| Dentists as Vanguard of Oral Health Rooban Thavarajah Journal of Orofacial Sciences 2018 10(2):57-58 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Clinical Complications in Procedures for Horizontal Bone Augmentation Through Autologous Onlay Grafts Obtained From the Mandibular Ramus: An Observational Study Daniel R.B de Resende, Aline Siqueira, Eduardo Rosas, Eduardo Borie Echevarría Journal of Orofacial Sciences 2018 10(2):59-62 Aim and Objective : The aim of this study was to describe clinically the prevalence of postsurgical complications in a group of patients treated with autologous bone grafts obtained from the mandibular ramus. Materials and Methods: Data were obtained from a sample of 76 adults, who were subjected to a surgical procedure of horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line of mandible. A total of 113 onlay grafts were removed and placed in 152 recipients’ area, previously fitted to the receptor site and stabilized through two fixation screws. All complications were recorded in relation to the recipient and donor sites, and the follow-up time of the sample was of 2 years. Results: Of the entire sample studied, 69.7% did not show any type of postsurgical complication; however, 30.3% of them exhibited a type of complication, with temporary paresthesia being the most prevalent (7.9%). Conclusion: More than 30% of the patients that received horizontal bone augmentation through autologous onlay bone grafts obtained from the oblique line according to the conventional technique showed some type of postsurgical complication. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Age Estimation by Modified Demirjian's Method in Children and Adolescents of Hyderabad Population—A Panoramic Study M. Priyanka, G. Kiran, R. Poornima, R. Shravani, K. C. Shobhita, P. Preethi Journal of Orofacial Sciences 2018 10(2):63-68 Introduction: Human identification is one of the most important tasks of forensic practitioner. Estimation of age is one of the essential factors which play a significant role in each aspect of life, including forensic medicine and dentistry, wherein race, age, and sex determination are used in person identification. Aims and Objectives: To correlate the relationship between chronological age (CA) with dental age (DA) using modified Demirjian’s method and to establish the applicability of modified Demirjian’s method in Hyderabad population. Materials and Methods: Our study samples consist of 113 randomly selected samples (39 males and 74 females) of age ranging from 8 to 20 years of Hyderabad population for children and adolescents. Panoramic radiographs of these patients were evaluated based on the modified Demirjian’s method. The obtained data were tabulated and analyzed using SPSS version 20.0. Results: The present study showed a significant correlation between CA and DA in both females (r = 0.84) and males (r = 0.882). The overall mean difference between the DA and CA for females and males was +1.14 and +0.86, respectively. In the whole sample, DA was found to be over estimated by +1.04 with CA. Conclusion: DA overestimated the CA by +1.04 years. According to the present study, there was a difference and overestimation of DA in comparison with CA in Hyderabad population and hence population specific formula for each area is necessary. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Comparison of the Shear Bond Strength of Treated and Untreated Brackets on Treated and Untreated Enamel Surfaces in Rebonding Delal Dara Kilinc, Gülşilay Sayar Journal of Orofacial Sciences 2018 10(2):69-74 Aim and Objective: This study aimed to compare the shear bond strength (SBS) of treated and untreated brackets on treated and untreated enamel surfaces in rebonding. The null hypothesis was that there was no difference between the SBS of the treated and untreated rebonded brackets on treated and untreated enamel surfaces. Materials and Methods: Fifty extracted premolars were bonded by the same conventional bonding method and then debonded, and the SBS of each tooth was recorded. The debonded brackets and teeth were divided into two equal groups. In the first group, the debonded brackets were recycled by direct flaming followed by alumina oxide sandblasting, and the teeth were treated with a tungsten carbide bur applied with a low-speed hand piece. In the second group, neither the teeth surfaces nor the bracket bases were treated. Rebonding was performed followed by debonding, and the SBS of each tooth was recorded again. Results: Both rebonded bracket groups showed lower SBS results than that of the first debonding tests. A statistically significant difference was found within the untreated bracket groups between the first and second debonding test (P < 0.001). Conclusion: The rebonding of treated enamel surfaces and treated bracket bases showed higher SBS values compared to the untreated ones. The null hypothesis was rejected. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Association of Maternal and Child Dental Anxiety With Dental Caries Experience and Dental Attendance Pattern of the Child Shruti Balasubramanian, Suprabha B Shrikrishna, Ramya Shenoy, Arathi Rao Journal of Orofacial Sciences 2018 10(2):75-79 Introduction: Children with early childhood caries may have dental anxiety. Maternal anxiety can influence the child dental anxiety. Aims and Objective: To explore the association of maternal and child dental anxiety with the dental caries experience and the dental attendance pattern of the child. Materials and Methods: This cross-sectional study involved 227 mother–child dyads with children aged between 3 and 6 years. Mothers answered a questionnaire on dental attendance pattern. Corah’s dental anxiety scale was used to assess maternal anxiety, and facial image scale was used to assess dental anxiety in children. The “dmft” index of the child was recorded by a calibrated dentist. Statistical tests (Chi-square and Student’s t-tests) were employed to analyze the data, and P < 0.05 was considered significant. Result: Maternal anxiety was significantly associated with the mean number of missing and filled teeth in children (P = 0.005; P < 0.001, respectively). Child anxiety was significantly associated with the mean number of missing teeth (P < 0.001), increased frequency of missed dental appointments (P = 0.003), and decreased the frequency of dental visits (P = 0.008). Conclusion: Both maternal and child dental anxiety can influence the dental caries experience of the child. The dental anxiety of the child can influence the dental attendance pattern. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Assessment of Sagittal Skeletal Base Relationship of Maxilla and Mandible by Horizontal Appraisal Method—A Comparative and Reliability Study Paoulomi Roy, Supriya Nambiar, B. Unnikrishnan, Asavari Desai, C. Suresh Journal of Orofacial Sciences 2018 10(2):80-85 Introduction: The evaluation of antero-posterior apical base relationship is crucial before orthodontic diagnosis and treatment planning. Aim and Objectives: The present study is aimed to compare the credibility of five cephalometric measurements in assessing the antero-posterior jaw relationship and to assess the correlation between various measurements used for antero-posterior discrepancy, including ANB, Yen angle, Beta angle, Wits appraisal, and horizontal appraisal. Materials and Methods: A total of 99 patients aged 16 years and above patients were subdivided into skeletal Classes I, II, and III groups of 33, each based upon the ANB angle derived from the pretreatment cephalogram. Results: The results showed that AH/BH and ANB had very high sensitivity and specificity to discriminate a Class II from Class I and Class III from Class I. Wits, YEN, and Beta showed lower specificity to differentiate Class II from Class I and Wits and Yen to differentiate Class III from Class I except Beta which had 100% sensitivity to differentiate Class III from Class I. Conclusion: The horizontal appraisal method enriches the current cephalometric tools available for the clinician to assess the antero-posterior jaw relationship accurately and reproducibly. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| A Study on Drug-Induced Tardive Dyskinesia: Orofacial Musculature Involvement and Patient's Awareness Arunachalam M Anusa, Rooban Thavarajah, Dinesh Nayak, Elizabeth Joshua, Umadevi Krishnamohan Rao, Kannan Ranganathan Journal of Orofacial Sciences 2018 10(2):86-95 Aim and Objective: Schizophrenia is a psychiatric disorder that requires long-term treatment. Long-term antipsychotic treatment is often associated with the emergence of tardive dyskinesia (TD), the severity of which is measured by Abnormal Involuntary Movement Scale (AIMS). This study examined the relationship among TD, orofacial musculature activity, and patient’s awareness of Abnormal Involuntary Movement (AIM). The knowledge would help dentists to deliver oral care for schizophrenics with TD. Materials and Methods: We identified 317 patients from a standard, data sharing initiative, of whom 38.3% exhibited AIM score of 2 to 15. The patient demographics, drug history, details of AIMS were subjected to descriptive and inferential statistical analysis using SPSS with P ≤ 0.05 as significance. Results: The mean of only orofacial features (n = 56) was 3.43 ± 2.68. Muscles of facial expression was involved in nine (7.9% of all TD), lip/perioral area in 27 (23.68%), jaw in 52 (45.61%), and tongue in 77 (67.54%). The patient’s perception of AIM precipitated stress when involving jaw, tongue, limbs, and trunk was statistically significant (P ≤ 0.05). The multiple regression model statistically significantly predicted TD for factors considered. Conclusion: Around 1% of global population is being diagnosed with schizophrenia, carry an inherent risk of developing TD. They might have orodental care requirements, including prosthodontic and restorative services. Primary physicians and dentists need to be aware of TD and its mechanism for appropriate patient management. