Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome

xlomafota13 shared this article with you from Inoreader Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome Via leak of cerebrospinal fluid Cureus. 2021 Jun 18;13(6):e15733. doi: 10.7759/cureus.15733. eCollection 2021 Jun. ABSTRACT Introduction Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of largely benign intraspinal neoplasms. These are amenable to gross total excision and usually carry a good functional outcome. Methods In this study, we reviewed the surgical outcomes of 35 patients who underwent excision of intradural extramedullary tumors. Patient demographics, severity and duration of symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were collected. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel and Nurick grading. The back pain was assessed with help of the Denis pain scale (DPS). Results The histopathological outcomes of the study were as follows: six patients of neurofibroma, 12 cases of s chwannoma, nine cases of meningiomas, three cases of ependymoma, one case of dorsal neurenteric cyst, two cases of epidermoid cyst, one case of cauda equina paraganglioma, and one case of filum terminale dermoid cyst. Paresthesia/numbness were the commonest symptoms (88.6%), weakness of limbs in (80%), sphincter dysfunction in 15 patients (42.9%), and paraplegia was seen in three patients (8.57%). The complications encountered were - one case each of cerebrospinal fluid (CSF) leak, surgical site infection, and pseudomeningocele. The percentage of spinal canal occupied ranged from 71-94%. The mean percentage of the spinal canal occupied by the tumor was 81.8%. In our series, 77.14% of patients (p<0.0001) had good functional outcomes as per improvement in Frankel score. The DPS and Nurick score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significant functional improvement was noted at the one-week, one-month, and on e-year follow-up, with a p-value of <0.0001. Conclusions The IDEM tumors are usually benign and are readily detected by contrast-enhanced MRI scans. These have excellent surgical outcomes with some exceptions. Greater canal occupancy and a longer duration of symptoms are usually seen to correspond with suboptimal functional outcomes. PMID:34285844 | PMC:PMC8286542 | DOI:10.7759/cureus.15733 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Facial Paresis and Pulsatile Middle Ear Mass

xlomafota13 shared this article with you from Inoreader Facial Paresis and Pulsatile Middle Ear Mass Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211031510. doi: 10.1177/01455613211031510. Online ahead of print. ABSTRACT Head and neck paragangliomas are uncommon pathologies that present with common symptoms such as pulsatile tinnitus and aural pressure. This article highlights an unusual presentation of a patient with facial paresis who was found to have a jugular paraganglioma. Emphasis is placed on how the otologic examination showed a pulsatile middle ear mass that led to the d iagnosis. This case illustrates the importance of maintaining a healthy degree of clinical suspicion when encountering common complaints. PMID:34284609 | DOI:10.1177/01455613211031510 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity

xlomafota13 shared this article with you from Inoreader Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211029785. doi: 10.1177/01455613211029785. Online ahead of print. ABSTRACT Middle ear adenomatous neuroendocrine tumors (MEANT) are rare, mainly benign neoplasms and account for less than 2% of the middle and inner ear neoplasms. There are no specific radiological or clinical findings; therefore, the diagnosis is often difficult. Biopsy prior to surgery is often proposed. The definite treatment is the complete surgical resection. We pres ent an uncommon clinical report of a MEANT, which was treated successfully with surgical excision. PMID:34284607 | DOI:10.1177/01455613211029785 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Lidcombe Program for Early Stuttering in Non-English-Speaking Countries: A Systematic Review

