Suspension laryngoscopy-assisted percutaneous dilatational tracheostomy: a safe method in COVID-19

xlomafota13 shared this article with you from Inoreader Suspension laryngoscopy-assisted percutaneous dilatational tracheostomy: a safe method in COVID-19 Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):389-394. doi: 10.14639/0392-100X-N1435. ABSTRACT OBJECTIVE: COVID-19 respiratory insufficiency has augmented demand of tracheostomies in intubated patients. Herein, we analyse our experience with suspension laryngoscopy-assisted percutaneous dilatational tracheostomy (SL-PDT) to assess the safety for both healthcare personnel and patients. METHODS: We conducted a retrospective review of all patients who underwent SL-PDT in the Intensive Care Unit (ICU) between March 13 and April 17, 2020 (first peak of SARS-CoV-2 pandemic). RESULTS: We included 28 SL-PDTs conducted in the ICU by a single operator using standard personal protective equipment (PPE) for high-risk procedures. The average procedure time was 30 minutes. Intraoperative complications were few, mild and promptly resolved. No operators were infected after the procedure. CONCLUSIONS: SL-PDT is a safe and quick technique: it is preferable to open surgical procedures, where air-flow cessation cannot be achieved and droplet emission is high. The cost/benefit ratio is low. A disadvantage is the need for an ENT surgeon who is familiar with direct laryngoscopy, with the main difficulty being the exposure of the upper airways. Minimal air leakage and good control of occasional bleeding makes it a safe procedure for the patient and medical personnel alike. PMID:34734573 | DOI:10.14639/0392-100X-N1435 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 manifestation in the oral cavity - a narrative literature review

xlomafota13 shared this article with you from Inoreader COVID-19 manifestation in the oral cavity - a narrative literature review Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):395-400. doi: 10.14639/0392-100X-N1584. NO ABSTRACT PMID:34734574 | DOI: 10.14639/0392-100X-N1584 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal

xlomafota13 shared this article with you from Inoreader The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):410-418. doi: 10.14639/0392-100X-N1463. ABSTRACT OBJECTIVE: Function-sparing surgery is the cornerstone for the treatment of benign parotid neoplasms. We assessed the incidences and determinants of the main postoperative complications, reappraising their influence on the patient's quality of life (QoL). METHODS: Patients who underwent parotid surgery for benign neoplasms were reviewed (2016-2019). Parotidectomy Outcome Invento ry-8 (POI-8) and condition-specific questionnaires were used to investigate the patient's perspective. RESULTS: We enrolled 211 patients. Preservation of the posterior branch of the great auricular nerve (GAN) seemed to reduce early dysfunction (87% vs 96%, p = 0.053), but not the late one. Deep lobe dissection and resection of more than one parotid segment favoured first bite syndrome (FBS) and Frey's syndrome (FS), respectively (16% vs 3%, p = 0.003; 37% vs 15%, p = 0.003). Neither GAN impairment, FBS, nor FS influenced patient QoL. Facial weakness affected 19 patients (9%), being more likely after total parotidectomy (23% vs 7%, p = 0.034). According to POI-8, QoL was mainly jeopardised by fear of revision surgery, especially in females (p = 0.005) and those experiencing early complications (p = 0.004). CONCLUSIONS: Reappraisal of the patient's perspective after functional parotid surg ery is fundamental to tailor preoperative counselling. PMID:34734576 | DOI:10.14639/0392-100X-N1463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic cauterisation and injection of Voicegel for treatment of congenital pyriform fossa sinus tracts

xlomafota13 shared this article with you from Inoreader Endoscopic cauterisation and injection of Voicegel for treatment of congenital pyriform fossa sinus tracts Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):432-435. doi: 10.14639/0392-100X-N1433. ABSTRACT OBJECTIVE: To demonstrate our experience in treating pyriform fossa sinus tracts (PFST) using a novel technique of endoscopic cauterisation of the pyriform fossa sinus opening combined with injection of sodium carboxymethylcellulose gel (VoiceGel) lateral to the tract to encourage tight closure. METHODS: Over a 48-month period, we used this technique on 11 patients who were diag nosed with PFST at BC Children's Hospital, a tertiary paediatric centre in Vancouver, BC, Canada. RESULTS: The 11 patients included 8 males and 3 females, and mean age at presentation was 69 months (range 22-108 months). Mean time from beginning of symptoms till diagnosis was 15 months (range 12-22 months). Ten PFST were on the left side of the neck and one on the right. Nine patients presented with recurrent neck infections and two had suppurative thyroiditis. All patients had endoscopic cauterisation of their PFST opening combined with injection of carboxymethylcellulose lateral to the sinus tract to cause tract collapse. Mean follow up was 15.8 months (range 8-24). All patients are asymptomatic without recurrence at the last follow-up visit. No post-operative complications were reported. CONCLUSIONS: Endoscopic management of paediatric PFST combined with the injection of sodium carboxymethylcellulose gel lateral to the sinus tract appears to be a safe and effective tr eatment option for PFST. PMID:34734578 | DOI:10.14639/0392-100X-N1433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients