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Effect of Orthodontic Sealant Containing Antimicrobial Selenium on the Shear Bond Strength of Orthodontic Bracket Pinandi S Pudyani, Fibriana Safitri, Ananto A Alhasyimi Journal of Orofacial Sciences 2018 10(2):96-100 Intoduction: Fixed orthodontic treatment has a high risk of enamel demineralization. Sealant containing selenium is a material that has been developed to prevent enamel demineralization and stated to be applicable as a primer bracket adhesion. Aim and Objective: This aim of this study was to investigate the shear bond strength (SBS) of an orthodontic bracket after application of sealant containing selenium as a primer. Materials and Methods: A total of 100 extracted human premolars were used in this study, which were randomly divided into two groups. Group I consisted of 50 teeth as the control group, to which a conventional primer (CP) was applied, whereas for group II comprising 50 teeth, a sealant containing selenium selenium primer (SP) was applied. SBS of the orthodontic brackets was measured using a universal testing machine. The adhesive remnant index (ARI) scores were calculated to determine the location of the bond failure using a stereomicroscope. A t test was used for analyzing the SBS data, whereas the Mann–Whitney test was used for analyzing the ARI scores. Results: There was no significant SBS difference (P > 0.05) between CP and SP groups. CP groups showed slightly higher SBS [9.05 ± 3.10 megapascal (MPa)] than that in the SP groups (8.21 ± 3.78 MPa). The bond failures of both the groups occurred at the adhesive–adhesive interface. Conclusion: The results showed that sealant containing selenium can be used as a primer within orthodontic adhesive material, as the physical–mechanical properties remained unchanged. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Does Darkening of Roots or Loss of White Line on Panoramic Radiographs Pose a Risk for Inferior Alveolar Nerve Damage? A CBCT Evaluation Chintan M Savani, Kishan Panicker, B. Sarat Ravi Kiran, Uday Kiran Uppada Journal of Orofacial Sciences 2018 10(2):101-107 Introduction: Surgical removal of impacted mandibular third molars may cause dysesthesia due to damage to the inferior alveolar nerve (IAN), and the risk increases when there is direct contact between the nerve and the tooth root. An accurate preoperative radiographic examination using Cone beam computed tomography (CBCT) provides precise information pertaining the relationship between the third molar roots and the inferior alveolar canal. Aim & Objective: This study was intended to correlate the two panoramic radiographic findings in predicting the absence of corticalization between the mandibular canal and the third molar on cone beam computed tomography (CBCT) images and to evaluate the possibility of inferior alveolar nerve (IAN) injury. Materials and Methods: The study was conducted on 60 patients, who were divided into two groups of 30 each. Group I included 30 patients whose panoramic radiographic findings showed darkening of the root of impacted mandibular third molar. Group II included 30 patients whose panoramic radiographic findings showed interruption of white line of mandibular canal. The patients whose panoramic radiographic findings showed darkening of the root or interruption in the white line of the canal were subjected to CBCT examination. Surgical removal of impacted mandibular third molar in all the patients was performed under local anesthesia (LA). Evaluation for any nerve injury was performed and recorded as presence or absence of paresthesia at regular postoperatively. Results: The results of this study showed that 46.7% patients had absence of cortication in Group I (darkening of roots), whereas it was absent in 33.3% of patients in Group II (loss of white lines). Presence of cortication was seen in 53.3% of patients in Group I when compared to 66.7% in Group II. The difference between the groups was not found to be statistically significant. Conclusion: Darkening of roots and interruption of white line observed on panoramic radiographs, both as isolated findings and in association, were effective in determining the risk relationship between the tooth roots and the mandibular canal necessitating CBCT evaluation. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Cytological Method of Barr Body Expression in Dental Pulp Tissue at Varying Temperature Ambika Murugesan, Sekar Balakrishnan, Indra Priyadharshini Kumaresan, Arun Jayakumar, Jayashree Mohan, Bharath Champakesan Journal of Orofacial Sciences 2018 10(2):108-111 Introduction: Natural disasters in large population need major attention in person identification. It can be performed by means of simple techniques that are easier to use. Aim: To identify the Barr body in female dental pulp by cytological method, after exposing at varying temperature. Objective: The expression of Barr bodies was compared among different age groups, various temperature, and two types of stain. Materials and Methods: Teeth obtained from 60 female individuals were divided into two groups based on their age. In each group, 30 teeth were exposed at three different temperatures (200°C, 300°C, and 400°C), 10 teeth in each temperature. The pulp tissue obtained from teeth was centrifuged and stained with hematoxylin and eosin (H&E) and Papanicolaou stain (PAP). Presence of visible sex chromatin in the nuclear periphery was considered positive for Barr chromatin test. The results obtained were analyzed by both descriptive analysis and independent t-test. Result: The peripherally condensed Barr body in hyperchromatic nuclear outline was clearly visible in younger individuals at 200°C and is more accurately expressed in H&E stain. Conclusion: In our study, based on the results obtained from the smear of pulp tissue, expression of Barr bodies’ decreases as age and temperature increases. Further study with increase in sample size is mandatory to confirm the above conclusion.
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Τετάρτη 2 Ιανουαρίου 2019
Orofacial Sciences
Erratum on “Anatomical terminology of the internal nose and paranasal sinuses: cross-cultural adaptation to Portuguese”
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Thiago Freire Pinto Bezerra, Aldo Stamm, Wilma Teresinha Anselmo-Lima, Marco Aurélio Fornazieri, Nelson D'Ávila Melo, Leonardo Balsalobre, Geraldo Pereira Jotz, Henrique Zaquia Leão, André Alencar Araripe Nunes, Alexandre Felippu, Antonio Carlos Cedin, Carlos D. Pinheiro-Neto, Diego Lima Oliveira, Eulalia Sakano, Eduardo Macoto Kosugi, Elizabeth Araújo, Fabiana Cardoso Pereira Valera, Fábio de Rezende Pinna, Fabrizio Ricci Romano, Francine Grecco de Melo Pádua
http://bit.ly/2F2kqo8
Cavernous hemangioma in unusual location: pterygopalatine fossa
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Bayram Şahin, Said Sönmez, Emine Dilek Yılmazbayhan, Kadir Serkan Orhan
http://bit.ly/2F5Dpz4
Frequency of GJB2 mutations in patients with nonsyndromic hearing loss from an ethnically characterized Brazilian population
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Felippe Felix, Marcia Gonçalves Ribeiro, Shiro Tomita, Mariano Gustavo Zalis
Abstract
Introduction
In different parts of the world, mutations in the GJB2 gene are associated with nonsyndromic hearing loss, and the homozygous 35delG mutation (p.Gly12Valfs*2) is a major cause of hereditary hearing loss. However, the 35delG mutation is not equally prevalent across ethnicities, making it important to study other mutations, especially in multiethnic countries such as Brazil.
Objective
This study aimed to identify different mutations in the GJB2 gene in patients with severe to profound nonsyndromic sensorineural hearing loss of putative genetic origin, and who were negative or heterozygote for the 35delG mutation.
Methods
Observational study that analyzed 100 ethnically characterized Brazilian patients with nonsyndromic severe to profound sensorineural hearing loss, who were negative or heterozygote for the 35delG mutation. GJB2 mutations were detected by DNA-based sequencing in this population. Participants' ethnicities were identified as Latin European, Non-Latin European, Jewish, Native, Turkish, Afro-American, Asian and Others.
Results
Sixteen participants were heterozygote for the 35delG mutation; 14 participants, including three 35delG heterozygote's, had nine different alterations in the GJB2 gene. One variant, p.Ser199Glnfs*9, detected in two participants, was previously unreported. Three variants were pathogenic (p.Trp172*, p.Val167Met, and p.Arg75Trp), two were non-pathogenic (p.Val27Ile and p.Ile196Thr), and three variants were indeterminate (p.Met34Thr, p.Arg127Leu, and p.Lys168Arg). Three cases of compound heterozygosity were detected: p.[(Gly12Valfs*2)];[(Trp172*)], p.[(Gly12Valfs*2)](;)[(Met34Thr)], and p.[(Gly12Valfs*2)(;)[(Ser199Glnfs*9)]).
Conclusion
This study detected previously unclassified variants and one case of previously unreported compound heterozygosity.
Resumo
Introdução
Em diferentes partes do mundo, mutações do gene GJB2 estão associadas a perda auditiva não sindrômica e a mutação homozigótica 35delG (p.Gly12Valfs*2) é uma das principais causas de perda auditiva hereditária. No entanto, a mutação 35delG não é igualmente prevalente em todas as etnias, faz com que seja importante estudar outras mutações, especialmente em países multiétnicos, como o Brasil.
Objetivo
Identificar diferentes mutações no gene GJB2 em pacientes com perda auditiva neurossensorial grave ou profunda não sindrômica de origem genética putativa e negativos ou heterozigotos para a mutação 35delG.
Método
Estudo observacional que analisou 100 pacientes brasileiros caracterizados etnicamente, com perda auditiva neurossensorial grave ou profunda não sindrômica, negativos ou heterozigotos para a mutação 35delG. As mutações de GJB2 foram detectadas por sequenciamento baseado no DNA nessa população. As etnias dos participantes foram identificadas como latino-europeia, não latino-europeia, judaica, nativa, turca, negra, asiática e outras.
