Tuesday, November 17, 2020

The Effect of Pitch and Loudness Auditory Feedback Perturbations on Vocal Quality During Sustained Phonation

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Dysphonia is a reduction in vocal quality that impacts communication and is often an early sign of a voice disorder. There is little information regarding the effects of auditory feedback control of loudness and pitch on voice quality. In this study, we used both loudness-shift and pitch-shift paradigms to study the relationship between auditory feedback control and vocal quality as measured by smoothed cepstral peak prominence (CPPS), which reflects the harmonicity of the voice signal.
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BRAFV600E Overrides NOTCH Signaling in Thyroid Cancer

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Thyroid, Ahead of Print.
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Novel Variants in EDNRB Gene in Waardenburg Syndrome Type II and SOX10 Gene in PCWH Syndrome

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Publication date: Available online 13 November 2020

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Lukas Varga, Daniel Danis, Jakub Drsata, Ivica Masindova, Martina Skopkova, Zuzana Slobodova, Viktor Chrobok, Milan Profant, Daniela Gasperikova

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ROBOTIC ELECTIVE COLECTOMY FOR DIVERTICULAR DISEASE: SHORT‐TERM OUTCOMES OF 80 PATIENTS

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ABSTRACT

Background

This study aimed to evaluate the impact of the robotic approach on the minimally invasive elective treatment of diverticular disease.

Methods

Data from patients who underwent elective robotic colectomy for diverticular disease from January 2015 to February 2020 were prospectively collected and retrospectively analyzed. Intraoperative and 30‐day postoperative outcomes were the variables assessed.

Results

A total of 80 patients (71% with prior complicated diverticulitis) met the inclusion criteria. Mean operative time was 241 min, one intraoperative complication (1.2%) was observed, the conversion rate was 2.5%. Mean hospital stay was 6.4 days and overall 30‐day complication rate was 22.5%. Fourteen patients (17.5%) had minor complications, while major postoperative complications occurred in 4 patients (5%). Anastomotic leak rate was 3.9% and the 30‐day readmission rate was 3.8%.

Conclusions

Robotic colectomy for diverticular disease has proven to be feasible and safe, with low intraoperative complications, conversion, and anastomotic leak rates.

This article is protected by copyright. All rights reserved.

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Outcomes of Cricothyroid Visor Maneuver (CVM) for Treatment of Vocal Polyp: A Case Report

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Via Voice

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Publication date: Available online 13 November 2020

Source: Journal of Voice

Author(s): Ali Dehqan

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Ethosuximide Induced Macroglossia and Oropharyngeal Edema

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Publication date: Available online 15 November 2020

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Hanqing Shang, Mica Glaun, Julina Ongkasuwan

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Remote monitoring of head and neck free flaps using near infrared spectroscopic tissue oximetry

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Publication date: Available online 14 November 2020

Source: American Journal of Otolaryngology

Author(s): Nicole C. Craker, Emily Slade, Thomas J. Gal, Ayooluwatomiwa Adekunle, Diana Bigler, Brian Cheung, Duane Wang, Melvyn Yeoh, James Liau, Alexandra Kejner

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Viral markers in nasopharyngeal carcinoma: A systematic review and meta-analysis on the detection of p16INK4a, human papillomavirus (HPV), and Ebstein-Barr virus (EBV)

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Publication date: January–February 2021

Source: American Journal of Otolaryngology, Volume 42, Issue 1

Author(s): Tristan Tham, Rosalie Machado, Daniel P. Russo, Saori Wendy Herman, Sushma Teegala, Peter Costantino

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Partial parotidectomy via periauricular incision: Retrospective cohort study and comparative analysis to alternative incisional approaches

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Abstract

Background

We investigated a periauricular approach to the parotid and compared outcomes to alternative parotidectomy incisions.

Methods

Retrospective chart review of patients (n = 97) undergoing partial parotidectomy for benign or malignant pathology by a single surgeon. After October 2017, most patients were approached via a periauricular incision (n = 59).

Results

There was no significant difference in patient age, tumor location, length of hospital stay, postoperative complication, or pathology. Mean tumor diameter was significantly smaller in the periauricular group (2.1 cm) than in the traditional incision group (2.6 cm). No permanent injuries to facial nerve branches occurred in either group. Patients were followed for a median of 44 days after surgery.

Conclusions

This is the largest study to date that demonstrates the periauricular incision is a safe and feasible approach for most parotid neoplasms. The cosmetic advantage of this approach is that the resulting scar is smaller and does not extend into the neck.

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Rising Costs of Otic Drops: Review of a National Database

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Objectives

US prescription drug prices have increased substantially during the past decade and now account for approximately 17% of total US health expenditures. Otic drop prices are of particular interest given their common use in otolaryngologic clinical practice. We hypothesized that otic drop prices increased at a rate significantly higher than the overall inflation rate. We considered potential causes for otic drop price fluctuations during this period and whether they could be correlated with corporate restructuring events.

