Adenotonsillectomy Does not Alter the Risk of Upper Airway Infections in Children

xlomafota13 shared this article with you from Inoreader Adenotonsillectomy Does not Alter the Risk of Upper Airway Infections in Children Via The Laryngoscope Objective Given the conflicting evidence regarding adenotonsillectomy and the risk of upper airway infections (UAIs), including acute pharyngitis (APT), rhinosinusitis (ARS), and otitis media (AOM), we evaluated the risk of developing UAIs following adenotonsillectomy in a childhood population. Methods In this population‐based follow‐up study, we used data from the National Health Insurance Service‐National Sample Cohort. The adenotonsillectomy group (n = 2,377) included patients aged <10 years who underwent an adenotonsillectomy. For every patient with APT (n = 2,309), ARS (n = 2,308), and AOM (n = 2,207) who had an adenotonsillectomy, four participants were randomly selected for the control groups (n = 9,204, n = 9,196, and n = 8,788, respectively) using propensity score matching. The number of postoperative hospital visits for UAIs was recorded for 1 to 9 years, and the equivalence test was used to compare the number of visits between the adenotonsillectomy and control groups. Results There were no significant differences in the incidence of APT, ARS, or AOM at the margin of equivalence of difference (−0.5 < 95% confidence interval of difference < 0.5) between the two groups from postoperative year 1 to year 9. The hospital visits for these diseases gradually decreased over time in both groups. There was a significant decrease in the number of visits for APT, ARS, and AOM in the 5–9 years age group when compared with those in the <4 years age group (P < .01). Conclusion Our results suggest that adenotonsillectomy does not alter the frequency of UAIs in children. 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.

Distress Screening in Head and Neck Cancer Patients Planned for Cancer‐Directed Radiotherapy

xlomafota13 shared this article with you from Inoreader Distress Screening in Head and Neck Cancer Patients Planned for Cancer‐Directed Radiotherapy Via The Laryngoscope Objective/Hypothesis To estimate the prevalence of baseline clinically significant distress (distress score ≥ 4) in head and neck cancer patients planned and treated with radical intent radiotherapy using the National Comprehensive Cancer Network Distress Thermometer (DT) and assess factors predictive of distress. Study Design Cross‐sectional study. Methods This was a cross‐sectional study evaluating distress in 600 head and neck cancer patients undergoing radiation therapy. The DT was used to screen patients for distress at baseline before radiotherapy. Results The median distress score of the entire cohort was 4 interquartile range (IQR) (IQR: 3–5), and 340 patients (56.7%) had clinically significant distress. On univariate analysis, the causal factors predictive of distress were low socioeconomic status (P = .04), presence of proliferative growth at presentation (P = .008), site of the tumor (oral cavity, P = .02), comorbidity (P = .04), and presence of Ryle's tube or tracheostomy tube at baseline (P = .01). Low socioeconomic status was significant (P = .04) on multivariate analysis for high levels of distress. Conclusions Among head and neck cancer patients, 56% of patients had clinically significant baseline distress, and patients with low socioeconomic status had high distress. There is a need for interventions to mitigate distress. Level of evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An objective, markerless videosystem for staging facial palsy

xlomafota13 shared this article with you from Inoreader An objective, markerless videosystem for staging facial palsy Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Mar 15. doi: 10.1007/s00405-021-06682-z. Online ahead of print. ABSTRACT PURPOSE: To propose a new objective, video recording method for the classification of unilateral peripheral facial palsy (UPFP) that relies on mathematical algorithms allowing the software to recognize numerical points on the two sides of the face surface that would be indicative of facial nerve impairment without positioning of markers on the face. METHODS: Patients with UPFP of different House-Brackmann (HB) degrees ranging from II to V were evaluated after video recording during two selected facial movements (forehead frowning and smiling) using a software trained to recognize the face points as numbers. Numerical parameters in millimeters were obtained as indicative values of the shifting of the face points, of the shift differences of the two face sides and the shifting ratio between the healthy (denominator) and the affe cted side (numerator), i.e., the asymmetry index for the two movements. RESULTS: For each HB grade, specific asymmetry index ranges were identified with a positive correlation for shift differences and negative correlation for asymmetry indexes. CONCLUSIONS: The use of the present objective system enabled the identification of numerical ranges of asymmetry between the healthy and the affected side that were consistent with the outcome from the subjective methods currently in use. PMID:33721067 | DOI:10.1007/s00405-021-06682-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Donor site sequelae and patient satisfaction after head and neck reconstruction with a radial forearm free flap

xlomafota13 shared this article with you from Inoreader Donor site sequelae and patient satisfaction after head and neck reconstruction with a radial forearm free flap Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Mar 15. doi: 10.1007/s00405-021-06649-0. Online ahead of print. ABSTRACT PURPOSE: Radial forearm free flap (RFFF) being a workhorse flap in head and neck reconstruction, we investigated its donor site delayed consequences. METHODS: Multicentric case series evaluating 189 patients who underwent RFFF for carcinologic reasons at least 6 months before. Patients and surgeon's appreciation regarding the aesthetic and functional consequences of the flap harvest on their daily life were evaluated by questionnaires using likert scales. Medical data were collected from patients' charts retrospectively. RESULTS: Thirty percent of patients had at least one sequelae. Experiencing a graft necrosis did not worsen long-term results. Cosmetic satisfaction was significantly worst for women, according to patients' and surgeons' opinion. For 81% and 92% patients, respectively, the flap harvest had no impact on d aily life nor sport practice. Ratio between the benefits of reconstruction and the sequelae at the donor site was judged "excellent" for 77% patients. CONCLUSIONS: Although objectively important, RFFF morbidity has little impact in head and neck cancer patient's life. PMID:33721068 | DOI:10.1007/s00405-021-06649-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles

xlomafota13 shared this article with you from Inoreader Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles Via Otolaryngology Indian Abstract The aim of this study was to determine the prevalence of nasal skin cancer, its location by facial aesthetic subunits and the type of reconstructive procedures performed for each nasal subunit after excision for nasal skin tumors. Observational cross-sectional study of all consecutive patients with the diagnosis of skin tumor located in the nasal unit, treated from 2018 to 2019 by the department of head and neck surgery of a general hospital. 60 patients were treated with nasal skin tumors excisions. A total of 52 patients (86,6%) had basal cell skin cancer, 7 (11,6%) had squamous cell skin cancer and 1 (1,6%) had melanoma. Fifty-nine patients (98.33%) presented a primary tumor and just 1 case (1,66%) recived a previous surgical treatment. Regardless of the type of tumor, the tip subunit was the most often involved with 29 (48,33%) cases in total. Despite of the nasal aesthetic subunit affected, the most frequent type of procedure used for reconstruction was the rotation or advancement flap, based on aesthetic nasal subunits, which was performed in 39 cases (65%). Nasal reconstruction after skin cancer can be very complex, especially since all patients have high expectations about the results. In order to achieve good results, there is a necessity for careful analysis of the defect, correct planning and excellent technical execution of the procedures Frequently, staged procedures will be needed to achieve an optimal result. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie

xlomafota13 shared this article with you from Inoreader Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1402-0543 Hintergrund Die hereditäre hämorrhagische Teleangiektasie (HHT) ist eine seltene, systemische Erbkrankheit, die durch mukokutane und viszerale Gefäßmalformationen gekennzeichnet ist. Ein interdisziplinäres Behandlungskonzept in HHT-Zentren wird empfohlen. Material und Methoden In einer retrospektiven Studie wurden Strukturen, Prozesse und die Daten aller Patienten analysiert, die von April 2014 bis August 2019 in unserem neu gegründeten HHT-Zentrum behandelt wurden. Ergebnisse Innerhalb des Universitätsklinikums Essen wurde zunächst ein Netzwerk von über 20 verschiedenen Fachabteilungen zur Behandlung von Patienten mit HHT aufgebaut. Von den 282 Patienten, die sich seit der Zentrumsgründung mit möglicher HHT im Westdeutschen Morbus-Osler-Zentrum vorstellten, wurde bei 261 Patienten (93 %) die Diagnose als möglich angesehen. Die meisten Patienten wiesen multiple Symptome auf (Epistaxis und/oder Teleangiektasien: je > 80 %, viszerale Beteiligung: 65 %), welche häufiger eine Behandlung im interdisziplinären Rahmen erforderten. Über 900 E-Mails fielen jährlich für die direkte Behandlung der Patienten mit HHT, deren Koordination, Kooperationen und Öffentlichkeitsarbeit an. Durch den internationalen Austausch innerhalb des Europäischen Referenznetzwerks für multisystemische vaskuläre Erkrankungen (VASCERN) ist eine Behandlung auf aktuellem Stand auch bei komplexen Fragestellungen gewährleistet. Schlussfolgerungen Ein HHT-Zentrum beinhaltet ein interdisziplinäres Netzwerk von medizinischen Fachrichtungen, bei denen die Abläufe durch Prozesse definiert und durch eine wirksame Öffentlichkeitsarbeit, Schulungs- und Veröffentlichungstätigkeit gekennzeichnet sind. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725037 Objectives The three-dimensional (3D) exoscope has several advantages over the operative microscope (OM) but has not been extensively reported for its use in malignant temporal bone resections (TBR). We sought to demonstrate the feasibility of performing TBR, both lateral (LTBR) and subtotal (STBR), using the 3D exoscope for head and neck cancers. Design present study is a retrospective chart review from August 2016 until August 2019. Setting The study was conducted at a tertiary care center. Participants Patients were undergoing TBR with the Karl Storz VITOM 3D exoscope. Main Outcome Measures Demographics, tumor and surgical characteristics, patient outcomes were the primary measurements of this study. Results Fifty-five patients underwent 3D exoscopic TBR from 2016 through 2019 of which 18% (n = 10) underwent STBR. The 3D exoscope was used uninterruptedly in all procedures with no intraoperative complications. Most tumors were primarily T3 (42%, n = 23) or T4 (55%, n = 30) and of cutaneous (62%, n = 34) and parotid (27%, n = 15) origin. These TBR were often accompanied by infratemporal fossa resections (87%, n = 48), auriculectomies (47%, n = 26), mandibulectomies (53%, n = 29), and parotidectomies (96%, n = 53). On final pathology, 24% (n = 13) had microscopically positive margins. Over the study period, 20% (n = 11) of patients had recurrences with a median recurrence time of 5 months (range: 2–30 months). Conclusion In the largest case series of LTBR and STBR under exclusive 3D exoscopic visualization to date, we demonstrate the 3D exoscope is a feasible alternative to the operative microscope for LTBR and STBR. While oncologic outcomes remain to be clarified, it carries significant potential for use in complex oncologic procedures. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract&n bsp; |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.