bluuebunny/crossref_metadata_2025_split huggingface dataset:
Naso-Glabello-Frontal Advancement Reconstruction for Chondroid Syringoma of the Nasal Tip
Authors: Tangco Ivy V. , Ayahao Felixberto D. 
Published: April 2019

OBJECTIVE: To present a naso-glabello-frontal advancement modification of the dorsal advancement (Rintala) flap for reconstruction of an unusual case of chondroid syringoma occurring at the nasal tip.
METHODS:
Design: Case report
Setting: Tertiary Government Training hospital
Patient: One
RESULTS: A 23-year-old man who presented with a nasal tip mass initially diagnosed as a benign adnexal tumor underwent excision and reconstruction with a naso-glabello-frontal advancement flap modification of the dorsal advancement flap with median brow lift. The procedure resulted in nasal tip reconstruction with minimal scars, including a horizontal upper medial brow margin scar that eventually became less apparent. Final histopathology revealed a rare benign mixed tumor, chondroid syringoma.

CONCLUSION: The naso-glabello-frontal advancement flap is a one-stage procedure that can be used to reconstruct such a cutaneous nasal defect after tumor excision. The modification observes nasal aesthetic subunits and may have a better aesthetic outcome than traditional rotational flaps or advancement flaps.

Keywords: rhinoplasty, surgical flaps, sweat gland neoplasm
Olfactory Neuroblastoma
Authors: Bickle Ian C. 
Published: April 2019

This 57 year-old woman presented with a seizure. She had a history of attending the ENT and neurosurgical departments for more than a decade. At the time of her initial presentation many years prior, her main complaint was of nasal congestion. A nasopharyngeal biopsy confirmed an olfactory neuroblastoma.

Olfactory neuroblastoma is an uncommon slow growing tumour of the nasal cavity with no established etiological basis. With a neuroectodermal origin, it arises from the olfactory epithelium of the upper nasal cavity.1 Most cases arise from the cribriform plate, upper third of the nasal septum, superior turbinates or anterior ethmoidal air cells. However, it typically presents late when multiple structures are involved, which may include the orbits and intracranial compartments.2

Accounting for approximately 2% of sinonasal tumors, although often late to present, ironically only a minority of patients experience anosmia.3 The commonest complaint at initial presentation is nasal blockage accounting for nearly a quarter of cases, with headache and epistaxis the next most frequent symptoms.1

Multi-modality imaging is essential in that the most recognized management of this infrequent tumor is a combination of craniofacial surgery and radiotherapy. The imaging pathway in this case was typical, with CT and MRI complementing each other in maximizing tumor delineation. Computed Tomography has superior definition is reviewing bony involvement which is a typical finding, whereas MRI has superiority in evaluating the extent of soft tissue invasion and establishing tumor boundaries against post obstruction fluid in the paranasal sinuses.3 In this case the CT illustrates the gross destruction of the skull base, orbital and sinus margins. (Figure 1-4) The MRI outlines the extension of disease involving the pituitary fossa, brainstem and frontal sinus invasion. (Figures 5 and 6)
Pneumococcal Conjugate Vaccine (Non-Typeable Haemophilus influenzae (NTHi) Protein D, Diphtheria or Tetanus Toxoid Conjugates) in Prevention of Acute Otitis Media in Children: A Cohort Study
Authors: Chu Trixy G. , Cachola Daniel Rafael R. , Regal Mary Agnes S. , Llamas Agnes Cecille G. , Martinez Norberto V. , Santos Wilfredo R. 
Published: April 2019

