Retropharyngeal internal carotid artery: a potential risk factor during nasotracheal intubation

xlomafota13 shared this article with you from Inoreader Retropharyngeal internal carotid artery: a potential risk factor during nasotracheal intubation Via radiol anat Surg Radiol Anat. 2021 Jun 13. doi: 10.1007/s00276-021-02784-9. Online ahead of print. ABSTRACT PURPOSE: To investigate the potential risk of the retropharyngeal internal carotid artery (RICA) during nasotracheal intubation (NTI). METHODS: We retrospectively surveyed 2028 patients and 90 healthy controls (HC) with neck computed tomography angiography (CTA). The incidence of RICA was analyzed, as well as the correlation between the average minimum carotid-pharyngeal dis tance (CPD) and the carotid-median plane distance (CMD). We also compared CPD between RICA and HC. RESULTS: RICA was observed in 91 out of the 2028 patients, reaching an incidence of 4.5% (91/2028). RICA in female patients was 65.9% (60/91) compared to 34.1% (31/91) in male patients. The incidence of RICA at nasopharynx (NP), oropharynx (OP), and hypopharynx (HP) was 31.9% (29/91), 61.5% (56/91), and 6.6% (6/91), respectively. The incidence of the mucosal eminence of the posterior wall of the pharynx in RICA was 30.8% (28/91). In 15 cases, RICA caused the pharyngeal cavity to become narrow, with an incidence of 16.5% (15/91). Moreover, CPD and CMD was positively correlated (r = 0.56, p < 0.01). The average minimum CPD of RICA was only 2.25 ± 1.26 mm, which was much shorter than HC (17.62 ± 1.98 mm) (t = 62.46, p < 0.01). Some CPD of RICA was even less than 1 mm, with an incidence of 20.9% (19/91). CONCLUSION: RICA is not uncommon in asymptomatic adults. It is ver y close to the midline and posterior wall of the pharynx and is more likely to occur in the nasopharynx (NP) and oropharynx (OP). RICA tear is likely to occur during NTI. PMID:34120193 | DOI:10.1007/s00276-021-02784-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changing trend in the management of head neck cancers during the COVID-19 pandemic

xlomafota13 shared this article with you from Inoreader Changing trend in the management of head neck cancers during the COVID-19 pandemic 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 Jun 13. doi: 10.1007/s00405-021-06898-z. Online ahead of print. ABSTRACT BACKGROUND: In the present study, we have shared our experience in managing head neck cancers, especially the oral malignancies, during the crisis of COVID 19. MATERIALS AND METHODS: Patients with oral cancers underwent pedicle/local flaps and free flaps reconstruction based on the availability of intensive care unit and comorbidities of the patients. The clinical outcomes were compared at the end of one week, one month, and three months after the primary surgery. RESULTS: Pedicle/local flaps were used in 25 cases and radial/fibular free flaps were used in 8 cases for the reconstruction of soft tissue defects. Patients with pedicle flap reconstruction had better clinical outcomes, including lesser ICU stay as compared to free flaps. CONCLUSION: Pedicle flap can be a valid alternative to the free flap for the soft t issue reconstruction in advanced oral malignancies during the COVID pandemic period in the Indian subcontinent, especially with limited infrastructure of the hospitals. PMID:34120204 | DOI:10.1007/s00405-021-06898-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of lateral supraclavicular incision in unilateral thyroid papillary carcinoma surgery

xlomafota13 shared this article with you from Inoreader Application of lateral supraclavicular incision in unilateral thyroid papillary carcinoma surgery Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Apr 20:S1808-8694(21)00069-0. doi: 10.1016/j.bjorl.2021.03.010. Online ahead of print. ABSTRACT INTRODUCTION: The standard approach to thyroidectomy is a collar incision via the anterior neck, and the neck scar has always been a source of worry for patients. Acceptable wound cosmetology has become a focus for thyroid surgeons. OBJECTIVE: To verify the effectiveness and cosmetic results of thyroidectomy through a lateral supraclavicular incision. METHODS: 180 patients were randomly divided into two groups: a lateral supraclavicular approach and a conventional transcervical approach. The main outcomes included incision length, intraoperative blood loss, operative time, total drainage volume, hospitalization expense, early postoperative pain measured by visual analog scale, infection, and perceived cosmetic outcome. RESULTS: There were no statistical significances between the two groups in t erms of age, gender, nodule size, intraoperative blood loss, operative time, total drainage volume, hospital expense and postoperative complications, whereas there were significant differences in terms of incision length (5.2±1.04cm vs. 6.9±1.14cm, p<0.05). CONCLUSIONS: The lateral supraclavicular incision is a safe and feasible approach for thyroidectomy. Compared with conventional approach, it provides a better cosmetic result. PMID:34119426 | DOI:10.1016/j.bjorl.2021.03.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Finger abduction as a novel function of the extensor digitorum brevis manus muscle

