The Effect of Somatosensorial System on Vestibular System

xlomafota13 shared this article with you from Inoreader The Effect of Somatosensorial System on Vestibular System Via Otolaryngology Indian Abstract The aim of this study was to investigate the effects of the somatosensory system on the vestibular system and the interconnected ways they work together to maintain balance. The study was conducted on 54 individuals (27 females and 27 males), aged between 18–25 years. vHIT as well as cVEMP tests were used to evaluate the participants. Tests were carried out while sitting, standing on firm surface and standing on foam respectively. According to the posterior vHIT results, there was a significant difference between VOR gains obtained while sitting and standing on firm surface in right side as well as on the left side (p < 0,01). Moreover, when VOR gains in standing on firm and standing on foam results were compared to each other, statistical significance was found right and left posterior canals (p < 0,05). Concerning the results obtained from VEMP, a statistically significant difference was seen in the comparison of P1-N1 amp litudes of the right side on firm surface and standing on foam (p < 0,01). When the inputs from somatosensorial system are disturbed, the parts of the vestibular system that are primarily affected are the posterior SSC, saccule and inferior vestibular nerve. This can be interpreted as the inferior vestibular nerve being more affected than the superior vestibular nerve when posture is disturbed due to somatosensory cues being unavailable or unstable. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sleep Endoscopy Patterns in Six Adults With Trisomy 21 and Obstructive Sleep Apnea

xlomafota13 shared this article with you from Inoreader Sleep Endoscopy Patterns in Six Adults With Trisomy 21 and Obstructive Sleep Apnea Via The Laryngoscope Obstructive sleep apnea (OSA) is prevalent amongst individuals with Trisomy 21 (T21). This case series describes the results of drug-induced sleep endoscopy of six adult patients with OSA and T21 and compares the patterns of collapse to those observed in adults without T21. Predominantly hypopharyngeal airway collapse was found in four of the six (66.7%) subjects with T21, a much higher proportion than in the general population. This finding may implicate anatomic differences underlying the increased prevalence of OSA in individuals with T21 and may have treatment implications. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety of Ibuprofen in Children With G6PD Deficiency: A Systematic Review

xlomafota13 shared this article with you from Inoreader Safety of Ibuprofen in Children With G6PD Deficiency: A Systematic Review Via The Laryngoscope Introduction Ibuprofen is included on websites and frequently referenced lists as medium risk for inducing hemolysis in children with glucose-6-phosphate dehydrogenase (G6PD) deficiency. This presents a challenge for otolaryngologists who perform tonsillectomy and other surgeries in children, as ibuprofen serves as an important alternative to opioids for perioperative pain control. We systematically review published literature and national medication databases to evaluate the risk of hemolytic anemia and related complications when ibuprofen is used in children with G6PD deficiency. Methods Systematic literature review using preferred reporting items for systematic reviews and meta-analyses methodology. National drug adverse reaction database inquiry. Results Our search yielded 774 results for review consideration. Of these, three studies were included in our final analysis (two retrospective case-series, and one nonrandomized prospective study). The prospective study showed no evidence of hemolysis from perioperative exposure to ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) in children with G6PD deficiency at high risk. Two population studies in the Middle East suggested extremely low incidence of ibuprofen-related hemolysis (approximate 1/100,000 affected children per year). United States Food and Drug Administration (FDA), European Medicine Agency, and Health Canada adverse drug reaction databases reveled reported ibuprofen-related hematologic adverse reactions of approximate 1/100 million affected children per year. Conclusions There is scant, low-quality evidence of hemolytic anemia caused by ibuprofen in children with G6PD deficiency. If an association does exist, it is extremely rare. Drug-induced hemolytic anemias are recognizable and reversible following discontinuation of the inciting medication. Given these low risks, ibuprofen should be considered an appropriate choice in the management of perioperative pain in children with G6PD deficiency. Level of Evidence N/A Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of a French version of the Sunnybrook facial grading system