xlomafota13 shared this article with you from Inoreader Recurrence of benign paroxysmal positional vertigo: experience in 3042 patients Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):461-466. doi: 10.14639/0392-100X-N1233. ABSTRACT OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences. METHODS: We retrospec tively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients. RESULTS: Mean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences. CONCLUSIONS: Our data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years. PMID:34734582 | DOI:10.14639/0392-100X-N1233 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye

xlomafota13 shared this article with you from Inoreader Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):443-449. doi: 10.14639/0392-100X-N1344. ABSTRACT OBJECTIVE: To evaluate the olfactory function in primary Sjögren's syndrome (pSS) patients and investigate its correlation with dry eye parameters. METHODS: Thirty-eight pSS patients (49.47 ± 10.06 years) and 20 healthy volunteers (47.40 ± 8.92 years) were enrolled in the study. All participants underwent ENT and eye examinations including a modified Connecticut Chemosensory Clinical Research Center (CCCRC) test, tear break-up time (TBUT), ocular surface staining (OSS) and Schirmer test. The parameters were compared between the two groups using Student-t test, and Pearson test was used to evaluate the correlations. RESULTS: Mean Schirmer and TBUT values were 2.39 ± 1.48 mm/5 min and 3.66 ± 1.5 sec in pSS and 18.30 ± 6.16 mm/5 min and 14.60 ± 3.64 sec in healthy subjects (p < 0.001, both). There was a significant decrease in mean odour threshold, odour identification, CCCRC and VAS scores in the pSS group (p < 0.001). Dry eye parameters showed moderate correlations with CCCRC parameters (r = 0.4-0.6, p < 0.001) and olfaction VAS score (r = 0.4-0.75, p < 0.05). CONCLUSIONS: There is a mild clinical impairment in smell sense in patients with pSS which seems to be correlated with dry eye parameters. Therefore, smell complaints should be queried in pSS patients suffering from severe dry eye. PMID:34734580 | DOI:10.14639/0392-100X-N1344 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Symptom improvement after transtympanic tube placement in Ménière's disease: preliminary observations

xlomafota13 shared this article with you from Inoreader Symptom improvement after transtympanic tube placement in Ménière's disease: preliminary observations Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):467-473. doi: 10.14639/0392-100X-N1705. ABSTRACT OBJECTIVE: The treatment of choice for Ménière disease (MD) aims at preventing severity and frequency of vertigo attacks. The purpose of this study was to evaluate the effectiveness of ventilation tube (VT) placement on vertigo control in patients affected by MD with no response to standard medical therapy. METHODS: 76 consecutive outpatients diagnosed with definite MD who fai led medical therapy received VT insertion at the Department of Otolaryngology Head and Neck Surgery, "Ospedale del Mare", Naples, Italy, with a 3-year follow up. RESULTS: Over the long term, VT placement was effective in controlling vertigo in 61.8% of patients. In the control group treated with standard preventive care (SPC) alone, all patients continued to experience recurrent vertigo during the entire study. Comparison of survival curves by using the log-rank test shows that significant differences in survival exist between subjects treated with VT placement and the control sample (p = 0.001). CONCLUSIONS: Our long-term follow-up confirms that VT placement is an effective and safe management option in intractable definite MD, especially in the elderly or in those refusing more invasive treatments. PMID:34734583 | DOI:10.14639/0392-100X-N1705 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute

xlomafota13 shared this article with you from Inoreader VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):419-431. doi: 10.14639/0392-100X-N1293. ABSTRACT OBJECTIVE: The recent introduction of 3D exoscopic surgery has engendered interesting technical improvements in head and neck surgery. The main goal of this study was to describe the application of 3D exoscopic technology on a wide range of pathologies of the neck, benign and malignant, through a minimally invasive retroauricular approach. METHODS: In the period January-December , 2019, 40 consecutive patients underwent neck surgery with a retroauricular approach, enhanced by using a 3D exoscope at the Head and Neck Oncological Unit of Candiolo Cancer Institute. RESULTS: Data regarding time to drain removal, length of hospitalisation, degree of pain experienced, need for opioid drugs during hospitalisation and after discharge, and intra-operative and post-operative complications were collected. All patients were followed for a minimum of 90 days with possible complications evaluated at each post-operative visit. Post-operative outcomes were evaluated at 3 months after surgery. CONCLUSIONS: The current study indicates that VITOM-3D-assisted retroauricular neck surgery (RANS-3D) may be an interesting approach for neck surgery. The hybrid execution of neck dissection under direct and exoscopic vision represents a valid alternative to video-assisted endoscopic- and robot-assisted techniques. PMID:34734577 | DOI:10.14639/0392-100X-N1293 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inhibitory effect of mesna and 5-fluorouracil on propylene glycol-induced cholesteatoma in rats

