In‐Office Superior Laryngeal Nerve Block for Paralaryngeal Pain and Odynophonia

xlomafota13 shared this article with you from Inoreader In‐Office Superior Laryngeal Nerve Block for Paralaryngeal Pain and Odynophonia Via The Laryngoscope Objectives Pain localized to the thyrohyoid region may be due to neuralgia of the superior laryngeal nerve (SLN), inflammation of the thyrohyoid complex, or a voice disorder. We present outcomes of treatment of paralaryngeal pain and odynophonia with SLN block. Study Design Retrospective Review. Methods A retrospective chart review of patients undergoing in-office SLN block for paralaryngeal pain between 2015 and 2018 at two tertiary care centers was conducted. Patient demographics, indications, and response to treatment were analyzed. Results Thirty-eight patients underwent blockade of the internal branch of the SLN for paralaryngeal pain, with 10 excluded for incomplete medical records. Eighty-two percent (23/28) reported an improvement in their symptoms. Patients underwent an average of 2.5 blocks (SD = 1.88, range 1–8), with 10 patients (36%) undergoing a single procedure. Of the 18 patients who underwent multiple blocks, nine had eventual cessation of symptoms (50%) compared to resolution in 6/10 undergoing a single injection. Eleven patients (39%) noted odynophonia related to vocal effort, and all of these patients had improvement in or resolution of their symptoms and were more likely to improve compared to those without odynophonia (P = .006). Of the four patients who had a vocal process granuloma (VPG) at presentation, three had complete resolution of the lesion at follow-up. Conclusion In-office SLN block is effective in the treatment of paralaryngeal pain. It may be used as an adjunct in the treatment of vocal process granulomas, as well as voice disorders where odynophonia is a prominent symptom. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Drug‐Eluting Endotracheal Tubes for Preventing Bacterial Inflammation in Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Drug‐Eluting Endotracheal Tubes for Preventing Bacterial Inflammation in Subglottic Stenosis Via The Laryngoscope Objectives/Hypothesis Subglottic stenosis (SGS) results from dysregulated extracellular matrix deposition by laryngotracheal fibroblasts causing scar tissue formation following intubation. Recent work has highlighted a relationship between this inflammatory state and imbalances in the upper airway microbiome. Herein, we engineer novel drug-eluting endotracheal (ET) tubes to deliver a model antimicrobial peptide Lasioglossin-III (Lasio) for the local modulation of the microbiome during intubation. Study Design Controlled in vitro study. Methods ET tubes were coated with a water-in-oil (w/o) emulsion of Lasio in poly(d,l-lactide-co-glycolide) (PLGA) by dipping thrice. Peptide release was quantified over 2 weeks via fluorometric peptide assays. The antibacterial activity was tested against airway microbes (Staphylococcus epidermidis, Streptococcus pneumoniae, and pooled human microbiome samples) by placing Lasio/PLGA-coated tubes and appropriate controls in 48 well plates with diluted bacteria. Bacterial inhibition and tube adhesion were tested by measuring optical density and colony formation after tube culture, respectively. Biocompatibility was tested against laryngotracheal fibroblasts and lung epithelial cells. Results We achieved a homogeneous coating of ET tubes with Lasio in a PLGA matrix that yields a prolonged, linear release over 1 week (typical timeframe before the ET tube is changed). We observed significant antibacterial activity against S. epidermidis, S. pneumoniae, and human microbiome samples, and prevention of bacterial adherence to the tube. Additionally, the released Lasio did not cause any cytotoxicity toward laryngotracheal fibroblasts or lung epithelial cells in vitro. Conclusion Overall, we demonstrate the design of an effective-eluting ET tube to modulate upper-airway bacterial infections during intubation which could be deployed to help prevent SGS. 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.

A Cross-Sectional Evaluation of Outcomes of Pediatric Thyroglossal Duct Cyst Excision

