Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients

xlomafota13 shared this article with you from Inoreader Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients Via The Laryngoscope Objectives/Hypothesis Antimalarial drugs (chloroquine and hydroxychloroquine) are widely used for the treatment of systemic lupus erythematosus (SLE). However, these drugs may have side effects such as hearing loss. This study aimed to describe the hearing function in SLE patients using antimalarials. Secondarily, this study aimed to investigate whether SLE causes hearing loss and if there are any serological or clinical aspects of this diseases associated with inner ear damage. Study Design Cross‐sectional study. Methods This study included 84 individuals (43 SLE patients and 41 controls) with audiometry and tympanometry tests. Epidemiological, clinical, serological, and treatment profiles of SLE patients were extracted from the charts. Results SLE patients had more sensorineural hearing loss than controls (23.2% vs. 0; P = .001). Pure‐tone averages in SLE patients using antimalarials and not using antimalarials were similar (8.75 vs. 8.75; P = .63). At 8,000 Hz, antimalarial dug nonusers performed worse than users (10.00 vs. 22.50; P = .03). Tympanometry was normal in all participants. SLE serological and clinical profiles in patients with and without hearing loss were the same (all P = nonsignificant). Conclusions There is a high prevalence of hearing loss in SLE that is not affected by antimalarial drug use. Level of Evidence 3b Laryngoscope, 131:E957–E960, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting the Premorbid Shape of a Diseased Mandible

xlomafota13 shared this article with you from Inoreader Predicting the Premorbid Shape of a Diseased Mandible Via The Laryngoscope Objectives/Hypothesis Virtual surgical planning (VSP) for reconstructions of advanced mandibular neoplasms that have distorted the contour of the mandible is challenging, as the premorbid shape of the mandible is unknown. We introduce a novel modeling technique, based on a statistical shape model (SSM), that has learned the shape of a normal mandible from a set of 84 mandibles, such that given a diseased mandible, the model can determine its premorbid shape. Methods Eighty‐four control mandibles were used to generate an SSM. Various mandibular defects were created, and the SSM was applied to predict the shape of the original mandible. The predicted and original shape of the defect were compared for accuracy using volumetric overlap and Hausdorff distance. All mandibular VSP cases in the past 2 years were reviewed to identify those that required virtual preprocessing due to significantly distorted mandibular contours. The SSM was compared to those cases requiring preprocessing and highlighted in one prospective VSP. Results The average volumetric overlap and Hausdorff distance between the defect replacement and the defect are 73.9% ± 13.3% and 4.51 mm ± 2.65 mm, respectively. The SSM is more accurate for smaller defects, and those not including the condyle. Ten out of 40 VSP cases required preprocessing using four different techniques. Qualitatively, the SSM outperformed those preprocessing techniques applied in the retrospective cases. Conclusions The SSM can accurately predict the premorbid shape of a distorted mandible and is superior to current preprocessing techniques. The SSM was successfully applied to a retrospective series and one prospective index case. Level of Evidence 4 Laryngoscope, 131:E781–E786, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing

xlomafota13 shared this article with you from Inoreader Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing Via The Laryngoscope Objectives/Hypothesis Although the Hadad‐Bassagusteguy flap represents the first choice for middle and posterior skull base reconstruction and coverage of exposed bony areas, in some cases it is unavailable. The aim of this study is to describe, as an alternative option in selected cases, a modified posterior pedicle middle turbinate flap (mPPMTF) extended to the lacrimal area. Anatomical features, step‐by‐step harvesting technique, and surgical applications are presented. Study design Anatomic dissection study and case report. Methods Four mPPMTFs were raised in two fresh‐frozen cadaver heads. A study of the vascular supply and measurements of length, width, and area of the flap were performed. The ability of the flap to cover the ventral skull base, particularly the upper clivus area, was tested. A clinical case in which an mPPMTF was used for clivus resurfacing after osteoradionecrosis is reported. Results The vascular supply of the mPPMTF was identified as the middle turbinate branch of the sphenopalatine artery. The flap had a mean length of 6.92 cm, mean maximum width of 1.08 cm, and mean total area of 5.33 cm2. The flap was able to reach the upper clivus, with a clival coverage ratio of 70.66%. In the clinical case, good surgical outcomes were observed, with accelerated re‐epithelization without complications. Conclusions The mPPMTF represents an alternative to the Hadad‐Bassagusteguy flap for posterior cranial fossa and nasopharynx resurfacing. The main drawbacks are its technically demanding and time‐consuming harvesting. Level of Evidence 4 Laryngoscope, 131:E767–E774, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews

