Surgical treatment of the neck in patients with salivary gland carcinoma

xlomafota13 shared this article with you from Inoreader Surgical treatment of the neck in patients with salivary gland carcinoma Via Head & Neck Abstract Background Elective neck dissection (END) in patients with salivary gland carcinoma is controversial and there are no universally accepted guidelines. Methods Patients were identified from the Danish Head and Neck Cancer Group. Between 2006 and 2015, 259 patients with primary salivary gland carcinoma were treated with END. Variables potentially associated with regional metastases were analyzed using logistic regression. Neck recurrence‐free survival was calculated using the Kaplan–Meier method. Results Occult metastases were found in 36 of the patients treated with END (14%) and were particularly frequent among patients with T3/T4 tumors and high‐grade histology tumors. In multivariate analyses, high‐grade histology and vascular invasion were associated with occult metastases. Conclusion We recommend END of levels II and III for patients with high‐grade or unknown histological grade tumors, and for T3/T4 tumors. Levels I, II, and III should be included in END in patients with submandibular, sublingual, or minor salivary gland carcinomas. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic scoring models in parotid gland carcinoma

xlomafota13 shared this article with you from Inoreader Prognostic scoring models in parotid gland carcinoma Via Head & Neck Abstract Background The aim was to identify prognostic factors and test three prognostic scoring models that predicted the risk of recurrence in patients with parotid gland carcinoma. Methods All Danish patients with parotid gland carcinoma, treated with curative intent, from 1990 to 2015 (n = 726) were included. Potential prognostic factors were evaluated using Cox regression and competing risk analyses. The concordance of each prognostic model was estimated using Harrel's C index. Results The study population consisted of 344 men and 382 women, with a median age of 63 years. Age above 60 years, high grade histology, T3/T4 tumor, regional lymph node metastases, and involved surgical margins were all associated with a significant reduction in recurrence‐free survival. The prognostic model that agreed best with actual outcomes had a C‐index of 0.76. Conclusion Prognostic scoring models may improve individualized follow‐up strategies after curatively intended treatment for patients with parotid gland carcinoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characterizing distant metastases and survival in oropharyngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Characterizing distant metastases and survival in oropharyngeal squamous cell carcinoma Via Head & Neck Abstract Background Outcomes of oropharyngeal squamous cell carcinoma (OPSCC) after development of distant metastases (DM) in the context of human papillomavirus (HPV) tumor status remain controversial in the literature. Methods OPSCC patients with DM treated between June 2015 and March 2019 were included from a prospectively enrolled database. Characteristics of DM including sites, episodes, and timing of disease were analyzed in addition to survival after DM. Results Sixty‐nine HPV‐positive and 18 HPV‐negative OPSCC patients with DM were included. The 2‐year survival after DM was higher for HPV‐positive patients (54.0% vs. 11.3%, p < 0.001). HPV‐positive patients did not demonstrate greater episodes or sites of DM. Multiple sites of DM, early development of DM, and Charlson comorbidity Index were independently associated with worse survival after DM. Conclusions While multiple sites, early DM, and comorbidities were poor prognostic factors, OPSCC patients with distant progression can have substantial survival after DM, including M1 patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spaced Intranasal Corticosteroid Therapy: A Better Treatment Option in Allergic Rhinitis?

xlomafota13 shared this article with you from Inoreader Spaced Intranasal Corticosteroid Therapy: A Better Treatment Option in Allergic Rhinitis? Via Otolaryngology Indian Abstract Intranasal corticosteroids are first-line therapy in the treatment of allergic rhinitis (AR) and are conventionally prescribed once daily as continuous therapy. The decreased consumption of drugs is proposed to have decreased side effects. The present study aimed at comparing the effect of INCS as a spaced therapy with the conventional continuous therapy. Case records of patients with Allergic Rhinitis, who were started on INCS were studied and improvement in symptom score was compared between continuous and spaced therapy groups. In total 182 patients with AR were studied, with 91 patients in each group. Among the total group, 57% were males, 54% were < 40 years of age, 54% had > 10 years of allergy history and 94% had no family history. There was significant improvement in mean Visual Analogue Score (VAS) for all patients in both groups (p = 0.001). However, the comparison of differences in VAS before and after therapy did n ot show significant difference for the two groups (p = 0.791). Our study suggests that the efficacy of INCS in controlling AR symptoms is observed to be similar with spaced therapy, as in continuous therapy. Spaced therapy may therefore be recommended for better patient compliance, lesser cost and avoidance of the side effects resulting in overall improvement of quality of life for allergic patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultra‐high frequency ultrasound and machine‐learning approaches for the differential diagnosis of melanocytic lesions

