A Volumetric Study of the Corpus Callosum

xlomafota13 shared this article with you from Inoreader A Volumetric Study of the Corpus Callosum in the Turkish Population Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1731033 Objective The aim of this study is to measure the average corpus callosum (CC) volume of healthy Turkish humans and to analyze the effects of gender and age on volumes, including the genu, truncus, and splenium parts of the CC. Patients and Methods Magnetic resonance imaging brain scans were obtained from 301 healthy male and female subjects, aged 11 to 84 years. The median age was 42 years (min–max: 11–82) in females and 49 years (min–max: 12–84) in males. Corpus callosum and its parts were calculated by using MRICloud. CC volumes of each subject were compared with those of the age and gender groups. Results All volumes of the CC were significantly higher in males than females. All left volumes except BCC were significantly higher than the right volumes in both males and females. The oldest two age groups (50–69 and 70–84 years) were found to have higher bilateral CC volumes, and bilateral BCC volumes were also higher than in the other two age groups (11–29 and 30–49 years). Conclusion The results suggest that compared with females/males, females have a faster decline in the volume of all volumes of the CC. We think that quantitative structural magnetic resonance data of the brain is vital in understanding human brain function and development. [...] 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.

Decompression of the geniculate ganglion and labyrinthine segments of the facial nerve through a middle cranial fossa approach using an ultrasonic surgical system: an anatomic study

xlomafota13 shared this article with you from Inoreader Decompression of the geniculate ganglion and labyrinthine segments of the facial nerve through a middle cranial fossa approach using an ultrasonic surgical system: an anatomic study 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 Jun 30. doi: 10.1007/s00405-021-06966-4. Online ahead of print. ABSTRACT PURPOSE: The aim of this study is to evaluate the feasibility and the safety of a novel, alternative method for bone tissue management in facial nerve decompression by a middle cranial fossa approach. Several applications of Piezosurgery technology have been described, and the technique has recently been extended to otologic surgery. The piezoelectric device is a bone dissector which, using micro-vibration, preserves the anatomic integrity of soft tissue thanks to a selective action on mineralized tissue. METHODS: An anatomic dissection study was conducted on fresh-frozen adult cadaveric heads. Facial nerve decompression was performed by a middle cranial fossa approach in all specimens using the piezoelectric device under a surgical 3D exoscope visualization. After the procedures, the temporal bones were examined for evidence of any injury to the facial nerve or the cochleovestibular organs. RESULTS: In all cases, it was possible to perform a safe dissection of the greater petrosal superficial nerve, the geniculate ganglion, and the labyrinthine tract of the facial nerve. No cases of semicircular canal, cochlea, or nerve damage were observed. All of the dissections were carried out with the ultrasonic device without the necessity to replace it with an otological drill. CONCLUSION: From this preliminary study, surgical decompression of the facial nerve via the middle cranial fossa approach using Piezosurgery seems to be a safe and feasible procedure. Further cadaveric training is recommended before intraoperative use, and a wider case series is required to make a comparison with conventional devices. PMID:34191113 | DOI:10.1007/s00405-021-06966-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictive Value of a Prognostic Model Based on Lymphocyte-to-Monocyte Ratio Before Radioiodine Therapy for Recurrence of Papillary Thyroid Carcinoma

