Outcome for sinonasal malignancies: a population-based survey

xlomafota13 shared this article with you from Inoreader Outcome for sinonasal malignancies: a population-based survey 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 Sep 12. doi: 10.1007/s00405-021-07057-0. Online ahead of print. ABSTRACT PURPOSE: Sinonasal malignancies (SNM) represent a rare and complex group of cancers that includes a wide range of histopathological subtypes. Data from population-based cohorts are scarce but warranted as a basis for randomized controlled treatment trials (RCTs). Our aim was to assess overall and histology subset-specific outcomes for SNM patients treated at a tertiary referral centre. METHODS: A retrospective, population-based, consecutive cohort of patients with SNMs diagnosed from 2001 through 2019 was examined. Outcome was analysed in relation to age, gender, site, stage, histopathology, and treatment. RESULTS: Two-hundred and twenty-six patients were identified, whereof 61% presented with stage IV disease. 80% completed treatment with curative intent, which comprised surgery with neoadjuvant (29%) or adjuvant (37%) radiotherapy, monotherapy with surgery (22%), definitive chemoradiotherapy (7%), or radiotherapy (5%). Median follow-up was 106 months. The 5- and 10-year overall survival rates were 57% and 35%, respectively. Median overall survival was 76 months (esthesioneuroblastoma: 147 months; adenocarcinoma: 117; salivary carcinoma: 88; mucosal melanoma: 69; squamous cell carcinoma: 51, undifferentiated carcinoma: 42; neuroendocrine carcinoma: 9; and NUT-carcinoma 5). The 5- and 10-year disease-free survival rates were 63% and 54%, respectively, and disease-specific survival 83% and 66%. Increasing age, stage IVB, melanoma histopathology, and treatment with definitive chemoradiotherapy emerged as significant independent prognostic risk factors for disease-specific mortality (p ≤ 0.001). CONCLUSION: The results indicate a seemingly good outcome in comparison to previous reports, particularly for mucosal melanoma, adenocarcinoma, and undifferentiated carcinoma. The study provides additi onal background for future RCTs focusing on histology subset-specific treatment for SNM. PMID:34510258 | DOI:10.1007/s00405-021-07057-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The prognostic value of before treatment neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader The prognostic value of before treatment neutrophil-to-lymphocyte ratio in nasopharyngeal carcinoma 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 Sep 12. doi: 10.1007/s00405-021-07070-3. Online ahead of print. ABSTRACT OBJECTIVE: The aim of this analysis was to evaluate the prognostic significance of inflammatory biomarkers (NLR, dNLR, PLR and LMR) in NPC patients. METHODS: This was a retrospective analysis of 111 NPC patients from January 2013 and December 2016. Receiver-operating characteristic (ROC) curve was plotted to determine the cut-off values of these inflammatory biomarkers. Univariate analysis and multivariate Cox regression model were used to evaluate the association between these parameters and progression-free survival (PFS) and overall survival (OS). RESULTS: The optimal critical value of NLR was 2.02, by which cases were divided into high NLR group (NLR ≥ 2.02) and low NLR group (NLR < 2.02). The elevated NLR was significantly associated with decreased OS (P = 0.009) and remained significant in multivariate analysi s (HR 8.48, 95% CI 1.69-42.46, P = 0.009). CONCLUSIONS: The before treatment NLR may be an independent prognostic biomarker for OS in patients with NPC. NLR, dNLR and PLR might be a useful complement to TNM staging in the prognosis evaluation of NPC patients. PMID:34510259 | DOI:10.1007/s00405-021-07070-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mechanisms Underlying the Antifibrotic Potential of Estradiol for Vocal Fold Fibrosis

