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Τετάρτη 6 Απριλίου 2022

Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter?

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Abstract

Purpose

To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS.

Methods

Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale.

Results

The most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%).

Conclusion

Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS.

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

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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.

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Assessment of deep convolutional neural network models for mandibular fracture detection in panoramic radiographs

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The aim of this study was to develop automated models for the identification and detection of mandibular fractures in panoramic radiographs using convolutional neural network (CNN) algorithms. A total of 1710 panoramic radiograph images from the years 2016 to 2020, including 855 images containing mandibular fractures, were obtained retrospectively from the regional trauma centre. CNN-based classification models, DenseNet-169 and ResNet-50, were fabricated to identify fractures in the radiographic images.
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Skeletal maturation in different anteroposterior and vertical skeletal growth patterns in female subjects

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Abstract

Purpose

The aim of the present work was to study the sequence of skeletal maturation in the various anteroposterior and vertical skeletal growth patterns and to detect whether differences existed between them.

Methods

Cephalograms of 861 growing and adolescent female patients were traced to categorize the subjects into 9 skeletal patterns. Each subject was assigned a skeletal maturational stage. Analysis of variance (ANOVA) followed by Bonferroni test were used to detect differences in the onset of the three growth stages (prepubertal, pubertal and postpubertal) between the 9 groups. The same statistical methods were used to detect differences between the mean ages at the three growth stages within each group.

Results

No statistically significant differences were found between the mean ages of pubertal and postpubertal growth stages between the 9 skeletal patterns. However, class III growers had a significantly earlier onset of prepubertal growth (10.25 ± 1.56 years) when compared to that of class II high angle cases (11.11 ± 1.67 years; P < 0.01). Also, significant differences were found between the mean ages at the three growth stages within the groups.

Conclusion

A map was created defining the sequence of skeletal maturation for each skeletal growth pattern. This map defines clinically relevant differences in the starting time points and the optimum intervals of growth modification for each skeletal growth pattern.

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Τρίτη 5 Απριλίου 2022

Incretin-induced changes in the transcriptome of skeletal muscles of fa/fa Zucker rat (ZFR) with obesity, without diabetes

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Between a Rock and a Hard Place: Anticoagulating an Adolescent with Post-Tonsillectomy Massive PE: A Case Report

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Annals of Otology, Rhinology &Laryngology, Ahead of Print.
Objectives:To report a case of a morbidly obese 17-year-old boy who presented 4 days post-tonsillectomy with acute deep venous thromboses and a massive pulmonary embolism. To describe a protocol and decision-making tree for providing anticoagulation in the immediate post-tonsillectomy period.Methods:A chart review and review of the literature.Results:The patient ultimately did well and had no bleeding from the tonsil beds or further thromboembolic complications. A review of the literature revealed no available data regarding the safety of anticoagulation in the immediate post-tonsillectomy period.Conclusions:We propose that if anticoagulation is needed within 14 days of tonsillectomy, submaximal anticoagulation with a reversible and titratable anticoagulant may be optimal. A multidisciplinary team approach is needed for these complex cases. Future reporting and investigation of anticoagulation post-tonsillec tomy is needed.
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The prognostic value of adding systemic inflammation response index to Epstein–Barr virus DNA in childhood nasopharyngeal carcinoma: A real‐world study

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Abstract

Background

To assess the prognostic value of the systemic inflammation response index (SIRI) combined with plasma load of Epstein–Barr virus (EBV) DNA in children and adolescents with locoregionally advanced nasopharyngeal carcinoma (CALANPC).

Methods

A total of 205 consecutive patients with CALANPC were enrolled. We used recursive partitioning analysis (RPA) to classify patients into various risk groups, with a primary endpoint of overall survival (OS).

Results

Elevated SIRI (≥1.53) and EBV DNA (≥4000 copy/ml) were significantly associated with inferior OS in CALANPC. RPA categorized patients into low- and high-risk groups based on prognostic factors. Survival curves showed excellent discrimination in OS (95.3% vs 77.6%; p < 0.001) between the low- and high-risk groups. A significant improvement was confirmed using the prognostic methods for conventional TNM staging systems (p < 0.05).

Conclusions

The combination of SIRI with EBV DNA provided a more detailed understanding of patient risks, and enhanced risk discrimination in CALANPC.

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N6‐methyladenosine modification contributes to arecoline‐mediated oral submucosal fibrosis

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Abstract

Background

Oral submucosal fibrosis (OSF) is a precancerous condition that closely related to the habit of chewing betel nut. The OSF patients of 3%–19% may develop cancer, and this probability is increasing year by year. Epigenetics modifications have been reported as part of the pathogenesis of OSF. However, in OSF field, the role and mechanism of arecoline-induced activation of transforming growth factor β (TGF-β) signaling on N6-methyladenosine (m6A) modification remain unclear. In this study, we investigated the effect and mechanism of arecoline on m6A modification.

