The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers

xlomafota13 shared this article with you from Inoreader The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers Via Head & Neck Abstract Background Numerous studies and guidelines suggest an outcome detriment from radiation treatment breaks (rTBs) and the need for compensatory dosing in patients with head and neck cancer. Methods In a consecutive cohort of 521 patients with oropharyngeal squamous cell carcinoma (OPSCC), we investigated the impact of rTBs and prolongation of overall treatment time (OTT) on OS, DFS, LRC, and cancer recurrence using competing risk and multivariate analyses. Results Neither OTT prolongation by ≤2 days nor rTBs of ≤3 days were associated with detriments to clinical outcomes. Consecutive breaks of ≥3 days were also not significantly associated with detriment to clinical outcomes. There was significantly increased competing mortality in those with longer breaks. Conclusions In OPSCC patients treated with definitive concurrent chemoradiotherapy, there is no significant association between disease failure and total rTBs of ≤3 consecutive or scattered days. Further investigation is needed for longer breaks. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Initial Presentation of Granulomatosis with Polyangiitis as Progressive Skull Base Osteomyelitis

xlomafota13 shared this article with you from Inoreader Initial Presentation of Granulomatosis with Polyangiitis as Progressive Skull Base Osteomyelitis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands A healthy man in his 30s presented with a 2-week history of severe bitemporal pain and pressure. He was initially treated for presumed acute rhinosinusitis, but his symptoms continued to worsen and underwent endoscopic sinus surgery at an outside community facility. He developed left abducens nerve palsy postoperatively, and magnetic resonance imaging (MRI) demonstrated evidence of extensive skull base osteomyelitis. He was initiated on intravenous (IV) broad-spectrum antibiotics but was subsequen tly found to have prostatic and submandibular sterile fluid collections. The patient subsequently developed new right abducens and left vagal nerve palsies and underwent revision endoscopic sinus surgery. Pathology revealed extensive inflammation, necrotizing granulomas, and evidence of small and medium vessel vasculitis. Extensive laboratory workup was negative, except for anti-PR-3 antibody positivity. Given the characteristic findings on pathology and laboratory findings, the patient was diagnosed with granulomatosis with polyangiitis (GPA). High-dose glucocorticoid therapy as well as rituximab infusion were promptly initiated. He had marked improvement in his symptoms and resolution of his right CN VI palsy but left-sided CN VI and CN X palsies persisted. This patient presented without the typical rhinologic manifestations of GPA, and rather presented with progressive sinusitis, skull base osteomyelitis with associated cranial neuropathies, and aseptic systemic abscesses. Prompt diagnosis of GPA is particularly important in those with otorhinolaryngological manifestations, as early initial immunosuppressive therapy has been linked to lower relapse and mortality rates. Vigilance and early differentiation between GPA and other forms of sinusitis is of critical importance, particularly when symptoms are refractory to standard rhinosinusitis therapies. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Office‐based Transnasal Oesophagoscopy: evaluating the safety, efficacy and application in head and neck cancer patients

xlomafota13 shared this article with you from Inoreader Office‐based Transnasal Oesophagoscopy: evaluating the safety, efficacy and application in head and neck cancer patients Via Clinical Otolaryngology Abstract Transnasal Oesophagoscopy (TNO) is an approach to inspect the upper aerodigestive tract, especially in the head and neck cancer (HNCA) population that present with dysphagia. Twenty-five (25) office-based TNO procedures were performed, with a same-day discharge rate of 96% (24/25) and no reported complications. This case series is the first to compare preoperative and postoperative outcomes (EAT-10) following stricture dilatation using TNO in the UK. Our results show a statistically significant improvement in symptom severity (EAT-10 scores) (n=11, P=0.001). Nearly half (45.5%) of patients undergoing dilatation developed strictures due to post-radiation/post-laryngectomy complications. Biopsy in 4/5 patients was sufficient for diagnosis/ruling out disease. Of these patients, 5/5 had a previous HNCA. This study identifies the remit for a new 'one-stop' TNO service for suspected cancer referrals, of which a large proportion are patients with a previous HNCA. Surveillance, therapeutics and diagnostics can be achieved in a single visit. Earlier staging or treatment may be achieved due to a fast turnover in clinic View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hybrid Ameloblastoma Arising from a Treated Odontogenic Keratocyst of the Mandible: A Case Report With Literature Review

xlomafota13 shared this article with you from Inoreader Hybrid Ameloblastoma Arising from a Treated Odontogenic Keratocyst of the Mandible: A Case Report With Literature Review Via Otolaryngology Indian Abstract Odontogenic Keratocyst (OKC) is an odontogenic cyst of developmental origin arising from remnants of the dental lamina. Malignant or benign transformations though rare have been noticed from their epithelium. Ameloblastomatous transformation from an OKC is extremely rare with such lesions being referred to as combined/"hybrid" odontogenic lesions. In this article, we present an intriguing case of a 60-year-old male who was operated on for OKC of the anterior mandible 3 years before, who came back with a complaint of swelling over the same site. Incisional biopsy revealed the acanthomatous type of ameloblastoma for which segmental resection with immediate reconstruction using recon plate was done. Excision biopsy revealed a plexiform variant as well, thus exhibiting a hybrid pattern. Surgeons should be aware of this hybrid presentation of ameloblastoma arising from the epithelium of OKC as the acanthomatous subtype is known for its notorious genetic behav ior leading to recurrence and aggressive nature of this tumor. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

xlomafota13 shared this article with you from Inoreader Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma Via leak of cerebrospinal fluid Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print. ABSTRACT Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petrous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surg ically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications. PMID:34587824 | DOI:10.1177/01455613211048966 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Basal cell adenoma of the parotid gland: A rare entity

