Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis

xlomafota13 shared this article with you from Inoreader Comparison of Absorbable Packing versus No Packing in Wound Healing after Endoscopic Sinus Surgery: A Systematic Review and Pooled Analysis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Nasal packing after endoscopic sinus surgery (ESS) is controversial. The aim of this systematic review was to compare absorbable packing versus no packing in wound healing after ESS for the treatment of chronic rhinosinusitis. Data Source: English electronic databases, including Cochrane Library, EMBASE, MEDLINE, and PubMed, were searched, and only randomized controlled trials were included. Methods: The outcome measures were the presence of synechiae/adhesion formation, mucosal edema, crusting, granulatio n formation, and infection. The McNemar's test was used for pooled analysis. Results: Four studies with 148 participants were included. The pooled analysis showed that absorbable packing may offer benefit in reducing adhesion at 6–8 weeks (odds ratio [OR]: 0.3864; 95% confidence interval [CI]: 0.2136–0.7235) and 12 weeks (OR: 0.2396, 95% CI: 0.08267–0.7709) postoperatively compared with no packing. There was no significant difference between the packed and the unpacked side at 2, 6–8, and 12 weeks after ESS in terms of presence of crusting, edema, and granulation formation. Conclusion: There is insufficient evidence to suggest that absorbable packing after ESS does not increase mucosal edema, granulation formation, and infection. However, the absorbable packing may be more effective than no packing for the prevention of mucosal adhesion after ESS. The use of absorbable nasal packing after ESS is recommended when used to reduce postoperative muco sal adhesion. More research in this area is clearly needed. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Preoperative prognostic factors for functional and clinical outcomes after open partial horizontal laryngectomies

xlomafota13 shared this article with you from Inoreader Preoperative prognostic factors for functional and clinical outcomes after open partial horizontal laryngectomies Via Head & Neck Abstract Background In minority of cases, the clinical recovery of the neolarynx after open partial horizontal laryngectomies (OPHLs) can be challenging, possibly affecting the final functional outcome. Methods One hundred and twenty-three patients who underwent OPHLs were selected. A series of clinical preoperative independent variables were considered. All patients were monitored for the following dependent outcome variables: sequelae; need for percutaneous endoscopic gastrostomy positioning; days before tracheal cannula removal and nasogastric tube removal; and length of hospital stay. Univariate and multivariate logistic regression analyses were performed to identify significant associations between preoperative clinical variables and outcomes variables. Results Multivariate analysis confirmed age, cT classification, body mass index, and smoking habits as significant prognostic factors for worse functional and clinical recovery outcomes. Conclusions Knowing what variables are significantly associated with worse clinical and functional outcomes can guide clinicians in defining the best surgical choice not only from an oncological perspective, but also for a better postoperative recovery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for surgical site infection in free‐flap reconstructive surgery for head and neck cancer: A retrospective Australian cohort study

xlomafota13 shared this article with you from Inoreader Risk factors for surgical site infection in free‐flap reconstructive surgery for head and neck cancer: A retrospective Australian cohort study Via Head & Neck Abstract Background Surgical site infections (SSI) are common complications of free-flap reconstruction for head and neck cancer defects. This study aimed to identify risk factors for SSI following a significant change in local antibiotic prophylaxis practice. Methods A retrospective cohort study was conducted of 325 patients receiving free-flap reconstruction for head and neck cancer defects at a tertiary hospital in Melbourne, Australia between 2013 and 2019. Charts were queried for recipient SSI (primary outcome), donor SSI, other infections, antibiotic use, hospital length of stay, and mortality. Results Risk factors for SSI included female sex, T-classification, hardware insertion, clindamycin prophylaxis, and operative duration. There was a trend toward increased SSI with shorter ≤24 h prophylaxis (OR: 0.43). Conclusion Antibiotic duration and type were associated with SSI. Complexity of surgery, T-classification, hardware use, and operative duration were also independently associated with SSI. A prospective trial is indicated to elicit optimal prophylactic antibiotic duration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasalance Scores as a Function of Skeletal Malocclusion of English-Speaking Adults in the North Indian Population

