Wednesday, September 1, 2021

Intrabony mandibular metastases caused by papillary thyroid carcinoma masquerading as a parotid swelling

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Ann R Coll Surg Engl. 2021 Sep;103(8):e264-e265. doi: 10.1308/rcsann.2020.7091.

ABSTRACT

Papillary carcinoma is the most common type of thyroid cancer, accounting for 80-90% of cases. Distant metastasis of papillary thyroid cancer is uncommon, but when it does occur, it is most commonly to the lungs, liver and bone. Bone metastases to the mandible are rarely reported. We present a 68-year-old man who was referred due to a right parotid mass. Appropriate imaging and biopsy revealed a thyroid malignancy with bone metastases. The patient subsequently underwent thyroidectomy, with histology revealing multifocal papillary carcinoma. Radioactive iodine treatment was then commenced to control the metastatic disease.

PMID:34464554 | DOI:10.1308/rcsann.2020.7091

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Do Ultrasound Patterns and Clinical Parameters Inform the Probability of Thyroid Cancer Predicted by Molecular Testing in Nodules with Indeterminate Cytology?

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Thyroid, Ahead of Print.
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Iodine seed localisation of non-palpable lesions in breast surgery first experience

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Rozhl Chir. 2021 Summer;100(6):261-265. doi: 10.33699/PIS.2021.100.6.261-265.

ABSTRACT

Surgical therapy of non-palpable malignant breast lesions requires precise preoperative localisation. Recently, radioactive iodine seed localisation has excelled among the number of localisation methods. We present our first experience with this method at our department. We describe the structure of the radioactive iodine seed, the principles of preoperative localisation and peroperative detection of the seed, the specimen transport process, histopathological examination, storage and disposal of the seed, as well as aspects of radiation protection.

PMID:34465114 | DOI:10.33699/PIS.2021.100.6.261-265

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Adherence to Home-Based Swallowing Therapy Using a Mobile System in Head and Neck Cancer Survivors

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Am J Speech Lang Pathol. 2021 Aug 31:1-11. doi: 10.1044/2021_AJSLP-21-00026. Online ahead of print.

ABSTRACT

Purpose A large knowledge gap related to dysphagia treatment adherence was identified by a recent systematic review: Few existing studies report on adherence, and current adherence tracking relies heavily on patient self-report. This study aimed to report weekly adherence and dysphagia-specific quality of life following home-based swallowing therapy in head and neck cancer ( HNC). Method This was a quasi-experimental pretest-posttest design. Patients who were at least 3 months post-HNC treatment were enrolled in swallowing therapy using a mobile health (mHealth) swallowing system equipped with surface electromyography (sEMG) biofeedback. Participants completed a home dysphagia exercise program across 6 weeks, with a target of 72 swallows per day split between three different exercise types. Adherence was calculated as percent trials completed of trials prescribed. The M. D. Anderson Dysphagia Inventory (MDADI) was administered before and after therapy. Results Twenty participants (75% male), with an average age of 61.9 years (SD = 8.5), completed the study. The majority had surgery ± adjuvant (chemo)radiation therapy for oral (10%), oropharyngeal (80%), or other (10%) cancers. Using an intention-to-treat analysis, adherence to the exercise regimen remained high from 84% in Week 1 to 72% in Week 6. Radiation therapy, time since cancer treatment, medical difficulties, and technical difficulties were all found to be predictive of poorer adherence at Week 6. A statistically significant improvement was found for composite, emotional, and physical MDADI subscales. Conclusions When using an mHealth system with sEMG biofeedback, adherence rates to home-based swallowing exercise remained at or above 72% over a 6-week treatment period. Dysphagia-specific quality of life improved following this 6-week treatment program.

PMID:34463544 | DOI:10.1044/2021_AJSLP-21-00026

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Success Rate of Type I Tympanoplasty Using Temporalis Fascia by Underlay Technique in Safe Mucosal COM in KMCH, Katihar

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Abstract

Otitis media is inflammation of middle ear, commonly seen in children of school going age. Chronic otitis media is permanent abnormality of tympanic membrane most commonly as a result previous acute otitis media. Early diagnosis and management of chronic otitis media is important because it may affects hearing of child which in turn may affect cognitive development of children. This is a retrospective observational study done on 60 patients of age between 18 and 60 yrs during the period from May 2019 to November 2019 in ENT department of Katihar Medical College, Katihar, Bihar and assessed success rate of Type I Tympanoplasty using Temporalis Fascia by Underlay technique in safe mucosal COM. Success rate was 90% when preoperative dry ear was for more than one month. Graft taken up properly in 50 patients out of 60 cases i.e. 83.33%.

