Endoscopic Incudo‐Malleolar Arthrodesis: A New Surgical Treatment for Incudo‐Malleolar Subluxation

xlomafota13 shared this article with you from Inoreader Endoscopic Incudo‐Malleolar Arthrodesis: A New Surgical Treatment for Incudo‐Malleolar Subluxation Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes in N3 Head and Neck Squamous Cell Carcinoma and Role of Upfront Neck Dissection

xlomafota13 shared this article with you from Inoreader Outcomes in N3 Head and Neck Squamous Cell Carcinoma and Role of Upfront Neck Dissection Via The Laryngoscope Objectives We investigated the prognostic factor of N3 head and neck squamous cell carcinoma (HNSCC), including the role of upfront neck dissection (UFND) before radiotherapy (RT). Methods We retrospectively reviewed the charts of consecutive N3 HNSCC patients treated with curative intent RT. Results In the study, 323 N3 HNSCC patients were included. Of those, 125 patients (39%) had UFND. Median follow‐up was 3.9 years (0–14.8 years). Overall survival (OS) at 5 years was 31.2%, and progression‐free survival (PFS) was 26%. In the multivariate analysis, OS was improved in PS 0, T1‐2 tumors, patients receiving concurrent chemotherapy, never or former smokers, and UFND. UFND was strongly associated with increased OS (45.7% vs. 21.2%, P < .001), and PFS (P < .001). Regardless of neck node size, UFND improved survival (P = .001 for ≤ 7 cm and P = .004 for > 7 cm). Conclusion UFND could improve treatment outcomes in N3 HNSCC, especially for non‐oropharyngeal cancer, regardless of neck node size. Level of Evidence 2B Laryngoscope, 131:E844–E850, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Peripheral Vestibular Disorders

xlomafota13 shared this article with you from Inoreader Peripheral Vestibular Disorders: Nationwide Evidence From Taiwan Via The Laryngoscope Objectives/Hypothesis This study aimed to evaluate the prevalence of peripheral vestibular disorders in an Asian population of predominantly Han Chinese ethnicity. Study Design Cross‐sectional study. Methods Patients with a peripheral vertigo disorder were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population‐representative sample of 2 million enrollees of Taiwan's National Health Insurance system covering over 99% of Taiwan's citizens. In 2016, 59,986 patients received a diagnosis of peripheral vestibular disorders in Taiwan. We calculated the population‐wide prevalence rates of peripheral vestibular disorders in 2016 by sex and age group (20 to 24, 25 to 29, 30 to 34, 35 to 39, 40 to 44, 45 to 49, 50 to 54, 55 to 59, 60 to 64, 65 to 69, and ≥ 70 years) stratified into five urbanization levels. Results The prevalence rate of peripheral vestibular disorders was 2,833.4 per 100,000 population during the year. Prevalence of Meniere's disease was 70.4 per 100,000, benign paroxysmal positional vertigo, 446.4, vestibular neuritis 307.2, and other or unspecified peripheral vestibular dizziness, 2,009.5 per 100,000. Prevalence rates steadily increased with age for every type of peripheral vestibular disorder, and were higher among females compared to males. The female‐to‐male gender ratios were 1.84, 1.89, and 1.93 for Meniere's disease, vestibular neuritis, and other peripheral vestibular dizziness, respectively. Counties with the lowest urbanization level had the highest prevalence rates of all types of peripheral vestibular disorders except vestibular neuritis. Conclusions Results showed that peripheral vestibular disorders are common in Taiwan, increase with age, are predominantly female, and show higher prevalence in rural areas. Level of Evidence 2b Laryngoscope, 131:639–643, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bepotastine Salicylate in Patients With Allergic Rhinitis

