Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy

xlomafota13 shared this article with you from Inoreader Presentation and outcomes of patients with clinically T1‐2, N0 supraglottic squamous cell carcinoma: The role of definitive radiotherapy compared to primary partial laryngectomy Via Head & Neck Abstract Background Early-stage supraglottic squamous cell carcinoma (SCC) is usually treated with a single modality. The aim of this study is to examine the role of radiotherapy (RT) versus partial laryngectomy (open, robotic-assisted, or endoscopic) with elective neck dissection (PL + END). Methods A retrospective analysis of the National Cancer Database, 2010–2016. The study population included adult patients with clinically T1-2, N0 supraglottic SCC. Results 3301 patients were included. RT was performed in 93.52%, open PL + END in 2.64%, robotic-assisted PL + END in 1.33%, and endoscopic surgical resection in 2.51%. In the surgery group, T was upstaged in 23.36% and N was upstage in 16.36%. Five-year survival in the primary surgery group compared to RT group was 61.89% versus 77.46% (HR: 0.56, 95%CI: 0.43, 0.72). Conclusions T was upstaged in 23% of surgical patients. This accurate staging is likely missed in patients who undergo RT and possibly contributes to lower overall survival of this treatment group. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Systematic Review and Meta‐Analysis: Timing of Elective Removal of Tympanostomy Tubes

xlomafota13 shared this article with you from Inoreader A Systematic Review and Meta‐Analysis: Timing of Elective Removal of Tympanostomy Tubes Via The Laryngoscope Objective(s) Tympanostomy tube (TT) placement is the most common surgical procedure in children. Less than 10% of TT do not self-extrude. This study is a systematic review (SR) on elective TT removal in the pediatric population: timing, perforation rates, and role of simultaneous repair. A PICOTS (population, intervention, comparison, outcome, timing, setting) question was formulated: In pediatric patients who have retained TT, what is the preferred time to elective removal of such tubes, and what are the outcomes in terms of perforation rates? Does an intervention at the time of TT removal improve perforation rates? Study Design Systematic review and meta-analysis. Methods We searched four major electronic databases: EMBASE, MEDLINE, CDSR, CCRCT for articles published prior to 02/19/20. EndNote® was used to gather references, review abstracts, and obtain full text articles. Inclusion criteria were studies reporting patients aged 0 to 18 years undergoing elective TT removal with follow-up greater than 3 months. Exclusion criteria included patients >18 years, duplicate patient series, or case series with fewer than five patients. Articles that were not available in English, not available in full text, and those that only addressed long-acting TT were excluded. Data were pooled and meta-analysis was conducted to examine how timing of TT removal, patching of the tympanic membrane, or any TM intervention at TT removal affected outcomes. Results A total of 1,064 references were found. We identified 63 unique studies for full text review. Of these, 17 were selected for SR. MINORS (Methodological Index for Nonrandomized Studies) scores were low-revealing high bias among the studies. Reported perforation rates after elective TT removal ranged from 0% to 57%. Four studies had data suitable for comparative meta-analysis, which showed a significant increase in perforation rates after elective removal of TT after 3 years compared to removal prior to 3 years (OR 2.89; CI 1.78–4.69). No difference in perforation rates were identified when TM intervention vs. no intervention at time of TT removal was performed (six studies: OR 1.21; CI 0.71–2.07). No difference in perforation rates was identified when the type of TM intervention was compared, including freshening of TM edges, to patching with various materials (paper, fat, gelfoam®/gelfilm®, Trichloroacetic acid) (three studies: OR 1.07; CI 0.52–2.19). Conclusion From the data reviewed in this SR and meta-analysis, elective TT removal at or prior to 3 years' retention showed decreased perforation rates. However, TM intervention at the time of TT removal was not shown to lower perforation rates. In the absence of tube complications such as granuloma formation, nonfunctional tube, or chronic tube otorrhea, it may be reasonable to wait up to 3 years to electively remove a retained TT. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation

xlomafota13 shared this article with you from Inoreader Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211065805. doi: 10.1177/00034894211065805. Online ahead of print. ABSTRACT OBJECTIVES: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis. METHODS: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed. RESULTS: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT (P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation (P = .042) in the multivariate analysis. CONCLUSIONS: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis. PMID:34965742 | DOI:10.1177/00034894211065805 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-Definition 3-D Exoscope for Micro-Laryngeal Surgery: A Preliminary Clinical Experience in 41 Patients

xlomafota13 shared this article with you from Inoreader High-Definition 3-D Exoscope for Micro-Laryngeal Surgery: A Preliminary Clinical Experience in 41 Patients Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211063741. doi: 10.1177/00034894211063741. Online ahead of print. ABSTRACT OBJECTIVE: The aim of this prospective clinical study is to evaluate the feasibility of the micro-laryngeal surgery (MLS) using a 3D operating exoscope (OE) in substitution to a conventional operating microscope (OM). METHODS: A total of 41 consecutive patients were included (male: 26; median age: 55.0 years; IQR: 46.0-68.0). After each procedure, the s urgeon and the scrub nurse were asked to fill out a tailored questionnaire on a 3-point Likert scale (1-not acceptable, 2-acceptable, 3-good) including 12 items. RESULTS: The majority of the procedures were therapeutic (n = 31, 75.6%), while the remaining were diagnostic (n = 10, 24.4%). All surgeries were successfully completed without the support of the OM, and no complications or unwanted delays were detected. The majority of the individual items were judged "good" either by surgeons (n = 399, 81.1%) and scrub nurses (n = 287, 87.5%). The natural posture during the procedure, and the ease of use the joystick and focusing were the best-rated items by the surgeons. CONCLUSIONS: This study demonstrates the feasibility of MLS using the OE. Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope and to better define advantages and disadvantages. PMID:34965750 | DOI:10.1177/00034894211063741 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report

