Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes

xlomafota13 shared this article with you from Inoreader Transoral robotic surgery (TORS) using the da Vinci Xi: prospective analysis of feasibility, safety, and outcomes Via Head & Neck Abstract Background The da Vinci Xi system is not Food and Drug Administration approved for transoral robotic surgery (TORS), resulting in limited data. Methods This prospective study evaluates the feasibility, safety, and outcomes of Xi-TORS in an oncological setting. Results Sixty-one patients with head and neck cancer were consecutively included for Xi-TORS. Adequate exposure and macroscopically complete resection were achieved in 59 patients (success rate = 96.7%). Intraoperative difficulties and complications were encountered in 47.5% and 20.3% of patients, respectively. Postoperative hemorrhage occurred in 11.9%; no treatment-related deaths were encountered. Two-year overall survival and disease-specific survival were 90.5% and 95.6%, respectively. No long-term (>1 month) tracheotomies were necessary, and only two patients remained tube-feeding dependent. The functional baseline level was regained at 12 months for the MD Anderson Dysphagia Inventory and at 24 months for the Swallowing quality-of-life questionnaire. QLQ-H&N35-assessed QOL returned to baseline 6 months postoperatively. Conclusions Xi-TORS is safe, feasible, and with high oncological and functional effectiveness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improvement of Pulmonary Function in Arthrogryposis Multiplex Congenita Patients Undergoing Posterior Spinal Fusion Surgery for Concomitant Scoliosis: A Minimum of 3-Year Follow-up

xlomafota13 shared this article with you from Inoreader Improvement of Pulmonary Function in Arthrogryposis Multiplex Congenita Patients Undergoing Posterior Spinal Fusion Surgery for Concomitant Scoliosis: A Minimum of 3-Year Follow-up Via leak of cerebrospinal fluid World Neurosurg. 2021 Oct 20:S1878-8750(21)01612-0. doi: 10.1016/j.wneu.2021.10.115. Online ahead of print. ABSTRACT OBJECTIVE: We sought to investigate the long-term outcome of pulmonary function for arthrogryposis multiplex congenita (AMC) patients undergoing posterior spinal fusion (PSF) and to further determine influential factors. METHODS: Eighteen AMC patients with a minimum of 3-year follow-up after PSF were prospectively collected. All the patients underwent a pulmonary function test before surgery and at the final follow-up. The percentage predicted values of vital capacity (VC%) and forced vital capacity (FVC%) were recorded. The following radiographic parameters were collected including Cobb angle and thoracic kyphosis. The total lung volumes (TLV) were measured on the image of 3-dimensional computed tomography scan by the reconstruction software. RESULTS: There were 10 males and 8 females with a mean age of 13.8 ± 6.1 years. The mean preoperative VC% and FVC% were 40.5% ± 7.6% and 39.5% ± 4.7%, which were significantly increased to 52.0% ± 7.5% and 51.2% ± 6.8% at the final follow-up (P < 0.001). Besides, there was remarkable improvement in terms of TLV (1.57 ± 0.2 L vs. 2.39 ± 0.6 L, P < 0.001). Remarkable correlations were observed between TLV and pulmonary function tests (r = 0.79, P < 0.001 for VC%; r = 0.78, P < 0.001 for FVC%). Multiple regression analysis showed that 2 variables including Δ thoracic kyphosis and Δ Cobb angle were independently associated with the improvement of pulmonary function. CONCLUSIONS: The pulmonary function of AMC patients can be well improved through PSF surgery. It was remarkably associated with the correction of curve magnitude and restoration of thoracic kyphosis. PMID:34687931 | DOI:10.1016/j.wneu.2021.10.115 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Intracranial Hypotension and Post-Dural Puncture Headache

xlomafota13 shared this article with you from Inoreader Pediatric Intracranial Hypotension and Post-Dural Puncture Headache Via leak of cerebrospinal fluid Semin Pediatr Neurol. 2021 Dec;40:100927. doi: 10.1016/j.spen.2021.100927. Epub 2021 Sep 3. ABSTRACT Pediatric intracranial hypotension can occur acutely following iatrogenic dural puncture for diagnostic or therapeutic purposes, or chronically from cerebrospinal fluid leak. The incidence of intracranial hypotension in children is not fully known. However, many steps can be taken to reduce the risk of a child developing a post-dural puncture headache. Other causes of intracranial hypotension, such as spontaneous intracranial hypotension or CSF fistulas, are rare and with little pediatric data to guide evaluation and management. This manuscript reviews the risk factors, diagnostic evaluations, and treatments for post-dural puncture headache, as well as a limited discussion of spontaneous intracranial hypotension as it may pertain to children and adolescents. PMID:34749914 | DOI:10.1016/j.spen.2021.100927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of three kinds of free flaps used in patients with oral and oropharyngeal tumors

