Radioiodine therapy induced sialadenitis versus chronic idiopathic sialadenitis—Presentation and outcomes

xlomafota13 shared this article with you from Inoreader Radioiodine therapy induced sialadenitis versus chronic idiopathic sialadenitis—Presentation and outcomes Via Head & Neck Abstract Background This study explores the unique characters of high dose radioactive iodine (RAI) induced chronic sialadenitis. Methods A retrospective study of patients having received salivary endoscopy and followed in our outpatient clinic. Results A total of 100 patients met the inclusion criteria, 75 were diagnosed with chronic idiopathic sialoadenitis and 25 with radio-iodine induced sialoadenitis (RIS). The main complaint in both groups was swelling of the parotid gland. Pain, dysphagia, and xerostomia were observed considerably more in the RIS group. During sialo-endoscopy, fibrosis of the Stensen's duct was more common in the RIS group (p = 0.003). RIS patients group generally managed better with interventional endoscopic treatment alone (80% vs. 46%). Conclusion RIS patients have distinct clinical characteristics. There may be a collateral muscular damage to the masticatory muscles. Fibrosis and parenchymal damage are major findings during sialendoscopy. Sialendoscopy is a safe and efficient treatment for RAI induced sialadenitis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation

xlomafota13 shared this article with you from Inoreader Dysphagia, trismus and speech impairment following radiation-based treatment for advanced stage oropharyngeal carcinoma: a one-year prospective evaluation 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 May 27. doi: 10.1007/s00405-021-06870-x. Online ahead of print. ABSTRACT OBJECTIVE: The objective was to assess swallowing, mouth opening and speech function during the first year after radiation-based treatment (RT(+)) after introduction of a dedicated preventive rehabilitation program for stage III-IV oropharyngeal carcinoma (OPC). METHODS: Swallowing, mouth opening and speech function were collected before and at six- and twelve-month follow-up after RT(+) for OPC as part of ongoing prospective assessments by speech-language pathologists . RESULTS: Objective and patient-perceived function deteriorated until 6 months and improved until 12 months after treatment, but did not return to baseline levels with 25%, 20% and 58% of the patients with objective dysphagia, trismus and speech problems, respectively. Feeding tube dependency and pneumonia prevalence was low. CONCLUSION: Despite suc cessful implementation, a substantial proportion of patients still experience functional limitations after RT(+) for OPC, suggesting room for improvement of the current rehabilitation program. Pretreatment sarcopenia seems associated with worse functional outcomes and might be a relevant new target for rehabilitation strategies. PMID:34043065 | DOI:10.1007/s00405-021-06870-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prophylactic administration of diphenhydramine/paracetamol reduced emergence agitation and postoperative pain following maxillofacial surgeries: a randomized controlled trial

xlomafota13 shared this article with you from Inoreader Prophylactic administration of diphenhydramine/paracetamol reduced emergence agitation and postoperative pain following maxillofacial surgeries: a randomized controlled trial 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 May 27. doi: 10.1007/s00405-021-06904-4. Online ahead of print. ABSTRACT BACKGROUND: Emergence agitation after maxillofacial surgeries is an anxious and problematic complication for the surgeon and anesthesiologist that may lead to self-extubation, haemorrhage, and surgical destruction. In this study, we investigated the effects of preemptive administration of diphenhydramine on emergence agitation and quality of recovery after maxillofacial surgery in adult patients. METHODS: Eighty-five patients undergoing maxillofacial surgery were randomized into two groups. The diphenhydramine group (Group D, n = 40) received diphenhydramine premedication 0.5 mg/kg before anesthesia induction, while the control group (Group C, n = 40) received volume-matched normal saline as a placebo. Before incision, all patients receive 0.1 mg/kg morphine sulfate slowly intravenously within 5 min. Continuous infusion of rem ifentanil 0.2 μg/kg/h and inhalation of isoflurane was maintained during the anesthesia period. Paracetamol 1 g was infused 15 min before extubation. We evaluated the incidence of agitation during the extubation period after general anesthesia, hemodynamic parameters, and recovery characteristics during the postoperative period. RESULTS: During extubation time, the incidence of emergence agitation was lower in Group D than in Group C (16% vs. 49%, P = 0.041). The time from isoflurane discontinuation to extubation (7.7 min in Group D vs. 6.8 min in Group C, P = 0.082) was not different. Grade of cough during emergence, the severity of pain, analgesic requirements, and hemodynamic changes were lower in group D compared with Group C. CONCLUSIONS: Preemptive administration of diphenhydramine provided smooth emergence from anesthesia. It also improved the quality of recovery after maxillofacial surgery. TRIAL REGISTRATION NUMBER: This study was registered at http://irc t.ir (registration number IRCT20130304012695N3). PMID:34043064 | DOI:10.1007/s00405-021-06904-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is Postoperative Adjuvant Radioactive Iodine Ablation Therapy Always Necessary for Intermediate-Risk Papillary Thyroid Cancer Patients With Central Neck Metastasis?

