Development and Validation of a Two‐Segment Continuum Robot for Maxillary Sinus Surgery

xlomafota13 shared this article with you from Inoreader Development and Validation of a Two‐Segment Continuum Robot for Maxillary Sinus Surgery Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Existing rigid instruments have difficulties in backward inspection and operation. Moreover, the pathway to the maxillary sinus is curved and narrow, resulting in complex and repetitive manual operations. There is a necessity to develop a retro-flexing robot and achieve path-following motion. Methods A continuum robotic system is developed for maxillary sinus surgery (MSS). And the system adopts an anatomical constraint-based optimization of the follow-the-leader strategy to generate a safe control scheme along a given path. Results The accuracy of the system is evaluated, and the task of reaching deep-seated targets is performed in a constrained anatomical space. The simulations and experiments of the path-following motion have validated the feasibility of the proposed method. Furthermore, a preliminary porcine study is performed to assess the capability of instruments. Conclusions The developed continuum robotic system can meet the requirements of MSS. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD)

xlomafota13 shared this article with you from Inoreader Study protocol: the ear-nose-throat (ENT) prospective international cohort of patients with primary ciliary dyskinesia (EPIC-PCD) Via Laryngologie BMJ Open. 2021 Oct 11;11(10):e051433. doi: 10.1136/bmjopen-2021-051433. ABSTRACT INTRODUCTION: Primary ciliary dyskinesia (PCD) is a rare, genetic, multiorgan disease with an estimated prevalence of 1 in 10 000. It affects mainly the upper and lower airways due to impaired mucociliary clearance. Almost all patients have sinonasal or otologic (ear-nose-throat, ENT) problems, although the ENT clinical phenotype may present great variability. Despite that, data on PCD ENT manifestations are scarce and based on small single-centre studies. To date, we know little about the spectrum and severity of PCD ENT disease, its association with lung disease, its course over life and its determinants of prognosis.This study protocol describes the aims and methods of the first prospective, observational, multinational cohort study focusing on ENT disease in patients with PCD. METHODS AND ANALYSIS: The ENT prospective international cohort of patients wi th PCD (EPIC-PCD) is a prospective standardised observational clinical cohort set up as a multinational multicentre study, embedded into routine patient care. It aims to longitudinally characterise ENT disease in patients with PCD and its association with lung disease, and to identify determinants of its prognosis. Patients of all ages, diagnosed with PCD who undergo an ENT clinical assessment at least once a year at one of the participating centres will be invited to participate. Collected data include diagnostic test results, results of ENT examinations, lung function measurements, information on management of ENT disease and patient-reported data on clinical symptoms and health-related quality of life (QoL). Data are collected using the standardised PCD-specific FOLLOW-PCD form and the validated QoL-PCD questionnaire. ETHICS AND DISSEMINATION: The study has been reviewed and approved by the Human Research Ethics Committees at all participating centres, based on local legisl ation. The results of the study will be published in scientific journals, presented at scientific conferences and disseminated to participants and national patient organisations. TRIAL REGISTRATION: NCT04611516. PMID:34635525 | DOI:10.1136/bmjopen-2021-051433 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extramedullary Solitary Plasmacytoma of Larynx: A Rare Entity and Therapeutic Challenge

xlomafota13 shared this article with you from Inoreader Extramedullary Solitary Plasmacytoma of Larynx: A Rare Entity and Therapeutic Challenge Via Otolaryngology Indian Abstract Solitary extramedullary plasmacytoma is a rare entity. The diagnosis is established by clinical evaluation, detailed radiological workup and histopathology with immunohistochemistry markers. There is no clear standard of care for a solitary laryngeal plasmacytoma. A case of solitary laryngeal plasmacytoma is being reported here with the rationale for the chosen treatment modality. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Migrated Foreign Body of Upper Digestive Tract—A Ten-Year Institutional Experience

