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Τρίτη 20 Δεκεμβρίου 2022

Ghost Cell Odontogenic Carcinoma: A Case Report and Literature Review

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Ghost Cell Odontogenic Carcinoma: A Case Report and Literature Review


Ghost cell odontogenic carcinoma (GCOC) is an exceptionally rare malignant odontogenic neoplasm with a significant potential for aggressive growth. Although the literature on this tumor is limited, its high recurrence rates suggest that early and multimodal intervention may be beneficial. This study reports a case of GCOC of the mandible that was successfully treated with surgical resection, reconstruction, and radiation. A comprehensive literature review was performed, and the relevant genomic and histopathological characteristics of this malignancy were determined. Laryngoscope, 2022

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The maximum phonation time as marker for voice treatment efficacy: a network meta‐analysis

alexandrossfakianakis shared this article with you from Inoreader

ABSTRACT

Purpose

There is a diversity in treatment approaches for voice therapy in which aerodynamic treatment effects between the approaches are lacking. The evidence of voice treatments on the maximum phonation time (MPT) was quantified using the statistical approach of a network meta-analysis (NMA).

Data sources

Three databases and manual search from inception to November 2021 were evaluated.

Study selection

Studies were considered which were reports of randomized controlled/clinical trials (RCT) evaluating the efficacy of a specific voice therapy treatment using MPT as an outcome measure in adult participants with voice disorders. Studies were excluded if participants had been diagnosed with neurological-motor-speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological, or technical instrumental treatments were used.

Data Extraction and Synthesis

Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension Statement guidelines were followed. Two reviewers independently screened citations, extracted data and assessed risk of bias using PEDro scale. Random effects model was used for meta-analysis.

Results

We identified finally 12 RCT studies (treatment groups n=285, and control group without an intervention n=62). Eight interventions were evaluated. The only effective intervention with a significant effect was Vocal Function Exercises (VFE) (mean pre-post difference 6.16 sec, 95% confidence interval, 1.18 sec to 11.13 sec).

Conclusions and Relevance

VFE effectively improved MPT from pre- to post-treatment in comparison with other voice interventions which were identified in the present NMA. Further high-quality intervention studies with large samples sizes, multidimensional measures, and homogeneous groups of dysphonia are needed to support evidence-based practice in laryngology.

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Efficacy of prophylactic preoperative desmopressin administration during functional endoscopic sinus surgery for chronic rhinosinusitis: a systematic review and meta‐analysis of randomized placebo‐controlled trials

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aim

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that examined the efficacy of prophylactic desmopressin versus placebo among patients undergoing functional endoscopic sinus surgery (FESS).

Methods

The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Scopus, and Web of Science databases were screened from inception until 18-March-2022. The included studies were evaluated for risk of bias. The efficacy endpoints were summarized as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI).

Results

Five RCTs comprising 380 patients (desmopressin=191 patients and placebo=189 patients) were included. Collectively, the included RCTs had an overall low risk of bias. The pooled results showed that the mean intraoperative blood loss (n=5 RCTs, MD=–37.97 ml, 95% CI [–56.97, –18.96], p<0.001), 5-point Boezaart scores (n=2 RCTs, MD=–0.97, 95 CI [–1.21, –0.74], p<0.001), and 10-point Boezaart scores (n=2 RCTs, MD= –3.00, 95% CI [-3.61, -2.40], p<0.001) were significantly reduced in favor of the desmopressin group compared with the placebo group. Operation time did not significantly differ between both groups (n=5 RCTs, MD=–3.73 min, 95% CI [–14.65, 7.18], p=0.50). No patient in both groups developed symptomatic hyponatremia (n=3 RCTs, 194 patients) or thromboembolic events (n=2 RCTs, 150 patients)

Conclusion

Among patients undergoing FESS, prophylactic administration of desmopressin does not correlate with significant clinical benefits. Data on safety is limited. Future research may explore the synergistic antihemorrhagic efficacy and safety of tranexamic acid (TXA) plus desmopressin versus TXA alone among patients undergoing FESS.

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