Objective: To compare the incidence of acute otitis media among children aged 2 to 6 months old in Sampaloc, Manila who were previously given 3 doses of pneumococcal conjugate vaccine (Non-Typeable Haemophilus influenzae (NTHi) protein D, diphtheria or tetanus toxoid conjugates) and those who did not receive the vaccine, over a period of one year.
Methods:
Study Design: Cohort Study
Setting: Primary Health Center in Sampaloc, Manila, Philippines
Participants: Medical records of well children aged 2 to 6 months were reviewed for inclusion. Participants were categorized into vaccinated and unvaccinated groups. Both groups underwent baseline history and physical examination including otoscopy and any signs and symptoms of active ear infection were noted. Subjects were followed up for a period of 1 year on a monthly basis for signs or symptoms of acute otitis media.
Results: A total of 176 subjects participated in the study. The overall incidence of AOM among participants was 5.11% (9 out of 176). An AOM incidence of 3.75% (3 out of 80) and 6.25% (6 out of 96) was found among the exposed and unexposed groups, respectively. Fisher’s exact test (one-tailed) p value =.34, relative risk (RR) .6 (95 percent CI 0.155, 2.323).
Conclusion: The results of this study showed no difference in the development of AOM in the two groups. However, based on the relative risk, Pneumococcal conjugate vaccine is still beneficial in preventing AOM in children.
Keywords: Pneumococcal Conjugate Vaccine; Acute Otitis Media
Rhinofacial Conidiobolomycosis in a 16-Year-Old Girl
Authors: Parilla Xirxiz Vin C. , Cachuela Joseph E. 
Published: April 2019

Objectives : To present the case of a 16-year old girl with progressive facial disfigurement spanning 11 months due to Conidiobolomycosis.
Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 16-year-old girl presented with a severe facial deformity of 11 months duration. The lesion started as a swelling in the right nasal vestibule, which later involved the entire nose, forehead, cheeks, upper and lower lip. A series of tissue biopsies revealed varied results -- chronic inflammation, chronic granulomatous inflammation with foreign body type giant cells, and eosinophilic granuloma—resulting in delayed provision of appropriate treatment. On the fourth biopsy using Grocott methenamine silver staining technique, septate fungal hyphae were identified. With a diagnosis of rhinofacial conidiobolomycosis, she was started on Itraconazole 100mg three times daily for eight months. Her facial swelling subsided gradually during the course of treatment and no systemic drug-related complications were observed.
Conclusion: Rhinofacial conidiobolomycosis is a rare chronic localized fungal infection that usually affects midline facial structures in immunocompetent hosts. Early detection and diagnosis, and appropriate medication can give rapid resolution. To the best of our knowledge, this may be the first documented case of rhinofacial conidiobolomycosis in the Philippines.

Keywords: Conidiobolomycosis; Conidiobolus; fungal infection; Itraconazole, Therapeutic use
True Congenital Macroglossia Surgically Managed Using a Modified Kole Technique
Authors: Smith Jenifer C. , Vicente Gil M. 
Published: April 2019

Objective: To describe a 2-year old boy with true congenital macroglossia surgically managed using a modified Kole technique.
Methods:
Study Design: Surgical Innovation
Setting: Tertiary Government Hospital
Patient: One
Results: A 2-year-old boy presented with congenital macroglossia, associated with difficulty feeding and phonating. On physical examination, the massive tongue had both increased length and width. At rest, it protruded between the upper and lower teeth, with drying and fissuring of the tip. Dribbling of saliva and mandible prognathism were also noted. The child was surgically treated with a modified Kole technique, wherein the apex of the anterior wedge resection was extended to the posterior third midline. Final histopathology was consistent with cavernous hemangioma.
Conclusion: The modified Kole technique proved viable, as the postoperative results were considered satisfactory. Tongue volume was uniformly reduced in length and width, enabling mouth and jaw closure, while tongue sensation and mobility were preserved. Feeding, speech intelligibility and cosmesis were markedly improved. Future application of this modification may prove its usefulness.
Keywords: macroglossia; glossectomy; congenital macroglossia
Low-Grade Cribriform Cystadenocarcinoma of the Parotid Gland
Authors: Carnate Jose M. 
Published: April 2019

This is the case of a 44-year-old woman with a one-year history of a left pre-auricular mass. The surgical specimen is a 5 centimeter diameter tan-brown irregularly-shaped tissue whose cut surfaces are brown with cystic spaces. Microscopic sections show cystic and dilated ductal spaces lined by cells forming irregular, variably-sized secondary spaces. These spaces are arranged in a cribriform pattern that is reminiscent of breast ductal hyperplasia. (Figure 1) The ductal cells lining the spaces are small, multilayered, and generally bland. The superficial cells show apocrine-type cytoplasmic snouting. There is no significant nuclear atypia or mitotic activity noted. Necrosis is also absent. (Figure 2) Based on these features, we signed the case as a low-grade cribriform cyastadenocarcinoma (LGCCC).