xlomafota13 shared this article with you from Inoreader Migrated Foreign Body of Upper Digestive Tract—A Ten-Year Institutional Experience Via Otolaryngology Indian Abstract The ingested foreign body is one of the commonest emergencies encountered by otolaryngologists Depending on the shape and duration of impaction, a small number of foreign bodies (1–2%) can perforate the wall of the gastrointestinal Tract. A migrated foreign body may remain quiescent or cause life-threatening suppurative and vascular complications. Data were collected retrospectively from the hospital records in a tertiary care hospital in South India from 2010 to 2020. Fifteen patients diagnosed with migrated foreign body and who underwent neck exploration were included in the study. Demographic details, mode of presentation, clinical and radiological findings, rigid esophagoscopy findings, neck exploration techniques employed were noted. The mean age of the patients was 37.66 years. All patients had a history of dysphagia, odynophagia, and point tenderness. All the patients underwent a lateral neck radiograph, and it was positive in 12 patients (80%), whi le in 3 patients (20%), it was negative. All the patients had a positive finding in Contrast-Enhanced Computed Tomography. Esophagoscopy was done prior to neck exploration to identify the site of injury and the probable site of migration. All the patients underwent lateral neck exploration, and foreign body was removed. Migrated foreign body can cause significant morbidity and mortality if not diagnosed and managed early. Strong suspicion and a systematic approach are needed for the diagnosis and management. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Unusual Tumor in an Uncommon Site-Orbital Rosai–Dorfman Disease: A Case Report

xlomafota13 shared this article with you from Inoreader An Unusual Tumor in an Uncommon Site-Orbital Rosai–Dorfman Disease: A Case Report Via Otolaryngology Indian Abstract Rosai–Dorfman disease (RDD) is also known as Sinus Histiocytosis with Massive Lymphadenopathy. It is a rare, benign, self-limiting disease of phagocytic histiocytes presenting with massive painless cervical lymphadenopathy. RDD can present as a nodal disease and also extra-nodal involvement with episodes of exacerbation and remissions and relapses after treatment. Its etiology remains poorly understood and is highly variable in its clinical presentation and response to treatment. Its treatment is poorly defined but the prognosis is usually fair. Here we are reporting a rare, unusual clinical presentation of infraorbital soft tissue mass diagnosed as RDD with cyto-histopathological correlation. Only a few such cases have been reported in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma: A Longitudinal Follow-Up Study

xlomafota13 shared this article with you from Inoreader Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma: A Longitudinal Follow-Up Study Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Safety and Efficacy of Mandibular Distraction Osteogenesis Among Infants Less Than 3 kg

xlomafota13 shared this article with you from Inoreader The Safety and Efficacy of Mandibular Distraction Osteogenesis Among Infants Less Than 3 kg Via The Laryngoscope Objectives/Hypothesis Mandibular distraction osteogenesis (MDO) is a safe and effective surgery to address respiratory and feeding issues due to micrognathia in patients with Robin Sequence (RS). Previous studies examining postoperative complications in neonates receiving MDO have considered 4 kg as the cut-off for low weight; however, an increasing number of MDO interventions are performed in infants <4 kg. To determine if a weight <3 kg at time of MDO is a risk factor for postoperative complications or need for subsequent tracheostomy or gastrostomy tube (G-tube). Study Design Retrospective chart review. Methods A retrospective review of all infants <6 months of age undergoing MDO at two tertiary pediatric hospitals from 2008 to 2018. Demographic data, syndromic status, weight, and age at time of surgery, length of postoperative hospital stay, and postoperative outcomes were recorded including tracheostomy placement, G-tube placement, hardware infection, reintubation, facial/marginal mandibular nerve damage, and need for revision MDO. Results Sixty-nine patients with RS were included. The mean age at MDO was 25 ± 20 days and mean weight was 3.32 ± 0.44 kg. There was no statistically significant correlation between weight (P = .699) or age (P = .422) and unfavorable postoperative outcomes. No patients (0%) underwent tracheostomy pre-MDO. Two patients (2.9%) required tracheostomy postsurgery; neither was <3 kg. Eight patients (11.6%) required a G-tube postoperatively. Conclusion Newborns <3 kg who undergo MDO experience the same rates of success and complication as larger infants, suggesting that MDO is a safe and efficacious procedure in infants less than 3 kg. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gait and Age‐Related Hearing Loss Interactions on Global Cognition and Falls

