Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review

xlomafota13 shared this article with you from Inoreader Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review Via Clinical Otolaryngology Abstract Introduction In-office biopsy (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy. Methods A systematic review following the PRISMA guidelines was conducted to assess the diagnostic accuracy of IOBs performed via flexible endoscopy. In addition, an analysis of potentially modifiable factors that may affect diagnostic accuracy was performed. PubMed, EMBASE, The Cochrane Library, Web of Science, CINAHL were used in the literature database search. Results 875 studies were identified, 16 of which were included into the systematic review. 1572 successful biopsies were performed using flexible endoscopy. 1283 cases were accurately diagnosed in the outpatient setting (81.6%). 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOBs was 73%, the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps), additional lighting system or learning curve. Conclusion IOBs are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOBs when benign or pre-malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tongue Edema Secondary to Suspension Laryngoscopy

xlomafota13 shared this article with you from Inoreader Reply to Tongue Edema Secondary to Suspension Laryngoscopy Via Journal of Voice In our article titled "Tongue Edema Secondary to Suspension Laryngoscopy," we presented two patients who underwent prolonged suspension micro laryngoscopy (SML) and developed edema of the tongue that was severe enough that intensive care unit admission with airway monitoring was required.1 At the time of its acceptance for publication in the Journal of Voice on September 23, 2019, the complication of tongue edema following SML had not been reported. We were surprised that this problem had not been described in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas

xlomafota13 shared this article with you from Inoreader Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas Via hno HNO. 2021 Nov 23. doi: 10.1007/s00106-021-01116-y. Online ahead of print. ABSTRACT The data of 86 patients with retrosigmoid microsurgical resection of vestibular schwannoma in tumor stage Koos II-IV were evaluated. In more than two thirds of the cases it was shown that the cochlear nerve followed the facial nerve, which is easily identified by electroneurography, in recurrent similar patterns in the region of the internal auditory canal. Starting from the fundus, this facil itated early identification and thus preservation of continuity of the cochlear nerve in the course of the internal auditory canal. This was of particular importance when safe functional preservation could not be guaranteed due to tumor size or formation despite intraoperative derivation of somatosenoric potentials, but when the possibility of subsequent hearing rehabilitation with a cochlear implant should be granted. Preoperative MRI sequences gave an indication of the possible nerve courses in some cases, but intraoperative imaging in the internal auditory canal was superior to MRI. PMID:34812915 | DOI:10.1007/s00 106-021-01116-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Transclival Endoscopic Endonasal Resection of a Ventral Pontine Cavernous Malformation

xlomafota13 shared this article with you from Inoreader Middle Transclival Endoscopic Endonasal Resection of a Ventral Pontine Cavernous Malformation Via leak of cerebrospinal fluid World Neurosurg. 2021 Nov 3;158:34-35. doi: 10.1016/j.wneu.2021.10.142. Online ahead of print. ABSTRACT The surgical management of lesions within or around the brainstem is usually associated with significant morbidity. Even though several safe entry zones have been described for brainstem lesions, especially cavernous malformations (CMs), their resection remains a challenge due to the convergence of highly functional nerve tracts and nuclei in this rather small structure. Moreover, the ventral location of some of these lesions usually calls for complex surgical approaches involving extensive bone drilling and significant manipulation of neurovascular structures. The expanded endoscopic endonasal approach has been subject to considerable advancements, widening the range of lesions accessible through this route. In this operative video, we describe the surgical nuances of an endoscopic endonasal transclival resection of a ventral pontine CM (F igures 1 and 2). A pedicled nasoseptal flap was harvested for reconstruction, gaining access to the sphenoid rostrum, which was resected. The sellar floor was removed to expose the middle third of the clivus, which was drilled out until posterior fossa dura mater was identified. A centered dural incision was performed to expose the ventral pons and basilar artery. Using image guidance, a limited pial incision over the most superficial aspect of the lesion allowed a prompt drainage of the hematoma and resection of the CM. The surgical cavity was directly inspected through the endoscope, confirming a complete resection. Reconstruction was carried out in a multilayered fashion. The patient presented a postoperative cerebrospinal fluid leak, which resolved with a lumbar drain. Neurologic status remained unchanged after surgery, with the patient displaying a favorable clinical outcome (Video 1). PMID:34740828 | DOI:10.1016/j.wneu.2021.10.142 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Intervention to Treat Pharyngolaryngeal Stenosis Caused by Behcet's Disease