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Primary Reconstruction in Segmental Resection of Mandible—An Outcome Analysis of Different Reconstructive Techniques

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Abstract

Functional and cosmetic defects in the maxillofacial region may result from trauma, inflammatory disease, benign or malignant tumors. There are several well established reconstructive options for restoring mandibular continuity and function. Traditionally, surgeons have used their past experience to determine the best way to perform the osteotomy, graft harvesting, and graft shaping procedures for mandibular reconstruction. Focus has now shifted to optimize functional and aesthetic outcomes in mandible reconstruction. Refinements in surgical techniques continue to improve patient's quality of life. The purpose of this study was to evaluate the outcome of a range of reconstructive techniques in 20 patients who underwent segmental resection of mandible during the period 2004-2017.

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A Study of Anatomical Variations of Sphenoid Sinus on CT PNS: Our Experience

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Abstract

Sphenoid sinus anatomical variations are very common, its prior knowledge is very essential while doing skull base surgery to avoid catastrophic complications which might be due to damage of surrounding neurovascular structures. This retrospective observational study was done to examine the different anatomical variations of sphenoid sinus on CT PNS which was conducted in KMCH, Katihar from May 2019 to April 2020 involving 60 cases above 15 years of age who had undergone CT PNS. Sellar type of pneumatization was seen in 66.7%, pterygoid process pneumatization was seen in 25%. Single septation was present in 43.3%, septum attached to optic nerve was seen in 33.3%, onodi cell was seen in 36.7%, anterior clinoid process pneumatization was seen in 13.3% of cases. By this study we came to a conclusion that preoperative assessment of sphenoid sinus anatomy and its variations is mandatory to avoid surrounding neurovascular structure damage and CSF leak.

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Sport and Recreational Causes of Nasal Bone Fractures

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Ann Otol Rhinol Laryngol. 2021 Sep 1:34894211042446. doi: 10.1177/00034894211042446. Online ahead of print.

ABSTRACT

OBJECTIVE: Nasal bone fractures are the most common facial bone fractures. However, there is limited literature on the etiology of these fractures, particularly distribution across sports and other recreational activities.

METHODS: The Nationwide Electronic Injury Surveillance System (NEISS) national injury database was queried for emergency department v isits involving the diagnosis of nasal or nose fractures associated with sports and recreation activities over the most recent 10 year span available. Demographic, disposition, and weighted incidence were analyzed.

RESULTS: Total incidence of nasal fractures across 10 years was 158 979. The mean age of nasal bone fractures was 20.4 years old. Nasal fractures were more common in males (74.6%) and white patients (54.1%). National estimated incidence of nasal fractures decreased from 21 028 in 2009 to 11 108 in 2018, a reduction of 47.2%. The most common causes among all patients were basketball (23.2%), baseball (17.1%), softball (9.8%), soccer (7.4%), and football (7%). In pediatric patients, the most common cause was baseball (25.1%). The majority (98.1%) of patients were discharged from the emergency department, while 0.9% of patients were admitted.

CONCLUSION: The most common recreational causes of nasal fractures are sports, with the most common being non-contact spor ts like basketball and baseball. However, the incidence of nasal bone fractures due to recreational causes nationwide has decreased significantly over the past 10 years. This may reflect improved safety protocols among athletes.

PMID:34467777 | DOI:10.1177/00034894211042446

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Design and analysis of a continuum robot for transnasal skull base surgery

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Abstract

Background

The traditional surgical instruments for transnasal endoscopic skull base surgery have poor flexibility and continuum robot has attracted extensive attention for its high dexterity and safety.

Methods

A new type of micro continuum surgical robot is designed. On the basis of kinematic analysis, a superposition method is proposed to analyze the reachable configuration space of the system, and the workspace is analyzed. The results obtained by superposition method can provide reference for the selection of joint parameters. At last, the static model of the system is established considering friction and coupling between two segments.

Results

The simulation results show that the workspace can meet the requirements of surgery. And the validity of the static model is verified by numerical simulation and experiment, which lays a foundation for the establishment of the driving force transmission system and precise control of the robot.

Conclusions

The research results of this paper contribute to the real-time control and movement of robot. The proposed continuum robot provides convenient conditions for the clinical application.

This article is protected by copyright. All rights reserved.

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COVID-19: Post-vaccine Smell and Taste Disorders: Report of 6 Cases

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Ear Nose Throat J. 2021 Sep 1:1455613211033125. doi: 10.1177/01455613211033125. Online ahead of print.