Resultados
Dezesseis participantes eram heterozigotos para a mutação 35delG e 14, incluindo três heterozigotos para 35delG, apresentaram nove alterações no gene GJB2. Uma variante, p.Ser199Glnfs*9, detectada em dois participantes, não havia sido relatada anteriormente. Três variantes eram patogênicas (p.Trp172*, p.Val167Met, e p.Arg75Trp), duas não patogênicas (p.Val27Ile e p.Ile196Thr) e três indeterminadas (p.Met34Thr, p.Arg127Leu, e p.Lys168Arg). Três casos de heterozigosidade composta foram detectados: p.[(Gly12Valfs*2)];[(Trp172*)], p.[(Gly12Valfs*2)](;)[(Met34Thr)], e p.[(Gly12Valfs*2)(;)[(Ser199Glnfs*9)]).
Conclusão
Este estudo detectou variantes não classificadas anteriormente e um caso de heterozigosidade composta ainda não relatada.
http://bit.ly/2F3d6J0
Nasal patency and otorhinolaryngologic-orofacial features in children
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Jovana de Moura Milanesi, Luana Cristina Berwig, Luiz Henrique Schuch, Rodrigo Agne Ritzel, Ana Maria Toniolo da Silva, Eliane Castilhos Rodrigues Corrêa
Abstract
Introduction
Nasal obstruction is a common symptom in childhood, related to rhinitis and pharyngeal tonsil hypertrophy. In the presence of nasal obstruction, nasal patency may be reduced, and nasal breathing is replaced by mouth breathing. Orofacial and otorhinolaryngologic changes are related to this breathing mode. Objective evaluation of upper airways may be obtained through nasal patency measurement.
Objective
To compare nasal patency and otorhinolaryngologic-orofacial features in children.
Methods
One hundred and twenty three children, 6–12 year-old, and of both sexes underwent speech therapy evaluation, according to Orofacial Myofunctional Evaluation protocol, clinical and endoscopic otorhinolaryngologic examination and nasal patency measurement, using the absolute and predicted (%) peak nasal inspiratory flow values.
Results
Lower values of absolute and estimated peak nasal inspiratory flow values were found in children with restless sleep (p = 0.006 and p = 0.002), nasal obstruction report (p = 0.027 and p = 0.023), runny nose (p = 0.004 and p = 0.012), unsystematic lip closure during mastication (p = 0.040 and p = 0.026), masticatory speed reduced (p = 0.006 and p = 0.008) and altered solid food swallowing (p = 0.006 and p = 0.001). Absolute peak nasal inspiratory flow was lower in children with pale inferior turbinate (p = 0.040), reduced hard palate width (p = 0.037) and altered speech (p = 0.004). Higher absolute values were found in children with increased tongue width (p = 0.027) and, higher absolute and predicted (%) in children with mild everted lip (p = 0.008 and p = 0.000).
Conclusions
Nasal patency was lower in children with restless sleep, rhinitis signs and symptoms, hard palate width reduced and with changes in mastication, deglutition and speech functions. It is also emphasized that most of the children presented signs and symptom of allergic rhinitis.
Resumo
Introdução
A obstrução nasal é um sintoma comum na infância relacionado a rinite e hipertrofia das tonsilas faríngeas. Na presença de obstrução nasal, a patência nasal pode estar reduzida e a respiração nasal ser substituída por respiração oral. Alterações orofaciais e otorrinolaringológicas estão relacionadas a esse modo de respiração. A avaliação objetiva das vias aéreas superiores pode ser obtida através da medida da patência nasal.
Objetivo
Comparar a patência nasal e características otorrinolaringológicas e orofaciais em crianças.
Método
Foram submetidas 123 crianças de seis a 12 anos, de ambos os sexos, a avaliação fonoaudiológica, de acordo com o protocolo de avaliação Miofuncional Orofacial, exame clínico e endoscópico otorrinolaringológico e medição da patência nasal, com o uso do pico de fluxo inspiratório nasal em valores absolutos e valores estimados (% pico de fluxo inspiratório nasal).
Resultados
Valores mais baixos de pico de fluxo inspiratório nasal e % pico de fluxo inspiratório nasal foram encontrados em crianças com sono agitado (p = 0,006 e p = 0,002), relato de obstrução nasal (p = 0,027 e p = 0,023), rinorreia (p = 0,004 e p = 0,012), fechamento não-sistemático dos lábios durante a mastigação (p = 0,040 e p = 0,026), velocidade mastigatória reduzida (p = 0,006 e p = 0,008) e alteração da ingestão de alimentos sólidos (p = 0,006 e p = 0,001). O pico de fluxo inspiratório nasal foi menor em crianças com conchas inferiores pálidas (p = 0,040), redução da largura do palato duro (p = 0,037) e alterações da fala (p = 0,004). Valores maiores foram encontrados em crianças com largura da língua aumentada (p = 0,027). Valores maiores de pico de fluxo inspiratório nasal e % pico de fluxo inspiratório nasal foram observados em crianças com lábio levemente evertido (p = 0,008 e p = 0,000).
Conclusões
A patência nasal foi menor em crianças com sono agitado, sinais e sintomas de rinite, redução da largura do palato duro e alterações nas funções de mastigação, deglutição e fala. Enfatiza-se também que a maioria das crianças apresentava sinais e sintomas de rinite alérgica.
http://bit.ly/2F5DkLM
Long-term follow-up of tonsillectomy efficacy in children with PFAPA syndrome
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Ozturk Aktas, Hande Gurbuz Aytuluk, Sebla Kumas Caliskan, Omer Erdur, Ahmet Adnan Cirik
Abstract
Introduction
The role of tonsillectomy in the periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome, is controversial. Although some studies reported high success rates with tonsillectomy, further investigations are needed with larger numbers of patients.
Objective
To seek the long-term outcomes of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.
Methods
Case series; multi-center study. The study comprised 23 patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome who underwent surgery (tonsillectomy with or without adenoidectomy) between January 2009 and November 2014.
Results
21 (91%) of 23 patients had complete resolution immediately after surgery. One patient had an attack 24 h after surgery, but has had no further attacks. One patient had three attacks with various intervals, and complete remission was observed after 3 months.
Conclusions
Tonsillectomy is a good option for the treatment of periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome.
Resumo
Introdução
O papel da tonsilectomia na síndrome da febre periódica, estomatite aftosa, faringite e adenite é controverso. Embora alguns estudos tenham relatado altas taxas de sucesso com a tonsilectomia, são necessárias mais pesquisas com um número maior de pacientes.
Objetivo
Avaliar os resultados em longo prazo da tonsilectomia na síndrome de febre periódica, estomatite aftosa, faringite e adenite.
Método
Série de casos; estudo multicêntrico. O estudo avaliou 23 pacientes com síndrome de febre periódica, estomatite aftosa, faringite e adenite submetidos a cirurgia (tonsilectomia com ou sem adenoidectomia) entre janeiro de 2009 e novembro de 2014.
Resultados
Dos 23 pacientes, 21 (91%) apresentaram resolução completa imediatamente após a cirurgia. Um paciente apresentou um episódio 24 horas após a cirurgia, mas sem recorrência posterior. Um paciente teve três episódios com vários intervalos e a remissão completa foi observada após 3 meses.
Conclusões
A tonsilectomia é uma boa opção para o tratamento da síndrome de febre periódica, estomatite aftosa, faringite e adenite.
http://bit.ly/2F0ewUu
Evaluation of postoperative patient satisfaction after covering the nasal dorsum with upper lateral cartilage: “upper lateral closing”
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Can Alper Çağıcı
Abstract
Introduction
Following nasal hump removal during septorhinoplasty, the middle vault should be reconstructed to avoid functional and esthetic problems. Middle vault reconstruction, however, may result in widening of the middle vault and may need a camouflage graft to cover dorsal irregularities.
Objective
To present the results of reconstructing the middle vault with a technique that covers the nasal dorsum with upper lateral cartilage, from the viewpoint of patient satisfaction.
Methods
Retrospective study of patients who underwent septorhinoplasty that included nasal dorsum closure with upper lateral cartilage from December 1, 2014 to January 31, 2016. Those with postoperative follow-up of less than 3 months were excluded. The final study group included 39 patients. The same surgeon performed all septorhinoplasties. The dorsum was closed using an "upper lateral closing" technique that approximated upper lateral cartilages to each other over the septum. Postoperative patient satisfaction was determined using a visual analog scale and the rhinoplasty outcomes evaluation questionnaire. The questionnaire evaluates patient esthetic and functional satisfaction with the operated nose. High scores indicate improved esthetic results.
Results
No dorsal irregularities were seen at postoperative follow-up evaluation of the patients. For esthetic nasal appearance, the median visual analogue scale scores was 86%, and the mean for the questionnaire was 77.03%.
Conclusion
The natural dome-shaped anatomy of the nasal dorsum was achieved by approximating the upper lateral cartilages to each other. Closing the dorsum with this technique also covers any dorsal irregularities and results in a smooth dorsum. Patients expressed satisfaction with the esthetic and functional aspects of the smooth, attractive nasal dorsum.
