The correlation between neonatal parameters and late‐onset inner ear disorders in congenital cytomegalovirus infection: an 10‐year population‐based cohort study

xlomafota13 shared this article with you from Inoreader The correlation between neonatal parameters and late‐onset inner ear disorders in congenital cytomegalovirus infection: an 10‐year population‐based cohort study Via Clinical Otolaryngology Abstract Objective To evaluate the correlation of neonatal parameters with late-onset sensorineural hearing loss (SNHL) and vestibular dysfunction in individuals with congenital cytomegalovirus (cCMV) infection using the National Health Insurance Research Database (NHIRD) in Taiwan. Design Retrospective cohort study. Setting The whole Taiwanese population. Participants Patients with related diagnostic codes and examinations in their records were regarded as having cCMV infection. Each subject in that group was matched to 10 control individuals with noncongenital CMV infection on the basis of several neonatal parameters, including low gestational age, low birth weight, low Apgar score, maternal history of CMV infection and prolonged cCMV infection. A total of 5,893 and 58,930 participants were enrolled in the study and control groups, respectively. Main outcome measures The main outcomes were the development of SNHL and the development of vestibular dysfunction within one year after birth as reflected by diagnostic codes and specific examinations. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (HR) and 95% confidence interval (CI) of each primary outcome between the two groups. Results Overall, 109 and 397 episodes of SNHL developed in the study group and the control group, respectively, and the study group demonstrated a significantly higher incidence of SNHL (adjusted HR: 2.56; 95% CI: 2.07–3.18). In addition, similar incidence rates of vestibular dysfunction were found in the study group and the control group, with 7 and 90 events, respectively (adjusted HR: 0.77; 95% CI: 0.36–1.67). In subgroup analyses, a higher incidence of SNHL was correlated with lower gestational age (GA) (adjusted HR: 2.09; 95% CI: 1.29–3.39), lower birth weight (BW) (adjusted HR: 2.05; 95% CI: 1.28–3.30), and prolonged cCMV infection (adjusted HR: 3.92; 95% CI: 1.95–7.88). Conclusions Low GA, low BW and a long disease course are significantly correlated with late-onset SNHL in cCMV infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis

xlomafota13 shared this article with you from Inoreader Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis Via Clinical Otolaryngology Abstract •Changes in the microvascular network of the nasal mucosa may be accompanied by changes in olfaction. •Contact endoscopic changes in the microvascular network of the nasal mucosa may be used as a marker of sinonasal sarcoidosis. •A modified version of the Negoro's classification, in use for the tongue mucosa, may be used for the classification of contact endoscopic microvascular patterns of the nasal mucosa in patients with sarcoidosis •The validation of the use of the vascular patterns of nasal mucosa on contact endoscopy as a marker of nasal disease activity is a major future research challenge •Contact endoscopy emerges as a promising technique for on-site diagnosis of early, advanced or late inflammatory mucosal spots or generalized mucosal affection in sarcoidosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cord Medialization in Unilateral Vocal fold paralysis improves forced vital capacity

xlomafota13 shared this article with you from Inoreader Cord Medialization in Unilateral Vocal fold paralysis improves forced vital capacity Via Clinical Otolaryngology Abstract Objective The lateralized vocal fold of unilateral vocal fold paralysis (ULVFP) is unphysiological for expiration wherein vocal folds normally adduct to increase expiratory resistance and prevent small airway collapse. ULVFP may therefore impair ventilatory function and ventilatory volume. This study seeks to test if vocal fold medialization improves forced vital capacity (FVC). Design Prospective inception cohort intervention study. Setting Academic Tertiary Care Institution. Participants Twenty-five patients of ULVFP with a phonatory gap ranging from 2-6 mm. Main outcome measures Vocal fold medialization undertaken with autologous fat injection. Forced Vital Capacity (FVC) assessments by spirometry undertaken pre-treatment and 1month post-treatment. Results Improvement in FVC noted in all patients with the quantum of improvement ranging from 0.1 to 0.6 liters. Mean FVC improved from 3.10 liters pre-injection to 3.45 liters post-injection. (p<0.001). A moderate correlation was noted between the degree of medialization and improvement in FVC (r=0.33, Pearson's Correlation Coefficient) Conclusion Objective improvement in FVC is consistently noted post vocal fold medialization for ULVFP, and is probably mediated by increased glottic expiratory resistance and consequent improvement in intrinsic PEEP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures

xlomafota13 shared this article with you from Inoreader Suspension Laryngoscopy Experiences in a Tertiary Airway Service: a Prospective Study of 150 Procedures Via Clinical Otolaryngology Abstract Objectives In most cases, suspension laryngoscopy (SL) is efficient, bloodless and with minimal post-procedure discomfort. We aimed to identify predictive patient factors for acceptable surgical views at SL as well as quantify our tertiary airway unit's complication rates. Design Prospective cohort study of 150 consecutive microlaryngoscopy procedures involving SL over an 8-month period between November 2019 and July 2020. Patients were assessed pre-operatively for pre-existing oral, temporomandibular, dental, pharyngeal or laryngeal pathology, interincisor distance and qualitative gross limitations to neck extension and forward head posture. Intraoperatively, the laryngoscopic view was graded by anaesthetic and surgical teams, and complications were recorded on patient interview in recovery. Setting Tertiary adult airway service for predominantly benign pathology. Results Adequate surgical views were obtained in 149/150 procedures. BMI had a weak positive correlation with a more difficult view (r=0.22, p=0.008;) but did not correlate with a statistically significant increase in any complication. There was a weak negative correlation between age and interincisor gap (r=-0.20, p=0.014), and wider mouth opening correlated very weakly with a lower incidence of sore throat (r=-0.19, p=0.023). Gross macroglossia showed a significant moderate positive correlation with tongue symptoms (r=0.45, p=1.611x10-8). Conclusion In the context of an experienced airway unit with a high caseload of predominantly benign pathology, SL is very effective and safe with low associated morbidity and no mortality. The most common complication of SL is temporary sore throat and there remain recognised risks of temporary tongue and dental symptoms. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection

xlomafota13 shared this article with you from Inoreader Predisposing factors of rhino-orbital-cerebral mucormycosis in patients with COVID 19 infection Via Otolaryngology Indian Abstract The predisposing factors of invasive fungal disease in COVID 19 infection are still debatable because of the limited human understanding of the virus with the current literature. In this study, we have tried to correlate the various predisposing factors influencing the clinical profile and treatment outcomes in patients with covid associated mucormycosis (CAM). It is a retrospective analysis of cases of CAM during the second wave of COVID 19 infection, which was managed in the department of Otorhinolaryngology from Dec 1, 2020, to June 10, 2021. The detailed clinical, radiological and management of patients with CAM were collected, recorded, evaluated and correlated with the predisposing factors. Of the total, 46 patients, 44(95.65%) were diabetic and 41 patients had a previous history of steroid intake. When clinical parameters were compared between blood sugar < 200 mg/dl and > 200 mg/dl, the old and newly diagnosed diabetes mellitus in patients with CAM, there was no significant differences in any of the above clinical parameters (p > 0.05), except the hospital stay (p = 0,004). Steroid intake in patients with coexisting DM associated with CAM is considered the most important factor for the development of the CAM. There was are no significant difference in any of the clinical/treatment outcomes in patients with CAM with respect to the initial blood sugar, except for the hospital stay. A large sample size with a long-term follow-up period may be needed for a better understanding of common predisposing factors for the development of CAM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma

xlomafota13 shared this article with you from Inoreader Radioactive Particle Implantation Combined with Chemotherapy for Treatment of Pancreatic Adenocarcinoma Via radioactive iodine Radiol Imaging Cancer. 2021 Sep;3(5):e219020. doi: 10.1148/rycan.2021219020. NO ABSTRACT PMID:34533374 | DOI:10.1148/ryca n.2021219020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