xlomafota13 shared this article with you from Inoreader The Lidcombe Program for Early Stuttering in Non-English-Speaking Countries: A Systematic Review Via Folia Phoniatrica et Logopaedica Background: The Lidcombe Program is a stuttering treatment approach for children between the ages of 3 and 6 years. Most papers about the Lidcombe Program, however, are based on studies conducted in native English-speaking countries. The aim of this paper is to systematically review the delivery and implementation of the Lidcombe Program in non-native English-speaking countries. Summary: A resource search was conducted between October and November 2019. Scopus, Pu bMed, ASHA, Cochrane Library, ERIC, Google Scholar, and SpeechBITE databases and reference lists of relevant papers were searched for the identification process. Joanna Briggs Institute tools were used for the appraisal of the studies. The search yielded 8 studies conducted in non-native English-speaking countries. The Lidcombe Program is efficacious in non-native English-speaking countries when delivered to both preschool and young school age children who stutter. It is reported to be delivered with minor changes and challenges. The number of weekly clinic visits and the total time needed to reach zero or near-zero stuttering levels with the Lidcombe Program can be up to 3 times greater in non-native English-speaking countries than in native English-speaking countries, mostly due to the increased time needed to introduce the parental verbal contingencies. Key Messages: Speech and language therapists practicing in non-native English-speaking countries are encouraged to use the Lidcombe Program for both preschool and young school age children who stutter, although this can take more time than that reported in native English-speaking countries. Further investigation to explore the therapy process with children and parents in non-native English-speaking countries is needed. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer Via radioactive iodine Int J Part Ther. 2021 Jun 25;8(1):311-318. doi: 10.14338/IJPT-D-20-00053. eCollection 2021 Summer. ABSTRACT PURPOSE: External beam radiotherapy is used in a subset of high-risk patients with differentiated thyroid cancer (DTC). Recurrent, radioactive iodine (RAI)-refractory DTC carries a poor prognosis. We report our initial experience of intensity-modulated proton therapy (IMPT) for recurrent, RAI-refractory DTC. PATIENTS AND METHODS: Fourteen patients with recurrent, RAI-re fractory DTC were consecutively treated with IMPT from November 2016 to March 2020 at our multisite institution. Patient, tumor, and treatment characteristics were recorded. Overall survival and local-regional recurrence-free survival were recorded and estimated using the Kaplan-Meier method. Acute and late treatment-related toxicities were recorded based on the Common Terminology Criteria for Adverse Events version 5.0. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module at baseline and after IMPT. Eleven patients were included in the final analysis. RESULTS: Median follow-up was 8 months (range, 3-40) for all patients. Median age at treatment with IMPT was 64 years (range, 40-77), and the majority were men (64%). Recurrent histologies included papillary (55%), Hurthle cell (36%), and poorly differentiated (9%) carcinoma; 1 patient had tall cell variant. Concurrent chemotherapy was not administered for any pat ient in this cohort. At 8 months, all patients were alive without local-regional failure. Acute grade 3 toxicities were limited to 1 patient with dysphagia, requiring feeding tube placement. Two patients experienced late grade 3 esophageal stenosis requiring dilation. There were no grade 4 or 5 toxicities. There were no differences in pretreatment versus posttreatment patient-reported outcomes in terms of dysphagia or hoarseness. CONCLUSION: In our early experience, IMPT provided promising local-regional control for recurrent, RAI-refractory DTC. Further study is warranted to evaluate the long-term efficacy and safety of IMPT in this patient population. PMID:34285957 | PMC:PMC8270099 | DOI:10.14338/IJPT-D-20-00053 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasound-guided implantation of radioactive (125)I seed in radioiodine refractory differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Ultrasound-guided implantation of radioactive (125)I seed in radioiodine refractory differentiated thyroid carcinoma Via radioactive iodine BMC Cancer. 2021 Jul 20;21(1):834. doi: 10.1186/s12885-021-08500-5. ABSTRACT BACKGROUND: Treatment for radioiodine refractory differentiated thyroid carcinoma (RR-DTC) is challenging. The purpose of this study was to assess the efficacy and safety of ultrasound-guided implantation of radioactive 125I-seed in radioiodine refractory differentiated thyroid carcinoma. METHODS: Thirty-six cervical metastatic lymph nodes (CMLNs) diagnosed with RR-DTC from 18 patients wer e enrolled in this retrospective study. US and contrast-enhanced ultrasound (CEUS) examinations were performed before implantation. Follow-up comprised US, CEUS, thyroglobulin (Tg) level and routine hematology at 1-3, 6, 9 and 12 months and every 6 months thereafter. The volumes of the nodules were compared before implantation and at each follow-up point. The volume reduction rate (VRR) of nodules was also recorded. RESULTS: The median volume of the nodules was 523 mm3 (148, 2010mm3) initially, which decreased significantly to 53mm3 (0, 286mm3) (P < 0.01) at the follow-up point of 24 months with a median VRR as 95% (86,100%). During the follow-up period (the range was 24-50 months), 25 (69%) nodules had VRR greater than 90%, of which 12 (33%) nodules had VVR ≈ 100% with unclear structures and only 125I seed images were visible in the US. At the last follow-up visit, the serum Tg level decreased from 57.0 (8.6, 114.8) ng/ml to 4.9 (0.7, 50.3) ng/ml, (P < 0.01). CONCLUSION: US-guided 125I seed implantation is safety and efficacy in treating RR- DTC. It could be an effective supplement for the comprehensive treatment of thyroid cancer. PMID:34284748 | DOI:10.1186/s12885-021-08500-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Marios Loukas, R. Shane Tubbs Peter Abrahams, Stephen Carmichael, Thomas Gest: Gray's Anatomy review 3rd edition : Academic Press, Elsevier Inc, 2022, ISBN: 978-0-323-63,916-3, 544 pp

xlomafota13 shared this article with you from Inoreader Marios Loukas, R. Shane Tubbs Peter Abrahams, Stephen Carmichael, Thomas Gest: Gray's Anatomy review 3rd edition : Academic Press, Elsevier Inc, 2022, ISBN: 978-0-323-63,916-3, 544 pp Via radiol anat Surg Radiol Anat. 2021 Jul 20. doi: 10.1007/s00276-021-02798-3. Online ahead of print. NO ABSTRACT PMID:34286372 | DOI:10.1007/s00276-021-02798-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Paramassetric Subcutaneous Dirofilariasis: A Rare Entity

