Posttraumatic Vernet syndrome without fracture: A case report and short literature review

xlomafota13 shared this article with you from Inoreader Posttraumatic Vernet syndrome without fracture: A case report and short literature review Via swallowing exercises Medicine (Baltimore). 2021 Oct 29;100(43):e27618. doi: 10.1097/MD.0000000000027618. ABSTRACT RATIONALE: The aim of this case is to emphasize the need to include nerve traction in the differential diagnosis of nerve deficits associated with Vernet syndrome. This mechanism of injury has been described only once, but must not be overlooked and should be considered and included as a possible cause in diagnostic algorithms. PATIENT CONCERNS: A patient presenting with dysphagia, ex treme hoarseness, and limited shoulder movement after head injury was admitted to the emergency department. DIAGNOSES: Multidisciplinary evaluation was performed, and nerve traction-induced Vernet syndrome was established as a running diagnosis. INTERVENTIONS: Intensive swallowing and speech exercises, assisted by a specialist, were performed. OUTCOMES: Swallowing and speech exercises significantly and objectively improved the patient's swallowing and voice, with mild hoarseness of voice remaining as the main symptom. Spectral acoustic analysis went from a voice pitch of 163.77 Hz to normal (187.77 Hz), jitter improved from 17.87% to 0.86% and shimmer values decreased from 39.86% to 19.60%. Breathiness during phonation measuring 2.91% was reduced to 1.08% and appropriate average intensity of voice (63.95 dB) was achieved. Initial dysphagia and fluid retention in the right piriform sinus, along with tracheal aspiration, were not observed in control fiberoptic endosc opic evaluation of swallowing. LESSONS: According to our knowledge and literature data, this is the second reported case of posttraumatic Vernet syndrome without radiologically confirmed jugular foramen fracture, induced by nerve traction. Such patients need a prompt multidisciplinary approach in diagnosis and timely posttraumatic rehabilitation therapy for favorable clinical evolution and retrieval of nerve function. PMID:34713846 | DOI:10.1097/MD.0000000000027618 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk factors for postoperative cerebrospinal fluid leakage after transsphenoidal surgery for pituitary adenoma: a meta-analysis and systematic review

xlomafota13 shared this article with you from Inoreader Risk factors for postoperative cerebrospinal fluid leakage after transsphenoidal surgery for pituitary adenoma: a meta-analysis and systematic review Via leak of cerebrospinal fluid BMC Neurol. 2021 Oct 27;21(1):417. doi: 10.1186/s12883-021-02440-0. ABSTRACT OBJECTIVE: Postoperative cerebrospinal fluid (CSF) leakage represents a challenge even for experienced pituitary surgeons. We aimed to quantitatively synthesize data from studies regarding the risk factors for postoperative CSF leakage after transsphenoidal surgery (TSS) for pituitary adenoma (PA). METHODS: PubMed, Web of Science, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched for case-control and cohort studies, focusing on the risk factors associated with postoperative CSF leakage after TSS for PA. Pooled odds ratios (ORs) and 95% confidence intervals were calculated to determine the risk factors. RESULTS: A total of 34 case-control and cohort studies involving a total of 9,144 patients with PA were included in this systematic review. The overall rate of postoperative CSF le akage after TSS for PA was 5.6%. Tumor size, adenoma consistency, revision surgery, and intraoperative CSF leakage were independent risk factors for postoperative CSF leakage (ORs, 3.18-6.33). By contrast, the endoscopic approach showed a slight protective benefit compared with the microscopic approach in TSS (OR, 0.69). CONCLUSIONS: This review provides a comprehensive overview of the quality of the evidence base, informing clinical staff of the importance of screening risk factors for postoperative CSF leakage after TSS for PA. More attention should be paid to PA patients at high risk for CSF leakage after TSS to reduce complications and improve prognosis. PMID:34706659 | DOI:10.1186/s12883-021-02440-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Woodruff's plexus-arterial or venous?