xlomafota13 shared this article with you from Inoreader Predictive Value of a Prognostic Model Based on Lymphocyte-to-Monocyte Ratio Before Radioiodine Therapy for Recurrence of Papillary Thyroid Carcinoma Via radioactive iodine Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211027910. doi: 10.1177/15330338211027910. ABSTRACT BACKGROUND: The aim of this study was to investigate the predictive value of a prognostic model based on the lymphocyte-to-monocyte ratio (LMR) before radioiodine treatment for the recurrence of papillary thyroid carcinoma (PTC). METHODS: Clinicopathological data of 441 patients with papillary thyroid cancer were collected retrospectively. The Receiver operating characteristi c (ROC) was used to determine the optimal cut-off value for predicting PTC recurrence by LMR before radioiodine treatment. Recurrence was the endpoint of the study, and survival was estimated by the Kaplan-Meier method, and any differences in survival were evaluated with a stratified log-rank test. Univariate and multifactorial analyses were performed using Cox proportional-hazards models to identify risk factors associated with PTC recurrence. RESULTS: The ROC curve showed that the best cut-off value of LMR before radioiodine treatment to predict recurrence in patients with PTC was 6.61, with a sensitivity of 54.1%, a specificity of 73%, and an area under the curve of 0.628. The recurrence rate was significantly higher in the low LMR group (16%) than in the high LMR group (5%) (P = 0.001, χ2 = 12.005). Multifactorial analysis showed that LMR < 6.61 (P = 0.006; HR = 2.508) and risk stratification (high risk) (P = 0.000; HR = 5.076) before ra dioiodine treatment were independent risk factors predicting recurrence in patients with PTC. Patients with preoperative LMR < 6.61 and high risk stratification had the lowest recurrence-free survival rate and the shortest recurrence-free survival time. CONCLUSIONS: The LMR-based prognostic model before radioactive iodine treatment is valuable for early prediction of PTC recurrence and it can be used in clinical practice as a supplement to risk stratification and applied in combination to help screen out patients with poorer prognosis early. PMID:34191658 | DOI:10.1177/153303382110 27910 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Metastatic malignant struma ovarii: a case report and review of the literature on the management of malignant struma ovarii

xlomafota13 shared this article with you from Inoreader Metastatic malignant struma ovarii: a case report and review of the literature on the management of malignant struma ovarii Via radioactive iodine Acta Clin Belg. 2021 Jun 30:1-5. doi: 10.1080/17843286.2021.1944583. Online ahead of print. ABSTRACT OBJECTIVES: To present a case of metastatic struma ovarii, to review the literature on malignant struma ovarii and to discuss the management in locoregional and metastatic disease. METHODS: We present a case of an 82-year-old patient with a malignant struma ovarii and liver metastasis. The patient was treated with pelvic surgery, total thyroidectomy, radioactive iodine therapy and TSH suppression therapy with levothyroxine. We performed a PubMed search for case reports of metastatic struma ovarii. RESULTS: 43 cases of metastatic struma ovarii were identified. 53.5% of patients presented with metastatic disease at diagnosis. Mean time to development of metastasis was 6.9 years in the group with initial locoregional disease. First-line treatment was pelvic surgery in all patients. Thyroidectomy was performed in 83.7% of patients, subsequent radioactive iodine therapy in 79.1%, followed by TSH suppression therapy in 46.5% of patients. Mean time of follow-up after diagnosis of metastases was 3.6 years, ranging from 0.5 to 24 years. At the end of the follow-up, 51.1% of patients were free of disease, 34.9% were alive with disease, 7.0% died of disease and 7.0% were lost to follow-up. CONCLUSION: The majority of patients with metastatic struma ovarii were treated with pelvic surgery, total thyroidectomy and radioactive iodine therapy. Suppression o f TSH with levothyroxine was given in less than half of the patients. In non-metastatic setting, the same approach could be considered depending on the patient profile. PMID:34191687 | DOI:10.1080/17843286.2021.1944583 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Isolated Traumatic Dislocation of the Malleus into the External Auditory Canal

xlomafota13 shared this article with you from Inoreader Isolated Traumatic Dislocation of the Malleus into the External Auditory Canal Via ear nose throat Ear Nose Throat J. 2021 Jun 30:1455613211026529. doi: 10.1177/01455613211026529. Online ahead of print. ABSTRACT We report a rare case of isolated malleus dislocation into the external auditory canal with lateralized intact tympanic membrane following a head trauma. The patient was a 63-year-old woman who presented at the outpatient department of our institute with hearing loss of 10 years' duration after a bicycle accident. During physical examination of the patient, total d islocation of the malleus-like bony structure into the external auditory canal on the right side was observed. In the computed tomography scan, an isolated malleus dislocation with intact incus-stapes articulation was identified. The patient was successfully treated with endoscopic exploratory tympanotomy and partial ossicular replacement prosthesis. The isolated malleus dislocation can rarely occur after trauma. A careful diagnostic step through history, physical examination, and temporal bone computed tomography scan are needed to confirm this rare condition. PMID:34191618 | DOI:10.1177/0 1455613211026529 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Endonasal Orbital Apex Decompression for Carotid Cavernous Fistula

