Radiotherapy-induced morphoea of the breast responding to photodynamic therapy

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Demyelination during anti-tumour necrosis factor therapy for psoriasis

Summary

Anti-tumour necrosis factor (anti-TNF) therapies have been associated with neurological complications, including in rare cases demyelinating disease. It is currently unknown whether patients who have received more than one immunosuppressive agent or anti-TNF have a greater risk of demyelination. We report the case of a 37-year-old woman with psoriasis who presented with an acute episode of demyelination while on anti-TNF therapy. This case was complicated by the fact that progressive multifocal leukoencephalopathy was considered the likely diagnosis initially and was only definitively excluded by brain biopsy. This case demonstrates the difficulty establishing the correct diagnosis in patients with atypical presentations on immunomodulating therapies. We present this rare case of demyelination in a patient who received multiple immunosuppressive therapies to highlight this challenging clinical situation and discuss management with a literature review.

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Ultra–low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma

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Orbital exenteration for sinonasal malignancies: indications, rehabilitation and oncologic outcomes

Purpose of review Review the recent literature regarding the management of orbital invasion in sinonasal malignant tumors. Recent findings There is a recent trend in preserving the orbit in cases of minimal invasion of periosteum and limited periorbit involvement, as well as in presence of good response to neoadjuvant chemotherapy, mainly in squamous cell carcinoma and neuroendocrine histologies. Summary The decision about orbital exenteration in cases of sinonasal malignancies is facilitated if the patient already has clear clinical signs of intraconal invasion such as visual loss, restriction of ocular mobility or infiltration of the eyeglobe. However, in borderline situations, confirmation of orbital involvement should be performed intraoperatively. In selected cases with minimal orbital invasion without functional compromise, orbit sparing surgery can be done with acceptable oncological outcomes. Correspondence to Luiz P. Kowalski, MD, PhD, Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente, 211, 01509900 Sao Paulo, Brazil. Tel: +55 11 2189 5172; e-mail: lp_kowalski@uol.com.br Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Perspectives on voice treatment for unilateral vocal fold paralysis

Purpose of review Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP. This study aims to review the most recent literature for the management of dysphonia due to UVFP to establish the current evidence base for voice treatment options. Recent findings There was found to be a lack of consistency in the rationale, selection and timing of the surgical intervention and/or voice therapy being provided for patients with UVFP. Summary Further consensus is required for the rationale and selection of voice treatment prescriptions for the management of UVFP in order to improve treatment effectiveness and voice outcomes in patients with UVFP. Correspondence to Chloe Walton, Australian Catholic University (ACU), 1100 Nudgee Road, Banyo, QLD 4014, Australia. Tel: +07 3623 7100; e-mail: Chloe.walton@acu.edu.au Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2FiOgCR

Orbital exenteration for sinonasal malignancies: indications, rehabilitation and oncologic outcomes

Purpose of review Review the recent literature regarding the management of orbital invasion in sinonasal malignant tumors. Recent findings There is a recent trend in preserving the orbit in cases of minimal invasion of periosteum and limited periorbit involvement, as well as in presence of good response to neoadjuvant chemotherapy, mainly in squamous cell carcinoma and neuroendocrine histologies. Summary The decision about orbital exenteration in cases of sinonasal malignancies is facilitated if the patient already has clear clinical signs of intraconal invasion such as visual loss, restriction of ocular mobility or infiltration of the eyeglobe. However, in borderline situations, confirmation of orbital involvement should be performed intraoperatively. In selected cases with minimal orbital invasion without functional compromise, orbit sparing surgery can be done with acceptable oncological outcomes. Correspondence to Luiz P. Kowalski, MD, PhD, Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, Rua Professor Antonio Prudente, 211, 01509900 Sao Paulo, Brazil. Tel: +55 11 2189 5172; e-mail: lp_kowalski@uol.com.br Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2Gzx23H

Perspectives on voice treatment for unilateral vocal fold paralysis

Purpose of review Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP. This study aims to review the most recent literature for the management of dysphonia due to UVFP to establish the current evidence base for voice treatment options. Recent findings There was found to be a lack of consistency in the rationale, selection and timing of the surgical intervention and/or voice therapy being provided for patients with UVFP. Summary Further consensus is required for the rationale and selection of voice treatment prescriptions for the management of UVFP in order to improve treatment effectiveness and voice outcomes in patients with UVFP. Correspondence to Chloe Walton, Australian Catholic University (ACU), 1100 Nudgee Road, Banyo, QLD 4014, Australia. Tel: +07 3623 7100; e-mail: Chloe.walton@acu.edu.au Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2FiOgCR