Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Κυριακή 30 Ιανουαρίου 2022

A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study

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Objectives/Hypothesis

Develop a patient-specific tissue engineered construct for laryngeal reconstruction following a partial laryngectomy.

Study Design

Bench and animal research.

Methods

A construct made from a porous polyethylene scaffold shaped in a canine-specific configuration and seeded with autologous canine adipose-derived stem cells in fibrin glue was implanted in a canine following a partial laryngectomy. After 1 year, the construct was first evaluated in vivo with high-speed imaging and acoustic–aerodynamic measures. It was then explanted and evaluated histologically.

Results

The canine study at 1 year revealed the construct provided voicing (barking) with acoustic and aerodynamic measures within normal ranges. The canine was able to eat and breathe normally without long-term support. The construct was integrated with epithelialization of all areas except the medial portion of the vocal fold structure. No anti-infective agents were needed after the standard perioperative medications were completed.

Conclusion

This study provided a successful first step toward developing a patient-specific composite construct for patients undergoing partial laryngectomies.

Level of Evidence

Not Applicable Laryngoscope, 2022

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Auditory Behavior in Adult-Blinded Mice

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Abstract

Cross-modal plasticity occurs when the function of remaining senses is enhanced following deprivation or loss of a sensory modality. Auditory neural responses are enhanced in the auditory cortex, including increased sensitivity and frequency selectivity, following short-term visual deprivation in adult mice (Petrus et al. Neuron 81:664–673, 2014). Whether or not these visual deprivation–induced neural changes translate into improved auditory perception and performance remains unclear. As an initial investigation of the effects of adult visual deprivation on auditory behaviors, CBA/CaJ mice underwent binocular enucleation at 3–4 weeks old and were tested on a battery of learned behavioral tasks, acoustic startle response (ASR), and prepulse inhibition (PPI) tests beginning at least 2 weeks after the enucleation procedure. Auditory brain stem responses (ABRs) were also measured to screen for potential effects of visual deprivation on non-behavioral hearing function. Control and enucleated mice showed similar tone detection sensitivity and frequency discrimination in a conditioned lick suppression test. Both groups showed normal reactivity to sound as measured by ASR in a quiet background. However, when startle-eliciting stimuli were presented in noise, enucleated mice showed decreased ASR amplitude relative to controls. Control and enucleated mice displayed no significant differences in ASR habituation, PPI tests, or ABR thresholds, or wave morphology. Our findings suggest that while adult-onset visual deprivation induces cross-modal plasticity at the synaptic and circuit levels, it does not substantially influence simple auditory behavioral performance.

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The music-related quality of life: Italian validation of MuRQoL into MUSQUAV questionnaire and preliminary data from a cohort of postlingually deafened cochlear implant users

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Eur Arch Otorhinolaryngol. 2022 Jan 28. doi: 10.1007/s00405-022-07258-1. Online ahead of print.

ABSTRACT

PURPOSE: Cochlear implant (CI) users do not receive much of the auditory information necessary for an accurate perception of music. This usually entails a dissatisfaction with the music they hear, so that their quality of life may potentially be affected. The main aim of this paper was to translate and validate into Italian an instrument to evaluate these aspects-The Music-Related Quality of Life Questionnaire (MuRQoL)-to help the work of clinicians and therapists.

METHODS: The translation of the MuRQoL into "Questionario Musica e Qualità della Vita" (MUSQUAV) was done according to the international guidelines. The translated questionnaire was administered to normal hearing (NH) and CI users adults. Exploratory factor analysis, confirmatory factor analysis and known group method were used to confirm construct validity and app licability of MUSQUAV.

RESULTS: We retrieved 225 results. The MUSQUAV questionnaire was acceptable according to the goodness-of-fit indices. The correlation between the items, evaluated using Cronbach's α coefficient, indicates a good internal consistency (> 0.80). The non-parametric Mann-Whitney test showed significant differences in the distinct populations tested.

