Graded reconstruction strategy using a multi-layer technique without lumbar drainage after endoscopic endonasal surgery

xlomafota13 shared this article with you from Inoreader Graded reconstruction strategy using a multi-layer technique without lumbar drainage after endoscopic endonasal surgery Via leak of cerebrospinal fluid World Neurosurg. 2021 Nov 9:S1878-8750(21)01704-6. doi: 10.1016/j.wneu.2021.11.003. Online ahead of print. ABSTRACT OBJECTIVE: Sellar reconstruction following endoscopic endonasal surgery (EES) requires modification based on the degree of cerebrospinal fluid (CSF) leak. For high-flow (grade II or III according to Esposito et al., 2007) intraoperative CSF leak, lumbar drainage (LD), in addition to the multi-layer closing technique, is generally recommended. However, LD has complications occasionally, including post-puncture headache, over-drainage symptoms, and increased length of stay (LOS). We retrospectively evaluated the outcome of our graded reconstruction strategy using a multi-layer technique with a novel material, without LD, after EES. METHODS: Ninety-seven patients who underwent EES with grade II or III intraoperative CSF leak between June 2020 and March 2021 were retrospectively reviewed. For grade II CSF leak, fibrin sealant and a nasoseptal flap (NSF) were placed; for grade III CSF leak, a multi-layer technique was utilized in combination with collagen matrix, an acellular dermal graft, injectable hydroxyapatite (HXA), and an NSF. Postoperatively, routine LD was not performed. RESULTS: This study included 48 (49.5%) grade II and 49 (50.5%) grade III CSF leaks. Upon follow-up period (mean, 8.7 months), no patient showed postoperative CSF leak in either group. No HXA-associated complications occurred. CONCLUSIONS: A graded surgical repair strategy after EES could avoid postoperative CSF leak. Combined use of injectable HXA and acellular dermal grafts for high-flow CSF leak can limit LD requirement, without significant risks. PMID:34767991< /a> | DOI:10.1016/j.wneu.2021.11.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines

xlomafota13 shared this article with you from Inoreader Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines Via oto-rhino-laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Nov 9:S1879-7296(21)00253-2. doi: 10.1016/j.anorl.2021.10.005. Online ahead of print. ABSTRACT GOALS: To perform a medical analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Reunion Island, a French overseas territory. MATERIAL AND METHOD: A multicenter retrospective observational study was conducted for an 8-year period, before and after introduction of sialendoscopy (2011-2014 and 2015-2018), following STROBE guidelines. OBJECTIVES: To compare populations treated before (period A) and after (period B) the introduction of sialendoscopy in terms of clinical characteristics, and analyze the characteristics of patients treated by sialendoscopy. RESULTS: Two hundred and sixty-five patients were included: 74 in 2011-2014 and 191 in 2015-2018; 139 had sialendoscopy. Populations A and B were comparable except for the proportion of parotids treated (9% vs. 31%, respectively; P<0.0001), and smaller stones (11mm vs. 7.4mm, respectively; P=0.003). One hundred and ten pure sialendoscopies and 29 combined routes (20.8%) were performed: 63% submandibular and 37% parotid. Median age was 46 years. The M/F sex ratio was 0.96. Thirty-seven patients presented stenosis. There were 10 cases of papillary catheterization failure (7.1%), and 16 false routes or creation of false channels (11.5%), including 9 during the learning period. The rate of crossover to gland resection decreased: 10.45% for 2015-2016 and 5.56% for 2017-2018. CONCLUSION: Although follow-up ranged between 12 and 55months (median, 30months), sialendoscopy appeared to be a useful and reliable technique, with a role in therapeutic strategy for the management of non-tumoral salivary pathologies in Reunion Island. PMID:34772641 | DOI:10.1016/j.anorl.2021.10.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines

xlomafota13 shared this article with you from Inoreader Medical analysis of the contribution of sialendoscopy in managing non-tumoral main salivary gland pathology in Reunion Island: Observational study following STROBE guidelines Via Laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Nov 9:S1879-7296(21)00253-2. doi: 10.1016/j.anorl.2021.10.005. Online ahead of print. ABSTRACT GOALS: To perform a medical analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Reunion Island, a French overseas territory. MATERIAL AND METHOD: A multicenter retrospective observational study was conducted for an 8-year period, before and after introduction of sialendoscopy (2011-2014 and 2015-2018), following STROBE guidelines. OBJECTIVES: To compare populations treated before (period A) and after (period B) the introduction of sialendoscopy in terms of clinical characteristics, and analyze the characteristics of patients treated by sialendoscopy. RESULTS: Two hundred and sixty-five patients were included: 74 in 2011-2014 and 191 in 2015-2018; 139 had sialendoscopy. Populations A and B were comparable except for the proportion of parotids treated (9% vs. 31%, respectively; P<0.0001), and smaller stones (11mm vs. 7.4mm, respectively; P=0.003). One hundred and ten pure sialendoscopies and 29 combined routes (20.8%) were performed: 63% submandibular and 37% parotid. Median age was 46 years. The M/F sex ratio was 0.96. Thirty-seven patients presented stenosis. There were 10 cases of papillary catheterization failure (7.1%), and 16 false routes or creation of false channels (11.5%), including 9 during the learning period. The rate of crossover to gland resection decreased: 10.45% for 2015-2016 and 5.56% for 2017-2018. CONCLUSION: Although follow-up ranged between 12 and 55months (median, 30months), sialendoscopy appeared to be a useful and reliable technique, with a role in therapeutic strategy for the management of non-tumoral salivary pathologies in Reunion Island. PMID:34772641 | DOI:10.1016/j.anorl.2021.10.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Economic analysis of the contribution of sialendoscopy in managing non-tumoral principal salivary gland pathology in the Réunion Island: Economic evaluation following the CHEERS methodology

xlomafota13 shared this article with you from Inoreader Economic analysis of the contribution of sialendoscopy in managing non-tumoral principal salivary gland pathology in the Réunion Island: Economic evaluation following the CHEERS methodology Via Laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Nov 9:S1879-7296(21)00252-0. doi: 10.1016/j.anorl.2021.10.004. Online ahead of print. ABSTRACT GOALS: Cost analysis of the contribution of sialendoscopy in the treatment of non-tumoral pathologies of the main salivary glands, in Réunion Island, a French overseas territory. OBJECTIVES: Calculation and comparison of median pricing (i.e., median payment to the healthcare establishment) per patient before and after the introduction of sialendoscopy, in the only regional establishment practicing sialendoscopy and in the whole of Réunion Island. Material and method A multicenter retrospective cost study was conducted over an 8-year period, before and after the introduction of sialendoscopy (period A: 2011-2014 and period B: 2015-2018), according to the CHEERS guidelines for economic studies, and included inpatients with non-tumoral pathology of the main salivary glands, whether treated by sialend oscopy or not. RESULTS: Two hundred sixty-five patients were included, 139 of whom were treated by sialendoscopy: 74 in 2011-2014 and 191 in 2015-2018. Between the two periods, median pricing in the only center practicing sialendoscopy did not vary significantly: €3468 vs. €3368 (i.e., +2.9% (P=0.1)). In the Island as a whole, pricing increased significantly: €598 vs. €2332, (i.e., +390% (P<0.0001)). CONCLUSION: Sialendoscopy is cost-effective in France in the public healthcare sector if outpatient management is optimal, but significantly increases the public health budget. It makes it possible to recruit and manage previously untreated patients (small stones, salivary strictures, etc.). PMID:34772642 | DOI:10.1016/j.anorl.2021.10.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relations Between Dysphonia and Personality: An Approximation From Gray' Theories.