xlomafota13 shared this article with you from Inoreader Surgical Intervention to Treat Pharyngolaryngeal Stenosis Caused by Behcet's Disease Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211053427. doi: 10.1177/01455613211053427. Online ahead of print. ABSTRACT We aimed to summarize the surgical treatment for pharyngolaryngeal stenosis and discuss prognosis in patients with Behcet's disease. Six cases of pharyngolaryngeal stenosis caused by Behcet's disease were analyzed retrospectively. All underwent surgical treatment for pharyngolaryngeal stenosis after systematic medical treatment. The follow-up time for the 6 patien ts was between 1 and 12 years. Four of the 6 patients underwent adhesiolysis as their first procedure. Two of these 4 experienced recurrence of stenosis within 6 months and underwent flap repair as their second procedure. The remaining two patients underwent flap reconstruction as their first procedure and maintained good swallowing function. Three of the 6 patients underwent preoperative tracheotomy because of dyspnea. Tracheal decannulation was successful in all patients. None of the patients experienced recurrence after their final surgical procedure and all recovered to a near-normal condition. Pharyngolaryngeal stenosis caused by Behcet's disease is a rare but severe complication; surgical intervention should be considered in patients with dysphagia after systematic medical treatment. PMID:34814770 | DOI:10.1177/01455613211053427 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trends in Diagnosis of NIFTP and Total Thyroidectomies for Papillary Thyroid Neoplasms

xlomafota13 shared this article with you from Inoreader Trends in Diagnosis of NIFTP and Total Thyroidectomies for Papillary Thyroid Neoplasms Via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study determines adoption rates of 2 recent strate gies developed to limit overtreatment of low-risk thyroid cancers: a new classification, noninvasive follicular thyroid neoplasm with papillarylike nuclear features, and hemithyroidectomy for selected papillary thyroid carcinomas up to 4 cm in size. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sudden Sensorineural Hearing Loss and COVID-19 Vaccination

xlomafota13 shared this article with you from Inoreader Sudden Sensorineural Hearing Loss and COVID-19 Vaccination Via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor Recent attention has centered on whether COVID-19 vaccines are associated with Bell Palsy or sudden sensorineural hearing loss (SSNHL). Formeister and colleagues address the latter, using Centers for Disease Control and Prevention (CDC) Vaccine Adverse Event Reporting System (VAERS) data to compare the incidence of SSNHL in individuals receiving a COVID-19 vaccine to historical baseline rates. Their study reports a lower estimated incidence of SSNHL in vaccinated individuals compared with historical norms. As the authors acknow ledge, the finding should be interpreted with care. The VAERS is an early warning system for detecting adverse events, and reports may be incomplete, inaccurate, coincidental, or unverifiable. Extrapolated epidemiological analyses are susceptible to bias, underreporting, or spurious associations. Many cases go unreported (particularly if mild and self-limited), and duplicate reporting may occur. As an example of potential distortions, long before the pandemic, VAERS reporting increased during pending litigation for vaccine injury. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influence of atherosclerosis on the molecular expression of the TRPC1/BK signal complex in the aortic smooth muscles of mice

xlomafota13 shared this article with you from Inoreader Influence of atherosclerosis on the molecular expression of the TRPC1/BK signal complex in the aortic smooth muscles of mice Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):4. doi: 10.3892/etm.2021.10926. Epub 2021 Oct 26. ABSTRACT Atherosclerosis (AS) is one a disease that seriously endangers human health. Previous studies have demonstrated that transient receptor potential channel-1 (TRPC1)/large conductance Ca2+ activated K+ channel (BK) signal complex is widely distributed in arteries. Therefore, it was hypothesized that TRPC1-BK signal complex may be a new target for the treatment of AS-related diseases. Apolipoprotein E-/- (ApoE-/-) mice were used to establish an atherosclerotic animal model in the present study, and the association between AS and the TRPC1-BK signal complex was examined. The present study aimed to compare the differences in the expression levels of mRNAs and proteins of the TRPC1-BK signal complex expressed in the aortic vascular smooth muscle tissue, between mice with AS and control mice. There were 10 mice i n each group. Reverse transcription PCR, western blotting and immunohistochemistry were used to detect the differences in the mRNA and protein expression levels of TRPC1, BKα (the α subunit of BK) and BKβ1 (the β1 subunit of BK). The mRNA expression level of TRPC1 in AS model mice was significantly higher compared with that in the control group (P<0.05). However, the mRNA expression levels of BKα and BKβ1 were lower compared with those in the controls (both P<0.01). The mice in the ApoE-/- group successfully developed AS. In this group, the protein expression level of TRPC1 was significantly higher than that in the control group (P<0.01), while the protein expression levels of BKα and BKβ1 were lower compared with those in the control group (P<0.01 and P<0.05, respectively). Collectively, it was identified that the protein and mRNA expression levels of the TRPC1/BK signal complex in the aortic vascular smo oth muscle tissue could be influenced by the development of AS in mice. Hence, the TRPC1/BK signal complex may be a potential therapeutic target for the prevention and treatment of AS-related complications in the future. PMID:34815756 | PMC:PMC8593874 | DOI:10.3892/etm.2021.10926 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiofrequency thermocoagulation for the treatment of trigeminal neuralgia

