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Κυριακή 7 Φεβρουαρίου 2021

Type 2 diabetes mellitus increases peritonsillar abscess susceptibility: real-world evidence.

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Type 2 diabetes mellitus increases peritonsillar abscess susceptibility: real-world evidence.

Clin Exp Otorhinolaryngol. 2021 Jan 14;:

Authors: Wu CL, Tsai MS, Lee TJ, Wang YT, Liu CY, Yang YH, Tsai YT, Hsu CM, Wu CY, Chang PJ, Chang GH

Abstract
Objectives: Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and lead to complications and poor outcomes. Our study aims to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM.
Methods: We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan's National Health Insurance (NHI) Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between the both cohorts.
Results: In total, 67 852 patients with and 135 704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio: 1.91, P < .001); moreover, PTA incidence was higher at 1 to 5 years after T2DM diagnosis than at <1 and >5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P < .001). Patients with a higher adapted Diabetes Complications Severity Index (aDCSI) had higher PTA risk than those with a lower aDCSI (aHRs: 2.17 for aDCSI ≥ 1 [P = .006] and 1.81 [1.24-2.64] for aDCSI = 0 [P = .002]). T2DM patients with high aDCSI (≥1) had nonsignificantly longer hospitalization duration, higher DNI complication than did those with low aDCSI (=0).
Conclusion: In patients with T2DM, PTA incidence was relatively high, and it increased with T2DM severity. Moreover, diabetic patients diagnosed within 1 to 5 years should be careful about PTA infection and physicians should keep in mind that PTA prognosis was correlated with T2DM severity.

PMID: 33541035 [PubMed - as supplied by publisher]

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Sialendoscopy combined with transoral sialodochoplasty for treatment of parotid duct stenosis with megaduct.

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Sialendoscopy combined with transoral sialodochoplasty for treatment of parotid duct stenosis with megaduct.

Clin Exp Otorhinolaryngol. 2021 Jan 14;:

Authors: Shin GC, Kim J, Lee SJ, Kang MS, Ahn SJ, Lim JY

Abstract
This study aimed to analyze the surgical outcomes of sialendoscopy combined with transoral sialodochoplasty for the treatment of patients with parotid duct stenosis with megaduct. This study included 13 patients with chronic obstructive sialadenitis caused by type 2 parotid duct stenosis who underwent transoral sialodochoplasty. All patients completed a three-point Likert-type rating scale at 3 months after surgery. Six (46.2%) glands showed complete resolution, and seven (53.8%) showed partial resolution of obstructive symptoms. Megaduct diameter between pre- and postoperative MR sialography significantly decreased after transoral sialodochoplasty (8.05 ± 2.67 vs. 4.15 ± 2.4, P = 0.028). Saliva excretion was improved after the transoral sialodochoplasty, as the distal ducts were visualized with a sialagogue postoperatively. Type 2 parotid duct stenosis can be successfully treated with sialendoscopy combined with sialodochoplasty. In cases of large megaduct, transoral sialo dochoplasty appears to offer benefits of reducing the diameter of dilated megaducts and improving salivary outflow.

PMID: 33541036 [PubMed - as supplied by publisher]

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Feasibility of Surgical Treatment for Laryngomalacia using Spontaneous Respiration Technique.

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Feasibility of Surgical Treatment for Laryngomalacia using Spontaneous Respiration Technique.

Clin Exp Otorhinolaryngol. 2021 Jan 08;:

Authors: Cha H, Lee DY, Kim EH, Lee JH, Jang YE, Kim HS, Kwon SK

Abstract
background: We review our institutional experience with pediatric laryngomalacia (LM) cases and report our experience in patients undergoing supraglottoplasty using the spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen (STRIVE Hi) technique.
Methods: The medical records of 29 children with LM who visited XX Hospital between January 2017 and March 2019 were retrospectively reviewed. Surgical management was performed using the STRIVE Hi technique. Intraoperative findings and postoperative surgical outcomes, including complications and changes in symptoms and weight, were analyzed.
Results: Of the total study population of 29 subjects, 20 (68.9%) were female. The patients were divided according to the Onley's classification as follows: type I (n = 13, 44.8%), II (n = 10, 34.5%), and III (n = 6, 20.7%). Twenty-five patients (86.2%) had comorbidities. Seventeen patients (58.6%) underwent microlaryngobronchoscopy under STRIVE Hi anesthesia. Four patients with several desaturation events required rescue oxygenation by intermittent intubation and mask bagging during the STRIVE Hi technique. However, the procedure was completed in all patients without any severe adverse effects. Overall, 15 children (51.7%) underwent supraglottoplasty. Among the subjects who underwent supraglottoplasty, 14 (93.3%) showed improvement of symptoms, and their postoperative weight percentile was significantly increased (p = 0.026). One patient required tracheostomy immediately after supraglottoplasty due to associated neurological disease.
Conclusion: The STRIVE Hi technique is feasible for supraglottoplasty in LM patients, while type III LM patients with micrognathia or glossoptosis may have a higher risk of requiring rescue oxygenation during the STRIVE Hi technique.

