FEES as a second‐stage diagnostic tool in 117 patients with dysphagia

xlomafota13 shared this article with you from Inoreader FEES as a second‐stage diagnostic tool in 117 patients with dysphagia Via Clinical Otolaryngology Abstract In 1988, Langmore et al. developed fiberoptic endoscopic evaluation of swallowing (FEES) as a safe and reliable tool for the diagnosis and monitoring of dysphagia.1 Currently, FEES represents the gold standard in oropharyngeal dysphagia, although videofluoroscopy may supplement clinical assessment in select cases.2 One or a work pair speech–language therapists (SLTs) most often serve as endoscopists during FEES. In Finland, an ear, nose and throat (ENT) specialist or a phoniatrics specialist as well as an SLT perform FEES either together or alone. Although this work‐pair setting is considered superior vis‐à‐vis safety and precision, a limited amount of research exists on various aspects of the care pathway for patients with dysphagia at a tertiary health care centre. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Objective Evaluation of Biomaterial Effects after Injection Laryngoplasty‐ Introduction of Artificial Intelligence‐Based Ultrasonic Image Analysis

xlomafota13 shared this article with you from Inoreader Objective Evaluation of Biomaterial Effects after Injection Laryngoplasty‐ Introduction of Artificial Intelligence‐Based Ultrasonic Image Analysis Via Clinical Otolaryngology Abstract Objective Hyaluronic acid (HA) can be degraded over time. However, persistence of the effects after injection laryngoplasty (IL) for unilateral vocal fold paralysis (UVFP), longer than expected from HA longevity, has been observed. The purpose of the study was to develop an methodology with clinical utility for objective evaluation of the temporal change in HA volume after IL using artificial intelligence (AI)‐based ultrasonic assessment. Design, setting and participants Imaging phantoms simulating injected HA were built in different volumes for designing the algorithm for machine learning. Subsequently, five adult patients who had undergone IL with HA for UVFP were recruited for clinical evaluation. Main outcome measures Estimated volumes were evaluated for injected HA by the automatic algorithm as well as voice outcomes at 2 weeks, and 2 and 6 months after IL. Results On imaging phantoms, contours on each frame were described well by the algorithm and the volume could be estimated accordingly. The error rates were 0 – 9.2%. Moreover, the resultant contours of the HA area were captured in detail for all participants. The estimated volume decreased to an average of 65.76% remaining at 2 months and to a minimal amount at 6 months while glottal closure remained improved. Conclusion The volume change of the injected HA over time for an individual was estimated non‐invasively by AI‐based ultrasonic image analysis. The prolonged effect after treatment, longer than HA longevity, was demonstrated objectively for the first time. The information is beneficial to achieve optimal cost‐effectiveness of IL and improve the life quality of the patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles

xlomafota13 shared this article with you from Inoreader Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles Via swallowing exercises Sci Rep. 2021 Mar 30;11(1):7131. doi: 10.1038/s41598-021-86502-w. ABSTRACT Several exercise methods, such as the Shaker exercise, tongue press exercise, chin tuck against resistance (CTAR) exercise, and submandibular push exercise, have been introduced to strengthen the muscles involved in swallowing. In this study, we compared the effectiveness of the CTAR, submandibular push, and Shaker exercises for the induction of selective supra- and infrahyoid muscle contractions using surfa ce electromyography (EMG). This study is a prospective non-randomized controlled study. Twenty-five healthy subjects and 20 patients experiencing swallowing difficulty were enrolled. During the three different types of exercises, the root mean square (RMS) values of the sternocleidomastoid (SCM), suprahyoid (anterior belly of the digastric and mylohyoid muscles), and infrahyoid (sternothyroid and thyrohyoid muscles) muscles were analyzed using surface EMG. Differences in the activity of swallowing muscles among the three different exercises were analyzed using one-way repeated measured analysis of variance. In terms of both the maximum and mean RMS values of the suprahyoid muscle, the submandibular push exercise showed a larger RMS value than the CTAR and Shaker exercises in healthy subjects (p < 0.05). In terms of both the maximum and mean RMS values of the suprahyoid muscle, the Shaker exercise and submandibular push exercise showed a larger RMS value than the CTAR exercise in patients with swallowing difficulty (p < 0.05). The submandibular push exercise may be effective as a swallowing muscle exercise owing to its superiority in inducing selective contractions of the supra- and infrahyoid muscles. The CTAR and Shaker exercises are also effective in this regard. PMID:33785793 | DOI:10.1038/s41598-021-86502-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Contemporary management of the neck in nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader Contemporary management of the neck in nasopharyngeal carcinoma Via Head & Neck Abstract Up to 85% of the patients with nasopharyngeal carcinoma present with regional nodal metastasis. Although excellent nodal control is achieved with radiotherapy, a thorough understanding of the current TNM staging criteria and pattern of nodal spread is essential to optimize target delineation and minimize unnecessary irradiation to adjacent normal tissue. Selective nodal irradiation with sparing of the lower neck and submandibular region according to individual nodal risk is now emerging as the preferred treatment option. There has also been continual refinement in staging classification by incorporating relevant adverse nodal features. As for the uncommon occurrence of recurrent nodal metastasis after radiotherapy, surgery remains the standard of care. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Establishment and validation of a novel nomogram to predict overall survival in nasopharyngeal carcinoma with lymph node metastasis

