فهرست مطالب nuno medeiros

Irradiation to treat head and neck cancer, causing chronic tissue damage, is associated with the development of vascular disease. Interest has risen over the effects of radiotherapy on major vessels, due to its high morbidity and mortality rate. However, small-vessel disease has been poorly studied and described.

Case Report:

We present a case of a patient with bilateral necrosis of the anterior third of the tongue, occurring 3 years after chemoradiotherapy treatment for squamous cell carcinoma of the floor of the mouth. Contrast-enhanced CT scan showed multiple areas of stenosis concerning both external carotid arteries and their branches, and total opacification of lingual arteries. Conservative management was performed, with auto-amputation on the fifth day, which allowed healing by secondary intention.

Necrosis of the tongue appears as a rare late complication of radiotherapy, possibly due to its acceleration effect on the atherosclerosis process. Following small-vessel disease, one can assume a higher potential risk of major-vessel disease, highlighting the importance of a routine assessment and prophylaxis of thrombotic events.

Validated questionnaires are a valuable tool in medical practice. The role of septoplasty in improving patients’ non-nasal symptoms and their quality of life is still controversial. The aim of this study was to determine the differences in outcome after septoplasty measured by a disease-specific questionnaire vs a general QoL questionnaire.A total of 50 patients underwent septoplasty and completed the SNOT-22 and the SF-36v2 questionnaires preoperatively and at 6 months post-op. Pre-op, post-op and variation for each domain in both questionnaires were calculated and compared with a measure of self-reported health transition (Question 2 of SF-36v2) and with the Minimal important difference (MID) for our sample.SNOT-22 scores significantly improved for each specific question and for the total score. SF-36v2 showed a significant improvement in scores for mental domains (Mental Health, Role Emotional, and Vitality) but less so for the physical domains. MID for our sample was 4.2 points. Patients with variations greater than 4.2 in SNOT-22 total score (74%) revealed significantly better variations in Physical Function, General Health, Social Function and Vitality.Validated questionnaires are a fundamental tool for assessing outcomes of commonly performed surgeries in ENT. Disease-specific questionnaire showed improvement in scores for the majority of patients. The general QoL showed improvement only in Mental Domains. This may suggest that the impact of septoplasty in patient’s general health might not be significant.