Persistent otorrhoea caused by cerebrospinal fluid leakage

xlomafota13 shared this article with you from Inoreader Persistent otorrhoea caused by cerebrospinal fluid leakage Via leak of cerebrospinal fluid Ned Tijdschr Geneeskd. 2021 Jun 10;165:D5456. ABSTRACT Persistent otorrhoea is a common issue for both children and adults, which can be caused by leakage of cerebrospinal fluid from the lateral skull base. Bacterial superinfection of the chronically humid middle ear, arising from continuous cerebrospinal fluid leakage, may contribute to an atypical clinical presentation. That is, otogenous cerebrospinal fluid leakage may mimic serious otitis media with concomitant conductive hearing loss, leading to a serious diagnostic delay in some patients. On the basis of three cases with cerebrospinal fluid leakage, resulting in persistent otorrhoea, we underline the importance of its timely diagnosis and treatment. PMID:34346583 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of primary tumor resection in patients with metastatic medullary thyroid cancer who have unresectable distant metastases

xlomafota13 shared this article with you from Inoreader Role of primary tumor resection in patients with metastatic medullary thyroid cancer who have unresectable distant metastases Via Head & Neck Abstract Background Whether patients with medullary thyroid carcinoma (MTC) who have unresectable synchronous distant metastases should undergo primary surgical resection (PTR) remains controversial. This study aimed to identify predictive factors associated with the survival of such patients. Methods We conducted a retrospective study of patients with MTC who were registered in the Surveillance, Epidemiology, and End Results registry. The overall and cancer-specific mortality rates were assessed using risk-adjusted Cox proportional hazards regression modeling and stratified propensity score matching. Results One hundred and eight matched patients were assessed. Patients in the PTR group had lower overall mortality than did those in the non-PTR group. The 1-, 3-, and 5-year overall and cancer-specific survival rates in the PTR group were significantly higher. Conclusions PTR appears to be the most appropriate intervention for patients with good performance status. Such patients are likely to benefit from surgery and to experience long-term stable disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The United Kingdom Thyroid Multi‐Disciplinary Team; a National Survey of Services and Comparison to Guidelines

xlomafota13 shared this article with you from Inoreader The United Kingdom Thyroid Multi‐Disciplinary Team; a National Survey of Services and Comparison to Guidelines Via Clinical Otolaryngology Abstract We have identified ambiguity in the current guidance on thyroid MDT's, and have also found nationwide variation in compliance with this. We recommend: All thyroid surgeons should complete a minimum of 20 thyroid procedures per year, and this should also form part of surgeons' annual appraisal. All surgeons should contribute data to UKRETS (unless prevented by local legal frameworks) and this should form part of surgeons' annual appraisal and be audited by individual MDT's and regional cancer networks. Thyroid MDT's should be held weekly where possible, with a minimum frequency of fortnightly. The core membership of thyroid MDT's (stand alone and joint) should include thyroid surgeons, specialist radiology, endocrinology, nuclear medicine, nurse specialists, histopathology +/- cytology and clinical oncology. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications

xlomafota13 shared this article with you from Inoreader Reliability of Early Ambulation after Intradural Spine Surgery : Risk Factors and a Preventive Method for Cerebrospinal Fluid Leak Related Complications Via leak of cerebrospinal fluid J Korean Neurosurg Soc. 2021 Aug 24. doi: 10.3340/jkns.2020.0350. Online ahead of print. ABSTRACT OBJECTIVE: Cerebrospinal fluid leakage related complications (CLC) occasionally occur after intradural spinal surgery. We sought to investigate the effectiveness of early ambulation after intradural spinal surgery and analyze the risk factors for CLC. METHODS: For this retrospective cohort study, we enrolled 314 patients who underwent intradural spinal surgery at a single institution. The early group contained 79 patients who started ambulation after 1 day of bedrest without position restrictions, while the late group consisted of 235 patients who started ambulation after at least 3 days of bed rest and were limited to the prone position after surgery. In the early group, Prolene 6-0 was used as the dura suture material, while black silk 5-0 was used as the dura suture material in the late group. RESULTS: The overall incidence rate of CLC was 10.8%. Significant differences between the early and late groups were identified in the rate of CLC (2.5% vs. 13.6%), surgical repair required (1.3% vs. 7.7%), and length of hospital stay (2.99 vs. 9.29 days) (p<0.05). Logistic regression analysis revealed that CLC was associated with practices specific to the late group (p=0.011) and the revision surgery (p=0.022). CONCLUSION: Using Prolene 6-0 as a dura suture material for intradural spinal surgery resulted in lower CLC rates compared to black silk 5-0 sutures despite a shorter bed rest period. Our findings revealed that suture - needle ratio related to dura defect was the most critical factor for CLC. One-day ambulation after primary dura closure using Prolene 6-0 sutures appears to be a cost-effective and safe strategy for intradural spinal surgery. PMID:34425635 | DOI:10.3340/jkns.2020.0350 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

xlomafota13 shared this article with you from Inoreader Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation Via radiol anat Surg Radiol Anat. 2021 Aug 23. doi: 10.1007/s00276-021-02820-8. Online ahead of print. ABSTRACT PURPOSE: There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum's fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. METHODS: The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. RESULTS: For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. CONCLUSION: The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position. PMID:34426859 | DOI:10.1007/s00276-021-02820-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Voice Outcomes Following Colon Interposition

xlomafota13 shared this article with you from Inoreader Voice Outcomes Following Colon Interposition Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211041786. doi: 10.1177/01455613211041786. Online ahead of print. ABSTRACT SIGNIFICANCE STATEMENT: This case highlights the consequences of colon interposition on phonation and swallowing. Findings in this patient included laryngopharyngeal reflux, vocal fold paralysis, poor esophageal peristalsis, failed bolus transfers, and others. The mechanical and functional differences between the colon and the esophagus can impact bolus transfer, reflux, and phonation. Further research is required to identify the mechanisms by which colon interposition can impact voice and swallowing. PMID:34427138 | DOI:10.1177/01455613211041786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Approaches to External Auditory Canal Hemangiomas: A Systematic Review

xlomafota13 shared this article with you from Inoreader Clinical Approaches to External Auditory Canal Hemangiomas: A Systematic Review Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211042449. doi: 10.1177/01455613211042449. Online ahead of print. ABSTRACT OBJECTIVES: Hemangioma is a common soft tissue tumor that can be categorized mainly into cavernous, capillary, and venous subtypes. It usually develops in the head and neck and rarely in the external auditory canal (EAC). METHODS: A systematic review of patients with capillary hemangioma of the EAC was performed. A computerized systematic search was conducte d in PubMed, Scopus, and Web of Science to extract relevant studies for a qualitative review. RESULTS: A total of 38 patients were included in the systematic review, and half of them were men. Hearing loss was the most common presenting feature (n = 19; 50%), followed by aural fullness (n = 15; 39.4%). Cavernous hemangioma was the predominant type (n = 22, 57.8%). Endaural and transcanal surgical approaches were the most frequent, with 10 (26.3%) and 9 (23.6%) cases, respectively. Most of the patients (n = 31, 81.5%) had no recurrence. CONCLUSIONS: Hemangioma of the EAC may not be uncommon, as health care professionals may expect. Hearing loss, aural fullness, and tinnitus are possible symptoms, but many patients remain asymptomatic. Surgical excision is the main effective management option, and complete resolution is the most prevalent outcome. Computed tomography assists in the diagnosis, but histopathological examination after resection is mandatory for the definitive diagnosis. PMID:34427123 | DOI:10.1177/01455613211042449 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CT Findings of Firework Injuries to the Head and Neck