xlomafota13 shared this article with you from Inoreader Finger abduction as a novel function of the extensor digitorum brevis manus muscle Via radiol anat Surg Radiol Anat. 2021 Jun 13. doi: 10.1007/s00276-021-02770-1. Online ahead of print. ABSTRACT A 25-year-old female presented with a chronic scapho-lunate ligament injury with development of carpal instability requiring reconstruction. During a standard dorsal longitudinal mid-line approach to the carpus, an extensor digitorum brevis manus (EDBM) muscle was found taking its origin from the dorsal wrist capsule overlying the lunate with innervation from the posterior interos seous nerve (PIN). Electrical stimulation of the muscle belly demonstrated abduction of the middle finger. The EDBM is a rare anatomical variant of the extensor compartment of the wrist and may be encountered during surgical approaches. Where possible these variant muscles should be carefully dissected off underlying structures, preserved and repaired at the conclusion of a procedure to ensure no perceived functional deficit to the patient. We present a case of a previously undescribed EDBM muscle function of pure finger abduction with no extension and a surgical technique of preserving its origin. We propose that the middle finger variant of the EDBM should be re-named the extensor digitorum brevis medius to reflect our findings. PMID:34121145 | DOI:10.1007/s00276-021-02770-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia

xlomafota13 shared this article with you from Inoreader Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia Via radioactive iodine J Contemp Brachytherapy. 2021 Jun;13(3):254-262. doi: 10.5114/jcb.2021.105944. Epub 2021 May 6. ABSTRACT PURPOSE: Prostate cancer with median lobe hyperplasia (MLH) is a relative contraindication for permanent prostate brachytherapy (PPB) because of an increased risk of post-implant dysuria and technical difficulties associated with achieving stability while implanting within the intravesical tissue. We examined treatment outcome, seed migration, and urination disorders after treat ment in MLH patients in order to determine to what degree MLH implants could be stabilized. MATERIAL AND METHODS: Between March 2007 and December 2016, 32 patients had MLH identified radiologically on magnetic resonance imaging, and 193 patients did not have MLH (non-MLH). All patients were treated with loose seeds. In this study, seed migration was defined as a seed distant from the target (≥ 1.5 cm) and/or with no dosimetric contribution to the target. The MLH patients were divided into 2 MLH groups of mild (< 10 mm) and severe (≥ 10 mm) MLH by measuring the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder. We retrospectively analyzed seed migration, dose-volume histograms (DVH), and genitourinary toxicity. RESULTS: MLH was classified as mild in 24 patients and severe in 8. Seed migration occurred in 61 (31.6%) of 193 non-MLH patients and 10 (31.5%) of 32 MLH patients. Implant seed migration and low-dose level of median lobe tended to be high in severe MLH cases. International Prostate Symptom Score (IPSS) peaked one month after implantation, but then resolved slowly and returned to around the pre-treatment level after one year. There were no severe complications. CONCLUSIONS: MLH does not appear to be a strong contraindication for low-dose-rate brachytherapy. However, we found that the seed migration and degree of cold spots tended to be higher in severe MLH cases than in others; therefore, close attention when treating severe MLH cases must be paid. PMID:34122564 | PMC:PMC8170528 | DOI:10.5114/jcb.2021.105944 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperparathyroidism subsequent to radioactive iodine therapy for Graves' disease

