Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Head Neck. 2015 Dec 29;

Authors: Wang CC, Liu SA, Wu SH, Lin WJ, Jiang RS, Wang L

Abstract
BACKGROUND: Transoral robotic surgery (TORS) for early glottic cancer has been reported, but the issue of anterior commissure involvement has seldom been addressed. Therefore, the purpose of this study was to preliminarily report the treatment results of TORS in this disease entity.
METHODS: Eight patients with T1 and T2 glottic carcinoma with anterior commissure involvement were selected to receive TORS. The clinical parameters, including rates of adjuvant radiotherapy (RT), survivals, as well as organ and function preservation, were retrospectively analyzed.
RESULTS: TORS was successfully performed in all patients without temporary tracheostomy. There were no major complications and no patient received adjuvant RT to the larynx after surgery. With a mean follow-up of 40 months, all patients survived with their larynx preserved and no local recurrence, tracheostomy, or tube feeding dependence.
CONCLUSION: TORS is a feasible approach for selected patients with early T classification glottic carcinoma with anterior commissure involvement. The preliminary oncologic and functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26714200 [PubMed - as supplied by publisher]

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Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports.

Head Neck. 2015 Dec 29;

Authors: Wang CC, Liu SA, Wu SH, Lin WJ, Jiang RS, Wang L

Abstract
BACKGROUND: Transoral robotic surgery (TORS) for early glottic cancer has been reported, but the issue of anterior commissure involvement has seldom been addressed. Therefore, the purpose of this study was to preliminarily report the treatment results of TORS in this disease entity.
METHODS: Eight patients with T1 and T2 glottic carcinoma with anterior commissure involvement were selected to receive TORS. The clinical parameters, including rates of adjuvant radiotherapy (RT), survivals, as well as organ and function preservation, were retrospectively analyzed.
RESULTS: TORS was successfully performed in all patients without temporary tracheostomy. There were no major complications and no patient received adjuvant RT to the larynx after surgery. With a mean follow-up of 40 months, all patients survived with their larynx preserved and no local recurrence, tracheostomy, or tube feeding dependence.
CONCLUSION: TORS is a feasible approach for selected patients with early T classification glottic carcinoma with anterior commissure involvement. The preliminary oncologic and functional outcomes are satisfactory. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

PMID: 26714200 [PubMed - as supplied by publisher]

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Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor.

Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor.

Braz J Otorhinolaryngol. 2015 Dec 3;

Authors: de Moraes BT, de Biase NG

Abstract
INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms.
OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes.
METHODS: Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor. Patients were diagnosed with essential or dystonic tremor according to the phenomenological characterization of each group. Once they were classified, the tasks associated with the presence of tremor in each syndrome were identified.
RESULTS: The tasks that significantly contributed to the differential diagnosis between essential and dystonic tremor were /s/ production, continuous whistling and reduction of tremor in falsetto. These tasks were phenomenologically different with respect to the presence of tremor in the two syndromes.
CONCLUSION: The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto.

PMID: 26712633 [PubMed - as supplied by publisher]

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Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes.

Upper airway endoscopy to optimize obstructive sleep apnea treatment in Apert and Crouzon syndromes.

J Craniomaxillofac Surg. 2015 Nov 17;

Authors: Doerga PN, Spruijt B, Mathijssen IM, Wolvius EB, Joosten KF, van der Schroeff MP

Abstract
INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent in children with Apert and Crouzon syndromes. Although often related to midface hypoplasia, it is a multi-level problem for which routine midface advancement might be a suboptimal treatment choice. We therefore wished to: 1.) use upper airway endoscopy to examine the level of obstruction in children with OSA; 2.) determine the relationship between endoscopic assessment and OSA severity; and 3.) evaluate the effect of surgery on endoscopic assessment and OSA severity.
METHODS: Prospective observational cohort study of patients considered for midface advancement, underwent upper airway endoscopy. Endoscopy findings were scored according to the system of Bachar, based on level (nose, uvulopalatine plane, tongue base, hypopharynx and larynx); and severity (no, partial or complete obstruction). Polysomnography was used to diagnose OSA.
RESULTS: We included 22 children (Apert N = 10, Crouzon N = 12), 17 had OSA, 14 of whom had multilevel obstruction and 3 single-level obstruction. The endoscopy findings were correlated with OSA severity: R = 0.56, P = 0.01. Midface advancement (N = 8) reduced Bachar's severity index in 7 of 8 patients, and OSA in all patients.
CONCLUSIONS: OSA in children with Apert or Crouzon syndrome is often a multi-level problem. Upper airway endoscopy is essential to optimizing OSA treatment.

