Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose

xlomafota13 shared this article with you from Inoreader Bilateral Sensorineural Hearing Loss in the Setting of Acute Methamphetamine Overdose Via ear nose throat Ear Nose Throat J. 2021 Dec 29:1455613211069353. doi: 10.1177/01455613211069353. Online ahead of print. ABSTRACT Substance abuse is a rare but known cause of sensorineural hearing loss (SNHL). We report a case of acute SNHL in a 28-year-old man following an overdose of methamphetamine and incidental ingestion of fentanyl. On initial encounter, he had moderate-to-severe hearing loss in the right ear and severe-to-profound hearing loss in the left ear in addition to acute kidn ey injury, liver failure, and lactic acidosis. The patient was treated with a two-week course of high-dose steroids and expressed a subjective improvement in hearing. This case highlights the importance of auditory testing following a drug overdose and is one of the only documented cases of hearing loss following methamphetamine use in recent years. There is a paucity of literature regarding the mechanism causing acute SNHL secondary to methamphetamines. Proposed etiologies include neurotransmitter depletion or reduced cochlear blood flow as possible causes of ototoxicity. PMID:34965172 | DOI:10.1177/01455613211069353 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial

xlomafota13 shared this article with you from Inoreader Efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS):a multicenter randomized controlled trial Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1248-1255. doi: 10.3760/cma.j.cn115330-20210429-00237. ABSTRACT Objective: To compare the therapeutic efficacy of Han-uvulopalatopharyngoplasty (HUPPP) combined with radiofrequency ablation of tongue base or HUPPP with traction of tongue base on moderate to severe patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: This is a multicenter randomized controlled trial. From March 2017 to July 2019, moderate to severe OSAHS patients from three clinical center in Shanghai who were intolerant to continuous positive airway pressure (CPAP) and with velopharyngeal and glossopharyngeal plane obstruction were enrolled in this study. According to the surgical type, they were 1∶1 randomized to HUPPP plus radiofrequency ablation of tongue base group (Ablation group) or HUPPP plus traction of tongue base group (Traction group). All patients completed over-night standard Polysomnography (PSG), upper-airway assessment (Friedman classification, Müller test, CT and cephalometric examination), preoperative routine examination, Epworth Sleepiness Scale (ESS) and Quebec sleep questionnaire (QSQ). Six to 12 months after operation, all the above-mentioned examinations were repeatedly performed. Changes of aforementioned variables before and after operation were assessed. Results: A total of 43 patients with moderate to severe OSAHS were enrolled in this study. One patient lost to follow-up, the remaining 21 were allocated to Ablation group and 21 were allocated to Traction group. The total therapeutic efficacy of all patients was 69.05% (61.90% in Ablation group and 76.19% in Traction group), but there was no statistical significance between the two groups (P= 0.317). The value of sleep scale score (ESS and QSQ), objective sleep variables (apnea-hypopnea index, oxygen saturation, percentage of time with blood oxygen less than 90% in total sleep time, oxygen desaturation index and micro-arousals) and upper airway cross-sectional area (palatopharyngeal and retrolingual area) of the two groups were improved (P<0.05), but the differences between the two groups were not statistically significant (P>0.05). Conclusion: For moderate to severe OSAHS who had glossopharyngeal plane obstruction, both HUPPP plus radiofrequency ablation of tongue base or HUPPP plus traction of tongue base are effective treatment for OSAHS, and the curative effect is similar. The choice of surgical type could be selected according to patient's or surgical conditions. PMID:34963211 | DOI:10.3760/cma.j.cn115330-20210429-00237 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study