xlomafota13 shared this article with you from Inoreader Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments Via Head & Neck Abstract Background To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085–0.979]) and anterior (HR = 0.278 [0.128–0.605]) and posterior (HR = 0.269 [0.115–0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537–8.495]) and posterior (HR = 5.195 [2.167–12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS. Conclusions Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Identification of enhancer RNAs for the prognosis of head and neck squamous cell carcinoma Via Head & Neck Abstract Background Enhancer RNAs (eRNAs) play an important role in carcinogenesis. The landscape of eRNAs in head and neck squamous cell carcinoma (HNSCC) remains largely unknown. Methods The eRNA expression matrix was obtained from the enhancer RNA in the cancer database. Functional enrichment analyses were performed using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG). Prognostic eRNAs were identified using Cox regression analysis, and a prognostic prediction model was constructed based on coefficients. Results KEGG analysis showed that eRNA-related transcription factors were mainly enriched in herpes simplex virus 1 (HSV1) infection. The zinc finger (ZNF) family may play an essential role in HNSCC. ENSR00000188847, ENSR00000250663, ENSR00000313345, ENSR00000317887, and ENSR00000336429 were identified. The prediction model was robust. Conclusions We constructed a robust 5-eRNA prognostic prediction model, and these eRNAs are potential biomarkers for HNSCC prognosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comprehensive analysis of the correction of alar retraction in rhinoplasty: A systematic review

xlomafota13 shared this article with you from Inoreader A comprehensive analysis of the correction of alar retraction in rhinoplasty: A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 6:S1748-6815(21)00387-9. doi: 10.1016/j.bjps.2021.08.008. Online ahead of print. ABSTRACT BACKGROUND: Alar retraction, as a type of alar deformity, seriously affects the esthetic perception of the nose in patients. Despite the rapid development of rhinoplasty in recent years, the treatment of alar retraction is still a challenge work in plastic surgery. This systematic review highlights the etiology, treatment, and prevention of alar retraction to further guide practitioners. METHODS: A systematic review was conducted from 1975 to 2020 through PubMed, Embase, Web of Science, and Cochrane database with the key words "alar retraction" and "rhinoplasty" or "Rhinoplasties" to investigate the surgical treatment of alar retraction. The inclusion and exclusion criteria were set to screen the literature. RESULTS: A total of 163 literatures were obtained through database retrieval. After remov ing the duplicate literature, reading the title and abstract, and reviewing the full text finally, 34 articles were included in the final study. Most of the articles have summarized the surgical methods to correct alar retraction by retrospective study. CONCLUSIONS: Alar retraction should be analyzed from the etiology, pathogenesis, and treatment. The diversity of surgical methods provides more options for the clinic. However, the plastic surgeons need to develop sharp analytical skills, improve clinical operational capability, and look for appropriate methods to achieve in good result. PMID:34580056 | DOI:10.1 016/j.bjps.2021.08.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection

xlomafota13 shared this article with you from Inoreader Hidden intra-meatal CSF fistula related to VP shunt as a cause for fatal tension pneumocephalus after vestibular schwannoma resection Via leak of cerebrospinal fluid Br J Neurosurg. 2021 Sep 28:1-6. doi: 10.1080/02688697.2021.1981240. Online ahead of print. ABSTRACT BACKGROUND: Cerebrospinal fluid (CSF) leak through petrosal air cells is a known complication after drilling the posterior wall of the internal acoustic canal (IAC) for resection of vestibular schwannoma (VS). Whereas mild pneumocephalus is common after retrosigmoid craniotomy, tension pneumocephalus has been rarely documented. OBJECTIVE: To testify a case of fatal tension pneumocephalus after VS resection in a patient with ventriculo-peritoneal (VP) shunt and to propose possible recommendations to limit the risk of this dramatic complication. METHODS: A case of fatal tension pneumocephalus after VS resection in presence of hidden CSF fistula is illustrated with pre- and post-operative images. RESULTS: In the uneventful situation of concomitant post-operative CSF fistula in presence of VP shunt, tension pneumocephalus may occ ur. The negative pressure created by the shunt system and the presence of osteo-dural defect allow the air to enter and, at the same time, prevent the outflow. CONCLUSION: After VS resection, tension pneumocephalus can occur as a consequence of CSF fistula from petrosal air cells in the presence of functioning VP shunt. Precautions as pre-operative increase to 'virtual-off' the pressure of the valve, subsequences CT scans after surgery and sealing of the petrous air cells are recommended to avoid such as fatal complication. PMID:34579610 | DOI:10.1080/02688697.2021.1981240 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System