Methods

Publicly available data on otic antibiotic drop pricing was assessed from 2012 to 2020 and were correlated with contemporaneous publicly available information about corporate and political events.

Results

CiproHC (Alcon Laboratories, Inc., Fort Worth, TX, US), Ciprodex (Alcon Laboratories, Inc., Fort Worth, TX, US), Cortisporin‐TC (Endo Pharmaceuticals, Dublin, Ireland), Coly‐Mycin S (JHP Pharmaceuticals, LLC, Rochester, MI, US), generic neomycin‐polymixin‐HC otic drop, ciprofloxacin otic drop, and ofloxacin otic had overall change in cost between January 2014 and January 2020 of 69.9%, 63%, 268.9%, 219.5%, 232.5%, 13%, and 62.4%, respectively. Generic ofloxacin otic drop showed the most price fluctuation, temporarily rising 945% from July 2015 to its peak price of $26/mL in October 2016.

Conclusion

Otic drop prices have been volatile, with overall price increases higher than overall inflation. Drug pricing is not transparent, making it difficult for prescribers and patients alike to be cost conscious when choosing the best therapy. We outline six factors that contribute to high US medication prices and also highlight two examples of otic drops that underwent significant price fluctuation during the studied period.

Level of Evidence

V Laryngoscope, 2020

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Pain Experience and Tolerance of Awake In‐Office Upper Airway Procedures: Influencing Factors

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Objectives/Hypothesis

Awake, unsedated in‐office upper airway procedures are performed frequently and have high completion rates, yet less is known about the patients' pain experience and potentially influencing factors. It is also unclear if patients' pain experiences become worse with repeated procedures. We identified procedure‐ and patient‐related factors that might influence procedural completion and pain scores.

Study Design

Retrospective chart review.

Methods

Pre‐, intra‐, and post‐procedure pain scores were collected prospectively for awake unsedated upper airway procedures performed at a single institution over a 5‐year period. Patient factors reviewed were demographics, body mass index, psychiatric and/or pain diagnosis, and related medications. Procedure factors reviewed were procedure type, route, side, and performance of the same procedure multiple times. Patients reported their pain level before, during, and after the procedure using a standard 0 to 10 scale. Maximum pain score change (PΔmax), or the difference between highest and lowest reported pain levels, was calculated. Descriptive and multivariate analyses were performed.

Results

Procedure completion was 98.7% for 609 first time patients and 99.0% in 60 patients undergoing 292 repeat procedures. PΔmax did not covary with age, gender, or BMI. PΔmax covaried with pain and psychiatric conditions and associated medications. PΔmax was highest for injection medialization and lowest for tracheoscopy. PΔmax decreased over time for those undergoing multiple identical procedures.

Conclusions

Procedures were performed with a very high completion rate and low pain scores. Age, sex, and BMI did not affect pain experience. A combination of pain and psychiatric conditions did. Injection medialization had the highest PΔmax and tracheoscopy the lowest.

Level of Evidence

4 Laryngoscope, 2020

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The changing face of tonsillectomy

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Abstract

Tonsillectomy is one of the commonest surgical procedures in children, and the subject of much debate and political discourse. Whilst historically recurrent tonsillitis has been the main indication, there has been a shift towards surgery for obstructive sleep apnoea (OSA) in recent years. For recurrent tonsillitis, indications for surgery are now well researched, accepted, and enforced at commissioning level. In the case of OSA, the evidence base for patient selection and management is perhaps not as robust.

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Survival and treatment outcome of head and neck cancer patients with pulmonary oligo‐metastases

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Abstract

Objectives

The purpose of this study is to determine the outcome of head and neck squamous cell carcinoma (HNSCC) patients developing lung metastasis.

Design

Retrospective study

Participants

HNSCC patients with lung metastasis treated between 2001 and 2018 were included .

Mean outcomes mesures

Statistical analyses described the relationship between patient survival, treatment efficacy and pulmonary metastasis occurrence.

Results

One hundred HNSCC patients were included in the study. The median overall survival (OS) was 21 months. The median recurrence‐free survival (RFS) was seven months. Patient survival with only lung metastases was significantly longer compared to patients with lung metastases and lymph nodes involvement or other metastases. Moreover, patients with a single metastasis had longer post‐RFS and OS than patients with multiple metastases. The local control of metastasis was better when patients presented only lung metastases, and it was more effective in single metastasis. The surgery allowed better metastases local control than supportive care or radio and/or chemotherapy. In case of specific therapy, pulmonary resection was associated with a longer post‐RFS and a longer OS compared to supportive care or radio and/or chemotherapy.

Conclusions

We confirmed, in the current study, the significant survival benefit for HNSCC patients treated by surgery for their pulmonary metastasis. While treatment of multiple metastases required palliative chemotherapy or best supportive care in most of the cases, specific surgical treatment in selected HNSCC patients should be considered.

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