Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period

xlomafota13 shared this article with you from Inoreader Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period 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. 2021 Aug 13. doi: 10.1007/s00405-021-07037-4. Online ahead of print. ABSTRACT PURPOSE: Despite sporadic case reports describing hearing problems in patients with coronavirus disease 2019 (COVID-19), whether COVID-19 affects the audiovestibular system remains unclear. This study assessed the evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period. METHOD: Three audiovestibular disorders namely, sudden sensorineural hearing loss (SSHL), autonomic dysfunction, and Meniere's disease (MD) were analyzed and compared from 2016 to 2020. RESULTS: The annual new cases at our clinic comprised overall 2107, 1997, 1984, 2068, and 1829 from 2016 to 2020, respectively, and the respectively annual cases of SSHL were 54, 46, 42, 45 and 38. Accordingly, annual incidences of SSHL in relation to overall cases of audiovestibular disorders were 2.6%, 2.3%, 2.1%, 2.2% and 2.1% from 2016 t o 2020, respectively, exhibiting a non-significant difference (p > 0.05). In contrast, incidence of autonomic dysfunction in the year 2020 was 15.3%, which revealed significantly higher than 8.5-13.1% from 2016 to 2019 (p < 0.001). Restated, the incidence of autonomic dysfunction in 2020 displayed a significantly higher percentage than the other 4 years. Conversely, the incidence of MD in 2020 was 9.8%, showing a significant decline compared with the other 4 years (12.6-15.6% from 2016 to 2019, p < 0.001), CONCLUSION: Evolution of incidence of audiovestibular disorders during the pandemic COVID-19 period revealed increase in the incidence of autonomic dysfunction and decrease in that of MD, while incidence of SSHL remained unchanged from 2016 to 2020. Thus, the SARS-CoV-2 may less affect the audiovestibular system. PMID:34389915 | DOI:10.1007/s00405-021-07037-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hydraulic insertions of cochlear implant electrode arrays into the human cadaver cochlea: preliminary findings

xlomafota13 shared this article with you from Inoreader Hydraulic insertions of cochlear implant electrode arrays into the human cadaver cochlea: preliminary findings 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. 2021 Aug 14. doi: 10.1007/s00405-021-06979-z. Online ahead of print. ABSTRACT OBJECTIVES: (1) To evaluate the feasibility of a non-invasive, novel, simple insertion tool to perform automated, slow insertions of cochlear implant electrode arrays (EA) into a human cadaver cochlea; (2) to estimate the handling time required by our tool. METHODS: Basic science study conducted in an experimental OR. Two previously anonymized human cadaver heads, three commercially available EAs, and our novel insertion tool were used for the experiments. Our tool operates as a hydraulic actuator that delivers an EA at continuous velocities slower than manually feasible. INTERVENTION(S): the human cadaver heads were prepared with a round-window approach for CI surgery in a standard fashion. Twelve EA insertion trials using our tool involved: non-invasive fixation of the tool to the head; directing the tool to the round window and EA mounting onto the tool; automated EA insertion at approximately 0.1 mm/s driven by hydraulic actuation. Outcome measurement(s): handling time of the tool; post-insertion cone-beam CT scans to provide intracochlear evaluation of the EA insertions. RESULTS: Our insertion tool successfully inserted an EA into the human cadaver cochlea (n = 12) while being attached to the human cadaver head in a non-invasive fashion. Median time to set up the tool was 8.8 (7.2-9.4) min. CONCLUSION: The first insertions into the human cochlea using our novel, simple insertion tool were successful without the need for invasive fixation. The tool requires < 10 min to set up, which is clinically acceptable. Future assessment of intracochlear trauma is needed to support its safety profile for clinical translation. PMID:34390390 | DOI:10.1007/s00405-021-06979-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dynamic analysis for flexion and extension of elbow joint motion based on musculoskeletal model of Anybody