LGCCC is an uncommon tumor presenting primarily as cystic parotid masses in elderly females. The histologic hallmark of this tumor is its morphologic resemblance to the spectrum of breast lesions ranging from ductal hyperplasia to low-grade ductal carcinoma-in-situ.1-4

Microscopic sections show an unencapsulated tumor consisting of single or multiple cysts lined by proliferated small and bland ductal cells with fine chromatin and small nucleoli. Within the cystic spaces, the cells are often arranged in a cribriform pattern with anastomosing intracystic micropapillae lining the cavity. Many superficial cells show apocrine-type secretions. Thus, the over-all appearance is quite comparable to breast lesions that are termed atypical ductal hyperplasia and low-grade ductal carcinoma-in-situ.1-4 Focal invasion into the surrounding tissue can be seen. Perineural or vascular invasion however is typically absent. Cellular pleomorphism and mitoses are also usually absent and necrosis is rare. Occasional tumors however may demonstrate a transition to an intermediate or high-grade cytology with the appearance of scattered mitoses and focal necrosis.1,2

This tumor needs to be distinguished from a conventional cystadenocarcinoma. The latter is a more frankly invasive tumor with smaller duct-like structures that infiltrate into the salivary parenchyma and surrounding connective tissue. A papillary-cystic variant of acinic cell carcinoma will have areas of acinar differentiation and a greater degree of epithelial proliferation.1,5 A high-grade salivary duct carcinoma will have a high-grade cytology with more frequent necrosis, mitoses, and pleomorphism.6 Special stains that help in the differential diagnosis include Periodic Acid-Schiff (PAS) stain with Diastase digestion (diastase-resistant cytoplasmic granules in an acinic cell carcinoma), and S100 (strong diffuse positivity in LGCCC).1

LGCCC is treated by complete surgical excision. Although there are only a few reported cases with follow-up, to our knowledge, none, to date, have recurred.1-4
Laryngeal Cancer Neck Node Metastases: Patterns of Spread
Authors: Austria Mark Jansen D.G. , Roldan Rodante A. 
Published: April 2019

Objective: To determine the patterns of neck node metastases of patients with laryngeal carcinoma in our institution.
Methods:
Design: Chart Review
Setting: Tertiary Public Hospital
Subjects: Records of thirty-eight (38) laryngeal cancer patients who underwent laryngectomy with neck dissection from January 2010 to January 2017 were considered.
Results: Records of 34 laryngeal cancer patients with ages ranging from 45-72 years old were included. The most common subsite was the glottis, with 19 (55.88%) patients. The distribution of neck node metastases for all subsites were 0/64 (0%) for level I, 22/64 (34.37%) for level II, 12/64 (18.75%) for level III, 7/64 (10.93%) for level IV, 0/64 (0%) for level V, and 1/64 (1.56%) for level VI. Distributions of lymph nodes per subsite for supraglottic SCCA were 0 (0%) for level I, 3/22 (13.63%) for level II, 2/12 (16.66%) for level III, 1/7 (14.28%) for level IV, 0 (0%) for level V, and 0/1 (0%) for level VI. For glottic SCCA, they were 0 (0%) for level I, 12/22 (54.54%) for level II, 8/12 (66.66%) for level III, 3/7 (42.85%) for level IV, 0 (0%) for level V, and 1/1 (100%) for level VI; and for transglottic SCCA, they were 0 (0%) for level I, 7/22 (31.81%) for level II, 5/12 (41.66%) for level III, 3/7 (42.85%) for level IV, 0 (0%) for level V, and 0/1 (0%) for level VI.
Conclusion: Our findings show that neck node levels II, III, and IV are most frequently affected in laryngeal carcinoma patients in our sample, and may guide recommendations for neck dissection in our institution.
Keywords: Laryngeal Cancer, Metastases, Neck dissection, Supraglottic, Subglottic, Glottic, Transglottic
Thyroid Gland Invasion in Laryngeal Carcinoma
Authors: Vitamog Maria Concepcion F. , Castañeda Samantha S. 
Published: April 2019