xlomafota13 shared this article with you from Inoreader Relations Between Dysphonia and Personality: An Approximation From Gray' Theories. Via Journal of Voice Our study sought to show the relation between dysphonia and personality traits as explained by Gray's theories. Personality traits were analyzed in a patient group of 141 patients who showed functional and congenital voice disorders. The results were compared to the control group made up of 99 vocally healthy individuals. Their objective voice quality was measured by using the Dysphonia Severity Index, Voice Handicap level was measured using the VHI-10, and a perceptive analysis was conducted with a listening jury. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pretreatment tumor sampling and prognostic factors in patients with soft-tissue sarcoma of the head and neck

xlomafota13 shared this article with you from Inoreader Pretreatment tumor sampling and prognostic factors in patients with soft-tissue sarcoma of the head and neck 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 Nov 12. doi: 10.1007/s00405-021-07162-0. Online ahead of print. ABSTRACT BACKGROUND: Insufficient preoperative work-up and consequent intralesional or marginal resection of soft-tissue sarcomas of the head and neck (STSHNs) is common. METHODS: This retrospective cohort study comprised 63 patients with STSHN treated at the Helsinki University Hospital between 2005 and 2017. We assessed the effect of pretreatment tumor sampling on surgical margin status and need for supplemental surgery, as well as prognostic factors and survival. RESULTS: The lack of representative pretreatment biopsy specimen was associated with unfavorable margin status. Primary surgery at a non-academic center was associated with need for supplemental surgery. The 3-year overall survival (OS) was 68%, disease-specific survival (DSS) 71%, and recurrence-free survival (RFS) 61%. Higher tumor grade and primary tumor size over 5 cm were associated with reduced DSS. CONCLUSIONS: Diagnosis and management of STSHNs should be centralized to experienced academic centers. Decision-making between needle biopsy, open biopsy, or upfront radical surgery depends on tumor location and size. PMID:34773167 | DOI:10.1007/s00405-021-07162-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cortical auditory evoked potentials with different acoustic stimuli: Evidence of differences and similarities in coding in auditory processing disorders

xlomafota13 shared this article with you from Inoreader Cortical auditory evoked potentials with different acoustic stimuli: Evidence of differences and similarities in coding in auditory processing disorders Via cortical auditory Int J Pediatr Otorhinolaryngol. 2021 Oct 14;151:110944. doi: 10.1016/j.ijporl.2021.110944. Online ahead of print. ABSTRACT OBJECTIVES: The use of cortical auditory evoked potentials allows for the study of the processing of acoustic signals at the cortical level, an important step in the diagnostic evaluation process, and for the monitoring of the therapeutic process associated with auditory processing disorders (APD). The differences and similarities in the acoustic coding between different types of stimuli in the context of APD remain unknown to this date. METHODS: A total of 37 children aged between 7 and 11 years, with and without APDs (identified based on verbal and non-verbal tests), all with a suitable intelligence quotient with respect to their chronological age, were assessed. Components P1 and N1 were studied using verbal and non-verbal stimuli. RESULTS: The comparison between stimuli in each group revealed that the cont rol group had higher latency and amplitude values for speech stimuli, except for the P1 amplitude, while the group with APDs had different results with respect to the amplitudes of P1 and N1, yielding higher values for speech sounds. The differences between the groups varied according to the type of stimulus: the difference was in amplitude for the verbal stimulus and latency for the non-verbal stimulus. CONCLUSION: The records of components P1 and N1 revealed that the children with APDs performed the coding underlying the detection and identification of acoustic signals, whether verbal and non-verbal, according to a different pattern than the children in the control group. PMID:34773882 | DOI:10.1016/j.ijporl.2021.110944 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Re: Virus Load and Incidence of Olfactory, Gustatory, Respiratory, Gastrointestinal Disorders in COVID‐19 Patients: A Retrospective Cohort Study

xlomafota13 shared this article with you from Inoreader Re: Virus Load and Incidence of Olfactory, Gustatory, Respiratory, Gastrointestinal Disorders in COVID‐19 Patients: A Retrospective Cohort Study Via Clinical Otolaryngology Abstract We read with interest the retrospective cohort study by Taziki Balajelini et al. [1], which investigated the relationship between viral load and the incidences of olfactory dysfunction (OD) and gustatory dysfunction (GD) in patients with COVID-19. In the study, the authors observed a significantly higher (p=0.001) mean cycle threshold (Ct) value of RT-PCR test for SARS-CoV-2 between patients with (28.13±4.55) and without OD (26.91±4.49). The Ct values of the RT-PCR test for SARS-CoV-2 correlate inversely with the viral load, where low Ct values indicate high viral loads and vice versa; therefore, the findings of the study suggest a lower viral load in patients with OD. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Open wound management following pull‐through resection for oral cancer: A case series of 14 patients