xlomafota13 shared this article with you from Inoreader A Cross-Sectional Evaluation of Outcomes of Pediatric Thyroglossal Duct Cyst Excision Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Thyroglossal duct cysts (TGDCs) are the most common form of congenital neck cysts. They may become infected causing dysphagia or respiratory distress. Accordingly, the treatment is always surgical removal. Objectives: The objectives of this article were to examine complications following TGDC excision by surgical specialty, demographics, and comorbid conditions. Methods: A retrospective review of the National Surgical Quality Improvement Program database was performed. Pediatric cases from January 1, 2014 to November 1, 2015 with a current procedure terminology code of 60,280 (excision of TGDC or sinus) were included. Statistical analysis was performed to assess associations between complications and surgical specialty, demographics, and comorbidities. Results: Of the 867 cases that met inclusion criteria, the median age was 4 years. There were 448 males (52.3%) and 408 females (47.7%). Thirty-six patients (4.2%) experienced at least one 30-day complication. The most predominant complications were reoperation (19 patients, 2.2%), readmission (18 patients, 2.1%), and surgical site infection (16 patients, 1.9%). There was no statistically significant difference between complications and surgical specialty. In those experiencing a complication, there was a statistically significant difference between males (86.1%) and females (13.9%). Of patients with at least one comorbidity, 36.67% had a complication, while 17.22% did not have a complication. There was also a statistically significant difference in the percentage of patients with a past medical history of asthma between those with at least one complication (16.67%) compared to those without any complications (4.76%). Conclusions: excision is a generally safe procedure across surgical specialties. There is a higher complication rate in males compared to females as well as those with a history of at least one medical comorbidity and those with asthma. The most common 30-day complications are reoperation, readmission, and surgical site infection. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Case of Nodular Lymphocyte Predominance Hodgkin’s Lymphoma of the Parotid Gland: Diagnostic Pitfall in Fine Needle Aspiration Cytology

xlomafota13 shared this article with you from Inoreader A Rare Case of Nodular Lymphocyte Predominance Hodgkin's Lymphoma of the Parotid Gland: Diagnostic Pitfall in Fine Needle Aspiration Cytology Via Otolaryngology Indian Abstract Primary malignant lymphoma of the salivary glands is a very rare entity, and primary parotid Hodgkin's Lymphoma (HL) is even rarer. It is rare in the initial evaluation to suspect a parotid tumor. Thus, it is important to keep lymphomatous involvement in mind when facing parotid masses in differential diagnosis. This study presented a case of a 56-year-old male with a 5-month history of left cheek enlargement. Fine Needle Aspiration (FNA) biopsy was performed with no suspicion for lymphoma. Parotidectomy was also done and nodular lymphocyte predominance HL within the parotid gland was confirmed by immunohistochemical study. The Nodular Lymphocyte Predominance Hodgkin's Lymphoma has been defined as a specific histopathological subtype of HL. The initial diagnostic approach is usually carried out through FNA, obtaining high sensitivity and specificity, which allows establishing an adjusted for co-correct diagnosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Diagnosis of Nasal Mass:Castleman’s Disease

xlomafota13 shared this article with you from Inoreader A Rare Diagnosis of Nasal Mass:Castleman's Disease Via Otolaryngology Indian Abstract Castleman disease (CD) is a rare disease of lymph nodes and related tissues. The disease can occur anywhere in the body where lymphoid tissue is normally present. Mediastinum is the most common site of involvement (approximately 70%) followed by the neck (15%) and the abdomen (15%) but extra lymphatic sites such as lungs, larynx, parotid glands, pancreas, meninges can be involved. Localised nasopharyngeal CD is extremely rare and to our knowledge the present case is the only case reported originating from the nasal cavity per se. According to literature only 4 cases of CD in nasopharynx has been reported till date. Microscopic subtypes are hyaline vascular, plasma cell, mixed, plasmablastic type. Hyaline vascular is the most common (90%) histological subtype. Four other cases were reported earlier, in which the nasopharynx was the site of origin. Our case had histopathologic features consistent with a mixture of plasma cell and hyaline vascular variant CD, while the previous four reported cases were of hyaline vascular type, making ours the first of its kind. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The risks of polytetrafluoroethylene pledget use in tracheopexy

xlomafota13 shared this article with you from Inoreader The risks of polytetrafluoroethylene pledget use in tracheopexy Via International Journal of Pediatric Otorhinolaryngology Publication date: Available online 28 July 2021 Source: International Journal of Pediatric Otorhinolaryngology Author(s): Gabriela Heslop, Lauren Sowa, Sparrow Helland, Ben Corbett, Todd M. Wine, Stig Somme, Jeremy D. Prager View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Civilian Penetrating Neck Trauma at a Level I Trauma Centre: A Five‐Year Retrospective Case Note Review