Resumo
Introdução
Após a remoção da giba nasal durante a rinosseptoplastia, a abóbada deve ser reconstruída para evitar problemas funcionais e estéticos. A reconstrução da abóboda entretanto, pode resultar em alargamento dorsal e pode necessitar de um enxerto para camuflar irregularidades dorsais.
Objetivo
Avaliar a satisfação dos pacientes com os resultados da reconstrução da abóboda com uma técnica que utiliza a cartilagem lateral superior para recobrir o dorso nasal.
Método
Estudo retrospectivo de pacientes submetidos a rinosseptoplastia, que incluiu fechamento do dorso nasal com cartilagem lateral superior, realizado de 1° de dezembro de 2014 a 31 de janeiro de 2016. Foram excluídos aqueles com acompanhamento pós-operatório de menos de 3 meses. O grupo final do estudo incluiu 39 pacientes. O mesmo cirurgião realizou todas as rinosseptoplastias. O dorso foi fechado com uma técnica de "fechamento lateral superior" que aproxima as cartilagens laterais superiores de cada lado sobre o septo. A satisfação pós-operatória dos pacientes foi determinada através de uma escala visual analógica e o questionário Rhinoplasty Outcomes Evaluation. O questionário avalia a satisfação estética e funcional do paciente com o nariz. Escores altos indicam percepção de melhoria estética.
Resultados
Não foram observadas irregularidades dorsais na avaliação pós-operatória de seguimento dos pacientes. Em relação à aparência nasal estética, o escore médio da escala visual analógica foi 86% e o escore médio do questionário foi 77,03%.
Conclusões
A anatomia natural em forma de domo do dorso nasal foi conseguida através da aproximação das cartilagens laterais superiores entre si. O fechamento do dorso com essa técnica também abrange todas as irregularidades dorsais e resulta em um dorso liso. Os pacientes expressaram satisfação com os aspectos estéticos e funcionais do dorso nasal liso e atraente.
http://bit.ly/2F3lAkb
Hypoparathyroidism: what is the best calcium carbonate supplementation intake form?
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Loraine Gollino, Maria Fernanda Giovanetti Biagioni, Nathalia Regina Sabatini, José Vicente Tagliarini, José Eduardo Corrente, Sérgio Alberto Rupp de Paiva, Gláucia Maria Ferreira da Silva Mazeto
Abstract
Introduction
In hypoparathyroidism, calcium supplementation using calcium carbonate is necessary for the hypocalcemia control. The best calcium carbonate intake form is unknown, be it associated with feeding, juice or in fasting.
Objective
The objective was to evaluate the calcium, phosphorus and calcium × phosphorus product serum levels of hypoparathyroidism women after total thyroidectomy, following calcium carbonate intake in three different forms.
Methods
A crossover study was carried out with patients presenting definitive hypoparathyroidism, assessed in different situations (fasting, with water, orange juice, breakfast with a one-week washout). Through the review of clinical data records of tertiary hospital patients from 1994 to 2010, 12 adult women (18-50 years old) were identified and diagnosed with definitive post-thyroidectomy hypoparathyroidism. The laboratory results of calcium and phosphorus serum levels dosed before and every 30 min were assessed, for 5 h, after calcium carbonate intake (elementary calcium 500 mg).
Results
The maximum peak average values for calcium, phosphorus and calcium × phosphorus product were 8.63 mg/dL (water), 8.77 mg/dL (orange juice) and 8.95 mg/dL (breakfast); 4.04 mg/dL (water), 4.03 mg/dL (orange juice) and 4.12 mg/dL (breakfast); 34.3 mg2/dL2 (water), 35.8 mg2/dL2 (orange juice) and 34.5 mg2/dL2 (breakfast), respectively, and the area under the curve 2433 mg/dL min (water), 2577 mg/dL min (orange juice) and 2506 mg/dL min (breakfast), 1203 mg/dL min (water), 1052 mg/dL min (orange juice) and 1128 mg/dL min (breakfast), respectively. There was no significant difference among the three different tests (p > 0.05).
Conclusion
The calcium, phosphorus and calcium × phosphorus product serum levels evolved in a similar fashion in the three calcium carbonate intake forms.
Resumo
Introdução
No hipoparatireoidismo, a suplementação de cálcio com carbonato de cálcio é necessária para o controle da hipocalcemia. A melhor forma de ingestão de carbonato de cálcio ainda é desconhecida, seja concomitante com alimentação, no suco ou em jejum.
Objetivo
Avaliar os níveis séricos de cálcio, fósforo e produto cálcio-fósforo em mulheres pós tireoidectomia por hipoparatireoidismo, após a ingestão de carbonato de cálcio em três formas diferentes.
Método
Foi realizado um estudo cruzado em pacientes com hipoparatireoidismo definitivo, avaliados em diferentes situações (em jejum, com água, suco de laranja, café da manhã, após washout de uma semana). A revisão dos prontuários dos pacientes de um hospital terciário de 1994 a 2010 identificou 12 mulheres adultas (18-50 anos), diagnosticadas com hipoparatireoidismo definitivo pós-tireoidectomia. Os resultados laboratoriais dos níveis séricos de cálcio e fósforo foram mensurados antes e a cada 30 minutos durante 5 horas, após a ingestão de carbonato de cálcio (cálcio elementar 500 mg).
Resultados
Os valores de pico máximo médio de cálcio, fósforo e produto cálcio-fósforo foram 8,63 mg/dL (água), 8,77 mg/dL (suco de laranja) e 8,95 mg/dL (café da manhã); 4,04 mg/dL (água), 4,03 mg/dL (suco de laranja) e 4,12 mg/dL (café da manhã); 34,3 mg2/dL2 (água), 35,8 mg2/dL2 (suco de laranja) e 34,5 mg2/dL2 (café da manhã), respectivamente, e a área sob a curva foi 2.433 mg/dL.min. (água), 2.577 mg/dL.min. (suco de laranja) e 2.506 mg/dL.min. (café da manhã), 1.203 mg/dL.min. (água), 1.052 mg/dL.min. (suco de laranja) e 1.128 mg/dL.min. (café da manhã), respectivamente. Não houve diferença significante entre os três diferentes testes (p > 0,05).
Conclusão
Os níveis séricos de cálcio, fósforo e produto cálcio-fósforo evoluíram de forma semelhante nas três formas de ingestão de carbonato de cálcio.
http://bit.ly/2R2GDty
The protective effects of whortleberry extract against cisplatin-induced ototoxicity in rats
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Doğukan Özdemir, Abdulkadir Özgür, Yıldıray Kalkan, Suat Terzi, Levent Tümkaya, Adnan Yılmaz, Metin Çeliker, Engin Dursun
Abstract
Introduction
Cisplatin is one of the main chemotherapeutic agents used for the treatment of many types of cancer. However, ototoxicity, one of the most serious side effects of cisplatin, restricts its usage.
Objective
We aimed to investigate the protective effects of whortleberry extract against cisplatin-induced ototoxicity by evaluating hearing and histopathological cochlear damage and by measuring the biochemical parameters affected byoxidative stress.
Methods
Forty-eight male rats were included in the study after performing Distortion Product Otoacoustic Emission test to confirm that their hearing levels were normal. The rats were randomly divided into six groups: the control group, the sham group, and, which received only whortleberry extract, only cisplatin, cisplatin + 100 mg whortleberry extract, cisplatin + 200 mg whortleberry extract, respectively. Audiologic investigation was performed by performing the Distortion Product Otoacoustic Emission test at the beginning and at the eighth day of the study. Cardiac blood samples were collected for biochemical analysis, and the rats were sacrificed to obtain cochlear histopathological specimens on the eighth day.
Results
The results revealed that whortleberry protects hearing against cisplatin-induced ototoxicity independent of the dose. However, high doses of whortleberry extract are needed to prevent histopathological degeneration and oxidative stress.
Conclusion
The results obtained in this study show that whortleberry extract has a protective effect against cisplatin-induced ototoxicity.
Resumo
Introdução
A cisplatina é um dos principais agentes quimioterápicos utilizados para o tratamento de muitos tipos de câncer. No entanto, a ototoxicidade, um dos efeitos colaterais mais graves da cisplatina, restringe seu uso.
Objetivo
Nosso objetivo foi investigar os efeitos protetores do extrato de uva-do-monte contra a ototoxicidade induzida por cisplatina, avaliar o dano auditivo e histopatológico coclear e medir os parâmetros bioquímicos afetados pelo estresse oxidativo.