xlomafota13 shared this article with you from Inoreader Nasalance Scores as a Function of Skeletal Malocclusion of English-Speaking Adults in the North Indian Population Via Folia Phoniatrica et Logopaedica Objective: The objective of this study is quantitative assessment of nasalance for skeletal Class I (normative values), Class II, and III malocclusion in the English language for the North Indian population and to compare the normative values with the nasalance scores obtained from individuals with skeletal Class II and III malocclusion and to evaluate the normative values as a function of gender. Material and Methods: The study was conducted on a total sample of 2 00 patients with 100, 50, and 50 in group 1 (control group, Skeletal Class I), group 2 (Skeletal Class II), and group 3 (Skeletal Class III), respectively. ANB angle (anteroposterior angle formed by point A, nasion, and point B) measured on lateral cephalogram was used to categorize the patients into 3 groups. The normative nasalance scores were compared for males and females in the control group. The nasalance scores of skeletal Class II and III subjects were compared to the combined normative scores of the control group. The NasalView was used for the objective assessment of nasalance. Oral syllables (/pa/and/pi/), nasal syllables (/ma/and/mi/), and 3 passages (Zoo passage, Rainbow passage, and Nasal sentences) were used to determine the nasalance scores. Results: The intragroup comparison of nasalance scores in group 1 showed statistically significant differences for different stimuli. The gender-related comparison showed no statistically significant differences in nasalance scores. The intergroup comparison of nasalance scores for skeletal malocclusion showed no statistically significant differences for different stimuli except statistically significant lower nasalance values for nasal sentences in group 3 compared to the control group. Conclusion: The study concluded that the nasalance scores for nasal sentences in skeletal Class III malocclusion were significantly lower than in the control group and were not statistically significant between the 3 groups for all other stimuli. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle-Ear Resonance Frequency and Eustachian Tube Function in Players of Wind Instruments

xlomafota13 shared this article with you from Inoreader Middle-Ear Resonance Frequency and Eustachian Tube Function in Players of Wind Instruments Via Folia Phoniatrica et Logopaedica Introduction: The effect of the continuous forced expiration action of players of wind instruments to produce sound, on the eustachian tube functions and the middle-ear resonance frequency (RF), has not been investigated in the literature to date. The aim of this study is to evaluate eustachian tube functions and the middle-ear RF of players of wind instruments. Methods: In this prospective case-control clinical study, a study group of 28 players of wind instrument s in the orchestra (28 participants, 56 ears) and a control group of 34 volunteers (34 participants, 68 ears) were included. The eustachian function of wind instrument players in a symphony orchestra was measured using an automatic eustachian tube function test in acoustic tympanometry and the RF of the middle ear was determined in multifrequency tympanometry. Results: There was a statistically significant difference among the musicians, especially in players of woodwind instruments, in terms of dysfunction of the eustachian tubes (p = 0.048). In the musicians, the pre- and postperformance RF mean values for all ears were 925 and 1,020 Hz, respectively, and these were significantly different (p = 0.004). Conclusion: This is the first study to uses multifrequency tympanometry to examine the middle-ear RF and eustachian tube function of wind instrument musicians in an orchestra. Eustachian tube dysfunction was found to be more prominent and a higher RF of the middle ear was seen after a performance, especially in players of wood wind instruments. However, the effect of these on the professional performance of players of wind instruments should be investigated in future work. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early and late clinico‐pathologic outcomes of minimally invasive total mesorectal excision for rectal cancer: A propensity score‐matched comparison of robotic and laparoscopic approaches

xlomafota13 shared this article with you from Inoreader Early and late clinico‐pathologic outcomes of minimally invasive total mesorectal excision for rectal cancer: A propensity score‐matched comparison of robotic and laparoscopic approaches Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Background This study aimed to compare the early and late clinical outcomes of laparoscopic and robotic total mesorectal excision (TME) using propensity score matching. Methods The retrospective study included 489 patients who underwent laparoscopic or robotic TME for rectal cancer between June 2011 and December 2018. Overall, 131 matched pairs were generated via propensity scoring matching according to several factors. Results The matched groups had generally similar demographic characteristics. The robotic TME group had significantly longer mean times for the total operation and the TME procedure. There were no significant differences in terms of the other procedure-specific parameters, although the robotic TME group had significantly shorter duration of hospitalization and shorter duration of need for postoperative indwelling urinary catheter. Moreover, the robotic TME group had non-significantly lower rates of late postoperative complication s and reoperation. Conclusions : Early and late clinico-pathologic outcomes of robotic TME were comparable to that of laparoscopic TME. 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.