xlomafota13 shared this article with you from Inoreader Civilian Penetrating Neck Trauma at a Level I Trauma Centre: A Five‐Year Retrospective Case Note Review Via Clinical Otolaryngology Abstract Objectives To report the experience of civilian penetrating neck trauma (PNT) at a UK level I trauma centre, propose an initial management algorithm and assess the degree of correlation between clinical signs of injury, operative findings, and radiological reports. Design Retrospective case note review Setting UK level I trauma centre April 2012-November 2017 Participants 310 cases of PNT were drawn from electronic patient records. Data was extracted on hard and soft signs of vascular or aerodigestive tract injury, clinical management, radiological imaging and patient outcomes. Main outcome measures Patient demographics, mechanism of injury, morbidity and mortality. The correlation between clinical signs, and radiological reports to internal injury on surgical exploration. Results 271 (87.4%) male and 39 (13.6%) female patients with a mean age 36 years (16 – 87) were identified. The most common causes of injury were assault 171 (55.2%) and deliberate self-harm 118 (38%). A knife was the most common instrument 240 (77.4%). Past psychiatric history was noted in 119 (38.4%) and 60 (19.4%) were intoxicated. 50% were definitively managed in theatre with a negative exploration rate of 38%, and 50% were managed in ED. Pre-operative radiological reports correlated with operative reports in 62% of cases with venous injury the most common positive and negative finding. Multivariate correlation was r=0.89, p=0.045 between hard signs plus positive radiology findings and internal injury on neck exploration. Conclusions Management of PNT by clinical and radiological signs is safe and effective, and can be streamlined by a decision-making algorithm as proposed here. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Multimodal evaluation of donor site morbidity in transgender individuals after phalloplasty with a free radial forearm flap: a case-control study

xlomafota13 shared this article with you from Inoreader Multimodal evaluation of donor site morbidity in transgender individuals after phalloplasty with a free radial forearm flap: a case-control study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 17:S1748-6815(21)00326-0. doi: 10.1016/j.bjps.2021.05.068. Online ahead of print. ABSTRACT BACKGROUND: In phalloplasty, there is a lack of standardized follow-up examinations of motor function and strength after harvesting oversized radial forearm free flaps (RFFF). METHODS: We evaluated the donor site of 20 transmen after phalloplasty, using a multimodal, standardized approach, assessing the following parameters: opposition of the thumb, composite range of motion of the finger joints, grip strength, mobility of the wrist, lesion of the superficial branch of the radial nerve, the dorsal branch of the ulnar nerve, the sensation of pain, and cold intolerance. The contralateral, nonoperated forearm was used as a control. RESULTS: No impairment of the mobility of the thumb (Kapandji score median 10, range 5-10) or fingers (all fingers at both sides pulp-to-palm 0 cm, nail-to-table 0 cm) w ere detected. Grip strength (median 36,3kg, p=0.629) and wrist extension (62.5°vs.70°, p=0.357), flexion (70°vs.70°, p=0.535), pronation (90°vs.90°), supination (90°vs.90°), radial (30°vs.30°, p=0.195), and ulnar deviation (40°vs.50°, p=0.125) did not statistically differ between donor and control hand. Injury of the dorsal branch of the ulnar nerve was uncommon (0% hypoesthesia, 10% positive Tinel's sign). We did not observe any persistent pain of the donor forearm (NRS median 0, range 0-9). We did observe irritation of the superficial branch of the radial nerve (hypoesthesia 40%, neuroma 45%). CONCLUSION: The harvest of an oversized RFFF for phalloplasty does not cause any significant difference in motor function or strength between the donor and nonoperated hand. A potential risk of injuring the radial nerve branch is to be avoided. An aesthetic impairment could be addressed in future studies. PMID:34321186 | DOI:10.1016/j.bjps.2021.05.068 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Curcumin enhances the membrane trafficking of the sodium iodide symporter and augments radioiodine uptake in dedifferentiated thyroid cancer cells via suppression of the PI3K-AKT signaling pathway