xlomafota13 shared this article with you from Inoreader Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1277-1282. doi: 10.3760/cma.j.cn115330-20210912-00607. ABSTRACT Objective: To explore the characteristics of dynamic balance during the onset of benign paroxysmal positional vertigo (BPPV) and its prediction of residual symptoms after successful repositioning. Methods: From January 2018 to August 2019, patients diagnosed with unilateral posterior semicircular canal or horizontal semicircular canal BPPV were consecutively enrolled from five otolaryngology clinics in Shanghai. The dynamic balance function was measured by sensory organization test (SOT) before repositioning maneuver, and the residual symptoms and its duration were followed up from one week to up to three months. Results: A total of 260 patients were recruited. After excluding 17 cases, 243 cases were successfully followed up including 89 males and 154 females, with an average age of (52. 9±13.0) years. There were 175 cases of posterior semicircular BPPV, 61 cases of horizontal semicircular BPPV and 7 cases of canal conversion (from horizontal to posterior semicircular). Among 243 patients, 118 cases reported residual symptoms, with an incidence of 48.6%. The results of SOT showed that 58.0%(141/243) of the patients had abnormal vestibular input and 41.6%(101/243) were categorized as "near falls". With respect to the detailed residual symptoms, 47 cases (39.8%) reported unsteadiness or floating, 35 cases (29.7%) had fogginess/heaviness feeling, 22 cases (18.6%) had transient dizzy while head moving, and 15 cases (12.7%) reported that the symptom was too subtle to describe. Compared with the group without residual symptoms, the group with residual symptoms had more abnormal vestibular input(χ²=67.25, P<0.001) and near falls(χ²=74.78, P<0.001) as identified by SOT test. Cox proportional hazards regression failed to reveal any SOT results having significantly impact on the duration of residual symptoms [abnormal vestibular input (HR= 0.93, 95%CI: 0.48, 1.80), and near falls (HR= 0.90, 95%CI: 0.56, 1.46)]. Kaplan-Meier survival analysis showed that there was no significant difference in the duration of residual symptoms among patients with different SOT manifestations [Log rank (Mantel-Cox) test, P>0.05]. Conclusions: The impaired dynamic balance during the onset of BPPV is characterized by "abnormal vestibular input". The residual symptoms are mainly characterized by unsteadiness or floating feeling. The defect of dynamic balance function is a predictor of the residual symptoms after successful repositioning, but not for the duration of such symptoms. PMID:34963215 | DOI:10.3760/cma.j.cn115330-20210912-00607 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction

xlomafota13 shared this article with you from Inoreader Efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of OSAHS with soft palate oropharyngeal obstruction Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1270-1276. doi: 10.3760/cma.j.cn115330-20210707-00436. ABSTRACT Objective: To explore the efficacy of relocation and expansion pharyngoplasty by suspension sutures in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Seventy-three patients(including 60 males and 13 females) with OSAHS admitted to the department of otorhinolaryngology of our hospital in recent two years were retrospectively analyzed. All the patients had velopharyngeal obstructionevaluated by electronic endoscopic Müller test and were divided into control group (34 cases) and observation group (39 cases). The patients in the control group were performed modified uvulopalatopharyngoplasty, while those in the observation group were performed relocation and expansion pharyngoplasty by suspension sutures.The scores of ESS, AHI and LSaO2 before and after trea tment were collected and compared. Results: The total effective rate of the observation group was 94.87%, which was significantly higher than 79.41% of the control group. The AHI was lower and LSaO2 value was higher (χ2=-1. 896,-1. 968,P<0.05)in the observation group. The sleeping symptoms and quality of life of the two groups were significantly improved. The ESS score of the observation group was decreased more significantly than that of the control group after treatment, and the difference was statistically significant (χ2=-1.451,P<0.05). The incidence of foreign body sensation in pharynx of the observation group (89.74%) was higher than that of the control group (55.88%), and the postoperative bleeding and postoperative recurrence rate (0.00%, 2.56%) was lower than that of the control group (8.82%, 14.70%)with statistical significance (χ2=4.738,4.249,4.119,P<0.05).The incidence of transient nasoph aryngeal reflux in both groups was low and statistically insignificant (χ2=0.629,P>0.05). Conclusions: Preoperative strict screening of indications plays an important role in the selection of palatopharyngeal surgery methods and curative effect. Relocation and expansion pharyngoplasty by suspension sutures can improve the clinical efficacy of OSAHS with better safety and less recurrence. PMID:34963214 | DOI:10.3760/cma.j.cn115330-20210707-00436 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations

xlomafota13 shared this article with you from Inoreader Features of the clinic, diagnosis and treatment of parapharyngeal abscesses in children: analysis of 121 observations Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):62-68. doi: 10.17116/otorino20218606162. ABSTRACT Parapharyngeal and retropharyngeal abscesses (PPA) in children are a rare pathology, for the diagnosis of which it is necessary to use additional instrumental examination methods. The tactics of treating patients remains a subject of discussion. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of PPA in children. MATERIAL AND METHODS: According to the hospital database, a retrospective analysis of the medical histories of children discharged from the clinic with a diagnosis of "J39.0 Retropharyngeal and parapharyngeal abscess" was carried out in the period from 01.01.14 to 31.12.19. In all cases, the diagnosis was confirmed by computed tomography (CT) data with contrast enhancement. Complaints at the time of treatment, anamnesis and instrumental diagnosis data, clinical features of the course of the disease and the e ffectiveness of treatment were analyzed. RESULTS: 121 children were treated for PPA (average age 73±41 months; Me=52.5 months), which is 0.4% of all hospitalized in the otorhinolaryngological department, 0.7% of the number of emergency hospitalizations, 0.8% of the number of hospitalized children with pharyngeal diseases, and 8.3% of the number of patients with pharyngeal abscess. Abscesses were more often localized in the upper pharynx, at the level of the I-II cervical vertebrae (49.6% of all observations); abscesses were found least often in the pharyngeal space (5.8%), there was no statistically significant difference between the right-sided and left-sided location: 47.9% and 46.2%, respectively. Surgical treatment was performed in 98 (81%) patients in the presence of an abscess capsule or an abscess diameter of more than 2 cm according to CT; the remaining 23 (19%) children were treated conservatively. The opening of the abscess was performed endopharyngeal, in the case of a pronounced deep lateral location of the abscess and its proximity to large blood vessels - with access through the tonsillar niche after preliminary tonsillectomy (19.4% of those operated). CONCLUSION: The final diagnosis of parapharyngeal and retropharyngeal abscess can be established by contrast-enhanced computed tomography. Conservative treatment is indicated for a limited group of patients at the initial stages of the disease, most patients need surgical treatment. PMID:34964332 | DOI:10.17116/otorino20218606162 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):105-112. doi: 10.17116/otorino202186061105. ABSTRACT The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutroph il extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis. PMID:34964339 | DOI:10.17116/otorino202186061105 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case of ear miasis in a 2-month-old child

xlomafota13 shared this article with you from Inoreader A case of ear miasis in a 2-month-old child Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):113-116. doi: 10.17116/otorino202186061113. ABSTRACT A clinical case is presented - a rare observation of ear myasis in a 2-month-old child. PMID:34964340 | DOI:10.17116/otorino202186061113 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal cysts in children

xlomafota13 shared this article with you from Inoreader Laryngeal cysts in children Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):57-61. doi: 10.17116/otorino20218606157. ABSTRACT Laryngeal cysts in children are relatively rare, occupying the 4-5th place in the structure of congenital malformations. The paper presents the combined experience of two Russian pediatric otorhinolaryngological clinics traditionally involved in the rehabilitation of patients with congenital and acquired pathology of the larynx. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of laryngeal cysts in children. MATERIAL AND METHODS: The study included 68 children with laryngeal cysts aged from 3 days to 16 years (on average 39.5±37.0 months, Me=15.5 months). The cyst was localized in the vestibular region of the larynx in 15 (22.1%) patients, in the vocal region - in 15 (22.1%) patients, and in the sub-vocal region - in 38 (55.9%) patients. Data on the presence of a history of tracheal intubation were available in 35 ( 89.7%) children, including 35 (92.1%) of 38 children with a subfold cyst. 11 patients were admitted with a previously applied tracheostomy. RESULTS: The main reasons for going to the clinic were signs of laryngeal stenosis (stridor, signs of obstruction of the upper airways) in 60.3% of patients, dysphonia - in 33.8%, and in 5.9%, the detection of a cyst became an accidental finding. To eliminate the cyst, the method of laser marsupialization was used in 10 patients, coagulatory ablation - in 2 patients, in the remaining 56 patients, decortication was performed with microinstruments, followed by laser treatment of the cyst bed. In the follow-up, children were traced from 6 months to 7 years. We did not observe a recurrence of a cyst in any case. CONCLUSION: Currently, the lining department is the "favorite" localization of the cyst in childhood. Subclavian cysts are more common in preterm infants who need tracheal intubation. A necessary condition for radical elimination is the resection of the cyst walls. PMID:34964331 | DOI:10.17116/otorino20218606157 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels

xlomafota13 shared this article with you from Inoreader The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.