Objective: To determine the prevalence of, and describe transglottic cancer with thyroid cartilage invasion as a possible risk for, thyroid gland invasion in a series of patients with laryngeal carcinoma who underwent total laryngectomy with thyroidectomy.
Methods
Study Design: Retrospective case series
Setting: Tertiary government hospital
Subjects: 61 laryngeal carcinoma patients who underwent total laryngectomy with hemi- or total thyroidectomy from January 2010 to August 2017.
Results
Out of 61 patients with laryngeal carcinoma, 11 patients had supraglottic, 11 glottic, 2 subglottic and 37 had transglottic involvement. Eleven had thyroid cartilage invasion, all of whom had transglottic tumors. Of these 11 patients, only 1 had thyroid gland invasion. This was a case of a 78 year-old male patient, with poorly differentiated SCC stage IVa transglottic tumor with thyroid cartilage invasion.
Conclusion
Thyroid gland invasion was uncommon in our sample of laryngeal carcinoma patients who underwent laryngectomy and thyroidectomy. Although transglottic involvement with thyroid cartilage invasion may increase the risk of thyroid gland invasion, it could not be confirmed by our series. Perhaps thyroidectomy should not be routinely performed on all patients with laryngeal carcinoma who undergo total laryngectomy, but more rigorous studies are needed to establish this.

Keywords: laryngeal carcinoma, transglottic, thyroid cartilage invasion, thyroid gland invasion, thyroidectomy
An Initial Overview of Management and Treatment Outcomes for Head and Neck Hemangiomas
Authors: Fernandez Rodolfo U. 
Published: April 2019

Objective: To provide an initial overview of the outcomes of different treatment modalities used for hemangiomas.
Methods:
Design: Case Series
Setting: Tertiary National University Hospital
Participants: Records of 21 patients diagnosed with head and neck hemangiomas in the Philippine General Hospital Department of Otorhinolaryngology from 2009 to 2014 were reviewed.
Results: Majority of the patients were female (61.9%) and in the pediatric age group (57.1%). Of the 21 patients, 6 underwent medical management, 13 had surgical management, 1 had both medical and surgical management, and 1 opted to observe the lesion. All patients treated with propranolol observed a decrease in the size of the lesion. Seven out of the 13 patients had radiofrequency ablation; all had gross residual lesion. Six of the 13 underwent excision, with complete excision being achieved in 5 of 6 cases.
Conclusion: Treatment response of patients in this series with hemangiomas of the head and neck to propranolol at a dose of 1 to 2 mg/kg/day may reflect international data. Outcomes analysis for radiofrequency ablation and surgical excision requires a longer duration of follow-up.

Keywords: propranolol hydrochloride, prednisone, pulsed radiofrequency treatment, capillary hemangioma, vascular tissue neoplasms
Histopathologically Positive Regional Neck Node Metastasis Among Patients with Laryngeal Squamous Cell Carcinoma
Authors: Soliman Efren Gerald L. , Pontejos Alfredo Quintin Y. 
Published: April 2019

Objective: To determine the patterns of regional neck node metastasis in laryngeal squamous cell carcinoma in Filipinos according to subsite and clinical stage, and to determine possible factors associated with level V involvement.
Methods:
Design: Retrospective Case Series
Setting: Tertiary National University Hospital
Participants: A chart review was conducted for patients diagnosed with laryngeal squamous cell carcinoma who underwent laryngectomy with neck dissection from January 2011 to April 2015. Medical information obtained included demographics, clinical parameters, and histopathologic reports of nodal involvement. The rate and location of positive neck nodes was recorded according to clinical stage and primary subsite. Fisher exact test was used to determine significant risk factors for level V cervical lymph node involvement.
Results: Of 56 patients included, most were male with an average age of 61 years. Most patients had cancer originating from the glottic subsite, with the majority being staged III and IVA according to the TNM classification. Histopathologically positive neck nodes were centered at levels II to IV. No significant association was seen between level V involvement and the studied clinicopathologic factors (age, sex, tumor differentiation, subsite involvement, involvement of other neck node levels).
Conclusion: Cervical neck node levels II, III, and IV are the most commonly involved in neck dissection, with many being positive for nodal metastasis for these levels. Level V nodes may be removed when clinically positive, but elective neck dissection may exclude this level. The current practice of neck dissection appears to be appropriate in terms of selecting the most likely locations of metastatic spread. Further study is recommended, with a greater population and standardized levels of neck dissection.
Keywords: laryngeal cancer, lymphatic metastasis, neck dissection, squamous cell carcinoma
Multiple Myeloma Presenting as a Parotid Mass
Authors: Borbe Benedick B. , Castaneda Samantha S. 
Published: April 2019

Objective: To present the case of a patient with left facial swelling as the primary manifestation of Multiple Myeloma, and discuss the surgical management, diagnostic dilemma, and subsequent medical management done for this unusual presentation.