xlomafota13 shared this article with you from Inoreader CT Findings of Firework Injuries to the Head and Neck Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211036242. doi: 10.1177/01455613211036242. Online ahead of print. ABSTRACT OBJECTIVES: The purpose of this study is to review the CT imaging findings of injuries in the head and neck caused by fireworks through a case series. METHODS: The imaging database from the University of Chicago Medicine was searched with "fireworks," "firecrackers," and "mortar" as keywords and CT as the imaging modality. Cases without acute CT findings or initial CT scans were excluded. RESULTS: Eighteen cases with acute CT findings of head and neck firework injuries were identified and included. The associated injuries included skull fractures (5, 28%), ocular injuries (7, 39%), soft tissue trauma (18, 100%), retained foreign bodies (8, 44%), and intracranial trauma (2, 11%). CONCLUSIONS: Fireworks can cause injuries of varying severity in the head and neck, including blunt and penetrating trauma, that warrant CT evaluation. PMID:34427141 | DOI:10.1177/01455613211036242 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dural Bleeding After Endoscopic Sinus Surgery

xlomafota13 shared this article with you from Inoreader Dural Bleeding After Endoscopic Sinus Surgery Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211039038. doi: 10.1177/01455613211039038. Online ahead of print. ABSTRACT We present a case of an 80-year-old female patient who had an extensive dural bleed after endoscopic sinus surgery. A review of the literature regarding the surgical tools and materials used to treat dural hemorrhage was performed. We describe our preferred method of using the combination of endoscopic bipolar, DuraGen Plus, and DuraMatrix to stop significant dura l bleeding and show effective hemostatic regulation. PMID:34427140 | DOI:10.1177/01455613211039038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multidisciplinary Simulation Training for Surgical Tracheostomy in Patients Mechanically Ventilated Secondary to Severe Acute Respiratory Syndrome Coronavirus 2

xlomafota13 shared this article with you from Inoreader Multidisciplinary Simulation Training for Surgical Tracheostomy in Patients Mechanically Ventilated Secondary to Severe Acute Respiratory Syndrome Coronavirus 2 Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211042119. doi: 10.1177/01455613211042119. Online ahead of print. ABSTRACT OBJECTIVE: A proportion of patients with coronavirus disease (COVID) and severe respiratory manifestations of disease will require admission to intensive care for intubation and ventilation. When anticipating prolonged ventilation, the patient may proceed to surgical tracheostomy to afford safe respiratory wean. As surgical tracheostomy is an aerosol-generating pr ocedure, it poses a high risk of viral transmission and ultimately may prompt anxiety and caution in participating staff members. We aimed to mitigate these risks by providing staff with appropriate training and experience, to improve their confidence as well as practical ability. METHODS: We developed a multidisciplinary simulation training experience and checklist in order to optimize team performance during the high-stakes procedure. We evaluated staff confidence before and after the training with questionnaires. RESULTS: Post-simulation, surgeons were more confident with donning the high level personal protective equipment, and nurses were more confident in performing their role. CONCLUSIONS: Simulation allows the multidisciplinary team an opportunity to practice high-risk procedures and prompts the team to assess staff knowledge base, troubleshoot queries, and teach roles and responsibilities in a safe environment. In the context of COVID-19, simulation encour ages staff sense of preparedness and protection for true participation during a high-risk procedure. PMID:34427150 | DOI:10.1177/01455613211042119 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intravascular Guidewire Residue After Endovascular Embolization for Intractable Epistaxis: A Case Report

xlomafota13 shared this article with you from Inoreader Intravascular Guidewire Residue After Endovascular Embolization for Intractable Epistaxis: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Aug 24:1455613211040581. doi: 10.1177/01455613211040581. Online ahead of print. ABSTRACT Endovascular embolization (EE) has become an effective method for the treatment of intractable epistaxis (IE). However, complications such as facial pain, headaches, aphasia, hemiplegia, and transient blindness can also occur during or after surgery. In this article, we report a rare case of IE with residual intravascular guidewire after EE. Open surgery was used t o remove the guidewire. However, to avoid serious complications such as massive hemorrhage, only part of the guidewire was removed. PMID:34427152 | DOI:10.1177/01455613211040581 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.