Optimal Multiple-Layered Anterior Skull Base Reconstruction Using a 360° Suturing Technique

xlomafota13 shared this article with you from Inoreader Optimal Multiple-Layered Anterior Skull Base Reconstruction Using a 360° Suturing Technique Via leak of cerebrospinal fluid Oper Neurosurg (Hagerstown). 2022 Jan 1;22(1):e1-e6. doi: 10.1227/ONS.0000000000000013. ABSTRACT BACKGROUND: Advances in technique and instrumentation have improved outcomes after resection of anterior skull base tumors. However, cerebrospinal fluid (CSF) leak occurs in 4%-20% of patients. To reduce the risk of CSF leak, we have developed a novel reconstruction technique that consists of a 4-layered graft with patchwork suturing and hard material. OBJECTIVE: To evaluate the effectiveness of this reconstruction technique when used for resection of anterior skull base tumors. METHODS: This case series included 59 patients with anterior skull base tumors in whom the 4-layered closure technique was used. The main outcome measures were complications, including CSF leak, meningitis, postoperative bleeding, and infection. RESULTS: There were no CSF leak cases or serious complications after closure of the anterior skull base using t he 4-layered technique. CONCLUSION: Closure of the anterior skull base in 4 layers prevented CSF leak and was not associated with any serious complications. However, further studies in larger numbers of patients are needed to confirm our outcomes using this closure method. PMID:34982903 | DOI:10.1227/ONS.0000000000000013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High prevalence of parvovirus B19 infection in patients with thyroid nodules: A case-control study

xlomafota13 shared this article with you from Inoreader High prevalence of parvovirus B19 infection in patients with thyroid nodules: A case-control study Via American Journal of Otolaryngology Publication date: March–April 2022 Source: American Journal of Otolaryngology, Volume 43, Issue 2 Author(s): Zahra Heidari, Mina Valinezhad View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clown Nose: A Rare Hypopharyngeal Cancer Metastasis

xlomafota13 shared this article with you from Inoreader Clown Nose: A Rare Hypopharyngeal Cancer Metastasis Via ear nose throat Ear Nose Throat J. 2022 Jan 5:1455613211069349. doi: 10.1177/01455613211069349. Online ahead of print. ABSTRACT Cutaneous metastases from squamous cell carcinomas of the head and neck region are uncommon, and their location at the nasal tip is exceptionally rare. A patient, previously treated with surgery and chemoradiation for a hypopharyngeal squamous cell carcinoma, developed several red nodular skin lesions at the nasal tip. Biopsy revealed cutaneous metastasis from the primary tumor. This manifestation was previously described as a "clown nose," given their appearance and location. Skin lesions should raise suspicion of malignancy, despite their location at uncommon places, particularly in patients with previous diagnosed cancer. Clinicians must be aware that metastases from head and neck cancer can present as a "clown nose." PMID:34983248 | DOI:10.1177/01455613211069349 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rationale for therapeutic decision-making in locally advanced and metastatic radioactive iodine (RAI)-refractory differentiated thyroid cancer, starting from a clinical case