xlomafota13 shared this article with you from Inoreader Dynamic analysis for flexion and extension of elbow joint motion based on musculoskeletal model of Anybody Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Purpose Little is known about how biomechanics governs the biological nature for humeral motion dynamically. Elbow motion ought to be investigated based on a musculoskeletal model and evidence the physiologic principle of upper limbs. Method A humeral model was reconstructed by MIMICS after CT images input in *.dicom format, it was processed by Geomagic Studio for Surfaces, then gridded mesh and assigned materials by Hypermesh. On the other hand, a musculoskeletal model was built by Anybody, physical motions were then simulated to export boundary condition and myodynamia during flexion and extension. Finally, all the humeral model and boundary were imported to Abaqus for finite element analysis. Result During the simulative motion of flexion, the primary muscles are brachii biceps, brachialis anticus and teretipronator, their myodynamia increased and then decreased gradually, and reached its peak value at 30°; During extension, the main muscles are triceps brachii and brachialis anticus, their myodynamia increased and then decreased gradually too, and reached peak at 50°; In these 2 cases, their strain and displacement distributed at the middle of humerus. Conclusion AnyBody is a novel modeling system to simulate physical motion, e.g. flexion and extension. Biceps brachii and brachialis anticus are functional for flexion, and triceps brachii plays a key role in extension critically. This simulation confirms the physiologic rule for sport event, humeral fixation and postoperative healing with clinical significance that minimizing joint forces from injury onset may promote pain-free ways. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Self-Perceived Voice Handicap during COVID19 Compulsory Facemask Use: a Comparative Study Between Portuguese and Spanish speakers

xlomafota13 shared this article with you from Inoreader Self-Perceived Voice Handicap during COVID19 Compulsory Facemask Use: a Comparative Study Between Portuguese and Spanish speakers Via Journal of Voice This study investigates self-perceptions of voice-related handicap, quantified by means of the Voice Handicap Index (VHI), as a function of facemask use in the general working population during the COVID19 outbreak. Each VHI item was answered twice in a raw; the first answer referred to the condition of not wearing a facemask (henceforth, the Without condition) and the second to facemask use (henceforth, the With condition). VHI scores were collected via Google Forms (Google, Mountain View, California), targeting two groups of speakers, Portuguese (n = 261) and Spanish (n = 297). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Arytenoid Adduction Operation for the Treatment of Unilateral Vocal Fold Paralysis

xlomafota13 shared this article with you from Inoreader Modified Arytenoid Adduction Operation for the Treatment of Unilateral Vocal Fold Paralysis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Unilateral vocal fold paralysis (UVFP) was a relative common glottic insufficiency disease; however, a completely satisfactory treatment of UVFP was elusive. This study was aimed to evaluate the surgical efficacy of modified arytenoid adduction with fenestration of the thyroid cartilage in the management of patients with UVFP, including voice and aspiration outcomes, and to summarize the postoperative complications. Methods: A retrospective analysis was performed on a total of 21 patients who underwent modified arytenoid adduction operation with fenestration of the thyroid cartilage for UVFP from July 2012 to June 2017. The scores of Grade, Roughness, Breathiness, Asthenia, Strain scale (GRBAS), voice self-satisfaction, dynamic laryngoscopy and the voice acoustic data (fundamental frequency [F0], fundamental frequency perturbation [jitter], loudness, amplitude perturbation [shimmer], and maximal phonatory time [MPT], etc.) were statistically analyzed preoperatively and 3–6 months postoperatively. The occurrence of postoperative complications was also summarized. Results: The voice subjective perception of 21 patients was significantly improved after operation. The rate of voice self-satisfaction was 90.5%. The mean values of voice acoustics parameters were significantly improved. The MPT was significantly longer (p #x3c; 0.001), and the ratings of postoperative aspiration were significantly decreased compared with the preoperation. Among the 21 patients, 15 cases had sense of laryngeal obstruction, 8 cases had of 1–2° laryngemphraxis (recovered after 10–15 days). There were 2 cases of laryngeal stridor, 1 case of incision infection, 1 case of pharyngeal fistula, and 1 case of falsetto (corrected by voice training). No patient had laryngeal hematoma, neck hematoma, or laryngospasm. Conclusion: The modified arytenoid adduction operation with fenestration of the thyroid cartilage can significantly improve the vocal function of patients with UVFP and effectively reduce the aspiration, with fewer postoperative complications, less trauma, and more convenient advantages. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Fold Movement and Silent Aspiration After Congenital Heart Surgery