Método
Foram incluídos no estudo 48 ratos machos após teste de emissão otoacústica evocada por produto de distorção para confirmar que seus níveis de audição eram normais. Os ratos foram divididos aleatoriamente em seis grupos: o grupo controle, o grupo simulado, o que recebeu apenas extrato de uva-do-monte, o que recebeu apenas cisplatina, o que recebeu cisplatina + 100 mg de extrato de uva-do-monte e o que recebeu cisplatina + 200 mg de extrato de uva-do-monte, respectivamente. A investigação audiológica foi feita através do teste de emissão otoacústica de produto de distorção no início e no oitavo dia do estudo. As amostras de sangue cardíaco foram coletadas para análise bioquímica e os ratos foram sacrificados para obtenção de espécimes histopatológicos cocleares no oitavo dia.
Resultados
Os resultados revelaram que o extrato de uva-do-monte protege a audição contra a ototoxicidade induzida por cisplatina, independentemente da dose. No entanto, são necessárias doses elevadas do extrato para evitar a degeneração histopatológica e o estresse oxidativo.
Conclusão
Os resultados obtidos neste estudo mostram que o extrato de uva-do-monte tem um efeito protetor contra a ototoxicidade induzida por cisplatina.
http://bit.ly/2BYNauL
Vocal assessment of addicts on methadone therapy via the RBH scale and objective acoustic parameters
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Veljko Mirkov, Slobodan M. Mitrović
Abstract
Introduction
A large number of people around the world struggle daily to become free of their addiction to illegal psychoactive substances. In order to create an atmosphere of improved supervision, established communication and improved quality of life for drug addicts, centers have been set up to provide methadone as a substitute.
Objective
The aim of the research was to assess the vocal features of drug addicts on methadone therapy via subjective and objective parameters, to ascertain if vocal damage has occurred and to determine whether subjective and objective acoustic vocal parameters are related, and how.
Methods
The research included 34 adults of both genders who were undergoing methadone treatment. A subjective vocal evaluation assessed voice pitch and clarity, while the subjective acoustic analysis utilized the Roughness-Breathiness-Hoarseness scale of roughness-breathiness-hoarseness. Objective acoustic analysis was conducted after recording and analyzing an uninterrupted vocal /a/ of at least three seconds duration, using the "GllotisController" software.
Results
The subjective acoustic analysis using the Roughness-Breathiness-Hoarseness scale showed pathological values in 52.9% male and 47% female participants. The average values of the roughness-breathiness-hoarseness for the entire sample were 0.91, 0.38 and 0.50, respectively. Lower roughness was associated with a higher fundamental frequency (f0) and lower jitter and shimmer values (p < 0.05). There was a statistically significant correlation between breathiness, jitter (p < 0.01) and shimmer (p < 0.05), and between hoarseness and jitter (p < 0.01).
Conclusion
A statistically significant correlation was found between the two subjective vocal assessments, voice clarity and pitch, and Roughness-Breathiness-Hoarseness scale, and the parameters of the objective acoustic vocal assessment.
Resumo
Introdução
Um grande número de pessoas em todo o mundo luta diariamente para livrar-se de seu vício em substâncias psicoativas ilegais. Com o objetivo de criar uma atmosfera de supervisão melhorada, comunicação estabelecida e melhora da qualidade de vida para drogaditos, foram criados centros que fornecem a substância substitutiva metadona.
Objetivo
Avaliar a voz de drogaditos que recebem terapia com metadona através de parâmetros subjetivos e objetivos, para determinar o eventual dano à voz, bem como determinar se os parâmetros vocais acústicos subjetivos e objetivos estão interligados e como isso ocorre.
Método
A pesquisa incluiu 34 participantes, usuários de terapia com metadona, de ambos os sexos. A avaliação vocal subjetiva consistiu na avaliação do tom (pitch) e clareza da voz, enquanto a análise acústica subjetiva consistiu no uso da escala RSA, de rugosidade, soprosidade e aspereza. A análise acústica objetiva foi realizada após a gravação e análise da vocalização ininterrupta de /a/ com duração de no mínimo três segundos, com o software GllotisController.
Resultados
A análise acústica subjetiva utilizando a escala RSA mostrou valores patológicos em 52,9% de homens e 47% em mulheres. Os valores médios dos parâmetros rugosidade, soprosidade e aspereza para toda a amostra foram 0,91, 0,38 e 0,50, respectivamente. O parâmetro rugosidade mais baixo esteve associado a valores mais altos de frequência fundamental (f0) e menor jitter e o shimmer (p < 0,05). Entre o parâmetro soprosidade e o jitter (p < 0,01) e o shimmer (p < 0,05) houve uma correlação estatisticamente significante, bem como entre o parâmetro aspereza e o jitter (p < 0,01).
Conclusão
Foi encontrada uma correlação estatisticamente significante entre a avaliação vocal subjetiva da clareza e do tom (pitch) da voz e os parâmetros da avaliação vocal acústica objetiva, bem como os parâmetros da análise vocal acústica subjetiva utilizando a escala de rugosidade, soprosidade e aspereza e os parâmetros acústicos objetivos.
http://bit.ly/2R0NVxO
Does the reduction of inferior turbinate affect lower airway functions?
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Ozlem Unsal, Mehtap Ozkahraman, Mufide Arzu Ozkarafakili, Meltem Akpinar, Arzu Yasemin Korkut, Senem Kurt Dizdar, Berna Uslu Coskun
Abstract
Introduction
Although the nose and lungs are separate organs, numerous studies have reported that the entire respiratory system can be considered as a single anatomical and functional unit. The upper and lower airways affect each other either directly or through reflex mechanisms.
Objective
In this study, we aimed to evaluate the effects of the radiofrequency ablation of persistent inferior turbinate hypertrophy on nasal and pulmonary function.
Methods
Twenty-seven patients with bilateral persistent inferior turbinate hypertrophy without septal deviation were included in this study. All of the patients were evaluated using anterior rhinoscopy, nasal endoscopy, acoustic rhinometry, a visual analogue scale, and flow-sensitive spirometry on the day before and 4 months after the radiofrequency ablation procedure.
Results
The post-ablation measurements revealed that the inferior turbinate ablation caused an increase in the mean cross-sectional area and volume of the nose, as well as in the forced expiratory volume in 1 s, forced vital capacity, and peak expiratory flow of the patients. These differences between the pre- and post-ablation results were statistically significant. The post-ablation visual analogue scale scores were lower when compared with the pre-ablation scores, and this difference was also statistically significant.
Conclusion
This study demonstrated that the widening of the nasal passage after the reduction of the inferior turbinate size had a favorable effect on the pulmonary function tests.
Resumo
Introdução
Embora o nariz e os pulmões sejam órgãos separados, numerosos estudos relataram que todo o sistema respiratório pode ser considerado como uma única unidade anatômica e funcional. As vias aéreas superiores e inferiores afetam uma à outra diretamente ou através de mecanismos reflexos.
Objetivo
Avaliar os efeitos da ablação por radiofrequência em conchas nasais inferiores com hipertrofia persistente sobre a função nasal e pulmonar.
Método
Foram incluídos neste estudo 27 pacientes com hipertrofia persistente bilateral de conchas inferiores sem desvio septal. Todos os pacientes foram avaliados com rinoscopia anterior, endoscopia nasal, rinometria acústica, escala visual analógica e espirometria sensível ao fluxo no dia anterior e quatro meses após o procedimento de ablação por radiofrequência.
Resultados
As medidas pós-ablação demonstraram que a ablação das conchas nasais inferiores resultou em um aumento da área transversal média e do volume do nariz, bem como do volume expiratório forçado em um segundo, da capacidade vital forçada e do fluxo expiratório máximo dos pacientes. Essas diferenças entre os resultados pré e pós-ablação foram estatisticamente significantes. Os escores da escala visual analógica pós-ablação foram menores quando comparados com os escores pré-ablação e essa diferença também foi estatisticamente significante.
Conclusão
O alargamento da passagem nasal após a redução do tamanho das conchas nasais inferiores teve efeito favorável nos testes de função pulmonar.
http://bit.ly/2BSLcMF
The first postoperative-stimulated serum thyroglobulin is a prognostic factor for thyroid microcarcinomas
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
Abstract
Introduction
Endogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce.
Objective
To assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma.
Methods
The medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence.
Results
Persistence/recurrence occurred in 27.8% of the cases. These patients were identified according to the following parameters: receiving more than one 131iodine dose (100% vs. 0%; p < 0.0001); accumulated 131iodine dose (232.14 ± 99.09 vs. 144 ± 33.61 mCi; p < 0.0001); presented active disease in the last assessment (53.3% vs. 0%; p < 0.0001); follow-up time (103.07 ± 61.27 vs. 66.85 ± 70.14 months; p = 0.019); and 1st stimulated thyroglobulin (19.01 ± 44.18 vs. 2.19 ± 2.54 ng/dL; p < 0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio = 1.242; 95% confidence interval: 1.022–1.509; p = 0.029] and follow-up time (odds ratio = 1.027; 95% confidence interval: 1.007–1.048; p = 0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6 ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve = 0.713 (p = 0.019)].
Conclusion
The first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma.
Resumo
Introdução
A tireoglobulina estimulada pelo hormônio tireoestimulante endógeno coletada após tireoidectomia total é um preditor útil de melhor prognóstico em pacientes com carcinomas diferenciados de tireoide em geral, mas os estudos com microcarcinomas são escassos.