xlomafota13 shared this article with you from Inoreader Mechanisms Underlying the Antifibrotic Potential of Estradiol for Vocal Fold Fibrosis Via The Laryngoscope Objectives/Hypothesis Vocal fold fibrosis remains a significant clinical challenge. Estrogens, steroid hormones predominantly responsible for secondary sexual characteristics in women, have been shown to alter wound healing and limit fibrosis, but the effects on vocal fold fibrosis are unknown. We sought to elucidate the expression of estrogen receptors and the effects of estrogens on TGF-β1 signaling in rat vocal fold fibroblasts (VFFs). Study Design In vitro. Methods VFFs were isolated from 10-week-old, male Sprague–Dawley rats, and estrogen receptor alpha (ERα) and G protein-coupled receptor 30 (GPR30) were examined via immunostaining and quantitative polymerase chain reaction (qPCR). VFFs were treated with estradiol (E2, 10−7, 10−8 or 10−9 M) ± transforming growth factor beta 1 (TGF-β1, 10 ng/mL). ICI 182,780 (ICI, 10−7 M) or G36 (10−7 M) were employed as antagonists of ERα or GPR30, respectively. qPCR was employed to determine estrogen receptor-mediated effects of E2 on genes related to fibrosis. Results ERα and GPR30 were expressed in VFFs at both the protein and the mRNA levels. E2 (10−7 M) did not alter Smad3, Smad7, Acta2 mRNA, or extracellular matrix related genes. However, the combination of E2 (10−8 M) and TGF-β1 significantly increased Smad7 (P = .03) and decreased Col1a1 (P = .04) compared to TGF-β1 alone; this response was negated by the combination of ICI and G36 (P = .009). Conclusions E2 regulated TGF-β1/Smad signaling via estrogen receptors in VFFs. These findings provide insight into potential mechanisms of estrogens on vocal fold injury with the goal of enhanced therapeutics for vocal fold fibrosis. Level of Evidence NA Laryngoscope, 131:2285–2291, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting Need for Surgery in Recurrent Laryngotracheal Stenosis Using Changes in Spirometry

xlomafota13 shared this article with you from Inoreader Predicting Need for Surgery in Recurrent Laryngotracheal Stenosis Using Changes in Spirometry Via The Laryngoscope Objectives/Hypothesis We sought to identify changes that occur in spirometric values between surgical interventions in patients with recurrent laryngotracheal stenosis and assess the utility of tracking those changes in predicting the need to return to surgery. Methods This is a retrospective, case-control study of laryngotracheal stenosis. Charts from a 10 year period were reviewed, and 80 patients were identified with recurrent laryngotracheal stenosis and serial spirometry. Recorded forced expiratory volume in 1 second (FEV1), forced inspiratory volume in 1 second (FIV1), peak expiratory flow (PEF), and peak inspiratory flow (PIF), and body mass index (BMI) were tabulated. Calculations were then performed to determine deviations in spirometric measurements from maximums. Comparing the patients who required intervention to those who did not, we used a regression analysis to generate a decision tree based on factors with the strongest predictive power. We then calculated receiver operating characteristic (ROC) curves for all calculated variables. Results Deviations in PEF, PIF, and FIV1 from each patient's maximums had strong predictive power in determining return to surgery. PIF was the only fixed measurement found to have a statistically significant role in predicting return to surgery. BMI did not play a role. Conclusion For each patient, the deviation from their overall spirometric maximums had the statistically strongest predictive power in determining need to return to surgery. This suggests the importance of the trends in spirometric measures for each individual, and implies these trends have greater import than fixed measures alone. Level of Evidence 4 Laryngoscope, 131:2199–2203, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influences of GABAergic Inhibition in the Dorsal Medulla on Contralateral Swallowing Neurons in Rats