Methods

MeRIP-Seq and RNA-seq were performed in arecoline-stimulated cells. Quantitative polymerase chain reaction and western blot were performed to detect the expression of m6A writers and erasers. CCK-8 and flow cytometry analyses were performed to measure the cell viability and apoptosis.

Results

m6A level was increased in OSF tissues compared to normal tissues; arecoline promoted the m6A methyltransferase Mettl3 and Mettl14 through TGF-β. MeRIP-seq and RNA-seq analyses found that MYC was the target gene of Mettl14. In addition, Mettl14 silence reversed the effects of arecoline on cell proliferation and apoptosis in Hacat cells.

Conclusion

TGF-β-METTL14-m6A-MYC axis was crucially implicated in arecoline-mediated OSF and may be an effective therapeutic strategy for OSF treatment.

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Coverage error of three resin composite systems to vital unrestored maxillary anterior teeth

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Abstract

Objective

Define the color of anterior teeth of a selected population and correlate it (by using coverage error [CE] and the frequency of best match) with the final color of all possible enamel-dentine combinations of three different resin composite systems.

Materials and methods

Color of 636 vital unrestored anterior teeth (central incisors, lateral incisors and canines; n = 212) and disk specimens (12 mm diameter, varying thickness) corresponding to enamel-dentin combinations of all available enamel (0.5 mm and 1.0 mm thickness) and dentin shades (3.0 mm thickness) of Essentia, Enamel Plus HRi and IPS Empress Direct composite systems was measured using a clinical dental spectrophotometer (Spectroshade Micro). CE and frequency of best match for all composite systems were calculated for the measured in-vivo teeth color space.

Results

Natural in-vivo teeth exhibit higher lightness when compared to enamel-dentin composite combinations, independently of the enamel thickness used. The best (lowest) CE was found for IPS Empress, while the highest values were found for Enamel Plus Hri independently of tooth type and enamel thickness (p < 0.001). The use of 0.5 mm instead of 1.0 mm enamel thickness within enamel-dentin composite combinations resulted in a lower CE for in-vivo tooth color (p < 0.001).

Conclusions

The color space defined by all possible enamel-dentin combinations of the studied resin composite systems does not fully match the color range of anterior teeth. All composite systems examined lack combinations with lightness values as high as the population's. IPS Empress Direct composite system represented better the in-vivo teeth color.

Clinical significance

The use of 0.5 mm enamel shade thickness is suggested when building layered restorations, as it provided better color coverage than using 1.0 mm thickness.

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Applications of maxillary tuberosity block autograft

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Abstract

Objective

Autogenous bone grafts are considered the gold standard due to their compatibility and osteogenic potential to induce new bone formation through osteogenesis, osteoinduction, and osteoconduction. The aim of this paper was to describe clinical applications of the maxillary tuberosity block autograft in small and moderate localized defects of the alveolar process around implants and teeth.

Clinical Considerations

Maxillary tuberosity is often used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion, but not as a bone block graft. The maxillary tuberosity block autograft may also provide a valuable bone source for challenging situations such as immediate implant placement into types II and III extraction sockets, treatment of horizontal and vertical bone defects with simultaneous implantation, reconstruction of circumferential defects around implants, and preservation of alveolar ridge.

Conclusions

The advantages of the maxillary tuberosity include intraoral corticocancellous autogenous graft with fewer intraoperative difficulties, no need for donor site restoration, less morbidity, and an excellent correction of localized alveolar ridge defects.

Clinical Significance

Within the limitations of the presented case reports, the use of maxillary tuberosity block autograft has shown to be successful in alveolar ridges augmentation that lack both width and height.

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Do antihypertensive medications effect the mandibular cortical bone thickness? A study using cone beam computed tomography images

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Publication date: Available online 4 April 2022

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Brett Spenrath, Antonia Kolokythas

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Hyper-IgE syndrome caused by DOCK8 mutation with a tumour-like lesion of the lip: a case report

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Autosomal recessive hyper-IgE syndrome caused by DOCK8 gene mutation is an immunodeficiency. However, the presentation of a tumour-like lesion of the lip in autosomal recessive hyper-IgE syndrome has not yet been reported. This article reports the case of a 20-year-old man with autosomal recessive hyper-IgE syndrome who presented with a tumour-like lesion of the lip, and hyperplasia and erosion of the gingiva. The clinical manifestations included coarse face and neck skin, a diffuse tumour-like lesion on the upper lip showing a reddish erosive nodular surface with yellowish-white exudation, erosive buccal mucosa, and severe periodontitis.
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