xlomafota13 shared this article with you from Inoreader Gait and Age‐Related Hearing Loss Interactions on Global Cognition and Falls Via The Laryngoscope Objectives Age-related hearing loss (ARHL) is considered a risk factor for cognitive impairment and falls. The association may be modulated by gait performance because ARHL is related to mobility decline, which strongly contributes to cognitive impairment and falls. We investigated the interactive effects of gait and ARHL on global cognition and falls among older adults. Study Design Retrospective cohort study. Methods The auditory acuity of 810 community-dwelling older adults was measured using a pure-tone average of hearing thresholds at 1,000 and 4,000 Hz in the better-hearing ear. Participants were then stratified as follows: normal hearing, ≤25 dB; mild hearing loss (HL), >25 and ≤40 dB; and moderate to severe HL, >40 dB. Gait speed was assessed as an indicator of gait performance and fall occurrence within the previous year. Global cognition was determined using the Montreal Cognitive Assessment (MoCA) test. Results A total of 320 (39.5%) and 233 (28.8%) participants had mild and moderate to severe HL, respectively. Hierarchical multiple and logistic regression analyses showed interactions between gait performance and moderate hearing loss on both global cognition and the occurrence of falls. Specifically, older adults with moderate hearing loss who walked slowly showed lower MoCA scores and a higher incidence of falls, whereas those with decent gait speed did not show such a tendency. Conclusion Our results suggest that poor gait performance might modulate the effects of ARHL, leading to cognitive decline and falls. Poor cognitive performance and falls may be prevalent in older adults with ARHL, especially in those with slower gait and moderate hearing loss. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Hospital Volume on Outcomes Following Head and Neck Cancer Surgery and Flap Reconstruction

xlomafota13 shared this article with you from Inoreader Impact of Hospital Volume on Outcomes Following Head and Neck Cancer Surgery and Flap Reconstruction Via The Laryngoscope Objective/Hypothesis Utilization of flaps for reconstruction of large head and neck cancer (HNCA) defects has become more prevalent. The present study aimed to assess the impact of center experience as measured by annual hospital caseload on mortality, major complications, resource utilization, and 90-day readmissions following HNCA resection with flap reconstruction. Study Design Non-Randomized Controlled Cohort Study. Methods All adult patients undergoing elective HNCA resection with flap reconstruction were identified utilizing the 2010 to 2018 Nationwide Readmissions Database. Hospitals were subsequently classified as low-, medium-, or high-volume based on annual institutional surgical caseload tertiles. Multivariable regression models were implemented to assess the independent association of hospital volume with the outcomes of interest. Results Over the nine-year study period, the proportion of HNCA resection with flap reconstruction gradually increased (12.8% in 2010 vs. 17.3% in 2018, P < .001). Although increasing hospital volume did not alter the odds of mortality, patients treated at high-volume centers were less likely to experience both surgical (adjusted odds ratio [AOR] 0.81, 95% confidence interval [CI] 0.67–0.97, P = .025) and medical complications (AOR 0.70, 95% CI 0.57–0.85, P < .001). Furthermore, these patients had shorter hospitalizations (−2.1 days, 95% CI −2.7 to −1.4 days, P < .001) and decreased costs (−$8,100, 95% CI −11,400 to −4,700, P < .001) compared to counterparts at low-volume centers. However, hospital volume did not impact 90-day readmissions. Conclusion Patients undergoing HNCA resection with flap reconstruction at high-volume centers were less likely to experience surgical and medical complications while incurring shorter hospitalizations and lower costs. Implementation of volume standards may be appropriate to improve outcomes in this surgical population. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sentinel Lymph Node Biopsy Versus Elective Node Dissection in Stage cT1‐2N0 Oral Cavity Cancer

