantile myofibromatosis (solitary or multicentric; well-circumscribed, spindle-shaped cells, including fibroblasts and smooth muscle cells on histopathology) 19 What is the natural history of infantile myofibromatosis? Most will involute by age 1 to 2 years. Visceral lesions causing functional impairment (e.g., pulmonary), may require surgical excision. For nonresectable, rapidly progressive, recurrent or symptomatic lesions, surgery, radiation therapy and chemotherapy should be considered. Other Sarcomas
20 What tumor type is composed of a mixed group of mesenchymal malignancies that are generally defined as either soft tissue (80%) or bony/cartilaginous (20%) tissue? Sarcomas. These tumors can arise from muscle, nerve, fat, vessel, fibrous tissue, bone, or...