xlomafota13 shared this article with you from Inoreader Rationale for therapeutic decision-making in locally advanced and metastatic radioactive iodine (RAI)-refractory differentiated thyroid cancer, starting from a clinical case Via radioactive iodine Arch Clin Cases. 2021 Dec 29;8(4):72-83. doi: 10.22551/2021.33.0804.10190. eCollection 2021. ABSTRACT Iodine uptake and organification are the hallmarks of thyroid cells differentiation. The loss of these characteristics in thyroid cancer leads to radioactive iodine refractoriness, a rare condition that bears a low survival rate and poor prognosis. We present a 52-year-old patient presenting dry cough and dyspnea in the supine position. Imaging examinations revealed a thyroid nodul e with a high suspicion of malignancy in the right thyroid lobe, multiple laterocervical and mediastinal lymph nodes, lung, bone, and brain metastases. Fine needle aspiration cytologic features have advocated for papillary thyroid cancer (PTC). The patient underwent total thyroidectomy and selective lymphadenectomy. Subsequently, the patient received suppressive treatment with levothyroxine and four courses of radioactive iodine therapy. In addition, to treat bone and brain metastases, the patient experienced external radiotherapy and glucocorticoid therapy. Despite this rigorous therapeutic management, the patient obtained an incomplete structural and functional response. Although the last two posttherapeutic 131I whole-body scans were negative, the patient had elevated stimulated thyroglobulin levels and loco-regional recurrence by thyroid ultrasound. This aspect would suggest that thyroid cells become unable to uptake 131I, most likely through the emergence of new genetic mutations in the cancer cells. In conclusion, our patient's case suggests a 131I-refractory PTC, requiring the initiation of novel targeted systemic agents such as tyrosine kinase inhibitors, in order to improve structural and functional outcomes of radioactive iodine therapy and to afford prolonged progression-free survival advantage. PMID:34984230 | PMC:PMC8717005 | DOI:10.22551/2021.33.0804.10190 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eustachian Tube Functions in Concurrent Chemoradiotherapy for Head and Neck Cancer Patients

xlomafota13 shared this article with you from Inoreader Eustachian Tube Functions in Concurrent Chemoradiotherapy for Head and Neck Cancer Patients Via Otolaryngology Indian Abstract Ototoxicity is a dose-limiting adverse event for concurrent chemoradiotherapy (CCRT) with high-dose cisplatin for locally advanced head and neck squamous cell carcinoma (HNSCC). Both irradiation to the Eustachian tube (ET) and weight loss are risk factors for patulous ET. The aim of this prospective, observational study was to elucidate the incidences of patulous ET conditions before and after CCRT in HNSCC patients by means of ET function tests. This prospective, observational study was conducted in 27 HNSCC patients who received CCRT with high-dose cisplatin, and ET function tests (sonotubometry and tubo-tympano-aerodynamic graphy) were performed before and 3 months after CCRT. Factors potentially affecting the incidence of patulous ET conditions after CCRT were evaluated. Of the 54 ears from 27 patients investigated, patulous ET conditions were observed in 12 ears (22.2%) from 9 patients (33.3%) before CCRT and 15 ears (27.8%) from 11 patients (40.7%) at 3 months after CCRT. Only patulous ET conditions before CCRT in each ear were significantly associated with patulous ET conditions after CCRT (p = 0.010). This is the first report to describe the incidences of patulous ET conditions before and after CCRT in HNSCC patients. HNSCC patients are potentially at higher risk of patulous ET. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinicopathological Difference Between Gingivobuccal and Oral Tongue Cancers: A Cross-Sectional Observational Study from a Tertiary Healthcare Centre in Northern India

xlomafota13 shared this article with you from Inoreader Clinicopathological Difference Between Gingivobuccal and Oral Tongue Cancers: A Cross-Sectional Observational Study from a Tertiary Healthcare Centre in Northern India Via Otolaryngology Indian Abstract Gingivobuccal and oral tongue squamous cell carcinomas are commonly considered together as a single clinical entity for staging and treatment purposes. Though there is data suggesting a significant difference between SCC of various oral cavity subsites, very few studies have compared clinicopathological characteristics between the tongue and gingivobuccal primaries. We retrospectively analysed 225 patients with biopsy-proven gingivobuccal (GB) and oral tongue (OT) SCC operated between April 1, 2018 and April 30, 2021 in All India Institute of Medical Sciences, Rishikesh, India to compare their clinicopathological characteristics. Demographic, clinical and histopathological data were collected from electronic medical records. An independent sample t-test was used to compare means and Pearson chi-square test or Fisher exact test was applied to compare the distribution of categorical variables. A relative male preponderance (12:1 vs. 5:1, p = 0.036) and increased smokeless tobacco consumption (82% Vs. 69%, p = 0.003) was seen in GB-SCC. Significantly higher proportion of patients with OT-SCC presented with early primaries (T1/T2) (54.1% vs. 24.8%, p < 0.001). Similarly, a higher proportion of GB-SCC patients presented with palpable neck nodes (cN +) (81% Vs. 67%, p = 0.02). Due to early primary tumours at presentation, stage I/II disease was also significantly higher in cases of OT-SCC (36.5% Vs.13.7%, p < 0.001). No difference was noticed in age at presentation, neck node status, and other clinicopathological parameters. GB-SCC has a higher male preponderance than OT-SCC due to relatively higher consumption of smokeless tobacco in males. Oral tongue cancers presented at an earlier stage than gingivobuccal malignancies. No difference in neck node status, however, suggests a relatively aggressive disease behaviour and early regional metastasis in tongue cancers. Follow up data regarding recurrence and survival is required to further characterise the differences between these two common OSCC subsites. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory dysfunction is associated with cognitive impairment in patients with obstructive sleep apnea: a cross-sectional study