xlomafota13 shared this article with you from Inoreader Paramassetric Subcutaneous Dirofilariasis: A Rare Entity Via Otolaryngology Indian Abstract Dirofilariasis is an uncommon zoonotic parasitic infection affecting humans due to the bite of a mosquito vector. It is an endemic caused by Dirofilaria which is characterized in humans as nodules in lungs, subcutaneous tissue, peritoneal cavity, eyes. We present a case of Dirofilariasis with subcutaneous presentation in paramassetric region. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Hypersensitivity in Patients with Chronic Noise Exposure

xlomafota13 shared this article with you from Inoreader Vestibular Hypersensitivity in Patients with Chronic Noise Exposure Via Otolaryngology Indian Abstract It has been demonstrated that high-intensity noise exposure adversely affects the human balance function. The Tullio phenomenon (TP) refers to sound-induced imbalance which is resulted from hypersensitivity of vestibular end organs to normal acoustic stimuli. Although different etiologies have been attributed to TP, evidence on the role of excessive noise exposure in the development of this symptom is limited. The present study aims to assess the vestibular functions in patients manifesting TP symptom who were exposed to long-term excessive noise levels. This was an analytic cross-sectional study conducted on 17 males diagnosed with TP with a history of chronic noise-induced hearing loss (TP group) and 17 healthy individuals. All subjects in both groups underwent complete otological, videonystagmography (VNG), and cervical vestibular myogenic potential (cVEMP) assessments. The most common complaint in TP subjects was vertigo and imbalance. During the VNG assessme nt, we found abnormal positional nystagmus and caloric irrigation (vestibular hyperfunction) results in 4 (23.53%) and 9 (52.94%) patients, respectively. Seven (41.17%) patients indicated cVEMP thresholds which were abnormally lower than the normal values ( ≤ 70 dB HL). However, when both VNG and cVEMP results were considered together, the abnormal rate reached 70.58% (12 of 17 cases). Our findings showed that both the semicircular canal as well as otolith stuctures could be affected in TP patients with a history of chronic noise exposure. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endotracheal Intubation with Laryngeal Mirror in Simulated Difficult Direct Laryngoscopy: Comparison of Gum Elastic Bougie Versus Styleted Endotracheal Tube

xlomafota13 shared this article with you from Inoreader Endotracheal Intubation with Laryngeal Mirror in Simulated Difficult Direct Laryngoscopy: Comparison of Gum Elastic Bougie Versus Styleted Endotracheal Tube Via Otolaryngology Indian Abstract Laryngeal mirror (LM) is an inexpensive, portable, readily available device which can help visualize the vocal cords in difficult airway (DA) situations. We evaluated its use in improving glottic view prior to placing the airway adjuncts in simulated difficult airway.Eighty patients scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation were allocated- Bougie group (Group B) and Stylet group (Group S). Direct laryngoscopy was performed and CL grade III simulated. The glottic view was obtained using laryngeal mirror and Gum Elastic Bougie (GEB)/ Styleted Endotracheal Tube (ETT) inserted under mirror view. Time taken to obtain glottic view in LM and time for successful intubation were noted.Significant improvement in glottic view with LM was observed, with the view improving to Grade I in 76.25% and grade II in 23.75% of patients. Both groups were comparable with respect to number of attempts and success rate (p =  0.55).The success rate was 90% in group B and 95% in group S. Time taken for intubation was less in Group S (52.44 ± 14.23 s vs. 62.805 ± 20.74 s) [p = 0.01]. Hence, overall stylet proved to be a better adjunct with mirror guided intubation.We recommend stylet assisted rather than GEB assisted ET intubation under LM guidance in emergency scenarios. Also, further controlled trials are recommended to know the exact location of the mirror in relation to bulb of the laryngoscope as well as different angles at which it is placed to improve the view and stabilize the assembly. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Future Solutions for Voice Rehabilitation in Laryngectomees: A Review of Technologies Based on Electrophysiological Signals

xlomafota13 shared this article with you from Inoreader Future Solutions for Voice Rehabilitation in Laryngectomees: A Review of Technologies Based on Electrophysiological Signals Via Otolaryngology Indian Abstract Loss of voice is a serious concern for a laryngectomee which should be addressed prior to planning the procedure. Voice rehabilitation options must be educated before the surgery. Even though many devices have been in use, each device has got its limitations. We are searching for probable future technologies for voice rehabilitation in laryngectomees and to familiarise with the ENT fraternity. We performed a bibliographic search using title/abstract searches and Medical Subject Headings (MeSHs) where appropriate, of the Medline, CINAHL, EMBASE, Web of Science and Google scholars for publications from January 1985 to January 2020. The obtained results with scope for the development of a device for speech rehabilitation were included in the review. A total of 1036 articles were identified and screened. After careful scrutining 40 articles have been included in this study. Silent speech interface is one of the topics which is extensively being studied. It is based o n various electrophysiological biosignals like non-audible murmur, electromyography, ultrasound characteristics of vocal folds and optical imaging of lips and tongue, electro articulography and electroencephalography. Electromyographic signals have been studied in laryngectomised patients. Silent speech interface may be the answer for the future of voice rehabilitation in laryngectomees. However, all these technologies are in their primitive stages and are potential in conforming into a speech device. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.