xlomafota13 shared this article with you from Inoreader Double‐Blind Placebo‐Controlled Trial of Bepotastine Salicylate in Patients With Allergic Rhinitis Via The Laryngoscope Objectives/Hypothesis To evaluate the efficacy and safety of a slow‐release form of bepotastine salicylate (HL151, Belion CR) in patients with perennial allergic rhinitis (PAR). Study Design Double‐blind, placebo‐controlled multicenter comparative study. Methods Two hundred seventy‐two PAR patients (aged 19–65 years) were studied to determine the efficacy and safety of HL151 (20 mg once daily administration) relative to those of a placebo in terms of improvements in total and nasal symptom scores. The subjects were randomized to the placebo (n = 138) or HL151 group (n = 134, 20 mg orally once daily for 4 weeks), and reflective and instantaneous total nasal symptom scores (TNSS) were measured daily in comparison with baseline. Among 272 subjects, 229 subjects (119 in the placebo group, 110 in the HL151 group) who completed the study were included for efficacy analysis. Results Instantaneous and reflective TNSS and nasal symptoms such as rhinorrhea, nasal itching, and sneezing at 2 and 4 weeks showed that HL151 was superior to the placebo (all P < .05). There were no significant differences in terms of adverse events and adverse drug reactions between the two groups. Regarding serious adverse events, there was only one case of acute hepatitis B, which was reported not to be associated with HL151. Conclusions This multicenter trial showed that once‐daily use of HL151 is efficacious and safe in adult patients with PAR and could improve compliance due to its convenience. Level of Evidence 1b Laryngoscope, 131:E702–E709, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Presence and duration of feeding tube in a 5‐year cohort of patients with head and neck cancer treated with curative intensity‐modulated radiation therapy

xlomafota13 shared this article with you from Inoreader Presence and duration of feeding tube in a 5‐year cohort of patients with head and neck cancer treated with curative intensity‐modulated radiation therapy Via Head & Neck Abstract Background Our study assessed post‐radiation therapy (RT) G‐tube presence, duration, and clinical predictors in patients with head and neck cancer (HNC). Methods We identified those 1–5‐years post‐RT with stage III/IV nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, or unknown primaries. Logistic regression identified predictors of post‐RT G‐tube presence, Kaplan–Meier analysis estimated G‐tube days, and log‐rank test compared by tumor site. Results The 977 patients had mean age 60.6 ± 11.6 years, 804 (82.3%) male, 764 (78.2%) stage IV, and 618 (63.3%) oropharyngeal primaries. All patients received intensity‐modulated RT (IMRT), 571 (58.4%) received chemotherapy, and 698 (71.4%) prophylactic G‐tube. G‐tube prevalence 1‐ and 5‐years post‐IMRT was 7.1% and 4.8%, respectively. Median post‐IMRT G‐tube days were overall 63 (95%CI: 56–70), nasopharynx 119 (95%CI: 109–131), oropharynx 57 (95%CI: 51–68), hypopharynx 126 (95%CI: 77–256), larynx 53 (95%CI: 21–63), unknown 30 (95%CI: 17–55), of which hypopharynx was highest p < 0.001. Conclusions At an institution offering prophylactic G‐tube for patients with advanced HNC, no differences were found in yearly G‐tube use 1–5 years post‐IMRT. Across all patients, median post‐IMRT days with G‐tube was 63 day but those with hypopharyngeal tumors registered the most days. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical‐based classification for transoral base of tongue resection

xlomafota13 shared this article with you from Inoreader Anatomical‐based classification for transoral base of tongue resection Via Head & Neck Abstract Background To propose a classification of transoral base of tongue (BOT) procedures able to provide uniform terminology in order to better define postoperative results. Methods The classification resulted from the consensus of the different authors and is based on anatomical and surgical principles. Results The classification comprises three types of BOT resections: type 1 is the resection of the entire lingual tonsil to the muscular plane; type 2 is performed by removing the entire lingual tonsil and part of BOT muscles; type 3 is performed by removing the entire lingual tonsil and the entire BOT muscles. Based on the extension of the dissection, we can use the suffix A (contralateral BOT), B (supraglottic larynx), C (lateral oropharynx), and/or D (oral tongue). Conclusion The proposed classification could allow us to easily compare data from different centers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extracellular Vesicles Act as Nano-Transporters of Tyrosine Kinase Inhibitors to Revert Iodine Avidity in Thyroid Cancer.