xlomafota13 shared this article with you from Inoreader Is Postoperative Adjuvant Radioactive Iodine Ablation Therapy Always Necessary for Intermediate-Risk Papillary Thyroid Cancer Patients With Central Neck Metastasis? Via radioactive iodine Ann Surg Oncol. 2021 May 27. doi: 10.1245/s10434-021-10164-1. Online ahead of print. ABSTRACT BACKGROUND: Papillary thyroid cancer (PTC) is commonly associated with neck lymph node metastasis (LNM), and recurrence does occur after radioactive iodine (RAI) ablation therapy. This study aimed to analyze the effectiveness of RAI ablation with regard to disease recurrence in intermediate-risk PTC patients with neck LNM. In addition, the study identified possible predisposing risk factor s that might benefit from RAI ablation and analyzed common RAI therapy complications among these patients. METHODS: A retrospective analysis of 349 intermediate-risk PTC patients with neck LNM who underwent thyroidectomy with neck dissection was performed. The oncologic results and clinicopathologic characteristics of these patients together with the incidence of postoperative RAI therapy complications were evaluated. RESULTS: Of the 349 patients, disease recurrence after treatment occurred for 27 patients (8%) during a mean follow-up period of 58.7 months (range 7-133 months). The recurrence-free survival curve of the patients who received postoperative RAI therapy (n = 208) did not differ significantly from that of the patients who did not receive it (n = 141) (P = 0.567). Nine patients without adjuvant RAI therapy (6%, 9/141) had recurrence. The recurrence rate for the central LNM patients without RAI therapy was only 2% (2/106). Both of these patients with recurrence had pathologic extranodal spread (ENS) and a high number (> 5) of metastatic central LNs. Postoperative RAI-related complications were observed in 24 patients (12%). CONCLUSIONS: Postoperative RAI is not necessary for intermediate-risk papillary thyroid cancer patients with central LNM, especially for patients with negative ENS and low number (< 5) of metastatic lymph nodes. PMID:34043093 | DOI:10.1245/s10434-021-10164-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of ENT Surgical Emergencies Amidst COVID-19 Lockdown: Our Experience in a Tertiary Referral Hospital

xlomafota13 shared this article with you from Inoreader Management of ENT Surgical Emergencies Amidst COVID-19 Lockdown: Our Experience in a Tertiary Referral Hospital Via Otolaryngology Indian Abstract To describe our experience with ENT emergencies during lockdown due to COVID-19 pandemic and provide recommendations for triage, management and protective measures. Retrospective case series. Eleven patients requiring emergency ENT procedures in a tertiary referral hospital during the lockdown period of 24th March to 3rd May 2020 were identified. Clinical profiles, screening and operating room protocols along with the post-operative care and use of personal protective equipment are described. Nine patients were discharged from the hospital and two were in stable condition in the hospital. While lockdowns may be effective in controlling the transmission of COVID-19, they have a negative impact on the routine functioning of healthcare services. Appropriate protocols for screening, triage and management of non-COVID patients with due precautions and infection control strategies can ensure that emergencies get timely and appropriate attention while preventing sprea d of infection among patients and healthcare workers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical and Surgical Study to Evaluate the Accuracy of “C-M-S” Technique in Facial Nerve Identification During Parotid Surgery