xlomafota13 shared this article with you from Inoreader Hyperparathyroidism subsequent to radioactive iodine therapy for Graves' disease Via radioactive iodine Head Neck. 2021 Jun 14. doi: 10.1002/hed.26786. Online ahead of print. ABSTRACT BACKGROUND: The development of primary hyperparathyroidism (PHPT) after radioactive iodine (RAI) treatment for thyroid disease is poorly characterized. The current study is the largest reported cohort and assesses the disease characteristics of patients treated for PHPT with a history of RAI exposure. METHODS: A retrospective analysis comparing patients, with and without a history of RAI treatment , who underwent surgery for PHPT. RESULTS: Twenty-eight of the 469 patients had a history of RAI treatment, all for Graves' disease. Patients with a history of RAI exposure had similar disease characteristics compared to control; however, patients with a history of RAI treatment had a higher rate of recurrence (7.4% vs 1.2%, p = 0.012). CONCLUSION: PHPT in patients with a history of RAI treatment can be approached in the same manner as RAI naive PHPT patients; however, the risk of recurrence of PHPT in RAI exposed patients may be higher. PMID:34124812 | DOI:10.1002/hed.26786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Parathyroid Changes After RAI in Patients With Differentiated Thyroid Carcinoma Via radioactive iodine Front Endocrinol (Lausanne). 2021 May 27;12:671787. doi: 10.3389/fendo.2021.671787. eCollection 2021. ABSTRACT OBJECTIVE: The purpose of this study was to investigate parathyroid hormone (PTH), serum calcium, phosphorus, and 25-hydroxyvitamin D (25-OH-VD) changes before and after radioactive iodine (RAI) in differentiated thyroid carcinoma (DTC) patients at different time points. METHODS: A total of 259 DTC patients who received RAI were prospectively enrolled. We evaluated P TH, serum calcium, phosphorus, and 25-OH-VD levels at baseline pre-RAI, five days, six weeks, and six months post-RAI, respectively. We analyzed the risk factors of hypocalcemia at five days post-RAI. RESULTS: The mean PTH, serum calcium and phosphorus values decreased five days post-RAI compared with pre-RAI (PTH 4.18 ± 1.23 pmol/L vs. 3.95 ± 1.41 pmol/L; calcium 2.27 ± 0.09 mmol/L vs. 2.20 ± 0.11 mmol/L; phosphorus 1.25 ± 0.17 vs. 0.98 ± 0.20 mmol/L, P < 0.05), and the differences were statistically significant. The mean 25-OH-VD levels did not significantly decrease at five days post-RAI. 21.2% (55/259) of patients had hypocalcemia at five days post-RAI, and all of them were given oral calcium supplements. At six weeks post-RAI, all of the above parameters were higher than those at five days post-RAI. Multivariate regression analysis showed that baseline pre-RAI serum calcium < 2.27 mmol/L, PTH < 4.18 pmol/L and negative 99mTcO 4 - thyroid imaging were risk factors for hypocalcemia at five days post-RAI. CONCLUSION: For DTC patients with normal PTH and serum calcium levels at pre-RAI, their PTH, serum calcium, and phosphorus levels decreased at five days post-RAI. About one-fifth of patients could have hypocalcemia at five days post-RAI. Lower baseline pre-RAI serum calcium and PTH levels and negative 99mTcO4 - thyroid imaging were risk factors for hypocalcemia five days post-RAI. PMID:34122347 | PMC:PMC8190475 | DOI:10.3389/fendo.2021.671787 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Contact endoscopy with narrow-band imaging for detection of perpendicular vascular changes in benign, dysplastic, and malignant lesions of the vocal folds

xlomafota13 shared this article with you from Inoreader Contact endoscopy with narrow-band imaging for detection of perpendicular vascular changes in benign, dysplastic, and malignant lesions of the vocal folds Via hno HNO. 2021 Jun 14. doi: 10.1007/s00106-021-01063-8. Online ahead of print. ABSTRACT BACKGROUND: Perpendicular vascular changes (PVC) are markers of tumor-induced neoangiogenesis at the vocal folds. Contact endoscopy with narrow-band imaging (CE-NBI) allows a detailed analysis of such vascular changes. OBJECTIVE: This work intends to evaluate the potential of CE-NBI for diagnosis of benign, dysplastic, and malignant lesions of the vocal folds. In addition, it should be d etermined whether CE-NBI offers an additional benefit in detecting PVC compared to white-light endoscopy (WLE) and NBI alone. MATERIALS AND METHODS: Three examiners evaluated histologically verified cases of benign, dysplastic, and malignant lesions of the larynx in WLE, NBI, and CE-NBI (n = 60). In each mode, they examined the lesion for PVC and assessed the lesion's dignity. The proportion of lesions with detected PVC, the statistical measures of performance in detecting high-grade dysplasia and carcinoma, and the interrater variability for each mode were calculated. RESULTS: CE-NBI proved superior to the other investigated diagnostic methods in terms of detecting PVC and in terms of sensitivity and accuracy in the diagnosis of high-grade dysplasia and carcinoma. A clear association of such pathologies with PVC was seen. CONCLUSION: CE-NBI detects PVC more frequently and reliably than the other methods investigated. The association of these vascular patterns to h igh-grade dysplasia and vocal fold carcinomas could be confirmed. Compared to WLE and NBI endoscopy, the diagnostic quality for detecting high-grade dysplasia and carcinoma is increased. Thus, CE-NBI can improve endoscopic differentiation between benign and malignant lesions of the vocal folds by enhancing the detection of PVC. PMID:34125236 | DOI:10.1007/s00106-021-01063-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incision-suture times in endoscopic ear surgery