xlomafota13 shared this article with you from Inoreader Open wound management following pull‐through resection for oral cancer: A case series of 14 patients Via Clinical Otolaryngology Abstract ●Following pull-through resection for oral cancer, primary closure of the oral defect is sometimes difficult. Incompletely closed defects may result in surgical site infection (SSI). ●We investigated the occurrence of SSI during and after open wound management following pull-through resection, other surgical outcomes, and postoperative quality of life (QOL). ●Open wound management was performed when the resection range was preoperatively expected to be half or less of the tongue and the defect was difficult to close primarily. ●The defect was left open, and drains were placed through the defect. The wound was cleansed after surgery, and the drains were removed as the wound healed. ●Open wound management was a simple and safe method with no occurrence of SSI. Postoperative QOL was acceptable when the oral defects were contained within half of the mobile tongue or less than half of the tongue base. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy

xlomafota13 shared this article with you from Inoreader Arterial calcification on preoperative computed tomography imaging as a risk factor for pharyngocutaneous fistula formation after total laryngectomy Via Head & Neck Abstract Background Research in esophageal surgery showed that computed tomography (CT) assessed arterial calcification (AC) is associated with postoperative complications. We investigated the association between AC and pharyngocutaneous fistula (PCF) formation after laryngectomy. Methods This was a retrospective cohort study of patients undergoing laryngectomy. AC was scored at 10 different anatomical locations on CT imaging, blinded for PCF occurrence. Association with PCF was investigated using logistic regression. Results The 224 patients were included; 62 (27.7%) developed a PCF. Moderate to severe AC was widespread in patients undergoing TL; 7.1% of patients had at most mild AC, of whom 1 experienced a PCF (p = 0.05). A higher cumulative calcification score was associated with PCF in univariable (OR 1.11, p = 0.04) and multivariable analysis (OR 1.14, p = 0.05). Conclusion AC is widespread in patients undergoing laryngectomy and its burden is associated with PCF. Extensive AC on preoperative imaging may be considered a risk factor for PCF. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Iron deficiency and high-intensity running interval training do not impact femoral or tibial bone in young female rats

xlomafota13 shared this article with you from Inoreader Iron deficiency and high-intensity running interval training do not impact femoral or tibial bone in young female rats Via swallowing exercises Br J Nutr. 2021 Nov 11:1-22. doi: 10.1017/S0007114521004426. Online ahead of print. ABSTRACT In the US, as many as 20% of recruits sustain stress fractures during basic training. In addition, approximately one-third of female recruits develop iron deficiency upon completion of training. Iron is a cofactor in bone collagen formation and vitamin D activation, thus we hypothesized iron deficiency may be contributing to altered bone microarchitecture and mechanics during 12-weeks of in creased mechanical loading. Three-week old female Sprague Dawley rats were assigned to one of four groups: iron adequate sedentary, iron deficient sedentary, iron adequate exercise, and iron deficient exercise. Exercise consisted of high-intensity treadmill running (54 min 3×/week). After 12-weeks, serum bone turnover markers, femoral geometry and microarchitecture, mechanical properties and fracture toughness, and tibiae mineral composition and morphometry were measured. Iron deficiency increased the bone resorption markers C-terminal telopeptide type I collagen and tartate-resistant acid phosphatase 5b (TRAcP 5b). In exercised rats, iron deficiency further increased bone TRAcP 5b, while in iron adequate rats, exercise increased the bone formation marker procollagen type I N-terminal propeptide. In the femur, exercise increased cortical thickness and maximum load. In the tibia, iron deficiency increased the rate of bone formation, mineral apposition, and zinc content. These data s how that the femur and tibia structure and mechanical properties are not negatively impacted by iron deficiency despite a decrease in tibiae iron content and increase in serum bone resorption markers during 12-weeks of high-intensity running in young growing female rats. PMID:34758890 | DOI:10.1017/S0007114521004426 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.