Objetivo
Avaliar se a primeira medida pós-operatória de tireoglobulina estimulada é um fator prognóstico em pacientes com microcarcinoma.
Método
Os dados clínicos de 150 pacientes com carcinoma diferenciado de tireoide foram estudados retrospectivamente e 54 (36%) casos com microcarcinoma foram selecionados. A primeira dosagem de tireoglobulina estimulada (1aTgE) pós-operatória, medida após a tireoidectomia, os dados da apresentação inicial e tratamento do microcarcinoma foram avaliados quanto ao resultado. O pior prognóstico foi definido como a persistência/recorrência da neoplasia.
Resultados
A persistência/recorrência ocorreu em 27,8% dos casos. Esses pacientes foram identificados de acordo com os seguintes parâmetros: receberam mais de uma dose de iodo131 (100% vs. 0%; p < 0,0001); dose acumulada de iodo131 (232,14 ± 99,09 vs. 144 ± 33,61 mCi; p < 0,0001); apresentou doença ativa na última avaliação (53,3% vs. 0%; p < 0,0001); tempo de seguimento (103,07 ± 61,27 vs. 66,85 ± 70,14 meses; p = 0,019); e 1ªTgE (19,01 ± 44,18 vs. 2,19 ± 2,54 ng/dL; p < 0,0001). Após a regressão logística multivariada, apenas a 1ªTgE [odds ratio = 1.242; intervalo de confiança de 95%: 1,022-1,509; p = 0,029] e tempo de seguimento (odds ratio = 1,027; intervalo de confiança de 95%: 1,007-1,048; p = 0,007) foram preditores independentes de risco de persistência/recorrência. O ponto de corte de 1,6 ng/dL para a 1ª TgE foi significativamente associado à persistência/recidiva da doença [área abaixo da curva = 0,713 (p = 0,019)].
Conclusão
A 1ª dosagem sérica de tireoglobulina estimulada previu a persistência/recorrência da doença em pacientes com microcarcinoma.
http://bit.ly/2R0jtnH
Comparison between chloral hydrate and propofol-ketamine as sedation regimens for pediatric auditory brainstem response testing
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Kamal Abulebda, Vinit J. Patel, Sheikh S. Ahmed, Alvaro J. Tori, Riad Lutfi, Samer Abu-Sultaneh
Abstract
Introduction
The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test.
Objective
The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing.
Methods
Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study. Drugs doses, adverse effects, sedation times, and the effectiveness of the sedative regimens were reviewed.
Results
73 patients underwent oral chloral hydrate sedation, while 117 received propofol-ketamine sedation. 12% of the patients in the chloral hydrate group failed to achieve desired sedation level. The average procedure, recovery and total nursing times were significantly lower in the propofol-ketamine group. Propofol-ketamine group experienced higher incidence of transient hypoxemia.
Conclusion
Both sedation regimens can be successfully used for sedating children undergoing auditory brainstem response testing. While deep sedation using propofol-ketamine regimen offers more efficiency than moderate sedation using chloral hydrate, it does carry a higher incidence of transient hypoxemia, which warrants the use of a highly skilled team trained in pediatric cardio-respiratory monitoring and airway management.
Resumo
Introdução
O uso de testes diagnósticos de potencial evocado auditivo de tronco encefálico sob sedação é atualmente o padrão-ouro em lactentes e crianças pequenas que não têm desenvolvimento suficiente para realizar o exame.
Objetivo
O objetivo do estudo foi comparar a sedação de crianças submetidas a testes de potencial evocado auditivo de tronco encefálico com propofol-quetamina e com hidrato de cloral por via oral.
Método
Pacientes entre 4 meses e 6 anos de idade que necessitaram de sedação para a realização do potencial evocado auditivo de tronco encefálico foram incluídos nesse estudo retrospectivo. Foram revisadas as doses dos medicamentos, os efeitos adversos, os tempos de sedação e a eficácia das formas de sedação.
Resultados
73 pacientes foram submetidos à sedação oral com hidrato de cloral, enquanto 117 receberam sedação com propofol-quetamina; 12% dos pacientes do grupo hidrato de cloral não alcançaram o nível desejado de sedação. Os tempos médios de procedimento, recuperação e o tempo total de cuidados de enfermagem foram significativamente menores no grupo propofol-quetamina, entretanto este grupo experimentou maior incidência de hipoxemia transitória.
Conclusão
Ambos os regimes de sedação podem ser utilizados com sucesso para sedar crianças para realização do exame de potencial evocado de tronco encefálico. Embora a sedação profunda com propofol e quetamina ofereça mais eficiência do que a sedação moderada com hidrato de cloral, ela apresenta maior incidência de hipoxemia transitória, o que requer uma equipe altamente qualificada, treinada em monitoramento cardiorrespiratório pediátrico e manejo de vias aéreas.
http://bit.ly/2BYMPZ1
A predictive model to distinguish malignant and benign thyroid nodules based on age, gender and ultrasonographic features
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Fábio Muradás Girardi, Laura Mezzomo da Silva, Cecilia Dias Flores
Abstract
Introduction
A discussion in literature about a standardized decision support tool for the management of thyroid nodules remains.
Objective
The purpose of this study was to create a statistical prediction model for thyroid nodules management.
Methods
Two hundred and four benign and 57 malignant thyroid nodules were selected for a retrospective study. The variables age, gender and ultrasonographic features were examined using univariate and multivariate models. A statistical formula was used to calculate the risk of cancer of each case.
Results
In multivariate analysis, irregular shape, absence of halo, lower mean age, homogeneous echotexture, microcalcifications and solid content were associated with cancer. After applying the formula, 20 cases (7.6%) with a calculated risk for malignancy ≤3.0% were found, all of them benign. Setting the calculated risk in ≥80%, 21 (8.0%) cases were selected, and in 85.7% of them cancer was confirmed in histopathology. Internal accuracy of the prediction formula was 92.5%.
Conclusions
The prediction formula reached high accuracy and may be an alternative to other decision support tools for thyroid nodule management.
Resumo
Introdução
Persiste na literatura uma discussão sobre uma ferramenta padronizada de apoio à decisão para o manejo de nódulos tireoidianos.
Objetivo
Criar um modelo de previsão estatística para o manejo de nódulos tireoidianos.
Método
Foram selecionados 204 casos de nódulos tireoidianos benignos e 57 malignos para o estudo retrospectivo. As variáveis idade, sexo e características ultrassonográficas foram analisadas com modelos univariados e multivariados. Uma fórmula estatística foi usada para calcular o risco de câncer de cada caso.
Resultados
Na análise multivariada, a forma irregular, a ausência de halo, menor idade média, ecotextura homogênea, microcalcificações e conteúdo sólido foram associadas ao câncer. Após a aplicação da fórmula, foram encontrados 20 casos (7,6%) com risco calculado de malignidade ≤ 3,0%, todos benignos. Definiu-se o risco calculado em ≥ 80%, 21 casos (8,0%) foram selecionados e em 85,7% deles o câncer foi confirmado pela histopatologia. A precisão interna da fórmula de previsão foi de 92,5%.
Conclusões
A fórmula de previsão alcançou alta precisão e pode ser uma opção para outras ferramentas de apoio à decisão para o manejo de nódulos da tireoide.
http://bit.ly/2R21Fsr
Identification and management of inverted or everted edges of traumatic tympanic membrane perforations
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Zhengcai Lou, Zi-Han Lou
Abstract
Introduction
Most of traumatic tympanic membrane perforations have inverted or everted edges, however, the effects of inverted and everted edges on the spontaneous healing of the eardrum remain controversial.
Objective
We investigated the influence of inverted or everted edges on the spontaneous healing of traumatic tympanic membrane perforations.
Methods
The clinical records of patients with a traumatic tympanic membrane perforations who met the study criteria were retrieved and categorized into two groups, based on whether the eardrum was inverted or everted. The features along the edge of each inverted or everted eardrum were described using 30° and 70° endoscopes.
Results
In total, 196 patients (196 ears) met the inclusion criteria; of these, 148 had inverted or everted eardrums while 48 did not. Of the 148 patients with inverted or everted eardrums, the perforation edges were everted in 77 patients, inverted in 44 patients, drooping in 17 patients, and both inverted and everted in 10 patients. The perforation shape was triangular in 18.9% of patients, sector-shaped in 11.5%, kidney-shaped in 14.2%, ovoid in 20.3%, and irregularly shaped in 35.1% of patients. The difference was not significant between the with and without inverted/everted eardrum edges groups in terms of the closure rate or closure time. Similarly, the difference was not significant between the with and without edge approximation groups in terms of the closure rate or closure time at the end of the 12-month follow-up period.