CONCLUSIONS: The MUSQUAV questionnaire is a valid, low-cost and rapid instrument for professional workers in the audiological field, especially useful in the assessment of the patients' perception and musical engagement.

PMID:35089391 | DOI:10.1007/s00405-022-07258-1

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Mucosal melanocytic lesion in the middle ear extending to the inner ear and nasopharynx

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Ear Nose Throat J. 2022 Jan 28:1455613211068571. doi: 10.1177/01455613211068571. Online ahead of print.

ABSTRACT

Benign dendritic melanocytic proliferation is usually observed in the skin. We report an extremely rare case of a melanocytic lesion in the middle ear mucosa. Only 3 cases of melanocytic lesions in the middle ear have been reported. Our report is the only one that describes an adult with a melanocytic lesion in the middle ear that extended to the inner ear and nas opharyngeal mucosa. A 23-year-old female presented with profound sensory neural hearing loss and recurrent discharge from the right ear. Examination revealed a blue right tympanic membrane with a small perforation. Computed tomography scans and magnetic resonance imaging were performed. After surgical exploration and histopathological examination, the patient was found to have a benign melanocytic lesion in the right middle ear. Melanocytic lesions are commonly found in the skin. There are no previous reports have described adult patients with melanocytic lesions in the middle ear that extend to the inner ear and nasopharynx, which cause profound hearing loss with recurrent ear discharge. These patients require regular follow-up to assess the progression of the lesion and to watch for any malignant behavior.

PMID:35088612 | DOI:10.1177/01455613211068571

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Intraoral Approach for Parapharyngeal Branchial Cleft Cysts

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Ear Nose Throat J. 2022 Jan 28:1455613211067846. doi: 10.1177/01455613211067846. Online ahead of print.

ABSTRACT

Branchial cleft cyst (BCC) most frequently arises from the second branchial cleft and is located anterior to the sternocleidomastoid muscle at the mandibular angle. However, very rarely, this may occur in the parapharyngeal space. Interestingly, the parapharyngeal BCC is frequently misdiagnosed as a peritonsillar abscess. In this study, we reported 2 cases of para pharyngeal BCC misdiagnosed as peritonsillar abscess.

PMID:35088618 | DOI:10.1177/01455613211067846

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A case of bilateral internal carotid artery ectopic position in oropharynx

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):54-56. doi: 10.3760/cma.j.cn115330-20210518-00282.

NO ABSTRACT

PMID:35090211 | DOI:10.3760/cma.j.cn115330-20210518-00282

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A new classification of maxillary defect and simultaneous accurate reconstruction

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):8-14. doi: 10.3760/cma.j.cn115330-20210724-00484.

ABSTRACT

Objective: To select the preferred flaps for the reconstruction of different maxillary defects and to propose a new classification of maxillary defects. Methods: A total of 219 patients (136 males and 83 females) underwent the simultaneous reconstruction of maxillary defects in the Beijing Tongren Hospital, Capital Medical University, between January 2005 and December 2018 were reviewed. Age ranged from 16 to 78 years. Based on the proposed new classification of the maxillary defects, 22 patients with class Ⅰ defects (inferior maxillectomy), 44 patients with class Ⅱ defects (supperior maxillectomy), 132 patients with class Ⅲ defects (total maxillectomy) and 21 patients with class Ⅳ defects (extensive maxillectomy) were enrolled. Survival rate, functional and aesthetic outcomes of flaps were ev aluated. Survival analysis was performed in 169 patients with malignant tumor, Kaplan-Meier method was used to calculate the survival rate, and Log-rank method was used to compare the difference of survival rate in each group. Results: A total of 234 repairs for maxillary defects were performed in 219 patients. Fibula flaps were used in 4/13 of class Ⅰ defects; temporal muscle flaps (11/24, 45.8%) and anterolateral thigh flaps (6/24, 25.0%) used in class Ⅱ defects; temporal muscle flaps (71/128, 55.5%), anterolateral thigh flaps (6/24, 25.0%) and fibula flaps (12/128, 9.4%) used in class Ⅲ defects; and anterolateral thigh flaps (8/20, 40.0%) and rectus abdominis flaps (8/20, 40.0%) used in class Ⅳ defects. The success rate of local pedicled flaps was 95.6% (109/114) and that of free flaps was 95.8% (115/120). Thrombosis(10/234,4.3%) was a main reason for repair failure. Among the followed-up 88 patients, swallowing and speech functions recovered, 82 (93.2%) of them we re satisfied with appearance, and 75 (85.2%) were satisfied with visual field. The 3-year and 5-year overall survival rates were 66.5% and 63.6%, and the 3-year and 5-year disease-free survival rates were 57.1% and 46.2%, respectively, in the 169 patients with malignant tumors. Conclusion: A new classification of maxillary defects is proposed, on which suitable flaps are selected to offer patients good functional and aesthetic outcomes and high quality of life.