xlomafota13 shared this article with you from Inoreader Influences of GABAergic Inhibition in the Dorsal Medulla on Contralateral Swallowing Neurons in Rats Via The Laryngoscope Objectives We aimed to examine the effect of unilateral inhibition of the medullary dorsal swallowing networks on the activities of swallowing-related cranial motor nerves and swallowing interneurons. Methods In 25 juvenile rats, we recorded bilateral vagal nerve activity (VNA) as well as unilateral phrenic and hypoglossal activity (HNA) during fictive swallowing elicited by electrical stimulation of the superior laryngeal nerve during control and following microinjection of the GABA agonist muscimol into the caudal dorsal medulla oblongata in a perfused brainstem preparation. In 20 animals, swallowing interneurons contralateral to the muscimol injection side were simultaneously recorded extracellularly and their firing rates were analyzed during swallowing. Results Integrated VNA and HNA to the injection side decreased to 49.0 ± 16.6% and 32.3 ± 17.9%, respectively. However, the VNA on the uninjected side showed little change after muscimol injection. Following local inhibition, 11 out of 20 contralateral swallowing interneurons showed either increased or decreased of their respective firing discharge during evoked-swallowing, while no significant changes in activity were observed in the remaining nine neurons. Conclusion The neuronal networks underlying the swallowing pattern generation in the dorsal medulla mediate the ipsilateral motor outputs and modulate the contralateral activity of swallowing interneurons, suggesting that the bilateral coordination of the swallowing central pattern generator regulates the spatiotemporal organization of pharyngeal swallowing movements. Level of Evidence NA Laryngoscope, 131:2187–2198, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid carcinoma discovered incidentally during surgical resection of head and neck squamous cell carcinoma: A case series

xlomafota13 shared this article with you from Inoreader Thyroid carcinoma discovered incidentally during surgical resection of head and neck squamous cell carcinoma: A case series Via radioactive iodine Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jun 21:S2212-4403(21)00481-8. doi: 10.1016/j.oooo.2021.06.012. Online ahead of print. ABSTRACT The occurrence of 2 synchronous primary cancers of different origin in the head and neck region is rare. The incidence of thyroid carcinoma found during surgical resection of primary oral squamous cell carcinoma (SCCa) is about 0.3% to 1.9% of patients. Because of the rarity of cases, there is no consensus on management. To clarify signific ance and management of such lesions, we report 13 cases in which incidental thyroid carcinoma was discovered during surgical resection for primary oral SCCa. A total of 1295 cases of head and neck SCCa from a 4-year period were reviewed, of which we found 13 cases of concurrent thyroid malignancy, providing an incidence rate of approximately 1%. Of these patients, 61.5% received a total or hemithyroidectomy and, of those, 62.5% received radioactive iodine for their thyroid carcinoma; 38.4% did not receive treatment for their thyroid malignancy. The mortality rate for this case series was 23%, of which all deaths were attributed to complications from SCCa. There were no cases where mortality was related to the thyroid carcinoma. Overall, this is consistent with the consensus that incidental thyroid carcinoma found during oral SCCa resection is insignificant compared with the aggressiveness of the primary malignancy. PMID:34511345 | DOI:10.1016/j.oooo.2021.06.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transoral Excision of a Large Accessory Parotid Gland Tumor

xlomafota13 shared this article with you from Inoreader Transoral Excision of a Large Accessory Parotid Gland Tumor Via ear nose throat Ear Nose Throat J. 2021 Sep 13:1455613211036237. doi: 10.1177/01455613211036237. Online ahead of print. ABSTRACT Accessory parotid gland (APG) tumors account for 1% to 7% of all parotid gland neoplasms but are more likely to be malignant than main parotid gland tumors. Management of APG neoplasms entails surgical excision. Four primary approaches to resection have been described in the literature with varying facial nerve outcomes. We report a case of a 4-cm APG pleomorphic adenoma utilizing a transoral approach for excision without postoperative facial nerve injury. A transoral approach is known to mitigate patients' cosmetic concerns; however, prior reports utilized endoscopic assistance on patients with smaller tumors. We conclude that large APG tumors can be excised through a transoral approach without undue risk to the distal facial nerves, though this transoral approach ultimately may not be appropriate for malignant neoplasms or difficult dissections. PMID:34510932 | DOI:10.1177/01455613211036237 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Case of Parotid Gland Fistula After Microtia Reconstruction Successfully Treated With Botulinum Toxin Type A