Conclusion
This study suggests that endoscopic inspection can clearly identify inverted/everted eardrum edges using 30° and 70° endoscopes. The edge is glossy in inverted/everted eardrums, whereas the edge is rough and irregular in non-inverted/everted cases. The inverted/everted eardrums gradually became necrotic, but this did not affect the healing process. Additionally, edge approximation did not improve the healing outcome of traumatic tympanic membrane perforations.
Resumo
Introdução
A maioria das perfurações de membrana timpânica traumáticas apresenta bordas invertidas ou evertidas; no entanto, os efeitos dessas configurações sobre a cicatrização espontânea do tímpano continuam a ser uma questão controversa.
Objetivo
Investigar a influência de bordas invertidas ou evertidas sobre a cicatrização espontânea de perfurações traumáticas de membrana timpânica.
Método
Os prontuários clínicos de pacientes com perfuração traumática de membrana timpânica que preencheram os critérios do estudo foram recuperados e categorizados em dois grupos, baseados na configuração invertida ou evertida das bordas da membrana timpânica. As características de configuração da borda de cada membrana foram descritas com o uso de endoscópios de 30° e 70°.
Resultados
No total, 196 pacientes (196 orelhas) preencheram os critérios de inclusão; desses, 148 apresentavam bordas de membranas timpânicas invertidas ou evertidas, enquanto 48 não. Dos 148 pacientes, as bordas da perfuração estavam evertidas em 77 pacientes, invertidas em 44 pacientes, caídas em 17 pacientes e ambas invertidas e evertidas em 10 pacientes. O formato da perfuração era triangular em 18,9% dos pacientes, em forma de fatia de pizza em 11,5%, em forma de rim em 14,2%, ovoide em 20,3% e de forma irregular em 35,1% dos pacientes. A diferença não foi significante entre os grupos com e sem membrana timpânica invertida/evertida em termos de taxa ou tempo de fechamento. Da mesma forma, a diferença não foi significativa entre os grupos com e sem aproximação das bordas em termos de taxa de fechamento ou tempo de fechamento no fim do período de seguimento de 12 meses.
Conclusões
Este estudo sugere que a avaliação com endoscópios de 30° e 70° pode identificar claramente as bordas invertidas/evertidas das perfurações de membranas timpânicas. A borda da perfuração timpânica em casos invertidos/evertidos é brilhante, enquanto a borda é áspera e irregular em casos não invertidos/evertidos. O rebordo timpânico invertido/evertido gradualmente torna-se necrótico, mas isso não afetou o processo de cicatrização. Além disso, a aproximação das bordas não melhorou o resultado da cicatrização.
http://bit.ly/2BSGEpv
Downregulation of Notch4 – a prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): M.K. Harishankar, A. Mathan Mohan, A. Vinod Krishnan, Arikketh Devi
Abstract
Introduction
Oral verrucous carcinoma is a special form of well-differentiated squamous cell carcinoma which possesses specific clinical, morphologic and cytokinetic features that differ from other types of oral cancers and hence diagnosis requires immense experience in histopathology. Hence it is certainly important to distinguish such a lesion from other oral tumors as treatment strategies vary widely between them.
Objective
In search of a critical diagnostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma, Notch4 receptor, one of the key regulatory molecules of the Notch signaling family has been aberrantly activated in the progression of several types of tumors. However its function in oral verrucous carcinoma remains unexplored. Thus the present study aims in determining the differential expression pattern of Notch4 in oral verrucous carcinoma and oral squamous cell carcinoma.
Methods
Ten patients reported positive for oral cancer (5 patients with oral verrucous carcinoma and 5 patients with oral squamous cell carcinoma). Five normal tissue samples were also obtained and evaluated for clinicopathological parameters and immunohistochemistry, western blotting and real time polymerase chain reaction for Notch4 expression.
Results
Our results reveal that the expression of Notch4 was considerably high in oral squamous cell carcinoma lesions compared to normal tissue, whereas in oral verrucous carcinoma, irrespective of the clinicopathological features, complete regulação descendente of Notch4 was observed.
Conclusions
These preliminary findings strongly support the fact that Notch4 is downregulated in oral verrucous carcinoma and could be considered as a suitable prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma. This distinguishing marker can help in improving therapeutic options in patients diagnosed with oral verrucous carcinoma.
Resumo
Introdução
O carcinoma verrucoso de cavidade oral é uma forma especial de carcinoma de células escamosas bem diferenciada que tem características clínicas, morfológicas e citocinéticas específicas que diferem de outros tipos de cânceres orais. Por essa razão, o diagnóstico requer grande experiência em histopatologia. Portanto, é certamente importante distingui-lo de outros tumores orais, pois as respectivas estratégias de tratamento variam muito.
Objetivo
Em busca de um marcador de diagnóstico crítico na distinção entre o carcinoma verrucoso e o carcinoma de células escamosas de cavidade oral, o receptor Notch4, uma das principais moléculas reguladoras da família de sinalizadores Notch, foi ativado de maneira anormal na progressão de vários tipos de tumores. No entanto, sua função no carcinoma verrucoso permanece inexplorada. Assim, o presente estudo tem como objetivo determinar o padrão de expressão diferencial de Notch4 no carcinoma verrucoso e de células escamosas de cavidade oral.
Método
Dez pacientes tiveram resultado positivo para câncer oral (cinco pacientes com carcinoma verrucoso e cinco pacientes com carcinoma de células escamosas) e cinco amostras normais foram também obtidas. Além da avaliação dos parâmetros clínico-patológicos, foram feitos análise imuno-histoquímica, Western Blot e reação de polimerase em cadeia em tempo real para a expressão de Notch4.
Resultados
Nossos resultados revelam que a expressão de Notch4 foi consideravelmente alta em carcinomas de células escamosas em comparação com os tecidos normais, enquanto que no carcinoma verrucoso, independentemente das características clínico-patológicas, observou-se regulação descendente completa de Notch4.
Conclusão
Esses achados preliminares apoiam fortemente o fato de que Notch4 estava regulado para baixo no carcinoma verrucoso oral e poderia ser considerado um marcador prognóstico adequado para distinguir entre carcinoma verrucoso e carcinoma de células escamosas de cavidade oral. Esse marcador distintivo pode ajudar a melhorar as opções terapêuticas em pacientes com diagnóstico de carcinoma verrucoso oral.
http://bit.ly/2R8JrFK
Laryngeal and vocal alterations after thyroidectomy
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Renata Mizusaki Iyomasa, José Vicente Tagliarini, Sérgio Augusto Rodrigues, Elaine Lara Mendes Tavares, Regina Helena Garcia Martins
Abstract
Introduction
Dysphonia is a common symptom after thyroidectomy.
Objective
To analyze the vocal symptoms, auditory-perceptual and acoustic vocal, videolaryngoscopy, the surgical procedures and histopathological findings in patients undergoing thyroidectomy.
Methods
Prospective study. Patients submitted to thyroidectomy were evaluated as follows: anamnesis, laryngoscopy, and acoustic vocal assessments. Moments: pre-operative, 1st post (15 days), 2nd post (1 month), 3rd post (3 months), and 4th post (6 months).
Results
Among the 151 patients (130 women; 21 men). Type of surgery: lobectomy + isthmectomy n = 40, total thyroidectomy n = 88, thyroidectomy + lymph node dissection n = 23. Vocal symptoms were reported by 42 patients in the 1st post (27.8%) decreasing to 7.2% after 6 months. In the acoustic analysis, f0 and APQ were decreased in women. Videolaryngoscopies showed that 144 patients (95.3%) had normal exams in the preoperative moment. Vocal fold palsies were diagnosed in 34 paralyzes at the 1st post, 32 recurrent laryngeal nerve (lobectomy + isthmectomy n = 6; total thyroidectomy n = 17; thyroidectomy + lymph node dissection n = 9) and 2 superior laryngeal nerve (lobectomy + isthmectomy n = 1; Total thyroidectomy + lymph node dissection n = 1). After 6 months, 10 patients persisted with paralysis of the recurrent laryngeal nerve (6.6%). Histopathology and correlation with vocal fold palsy: colloid nodular goiter (n = 76; palsy n = 13), thyroiditis (n = 8; palsy n = 0), and carcinoma (n = 67; palsy n = 21).
Conclusion
Vocal symptoms, reported by 27.8% of the patients on the 1st post decreased to 7% in 6 months. In the acoustic analysis, f0 and APQ were decreased. Transient paralysis of the vocal folds secondary to recurrent and superior laryngeal nerve injury occurred in, respectively, 21% and 1.3% of the patients, decreasing to 6.6% and 0% after 6 months.
Resumo
Introdução
A disfonia é um sintoma comum após a tireoidectomia.
Objetivo
Analisar os sintomas vocais, auditivo-perceptivos e acústica vocal, videolaringoscopia, procedimento cirúrgico e achados histopatológicos em pacientes submetidos à tireoidectomia.
Método
Estudo prospectivo. Pacientes submetidos à tireoidectomia foram avaliados da seguinte forma: anamnese, laringoscopia e avaliações vocais acústicas. Momentos: pré-operatório, 1ª avaliação pós (15 dias), 2ª avaliação pós (1 mês), 3ª avaliação pós (3 meses) e 4ª avaliação pós-operatória (6 meses).