xlomafota13 shared this article with you from Inoreader Validation of a French version of the Sunnybrook facial grading system Via Laryngologie Eur Ann Otorhinolaryngol Head Neck Dis. 2021 Sep 17:S1879-7296(21)00181-2. doi: 10.1016/j.anorl.2021.08.003. Online ahead of print. ABSTRACT BACKGROUND: The aim of this study was to translate the Sunnybrook Facial Grading System and its specific criteria into French and validate its use by French-speaking physicians for facial palsy evaluation. MATERIAL AND METHODS: The original English version of the Sunnybrook Facial Grading System and its specific criteria was translated into French according to international standards. Twenty videos of patients with a wide range of facial palsy in terms of duration and severity were independently rated, twice each, by 6 physicians with varied experience in facial palsy care. Internal consistency and intra- and inter-rater reliability were analyzed. RESULTS: The French version of Sunnybrook Facial Grading System and its specific criteria both showed good internal consistency, with Cronbach alph a of 0.84 and 0.86 respectively. Inter-rater reliability was excellent in both sessions for the composite score, the score of symmetry at rest and during voluntary movement and synkinesis: intraclass correlation coefficient (ICC) between 0.77 and 0.98. Intra-rater reproducibility on the composite score and subscores was also excellent and comparable for expert, experienced and novice physicians, with an average ICC of 0.95. CONCLUSION: The French version of the Sunnybrook Facial Grading System and its specific criteria is reliable, reproducible and easy to use by French-speaking teams for facial palsy evaluation. PMID:34544661 | DOI:10.1016/j.anorl.2021.08.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aberrant course of the precavernous-cavernous junction of the internal carotid artery

xlomafota13 shared this article with you from Inoreader Aberrant course of the precavernous-cavernous junction of the internal carotid artery Via radiol anat Surg Radiol Anat. 2021 Sep 21. doi: 10.1007/s00276-021-02839-x. Online ahead of print. ABSTRACT We present an extremely rare case of an aberrant course of the precavernous-cavernous junction of the internal carotid artery (ICA), which was observed by magnetic resonance (MR) angiography. The patient was a 67-year-old woman with no symptoms related to the anomalous ICA. The anomalous segment of the ICA was stenotic and formed a loop postero-supero-laterally. We found no simila r cases in the relevant English-language literature. Segmental agenesis of the ICA with collateral formation, probably via the proximal segment of the primitive trigeminal artery, may be associated with the development of this variation. PMID:34546381 | DOI:10.1007/s00276-021-02839-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sliced vs crushed cartilage for camouflage: long-term graft survival and histological outcomes

xlomafota13 shared this article with you from Inoreader Sliced vs crushed cartilage for camouflage: long-term graft survival and histological outcomes Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 21. doi: 10.1007/s00405-021-07079-8. Online ahead of print. ABSTRACT PURPOSE: In this study, we proposed a "sliced-partial thickness cartilage graft" for nasal contour restoration purposes and compared the long-term graft survival and histological changes of sliced, crushed, and intact cartilage grafts. METHODS: Nasal septal and auricular cartilage grafts were harvested from 8 rabbits. Sliced, crushed, or intact cartilage grafts were measured in thickness with a micrometer and re-implanted. 4 months later, specimens were histologically evaluated and thickness were measured. RESULTS: Both nasal septal and auricular crushed cartilage lost significantly more chondrocytes than sliced samples together with fibrosis, multiple fracture lines, and even ossification. Sliced and intact cartilages were histologically similar except sliced cartilage had some minor changes limited to its cut surface. Sliced cartilages retained their thickness, histology, and structural properties in the long term similar to intact cartilages whereas -contrary to expectations- crushed specimens had significantly higher thickness measurements at the end of 4 months. CONCLUSION: Sliced cartilage grafts prepared with an atraumatic cartilage slicer are an ideal camouflaging material with its uniform thickness, and malleability. Crushed cartilages seemingly getting thicker without histological findings could be explained by lower than actual initial measurements due to its structural weakness and getting squeezed when the standard pressure of the micrometer was applied. PMID:34546396 | DOI:10.1007/s00405-021-07079-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers

xlomafota13 shared this article with you from Inoreader Comparison of PET-CT, CT and MRI scan in initial staging and management of head and neck cancers Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 21. doi: 10.1007/s00405-021-07087-8. Online ahead of print. ABSTRACT BACKGROUND: To evaluate the utility of positron-emission tomography (FDG PET) in initial staging and management of head and neck cancers. METHODS: This is a retrospective study of 99 treatment naïve head and neck cancer patients treated between January 2017 and December 2020 at a tertiary teaching centre. Change in initial staging and management was noted based on PET scan compared to cross-sectional imaging (CT and MRI). RESULTS: There were 73 (73.7%) males and 26 (26.2%) females with male-to-female ratio of 2.8:1.Overall, change in management was seen in 36/99 (36.4%) patients due to PET scan. With regards to initial staging, T, N and M stage was changed in 14/99 (14.1%), 19/99 (19.1%) and 3/99 (3%) patients, respectively. These changes were significantly higher in patients with unknown primary (63.3%, p value -0.001) and N3 (41%, p -0.045) nodal disease. CONCLUSION: PET-CT plays an important role in appropriate initial staging and subsequent treatment planning of head and neck cancers. ADVANCES IN KNOWLEDGE: Initial staging PETCT changes management in 36.4% cases. Accuracy of various different imaging modalities have been compared. PMID:34546395 | DOI:10.1007/s00405-021-07087-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base

xlomafota13 shared this article with you from Inoreader Adjuvant Radiotherapy in Grade II, Atypical Meningioma of the Skull Base Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1735879 Introduction Atypical meningiomas (AM) are meningiomas that are more aggressive than their grade-I counterparts and have a higher rate of recurrence. The effect of adjuvant radiotherapy (ART) on AM of the skull base is not defined. Methods A retrospective review of all AM's of the skull base primarily resected at our institution from 1996 to 2018 was completed. ART was defined as radiotherapy (RT) that occurred within 6 months of initial resection, regardless of Simpson's grade. Minimum time length of follow-up after resection was 2 years. Statistical analysis was performed using SAS. Results There were a total of 59 skull base–located (SBL) AMs resected at our institution from 1996 to 2018. The average age of our cohort was 53.2 years. Gross total resection, defined as Simpson's grades I to III resection, was achieved in 36 (61%) of cases. Thirty-five of 59 (59%) patients received ART. Recurrence was observed in 14 patients (24%), and mean time to recurrence was 63.8 months. Patients who received ART had a lower observed rate of recurrence (8 vs. 46%); however, time to recurrence was not significantly different between the two populations. Conclusion We observe that AM in the skull base location have higher recurrence rates than we would expect from grade-I meningioma. These data suggest that ART may offer benefit to the overall observed frequency of recurrence of SBL AM; however, the time to recurrence between patients who received ART and those who did not was not statistically significant in survival analysis. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract< /a>  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ki-67/MIB-1 and Recurrence in Pituitary Adenoma