PMID: 33541038 [PubMed - as supplied by publisher]

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Chirurgie thyroïdienne avec hypnosédation : à propos de 50 cas

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Publication date: February 2021

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 138, Issue 1

Author(s): G. Badidi, M. Baulieu, P. Vercherin, V. De Pasquale, M. Gavid, J.M. Prades

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Planification virtuelle comparée à la conformation manuelle pour les reconstructions mandibulaires par lambeau libre de fibula : étude scannographique de la symétrie

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Publication date: February 2021

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 138, Issue 1

Author(s): S. Bartier, O. Mazzaschi, L. Benichou, E. Sauvaget

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Plasma Ablation assisted Endoscopic Endonasal Transpterygoid Approach to Sphenoid Lateral Recess Cerebrospinal Fluid Leaks : Technique and Outcome.

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Plasma Ablation assisted Endoscopic Endonasal Transpterygoid Approach to Sphenoid Lateral Recess Cerebrospinal Fluid Leaks : Technique and Outcome.

World Neurosurg. 2021 Feb 03;:

Authors: Rathod R, Virk RS, Nayak G

Abstract
BACKGROUND: Management of sphenoid lateral recess (SLR) cerebrospinal fluid (CSF) leaks present a challenge because of the location and requiring complete visualisation of the defect for a successful repair. Endoscopic endonasal transpterygoid approach (EETPA) is considered the gold standard in addressing these defects. We layout our experience in implementing this approach with plasma ablation.
METHODS: A case series of 11 diagnosed patients of SLR CSF leaks who underwent plasma ablation assisted EETPA repair by a single surgeon between 2011 and 2020 at our institution. Outcomes in terms of surgical field grade on Wormald 11-point grading scale, post-operative complications, healing on nasal endoscopy and imaging and surgical success rate were assessed.
RESULTS: The etiology was spontaneous leak in 10 (90.9%) patients and secondary to temporal lobe abscess and/or meningitis in one (9.09%). Three (27%) patients were previously operated elsewhere by the transsphenoid route which we re-operated by this technique. As per Wormald grading, Grade 1 field in 3 (27.27%), Grade 2 in 6 (54.5%) and Grade 3 in 2 cases (18.18%) was noted. Complications occurred in 3 patients (27%) in the form of dry eye (9%), meningitis (9%) and transient CSF rhinorrhoea in immediate post-operative period (9%). Repair sites were well healed on follow up nasal endoscopy and imaging. Surgical success rate was 100%.
CONCLUSIONS: Plasma ablation assisted EETPA allows for uni-nostril approach to the SLR, provides easy accessibility and better visualisation with a bloodless field which allows appropriate repair thus minimising complications and preventing recurrence.

PMID: 33548527 [PubMed - as supplied by publisher]

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Surgical approach to the facial recess influences the acceptable trajectory of cochlear implantation electrodes.

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Surgical approach to the facial recess influences the acceptable trajectory of cochlear implantation electrodes.

Eur Arch Otorhinolaryngol. 2021 Feb 05;:

Authors: Copson B, Wijewickrema S, Ma X, Zhou Y, Gerard JM, O'Leary S

Abstract
PURPOSE: To provide practical guidance to the operative surgeon by mapping the location, where acceptable straight-line virtual cochlear implant electrode trajectories intersect the facial recess. In addition, to investigate the influence of facial recess preparation, virtual electrode width and surgical approach to the cochlea on these available trajectories.
METHODS: The study was performed on imaging data from eight cadaveric temporal bones within the University of Melbourne Virtual Reality (VR) Temporal Bone Surgery Simulator. The facial recess was opened to varying degrees, and acceptable trajectory vectors with varying diameters were calculated for electrode insertions via cochleostomy or round window membrane (RWM). The percentage of acceptable insertion vectors through each location of the facial recess was visually represented using heatmaps.
RESULTS: Seven of the eight bones allowed for acceptable vector trajectories via both cochleostomy and RWM approaches. These acceptable trajectories were more likely to lie superiorly within the facial recess for insertion via the round window, and inferiorly for insertion via cochleostomy. Cochleostomy insertions required a greater degree of preparation and skeletonisation of the junction of the facial nerve and chorda tympani within the facial recess. The width of the virtual electrode had only marginal impact on the availability of acceptable trajectories. Heatmaps emphasised the intimate relationship the acceptable trajectories have with the facial nerve and chorda tympani.
CONCLUSION: These findings highlight the differences in the acceptable straight-line trajectories for electrodes when implanted via the round window or cochleostomy. There were notable exceptions to both surgical approaches, likely explained by the variation of hook region anatomy. The methodology used in this study holds promise for translation to patient specific surgical planning.

