Assessment of pharyngeal motor function using a novel velopharyngeal squeeze maneuver and a novel endoscopic pharyngeal contraction grade scale in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader Assessment of pharyngeal motor function using a novel velopharyngeal squeeze maneuver and a novel endoscopic pharyngeal contraction grade scale in patients with dysphagia after radiotherapy for nasopharyngeal carcinoma Via Head & Neck Abstract Background To investigate a novel velopharyngeal squeeze maneuver (VPSM) and novel endoscopic pharyngeal contraction grade (EPCG) scale for the evaluation of pharyngeal motor function. Methods During endoscopic examination of 77 post-irradiated nasopharyngeal carcinoma patients and control subjects, VPSM was rated and lateral pharyngeal wall movement graded with EPCG scale during swallowing. Pharyngeal constriction ratio (PCR) measured by videofluoroscopy was used for correlation. Results VPSM and EPCG scale showed almost perfect intra-rater and inter-rater reliability (Kappa: >0.90). VPSM was present in 61% of patients suggesting good pharyngeal motor function. VPSM was predictive of EPCG scale (Wald statistic = 29.99, p < 0.001). EPCG scale also correlated strongly with PCR (r: 0.812) and was predictive for aspiration (odds ratio: 22.14 [95% CI 5.01–97.89, p < 0.001]). Conclusions VPSM and EPCG scale are two novel tools to assess pharyngeal motor function, and both correlate well with pharyngeal contractility and aspiration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe COVID‐19: A multicenter prospective cohort study

xlomafota13 shared this article with you from Inoreader Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe COVID‐19: A multicenter prospective cohort study Via Head & Neck Abstract Background Optimal timing for tracheotomy for critically ill COVID-19 patients requiring invasive mechanical ventilation (IMV) is not established. Methods Multicenter prospective cohort including all COVID-19 patients admitted to intensive care units (ICUs) in 36 hospitals who required tracheotomy during first pandemic wave. With a target emulation trial framework, we studied the causal effects of early (7–10 days) versus late (>10 days) tracheotomy (LT) on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Results Of 696 patients, 20.4% received early tracheotomy (ET). ET was associated with faster weaning (hazard ratio [HR] [95% confidence interval, CI]: 1.25 [1.00–1.56]) without differences in mortality (HR [95% CI]: 0.85 [0.60–1.21]) or complications (adjusted rate ratio [95% CI]: 0.56 [0.23–1.33]). Conclusions ET had a similar or lower post-tracheotomy weaning time than LT, potentially shortening IMV and ICU stays, without changing complication or mortality rates in COVID-19 patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Therapeutic approaches and outcomes in patients with larynx or hypopharynx high‐grade neuroendocrine carcinoma: A single‐center retrospective analysis

xlomafota13 shared this article with you from Inoreader Therapeutic approaches and outcomes in patients with larynx or hypopharynx high‐grade neuroendocrine carcinoma: A single‐center retrospective analysis Via Head & Neck Abstract Background High-grade neuroendocrine carcinoma of the larynx (HG-NECL) is rare and aggressive with limited data regarding response to systemic therapy. We evaluated clinicopathological features, therapeutic approaches, and outcomes in patients with laryngeal or hypopharyngeal HG-NECL. Methods Data were retrospectively collected through 1997–2020. Median disease-free (mDFS), progression-free (mPFS), and overall survival (mOS) were estimated using the Kaplan–Meier method. Results Fifteen patients were identified; most had locoregional (N = 7) or metastatic disease (N = 5). The main curative-intent treatment was chemoradiation concurrent with platinum-based chemotherapy; the rate of complete response was 78%. Most patients (80%) developed recurrence; the mDFS was 13.1 months. For the first-line palliative therapy, the ORR and mPFS were 50% and 3.1 months, respectively. For all patients, the mOS was 17.8 months, and 8.6 months for metastatic disease. Conclusion Laryngeal HG-NEC is associated with high relapse rates and dismal prognosis for those with recurrent/metastatic disease. Novel therapeutic strategies are needed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The prognostic impact of depression or depressive symptoms on patients with head and neck cancer: A systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader The prognostic impact of depression or depressive symptoms on patients with head and neck cancer: A systematic review and meta‐analysis Via Head & Neck Abstract Background This systematic review and meta-analysis sought to assess the extent to which pretreatment depression or depressive symptoms are related to prognosis in patients with head and neck cancer (HNC). Methods Medline, EMbase, Scopus, and The Cochrane Library databases were searched. A meta-analysis was done to generate a forest plot and pooled hazard ratio (HR) with 95% CI for overall survival (OS). RevMan 5.3 and Meta Essentials were used for statistical analysis. Results Based on seven studies involving 1743 patients, the results showed that HNC patients with pretreatment depression or depressive symptoms had worse OS than patients without depression or depressive symptoms, with an HR of 1.33, 95% CI 1.16–1.52, p = <0.0001. There is heterogeneity in the pooled summary effect (I 2 = 80%, p < 0.0001). Conclusions Pretreatment depression or depressive symptoms may indicate worse OS in patients with HNC. The pooled analysis demonstrated a statistically significant effect. These results were limited by mild heterogeneity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroid Hemiagenesis Accompanying an Ectopic Lingual Thyroid