xlomafota13 shared this article with you from Inoreader Comparison of three kinds of free flaps used in patients with oral and oropharyngeal tumors Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1150-1157. doi: 10.3760/cma.j.cn115330-20210719-00468. ABSTRACT Objective: To compare the recovery and quality of life of patients with oral and oropharyngeal tumors treated with three kinds of free soft tissue flaps. Methods: The clinical data of 103 patients, including 66 males and 37 females, aged 26-74 years, who underwent primary repair of defects after resection of oral and oropharyngeal tumors in Sichuan Tumor Hospital from July 2014 to August 2020 were analyzed. Anterolateral thigh flap (ALTF) was used in 43 patients, radial forearm free flap (RFFF) in 45 patients, and lateral arm free flap (LAFF) in 15 patients. Postoperative qualities of life of patients were evaluated by the university of Washington quality of life questionnaire and oral health impact scale (HIP-14 Chinese edition). SPSS 23.0 software was used for statistical analysis. Results: The T staging of RFFF or LAFF group was significantly lower than that of ALTF group (P<0.05). There was no significant difference in mean flap areas between ALTF group ((55.87±27.38) cm2) and LAFF group ((49.93±19.44) cm2), while RFFF group had smaller mean flap area ((33.18±6.05) cm2) than ALTF group (t=5.311, P<0.001) and LAFF group (t=3.284, P=0.005). In terms of oral functions including swallowing, mastication, taste and spitmouth, there were no significant differences between LAFF group and RFFF group (P>0.05), but both groups had better oral functions than ALTF group (P<0.05). There was no significant difference in appearance scores between LAFF group (75(75, 75)) and ALTF group (75(75,75) vs.75(75,75),Z=-1.532, P=0.126), and both groups had higher scores than RFFF group (50(50, 75),Z values were -3.447 and -3.005 respectively, P<0.05). RFFF grou p had higher speech score (100(67, 100)) than LAFF group (67(50, 76),Z=-2.480, P<0.05) and ALTF group (67(33, 67),Z=-5.414, P<0.05). ALTF group had lower mean score of quality of life than RFFF group [72(56,77) vs.79(69, 89),Z=-3.070, P<0.05), but there was no statistical difference in the mean scores of qualities of life between ALTF group and LAFF group (Z=1.754, P=0.079). According to the evaluation of oral health impact scale (HIP-14 Chinese version) 1 year after surgery, individual item scores and the average score of all items in ALTF group were lower than those in RFFF and LAFF groups (P<0.05), with no significant difference between RFFF group and LAFF group (P>0.05). Conclusions: RFFF has unique advantages for small tissue defects, while ALTF is suitable for large tissue defects, such as buccal penetrating defect, whole tongue and near whole tongue defect, and LAFF is a compromise cho ice between ALTF and RFFF. ALTF is inferior to RFFF and LAFF in oral functional reconstruction, including swallowing, chewing, taste and spittle. ALTF and LAFF are superior to RFFF in postoperative appearance. PMID:34749453 | DOI:10.3760/cma.j.cn115330-20210719-00468 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Simultaneous cochlear implantation and translabyrinthine removal of vestibular schwannoma in type 2 neurofibromatosis caused by a deletion of 22q12.1-q12.2 including NF2 gene

xlomafota13 shared this article with you from Inoreader Simultaneous cochlear implantation and translabyrinthine removal of vestibular schwannoma in type 2 neurofibromatosis caused by a deletion of 22q12.1-q12.2 including <em>NF2</em> gene Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1199-1204. doi: 10.3760/cma.j.cn115330-20201105-00854. NO ABSTRACT PMID:34749460 | DOI:10.3760/cma.j.cn115330-20201105-00854 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiological investigation of tinnitus