xlomafota13 shared this article with you from Inoreader Vocal Fold Movement and Silent Aspiration After Congenital Heart Surgery Via The Laryngoscope Objectives/Hypothesis Infants who undergo congenital heart surgery are at risk of developing vocal fold motion impairment (VFMI) and swallowing difficulties. This study aims to describe the dysphagia in this population and explore the associations between surgical complexity and vocal fold mobility with dysphagia and airway protection. Study Design Retrospective chart review. Methods This is a retrospective chart review of infants (age <12 months) who underwent congenital heart surgery between 7/2008 and 1/2018 and received a subsequent videofluoroscopic swallow study (VFSS). Demographic information, Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) category of each surgery, vocal fold mobility status, and VFSS findings were collected and analyzed. Results Three hundred and seventy-four patients were included in the study. Fifty-four percent of patients were male, 24% were premature, and the average age at the time of VFSS was 59 days. Sixty percent of patients had oral dysphagia and 64% of patients had pharyngeal dysphagia. Fifty-one percent of patients had laryngeal penetration and 45% had tracheal aspiration. Seventy-three percent of these aspirations were silent. There was no association between surgical complexity, as defined by the STAT category, and dysphagia or airway protection findings. Patients with VFMI after surgery were more likely to have silent aspiration (odds ratio = 1.94, P < .01), even when adjusting for other risk factors. Conclusion Infants who undergo congenital heart surgery are at high risk for VFMI and aspiration across all five STAT categories. This study demonstrates the high prevalence of silent aspiration in this population and the need for thorough postoperative swallow evaluation. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Population‐Based Analysis of Outpatient Thyroidectomy: Safe and Under‐Utilized

xlomafota13 shared this article with you from Inoreader A Population‐Based Analysis of Outpatient Thyroidectomy: Safe and Under‐Utilized Via The Laryngoscope Objectives/Hypothesis Performance of thyroidectomy on an outpatient basis has gained popularity although many jurisdictions have not shifted their practice despite a strong safety profile. We sought to assess the uptake and safety of outpatient thyroidectomy in Ontario. Study Design Retrospective cohort study. Methods This was a population-based retrospecive cohort of adult patients undergoing hemithyroidectomy or total thyroidectomy between 1993 and 2017 in Ontario, Canada. Outpatient surgery was defined as discharge home on the same day of surgery. Outcomes of interest include 30-day all cause death, hematoma, emergency department use, and readmission. To adjust for confounding, propensity scores were calculated. Logistic regression models with inverse probability of treatment weighting (IPTW) were then used to estimate the exposure-outcome relationship. Results The final cohort consisted of 81,199 patients: 8,442 underwent same day surgery and 72,757 were admitted. The proportion of patients undergoing outpatient thyroidectomy increased overtime (2.3% in 1993–1994 to 17.8% in 2016–2017). Factors associated with higher odds of outpatient thyroidectomy included: younger age, less material deprivation, less comorbidities, and higher surgeon volume. The absolute number of deaths (≤5) and hematomas (64, 0.8%) in the outpatient cohort was low. After IPTW adjustment, patients with outpatient management had lower odds of neck hematoma (OR 0.73[95CI% 0.58–0.93)], but higher odds of emergency department use (OR 1.67[95%CI 1.56–1.79]). Conclusions Outpatient thyroidectomy is not associated with an increased mortality risk. Less than one in five patients undergo outpatient thyroidectomy in Ontario, despite a well-established safety profile. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Technical Considerations in Pedicle Management in Upper and Midfacial Free Flap Reconstruction

xlomafota13 shared this article with you from Inoreader Technical Considerations in Pedicle Management in Upper and Midfacial Free Flap Reconstruction Via The Laryngoscope Objectives Mid and upper face free flaps frequently are associated with challenges due to pedicle length. We sought to evaluate the frequency at which alternative pedicle maneuvers were required for these reconstructions and determine if there was any association with flap survival or postoperative complications. Study Design Retrospective review at three tertiary care institutions. Methods Database review. Results Free flap reconstruction of the upper and midface was performed in 295 patients (108 bony, 187 soft tissue). In 82% of cases, the vessels reached the ipsilateral neck for anastomosis to traditional target vessels. Arterial grafts were required in 2% of reconstructions (4% bony and 1% soft tissue). Venous grafting was required in 7% of reconstructions (21% fibula, 16% scapula, and 3% soft tissue) and was associated with an increase in flap failure rate (19% vs 3%, P = .003). The most common recipient artery for revascularization was the cervical facial artery (78%). Alternate recipient vessels were selected in 13% of cases, including the superficial temporal vessels (7%), distal facial branches through a separate facial incision (4%), and angular vessels (2%). Vein grafting was associated with a higher flap failure rate. Alternative maneuvers did not affect need for intraoperative pedicle revision or complications. Conclusions In upper and midface reconstruction, vascular grafting, targeting more distal branches of the facial system, or additional maneuvers to optimize pedicle orientation is often required to secure revascularization. Vein grafting is associated with a higher free flap failure rate. Scapular border flaps often require vascular grafting or atypical anastomotic locations. Level of Evidence 3—Non randomized cohort study 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of Submandibular Stone Removal With and Without Salivary Endoscopes