PMID:35090203 | DOI:10.3760/cma.j.cn115330-20210724-00484

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Spindle cell carcinoma of larynx: a report of 3 cases

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):59-61. doi: 10.3760/cma.j.cn115330-20210304-00106.

NO ABSTRACT

PMID:35090213 | DOI:10.3760/cma.j.cn115330-20210304-00106

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Virtual reality-assisted management of communicated solitary fibrous tumor in skull base: a case report

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):65-68. doi: 10.3760/cma.j.cn115330-20210630-00405.

NO ABSTRACT

PMID:35090215 | DOI:10.3760/cma.j.cn115330-20210630-00405

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Precise resection and defect repair of external nose malignant tumor

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):15-21. doi: 10.3760/cma.j.cn115330-20210630-00399.

ABSTRACT

Objective: To explore the methods for the accurate resection of malignant tumors of the external nose, and the accurate evaluation and repair of tissue defects. Methods: We collected 48 cases with nasal malignant tumors treated in 980 Hospital, Joint Support Force of the People's Liberation Army from January 2010 to June 2020, including 28 males and 20 females, aged 36-86 years. The pathological types of tumors included basal cell carcinomas (n=29), squamous cell carcinomas (n=11), trichilemmal carcinomas(n=6), denoid cystic carcinoma (n=1) and non-Hodgkin lymphoma (n=1). Tumor resection was mainly based on the traditional extended resection determined by the safety margin, and Mohs surgery was used to minimize the scope of resection, for the margin that significant ly affected the repairing results, such as the lesion adjacent to the nasal alar margin, nasal columella or deep easy-penetrating margin. All cases obtained tumor resection and primary/secondary defect reconstruction. Results: According to the pathological type and tumor size, the safe resection margin was mainly 4-10 mm, and Mohs surgery was used in 24 cases. Limited-size defects in 38 cases were repaired with double-leaf flaps, kite flaps, nasal dorsum brow flaps, nasolabial flaps or free tissues. Among 10 cases with compound defects, 8 cases were repaired with frontal flaps, including 4 cases with single frontal flaps, 2 cases with additional titanium mesh stent reconstruction and 2 cases with over and out frontal flaps. During follow-up of 1 to 10 years, all the flaps survived without flap necrosis, and the postoperative nasal contour and ventilation were satisfactory. One patient had tumor recurrence 18 months after operation, 2 patients died of cardiovascular and cerebr ovascular diseases, and other patients survived without tumors. Conclusions: Mohs surgery can basically meet the requirements for precise resection of external nasal malignant tumors. Individualized application of adjacent tissue flaps and various frontal flaps is a reasonable choice to achieve the satisfactory outcome of external nasal repair and to take into account the complexity of operation.

PMID:35090204 | DOI:10.3760/cma.j.cn115330-20210630-00399

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Research progress of nasal mucosal epithelial cells in chronic rhinosinusitis

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):78-81. doi: 10.3760/cma.j.cn115330-20210303-00103.

NO ABSTRACT

PMID:35090218 | DOI:10.3760/cma.j.cn115330-20210303-00103

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