xlomafota13 shared this article with you from Inoreader Single Surgeon Experience with 500 Cases of the Robotic Bilateral Axillary Breast Approach (BABA) for Thyroid Surgery Using the Da-Vinci Xi System Via radioactive iodine J Clin Med. 2021 Sep 7;10(18):4048. doi: 10.3390/jcm10184048. ABSTRACT OBJECTIVES: Robotic bilateral axillary breast approach (BABA) thyroid surgery began in 2008 and is now one of the most widely used remote-access thyroid surgeries worldwide. This study aimed to analyze the results of 500 robotic BABA thyroid surgeries performed in a single institution in Korea compared with open thyroid surgery. METHODS: From December 2018 to March 2020, 502 robotic BABA thyroidectomies (R Ts) and 531 conventional open thyroidectomies (OTs) were performed in our institution by a single endocrine surgeon. We retrospectively reviewed patient medical records and performed a comparative analysis of OT and RT. RESULTS: The RT group was younger (43.41 ± 11.41 versus 54.28 ± 13.41 years, p < 0.001) and had a higher proportion of females (84.3% versus 69.3%, p < 0.001), a lower BMI (24.66 ± 3.97 versus 25.83 ± 4.07 kg/m2), a higher proportion of lobectomies (52.6% versus 45.2%) and a lower proportion of lateral neck dissections (3.4% versus 10.0%, p < 0.001). The RT group had a longer operation time (145.33 ± 40.80 versus 93.39 ± 43.55 min, p < 0.001) and higher surgical costs. Although the OT group had a larger tumor size and a higher proportion of extrathyroidal extension, the numbers of retrieved lymph nodes were not significantly different between the two groups. Additionally, there was no difference in the st imulated thyroglobulin level before radioactive iodine therapy (7.01 ± 35.73 versus 8.39 ± 58.77, p = 0.782). The rates of transient vocal cord palsy and transient hypoparathyroidism were significantly lower in the RT group, and those of scar-related complications were higher in the OT group. CONCLUSIONS: Robotic BABA thyroid surgery has advantages not only in better cosmetic outcomes but also in lower rates of vocal cord palsy and hypoparathyroidism, with comparable lymph node retrieval and serum thyroglobulin levels. PMID:34575159 | DOI:10.3390/jcm10184048 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review

xlomafota13 shared this article with you from Inoreader Variability in Thyroid Cancer Multidisciplinary Team Meeting Recommendations Is Not Explained by Standard Variables: Outcomes of a Single Centre Review Via radioactive iodine J Clin Med. 2021 Sep 15;10(18):4150. doi: 10.3390/jcm10184150. ABSTRACT Multidisciplinary team (MDT) meetings are the mainstay of the decision-making process for patients presenting with complex clinical problems such as papillary thyroid carcinoma (PTC). Adherence to guidelines by MDTs has been extensively investigated; however, scarce evidence exists on MDT performance and variability where guidelines are less prescriptive. We evaluated the consistency of MDT management recommend ations for T1 and T2 PTC patients and explored key variables that may influence therapeutic decision making. A retrospective review of the prospective database of all T1 and T2 PTC patients discussed by the MDT was conducted between January 2016 and May 2021. Univariate analysis (with Bonferroni correction significance calculated at p < 0.006) was performed to establish clinical variables linked to completion thyroidectomy and Radioactive iodine (RAI) recommendations. Of 468 patients presented at thyroid MDT, 144 pT1 PTC and 118 pT2 PTC met the selection criteria. Only 18% (n = 12) of pT1 PTC patients initially managed with hemithyroidectomy were recommended completion thyroidectomy. Mean tumour diameter was the only variable differing between groups (p = 0.003). pT2 patients were recommended completion thyroidectomy in 66% (n = 16) of instances. No measured variable explained the difference in recommendation. pT1 patients initially managed with total thyroidectomy were not recommended RAI in 71% (n = 55) of cases with T1a status (p = 0.001) and diameter (p = 0.001) as statistically different variables. For pT2 patients, 60% (n = 41) were recommended RAI post-total thyroidectomy, with no differences observed among groups. The majority of MDT recommendations were concordant for patients with similar measurable characteristics. Discordant recommendations for a small group of patients were not explained by measured variables and may have been accounted for by individual patient factors. Further research into the MDT decision-making process is warranted. PMID:34575260 | DOI:10.3390/jcm10184150 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.