xlomafota13 shared this article with you from Inoreader Woodruff's plexus-arterial or venous? Via radiol anat Surg Radiol Anat. 2021 Oct 29. doi: 10.1007/s00276-021-02852-0. Online ahead of print. ABSTRACT PURPOSE: Woodruff's plexus is a vascular network located on the posterior lateral wall of the inferior meatus of the nasal cavity and it is generally considered to be responsible for posterior epistaxis. Despite being initially identified in 1949 as a venous plexus, discrepancies exist within literature regarding this anatomical structure, particularly its arterial or venous natur e and its association with posterior epistaxis. This systematic review aims to collate information pertaining to Woodruff's plexus and evaluate our current understanding of this vascular area. METHODS: The systematic review was performed using published data in PubMed, Google Scholar, Scopus, EBSCO and Web of Science platforms using keywords such as 'Woodruff', 'posterior' and 'plexus'. Articles referring to Woodruff's plexus were collected and analysed by independent reviewers. RESULTS: The search revealed 154 papers, out of which only 40 were included in the review. Out of this number only two papers were anatomical dissection studies, both of which identify the plexus as venous in nature. Seventeen studies describe the plexus as venous by citing these two papers. The remainder of the articles (23) consider Woodruff's plexus as arterial with variability in the reported arteries that supply it. CONCLUSION: Woodruff's original description of a venous plexus is supp orted by modern anatomical studies. There are a multitude of reports that Woodruff's plexus is arterial in nature, despite the absence of existing anatomical studies to support this notion. This misconception has likely arisen due to clinical associations in relation to posterior epistaxis. PMID:34714375 | DOI:10.1007/s00276-021-02852-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Post-operative clinical course in children undergoing mastoidectomy due to complicated acute mastoiditis

xlomafota13 shared this article with you from Inoreader Post-operative clinical course in children undergoing mastoidectomy due to complicated acute mastoiditis 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 Oct 29. doi: 10.1007/s00405-021-07149-x. Online ahead of print. ABSTRACT PURPOSE: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) following surgical treatment. METHODS: A retrospective chart review of children diagnosed with CAM who underwent mastoid surgery during 2012-2019 in a tertiary care university hospital. 33 patients, divided into 2 groups: 17 patients with sub-periosteal abscess (SPA) alone-single complication group (SCG) and 16 patients with SPA and additional complications: sigmoid sinus thrombosis (SST), peri-sinus fluid/abscess, epidural/subdural abscess, and acute meningitis-multiple complications group (MCG). RESULTS: 33 patients belong to the SCG 17(51%) and 16(49%) belonged to the MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P = 0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P = 0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings; a total of 18 positive cultures were reported. Fusobacterium necrophorum counted for 8/18(44.5%) of all positive cultures, 7/9(77.8%) in the MCG vs. 1/9(11.1%) in the SCG, P = 0.004. Streptococcus pneumoniae was reported only in SCG (5/9, 55.5%, vs. 0/9, P = 0.008). CONCLUSION: Post-mastoidectomy fever due to CAM is not unusual and seems to be a benign condition for the first 5-6 days, following surgery. MCG patients are more prone to develop POF. F. necrophorum is more likely to be associated with MCG, and S. pneumoniae is common in SCG patients. PMID:34714371 | DOI:10.1007/s00405-021-07149-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Electrically Induced Blink for the Prevention of Ocular Symptoms and Blurred Vision in Patients With Acute Facial Nerve Palsy

xlomafota13 shared this article with you from Inoreader Electrically Induced Blink for the Prevention of Ocular Symptoms and Blurred Vision in Patients With Acute Facial Nerve Palsy Via ear nose throat Ear Nose Throat J. 2021 Oct 29:1455613211048576. doi: 10.1177/01455613211048576. Online ahead of print. ABSTRACT Objectives: Facial nerve palsy causes blurred vision and ocular discomfort due to deficits in blinking and eye closure. The objective of this study was to determine whether eye-blinks could be elicited by electrical stimulation and whether electrically induced blink would have an effect on the visual acuity and ocular symptoms in patients with acute facial nerve palsy. Methods: The zygomatic branch of the facial nerve of fifteen participants with acute facial nerve palsy was electrically stimulated in order to elicit a blink. In successful cases, the participant proceeded with a two-hour TV watching session in which an electrically induced blink was delivered every 5 seconds. The control condition consisted of an otherwise similar TV watching session without electrically induced blinking. Subjective ocular symptoms were evaluated with a Dry Eye Questionnaire and visual acuity was assessed with a Logarithm of the Minimum Angle of Resolution (LogMAR) chart before and after both sessions. Results: The stimulation produced a blink in 8 participants (53%). The visual acuity in the affected eye decreased during the control session, whereas no significant change occurred during the stimulation session. The ocular symptoms were significantly reduced during the stimulation session. Conclusions: Electrically elicited blink is a promising method for reducing the eye symptoms in individuals with acute facial nerve palsy. PMID:34714168 | DOI:10.1177/01455613211048576 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extensive Parapharyngeal Abscess in a 4-Month-Old Infant