xlomafota13 shared this article with you from Inoreader Curcumin enhances the membrane trafficking of the sodium iodide symporter and augments radioiodine uptake in dedifferentiated thyroid cancer cells <em>via</em> suppression of the PI3K-AKT signaling pathway Via radioactive iodine Food Funct. 2021 Jul 29. doi: 10.1039/d1fo01073e. Online ahead of print. ABSTRACT Radioactive iodine (RAI) is commonly used to treat differentiated thyroid cancer (DTC). A major challenge is the dedifferentiation of DTC with the loss of radioiodine uptake. Patients with distant metastases have persistent or recurrent disease and develop resistance to RAI therapy due to tumor dedifferentiation. Hence, tumor redifferentiation to restore sensitivity to RAI therapy is considered a prom ising strategy to overcome RAI resistance. In the present study, curcumin, a natural polyphenolic compound, was found to re-induce cell differentiation and increase the expression of thyroid-specific transcription factors, TTF-1, TTF-2 and transcriptional factor paired box 8 (PAX8), and iodide-metabolizing proteins, including thyroid stimulating hormone receptor (TSHR), thyroid peroxidase (TPO) and sodium iodide symporter (NIS) in dedifferentiated thyroid cancer cell lines, BCPAP and KTC-1. Importantly, curcumin enhanced NIS glycosylation and its membrane trafficking, resulting in a significant improvement of radioiodine uptake in vitro. Additionally, AKT knockdown phenocopied the restoration of thyroid-specific gene expression; however, ectopic expressed AKT inhibited curcumin-induced up-regulation of NIS protein, demonstrating that curcumin might improve radioiodine sensitivity via the inhibition of the PI3K-AKT-mTOR signaling pathway. Our study demonstrates that curcumin could re present a promising adjunctive therapy for restoring iodide avidity and improve radioiodine therapeutic efficacy in patients with RAI-refractory thyroid carcinoma. PMID:34323243 | DOI:10.1039/d1fo01073e View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Indication for radioactive iodine in patients with papillary thyroid carcinoma without apparent disease after total thyroidectomy but with elevated antithyroglobulin antibodies

xlomafota13 shared this article with you from Inoreader Indication for radioactive iodine in patients with papillary thyroid carcinoma without apparent disease after total thyroidectomy but with elevated antithyroglobulin antibodies Via radioactive iodine Clin Endocrinol (Oxf). 2021 Jul 29. doi: 10.1111/cen.14570. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate a criterion for the selective indication of radioactive iodine (RAI) based on the short-term behavior of antithyroglobulin antibodies (TgAb) in patients with papillary thyroid carcinoma (PTC) who have negative thyroglobulin (Tg) and neck ultrasonography (US) without abnormalities after total thyroidectomy but elevated TgAb. DESIGN: This was a prospective study th at evaluated 216 patients with low- or intermediate risk PTC who had nonstimulated Tg ≤ 0.2 ng/ml and no US abnormalities but elevated TgAb 3 months after thyroidectomy. RAI was not indicated in patients with negative TgAb or a > 50% reduction in TgAb concentrations 6 months after initial assessment followed by a negative test or an additional reduction (also > 50%) after 12 months. RESULTS: Only two of the 114 patients who did not receive RAI developed recurrences; another 108 patients met the criterion of an excellent response to therapy in the last assessment and TgAb persisted in four patients but there was an additional reduction in their concentration during follow-up. Among the 102 patients who received RAI, post-therapy whole-body scanning (RxWBS) detected persistent disease in 8 (8%). Two of the 94 patients without persistent disease on RxWBS developed recurrences. In the last assessment, in the absence of additional treatment, 54/92 patients (58.7%) without s tructural recurrence had negative TgAb. CONCLUSIONS: The indication for RAI can be based on the short-term behavior of TgAb in patients with PTC and elevated TgAb after thyroidectomy who are not high risk and who do not have apparent disease (nonstimulated Tg ≤ 0.2 ng/ml and no US abnormalities). This article is protected by copyright. All rights reserved. PMID:34323308 | DOI:10.1111/cen.14570 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel Method of Cartilage Harvest in Otology with Micro Dermatome: A Descriptive Study

xlomafota13 shared this article with you from Inoreader Novel Method of Cartilage Harvest in Otology with Micro Dermatome: A Descriptive Study Via Otolaryngology Indian Abstract Cartilage is used in middle ear surgery for reconstruction of tympanic membrane, ossicular chain, posterior canal wall and lateral attic wall. When used in tympanic membrane reconstruction, thickness of the cartilage is thought to interfere with the sound conduction. In our otology practice for tympanic membrane reconstruction, we prefer the sliced cartilage graft to achieve acoustic benefit. We have used a microdermatome for precise reduction of the thickness of the cartilage. This also allows us to select exact thickness of cartilage slice and also permits slicing from donor site directly. To describe the use of novel method of cartilage slicing using a micro dermatome and to report our preliminary experience. This is a descriptive study, with a total number of 350 cartilage grafts used in tympanoplasty and mastoidectomies have been prepared with micro dermatome from 2019 to 2021. Our study reports the technique of slicing the Conchal cartilage and how its unif orm measurement can be obtained. Our modified technique using the micro dermatome is easy to master, provides precise cartilage thickness as per needs within a short span of time. Harvesting from the donor site is as per the graft requirement and rest of the cartilage is left in place for the future revision surgery if needed. The cartilage obtained were structurally integral without any undue breakage and functionally stable. The thickness of the cartilages obtained makes it pliable for easy handling and placement in ear surgeries. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.