xlomafota13 shared this article with you from Inoreader Anatomical and Surgical Study to Evaluate the Accuracy of "C-M-S" Technique in Facial Nerve Identification During Parotid Surgery Via Otolaryngology Indian Abstract Facial nerve identification is considered to be a crucial step in parotid surgery as inadvertent injury to the nerve will lead to facial paralysis. Multiple landmarks are described in literature to identify the facial nerve during parotid surgery but controversies remain as the consistency and accuracy of these landmarks vary. Numerous studies exist in literature but they fail to address a single landmark that is most reliable to identify the facial nerve during parotid surgery. The purpose of this study is to find reliable landmarks for identification of the main trunk of facial nerve during parotid surgery by evidence gathered by cadaveric dissection and intraoperative study during parotid surgery and develop a systematic approach to identify the facial nerve trunk. This prospective study included 41 cadavers (82 parotid regions) and 20 patients with parotid pathology who underwent parotidectomy. We evaluated the feasibility of our C-M-S technique to identify the main trunk of facial nerve in both anatomical and surgical study. The relationship of landmarks (tragal pointer, tympanomastoid suture, superior border of posterior belly of digastric muscle) to the facial nerve trunk was assessed and the shortest distance between them from the facial trunk was measured using a slide caliper. The measurements were compared between the anatomical and surgical study. The main trunk of facial nerve was successfully identified in all cases using C-M-S technique in both anatomical and surgical study. Distance of facial nerve trunk to tragal pointer was more in the cadaveric sample (13.04 ± 5.238 mm) compared to live patients (9.95 ± 3.967 mm) with statistically significant difference (p = 0.036). The mean distance of tympanomastoid suture and posterior belly of digastric muscle to the facial nerve trunk was similar in anatomical and surgical study with p value of 0.877 and 0.083 respectively. The tympanomast oid suture, posterior belly of digastric muscle and tragal pointer are the most useful landmarks for facial nerve identification during parotid surgery. In our study we found that the tympanomastoid suture line is the most consistent landmark present in all our cases and being closest to the facial nerve trunk in both anatomical and surgical study. Further we recommend using the "C-M-S technique" in order to locate the main trunk of the facial nerve. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ropivacaine: A Novel Local Anaesthetic Drug to Use in Otorhinolaryngology Practice

xlomafota13 shared this article with you from Inoreader Ropivacaine: A Novel Local Anaesthetic Drug to Use in Otorhinolaryngology Practice Via Otolaryngology Indian Abstract Ropivacaine is a long-acting amide local anaesthetic agent which has a significant vasoconstrictive property, long duration of action, least central nervous system and cardiac complications due to the pure (S)-enantiomer property by reversible inhibition of sodium ion influx in nerve fibres. By using additives the duration of analgesia may be prolonged. Ropivacaine has been used routinely in our otorhinolaryngology procedures since 2010 (10 years). The present article details the clinical applications of ropivacaine and its current place as a local anaesthetic in otorhinolaryngology practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Leiomyosarcoma of Nose a Very Rare Tumor Case Report: Unusual Case Leiomyosarcoma Inferior Turbinate

xlomafota13 shared this article with you from Inoreader Leiomyosarcoma of Nose a Very Rare Tumor Case Report: Unusual Case Leiomyosarcoma Inferior Turbinate Via Otolaryngology Indian Abstract Leiomyosarcoma (LMS) accounts for approximately 7% of all soft tissue sarcomas and occurs most frequently in the gastrointestinal tract and uterus. In the head and neck, however, LMS makes up only 2.3%. LMS of the nasal cavity and Para nasal sinuses are very rare and only about 20 cases of LMS of the nose and Para nasal sinuses have been reported in the literature. Initially, LMS should be treated by extensive surgical excision, long-term follow-up is essential due to the high rate of local recurrence. Radiotherapy and chemotherapy are insufficient therapeutic approaches. Frequency of recurrence and prognosis depend on the tumor site. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Revisiting “Meniere’s Disease” as “Cervicogenic Endolymphatic Hydrops” and Other Vestibular and Cervicogenic Vertigo as “Spectrum of Same Disease”: A Novel Concept