xlomafota13 shared this article with you from Inoreader An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews Via The Laryngoscope Objectives/Hypothesis Spin—the practice of adding or omitting information intentionally or unintentionally to make the results of a study more favorable—may influence clinical decision making, especially when present in study abstracts. Here, we quantify and characterize the presence of spin in the abstracts of systematic reviews regarding tonsillectomy. Methods This study is an analysis of systematic review abstracts. Searches were conducted on September 23, 2019 on PubMed and Embase using the advanced search feature to retrieve systematic reviews regarding tonsillectomies. The nine most severe forms of spin were then evaluated. Spin was classified by two investigators in parallel, with each blinded to the classifications of the other. Study characteristics were also recorded in duplicate. Consensus meetings between investigators were held to resolve disagreements. Results In the 85 included systematic reviews, at least one form of spin was present in 44.7% (38/85) of abstracts. Journals with higher impact factors were less likely to contain spin in the abstracts of systematic reviews (point biserial correlation coefficient of −0.30). No statistically significant associations were found between the presence of spin and intervention type (P = .56) or adherence to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (P = .08); however, there was a significant association between spin and funding source (P = .03). Conclusions Spin was common in the abstracts of our sample of tonsillectomy systematic reviews. Researchers, clinicians, and peer reviewers could benefit from learning to recognize spin in medical literature. Further research is needed into the effects of spin on clinical decision making. Level of Evidence NA Laryngoscope, 131:E727–E731, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Management in Tracheobronchopathia Osteochondroplastica: A Case Study

xlomafota13 shared this article with you from Inoreader Surgical Management in Tracheobronchopathia Osteochondroplastica: A Case Study Via The Laryngoscope Tracheobronchopathia Osteochondroplastica is a benign condition characterized by osseous and cartilaginous submucosal growths of the tracheobronchial tree. This is a case report of an individual that was to undergo elective surgery using general anesthesia with endotracheal tube intubation. However, the anesthesiologist encountered a large osseous mass of the precricoid region and could not be intubated. This case report describes the technique for removal of the obstructing lesion using a Sonopet ultrasonic aspirator. Laryngoscope, 131:E911–E913, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes

xlomafota13 shared this article with you from Inoreader Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes Via The Laryngoscope Objectives/Hypothesis Evaluate the impact and accuracy of clinical laryngeal cancer staging. Study Design Retrospective cohort study. Methods Two hundred sixty‐five consecutive patients with laryngeal squamous cell carcinoma who underwent total laryngectomy from 2001 to 2017 were studied. Clinical versus pathologic tumor (T) and nodal (N) categories were compared. Logistic regression and Cox proportional hazards analyzed the association of stage change with perioperative factors and outcomes. Results Forty‐seven patients (17.7%, accuracy = 0.969 ± 0.010 [standard error]) changed between T1‐2 and T3‐4. Sixty‐four patients (24.1%, accuracy = 0.866 ± 0.020) had inaccurate N category. Salvage patients were less likely to have stage change (downstage: odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.08‐0.50, P < .001; upstage: OR = 0.41, 95% CI: 0.23‐0.74, P = .003), but more likely to have inaccurate nodal category (39.8% vs. 11.7%, P < .001). Patients with stage change tended to have greater odds of positive/close margins (upstage: OR = 1.78, 95% CI: 0.91‐3.5, P = .092) and chemotherapy (downstage: OR = 2.21, 95% CI: 0.80‐6.14, P = .128; upstage: OR = 1.87, 95% CI: 0.85‐4.11, P = .119). Stage change was associated with recurrence (P = .047) with downstaged patients less likely to recur (hazard ratio = 0.26, 95% CI: 0.08‐0.82, P = .021). Stage change was not associated with positron emission tomography scan, subsite, time to surgery, or mortality. Conclusions A third of laryngeal cancer patients were downstaged or upstaged after laryngectomy with 18% and 24% of clinical T and N categories inaccurate, respectively. Stage change was less common for salvage patients and associated with risk of recurrence. Level of Evidence 3 Laryngoscope, 131:559–565, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

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.