xlomafota13 shared this article with you from Inoreader Epidemiological investigation of tinnitus in Sichuan and Chongqing Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1164-1173. doi: 10.3760/cma.j.cn115330-20201019-00816. ABSTRACT Objectives: To investigate the prevalence and associated risk factors of tinnitus in Sichuan and Chongqing. Methods: We designed a tinnitus epidemiological questionnaire. The multi-stage stratified cluster random sampling methods was applied to obtain study subjects in six areas (Nanchong, Jiangjin, Fengdu, Yunyang, Suining and Ya'an), which were selected for epidemiological investigation. Home visit completion of epidemiological questionnaires was conducted. The trained investigators guided the respondents to fill in the tinnitus epidemiological questionnaires, and the epidemiological status of six areas on prevalence and risk factor was investigated. SPSS 22.0 software was used for statistical analysis. Results: Sampling population were 10 289, in which 9 273 were valid questionnaires. There were 4 281 males and 4 992 females, with an average age of 47.3 years, among which 34.83% (3 230/9 273) had tinnitus. 3.99% (370/9 273) were diagnosed with bothersome tinnitus. In a multivariable logistic regression mod, the following factors were associated with onsetting of tinnitus: sleep disorder [Odds Ratio(OR)=3.74] and noise exposure(OR=1.99). The risk of disease was lowest in the age of 30-40 years old, while the risk of disease was higher for people under 30 and over 40. In another multivariable logistic regression mode, the following factors were associated with having bothersome tinnitus: older people were more likely to suffer from tinnitus, sleep disorders (OR=4.68) and noise exposure (OR=1.56). Conclusions: The prevalence of tinnitus in Sichuan and Chongqing is about 34.83%, but most of the tinnitus is short-lived and has low loudness, which will not affect the patients. Only a small number of patients with tinnitus (3.99%) pers ist and affect their health and need treatment. The occurrence and exacerbation of tinnitus may be related to sleep, age, and noise exposure. PMID:34749455 | DOI:10.3760/cma.j.cn115330-20201019-00816 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Drainage of intraorbital abscess in infant via endoscopic nasalsinus approach: a case report

xlomafota13 shared this article with you from Inoreader Drainage of intraorbital abscess in infant via endoscopic nasalsinus approach: a case report Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1204-1206. doi: 10.3760/cma.j.cn115330-20201223-00946. NO ABSTRACT PMID:34749461 | DOI:10.3760/cma.j.cn115330-20201223-00946 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resection and free flap repair of recurrent maxillofacial and paranasal sinus skull base malignant tumor: report of 9 cases

xlomafota13 shared this article with you from Inoreader Resection and free flap repair of recurrent maxillofacial and paranasal sinus skull base malignant tumor: report of 9 cases Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1179-1184. doi: 10.3760/cma.j.cn115330-20210223-00082. ABSTRACT Objective: To investigate the treatment method and effect of surgical resection and free flap repair of recurrent malignant tumors of maxillofacial paranasal sinus and skull base. Methods: The clinical data of 9 patients with recurrent maxillofacial paranasal sinus and skull base malignant tumors who underwent surgical resection and free flap repair in the Department of Otorhinolaryngology Head and Neck Surgery of Shandong Provincial Hospital from August 2009 to May 2019 were analyzed retrospectively, including 5 males and 4 females, aged 32-69 years. There were 4 cases of squamous cell carcinoma, 3 cases of adenoid cystic carcinoma, 1 case of myoepithelial carcinoma and 1 case of malignant fibrous histiocytoma. All patients were repaired with anterolateral femoral flap. The treatment process an d postoperative effect were analyzed by descriptive statistics. Results: All patients were followed up from 16 months to 6 years. There were 6 cases of recurrence after operation, including 1 case of local recurrence and 5 cases of skull base and craniocerebral recurrence. The median tumor free survival time of recurrent patients was 35 months. Conclusion: Surgical resection and free flap repair can effectively prolong the life of patients with recurrent maxillofacial paranasal sinus and skull base malignant tumors. PMID:34749457 | DOI:10.3760/cma.j.cn115330-20210223-00082 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rhinocerebral mucormycosis secondary to acute leukemia: a case report

xlomafota13 shared this article with you from Inoreader Rhinocerebral mucormycosis secondary to acute leukemia: a case report Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1207-1209. doi: 10.3760/cma.j.cn115330-20210122-00030. NO ABSTRACT PMID:34749462 | DOI:10.3760/cma.j.cn115330-20210122-00030 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical features of vestibular syncope associated with tumarkin attacks in delayed endolymphatic hydrops