xlomafota13 shared this article with you from Inoreader Endoscopic Endonasal Orbital Apex Decompression for Carotid Cavernous Fistula Via ear nose throat Ear Nose Throat J. 2021 Jun 30:1455613211030347. doi: 10.1177/01455613211030347. Online ahead of print. ABSTRACT SIGNIFICANCE STATEMENT: This case report demonstrates a novel approach to treating a rare indirect carotid cavernous fistula (CCF) and associated abducens palsy. Although endovascular treatment is the standard of care in the management of CCFs, it was contraindicated in this patient. Instead, she underwent an endoscopic endonasal approach (EEA) with decompression of the medial orbital apex, including the cavernous sinus and optic nerve, with complete resolution of headache, lateral gaze palsy, and diplopia within 2 months. PMID:34191645 | DOI:10.1177/01455613211030347 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Actualización en carcinoma escamoso orofaríngeo

xlomafota13 shared this article with you from Inoreader Actualización en carcinoma escamoso orofaríngeo Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El carcinoma escamoso de orofaringe (CEOF) ha tenido un aumento en su incidencia en las últimas décadas, explicándose por el aumento sustancial de su tipo relacionado con el virus papiloma humano (VPH). Existen diferencias clínicas y pronósticas entre los dos grupos de CEOF según su relación etiológica con VPH. Por un lado, los relacionados con VPH se presentan en una población más joven, con menos prevalencia de tabaquismo y consumo de alcohol; además de presentar un tamaño pequeño del tumor primario, con un compromiso linfonodal temprano. Además, aquellos relacionados con VPH presentan un mejor pronóstico que su contraparte no relacionada con el virus, presentando en algunos estudios hasta un 58% menos riesgo de muerte independiente de la modalidad de tratamiento. Actualmente, el sistema de clasificación TNM en su 8va edición presenta un sistema diferente de clasificación y etapificación para ambos grupos. A pesar de aquello, a la fecha el tratamien to habitual no difiere entre ambos, lo que ha llevado a la realización de estudios que buscan responder si la deintensificación de la terapia en aquellos grupos relacionados con VPH y con bajo riesgo de metástasis a distancia, mantendría los buenos resultados oncológicos, disminuyendo las complicaciones a corto y largo plazo asociadas al tratamiento. Sin embargo, aún no existe evidencia que avale consistentemente esta práctica. Finalmente, la prevención primaria a través de la vacuna contra VPH es un elemento prometedor, sin embargo, no existe evidencia que confirme su utilidad. Abstract Oropharyngeal squamous cell carcinoma (OPSCC) has suffered an increase in its incidence in recent decades, explained by the increase in its type related to the human papilloma virus (HPV). There are clinical and prognostic differences between the two groups of OPSCC according to their etiological relationship with HPV. On the one hand, those related to HPV appear in a younger population, with a lower prevalence of smoking and alcohol consumption; in addition to presenting a small size of the primary tumor, with early lymph node involvement. Furthermore, those related to HPV have a better prognosis than their non-virus counterpart, presenting in some studies up to 58% less risk of death, independent of treatment used. Currently, the TNM classification system in its 8th edition presents a different classification for both groups. Despite this, the treatment does not differ between the two, which has led to studies that seek to answer whether the de-escalation of therapy in the group associated to HPV and with a low risk of distant metastasis would maintain the reported good oncological results, reducing early and long-term complications associated with treatment, however, there is still no evidence to support its use. Finally, primary prevention through the HPV vaccine is a promising element, however there is no evidence to confirm its usefulness. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Uso de profilaxis antibiótica en el taponamiento nasal, una revisión actualizada

