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

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Κυριακή 21 Φεβρουαρίου 2021

Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS.

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Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS.

Ear Nose Throat J. 2021 Feb 19;:145561320986030

Authors: Koskinen A, Lundberg M, Lilja M, Myller J, Penttilä M, Huhtala H, Lee JM, Blomgren K, Toppila-Salmi S

Abstract
OBJECTIVES: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique.
METHODS: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011.
RESULTS: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation.
CONCLUSION: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.

PMID: 33601904 [PubMed - as supplied by publisher]

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Biological and biocompatible characteristics of fullerenols nanomaterials for tissue engineering.

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Biological and biocompatible characteristics of fullerenols nanomaterials for tissue engineering.

Histol Histopathol. 2021 Feb 19;:18316

Authors: Zhao Y, Shen X, Ma R, Hou Y, Qian Y, Fan C

Abstract
Fullerenes, as hydrophobic molecules, are limited in biomedical function due to their very low solubility. But taking C60 (OH) x as an example, the properties of fullerenols were analyzed. It was found that fullerenols had good stability, water solubility, good biocompatibility and low cytotoxicity by adding a hydroxyl group to carbon atoms. In the biomedical field, it has been found that fullerene C60 can be used as a powerful free radical scavenger, with antioxidant activity, with antibacterial and inhibitory effects on cancer cells. Fullerenols inherit the good properties of fullerenes, and are better used in cancer treatment, including loading drug therapy and directly as an anticancer drug. In addition, fullerenols are also used in the repair of myocardial injury, the treatment of myocardial infarction and neuroprotection. With the development of tissue engineering technology, the preparation of nerve scaffolds which can improve ischemia, hypoxia and oxidative stress aft er nerve injury has become a research hotspot. The electron absorption and reduction characteristics of fullerenols in biomedical research bring new ideas for the treatment of oxidative stress in the repair of peripheral nerve defects. It seems that the research on fullerenols loaded neural scaffold has great prospects.

PMID: 33604882 [PubMed - as supplied by publisher]

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Visual representations of time elicit early responses in human temporal cortex.

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Visual representations of time elicit early responses in human temporal cortex.

Neuroimage. 2020 08 15;217:116912

Authors: Amadeo MB, Campus C, Gori M

Abstract
Time perception is inherently part of human life. All human sensory modalities are always involved in the complex task of creating a temporal representation of the external world. However, when representing time, people primarily rely on auditory information. Since the auditory system prevails in many audio-visual temporal tasks, one may expect that the early recruitment of the auditory network is necessary for building a highly resolved and flexible temporal representation in the visual modality. To test this hypothesis, we asked 17 healthy participants to temporally bisect three consecutive flashes while we recorded EEG. We demonstrated that visual stimuli during temporal bisection elicit an early (50-90 ​ms) response of an extended area of the temporal cortex, likely including auditory cortex too. The same activation did not appear during an easier spatial bisection task. These findings suggest that the brain may use auditory representations to deal with complex tem poral representation in the visual system.

PMID: 32389726 [PubMed - indexed for MEDLINE]

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Attentional modulation of the auditory steady-state response across the cortex.

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Attentional modulation of the auditory steady-state response across the cortex.

Neuroimage. 2020 08 15;217:116930

Authors: Manting CL, Andersen LM, Gulyas B, Ullén F, Lundqvist D

Abstract
Selective auditory attention allows us to focus on relevant sounds within noisy or complex auditory environments, and is essential for the processing of speech and music. The auditory steady-state response (ASSR) has been proposed as a neural measure for tracking selective auditory attention, even within continuous and complex soundscapes. However, the current literature is inconsistent on how the ASSR is influenced by selective attention, with findings based primarily on attention being directed to either ear rather than to sound content. In this experiment, a mixture of melody streams was presented to both ears identically (diotically) as we examined if selective auditory attention to sound content influences the ASSR. Using magnetoencephalography (MEG), we assessed the stream-specific ASSRs from three frequency-tagged melody streams when attention was directed between each melody stream, based on their respective pitch and timing. Our main results showed that selective att ention enhances the ASSR power of an attended melody stream by 14% at a general sensor level. This ability to readily capture attentional changes in a stimuli-precise manner makes the ASSR a useful tool for studying selective auditory attention, especially in complex auditory environments. As a secondary aim, we explored the distribution of cortical ASSR sources and their respective attentional modulation using a distributed source model of the ASSR activity. Notably, we uncovered the existence of ASSR attentional modulation outside the temporal cortices. Across-subject averages of the attentional enhancement over the cortical surface suggest that frontal regions show up to ~80% enhancement, while temporal and parietal cortices were enhanced by 20-25%. Importantly, this work advocates a novel 'beyond the temporal cortex' perspective on ASSR modulation and also serves as a template for future studies to precisely pin-point which cortical sites are more susceptible to ASSR attentional modulation.