xlomafota13 shared this article with you from Inoreader Ki-67/MIB-1 and Recurrence in Pituitary Adenoma Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1735874 Objectives Ki-67/MIB-1 is a marker of cellular proliferation used as a pathological parameter in the clinical assessment of pituitary adenomas, where its expression has shown utility in predicting the invasiveness of these tumors. However, studies have shown variable results when using Ki-67/MIB-1 association with recurrence. The purpose of this study is to determine if a high Ki-67/MIB-1 labeling index (LI) is predictive of recurrence in pituitary adenomas. Methods A retrospective chart review was performed for patients undergoing pituitary adenoma resection with at least 1 year of follow-up. Additionally, systematic data searches were performed and included studies that correlated recurrence rate to Ki-67/MIB-1 LI. Our institutional data were included in a synthesis with previously published data. Results Our institutional review included 79 patients with a recurrence rate of 26.6%. We found that 8.8% of our patients had a high Ki-67/MIB-1 LI (>3%); however, high Ki-67/MIB-1 was not associated with recurrence. The systematic review identified 244 articles and 49 full-text articles that were assessed for eligibility. Quantitative analysis was performed on 30 articles including our institutional data and 18 studies reported recurrence by level of Ki-67/MIB-1 LI. Among studies that compared Ki-67/MIB-1 ≥3 vs. <3%, 10 studies reported odds ratios (OR) greater than 1 of which 6 were statistically significant. A high Ki-67/MIB-1 had higher odds of recurrence via the pooled odds ratio (OR = 4.15, 95% confidence interval [CI]: 2.31–7.42). Conclusion This systematic review suggests that a high Ki-67/MIB-1 should prompt an increased duration of follow-up due to the higher odds of recurrence of pituitary adenoma. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is intraoperative margin sampling necessary in inverted papilloma resection?

xlomafota13 shared this article with you from Inoreader Is intraoperative margin sampling necessary in inverted papilloma resection? Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 16. doi: 10.1007/s00405-021-07075-y. Online ahead of print. ABSTRACT PURPOSE: To explore the association between intraoperative surgical margin sampling by the frozen sections and recurrence in inverted papilloma surgery. METHODS: A multicenter, retrospective study of patients who underwent attachment-oriented IP resection in four tertiary care medical centers with a minimal follow-up of 36 months. RESULTS: The study included 220 surgeries with a mean follow-up period of 49 months (range 36-204). The endoscopic approach was used in all but 4 cases; 73% of procedures were primary. Overall recurrence was 10.45% (n = 23). Squamous cell carcinoma was found in 5 cases (2.2%). Intraoperative margin sampling was obtained in 145 cases. There was no difference in the recurrence rate between frozen section and no-frozen section groups (p = 0.44). Furthermore, margin sampling in various sites of tum or origin, in cases with concomitant nasal polyps (p = 0.53) and in revision cases (p = 0.08) showed no correlation with recurrence. In 26 cases when the surgery was extended following a positive frozen section, there was a significantly higher recurrence rate (OR = 6.94). CONCLUSIONS: According to our results, intraoperative margin sampling did not affect the recurrence rate of IP, and therefore, its routine use should be questioned. PMID:34532762 | DOI:10.1007/s00405-021-07075-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional printing in otolaryngology education: a systematic review

xlomafota13 shared this article with you from Inoreader Three-dimensional printing in otolaryngology education: a systematic review Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 17. doi: 10.1007/s00405-021-07088-7. Online ahead of print. ABSTRACT PURPOSE: The progressive expansion of the technology that facilitates the development of three-dimensional (3D) printing within the field of otorhinolaryngology has opened up a new study front in medicine. The objective of this study is to systematically review scientific publications describing the development of 3D models having applications in otorhinolaryngology, with emphasis on subareas with a large number of publications, as well as the countries in which the publications are concentrated. METHODS: In this literature review, specific criteria were used to search for publications on 3D models. The review considered articles published in English on the development of 3D models to teach otorhinolaryngology. The studies with presurgical purposes or without validation of the task by surgeons were excluded from this review. RESULTS: This review considered 39 articles published in 10 countries between 2012 and 2021. The works published prior to 2012 were not considered as per the inclusion criteria for the research. Among the 39 simulators selected for review, otology models comprised a total of 15 publications (38%); they were followed by rhinology, with 12 (31%); laryngology, with 8 (21%); and head and neck surgery, with 4 publications (10%). CONCLUSION: The use of 3D technology and printing is well established in the context of surgical education and simulation models. The importance of developing new technological tools to enhance 3D printing and the current limitations in obtaining appropriate animal and cadaver models signify the necessity of investing more in 3D models. PMID:34533591 | DOI:10.1007/s00405-021-07088-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.