xlomafota13 shared this article with you from Inoreader Sentinel Lymph Node Biopsy Versus Elective Node Dissection in Stage cT1‐2N0 Oral Cavity Cancer Via The Laryngoscope Objective To compare overall survival (OS) and disease-free survival (DFS) between sentinel lymph node biopsy (SNB) and elective neck dissection (END) in the surgical management of cT1-2N0 oral cavity squamous cell carcinoma (OCSCC). Methods English full-text articles were searched in PubMed and Embase on May 9, 2021. Articles had to compare SNB with END in cT1-T2N0 OCSCC patients; report hazard ratios (HRs), Kaplan–Meier curves, or P-values with total number of events for survival outcomes; be from a clinical trial, cohort, or case–control study. Two reviewers reviewed articles and a third settled disagreements. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Risk of Bias in Non-randomized Studies of Interventions tool and revised Cochrane risk-of-bias tool for randomized trials were used. The generic inverse variance method with a random-effect model was used for meta-analysis. Results Ten studies, five retrospective, three prospective, and two randomized controlled trials, were included (total number of patients [n] = 10,498, END n = 9102, SNB n = 1396). No significant differences were found in OS (HR = 0.92; 95% confidence interval [CI]: 0.65–1.31) or DFS (HR = 0.70; 95% CI: 0.41–1.20). Heterogeneity was not detected in pooled OS analysis (P = .18; I 2 = 30%), but was in pooled DFS analysis (P = .003; I 2 = 66%). Conclusions No statistically significant differences in OS or DFS were observed between SNB and END in cT1-2N0 OCSCC, suggesting that SNB might be an alternative to END in the management of early-stage, clinically node-negative OCSCC. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Canalicular adenoma presenting as epipharyngeal tumour – a case report

xlomafota13 shared this article with you from Inoreader Canalicular adenoma presenting as epipharyngeal tumour – a case report Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1651-0778 Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perioperative Complication Profile of Skull Base Meningioma Resection in Older versus Younger Adult Patients

xlomafota13 shared this article with you from Inoreader Perioperative Complication Profile of Skull Base Meningioma Resection in Older versus Younger Adult Patients Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1736408 Objectives To better understand the risk-benefit profile of skull base meningioma resection in older patients, we compared perioperative complications among older and younger patients. Design Present study is based on retrospective outcomes comparison. Setting The study was conducted at a single neurosurgery institute at a quaternary center. Participants All older (age ≥ 65 years) and younger (<65 years) adult patients treated with World Health Organization grade 1 skull base meningiomas (2008–2017). Main Outcome Measures Perioperative complications and patient functional status are the primary outcomes of this study. Results The analysis included 287 patients, 102 older and 185 younger, with a mean (standard deviation [SD]) age of 72 (5) years and 51 (9) years (p < 0.01). Older patients were more likely to have hypertension (p < 0.01) and type 2 diabetes mellitus (p = 0.01) but other patient and tumor factors did not differ (p ≥ 0.14). Postoperative medical complications were not significantly different in older versus younger patients (10.8 [11/102] vs. 4.3% [8/185]; p = 0.06) nor were postoperative surgical complications (13.7 [14/102] vs. 10.8% [20/185]; p = 0.46). Following anterior skull base meningioma resection, diabetes insipidus (DI) was more common in older versus younger patients (14 [5/37] vs. 2% [1/64]; p = 0.01). Among older patients, a decreasing preoperative Karnofsky performance status score independently predicted perioperative complications by logistic regression analysis (p = 0.02). Permanent neurologic deficits were not signific antly different in older versus younger patients (12.7 [13/102] vs. 10.3% [19/185]; p = 0.52). Conclusion The overall perioperative complication profile of older and younger patients was similar after skull base meningioma resection. Older patients were more likely to experience DI after anterior skull base meningioma resection. Decreasing functional status in older patients predicted perioperative complications. [...] 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.