xlomafota13 shared this article with you from Inoreader Extensive Parapharyngeal Abscess in a 4-Month-Old Infant Via ear nose throat Ear Nose Throat J. 2021 Oct 29:1455613211049854. doi: 10.1177/01455613211049854. Online ahead of print. ABSTRACT Parapharyngeal abscess in an infant is a very rare condition. We present the case of a 4-month-old girl with large masses on the neck's left side. Computed tomography showed an extensive parapharyngeal abscess. Left tonsillectomy was performed under general anesthesia from a transoral approach, followed by an incision and evacuation of the abscess from the parapha ryngeal space. Microbiological analysis identified a massive occurrence of Streptococcus intermedius. PMID:34714174 | DOI:10.1177/01455613211049854 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of the effects of platelet-rich plasma and dexamethasone ınjection on scar formation after vocal fold ınjury in rabbits

xlomafota13 shared this article with you from Inoreader Comparison of the effects of platelet-rich plasma and dexamethasone ınjection on scar formation after vocal fold ınjury in rabbits 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 Oct 30. doi: 10.1007/s00405-021-07154-0. Online ahead of print. ABSTRACT OBJECTIVES: In this study, a histopathological comparison was aimed between platelet-rich plasma (PRP) injection and dexamethasone injection in the prevention of scar formation after vocal fold injury. MATERIALS AND METHODS: Electrocautery was applied to damage the right and left vocal folds of a total of 12 New Zealand rabbits. PRP obtained from the rabbit's own blood was injected into the right vocal fold, and dexamethasone was injected into the left vocal fold. After 8 weeks, the experimental animals were euthanized, and the levels of inflammatory cell infiltration, vascularization, collagen, elastin, and hyaluronic acid (HA) were compared in histopathological evaluation. RESULTS: In statistical comparison of histopathological data obtained; in terms of plasma cell infiltration, vascularization, and edema parameters, statistically significant results were obtained in favor of the PRP group. Although the difference between collagen, elastin and HA, which are critical in vocal fold scar healing, was more positive in favor of PRP, no significant result was revealed in the statistical evaluation. CONCLUSIONS: PRP injection in rabbits with vocal fold damage reveals similar characteristics with dexamethasone injection in preventing scar formation. PRP injection has favorable effects on vascularization, prevention of edema, and number of plasma cells. PMID:34718850 | DOI:10.1007/s00405-021-07154-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identification of biomarkers related to glycolysis with weighted gene co‐expression network analysis in oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Identification of biomarkers related to glycolysis with weighted gene co‐expression network analysis in oral squamous cell carcinoma Via Head & Neck Abstract Background Oral squamous cell carcinoma (OSCC) is the most common tumor in the oral cavity and maxillofacial region. Increasing evidence suggests that aerobic glycolysis plays an important role in the occurrence, development, and prognosis of OSCC. Therefore, the identification of biomarkers related to glycolysis in OSCC represents considerable potential for improving its treatment. Methods In the present study, a single-sample gene-set enrichment analysis (ssGSEA) algorithm with weighted gene co-expression network analysis (WGCNA) were used to quantify the degree of glycolysis and identify key modules with the greatest correlation with glycolysis. Results Glycolytic scores significantly correlated with prognosis. In the key module 5 HUB genes were finally selected, which displayed a robust predictive effect. The expressions of key genes were associated with glycolysis. Conclusions The research comprehensively analyzed the glycolysis of OSCC and identified several biomarkers related to glycolysis. These biomarkers may represent potential therapeutic targets for future OSCC therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival analysis of patients with subglottic squamous cell carcinoma based on the SEER database