xlomafota13 shared this article with you from Inoreader Ultra‐high frequency ultrasound and machine‐learning approaches for the differential diagnosis of melanocytic lesions Via Experimental Dermatology Abstract Malignant melanoma (MM) is one of the most dangerous skin cancers. The aim of this study is to present a potential new method for the differential diagnosis of MM from melanocytic naevi (MN). We examined 20 MM and 19 MN with a new ultra‐high frequency ultrasound (UHFUS) equipped with a 70 MHz linear probe. Ultrasonographic images were processed for calculating 8 morphological parameters (area, perimeter, circularity, area ratio, standard deviation of normalized radial range, roughness index, overlap ratio and normalized residual mean square value) and 122 texture parameters. Color‐Doppler images were used to evaluate the vascularization. Features reduction was implemented by means of Principal Component Analysis (PCA) and 23 classification algorithms were tested on the reduced features using histological response as ground‐truth. Best results were obtained using only the first component of the PCA and the weighted k‐nearest neighbor classifier; this combination led to an accuracy of 76.9%, area under the ROC curve of 83%, sensitivity of 84% and specificity of 70%. The histological analysis still remains the gold‐standard, but the UHFUS images processing using a machine‐learning approach could represent a new non‐invasive approach. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Inhibition of pyruvate oxidation as a versatile stimulator of the hair cycle in models of alopecia

xlomafota13 shared this article with you from Inoreader Inhibition of pyruvate oxidation as a versatile stimulator of the hair cycle in models of alopecia Via Experimental Dermatology Abstract Hair follicle stem cells (HFSCs) are known to be responsible for the initiation of a new hair cycle, but typically remain quiescent for very long periods. In alopecia, or hair loss disorders, follicles can be refractory to activation for years or even permanently. Alopecia can be triggered by autoimmunity, age, chemotherapeutic treatment, stress, disrupted circadian rhythm or other environmental insults. We previously showed that hair follicle stem cells and the hair cycle can be manipulated by regulation of pyruvate entry into mitochondria for subsequent oxidation to fuel the TCA cycle in normal adult mice with typical hair cycling. Here, we present new data from our efforts to develop murine models of alopecia based on environmental triggers that have been shown to do the same in human skin. We found that inhibition of pyruvate transport into mitochondria can accelerate the hair cycle even during refractory hair cycling due to age, repeated chemotherapeutic treatment and stress. Hair cycle acceleration in these alopecia models led to the formation of histologically normal hair follicles within 30–40 days of treatment without any overt signs of toxicity or deleterious effects. Therefore, we propose inhibition of pyruvate entry into mitochondria as a versatile treatment strategy for alopecia in humans. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance

xlomafota13 shared this article with you from Inoreader MDCT evaluation of pancreatic contour variations in head, neck, body and tail: surgical and radiological significance Via radiol anat Surg Radiol Anat. 2021 Mar 18. doi: 10.1007/s00276-021-02735-4. Online ahead of print. ABSTRACT OBJECTIVE: The purpose of the study was to investigate the incidence of pancreatic contour variations on multidetector CT (MDCT) for abdominal examinations. METHODS: A retrospective analysis of 700 MDCT scans was performed in patients who underwent triple phase CT abdomen between October 2018 and January 2021. After excluding 176 patients, finally total of 524 patients were included in the study. For simplification, we classified the pancreatic contour variations as classified by Ross et al. and Omeri et al. Pancreatic head-neck variations was classified into Type I-anterior, Type II-posterior and Type III-horizontal variety. Pancreatic body-tail variation was divided into Type Ia-anterior projection; Ib-posterior projection and Type IIa-globular, IIb-lobulated, IIc-tapered, and IId-bifid pancreatic tail. RESULTS: The most common type of variation in the head was Type II (n = 112, 21.3%) followed by Type III (n = 37, 7%) and Type I (n = 21, 4%). The most common type of variation in the body of pancreas was Type Ia (n = 33, 6.2%) followed by Type Ib (n = 13, 2.4%). In the tail region of pancreas, the most common variation was Type IIb (n = 21, 4%) followed by Type IIa (n = 19, 3.6%). CONCLUSION: Pancreatic contour variations are not very uncommon in daily practice. Knowledge of these variations is important for surgeons, radiologists and avo ids misjudgement of normal pancreatic tissue as tumor or lymph node especially on unenhanced or single phase MDCT. PMID:33738524 | DOI:10.1007/s00276-021-02735-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Brain Gene Expression in Systemic Hypothyroidism and Mouse Models of MCT8 Deficiency: The Mct8-Oatp1c1-Dio2 Triad

xlomafota13 shared this article with you from Inoreader Brain Gene Expression in Systemic Hypothyroidism and Mouse Models of MCT8 Deficiency: The Mct8-Oatp1c1-Dio2 Triad Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety of (rhino)septoplasty without nasal packing in routine ENT practice

