Combined endoscopic transsphenoidal and tubular retractor-assisted transventricular approach for giant pituitary adenomas

xlomafota13 shared this article with you from Inoreader Combined endoscopic transsphenoidal and tubular retractor-assisted transventricular approach for giant pituitary adenomas Via leak of cerebrospinal fluid World Neurosurg. 2021 Sep 6:S1878-8750(21)01323-1. doi: 10.1016/j.wneu.2021.08.135. Online ahead of print. ABSTRACT BACKGROUND: Surgical resection remains the standard treatment for most giant pituitary adenomas (GPAs). The selected surgical approach for these complex lesions depends mainly on their extension. Single approaches may be limited in some cases presenting with invasion into multiple compartments, thereby limiting extent of resection. METHODS: We report a series of patients with GPA operated on through a combined approach involving an endoscopic endonasal transsphenoidal approach and a tubular retractor-assisted transventricular approach, describing the technique, its indications, limitations, and outcomes. Baseline and postoperative clinical, functional, and morphological variables were documented up until each patient's last follow-up visit. RESULTS: Five patients harbouring tumours extending into the third and latera l ventricles were included. Mean extent of resection was 94.6%. Mean follow-up was 39.4 months. One patient presented with a growth hormone-secreting GPA, who achieved remission after repeat resection during follow-up. There were no intraoperative complications, and one patient required reoperation for cerebrospinal fluid leak repair. One patient received adjuvant radiotherapy, and three patients remained stable requiring no additional treatment. All patients maintained an adequate postoperative functional status. CONCLUSIONS: The combined approach herein described may be a safe and effective option for some patients with GPAs extending into the third and lateral ventricles. An adequate patient selection is mandatory to exploit the benefits of each individual approach. PMID:34500097 | DOI:10.1016/j.wneu.2021.08.135 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills

xlomafota13 shared this article with you from Inoreader Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills Via leak of cerebrospinal fluid ORL J Otorhinolaryngol Relat Spec. 2021 Sep 9:1-8. doi: 10.1159/000517562. Online ahead of print. ABSTRACT INTRODUCTION: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. METHODS: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of patients with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expr essive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. RESULTS: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p < 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). CONCLUSION: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3. PMID:34500448 | DOI:10.1159/000517562 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Screening Test for Aphasia and Dysarthria (STAD) for patients with neurological communicative disorders: a large-scale, multicenter validation study in Japan

xlomafota13 shared this article with you from Inoreader The Screening Test for Aphasia and Dysarthria (STAD) for patients with neurological communicative disorders: a large-scale, multicenter validation study in Japan Via Folia Phoniatrica et Logopaedica View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Robotic surgery for colorectal liver metastases resection: a systematic review

xlomafota13 shared this article with you from Inoreader Robotic surgery for colorectal liver metastases resection: a systematic review Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background The role of robotic surgery for colorectal cancer liver metastases (CRCLMs) has never been investigated in large series. Methods A systematic literature review was carried out on PubMed and Cochrane libraries. Results We selected 9 studies between 2008 to 2021. 262 patients were included. 131 patients underwent simultaneous resections. The mean blood loss was 309.4 ml (range, 200-450 ml), the mean operative time was 250.5 min (range, 198.5-449.0 min). The mean length of hospital stay was 7.98 days (range, 4.5 to 12 days). The overall postoperative mortality was 0.4%. The overall morbidity rate was 37.0%, Clavien-Dindo grade III-IV complications were 8.4%. The mean 3-year overall survival was 55.25% (range, 44.4-66.1%), the mean 3-year disease free survival was 37% (range, 33.3-41.9%). Conclusion We can conclude that robotic-assisted surgery might be considered as a technical upgrade option for minimally invasive approach to CRCLM resections even for simultaneous operations and challenging cases. 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.