No Association of Filaggrin Copy Number Variation and Atopic Dermatitis Risk in White and Black Americans

xlomafota13 shared this article with you from Inoreader No Association of Filaggrin Copy Number Variation and Atopic Dermatitis Risk in White and Black Americans Via Experimental Dermatology Abstract Atopic dermatitis (AD) is a chronic, inflammatory skin condition with a multifactorial pathophysiology. The filaggrin gene (FLG) has particularly been implicated given loss of function (LoF) mutations in this gene lead to skin barrier dysfunction and such mutations can increase a patient's likelihood of developing AD. FLG has intragenic copy number variation (CNV) which impacts the total amount of filaggrin produced. Previous research reported a dose-dependent effect such that as amount of FLG increases, risk of AD decreases. To gain a better understanding, we evaluated FLG CNV in a large case-control study of Whites and Blacks with and without AD. The goal of our study was to determine if FLG CNV has a dose-dependence effect on the risk of developing AD as well as to determine if FLG CNV varies by race. The frequencies as well as odd ratios comparing a given CNV by race or race within those with AD did not significantly vary. It had been thoug ht that FLG CNV might vary by race and represent an important association with AD in Black AD subjects. However, our work suggests that while there are racial differences with respect to CNV, these differences do not appear to explain AD risk. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: a retrospective multicentre study

xlomafota13 shared this article with you from Inoreader The prevalence of oropharyngeal squamous cell carcinoma in patients admitted with symptoms of peritonsillar abscess or cellulitis: a retrospective multicentre study Via Clinical Otolaryngology ABSTRACT Objectives Anecdotal evidence suggests that oropharyngeal squamous cell carcinoma (OPSCC) should be suspected in patients presenting with symptoms of peritonsillar abscess (PTA) or cellulitis (PTC). The aim of this study was to estimate the prevalence of OPSCC in patients presenting with symptoms of PTA/PTC. Method, Setting and Participants We retrospectively identified all adults with a coded diagnosis of PTA or PTC who presented between 2012-2016 inclusive, across six ENT units in Merseyside. Records were compared to that of the centralised regional head and neck cancer database. The clinical records of a subset of patients were reviewed for the purposes of data validation. Results A total of 1975 patients with PTA/PTC were identified. Three patients were subsequently diagnosed with OPSCC. None of the three actually had an objective underlying diagnosis of PTA/PTC on the same side. The prevalence of OPSCC in patients admitted with symptoms of PTA/PTC was 0.15%, or approximately 1:650 admissions. The records of 510 patients who presented over a one-year period (2016) were reviewed in even greater detail. There were 298 patients with PTA (59.4%), 151 with PTC (29.1%) and 61 had an alternative diagnosis (11.9%). High risk features (age ≥40, tonsillar asymmetry or tonsillar lesion) were present in 106 patients (24%). Urgent follow up was expedited for 77 patients (73%). Conclusion This study estimates the risk of OPSCC in patients with peritonsillar symptoms. The prevalence is low, even in a region with a relatively heavy disease burden. Clinicians should, however, retain a high level of suspicion in patients with persistent symptoms. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Triple Semicircular Canal Occlusion Combined with Endolymphatic Sac Decompression: An Effective Surgical Strategy for Vertigo Control of Intractable Meniere's Disease

xlomafota13 shared this article with you from Inoreader Triple Semicircular Canal Occlusion Combined with Endolymphatic Sac Decompression: An Effective Surgical Strategy for Vertigo Control of Intractable Meniere's Disease Via Clinical Otolaryngology Abstract Triple semicircular canal occlusion is an efficient strategy for vertigo control in patients with intractable Meniere's disease The surgery can block the movement of endolymph in the canals to eliminate vertigo attacks induced by position changing Patients with advanced stage MD suffered more from hearing deterioration postoperatively The aural fullness remission was satisfactory postoperative Vestibular rehabilitation is important and effective for vestibular function compensation, it should be recommended to all patients postoperatively. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Testing Olfactory and Gustatory Dysfunctions among Quarantine COVID-19 Suspects