xlomafota13 shared this article with you from Inoreader Basal cell adenoma of the parotid gland: A rare entity Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211045524. doi: 10.1177/01455613211045524. Online ahead of print. ABSTRACT Basal cell adenoma (BCA) is a rare benign salivary gland tumor accounting for only 1-2% of all salivary gland tumors. We report a case of a 50-year-old man presenting a BCA of the parotid gland. A pleomorphic adenoma was initially suspected based on radiological features and fine needle aspiration cytology findings (FNAC). PMID:34587790 | DOI:10.1177/01455613211045524 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

xlomafota13 shared this article with you from Inoreader Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print. ABSTRACT Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petr ous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surgically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications. PMID:34587824 | DOI:10.1177/01455613211048966 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Case of Nasal Rhinosporidiosis in the United States

xlomafota13 shared this article with you from Inoreader A Case of Nasal Rhinosporidiosis in the United States Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211049004. doi: 10.1177/01455613211049004. Online ahead of print. ABSTRACT Rhinosporidiosis, an infectious granulomatous disease, is seldom encountered in the United States. We present a case of rhinosporidiosis in a 26-year-old man, who presented with an unusual mass in his nasal cavity. Suspicion for rhinosporidiosis was high due to the patient's travel and activity history. After imaging and proper diagnosis, surgery was performed to excise the lesion. As international travel resumes during the COVID-19 pandemic, the potential for encountering this rare organism is heightened. PMID:34587820 | DOI:10.1177/01455613211049004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 and anosmia: The story so far

xlomafota13 shared this article with you from Inoreader COVID-19 and anosmia: The story so far Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211048998. doi: 10.1177/01455613211048998. Online ahead of print. ABSTRACT OBJECTIVES: The pandemic has affected over 182 million coronavirus disease 2019 (COVID-19) cases worldwide. Accumulated evidence indicates that anosmia is one of the significant characteristics of COVID-19 with a high prevalence. However, many aspects of COVID-19-induced anosmia are still far from being fully understood. The purpose of this review is to summarize recent developments in COVID-19-induced anosmia to increase awareness of the condition. METHODS: A literature search was carried out using the PubMed, Embase, Web of Science, and Scopus. We reviewed the latest literature on COVID-19-induced anosmia, including mechanisms of pathogenesis, olfactory testing, anosmia as predictive tool, pathological examinations, imaging findings, affected factors, co-existing diseases, treatments, prognosis, hypothesis theories, and future directions. RESULTS: The possible pathogenesis of COVID-19-induced anosmia may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The D614G spike variant may also play a role in the increased number of anosmia patients. Anosmia may also be an essential indicator of COVID-19 spread and an early indicator of the effectiveness of political decisions. The occurrence and develop ment of COVID-19-induced anosmia may be influenced by smoking behaviors and underlying diseases such as type 2 diabetes, gastroesophageal disorders, and rhinitis. Most patients with COVID-19-induced anosmia can fully or partially recover their olfactory function for varying durations. COVID-19-induced anosmia can be treated with various approaches such as glucocorticoids and olfactory training. CONCLUSION: Anosmia is one of the main features of COVID-19 and the underlying disease of the patient may also influence its occurrence and development. The possible pathogenesis of COVID-19-induced anosmia is very complicated, which may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system. PMID:34587819 | DOI:10.1177/01455613211048998 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment Efficacy of Forced Prolonged Position After Cupulolith Repositioning Maneuver in Apogeotropic HSCC BPPV

xlomafota13 shared this article with you from Inoreader Treatment Efficacy of Forced Prolonged Position After Cupulolith Repositioning Maneuver in Apogeotropic HSCC BPPV Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211038274. doi: 10.1177/01455613211038274. Online ahead of print. ABSTRACT OBJECTIVES: To evaluate the therapeutic efficacy of the forced prolonged position (FPP) in patients with horizontal semicircular canal (HSCC) cupulolithiasis in whom the cupulolith repositioning maneuver (CuRM) failed. METHODS: Fifty-four consecutive patients with HSCC cupulolithiasis were included, and immediate treatment efficacy of CuRM and short-term tre atment efficacy of FPP were investigated. RESULTS: We performed the CuRM in HSCC cupulolithiasis, and, if the CuRM did not show immediate success, instructed the patients to perform the FPP or the sham position (by random allocation) at home. The immediate therapeutic success of the CuRM was assessed by the absence of nystagmus and vertigo on positional testing after 30 minutes of the maneuver, which was 14.8% on the first visit day. And the resolution rate of HSCC cupulolithiasis was higher in the FPP group than in the sham position group at the second (78.3% vs 55.6%), third (75.0% vs 42.9%), and fourth visits (100% vs 25.0%). CONCLUSION: Although the CuRM has been considered to be a good therapeutic option for HSCC cupulolithiasis because it theoretically aims to detach otoconial particles attached both on the utricle and canal sides of the cupula, the immediate success rate was only 14.8% at the first visit. The FPP can be additionally recommended to improve the reso lution rate in HSCC cupulolithiasis patients in whom the CuRM fails. PMID:34587821 | DOI:10.1177/01455613211038274 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incidence of Audiological Adverse Effects Induced by COVID-19 Vaccines: A Preliminary Study

xlomafota13 shared this article with you from Inoreader Incidence of Audiological Adverse Effects Induced by COVID-19 Vaccines: A Preliminary Study Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211048975. doi: 10.1177/01455613211048975. Online ahead of print. NO ABSTRACT PMID:34587817 | DOI:10.1177/01455613211048975 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.