xlomafota13 shared this article with you from Inoreader A Case of Parotid Gland Fistula After Microtia Reconstruction Successfully Treated With Botulinum Toxin Type A Via ear nose throat Ear Nose Throat J. 2021 Sep 13:1455613211038325. doi: 10.1177/01455613211038325. Online ahead of print. ABSTRACT Parotid gland fistula after microtia reconstruction is relatively rare, with only 3 cases having been reported in the literature. It may be caused by the presence of an accessory parotid gland or surgical damage to parotid gland tissues. The principal treatment is dressing the wound. Here, we report the first case of parotid fistula after microtia reconstruction u sing a delayed retroauricular flap, which healed following wound dressing and an injection of botulinum toxin type A (CBTXA) into the parotid gland. PMID:34510956 | DOI:10.1177/01455613211038325 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MiR-183 regulates the differentiation of osteoblasts in the development of osteoporosis by targeting Smad4

xlomafota13 shared this article with you from Inoreader MiR-183 regulates the differentiation of osteoblasts in the development of osteoporosis by targeting Smad4 Via histochem Acta Histochem. 2021 Sep 9;123(7):151786. doi: 10.1016/j.acthis.2021.151786. Online ahead of print. ABSTRACT OBJECTIVE: To discuss the effect of miR-183 on osteoblast differentiation in the osteoporosis progression via targeting Smad4. METHODS: Osteoporosis models were constructed on ovariectomized (OVX) mice to determine the expression of miR-183 and Smad4. Then, MC3T3-E1 cells and primary osteoblasts were divided into Mock, miR-control, miR-183 mimic, miR-183 inhibit or, siSmad4 and miR-183 inhibitor + siSmad4 groups. Alkaline phosphatase (ALP) staining were performed to determine ALP activity, alizarin red staining to evaluate the calcium deposit, while qRT-PCR and Western blotting were used to determine the expression of related molecules. Besides, MC3T3-E1 cells transfected with miR-control or miR-183 mimic were cultured with or without TGF-β1 to verify whether miR-183 regulates the TGF-β signaling pathway. RESULTS: MiR-183 was up-regulated with decreased Smad4 in the femur of OVX mice, and dual luciferase reporter gene assay showed that Smad4 was a target of miR-183. As compared to Mock group, MC3T3-E1 cells and primary osteoblasts in the miR-183 mimic group and siSmad4 group had significant reductions of OCN, OPN, Runx2 and Osx, as well as decreased ALP activity and calcium deposit. Contrarily, miR-183 and Smad4 were up-regulated and down-regulated respectively. However, cells in the miR-183 inhibitor group manifested the opposite c hanges. Besides, osteoblast differentiation in the miR-183 inhibitor + siSmad4 group was weakened evidently when compared to miR-183 inhibitor group. Pathway analysis indicated that miR-183 regulated osteogenic differentiation via TGF-β signaling pathway. CONCLUSION: MiR-183 was up-regulated in osteoporosis, and miR-183 overexpression can inhibit osteoblast differentiation by targetedly down-regulating TGF-β pathway member Smad4 to trigger osteoporosis. PMID:34509805 | DOI:10.1016/j.acthis.2021.151786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Exposure to Higher Concentrations of Particulate Matter Air Pollution Associated with Higher Incidence of Papillary Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Exposure to Higher Concentrations of Particulate Matter Air Pollution Associated with Higher Incidence of Papillary Thyroid Cancer Via Clinical Thyroidology Clinical Thyroidology, Volume 33, Issue 9, Page 414-417, September 2021. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Cancer Risk in Relation to Thyroid Nodule Location

xlomafota13 shared this article with you from Inoreader Thyroid Cancer Risk in Relation to Thyroid Nodule Location Via Clinical Thyroidology Clinical Thyroidology, Volume 33, Issue 9, Page 394-396, September 2021. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.