xlomafota13 shared this article with you from Inoreader Outcomes of Submandibular Stone Removal With and Without Salivary Endoscopes Via The Laryngoscope Objectives/Hypothesis For patients with submandibular sialolithiasis, there are many gland-preserving treatment options including sialendoscopy. Sialendoscopy, however, requires expensive instrumentation with limited availability, which may not be required for routine cases. The objective of this study is to compare the outcomes of patients with submandibular sialolithiasis undergoing sialendoscopy versus those undergoing transoral incisional sialithotomy. Study Design Longitudinal, prospective study of patient undergoing gland-preserving therapy for submandibular sialolithiasis. Methods The study was a prospective, nonrandomized trial of 30 patients with submandibular sialolithiasis who received gland-preserving treatment by either sialendoscopy-assisted techniques (Scope group; 14 patients) or transoral sialithotomy with or without dochoplasty (No Scope group; 16 patients). Factors analyzed between the two groups included age, race, gender, size of stone, location of stone, gland(s) involved, surgical method, and modified salivary Oral Health Impact Profile (sOHIP) scores before and after therapy. Results There were no significant differences between the Scope and No Scope groups regarding age, race, or gender. There was a significant difference in stone size between the groups, with the No Scope group having larger stones on average. Both treatments led to statistically significant symptomatic improvement in sOHIP scores. There was no statistically significant difference in salivary quality of life improvement between the Scope and No Scope groups (P = .33). Conclusions Sialendoscopy is an important diagnostic and therapeutic tool in the management of salivary disorders, but is not associated with improved outcomes in gland-preserving treatments for routine submandibular sialolithiasis. Transoral stone removal alone may have equivalent symptomatic outcomes in the management of select sialoliths. Level of Evidence III Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Automatic Registration and Precise Tumor Localization Method for Robot‐assisted Puncture Procedure under Inconsistent Breath‐holding Conditions

xlomafota13 shared this article with you from Inoreader Automatic Registration and Precise Tumor Localization Method for Robot‐assisted Puncture Procedure under Inconsistent Breath‐holding Conditions Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background During percutaneous puncture procedure, breath holding is subjectively controlled by patients, and it is difficult to ensure consistent tumor position between the preoperative CT scanning phase and the intraoperative puncture phase. In addition, the manual registration process is time-consuming and has low accuracy. Methods We have proposed an automatic registration method using optical markers and a tumor breath-holding position estimation model based on the support vector regression algorithm. A robot system and a tumor respiratory motion simulation platform are built to perform puncture tests under different breath-holding states. Results The experimental results show that automatic registration has higher accuracy than manual registration, and with the tumor breath-holding position estimation model, the targeting accuracy of puncture under inconsistent breath-holding conditions is greatly improved. Conclusions The proposed automatic registration and tumor breath-holding position estimation model can improve the accuracy and efficiency of puncture under inconsistent breath-holding conditions. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acral Peeling in Nagashima Type Palmo‐plantar Keratosis Patients Reveals the Role of Serine Protease Inhibitor B 7 in Keratinocyte Adhesion

xlomafota13 shared this article with you from Inoreader Acral Peeling in Nagashima Type Palmo‐plantar Keratosis Patients Reveals the Role of Serine Protease Inhibitor B 7 in Keratinocyte Adhesion Via Experimental Dermatology Abstract Acral peeling skin syndrome (APSS) is a heterogenous group of genodermatoses, manifested by peeling of palmo-plantar skin, occasionally associated with erythema and epidermal thickening. A subset of APSS is caused by mutations in protease inhibitor encoding genes, resulting in unopposed protease activity and desmosomal degradation and/or mis-localization, leading to enhanced epidermal desquamation. We investigated two Arab-Muslim siblings with mild keratoderma and prominent APSS since infancy. Genetic analysis disclosed a homozygous mutation in SERPINB7, c.796C>T, which is the founder mutation in Nagashima type palmo-plantar keratosis (NPPK). Although not previously formally reported, APSS was found in other patients with NPPK. We hypothesized that loss of SERPINB7 function might contribute to the peeling phenotype through impairment of keratinocyte adhesion, similar to other protease inhibitor mutations that cause APSS. Mis-localization of desmosomal components was obse rved in a patient plantar biopsy compared to a biopsy from an age and gender matched healthy control. Silencing of SERPINB7 in normal human epidermal keratinocytes led to increased cell sheet fragmentation upon mechanical stress. Immunostaining showed reduced expression of Desmoglein 1 and Desmocollin 1. This study shows that in addition to stratum corneum perturbation, loss of SERPINB7 disrupts desmosomal components, which could lead to desquamation, manifested by skin peeling. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.