PMID: 33547488 [PubMed - as supplied by publisher]

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Benign recurrent vestibulopathy: MRI and vestibular tests results in a series of 128 cases.

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Benign recurrent vestibulopathy: MRI and vestibular tests results in a series of 128 cases.

Eur Arch Otorhinolaryngol. 2021 Feb 06;:

Authors: Ducroz C, Dumas G, Quatre R, Attyé A, Fabre C, Schmerber S

Abstract
PURPOSE: Benign recurrent vestibulopathy is a recent entity, close to probable Meniere's disease and vestibular-migraine. So far, no study has systematically investigated the presence of endolymphatic hydrops of the lateral semicircular canal in benign recurrent vestibulopathy using magnetic resonance imaging. The aim of this study was to determine magnetic resonance imaging data and vestibular test results in patients with benign recurrent vestibulopathy.
METHODS: 128 patients with benign recurrent vestibulopathy included since 2010 were retrospectively analyzed. Patients had magnetic resonance imaging with a delayed acquisition, audiogram, head shaking test, caloric-test, skull-vibration-induced-nystagmus-test, video-head- impulse-test, and vestibular evoked myogenic potential. Endolymphatic hydrops presence was classified into four categories: cochlear, saccular, lateral semicircular canal and association with saccule.
RESULTS: In benign reccurent vestibulopathy, 23% of cases showed an endolymphatic hydrops on magnetic resonance imaging, more frequently located in the lateral semicircular canal (59%) and related to the disease duration. The most often impaired tests were caloric-test (49%) with fluctuations of hypofunction in 67% and skull-vibration-induced-nystagmus-test (61%). No correlation between the caloric-test and the presence and location of the endolymphatic hydrops was observed.
CONCLUSION: In our series of benign reccurent vestibulopathy, a rare endolymphatic hydrops was most often observed for the lateral semicircular canal and correlated with the seniority of the pathology. Hydrops identified at the magnetic resonance imaging was not correlated with the caloric-test results. Skull-vibration-induced-nystagmus-test and caloric-test were the most often modified vestibular tests.

PMID: 33547924 [PubMed - as supplied by publisher]

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The use of periocular fillers in aesthetic medicine.

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The use of periocular fillers in aesthetic medicine.

J Plast Reconstr Aesthet Surg. 2021 Jan 09;:

Authors: Mandal P, Gama F

Abstract
The periocular area is the first to display signs of ageing. Dermal fillers are an increasingly popular, minimally invasive method for facial rejuvenation. The eye is anatomically delicate and complex. Therefore, special consideration must be taken if dermal fillers are employed. This article examines the literature to assess the efficacy and safety of dermal fillers around the eye as well as the management of complications secondary to dermal filler use, such as oedema, granuloma formation, filler migration, xanthelasma, skin necrosis and visual loss. Hyaluronic acid (HA) is the most popular and commonly employed dermal filler for periocular use. It is effective, with good observer improvement and patient satisfaction (p<0.0001). Ninety percent of adverse events are mild in nature and self-resolve within 1 month. Malar oedema is a delayed complication unique to the periocular area, occurring in 11% of patients. This can be managed with use of hyaluronidase if a HA filler has been employed. Other complications, such as granuloma formation, filler migration and xanthelasma, have also been reported with variable management outcomes. Vascular adverse events include skin necrosis and visual loss. No Level 1 evidence exists for the management of visual loss. Two cases of visual restoration have been identified in the literature; however, this is rare.

PMID: 33546985 [PubMed - as supplied by publisher]

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A sling of a normal right inferior vena cava around the abdominal aorta.

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A sling of a normal right inferior vena cava around the abdominal aorta.

Surg Radiol Anat. 2021 Feb 06;:

Authors: Karaosmanoglu AD, Ardali Duzgun S, Akata D, Ozmen MN, Karcaaltincaba M

Abstract
Variations in the anatomy of inferior vena cava (IVC) may have important clinical implications. In-depth knowledge of its embryology and variations are of fundamental importance to prevent any potential medical complications related to anatomic variations of the IVC. In this article, we described a previously unreported, to the best of our knowledge, a variation of IVC. In the case we presented, the IVC was seen almost completely encircling the abdominal aorta. We decided to call this anatomic variation as "a sling of a normal right IVC around the abdominal aorta". Cross-sectional imaging is a prompt and highly reliable method to evaluate IVC anatomy and may have significant clinical importance to prevent any potential complications related to IVC during surgery or interventional radiology procedures.

PMID: 33547916 [PubMed - as supplied by publisher]

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[New approval: Atezolizumab and bevacizumab for first line of unresecable hepatocellular carcinoma].

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[New approval: Atezolizumab and bevacizumab for first line of unresecable hepatocellular carcinoma].

Bull Cancer. 2021 Feb 02;:

Authors: Minot-This MS, Edeline J

PMID: 33546873 [PubMed - as supplied by publisher]

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