xlomafota13 shared this article with you from Inoreader Clinical features of vestibular syncope associated with tumarkin attacks in delayed endolymphatic hydrops Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1194-1198. doi: 10.3760/cma.j.cn115330-20201208-00912. ABSTRACT Objective: To analyze the clinical characteristics of vestibular syncope (VS) associated with drop attacks (DA) in delayed endolymphatic hydrops (DEH). Methods: DEH cases with complete data were retrospectively analyzed, including three DEH cases with DA and VS (VS group), and six DEH cases without DA or VS (control group). The clinical profile, the results of neurotological examinations [such as pure tone audiometry, electrocochleography (EcochG), caloric test, vestibular evoked myogenic potentials (VEMP), and video head impulse test (vHIT)] and treatment outcomes were analyzed. Results: (1) In the VS group, there were three cases of ipsilateral DEH; in the control group, there were six cases of ipsilateral type. One case in each group had a history of migraine. (2) The prevalence of abn ormal results in caloric test, vHIT, cervical VEMP, and ocular VEMP in the VS group was 3/3, 1/3, 2/2, and 2/2, respectively, and in the control group was 3/6, 0/3, 1/6, and 4/6, respectively. Two cases in each group underwent EcochG, and no identifiable waveform was elicited on the affected side, and-SP/AP ratio of unaffected side was less than 0.4. (3) Patients in both groups were initially treated with conservative medication. Two cases in the VS group subsequently received intratympanic injections of dexamethasone. No DA or VS occurred during a follow-up period lasting over one year. All patients achieved good control of vertigo during the follow-up period. Conclusions: VS may occur in the patients with DEH. The differential diagnosis of syncope in patients with otogenic vertiginous disease can help improve clinical diagnosis and treatment. PMID:34749459 | DOI:10.3760/cma.j.cn115330-20201208-00912 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction

xlomafota13 shared this article with you from Inoreader Clinical comparative study of free posterior tibial artery perforator flap and radial forearm free flap for head and neck reconstruction Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Nov 7;56(11):1158-1163. doi: 10.3760/cma.j.cn115330-20210518-00280. ABSTRACT Objective: To compare the clinical application results of the FPTF (free posterior tibial artery perforator flap) and RFFF (radial forearm free flap) for reconstruction of head and neck defects. Methods: A retrospective analysis of 27 cases treated with FPTF (19 males and 8 females, aged 14-69 years) and 24 cases with RFFF (11 males and 13 females, aged 22-69 years) for head and neck defect reconstruction at Beijing Tongren Hospital of Capital Medical University from January 2015 to December 2020 was conducted. Flap size, vascular pedicle length, matching degree of recipient area blood vessels, preparation time, total operation time, hospital stay, recipient area complications, donor area complications and scale-based patient satisfaction were compared between two groups of patients with FTPF an d RFFF. SPSS 26.0 statistical software was used for statistical analysis. Results: There was no statistically significant difference between the two groups of patients in tumor T staging (P=0.38), primary sites (P=0.05) and mean flap areas ((53.67±29.84) cm2 vs. (41.13±11.08) cm2, t=-1.472, P=0.14). However the mean vascular pedicle length of FPTF was more than that of RFFF ((11.15±2.48)cm vs. (8.50±1.69)cm, t=-4.071, P<0.01). The donor sites of 4 patients in FPTF group could be sutured directly, while all the 24 patients in RFFF group received skin grafts from the donor sites. There was no statistically significant difference in the recipient area arteries between two groups of flaps (P=0.10), with more commonly using of the facial artery (RFFF: FPTF=21∶27), but there was significant difference in the recipient area veins (P<0.01), with more commonly using of the external jugular vein in RFFF (14/24) than FPTF (4/32) and the posterior facial vein in FPTF (27/32) than RFFF (9/24). There were 10 recipient complications and 3 donor complications in RFFF group; no recipient complication and 3 donor complications occurred in FPTF group. With patient's subjective evaluation of the donor site at 12 months after surgery, FPTF was better than RFFF (χ²=22.241, P<0.01). Conclusions: FPTF is an alternative to RFFF in head and neck reconstruction and has unique advantages in aesthetics and clinical application. PMID:34749454 | DOI:10.3760/cma.j.cn115330-20210518-00280 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.