xlomafota13 shared this article with you from Inoreader Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report Via radioactive iodine J ASEAN Fed Endocr Soc. 2021;36(2):213-215. doi: 10.15605/jafes.036.02.10. Epub 2021 Aug 19. ABSTRACT Levothyroxine remains the standard therapy for patients with hypothyroidism worldwide. Levothyroxine allergy is rarely seen and alternative therapies are less efficacious and scarcely available. The use of liothyronine (LT3) monotherapy is less favoured due to its short half-life and unpredictable pharmacological profile. We report a 59-year-old male with a hypersensitivity reactio n to levothyroxine who was successfully desensitized with oral levothyroxine within a day using a 14-step protocol. PMID:34966208 | PMC:PMC8666481 | DOI:10.15605/jafes.036.02.10 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Associations of Hearing Loss and Dual Sensory Loss With Mortality

xlomafota13 shared this article with you from Inoreader Associations of Hearing Loss and Dual Sensory Loss With Mortality Via JAMA Otolaryngology–Head & Neck Surgery Online First This systematic review and meta-analysis assesses the epidemiol ogical associations of hearing loss and dual sensory loss with mortality among adults. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery Via JAMA Otolaryngology–Head & Neck Surgery Online First This randomized clinical trial examines the efficacy of an anim ated surgical guide in helping Canadian patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of tendon tension and hysteresis by tendon twisting and development of anti‐twist tendon mechanism of robotic surgical instruments

xlomafota13 shared this article with you from Inoreader Analysis of tendon tension and hysteresis by tendon twisting and development of anti‐twist tendon mechanism of robotic surgical instruments Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Control of the joints of robotic surgical instruments is difficult owing to hysteresis, and tendon twisting due to axial rotation of surgical tools also causes hysteresis. Therefore, a new mechanism is needed to prevent tendon twisting. Methods Tendon tension and hysteresis change were analyzed by observing the movement of the joint depending on whether the tendons twisted for the same input signal. An anti-twist tendon mechanism to prevent twisting was developed. A 3-mm needle driver applied with the proposed mechanism was manufactured. Results The anti-twist mechanism makes no tension change because of twisting or friction between the tendon and the system, i.e., the operating performance was the same regardless of rotation. Conclusion The proposed mechanism has been verified and can be applied to small surgical instruments 3 mm in size. These findings can be applied in the development of instruments for precise surgeries such as microsurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathological diagnosis, differential diagnosis and origin investigation of easily misdiagnosed adult gastric duplication cysts

xlomafota13 shared this article with you from Inoreader Pathological diagnosis, differential diagnosis and origin investigation of easily misdiagnosed adult gastric duplication cysts Via Cellular and Molecular Biology Histol Histopathol. 2021 Dec 29:18417. doi: 10.14670/HH-18-417. Online ahead of print. ABSTRACT OBJECTIVES: To study diagnosis, differential diagnosis, and origin of easily misdiagnosed adult gastric duplication cysts. METHODS: Six cases with GDCs were studied using immunohistochemical methods to research the expression of tumor markers. RESULTS: Most GDCs were located in the abdominal cavity outside the digestive organs. The cyst wall tissues included a repetition of the full-thickness structure of the stomach wall that was lined by a variety of different epithelia. The expression of CK7 was positive in all epithelia (6/6), while CK7 expression was positive in cardia glands in 5/5 and positive in fundus glands in 1/5. CK 20 was 100% (4/4) positively expressed in the SCE, 100% (3/3) negative in the CCE, and in the SE. It was also expressed positively 100% (5/5) in fundus glands and 80% (4/5) in cardia glands. Both CK7 and C K20 were negatively expressed in the pyloric glands in case 3. The expression of MUC1 was positive in all epithelia and glands, whereas MUC2 expression was negative. MUC5AC was expressed differently in epithelia and glands. CONCLUSIONS: GDCs can originate from the antrum or the fundus of the stomach. Tumor markers can help diagnosis and differential diagnosis. This study may help to improve clinical precision treatment. PMID:34964481 | DOI:10.14670/HH-18-417 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics and function of resident macrophages in stria vascularis

xlomafota13 shared this article with you from Inoreader Characteristics and function of resident macrophages in stria vascularis Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1365-1370. doi: 10.3760/cma.j.cn115330-20210119-00027. NO ABSTRACT PMID:34963230 | DOI:10.3760/cma.j.cn115330-20210119-00027 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose

xlomafota13 shared this article with you from Inoreader Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose Via ear nose throat Ear Nose Throat J. 2021 Dec 29:1455613211069353. doi: 10.1177/01455613211069353. Online ahead of print. ABSTRACT Substance abuse is a rare but known cause of sensorineural hearing loss (SNHL). We report a case of acute SNHL in a 28-year-old man following an overdose of methamphetamine and incidental ingestion of fentanyl. On initial encounter, he had moderate-to-severe hearing loss in the right ear and severe-to-profound hearing loss in the left ear in addition to acute kidn ey injury, liver failure, and lactic acidosis. The patient was treated with a two-week course of high-dose steroids and expressed a subjective improvement in hearing. This case highlights the importance of auditory testing following a drug overdose and is one of the only documented cases of hearing loss following methamphetamine use in recent years. There is a paucity of literature regarding the mechanism causing acute SNHL secondary to methamphetamines. Proposed etiologies include neurotransmitter depletion or reduced cochlear blood flow as possible causes of ototoxicity. PMID:34965172 | DOI:10.1177/01455613211069353 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.