Collin M Burkart | PubMed Health

PubMed2005

Management of incidental thyroglossal duct cysts during laryngotracheal reconstruction.

Thyroglossal duct cysts originate from trapped elements of the thyroglossal duct tract during embryological descent of the thyroid gland. The incidental finding of a thyroglossal duct cyst during cervical surgery has not been described previously. We present four cases of small asymptomatic thyroglossal duct cysts discovered as an incidental finding during laryngotracheal reconstruction. In each case, the cyst was removed using a Sistrunk procedure. In all four cases the patient was successfully decannulated, and there were no cases of cyst recurrence. We also consider the implications that these four cases may have on the perceived incidence of the thyroglossal duct cysts and their management.

Child, Preschool↗

PubMed2005

Lingual cyst lined by squamous epithelium.

Lingual choristomas or foregut duplication cysts are infrequently reported congenital anomalies that typically present in the perinatal period, and can cause respiratory or feeding problems. These cysts are lined by epithelial cells characteristic of the upper aerodigestive tract. We describe two children who presented shortly after birth with lingual cysts lined with squamous epithelium and foci of respiratory epithelium. Unlike previously reported lingual choristomas, these cysts did not contain gastrointestinal epithelium. In both these cases, the lingual cysts were successfully excised via a transoral approach. This article will discuss the histological findings in these two cases, the differential diagnosis and attempt to classify these lesions in the context of existing terminology.

Adult↗

PubMed2005

Antibiotics for reduction of posttonsillectomy morbidity: a meta-analysis.

OBJECTIVE: To reconcile conflicting published reports regarding the clinical efficacy of postoperative antibiotics for reduction of posttonsillectomy morbidity. STUDY DESIGN: Systematic review (meta-analysis). METHODS: Meta-analysis of seven randomized controlled trials of postoperative oral antibiotics in patients undergoing tonsillectomy or adenotonsillectomy. Postoperative pain and time to return to normal activity and diet were studied as distinct end points using a random effects model with weighted mean difference (RevMan 4.2). Search strategy included electronic searches of PubMed and Cochrane library databases; cross-referencing textbooks, reviews, and original trials; and contacting experts in the field. RESULTS: Subjects treated with antibiotics experienced an earlier return to a normal diet (-1.22 days; 95% confidence interval [CI] = -1.97, -0.48; P = .001) and an earlier return to normal activity (-0.99 days; 95% CI = -1.80, -0.17; P = .02). Evaluation of mean pain visual analogue scores (VAS 0-10) over the first 5 and 7 postoperative days failed to demonstrate any significant effect of antibiotic therapy (VAS difference over 5 days = 0.41; -1.18, 2.00; P = .61) (VAS difference over 7 days = -0.64; -3.46, 2.18; P = .66). Cost analysis suggests routine therapy may be cost-effective but did not include analysis of side effects or resistance resulting from antibiotic usage. CONCLUSION: The results of this systematic meta-analysis suggest that postoperative oral antibiotics do not significantly reduce posttonsillectomy pain but result in an earlier return to normal activity and diet by approximately 1 day. Given the frequency that tonsillectomy is performed, this possible benefit should be weighed against the cost and potential side effects of routine antibiotic therapy.

Adenoidectomy↗