xlomafota13 shared this article with you from Inoreader Extracellular Vesicles Act as Nano-Transporters of Tyrosine Kinase Inhibitors to Revert Iodine Avidity in Thyroid Cancer. Via radioactive iodine Related Articles Extracellular Vesicles Act as Nano-Transporters of Tyrosine Kinase Inhibitors to Revert Iodine Avidity in Thyroid Cancer. Pharmaceutics. 2021 Feb 10;13(2): Authors: Rajendran RL, Paudel S, Gangadaran P, Oh JM, Oh EJ, Hong CM, Lee S, Chung HY, Lee J, Ahn BC Abstract A new approach for using extracellular vesicles (EVs) to deliver tyrosine kinase inhibitors (TKIs) to enhance iodine avidity in radioactive iodine-refractory thyroid cancer is needed. We isolated and characterized primary human adipose-derived stem cells (ADSCs) and isolated their EVs. The EVs were characterized by transmission electron microscopy, nanoparticle tracking analysis, and western blotting. A new TKI was loaded into the EVs by incubation (37 °C; 10 min) or sonication (18 cycles; 4 s per cycle) with 2 s intervals and a 2 min ice bath every six cycles. TKI loading was confirmed and measured by mass spectrometry. EV uptake into radioactive iodine-refractory thyroid cancer cells (SW1736 cells) was confirmed by microscopy. We treated the SW1736 cells with vehicle, TKI, or TKI-loaded EVs (sonication TKI-loaded EVs [EVsTKI(S)]) and examined the expression of iodide-metabolizing proteins and radioiodine uptake in the SW1736 cells. ADSCs cells showed >99% of typical ste m cell markers, such as CD90 and CD105. The EVs displayed a round morphology, had an average size of 211.4 ± 3.83 nm, and were positive for CD81 and Alix and negative for cytochrome c. The mass spectrometry results indicate that the sonication method loaded ~4 times more of the TKI than did the incubation method. The EVsTKI(S) were used for further experiments. Higher expression levels of iodide-metabolizing mRNA and proteins in the EVsTKI(S)-treated SW1736 cells than in TKI-treated SW1736 cells were confirmed. EVsTKI(S) treatment enhanced 125I uptake in the recipient SW1736 cells compared with free-TKI treatment. This is the first study that demonstrated successful delivery of a TKI to radioactive iodine-refractory thyroid cancer cells using EVs as the delivery vehicle. This approach can revert radioiodine-resistant thyroid cancer cells back to radioiodine-sensitive thyroid cancer cells. PMID: 33578882 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Osteomyelitis of the jaws in patients with pycnodysostosis: a systematic review.

xlomafota13 shared this article with you from Inoreader Osteomyelitis of the jaws in patients with pycnodysostosis: a systematic review. Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Related Articles Osteomyelitis of the jaws in patients with pycnodysostosis: a systematic review. Braz J Otorhinolaryngol. 2021 Jan 29;: Authors: de França GM, Felix FA, de Morais EF, Medeiros MRS, Andrade ACM, Galvão HC Abstract INTRODUCTION: Pycnodysostosis is a rare autosomal recessive syndrome that provides the abnormal bone metabolism that increases the susceptibility of patients to develop osteomyelitis. OBJECTIVE: This systematic review was conducted to analyze the risk factors associated with the development of complications in the jaws (fractures and osteomyelitis), as well as their clinical-pathological characteristics and therapeutic approaches in patients with pycnodysostosis. METHODS: Searches were performed in the PubMed, Web of Science, Scopus, Lilacs, and Cochrane databases. Case reports or case series that met the eligibility criteria according to the PRISMA statement were included. The full texts of 31 articles were retrieved. Twenty of these articles published between 1969 and 2018 were selected, which described 26 cases of osteomyelitis in patients with pycnodysostosis. RESULTS: The mean age of the patients was 37.84 years; the male-to-female was 1.36:1. The mandible was the most affected site (76.9%). Tooth extraction was the main risk factor for osteomyelitis (61.5%), followed by infection (26.8%) and mandibular fracture (23.0%). Antibiotic therapy alone or combined with some surgical procedure was the treatment used in most cases (80.7%). CONCLUSION: The findings of this review showed that patients with pycnodysostosis are more likely to develop osteomyelitis of the jaws after surgical procedures, especially tooth extraction which remains the main risk factor for its establishment. In addition, prophylactic antibiotic-therapy in the pre- and postoperative periods may prevent the development of osteomyelitis in pycnodysostosis. PMID: 33579598 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of topical isoconazole nitrate in the treatment of otomycosis

xlomafota13 shared this article with you from Inoreader Efficacy of topical isoconazole nitrate in the treatment of otomycosis Via American Journal of Otolaryngology Publication date: Available online 13 February 2021 Source: American Journal of Otolaryngology Author(s): Filiz Gülüstan, Mehmet Akif Abakay, Emine Demir View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gender Differences in Compensation, Mentorship, and Work‐Life Balance within Facial Plastic Surgery