xlomafota13 shared this article with you from Inoreader Radiofrequency thermocoagulation for the treatment of trigeminal neuralgia Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):17. doi: 10.3892/etm.2021.10939. Epub 2021 Oct 30. ABSTRACT Although microvascular decompression (MVD) should be considered as the first-line treatment for classic trigeminal neuralgia (TN) owing to neurovascular compression of the trigeminal nerve, an increasing number of surgeons prefer radiofrequency thermocoagulation (RFT). RFT is a Gasserian ganglion-level ablative intervention that may achieve immediate pain relief for TN. It is used for emergency management when MVD is not suitable for the patient. As the gold surgical standard of classic trigeminal neuralgia, MVD has the advantage of longer efficacy. However, there are currently no high-quality controlled trials to evaluate the efficacy of MVD and RFT. For the present systematic review, the PubMed, Embase and Cochrane databases (all entries up until July 31, 2020) were searched to identify studies related to RFT in order to provide valuable informat ion for clinical decision-making. The efficacy of the RFT method was evaluated in terms of the initial pain relief percentage, recurrence rate and follow-up time. Furthermore, the incidence rate of various postoperative complications was retrieved. RFT was used for a wider range of applications than MVD, including use for primary (owing to neurovascular compression of the trigeminal nerve), idiopathic and secondary (due to primary neurological diseases) TN, and provided a high rate of initial pain relief and long-term pain control. Although this method has several side effects, the incidence of complications could be reduced by precise cannulation. Furthermore, the complications that occurred were not permanent. Thus, RFT is a safe and effective minimally invasive method of pain relief for patients with TN. PMID:34815769 | PMC:PMC8593925 | DOI:10.3892/etm.2021.10939 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long non-coding RNA profiles in plasma exosomes of patients with gastric high-grade intraepithelial neoplasia

xlomafota13 shared this article with you from Inoreader Long non-coding RNA profiles in plasma exosomes of patients with gastric high-grade intraepithelial neoplasia Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):1. doi: 10.3892/etm.2021.10923. Epub 2021 Oct 26. ABSTRACT Long non-coding (lnc) RNAs in circulating exosomes are a new class of promising cancer biomarkers; however, their expression in exosomes derived from gastric high-grade intraepithelial neoplasia (GHGIN) has not been reported. In the present study, differentially expressed (DE) lncRNAs were analyzed in the peripheral blood collected from 5 patients with GHGIN and 5 healthy donors using high-throughput sequencing. Reverse transcription-quantitative PCR analysis was performed on 6 randomly selected DE lncRNAs to validate the reliability of the sequencing results. The potential roles of the DE lncRNAs in GHGIN were investigated using Gene Ontology (GO) and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway enrichment analyses. A total of 25,145 lncRNAs were identified in all the samples and 83 DE lncRNAs were further screened, including 76 upregulated and 7 downregulated DE lncRNAs. GO and KEGG analyses predicted that the DE lncRNAs played notable roles in 'protein/macromolecule glycosylation', 'regulation of protein ubiquitination', 'renin-angiotensin system' and 'MAPK signaling pathways'. A lncRNA-micro (mi)RNA-mRNA interaction network was constructed and used to perform association analyses. It was found that 83 lncRNAs were abnormally expressed in GHGIN, with some potential functions associated with gastric cancer. Furthermore, the lncRNA-miRNA-mRNA interaction network indicated that 7 DE lncRNAs may play a notable role in the occurrence and development of GHGIN. The results of the present study showed the expression profiles of lncRNAs in human GHGIN, elucidated some of the molecular changes associated with GHGIN and improved the understanding of the molecular mechanisms underlying GHGIN and gastric cancer. PMID:34815753 | PMC:PMC8593877 | DOI:10.3892/etm.2021.10923 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Altered Wnt5a expression affects radiosensitivity of non-small cell lung cancer via the Wnt/β-catenin pathway

xlomafota13 shared this article with you from Inoreader Altered Wnt5a expression affects radiosensitivity of non-small cell lung cancer via the Wnt/β-catenin pathway Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):5. doi: 10.3892/etm.2021.10927. Epub 2021 Oct 26. ABSTRACT It has been reported that upregulation of wingless-type protein 5a (Wnt5a) is associated with poor prognosis in patients with non-small cell lung cancer (NSCLC). Wnt5a expression is often upregulated in radiation-resistant NSCLC cells. However, the biological functions or molecular mechanisms of radiosensitivity in NSCLC remain unknown. In the present study, MTT assay and flow cytometric analysis were performed to assess the effect of overexpression or knockdown of Wnt5a and/or radiation on the proliferation and apoptosis of NSCLC cells. Furthermore, western blot analysis was performed to detect canonical Wnt signaling (β-catenin) in H1650 and A549 cells. The results demonstrated that Wnt5a knockdown combined with irradiation inhibited proliferation and induced apoptosis in NSCLC cells compared with Wnt5a knockdown or radiotherapy alone. In additio n, the combination of Wnt5a knockdown and irradiation decreased nuclear and increased cytoplasmic β-catenin expression in H1650 and A549 cells, the effects of which were reversed following overexpression of Wnt5a. The combination of overexpressing Wnt5a and irradiation resulted in significant tumor regression, while β-catenin knockdown reversed Wnt5a overexpression-induced NSCLC cell proliferation. Taken together, these results suggest that Wnt5a may be involved in the activation of β-catenin-dependent canonical Wnt signaling, and thus may influence the effectiveness of radiation therapy in NSCLC. PMID:34815757 | PMC:PMC8593861 | DOI:10.3892/etm.2021.10927 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.