xlomafota13 shared this article with you from Inoreader Survival analysis of patients with subglottic squamous cell carcinoma based on the SEER database Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 19:S1808-8694(21)00167-1. doi: 10.1016/j.bjorl.2021.09.001. Online ahead of print. ABSTRACT OBJECTIVE: This study aimed to investigate the demographic and clinicopathological characteristics, and survival outcomes of subglottic Squamous Cell Carcinoma (SCC) based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: Demographic and clinicopathological information, including age, sex, race, tumor size, histologic grade, clinical/TNM stage, tumor invasion extent, Lymph Node Metastasis (LNM) extent, size of metastatic lymph nodes, LNM ratio and treatment data, of 842 subglottic SCC patients diagnosed between 1996 and 2016 were acquired. Kaplan-Meier survival analyses were performed to assess the effects of clinicopathological characteristics, treatment modalities, surgical procedures, and adjuvant therapies on overall survival and cancer-specific survival. RESULTS: Subgl ottic SCC was more frequent among males aged 60-70 years, with low-grade but locally advanced lesions without local or distant metastases. Age and several primary tumor/LNM related variables were independent risk factors for overall survival and cancer specific survival. Advanced-stage and high-grade disease led to unfavorable prognosis. The most common treatment modality and surgical procedure were surgery plus radiotherapy and total laryngectomy, respectively. Surgery plus radiotherapy provided favorable 5-year survival outcomes, while total laryngectomy had the worst. Surgery plus adjuvant therapy showed better survival outcomes than surgery alone. CONCLUSION: This study confirmed the rarity of subglottic SCC. Patients with subglottic SCCs suffered poor prognosis especially for those with advanced-stage or high-grade lesions. The prognosis of subglottic SCC remained poor over the years, despite recent progress in cancer therapies. Surgery plus adjuvant therapy improved the survival outcome. Although larynx preservation surgery was beneficial for early-stage disease, total laryngectomy was favored for patients with advanced tumors. LEVEL OF EVIDENCE: Level 4. PMID:34716102 | DOI:10.1016/j.bjorl.2021.09.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation between cow's milk protein allergy and otitis media: a systematic review

xlomafota13 shared this article with you from Inoreader Correlation between cow's milk protein allergy and otitis media: a systematic review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 18:S1808-8694(21)00150-6. doi: 10.1016/j.bjorl.2021.07.005. Online ahead of print. ABSTRACT OBJECTIVES: To review the evidence pertaining to the association between cow's milk protein allergy and recurrent acute otitis media and otitis media with effusion. METHODS: The CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched. RESULTS: Four studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow's milk protein allergy, 10.7% of cow's milk protein allergy in 242 children who underwent ENT procedures, 40% of cow's milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow's milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p < 0.1). CONCLUSION: Considering the characteris tics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow's milk protein allergy and otitis media. PMID:34716104 | DOI:10.1016/j.bjorl.2021.07.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cone beam computed tomography with oral contrast for accurate diagnosis and surgical planning of pharyngeal leakage and fistula: a case series

xlomafota13 shared this article with you from Inoreader Cone beam computed tomography with oral contrast for accurate diagnosis and surgical planning of pharyngeal leakage and fistula: a case series Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 13:S1808-8694(21)00153-1. doi: 10.1016/j.bjorl.2021.08.001. Online ahead of print. ABSTRACT OBJECTIVE: Pharyngocutaneous fistula is one of the severe complications related to head and neck surgeries. Detecting the accurate three-dimensional location of both the fistula and leakage is essential for surgical treatment. Videofluoroscopy is usually used for locating these; however, its imaging is two-dimensional. We evaluated pharyngeal leakage and fistulae using Cone Beam Computed Tomography (CBCT), known for its three-dimensional high spatial resolution imaging, taken in a sitting position, with oral contrast (contrast CBCT). METHODS: Pharyngeal leakage and fistulae were evaluated in a total of 31 subjects by sequentially performing videofluoroscopy and contrast CBCT. The detection accuracy of videofluoroscopy and contrast CBCT for leakage and fistula, as well as the ability to determine the extent and depth for surgical planning, were investigated and compared. RESULTS: Videofluoroscopy and contrast CBCT showed suspicious leakage and/or fistula in six and three of the 31 subjects, respectively. Surgical findings revealed the presence of leakage and/or fistula in three of the 31 subjects. The positive predictive values of videofluoroscopy and contrast CBCT were 50% (3/6) and 100% (3/3), respectively. Contrast CBCT provided more precise images, showing the extent and depth of leakage and fistula in three-dimensions. CONCLUSION: The present study's results indicate the usefulness of contrast CBCT in terms of accurate diagnosis of leakage and fistula, due to its three-dimensional imaging being performed with the patient in a sitting position. LEVEL OF EVIDENCE: 4. PMID:34716103 | DOI:10.1016/j.bjorl.2021.08.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.