Papillary Thyroid Carcinoma with Desmoid-Type Fibromatosis: Review of Published Cases

xlomafota13 shared this article with you from Inoreader Papillary Thyroid Carcinoma with Desmoid-Type Fibromatosis: Review of Published Cases Via radioactive iodine Cancers (Basel). 2021 Sep 6;13(17):4482. doi: 10.3390/cancers13174482. ABSTRACT Desmoid-type fibromatosis (DTF) is a very rare variant of papillary thyroid carcinoma (PTC). It is essentially a dual tumor with a component of classical PTC with malignant epithelial proliferation (BRAF-mutated) and another component of mesenchymal proliferation (CTNNB1-mutated). We conducted a literature review on PTC-DTF. In total, 31 articles were identified, that together reported on 54 patients. The mean age was 47 years, with a 2.2:1 female predominance. No ultrasound features were found to be helpful in differentiating PTC-DTF from other PTC variants. Of the 43 cases that reported histological details, 60% had locally infiltrative disease (T3b or T4). Around 48% had cervical lymph node metastases, but none had distant metastases. While PTC-DTF may be locally more aggressive than classic PTC, its overall behavior is similar and can include extrathyroidal extension and lymph node metastases, which may contain a stromal component and show extranodal invasion. The mainstay of treatment for PTC-DTF is surgery, and the DTF component is not expected to be sensitive to radioactive iodine. External radiotherapy, non-steroidal anti-inflammatory drugs, tyrosine kinase inhibitors and chemotherapy have also been used in selected cases. Due to the rarity of these tumors and the lack of specific treatment guidelines, management should be discussed in a multidisciplinary tea m. PMID:34503292 | DOI:10.3390/cancers13174482 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive Iodine Treatment and the Risk of Long-Term Cardiovascular Morbidity and Mortality in Thyroid Cancer Patients: A Nationwide Cohort Study