Resultados
Dos 151 pacientes, 130 eram mulheres e 21, homens. Tipos de cirurgia: lobectomia + istmectomia n = 40, tireoidectomia total n = 88, tireoidectomia + dissecção de linfonodo n = 23. Sintomas vocais foram relatados por 42 pacientes na 1ª avaliação pós-operatória (27,8%), reduzidos para 7,2% após 6 meses. Na análise acústica, f0 e APQ estavam diminuídos nas mulheres. As videolaringoscopias mostraram que 144 pacientes (95,3%) tiveram exames normais no momento pré-operatório. Paralisia das cordas vocais foi diagnosticada em 34 pacientes na 1ª avaliação pós-operatória, 32 do nervo laríngeo recorrente (lobectomia + istmectomia - n = 6; tireoidectomia total - n = 17; tireoidectomia total+dissecção de linfonodos - n = 9) e 2 do nervo laríngeo superior (lobectomia + istmectomia - n = 1; tireoidectomia total + dissecção de linfonodos - n = 1). Após 6 meses, 10 pacientes persistiram com paralisia do nervo laríngeo recorrente (6,6%). Histopatologia e correlação com paralisia das cordas vocais: bócio coloide nodular (n = 76; paralisia n = 13), tireoidite (n = 8; paralisia n = 0) e carcinoma (n = 67; paralisia n = 21).
Conclusão
Os sintomas vocais, relatados por 27,8% dos pacientes na 1ª avaliação pós-operatória, diminuíram para 7% em 6 meses. Na análise acústica, f0 e APQ diminuíram. A paralisia transitória de cordas vocais secundária à lesão do nervo laríngeo recorrente e nervo laríngeo superior ocorreu, respectivamente, em 21% e 1,3% dos pacientes, reduziu-se para 6,6% e 0% após 6 meses.
http://bit.ly/2BYMwNR
Management of hyperacusis in children – two case reports
Publication date: January–February 2019
Source: Brazilian Journal of Otorhinolaryngology, Volume 85, Issue 1
Author(s): Tanit Ganz Sanchez, Isabella Marques Pereira
http://bit.ly/2R5zcSc
Functional and aesthetic results after septorhinoplasty and concomitant radiofrequency of the inferior turbinate: is there a role for patient reported outcome measures (PROMs)?
Abstract
Purpose
Functional and aesthetic results after septorhinoplasty (SRP) are often not clearly demonstrated. There is still an open topic in the literature about analysis of aesthetic, functional results and patients' satisfaction after SRP. The aim of our study is to determine patients' satisfaction after SRP and concomitant radiofrequency of the inferior turbinate (RF) regarding nose appearance and improvement of symptoms, using patient reported outcome measures (PROMs).
Methods
ROE questionnaire and the NOSE scale were used for a retrospective evaluation to assess patient's satisfaction in 369 patients undergoing SRP surgery from 2003 to 2016. Two additional questions were asked to confirm satisfaction following surgery.
Results
258 patients completed the questionnaires (71.7%). The global average ROE score was 18.14 (75.6%). The percentage of satisfaction of aesthetic result was 87.3%, in particular 10.5% were very happy, 57% very much satisfied and 19.8% moderately satisfied. The global post-operative average NOSE score was 13.1 with the resolution of nasal obstruction in 72.1% cases and a marked improvement in 9.3%. The results of the two additional questions showed that 81% of patients would undergo the procedure again if required and 72.1% of patients were globally satisfied.
Conclusions
Our study demonstrates the utility of PROMs in evaluating aesthetic and functional results after SRP and simultaneous RF. In our series, the patients undergoing SRP and RF are generally satisfied by the functional and aesthetic results. This kind of assessments should be the most common post-operative evaluation methods in this surgery.
http://bit.ly/2Aren9H
Rating surgical field quality in endoscopic ear surgery: proposal and validation of the “Modena Bleeding Score”
Abstract
Purpose
To develop and validate a bleeding score that could be applied in endoscopic ear surgery (EEarS).
Methods
A prospective validation study was performed. A new bleeding score, called "Modena Bleeding Score" (MBS), was created by the authors. It provides five grades for rating the surgical field during EEarS procedures (from grade 1—no bleeding to grade 5—bleeding that prevents every surgical procedure except those dedicated to bleeding control). A preliminary "face validity" was performed by 18 ENT specialists to assess possible misunderstandings in interpreting the scale. Then, 15 videos of endoscopic ear surgery procedures, each divided into three parts (t0, t1, and t2), were subsequently evaluated by 15 specialists, using MBS. The videos were randomly selected and assigned. Intra-rater reliability and inter-rater reliability were calculated. The clinical validity of the instrument was calculated using a referent standard (i.e., four ENT experts whose ratings were compared to those obtained by the former sample).
Results
The face validity showed a good consensus about the clarity and comprehension of the scale; both intra and inter-rater reliability demonstrated good performance (intra-rater reliability ranged from 0.741 to 0.991 and inter-rater reliability was 0.790); clinical validity also showed positive values, ranging from 0.75 to 0.93.
Conclusions
MBS has proved to be an effective method to rate surgical field during EEarS, with good-to-excellent performances. Its use would possibly help comparisons of groups in clinical trials or comparisons between studies.
http://bit.ly/2SE6xAo
Finding an oral potentially malignant disorder in screening program is related to early diagnosis of oral cavity cancer – Experience from real world evidence
Publication date: February 2019
Source: Oral Oncology, Volume 89
Author(s): Pei-Shan Ho, Wen-Chen Wang, Yu-Ting Huang, Yi-Hsin Yang
Abstract
Objectives
Our study evaluates the effectiveness of the Taiwan Oral Mucosal Screening (TOMS) program in stage-shift among oral cavity cancer patients, and identifies the related factors with early cancer diagnosis.
Materials and methods
This retrospective cohort study used the Taiwan Cancer Registry (TCR), TOMS and Taiwan Death Registry (TDR) databases. We identified oral cavity cancer patients (ICD-C-O: C00-C06) from the TCR during 2012–2015. Patients' screening history, first screening status and subsequent screenings were analyzed with cancer stages and survival outcomes.
Results
The 5-year survival rates for stages 0–4 were 83.9%, 82.1%, 72.7%, 60.1% and 38.0%. Among 18,625 patients identified from the TCR, 37% did not have any prior screenings. Patients with prior positive or negative screenings all had better survival rates (3-year: 71.4% and 68.7% vs. 63.5%, Log-rank p-value < 0.0001). The best chance for early-stage diagnosis occurs in oral potentially malignant disorder (OPMD, OR = 1.99, 95% CI = 1.78–2.22, p < 0.0001) patients at their first screenings. The hazard ratios (HR) for patients with prior screenings indicated a significant survival benefit. The group of incomplete diagnosis confirmation also has better survival (HR = 0.78, 95% CI = 0.81–0.93, p < 0.0001), and a greater chance of early diagnosis at subsequent screenings.
Conclusion
While TOMS improved stage-shift for early cancer diagnosis, we found no obvious differences in participants with cancers at screening (stages 0–1: 26.3% vs. 27.8% in non-screening group). Survival benefit and early diagnosis are found in most of screening groups, and identifying an OPMD is particularly essential to early diagnosis of oral cavity cancer patients.
http://bit.ly/2s5DGtk
Τρίτη 1 Ιανουαρίου 2019
Clinical features and management of Meniere’s disease patients with drop attacks
Abstract
Purpose
The aims of the present study are to investigate the variations in clinical features, including medical history, hearing function, vestibular function, and degree of endolymphatic hydrops (EH), in Meniere's disease (MD) patients with and without drop attacks (DAs), and to examine the efficacy of intratympanic gentamicin (ITG) treatment in alleviating DAs.
Methods
In total, 177 unilateral definite MD patients, including 16 patients with DAs and 161 patients without DAs, were enrolled. The results of hearing test, vestibular-evoked myogenic potentials (VEMPs), and magnetic resonance imaging (MRI) were analyzed. Thirteen patients with DAs received a single ITG treatment and were followed up.
Results
The disease course of MD in the DA group was significantly longer than that in the control group (p = 0.007). MD patients with DAs had significantly greater hearing loss and worse EH than MD patients without DAs (p < 0.05). However, there was no between-group difference in vestibular function. In the study, 92.31% of refractory definite MD patients with DAs achieved satisfactory control of DAs after ITG treatment.
Conclusions
MD patients with DAs tend to suffer from severe hearing loss and a significant degree of EH in the inner ear. However, the vestibular function of MD patients with DAs may not be completely abolished, but be sensitive to stimulating signals. ITG treatment, which helps to decrease vestibular sensitivity, was an effective treatment to control DAs.
http://bit.ly/2BShlUr
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Abstract Objectives To investigate factors related to reasoning skills in 434 school children aged 5–9 years. Methods The Leiter Interna...