xlomafota13 shared this article with you from Inoreader Olfactory dysfunction is associated with cognitive impairment in patients with obstructive sleep apnea: a cross-sectional study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Jan 6. doi: 10.1007/s00405-021-07194-6. Online ahead of print. ABSTRACT PURPOSE: Obstructive sleep apnea (OSA) increases the risk for olfactory dysfunction. However, the relationship between olfactory function and cognition in OSA patients is unclear. The present study aimed to investigate the relationship between cognition and olfactory dysfunction (OD) in patients with OSA. METHOD: This was a cross-sectional study in which 74 patients with OSA and 22 controls were recruited. All subjects completed polysomnography, Sniffin' Sticks, and -neurocognitive assessments. According to results of Sniffin' Sticks, OSA patients were divided into two groups: OSA with OD (53 cases) and OSA without OD (21 cases). Neurocognitive function was assessed by Montreal Cognitive Assessment (MoCA), Memory and Executive Screening (MES), and Shape Trail Test (STT). Cognition was compared between OSA with and without OD. C orrelation between olfactory parameters and respiratory sleep parameters and neurocognitive assessments was analyzed. RESULTS: Compared with OSA without OD, OSA with OD showed significantly decreased neurocognitive scores of MoCA (29-27 vs 27-23, p < 0.01), MES-5R (45-40.1 vs 43-33.5, p < 0.01) and increased consuming time of STT-B (91.66 vs 121.63, p < 0.01). A positive correlation was found between the scores of MoCA and MES-5R and all olfactory parameters. In addition, a negative correlation was present between the time consumed for STT-B and odor thresholds (r = - 0.344, p < 0.01), odor identification (r = - 0.335, p < 0.01), and threshold-discrimination-identification scores (r = - 0.448, p < 0.01). CONCLUSION: Olfactory function is associated cognitive function in patients with OSA and may provide a new direction for early treatment interventions in OSA patients at risk for cognitive impairment. PMID:34988658 | DOI:10.1007/s00405-021-07194-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Falls Among People With Bilateral Vestibulopathy

xlomafota13 shared this article with you from Inoreader Falls Among People With Bilateral Vestibulopathy Via JAMA Otolaryngology–Head & Neck Surgery Online First This review examines the current knowledge and applied methods on fall incidence, causes, and injuries in bilateral vestibulopathy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CPPS and Voice-Source Parameters: Objective Analysis of the Singing Voice

xlomafota13 shared this article with you from Inoreader CPPS and Voice-Source Parameters: Objective Analysis of the Singing Voice Via Journal of Voice In recent years cepstral analysis and specific cepstrum-based measures such as smoothed cepstral peak prominence (CPPS) has become increasingly researched and utilized in attempts to determine the extent of overall dysphonia in voice signals. Yet, few studies have extensively examined how specific voice-source parameters affect CPPS values. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