xlomafota13 shared this article with you from Inoreader Inhibitory effect of mesna and 5-fluorouracil on propylene glycol-induced cholesteatoma in rats Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):481-486. doi: 10.14639/0392-100X-N1392. ABSTRACT OBJECTIVE: The aim of this study was to investigate the inhibitory effect of different doses of sodium-2-mercaptoethanesulphonate (MESNA) and 5-fluorouracil on cholesteatoma formation. METHODS: Fifty-six Wistar albino male rats were divided into seven groups with eight rats in each. On the first, eighth and fifteenth days, 0.2 ml of saline was administered to the group 1 (contro l group), and propylene glycol to induce cholesteatoma the other groups. On the 22nd day of the study, 0.2 ml saline was given to Group 1 and Group 2. Groups 3 to 7 were treated with 0.2 ml 100% MESNA, 0.2 ml 50% MESNA, 0.2 ml 20% MESNA, 0.2 ml 5-fluorouracil and 0.1 ml 100% MESNA plus 0.1 ml 5-fluorouracil, respectively, with all applications performed by intratympanic injection. RESULTS: Significant differences were found between Group 1 and all other groups except Group 3. Significant differences were also found between Group 3 and Groups 2, 5 and 6 (P < 0.05). CONCLUSIONS: According to the results of this study, experimental cholesteatoma induced with propylene glycol may be inhibited by MESNA at 100% concentration. PMID:34734585 | DOI:10.14639/0392-100X-N1392 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between upper airway obstruction and malocclusion in mouth-breathing children

xlomafota13 shared this article with you from Inoreader Association between upper airway obstruction and malocclusion in mouth-breathing children Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):436-442. doi: 10.14639/0392-100X-N1225. ABSTRACT OBJECTIVES: To evaluate the association between upper airway obstruction and occlusal anomalies in mouth-breathing children. METHODS: 356 mouth-breathing children were evaluated by ENT physicians and specialists in orthodontics. ENT examination included nasal endoscopy to assess the adenoidal hypertrophy, tonsillar grading and presence of nasal septum deviation. Clinical orthodo ntic examination was performed to record occlusal variables. Univariate and multivariable logistic regression were performed to study the association between registered variables. RESULTS: 221 patients (mean age ± sd = 6.2 ± 2.5 years) met inclusion criteria. 81.4% of children presented malocclusion. A significant association between tonsillar grade 2 and the presence of malocclusion, Class II relation and increased overjet was shown. Tonsillar grade 4 showed a significant association with the presence of malocclusion and increased overjet. Adenoidal hypertrophy and nasal septum deviation did not show any association with occlusal findings. CONCLUSIONS: A high frequency of orthodontic problems was seen in mouth-breathing children. Our results suggested that severe tonsillar hypertrophy may determine presence of malocclusion and increased overjet. On the other hand, the association between mild tonsillar hypertrophy and many occlusal anomalies in mouth-breathers suggest an important role of malocclusion in the onset of oral breathing in children. PMID:34734579 | DOI:10.14639/0392-100X-N1225 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of Large Tissue Defects After the Resection of Brain Tumors Using a Skin Flap With Vascular Pedicle

xlomafota13 shared this article with you from Inoreader Reconstruction of Large Tissue Defects After the Resection of Brain Tumors Using a Skin Flap With Vascular Pedicle Via leak of cerebrospinal fluid J Craniofac Surg. 2021 Nov-Dec 01;32(8):2692-2694. doi: 10.1097/SCS.0000000000007610. ABSTRACT The reconstruction of large tissue defects after the resection of brain tumors is challenging for every neurosurgeon. The authors describe the benefits of a skin flap with vascular pedicle in the reconstruction of large tissue defects after the resection of brain tumors. In this retrospective analysis, a skin flap with vascular pedicle reconstruction was used in 5 patients who underwent intracranial tumor resection, accompanied by tissue defects, cerebrospinal fluid leakage and scalp infection. The surgical techniques are described, and the outcomes were discussed. The harvested flaps showed well-vascularized healing of the transplanted skin without partial necrosis in all 5 patients. One patient had cerebrospinal rhinorrhea, which was successfully treated by endoscopic repair. Another patient had cerebrospinal fluid leakage, which was successfully treated by continuous lumbar drainage. A skin flap with vascular pedicle is an effective choice for the reconstruction of large tissue defects after the resection of brain tumors. PMID:34727473 | PMC:PMC8549454 | DOI:10.1097/SCS.0000000000007610 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.