xlomafota13 shared this article with you from Inoreader Uso de profilaxis antibiótica en el taponamiento nasal, una revisión actualizada Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El uso de profilaxis antibiótica en el taponamiento nasal es una práctica ampliamente usada por el eventual riesgo de síndrome de shock tóxico o complicaciones infecciosas locales. En los últimos años, se ha cuestionado su real impacto tomando en cuenta los riesgos asociados al uso de antibióticos y la baja o casi nula incidencia de las complicaciones infecciosas. Se realizó una revisión exhaustiva de la literatura sobre el uso de profilaxis antibiótica en taponamiento nasal. Se observó que no existían diferencias estadísticamente significativas en la incidencia de complicaciones infecciosas y no hubo reportes de síndrome de shock tóxico en ninguno de los grupos con y sin profilaxis antibiótica. No hubo diferencias significativas en los cultivos de los pacientes con o sin antibióticos en taponamiento nasal por epistaxis. El uso de profilaxis antibiótica en taponamiento nasal es una práctica cuestionable y se requieren más estudios al respecto. Abs tract Antibiotic prophylaxis in nasal packing is a widely used practice due to the possible risk of toxic shock syndrome and infectious complications. Lately, its real impact has been questioned due to the associated risks with antibiotic use and low incidence of infectious complications. A comprehensive review of the literature on the use of antibiotic prophylaxis in nasal packing was performed. No statistically significant differences in the incidence of infectious complications and no reports of toxic shock syndrome were reported in any of the groups with and without antibiotic prophylaxis. There were no significant differences in the antibiotic cultures of patients with or without prophylactic antibiotics in nasal packing due to epistaxis. The use of antibiotic prophylaxis in nasal packing is a questionable practice and further studies are required. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Manifestaciones otorrinolaringológicas en la infección por virus de inmunodeficiencia humana

xlomafota13 shared this article with you from Inoreader Manifestaciones otorrinolaringológicas en la infección por virus de inmunodeficiencia humana Via Otorrinolaringología y cirugía de cabeza y cuello Resumen La infección por el virus de la inmunodeficiencia humana (VIH) es una pandemia global que afecta a 38 millones de personas en el mundo. En Chile, se ha visto un alza sostenida en la incidencia de VIH, aumentando un 57% entre 2010 y 2019, reportándose 74.000 personas que viven con VIH en el país. Las manifestaciones en cabeza y cuello ascienden a un 80% de los pacientes con VIH. Éstas pueden presentarse durante el síndrome retroviral agudo, en etapas más avanzadas, incluso como forma de debut, o aparecer en casos de falla de tratamiento o complicaciones derivadas del síndrome inflamatorio de reconstitución inmune. Con la mayor cobertura de terapia antirretroviral (TARV) se ha visto a lo largo del tiempo un cambio en la frecuencia de las manifestaciones otorrinolaringológicas. Las lesiones de la cavidad oral han representado un signo de avance de la enfermedad o de falla al tratamiento, siendo más frecuentes la candidiasis y la leucoplasia vellosa. En el área r inosinusal predominan la rinitis y rinosinusitis, en el cuello las linfadenopatías e hipertrofia parotídea, y en el oído la hipoacusia, alteraciones vestibulares y del oído medio. Para la especialidad de otorrinolaringología es fundamental conocer estas manifestaciones para mantener un alto índice de sospecha del diagnóstico. De esta forma, se permite un diagnóstico precoz y tratamiento oportuno para así mejorar la calidad de vida del paciente. Además, se requiere un seguimiento cercano de forma de detectar signos tempranos de falla al tratamiento o progresión a etapas más avanzadas. Abstract The human immunodeficiency virus (HIV) infection is a global pandemic, affecting 38 million people worldwide. In Chile, its incidence has risen continuously, increasing to 57% from 2010 to 2019, with 74,000 infected people in the country. Head and neck manifestations account to 80% of HIV patients. These manifestations may be present during the acute retroviral syndrome, in more advanced stages, even as a debut, or appear in treatment failure or complications secondary to the immune reconstitution inflammatory syndrome. With the increase in antiretroviral therapy (ART) coverage, the prevalence of otorhinolaryngological manifestations has changed. Oral lesions may be an early sign for advanced stages or treatment failure, with a predominance of candidiasis and hairy leukoplakia. Rhinitis and rhinosinusitis are the main manifestations in the sinonasal area, lymphadenopathy and parotid hypertrophy in the neck, and hearing loss, vestibular and middle ear disorders in the ear. It is essential for otorhinolaryngologists to be aware of these manifestations in order to maintain a high index of clinical suspicion, allowing an early diagnosis and opportune treatment to improve the patient's quality of life. In addition, a close follow-up is required to identify early signs of treatment failure or progression to more advanced stages. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones

xlomafota13 shared this article with you from Inoreader Cirugía del sueño: Definición de una especialidad emergente, propuesta de una clasificación anatomofuncional integral e indicaciones Via Otorrinolaringología y cirugía de cabeza y cuello Resumen Los trastornos respiratorios del sueño (ronquido primario y síndrome de apnea-hipopnea obstructiva del sueño) han sido tratados mediante múltiples modalidades a lo largo de la historia. Sin embargo, la cirugía de la vía aérea superior siempre ha estado presente, dando cabida a la aparición de múltiples técnicas para este fin. El estudio adecuado de los sitios anatómicos de estrechez o colapso de la vía aérea superior y sus contribuyentes (bajo el concepto de topodiagnóstico) y el mejor entendimiento de los mecanismos de acción de los diferentes procedimientos descritos, ha permitido el nacimiento de una nueva disciplina, dedicada al manejo quirúrgico planificado de este grupo de patologías: la cirugía del sueño. Abstract Sleep-related breathing disorders (primary snoring and obstructive sleep apnea-hypopnea syndrome) have been treated with multiple modalities throughout history. However, upper airway surgery has always been present, giving appearan ce of multiple techniques for this purpose. The adequate study of the anatomical sites of upper airway narrowness or collapse and its contributors (under the concept of topodiagnosis) and a better understanding of the different procedures, has allowed the birth of a new discipline, dedicated to a planned surgical management for this group of pathologies: sleep surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aspectos psicosociales de los programas de salud de personas mayores con hipoacusia y su impacto en la adherencia al uso de audífonos: una revisión narrativa

xlomafota13 shared this article with you from Inoreader Aspectos psicosociales de los programas de salud de personas mayores con hipoacusia y su impacto en la adherencia al uso de audífonos: una revisión narrativa Via Otorrinolaringología y cirugía de cabeza y cuello Resumen El envejecimiento progresivo de la población mundial es una preocupación reconocida por la mayoría de las propuestas de políticas públicas en diversas áreas, incluida salud. La persona mayor pertenece a un grupo social vulnerable, que requiere ser considerado en las intervenciones y políticas de salud pública. Existe una considerable pérdida de las capacidades sensoriales y motrices que suponen una disminución de la autonomía, la que si se asocia a la realidad de las personas mayores con menos ingresos, dificulta un acceso oportuno a prestaciones de salud para poder enfrentar la discapacidad de manera apropiada. Las consecuencias de la pérdida de la capacidad auditiva en la persona mayor se manifiestan en problemas de la comprensión del habla, deterioro cognitivo y trastornos de la salud mental como ansiedad y depresión. Lamentablemente, las intervenciones para aumentar la adherencia de los usuarios al uso de audífonos no han mostrado muchos resultados fa vorables. Un correcto diagnóstico permite tener una orientación y rehabilitación adecuada a través de la generación de programas y estrategias enfocadas en la integración social, permitiendo que la calidad de vida se mantenga o mejore no solo en las personas con hipoacusia. Implementar un abordaje que busque tener un impacto positivo en la adherencia al uso de audífonos debe incluir y desarrollar programas de rehabilitación auditiva que consideren aspectos de contexto como vivienda, red de apoyo e integración social, entre otros. Abstract Progressive aging of the world population is a concern recognized by most public policy proposals in various areas, including health. The elderly belongs to a vulnerable social group, which requires consideration in public health interventions and policies. There is a considerable loss of sensory and motor capacities that decreases autonomy, which if associated with lesser income in older adults, hinders timely access to health benefits and its possibility to face disability appropriately. The consequences of hearing loss in the elderly are manifested in problems of speech comprehension, cognitive deterioration, and mental health disorders such as anxiety and depression. Unfortunately, interventions to increase user adherence to hearing aid use have not shown many positive results. A correct diagnosis allows to have an adequate orientation and rehabilitation through the generation of programs and strategies focused on social integration, allowing the quality of life to be maintained or improved not only in people with hearing loss. Implementing an approach that seeks to have a positive impact on adherence to hearing aid use should include and develop auditory rehabilitation programs that consider contextual aspects such as housing, support network and social integration, among others. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.