PMID: 32422403 [PubMed - indexed for MEDLINE]

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A backward encoding approach to recover subcortical auditory activity.

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A backward encoding approach to recover subcortical auditory activity.

Neuroimage. 2020 09;218:116961

Authors: Schmidt F, Demarchi G, Geyer F, Weisz N

Abstract
Several subcortical nuclei along the auditory pathway are involved in the processing of sounds. One of the most commonly used methods of measuring the activity of these nuclei is the auditory brainstem response (ABR). Due to its low signal-to-noise ratio, ABR's have to be derived by averaging over activity generated by thousands of artificial sounds such as clicks or tone bursts. This approach cannot be easily applied to natural listening situations (e.g. speech, music), which limits auditory cognitive neuroscientific studies to investigate mostly cortical processes. We propose that by individually training backward encoding models to reconstruct evoked ABRs from high-density electrophysiological data, spatial filters can be tuned to auditory brainstem activity. Since these individualized filters can be applied (i.e. generalized) to any other data set using the same spatial coverage, this could allow for the estimation of auditory brainstem activity from any continuous sensor level data. In this study, we established a proof-of-concept by using backward encoding models generated using a click stimulation rate of 30 ​Hz to predict ABR activity recorded using EEG from an independent measurement using a stimulation rate of 9 ​Hz. We show that individually predicted and measured ABR's are highly correlated (r ​~ ​0.7). Importantly these predictions are stable even when applying the trained backward encoding model to a low number of trials, mimicking a situation with an unfavorable signal-to-noise ratio. Overall, this work lays the necessary foundation to use this approach in more interesting listening situations.

PMID: 32439538 [PubMed - indexed for MEDLINE]

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Hypothyroidism in Head and Neck Squamous Cell Carcinoma Patients Receiving Radiotherapy With or Without Immune Checkpoint Inhibitors

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Objectives/Hypothesis

Hypothyroidism is a relatively common complication of head and neck squamous cell carcinoma (HNSCC) treatment. The objective of this study was to determine whether the addition of programmed death ligand‐1 (PD‐1) or programmed death ligand‐1 (PD‐L1) inhibition (anti‐PD‐1/PD‐L1 therapy) to standard treatment increases the risk of hypothyroidism in HNSCC.

Study Design

Retrospective Cohort.

Methods

This is a retrospective, single institutional cohort study. Patients who received radiotherapy (RT) for HNSCC were identified in the electronic medical record. Patient factors collected include age, sex, body mass index (BMI), smoking status, alcohol use, Charlson comorbidity index, and HNSCC treatment records. The rate of hypothyroidism for patients with HNSCC receiving RT (+/− chemotherapy and surgery) (RT group, n = 101) was compared to that of HNSCC patients receiving RT (+/− chemotherapy and surgery) + anti‐PD‐1/PD‐L1 therapy, either concurrently or after RT (RT + anti‐PD‐1/PD‐L1 group, n = 38).

Results

There was no significant difference in the rate of clinical or subclinical hypothyroidism between the two groups. Multinomial logistic regression found no significant difference in hypothyroidism based on age, sex, or BMI.

Conclusions

The addition of anti‐PD‐1/PD‐L1 therapy to standard HNSCC treatment does not significantly increase the risk of developing hypothyroidism.

Level of Evidence

3 Laryngoscope, 2021

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Multi‐Institutional Analysis of Outcomes in Supraglottic Jet Ventilation with a Team‐Based Approach

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Objectives/Hypothesis

To evaluate the safety and complications of endoscopic airway surgery using supraglottic jet ventilation with a team‐based approach.

Study Design

Retrospective cohort study.

Methods

Subjects at two academic institutions diagnosed with laryngotracheal stenosis who underwent endoscopic airway surgery with jet ventilation between January 2008 and December 2018 were identified. Patient characteristics (age, gender, race, follow‐up duration) and comorbidities were extracted from the electronic health record. Records were reviewed for treatment approach, intraoperative data, and complications (intraoperative, acute postoperative, and delayed postoperative).

Results

Eight hundred and ninety‐four patient encounters from 371 patients were identified. Intraoperative complications (unplanned tracheotomy, profound or severe hypoxic events, barotrauma, laryngospasm) occurred in fewer than 1% of patient encounters. Acute postoperative complications (postoperative recovery unit [PACU] rapid response, PACU intubation, return to the emergency department [ED] within 24 hours of surgery) were rare, occurring in fewer than 3% of patient encounters. Delayed postoperative complications (return to the ED or admission for respiratory complaints within 30 days of surgery) occurred in fewer than 1% of patient encounters. Diabetes mellitus, active smoking, and history of previous tracheotomy were independently associated with intraoperative, acute, and delayed complications.

Conclusions

Employing a team‐based approach, jet ventilation during endoscopic airway surgery demonstrates a low rate of complications and provides for safe and successful surgery.

Level of Evidence

Level 4 Laryngoscope, 2021

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