xlomafota13 shared this article with you from Inoreader Incision-suture times in endoscopic ear surgery Via hno HNO. 2021 Jun 14. doi: 10.1007/s00106-021-01066-5. Online ahead of print. ABSTRACT BACKGROUND: Endoscopic ear surgery (EES) is increasingly used internationally instead of microscopic ear surgery (MES), but has not yet become established as a routine procedure everywhere in Germany. OBJECTIVE: The incision-suture time and practicability of EES in the setting of a German clinic were investigated. MATERIALS AND METHODS: In a retrospective study, 60 consecutive MES patients from 2015 were compared with 60 consecutive EES patients from 2018. Hearing results, tympanic membrane findings after 3 weeks, and incision-suture times were compared. RESULTS: In EES, access was mostly transmeatal and bone of the anterior auditory canal wall had to be removed less often than in MES. There was no statistically significant difference in surgery times between the two groups. Perforation closure was achieved in 57/60 and 59/60 ears in the MES and EES groups, respectively. Hearing was improved in both groups. There was no statistical difference in hearing improvement between the two groups. CONCLUSION: EES is a time efficient and minimally invasive method which represents a viable alternative to MES with comparable results. PMID:34125238 | DOI:10.1007/s00106-021-01066-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopically guided reconstruction of the ossicular chain-an introduction

xlomafota13 shared this article with you from Inoreader Endoscopically guided reconstruction of the ossicular chain-an introduction Via hno HNO. 2021 Jun 14. doi: 10.1007/s00106-021-01062-9. Online ahead of print. ABSTRACT The term "endoscopic ossiculoplasty" refers to surgical methods with the intention to reconstruct the ossicular chain using endoscopic vision. Apart from malformations and injuries, inflammatory processes cause the majority of indications for ossicular reconstruction. This article offers a commented overview of current literature and preliminary personal experience. PMID:34125235 | DOI:10.1007/s00106-021-01062-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasalance and perceived voice changes in patients undergoing septoplasty and turbinate hypertrophy reduction

xlomafota13 shared this article with you from Inoreader Nasalance and perceived voice changes in patients undergoing septoplasty and turbinate hypertrophy reduction 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 Jun 14. doi: 10.1007/s00405-021-06937-9. Online ahead of print. ABSTRACT PURPOSE: The purpose of this study was to investigate the changes in voice nasality after septoplasty and turbinate hypertrophy reduction and to evaluate the effect of these changes on patients' voice-related quality of life. METHODS: Sixty patients with nasal obstruction symptoms caused by septal deviation and inferior turbinate hypertrophy who underwent septoplasty and inferior turbinate hypertrophy reduction and 25 healthy controls were included. Active anterior rhinomanometry and acoustic rhinometry were utilized for the evaluation of nasal patency and nasometry was used for quantitative assessment of nasalance. All participants completed validated questionnaires for assessing nasal obstruction symptom severity, psychological status and the impact of voice performance on their quality of life preoperatively and 6 months af ter septoplasty. RESULTS: Patients presented preoperatively statistically significantly lower nasalance scores and higher VHI scores than controls (p < 0.05). Septoplasty and inferior turbinate hypertrophy reduction led to improvement of nasalance for the nasal text and the physical subscale of the VHI scores. Postoperatively, there were no statistically significant differences in nasalance and VHI scores between patients and controls. Significant correlations were found only for the baseline and the postoperative nasalance scores for the nasal text and the total nasal cavity volume (p < 0.05). Postoperatively, patients who presented significant improvement of nasal obstruction symptoms and resolution of stress levels were more likely to positively evaluate the impact of their voice quality on their daily life (OR: 2.32, 95% CI 1.08-5.15, p = 0.041 and OR: 3.06, 95% CI 1.15-7.04, p = 0.038, respectively). CONCLUSION: Septoplasty and inferior turbinate hypertrophy r eduction may increase the nasal resonance, but in the long term, this change appears not to be significant enough. The severity of nasal obstruction symptoms and psychological status mainly affect the patients' perceptual assessment regarding the effect of voice performance on their quality of life. PMID:34125283 | DOI:10.1007/s00405-021-06937-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.