Antonios Tzangaroulakis

Publications (4)8.41 Total impact

• Source

  Available from: sbccp.org.br

  Article: Juvenile recurrent respiratory papillomatosis: still a mystery disease with difficult management.

  Sofia Stamataki, Thomas P Nikolopoulos, Stavros Korres, Dimitrios Felekis, Antonios Tzangaroulakis, Eleftherios Ferekidis
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  ABSTRACT: Juvenile recurrent respiratory papillomatosis (RRP) is the most common benign neoplastic disease of the larynx in children and adolescents and has a significant impact on patients and the health care system with a cost ranging from $60,000 to $470,000 per patient. The aim of this paper is to review the current literature on RRP and summarize the recent advances. RRP is caused by human papillomavirus (HPV; mainly by types 6 and 11). Patients suffer from wart-like growths in the aerodigestive tract. The course of the disease is unpredictable. Although spontaneous remission is possible, pulmonary spread and malignant transformation have been reported. Surgical excision, including new methods like the microdebrider, aims to secure an adequate airway and improve and maintain an acceptable voice. Repeated recurrences are common and thus overenthusiastic attempts to eradicate the disease may cause serious complications. When papillomas recur, old and new adjuvant methods may be tried. In addition, recent advances in immune system research may allow us to improve our treatment modalities and prevention strategies. A new vaccine is under trial to prevent HPV infection in women; the strongest risk factor for juvenile RRP is a maternal history of genital warts (transmitted from mother to child during delivery). Better understanding of the etiology of the disease and the knowledge of all available therapies is crucial for the best management of the affected patients.
  Head & Neck 03/2007; 29(2):155-62. · 2.40 Impact Factor
• Article: Juvenile recurrent respiratory papillomatosis: Still a mystery disease with difficult management

  Sofia Stamataki MD, Thomas P. Nikolopoulos MD, DM, PhD, PhD Stavros Korres MD, Dimitrios Felekis MD, PhD Antonios Tzangaroulakis MD, PhD Eleftherios Ferekidis MD, Sofia Stamataki, Thomas P. Nikolopoulos, Stavros Korres, Dimitrios Felekis, Antonios Tzangaroulakis, Eleftherios Ferekidis
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  ABSTRACT: Juvenile recurrent respiratory papillomatosis (RRP) is the most common benign neoplastic disease of the larynx in children and adolescents and has a significant impact on patients and the health care system with a cost ranging from $60,000 to $470,000 per patient. The aim of this paper is to review the current literature on RRP and summarize the recent advances. RRP is caused by human papillomavirus (HPV; mainly by types 6 and 11). Patients suffer from wart-like growths in the aerodigestive tract. The course of the disease is unpredictable. Although spontaneous remission is possible, pulmonary spread and malignant transformation have been reported. Surgical excision, including new methods like the microdebrider, aims to secure an adequate airway and improve and maintain an acceptable voice. Repeated recurrences are common and thus overenthusiastic attempts to eradicate the disease may cause serious complications. When papillomas recur, old and new adjuvant methods may be tried. In addition, recent advances in immune system research may allow us to improve our treatment modalities and prevention strategies. A new vaccine is under trial to prevent HPV infection in women; the strongest risk factor for juvenile RRP is a maternal history of genital warts (transmitted from mother to child during delivery). Better understanding of the etiology of the disease and the knowledge of all available therapies is crucial for the best management of the affected patients. © 2006 Wiley Periodicals, Inc. Head Neck, 2006
  Head & Neck 01/2007; 29(2):155 - 162. · 2.40 Impact Factor
• Article: Correlation of clinical and surgical findings to histological features (koilocytosis, papillary hyperplasia) suggesting papillomavirus involvement in the pathogenesis of cholesteatoma.

  Eleftherios Ferekidis, Thomas P Nikolopoulos, John Yiotakis, Elisa Ferekidou, Dimitrios Kandiloros, Konstantina Papadimitriou, Antonios Tzangaroulakis
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  ABSTRACT: The clinical course of cholesteatoma is rather unpredictable, as some cases show aggressive development, while others have a mild, more 'benign' nature. The aim was to correlate the clinical course and surgical findings of cholesteatomas with histological features. The study included 45 patients with cholesteatoma, 29 of whom had surgically aggressive and 16 simple (not surgically aggressive) cholesteatoma. All patients underwent mastoid surgery and the cholesteatoma specimens were sent for histological examination. The clinical course of the cholesteatomas had a statistically significant association (p < 0.001) with the 'aggressiveness' found in surgery, suggesting that clinical history correlates well with surgical findings. All 29 specimens of patients with surgically aggressive cholesteatoma had characteristic papillary hyperplasia of the epithelium and marked koilocytosis, suggesting papillomavirus-incduced lesions. In contrast, none of the specimens of the 16 patients with simple (non-aggressive) cholesteatoma had papillary hyperplasia and there was no marked koilocytosis, as few koilocytes could occasionally be found. The difference was statistically significant (p < 0.001). In situ hybridization for human papillomnavirus (HPV) was performed in 14 specimens (7 each with aggressive and simple cholesteatomna). Positive staining was found in three aggressive cholesteatomas. All seven simple cholesteatomas were negative for HPV. The results of the present paper suggest that papillomaviruses may play an important role in the pathogenesis of cholesteatomas. Further studies with controls and the development of new methods to identify known and unknown types of papillomavirus are needed to explore their exact role.
  Medical science monitor: international medical journal of experimental and clinical research 09/2006; 12(9):CR368-71. · 1.70 Impact Factor
• Article: Pulsatile tinnitus: a review of the literature and an unusual case of iatrogenic pneumocephalus causing pulsatile tinnitus.

  John Xenellis, Thomas P Nikolopoulos, Dimitris Felekis, Antonios Tzangaroulakis
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  ABSTRACT: Pulsatile tinnitus is frequently attributed to identifiable and treatable causes, in contrast to the more common subjective non-pulsatile tinnitus. It usually originates from vascular structures as a result of either increased blood flow or lumen stenosis; atherosclerotic carotid or subclavian artery disease; arterial, venous, or arteriovenous malformations, fistulas, or dissection; and paragangliomas. Other causes have also been reported, with often unclear pathophysiology. The aim of this paper is to present a case of pulsatile tinnitus secondary to iatrogenic pneumocephalus and to review the literature on pulsatile tinnitus. A 48-year-old white woman had a roaring, very disturbing, pulsatile tinnitus after the removal of a cerebellar lobe meningioma. When the patient experienced the symptom of tinnitus, a pulsatile movement of the tympanic membrane could be clearly seen, and this was synchronous with the patient's heartbeat. Computed tomography revealed an epidural pneumocephalus in the left posterior fossa communicating freely with the air cell system of the left mastoid cavity without any sign of residual tumor. A simple mastoidectomy was performed. The whole air cell system was removed and the mastoid cavity was filled with abdominal fat. After the operation, the pulsatile tinnitus ceased completely and the pneumocephalus disappeared gradually. The patient is free of symptoms 11 months after surgery. Otologists, neurosurgeons, and skull base surgeons should be aware of this surgical complication and be careful to identify any accidental opening to the air cell system of the temporal bone and meticulously close it when it happens. The review of the literature leads to the conclusion that pulsatile tinnitus should be thoroughly investigated, as it may be related to diseases that may have serious complications.
  Ontology & Neurotology 12/2005; 26(6):1149-51. · 1.90 Impact Factor