xlomafota13 shared this article with you from Inoreader Safety of (rhino)septoplasty without nasal packing in routine ENT practice 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 Mar 18. doi: 10.1007/s00405-021-06713-9. Online ahead of print. ABSTRACT PURPOSE: This retrospective study assesses the risks and benefits linked to the non-use of nasal packing after a (rhino)septoplasty, compared with post-operative care with anterior nasal packing such as Merocel®. METHODS: Complication rates observed during the first week after surgery were compared between groups with and without use of classic nasal packing over a large sample of 534 patients, who had undergone either a closed or open procedure, with bilateral turbinoplasty, and with or without osteotomies. Complications listed include epistaxis, haematoma, impetiginization, septal perforation, hyperalgesia, and dyspnoea. RESULTS: No significant difference was observed between the group with and without packing regarding the immediate post-operative complications of epistaxis (4.4% of the cases with nasal packing versu s 3% without, p = 0.918) and impetiginization (3% of the cases with nasal packing versus 4.2% without, p = 0.478). The technique used, as well as any osteotomies performed, had no impact on the results. CONCLUSION: Non-use of nasal packing after a (rhino)septoplasty is a safe alternative to classic post-operative methods. Provided that there is a rigorous surgical technique and strict clinical control, it should be used as a principal technique in any routine practice due to its safety for patients immediately post-surgery. PMID:33738566 | DOI:10.1007/s00405-021-06713-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Injection laryngoplasty under ultrasonographic control

xlomafota13 shared this article with you from Inoreader Injection laryngoplasty under ultrasonographic control 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 Mar 18. doi: 10.1007/s00405-021-06666-z. Online ahead of print. ABSTRACT BACKGROUND: Cervical ultrasound allows real-time visualization of the laryngeal structures. We describe its application for injection laryngoplasty in the voice clinic. METHODS: Hyaluronic acid infiltration of the vocal fold under ultrasonographic control. CONCLUSIONS: With this technique, the position of the needle in the depth of the vocal fold and its spatial relations with nearby structures can be assessed. This allows for an accurate infiltration of the material in contrast to other techniques and avoids discomfort related to the gag reflex with nasofibrolaryngoscopy. No specific complications have been observed so far, however, this technique may be difficult in cases with calcified cartilages or uncooperative patients. PMID:33738568 | DOI:10.1007/s00405-021-06666-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer

xlomafota13 shared this article with you from Inoreader Evolution of voice after transoral laser cordectomy for precancerous lesions and early glottic cancer 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 Mar 18. doi: 10.1007/s00405-021-06751-3. Online ahead of print. ABSTRACT PURPOSE: To evaluate voice quality evolution after a transoral laser cordectomy (TLC) for precancerous lesions and early glottic cancer. METHODS: This prospective study enrolled 18 patients scheduled for TLC for high-grade dysplasia, Tis, T1, and T2 glottic squamous cell cancers, from May 2017 to March 2020. Patients were grouped according to the extent of TLC: Group I (n = 11, 61.1%): unilateral subepithelial or subligamental cordectomy; Group II (n = 7, 38.9%): unilateral transmuscular, total, or extended cordectomy. Voice quality parameters, including dysphonia grade (G), roughness (R), breathiness (B), maximal phonation time (MPT), jitter, and shimmer, were evaluated before, and at 6 weeks and 6 months after the TLC. RESULTS: In Group I, the degree of G and R items remained without substantial improvement 6 weeks aft er surgery; however, improved above the pre-surgery level up to 6 months after surgery. The MPT, jitter, and shimmer did not change significantly at 6 weeks or 6 months post-TLC. In Group II, G, R, and B remained significantly impaired even 6 months post-surgery. Jitter, and shimmer worsened at 6 weeks, but reached preoperative levels at 6 months post-surgery. MPT was significantly worse at 6 weeks and remained deteriorated at 6 months post-surgery. All measured parameters were significantly worse in Group II than in Group I at 6 weeks and 6 months post-surgery. No patient required a phonosurgical procedure. CONCLUSION: After a TLC, voice quality evolution depended on the extent of surgery. It did not improve at 6 weeks post-surgery. Improvements in less extent cordectomies occurred between 6 weeks and 6 months post-surgery. Understanding voice development over time is important for counseling patients when considering phonosurgical procedures. PMID:33738567 | DOI:10.1007/s00405-021-06751-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Non-aesthetic uses of botulinum toxin in the head and neck

xlomafota13 shared this article with you from Inoreader Non-aesthetic uses of botulinum toxin in 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 Mar 18. doi: 10.1007/s00405-021-06750-4. Online ahead of print. ABSTRACT INTRODUCTION: The use of botulinum toxin in the specialty of aesthetic surgery in the head and neck is well known. However, it has also been used for other conditions affecting the head and neck, and in recent years its use, as well as the number of relevant applications, has expanded enormously. REVIEW: This article presents a summary of the current range of uses in the laryngeal, pharyngeal, cervical, oromandibular and facial muscles and salivary glands. We highlight particular conditions focusing on dystonia (laryngeal, craniocervical, oromandibular and cervical), multiple system atrophy, migraines, facial nerve palsy, post-laryngectomy, cricopharyngeal dysphagia, Zenker's diverticulum, retrograde cricopharyngeal dysfunction disorder, sialorrhea and gustatory sweating (Frey's syndrome). CONCLUSION: This article should aid the ear, nose and throat surgeon garner knowledge about the range of uses for botulinum toxin in the head and neck. PMID:33738565 | DOI:10.1007/s00405-021-06750-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.