xlomafota13 shared this article with you from Inoreader Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma Via The Laryngoscope Objectives/Hypothesis We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). Study Design Retrospective cohort study. Methods A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. Results A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70–0.95]) and stage III–IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74–3.05], P = .23). Propensity score analysis also showed no OS benefit with the use of PORT (P = .41). Conclusions Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III–IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health

xlomafota13 shared this article with you from Inoreader Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health Via Journal of the Association for Research in Otolaryngology Abstract Stimulus polarity can affect both physiological and perceptual measures in cochlear-implant recipients. Large differences between polarities for various outcome measures (e.g., eCAP threshold, amplitude, or slope) theoretically reflect poorer neural health, whereas smaller differences reflect better neural health. Therefore, we expect large polarity effects to be correlated with other measures shown to contribute to poor neural health, such as advanced age or prolonged deafness. Our earlier studies using the electrically evoked compound action potential (eCAP) demonstrated differences in polarity effects between users of Cochlear and Advanced Bionics devices when device-specific clinical pulse designs were used. Since the stimuli differed slightly between devices, the first goal of this study was to determine whether small, clinically relevant differences in pulse phase duration (PD) have a significant impact on eCAP polarity effects to potentially explain the de vice differences observed previously. Polarity effects were quantified as the difference in eCAP thresholds, mean normalized amplitudes, and slope of the amplitude growth function obtained for anodic-first versus cathodic-first biphasic pulses. The results showed that small variations in PD did not explain the observed differences in eCAP polarity effects between devices. Therefore, eCAP polarity sensitivity measures are relatively robust to small differences in pulse parameters. However, it remains unclear what underlies the observed manufacturer differences, which may limit the utility of eCAP polarity sensitivity measures. The second goal was to characterize polarity sensitivity in a large group of CI recipients (65 ears) to relate polarity sensitivity to age and duration of deafness as a proxy for neural health. The same pulse parameters were used for both device groups. The only significant predictors of eCAP polarity effects were age for threshold and amplitude polarity effect s for Cochlear recipients and age and duration of deafness for slope for AB recipients. However, three of these four correlations were in the opposite direction of what was expected. These results suggest that eCAP polarity sensitivity measures likely reflect different mechanisms than the effects that age and duration of deafness induce on the peripheral auditory system. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Systematic Review on the Association Between Clinical Symptoms and CBCT Findings in Symptomatic TMJ Degenerative Joint Disease

xlomafota13 shared this article with you from Inoreader A Systematic Review on the Association Between Clinical Symptoms and CBCT Findings in Symptomatic TMJ Degenerative Joint Disease Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Nov-Dec;35(4):332-345. doi: 10.11607/ofph.2953. ABSTRACT AIMS: To evaluate the association between clinical signs/symptoms and bone changes on CBCT images in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). METHODS: An electronic literature search of the MEDLINE, PubMed, EMBASE, Scopus, and Web of Science databases, as well as Google Scholar for gray literature, was conducted to identify relevant art icles on February 26, 2021. Risk of bias was evaluated using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Recommendation, Assessment, Development, and Evaluation) system instrument was applied to assess the level of evidence across studies. RESULTS: Nine papers assessing clinical signs/symptoms and CBCT findings were included. TMJ pain (arthralgia) and TMJ noises carried the strongest associations with various CBCT findings, each of which were supported by four studies with significant associations. Only one study found significant associations between masticatory myalgia (muscle pain) and CBCT findings. Range of motion carried no significant associations with CBCT findings in the included studies. Based on the GRADEpro system, the certainty of evidence is low for said associations. CONCLUSION: The results suggest that TMD patients with TMJ arthralgia and joint noises may benefit from CBCT imaging. There would be less benefit in TMD patients exhibi ting primarily myalgia or limited range of motion, and therefore these patients should not be prescribed routine CBCT radiographs unless indicated by other clinical findings. The heterogeneity of reporting in the included studies suggests that embracing universal clinical (DC/TMD) and radiographic diagnostic criteria for TMJ-DJD would benefit both research and clinical outcomes. PMID:34990502 | DOI:10.11607/ofph.2953 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.