xlomafota13 shared this article with you from Inoreader Gender Differences in Compensation, Mentorship, and Work‐Life Balance within Facial Plastic Surgery Via The Laryngoscope Objectives Our objective was to identify gender differences in work‐life balance, professional advancement, workload, salary, and career satisfaction among facial plastic and reconstructive surgeons. Study Design Cross‐Sectional Survey. Methods American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) members were invited by email to respond to a confidential 25‐question online survey. The survey had a response rate of 12%. There were a total of 139 participants; 23 participants were in training and 116 were either board‐eligible or board‐certified facial plastic surgeons. Collected variables included general demographics, personal life, academic involvement, career development, workload, and career satisfaction. Results Forty percent of participants were female. Fifty‐nine percent of female participants were 25–35 years old compared with 15% of male participants. The majority of male participants were over 45 years old (63%) while only 19% of female participants fell into this age category (P < .0001). Women were more likely to be in a relationship with a physician (35% vs. 19%) or non‐physician full‐time professional (55% vs. 31%). The vast majority of men had children (89%) while only half of women (52%) had children. On average, women with children had fewer children than men (P < .0001). No gender difference was seen with respect to working full versus part‐time (P = .81). Participants were equally satisfied with a surgical career regardless of gender. Conclusion Although significant progress has already been made towards closing the gender gap, gender disparities remain both professionally and personally for facial plastic surgeons. With an increasing number of women in medicine, we should continue to strive to close the gender gap. Level of Evidence 4 Laryngoscope, 131:E787–E791, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

In‐Office KTP Laser for Treating Hereditary Hemorrhagic Telangiectasia–Associated Epistaxis

xlomafota13 shared this article with you from Inoreader In‐Office KTP Laser for Treating Hereditary Hemorrhagic Telangiectasia–Associated Epistaxis Via The Laryngoscope Objective To evaluated the efficacy and safety of in‐office potassium titanyl phosphate (KTP) laser treatment for the management of epistaxis in hereditary hemorrhagic telangiectasia (HHT) patients. Methods A retrospective case series of all HHT patients over age of 18 who underwent in‐office KTP laser treatment from July 1, 2017 to December 31, 2019 was performed. The primary outcome measure was the epistaxis severity score (ESS) pre‐ and post‐procedure. Secondary outcome measures included patient reported pain (on a 10‐point Likert‐type scale), and procedural adverse events and complications. Results A total of 16 patients underwent KTP in‐office laser treatment during the review period. There was both a clinically and statistically significant decrease in the ESS after in‐office laser treatment, baseline ESS –7.24, SD 1.71, follow up ESS –4.92, SD 1.83 (mean difference 2.94, 95% confidence interval, 1.83–4.04, P < .0001). There were no reported adverse events or complications associated with the procedure. The mean pain score reported was 0.19, SD 0.75. The average blood loss was 10.8 mL, SD 37.3. The majority of patients (62.5%, 10/16) had no blood loss during the procedure. Conclusion Clinically and statistically significant decreases were noted in the ESS of HHT patients after in‐office KTP laser photocoagulation. The procedure was well tolerated by patients, without any adverse events or complications. Level of Evidence 4 Laryngoscope, 131:E689–E693, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Wendler Glottoplasty on Acoustic Measures of Voice

xlomafota13 shared this article with you from Inoreader Effect of Wendler Glottoplasty on Acoustic Measures of Voice Via The Laryngoscope Objectives Voice therapy has been the primary treatment for voice feminization in transfemale patients due to concerns that surgery worsens voice quality. We aim to determine the impact of Wendler glottoplasty on acoustic measures of voice. Study Design Retrospective case series. Methods Transgender female patients treated for vocal feminization with Wendler glottoplasty at a single tertiary care center were identified. Pre‐ and postoperative measures were taken with the Kay Elemetrics Real‐Time Pitch, Analysis of Dysphonia in Speech and Voice, and Multidimensional Voice Program. Results Twenty‐eight patients were included in this study. There were no statistically significant changes in fundamental frequency variation, peak amplitude variation, soft phonation index, noise‐to‐harmonics ratio, cepstral peak prominence, or cepstral spectral index of dysphonia at a significance level of P < .05. Average speaking fundamental frequency (SF0) increased from 143 Hz after voice therapy to 163 Hz after surgery (P = .0009). Lower range decreased in 61% and increased in 26% of patients. Upper range decreased in 52% and increased in 48% of patients. Conclusions Wendler glottoplasty does not worsen voice quality based on acoustic measures. Although most patients experience an increase in average SF0, effects on vocal range are variable with approximately half of patients experiencing a reduction and half experiencing an increase in upper pitch limit. Level of Evidence 4 Laryngoscope, 131:583–586, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.