xlomafota13 shared this article with you from Inoreader Thyroid Hemiagenesis Accompanying an Ectopic Lingual Thyroid Via ear nose throat Ear Nose Throat J. 2021 Sep 16:1455613211036229. doi: 10.1177/01455613211036229. Online ahead of print. ABSTRACT Lingual thyroid is an uncommon condition and cases accompanying thyroid hemiagenesis are rarely documented. Patients with thyroid hemiagenesis are usually asymptomatic and generally diagnosed incidentally. Herein, we reported the case of thyroid hemiagenesis accompanying an ectopic lingual thyroid with euthyroidism and presented with regional symptoms. PMID: 34525880 | DOI:10.1177/01455613211036229 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sinonasal Tissue Remodelling during Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader Sinonasal Tissue Remodelling during Chronic Rhinosinusitis Via International Journal of Otolaryngology The purpose of this review is to summarise contemporary knowledge of sinonasal tissue remodelling during chronic rhinosinusitis (CRS), a chronic disease involving long-term inflammation of the paranasal sinuses and nasal passage. The concept of tissue remodelling has significant clinical relevance because of its potential to cause irreversibility in chronic airway tissues. Recent studies have indicated that early surgical treatment of CRS may improve clinical outcome. Tissue remodelling has been described in the literature extensively with no consensus on how remodelling is defined. This review describes various factors implicated in establishing remodelling in sinonasal tissues with a special mention of asthma as a comorbid condition. Some of the main histological features of remodelling i nclude basement membrane thickening and collagen modulation. This may be an avenue of research with regard to targeted therapy against remodelling in CRS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Functional Outcomes in Tracheoesophageal Voicing With Intratracheal Pressures and Esophagram Findings

xlomafota13 shared this article with you from Inoreader Association of Functional Outcomes in Tracheoesophageal Voicing With Intratracheal Pressures and Esophagram Findings Via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study examines the association between intratrache al manometric pressure, speech function, and proximal esophageal abnormalities in patients with tracheoesophageal voice prosthesis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sensitivity of Communicative Participation Item Bank for Measuring Unilateral Vocal Fold Immobility

xlomafota13 shared this article with you from Inoreader Sensitivity of Communicative Participation Item Bank for Measuring Unilateral Vocal Fold Immobility Via JAMA Otolaryngology–Head & Neck Surgery Online First This case series examines differences in patients' scores on the Communicative Participation Item Bank before and after treatment of unilateral vocal fold immobility and how the scores compare with qualitative self-reports of treatment outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Case of Clofazimine-Induced Purple Nasal Mucosal Discoloration

xlomafota13 shared this article with you from Inoreader A Novel Case of Clofazimine-Induced Purple Nasal Mucosal Discoloration Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a woman in her 70s with a history o f Mycobacterium abscessus pulmonary infection refractory to multiple medication regimens over the preceding decade who presented with clofazimine-induced purple nasal mucosal discoloration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cystic Neck Mass

xlomafota13 shared this article with you from Inoreader Message: A 44-year-old woman presented to the otolaryngology clinic with a 6-month history of a right neck mass with compressive symptoms. She first noticed swelling that progressed to pressure and dyspnea while supine. She reported fatigue but denied pain, voice change, weight loss, hemoptysis, and dysphagia. A physical examination revealed a visible and palpable fullness to the right neck without overlying cutaneous or sinus tract changes. Results of a complete blood cell count, a thyroid stimulating hormone test, triiodothyronine and levorotatory thyroxine testing, and a complete metabolic panel were normal. Ultrasonography showed a 7.9 × 6.3-cm septate cystic mass lateral to the right thyroid gland. A contrast-enhanced computed tomography scan of the neck demonstrated a large, nonenhancing cystic-appearing lesion abutting the lateral and posterior margins of the right thyroid lobe and extending from th e level of the piriform sinus to the thoracic inlet (Figure). Ultrasound-guided fine-needle aspiration revealed clear fluid with a parathyroid hormone (PTH) level of 67 pg/mL (reference range, <100 pg/mL; to convert to ng/L multiply by 1.00). A barium swallow study showed no communication between the cyst and the piriform sinus. Excision in the operating room was performed, and right thyroid lobectomy was necessary because of the intimate association of the lesion to the thyroid lobe. Cystic Neck Mass Via JAMA Otolaryngology–Head & Neck Surgery Online First A 44-year-old woman presented with a 6-month history of a righ t neck mass with compressive symptoms. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Defective Levothyroxine Response in a Patient with Dyshormonogenic Congenital Hypothyroidism Caused by a Concurrent Pathogenic Variant in Thyroid Hormone Receptor-β

xlomafota13 shared this article with you from Inoreader Defective Levothyroxine Response in a Patient with Dyshormonogenic Congenital Hypothyroidism Caused by a Concurrent Pathogenic Variant in Thyroid Hormone Receptor-β Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pilot study on the value of Raman spectroscopy in the entity assignment of salivary gland tumors

xlomafota13 shared this article with you from Inoreader Pilot study on the value of Raman spectroscopy in the entity assignment of salivary gland tumors Via Head and neck cancers by Till Jasper Meyer, Elena Gerhard-Hartmann, Nina Lodes, Agmal Scherzad, Rudolf Hagen, Maria Steinke, Stephan Hackenberg Background The entity assignment of salivary gland tumors (SGT) based on histomorphology can be challenging. Raman spectroscopy has been applied to analyze differences in the molecular composition of tissues. The aim of this study was to evaluate the suitability of RS for entity assignment in SGT. Methods Raman data were collected in deparaffinized sections of pleomorphic adenomas (PA) and adenoid cystic carcinomas (ACC). Multivariate data and chemometric analysis were completed using the Unscrambler software. Results The Raman spectra detected in ACC samples were mostly assigned to nucleic acids, lipids, and amides. In a principal component-based linear discriminant analysis (LDA) 18 of 20 tumor samples were classified correctly. Conclusion In this proof of concept study, we show that a reliable SGT diagnosis based on LDA algorithm appears possible, despite variations in the entity-specific mean spectra. However, a standardized workflow for tissue sample prep aration, measurement setup, and chemometric algorithms is essential to get reliable results. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.