xlomafota13 shared this article with you from Inoreader Radioactive Iodine Treatment and the Risk of Long-Term Cardiovascular Morbidity and Mortality in Thyroid Cancer Patients: A Nationwide Cohort Study Via radioactive iodine J Clin Med. 2021 Sep 6;10(17):4032. doi: 10.3390/jcm10174032. ABSTRACT (1) Background: This study aimed to investigate the association between radioactive iodine (RAI) and long-term cardiovascular disease (CVD) morbidity/mortality in thyroid cancer. (2) Methods: The study was conducted using data from the Taiwan National Health Insurance Database during 2000-2015. Thyroid cancer patients aged ≥20 years were categorized into RAI (thyroidectomy with RAI) and non-RAI (thyroidectomy only) groups. The Cox proportional hazard regression model and Kaplan-Meier method were used for analysis. (3) Results: A total of 13,310 patients were included. Kaplan-Meier analysis demonstrated that the two groups had similar cumulative risks of CVD (log-rank p = 0.72) and CVD-specific mortality (log-rank p = 0.62). On Cox regression analysis of different RAI doses, the risk of CVD was higher in the cumulative dosage >3.7 GBq (hazard ratio = 1.69, 95% confidence interval = 1.24-2.40, p < 0.001). (4) Conclusions: RAI was not associated with an increased risk of CVD in thyroid cancer. However, CVD surveillance is indicated in the patients receiving the cumulative RAI dosage above 3.7 GBq. PMID:34501480 | DOI:10.3390/jcm10174032 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma Via radioactive iodine Cancers (Basel). 2021 Aug 27;13(17):4335. doi: 10.3390/cancers13174335. ABSTRACT PURPOSE: the validation of a new scoring model considering the principal risk factors of differentiated thyroid cancer (DTC) relapse. METHODS: we evaluated all DTC patients treated with thyroidectomy and radioactive iodine (RAI) therapy. Three domains were considered: the demographic domain (age and gender), the surgical domain (histology and the American Thyroid Association risk categories), and the RAI-related domain (pre-RAI thyroglobulin and post-therapeutic 131I whole-body scan). The progression-free survival was assessed. The patients' sample was randomly split into a training and validation set. The three-domain score was calculated as the weighted sum of the levels of each significant factor, then scaled to an integer range (0-100) and, finally, stratified into terciles: mild risk 0-33, moderate risk 34-66, and severe risk 67-100. RESULTS: 907 DTC patients were included. The RAI-related domain was the most relevant factor in the score calculation. The tercile stratification identified significantly different survival curves: patients within the two upper terciles showed approximately 6 to 30 times more progressive risk than patients at mild risk. CONCLUSION: we have validated a three-domain scoring system and the principal impact on this score is provided by the peri-RAI findings, whose prognostic role seems to be essential in risk identificat ion. PMID:34503146 | DOI:10.3390/cancers13174335 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer Via radioactive iodine Cancers (Basel). 2021 Aug 27;13(17):4338. doi: 10.3390/cancers13174338. ABSTRACT This study assessed the long-term predictive value of the response to therapy, evaluated by serum thyroglobulin (Tg) determination and neck ultrasound, and estimated the potential additional impact of diagnostic whole-body scan (WBS) in patients with differentiated thyroid cancer (DTC) treated with surgery and radioactive iodine (RAI) therapy. We retrospectively evaluated 606 DTC patients treated with surgery and RAI. Response to 131I therapy at 12 months was assessed by serum Tg measurement, neck ultrasound, and diagnostic WBS. According to American Thyroid Association (ATA) guidelines, patients were classified as having a low, intermediate or high risk of recurrence and at 12 months as having an excellent response (ER) or no-ER. Follow-up was then performed every 6-12 months with serum Tg determination and imaging procedures. With a median follow-up of 105 months (range 10-384), 42 (7%) events requiring further treatments occurred. Twenty-five patients had additional RAI therapy, 11 with structural disease in the thyroid bed, eight in both thyroid bed and neck lymph nodes, four had lung metastases and two had bone metastases. The other 17 patients had additional surgery for nodal disease followed by RAI therapy. The ATA intermediate and high risk of recurrence, post-operative and pre-RAI therapy Tg ≥ 10 ng/mL, and the absence of ER at 12 months were independent pre dictors of events. Diagnostic WBS at 12 months permitted the identification of only five recurrences among the 219 ER patients according to serum Tg levels and ultrasound. In DTC patients, the response to therapy at 12 months after RAI therapy could rely on serum Tg measurement and neck ultrasound, while diagnostic WBS was not routinely indicated in patients considered in ER. PMID:34503148 | DOI:10.3390/cancers13174338 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Long-Term Prognostic Value of the Response to Therapy Assessed by Laboratory and Imaging Findings in Patients with Differentiated Thyroid Cancer Via radioactive iodine Cancers (Basel). 2021 Aug 27;13(17):4338. doi: 10.3390/cancers13174338. ABSTRACT This study assessed the long-term predictive value of the response to therapy, evaluated by serum thyroglobulin (Tg) determination and neck ultrasound, and estimated the potential additional impact of diagnostic whole-body scan (WBS) in patients with differentiated thyroid cancer (DTC) treated with surgery and radioactive iodine (RAI) therapy. We retrospectively evaluated 606 DTC patients treated with surgery and RAI. Response to 131I therapy at 12 months was assessed by serum Tg measurement, neck ultrasound, and diagnostic WBS. According to American Thyroid Association (ATA) guidelines, patients were classified as having a low, intermediate or high risk of recurrence and at 12 months as having an excellent response (ER) or no-ER. Follow-up was then performed every 6-12 months with serum Tg determination and imaging procedures. With a median follow-up of 105 months (range 10-384), 42 (7%) events requiring further treatments occurred. Twenty-five patients had additional RAI therapy, 11 with structural disease in the thyroid bed, eight in both thyroid bed and neck lymph nodes, four had lung metastases and two had bone metastases. The other 17 patients had additional surgery for nodal disease followed by RAI therapy. The ATA intermediate and high risk of recurrence, post-operative and pre-RAI therapy Tg ≥ 10 ng/mL, and the absence of ER at 12 months were independent pre dictors of events. Diagnostic WBS at 12 months permitted the identification of only five recurrences among the 219 ER patients according to serum Tg levels and ultrasound. In DTC patients, the response to therapy at 12 months after RAI therapy could rely on serum Tg measurement and neck ultrasound, while diagnostic WBS was not routinely indicated in patients considered in ER. PMID:34503148 | DOI:10.3390/cancers13174338 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of stellate ganglion injections guided by different approaches on hearing threshold in patients with sudden deafness

xlomafota13 shared this article with you from Inoreader Effect of stellate ganglion injections guided by different approaches on hearing threshold in patients with sudden deafness Via American Journal of Otolaryngology Publication date: Available online 10 September 2021 Source: American Journal of Otolaryngology Author(s): Hong Zhu, Huafeng Yan, YanE Zhang View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New onset tinnitus in the absence of hearing changes following COVID-19 infection

xlomafota13 shared this article with you from Inoreader New onset tinnitus in the absence of hearing changes following COVID-19 infection Via American Journal of Otolaryngology Publication date: Available online 10 September 2021 Source: American Journal of Otolaryngology Author(s): Ghazal S. Daher, Ashley M. Nassiri, Greg Vanichkachorn, Matthew L. Carlson, Brian A. Neff, Colin L.W. Driscoll View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.