xlomafota13 shared this article with you from Inoreader Revisiting "Meniere's Disease" as "Cervicogenic Endolymphatic Hydrops" and Other Vestibular and Cervicogenic Vertigo as "Spectrum of Same Disease": A Novel Concept Via Otolaryngology Indian Abstract Vertigo and dizziness are one of the commonest and least understood symptom. Vestibular vertigo of Meniere's disease and Benign Paroxysmal positional vertigo (BPPV) and cervicogenic dizziness are classified as separate entities. Cervicogenic dizziness is not considered the domain of Otolaryngologists, as it is mainly related to neck proprioceptors. Headache and neck pain, have been found to be associated with both Meniere's disease and BPPV, so is cervicogenic dizziness. The present study was undertaken to study the association between cervical signs and symptoms in patients with Vestibular Vertigo of Meniere's disease, Benign Paroxysmal Positional Vertigo and cervicogenic dizziness. 132 patients complaining of vertigo and diagnosed with Meniere's disease, BPPV or cervicogenic dizziness were examined for symptoms and signs related to neck, shoulder and muscle tightness and asymmetry. Most of the patients of Meniere's Disease (80% for unilateral and 88.2 3% for bilateral), Benign Paroxysmal Positional Vertigo (75%for right sided BPPV, 66.67% for left sided BPPV) and cervicogenic dizziness (90%) had associated symptoms of neck pain or headache, and were found to be positive for neck tightness and/or asymmetry of shoulder. Headache was more common in patients with Meniere's Disease. Vestibular Dizziness of Meniere's Disease, Benign Paroxysmal Positional Vertigo and Cervicogenic Dizziness may be spectrum of the same disease with underlying myofascial problems. Meniere's Disease of Idiopathic or primary type needs to be revisited as Cervicogenic Hydrops. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multi-Layer Onlay Graft Using Hydroxyapatite Cement Placement without Cerebrospinal Fluid Diversion for Endoscopic Skull Base Reconstruction

xlomafota13 shared this article with you from Inoreader Multi-Layer Onlay Graft Using Hydroxyapatite Cement Placement without Cerebrospinal Fluid Diversion for Endoscopic Skull Base Reconstruction Via leak of cerebrospinal fluid J Korean Neurosurg Soc. 2021 May 28. doi: 10.3340/jkns.2020.0231. Online ahead of print. ABSTRACT OBJECTIVE: The skull base reconstruction step, which prevents cerebrospinal fluid (CSF) leakage, is one of the most challenging steps in endoscopic skull base surgery (ESS). The purpose of this study was to assess the outcomes and complications of a reconstruction technique for immediate CSF leakage repair using multiple onlay grafts following ESS. METHODS: A total of 230 consecutive patients who underwent skull base reconstruction using multiple onlay grafts with fibrin sealant patch (FSP), hydroxyapatite cement (HAC), and pedicled nasoseptal flap (PNF) for high-flow CSF leakage following ESS at three institutions were enrolled. We retrospectively reviewed the medical and radiological records to analyze the preoperative features and postoperative results. RESULTS: The diagnoses included craniopharyngioma (46.8%), meningioma (34.0%), pituitary adenoma (5.3%), chordoma (1.6%), Rathke's cleft cyst (1.1%) and others (n=21, 11.2%). The trans-planum/tuberculum approach (94.3%) was the most commonly adapted surgical method, followed by the trans-sellar and transclival approaches. The third ventricle was opened in 78 patients (41.5%). Lumbar CSF drainage was not performed postoperatively in any of the patients. Postoperative CSF leakage occurred in four patients (1.7%) due to technical mistakes and were repaired with the same technique. However, postoperative meningitis occurred in 13.5% (n=31) of the patients, but no microorganisms were identified. The median latency to the diagnosis of meningitis was 8 days (range, 2-38). CSF leakage was the unique risk factor for postoperative meningitis (p<0.001). CONCLUSION: The use of multiple onlay grafts with FSP, HAC, and PNF is a reliable reconstruction technique that provides immediate and complete CSF leakage repair and mucosal grafting on the skull base without th e need to harvest autologous tissue or perform postoperative CSF diversion. However, postoperative meningitis should be monitored carefully. PMID:34044491 | DOI:10.3340/jkns.2020.0231 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Salmonella thyroid abscess

xlomafota13 shared this article with you from Inoreader Salmonella thyroid abscess Via European Annals of Otorhinolaryngology, Head and Neck Diseases Publication date: Available online 27 May 2021 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): M. Sahli, B. Hemmaoui, N. Errami, F. Benariba View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.