ABSTRACT

Post-vaccine olfactory and gustatory disorders are very rare and were reported in patients who received influenza vaccines. In this article, we report 6 cases of post-coronavirus disease 2019 (COVID-19) vaccine olfactory and gustatory disorders in patients with negative nasal swabs. Precisely, olfactory and gustatory dysfunctions were reported in 5 and 1 patients, respectively. Sense disorders occurred after the first injection of AstraZeneca (n = 4) or the second injection of Pfizer (n = 2) vaccines. In 4 cases, the olfactory or gustatory disorder was confirmed with psychophysical evaluations. The duration of chemosensory dysfunction ranged from 4 to 42 days. None of the patient reported mid- or long-term olfactory or gustatory disorder. The occurrence of olfactory and gustatory dysfunctions in adults benefiting from COVID-19 vaccines is still rare but has to be known by otolaryngologists.

PMID:34467793 | DOI:10.1177/01455613211033125

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A Novel Concept for Surgical Management of a Traumatic Comminuted Cricoid Fracture

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Ear Nose Throat J. 2021 Sep 1:1455613211040579. doi: 10.1177/01455613211040579. Online ahead of print.

ABSTRACT

The cricoid plays 2 key roles: phonation and maintenance of the airway frame, both of which are lost in cases of comminuted cricoid fractures. The management of these 2 functions becomes a challenge in planning surgical treatment. We report the treatment course in a case of traumatic comminuted cricoid fracture that was resolved with good airway and phonatory funct ions. A 25-year-old man fell down the stairs and complained of respiratory discomfort and hoarseness of voice. A computed tomography scan showed comminuted cricoid fracture; therefore, surgery was performed to restore the patient's airway and phonation functions. We found that the airway was maintained by the anterior part and that the phonation depended on the posterior part of the cricoid. This novel concept helped clarify the treatment goal in this case of comminuted cricoid fractures. Furthermore, it is important that the anterior part of the cricoid is reconstructed with sufficient internal diameter, while the posterior part of the cricoid is reconstructed in the correct position.

PMID:34467797 | DOI:10.1177/01455613211040579

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Role of lncRNA BCYRN1 in trophoblast cell physiology and pathogenesis of preeclampsia

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Exp Ther Med. 2021 Oct;22(4):1137. doi: 10.3892/etm.2021.10571. Epub 2021 Aug 6.

ABSTRACT

Long non-coding RNAs (lncRNAs) may play a key role in the pathogenesis of preeclampsia (PE). The present study investigated the role of the lncRNA brain cytoplasmic RNA 1 (BCYRN1) in PE. A total of 30 patients with severe PE (SPE) and 30 patients with mild PE (MPE) were recruited, whilst 30 healthy pregnant individuals were enrolled as controls. Placental tissues of enrolled subjects were collected after delivery. The clinical data of pregnant women and newborns were recorded before the correlation between BCYRN1 expression and clinical characteristics was analyzed. Furthermore, HTR-8/SVneo cells were transfected with BCYRN1 overexpression plasmids and BCYRN1 small interfering (si)RNA. Cell Counting Kit-8, Transwell, flow cytometry and tube formation assays were used to detect the function of BCYRN1 in HTR-8/SVneo cells. Reverse transcription-quan titative PCR was used to detect BCYRN1 expression in placental tissues and HTR-8/SVneo cells. Western blotting was used to detect the protein expression levels of Wnt1 and β-catenin. BCYRN1 expression was lower in placenta with mild PE compared with in normal placenta, and was in turn lower in placenta with severe PE. BCYRN1 was negatively correlated with systolic blood pressure and 24-h urinary protein in patients with PE. BCYRN1 siRNA inhibited cell viability, migration, invasion and tube forming abilities whilst increasing apoptosis. By contrast, BCYRN1 overexpression conferred opposite effects. The levels of Wnt1 and β-catenin expression in the cells and placental tissues were next measured. Cells overexpressing BCYRN1 were further treated with the Wnt pathway inhibitor XAV939. Wnt1 and β-catenin expression were elevated when BCYRN1 was overexpressed, but were decreased after BCYRN1 knockdown. XAV939 attenuated the effect of BCYRN1 overexpression on HTR-8/SVneo cells. Overall , the resulted indicated that upregulation of BCYRN1 increased trophoblast viability and prevented apoptosis by activating the Wnt/β-catenin pathway to delay PE onset.

PMID:34466147 | PMC:PMC8383326 | DOI:10.3892/etm.2021.10571

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