Methods:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One (1)

Results: A 55-year old man with an enlarging left pre-auricular mass of one (1) year duration underwent superficial parotidectomy with facial nerve preservation and selective lymphadenectomy for pleomorphic adenoma based on initial clinical and cytologic findings. Histopathologic examination showed plasmacytoid proliferation, and subsequent work-ups finally revealed Multiple Myeloma.

Conclusion: Emphasized in this case report is the thorough work-up and targeted therapy needed for the timely diagnosis and treatment of a patient with Multiple Myeloma.

Keywords: Multiple myeloma, plasmacytoma, parotid gland, pleomorphic adenoma
Tuberculosis of the Temporomandibular Region
Authors: Santos Jesusa M. , Reala Elias T. 
Published: April 2019

Objective: To describe a unique case of extrapulmonary tuberculosis (TB) of the temporomandibular area focusing on its insidious and destructive course over a 2-year period with insights into the diagnostic and therapeutic pitfalls encountered throughout its clinical development.

Methods:
Study Design: Case Report
Setting: Tertiary Government Hospital
Patient: One

Results: A 33-year old man initially presented with right pre-auricular swelling and trismus that were unresponsive to antibiotic therapy. On subsequent follow-ups, initial symptoms were accompanied by a non-healing right pre-auricular wound, right ear discharge, trismus, and right facial paralysis (House-Brackmann III). Cranial and temporal bone computed tomography scans revealed osteolytic destruction of the right temporomandibular region extending to the auditory canal and of the right mastoid bone extending to the right mandibular condyle and parotid. Infected malignancy of the parotid, mandible and temporal bone were considered, but definitive diagnosis from an incision biopsy revealed caseating granulomatous inflammation consistent with tuberculosis. He was started on anti-tuberculosis medications with significant resolution of pre-auricular swelling, non-healing pre-auricular wound, facial paralysis and ear discharge but minimal improvement in mouth opening.

Conclusion: Tuberculosis of temporomandibular region is rare and is associated with nonspecific manifestations. Delay in diagnosing and initiating appropriate treatment can lead to morbidity and serious complications involving destruction of the temporal bone, middle ear, mandible and parotid gland over its progression. A high index of suspicion by the physician and awareness of the patient’s health seeking behaviors could have aided in the early diagnosis and treatment of this extrapulmonary TB.

Keywords: tuberculosis, temporomandibular region, pre-auricular swelling, trismus, antituberculosis therapy, facial paralysis, chronic mastoiditis, ear discharge
MALANG FLOWER CARNIVAL AS LAUNCHING PAD FOR FARIZ HOTEL MALANG
Authors: Chandra Gian Avila , Torres Andrea , Zacny Jessica A. , Aldrianita Thalita , Qadri Aisah Anugerah 
Published: April 2019

Fariz is hotel located in a strategic place near airport and culinary spot.Currently the management of Fariz hotel do not think foreign tourist as a target market. Fariz hotel still lacks some resource to do an international promotion. Fariz hotel currently using online application and website to promote their service. Their current customer mainly is tour and travel or a company. Fariz hotel potencies are its strategic location and affordable price.
The team suggested a promotion program using Malang Flower Carnival as the theme. The program is a bundle package that use Malang Flower Carnival attractiveness to catch foreign tourist interest. This program is not only promote Fariz hotel but also promote Indonesian culture.Malaysia, China, and Australia are countries which both interested in Indonesian culture and have the most tourist visiting Indonesia. That countries are the main target for this promotion program. Fariz hotel management are agreed to do international marketing as long as the marketing program is makes sense and suitable with the current Fariz hotel situations. The team suggest that Fariz hotel should improve the English of their human resource, focusing their target segment, and participate in promoting Malang Flower Carnival.