xlomafota13 shared this article with you from Inoreader Testing Olfactory and Gustatory Dysfunctions among Quarantine COVID-19 Suspects Via Otolaryngology Indian Abstract The World Health Organization (WHO) has cautioned on specific respiratory symptoms for suspecting an individual of Corona Virus Disease 2019 (COVID-19). Meanwhile, many suspects are reporting dysfunctions of smell and taste. This study aimed to investigate the percentage of positive COVID-19 who had associated loss of sensation as detected by psychophysical testing. Eight hundred and thirty two suspects were enrolled. At the time of sampling for testing COVID-19 status, olfactory dysfunction (OD) and gustatory dysfunction (GD) tested using odorants like coffee and camphor and solutions of sweet and salty solvants, respectively. The strength of the association between test results of these sensory losses and COVID-19 positivity was assessed by calculating sensitivity, specificity, and predictive values. The responses in positive and negative individuals presented as age-adjusted odds ratio with 95% CI. Seventy six (9.1%) [95% CI: 7.4%–11.3%] of 832 suspects we re tested positive for COVID-19. Paediatric cases of age between 2 and 10 years could not reply appropriately, hence OD in 134 and GD in 118 could not be tested. Anosmia or hyposmia was present in 62 (81.6%) and ageusia in 64 (84.2%) of the total 76 confirmed cases. The OD and GD dysfunctions were significantly higher among confirmed COVID-19 cases compared to negative subjects [Adj OR (95% CI): Smell 3.22 (1.77–5.88); taste 3.05 (1.61–5.76), p < 0.001]. In this study, testing of smell and taste dysfunctions had higher sensitivity in identifying recent-onset loss of sensations in COVID-19 cases. Hence, it may be used as a simple and cost-effective screening test. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Pilot Study Comparing Teletherapy with the Conventional Face-to-Face Therapy for Speech-Language Disorders

xlomafota13 shared this article with you from Inoreader A Pilot Study Comparing Teletherapy with the Conventional Face-to-Face Therapy for Speech-Language Disorders Via Otolaryngology Indian Abstract Speech-language therapists along with affected individuals face various challenges for accomplishing the rehabilitation services. In the current COVID19 pandemic scenario, telerehabilitation has emerged as a substitute to the traditional face-to-face therapy, and is the only option possible in some cases. To subjectively assess the feasibility & acceptability of telerehabilitation provided by speech-language pathologist to patients of speech and language disorders. This qualitative study includes 20 patients suffering from disorders of fluency, voice, swallowing and neurogenic disorders. The participants included were undergoing face-to-face therapy at our institute. After the completion of face-to-face session series, telerehabilitation services were provided through a video calling app. The outcomes of teletherapy were assessed subjectively using a structured questionnaire on 11 parameters using a Likert scale. Of the included 20 patients, after complet ion of teletherapy, four patients chose the physical interaction as the preferred mode of therapy while 16 chose teletherapy as the preferred mode. Except three clients who rated their overall satisfaction as '3', others rated as '4' or '5'.The therapists were satisfied with the outcomes in 17 cases, and were pleased with the overall progress of all the clients (rated 4 or 5). Telerehabilitation is a reliable method to deliver speech and language services at community level, on long-term basis, as is proven by the high satisfaction scores among the clients as well as the service providers. Clinical Trial Registration The trial has been registered in Clinical Trials Registry of India (CTRI) vide number CTRI/2018/04/ 012,922 (http://ctri.nic.in/Clinicaltrials/login.php) on 02/04/2018. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Modified Danker’s Approach for Management of Sinonasal Inverted Papilloma: Our Experience

xlomafota13 shared this article with you from Inoreader Endoscopic Modified Danker's Approach for Management of Sinonasal Inverted Papilloma: Our Experience Via Otolaryngology Indian Abstract Sinonasal inverted papilloma (SNIP), Inverting papilloma, Schneiderian papilloma etc. It is a benign tumor with incidence nearly 70% of all sinonasal papilloma and 0.5–4.0% of all sinonasal neoplasms. The most common site of origin is lateral nasal wall and common presenting symptom is nasal obstruction followed by epistaxis. On histopathology examination, it is characterized by invagination of neoplastic epithelium into underlying stroma. With the advent of technology, the endoscopic modified dankers approach became the surgical approach of choice. The present study was undertaken to study its role in management of SNIP with reference to rate of recurrence and malignancy. An observational study was conducted in a tertiary health center in which 40 biopsy proven cases of SNIP, operated by endoscopic assisted modified Danker's approach between September 2008 and January 2019 with minimum follow-up period of 6 months were analyzed. Male:Female r atio was 2.33:1. The most common symptom was nasal obstruction (97.5%) followed by rhinorrhoea (87.5%). Using various imaging and diagnostic measures, lateral nasal wall was found to be the most common site of origin. Out of total 40 cases, 9 (27.5%) patients had recurrence, of these, 6 were benign and remaining 3 had malignancy as confirmed by biopsy. Most of the cases of SNIP can be managed endoscopically, although extensive lesions or the lesions with malignant transformation, external approach may be needed so expertise in both endoscopic and conventional techniques is needed. Although most of the recurrences occurred in first 2 years, but life time follow-up is advisable. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.