PMID: 26712482 [PubMed - as supplied by publisher]

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[BIOFILM FORMATION BY STREPTOCOCCUS PNEUMONIAE].

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[BIOFILM FORMATION BY STREPTOCOCCUS PNEUMONIAE].

Mol Gen Mikrobiol Virusol. 2015;33(3):16-22

Authors: Mayanskiy AN, Chebotar IV, Lazareva AV, Mayanskiy NA

Abstract
The biofilm process in Streptococcus pneumoniae (pneumococcus) is described. Virtually all wild-type pneumococci are capable of the biofilm formation. The pneumococcal capsule may reduce the biofilm production, and the propensity to form biofilms has a reverse correlation with the amount of the capsule material. Invasive pneumococcal isolates and noninvasive strains that persist in the nasopharynx have different biofilm potential. A number of issues related to effector and regulatory factors in the pneumococcal biofilms are discussed in this review. In the summary, a biofilm may be essential only for the persistent pneumococcal infection.

PMID: 26665737 [PubMed - indexed for MEDLINE]

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Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness.

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Vocal fold hyalinosis in Urbach-Wiethe disease, a rare cause of hoarseness.

B-ENT. 2015;11(2):151-5

Authors: Honings J, van Rossum MM, van den Hoogen FJ

Abstract
BACKGROUND: Lipoid proteinosis is an autosomal recessive disorder characterized by hyalin deposits in the skin and mucosa of the upper aerodigestive tract; currently, no treatment exists. Nearly all patients experience hoarseness and speech difficulties, due to hyalin deposition in the vocal folds and diminished mobility in infiltrated lips, tongue, and palate.
METHODS: We describe a patient with extensive hyalin plaques on the vocal folds, which resulted in near-aphonic hoarseness. Hyalin deposits in the vocal folds and skin were treated with laser resection.
RESULTS: Both the vocal folds and skin improved in appearance, with smoother surface epithelium. However, the patient's speech remained impaired, due to extensive hyalin plaques in the mouth, tongue, and lips. The voice improved only temporarily.
CONCLUSIONS: Laser resection of hyalin plaques in the vocal folds and skin is a feasible treatment for lipoid proteinosis. However, speech may remain severely limited, due to impaired tongue and lip movement.

PMID: 26563017 [PubMed - indexed for MEDLINE]

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Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution.

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Accuracy of identifying the cricothyroid membrane by anesthesia trainees and staff in a Canadian institution.

Can J Anaesth. 2015 May;62(5):495-503

Authors: Lamb A, Zhang J, Hung O, Flemming B, Mullen T, Bissell MB, Arseneau I

Abstract
PURPOSE: We sought to determine the rate of successful identification of the cricothyroid membrane by anesthesia residents and staff at a Canadian institution.
METHODS: In this prospective study, healthy adult volunteer subjects were positioned supine with their necks placed in neutral position. There were 12 subjects, half of whom were non-obese (body mass index < 30.0 kg·m(2)) and half of whom were obese. There were equal numbers of male and female subjects in each of the obese and non-obese groups. Anesthesia staff and resident participants were allowed to palpate multiple subjects but with only one attempt per subject. For each subject, ultrasonography was used to identify the superior and inferior borders of the cricothyroid membrane, which were then marked with "invisible" ink that could be made visible with ultraviolet light. The midline was also marked with invisible ink. Identification of the cricothyroid membrane was considered correct if the mark was between the superior and inferior borders and within 0.5 cm of the midline.
RESULTS: Altogether, 61 participants palpated 12 subjects, resulting in 186 identifications. The success rates for the subgroups were as follows: non-obese men 72% (95% confidence interval [CI] 59 to 85%); obese men 39% (95% CI 26 to 54%); non-obese women 24% (95% CI 12 to 36%); obese women 35% (95% CI 21 to 49%).
CONCLUSION: Success rates for correct identification of the cricothyroid membrane were poor in this Canadian institution.

PMID: 25637060 [PubMed - indexed for MEDLINE]

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