xlomafota13 shared this article with you from Inoreader Establishment and validation of a novel nomogram to predict overall survival in nasopharyngeal carcinoma with lymph node metastasis Via Head & Neck Abstract Background The aim of the present study was to establish and validate a nomogram to predict the overall survival (OS) in nasopharyngeal carcinoma (NPC) patients with lymph node metastasis (LNM). Methods A novel nomogram was constructed using 863 patients with LNM‐positive NPC from the Surveillance, Epidemiology, and End Results (SEER) database. Significant prognostic factors in the nomograms were determined using multivariate Cox risk analysis. The predictive capability was evaluated using calibration curves and decision curve analysis (DCA). Results Multivariate analysis identified seven factors that could be used to construct the nomogram: age, pathological type, T stage, M stage, surgery of primary site, radiotherapy, and chemotherapy. The calibration curves and DCA demonstrated optimal agreement. Based on the nomogram, all patients could be stratified into three risk groups: low, middle, and high. Conclusions The novel nomogram demonstrated its potential as an individualized tool to predict OS. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival outcomes for head and neck patients with Medicaid: A health insurance paradox

xlomafota13 shared this article with you from Inoreader Survival outcomes for head and neck patients with Medicaid: A health insurance paradox Via Head & Neck Abstract Purpose Privately insured patients with head and neck cancer (HNC) typically have better outcomes; however, differential outcome among Medicaid versus the uninsured is unclear. We aimed to describe outcome disparities among HNC patients uninsured versus on Medicaid. Methods A cohort of 18–64‐year‐old adults (n = 57 920) with index HNC from the Surveillance, Epidemiology, and End Results 18 database (2007–2015) was analyzed using Fine and Gray multivariable competing risks proportional hazards models for HNC‐specific mortality. Results Medicaid (sdHR = 1.65, 95% CI 1.58, 1.72) and uninsured patients (sdHR = 1.55, 95% CI 1.46, 1.65) had significantly greater mortality hazard than non‐Medicaid patients. Medicaid patients had increased HNC mortality hazard than those uninsured. Conclusion Compared with those uninsured, HNC patients on Medicaid did not have superior survival, suggesting that there may be underlying mechanisms/factors inherent in this patient population that could undermine access to care benefits from being on Medicaid. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Determination of posterolateral oropharyngeal wall thickness and the potential implications for transoral surgical margins in tonsil cancer

xlomafota13 shared this article with you from Inoreader Determination of posterolateral oropharyngeal wall thickness and the potential implications for transoral surgical margins in tonsil cancer Via Head & Neck Abstract Background Margins in transoral surgery for tonsil cancer can be limited by oropharyngeal wall thickness (OWT), but the normal range is not well established. Methods In 240 noncancer subjects, OWT was measured bilaterally in the vicinity of the tonsils with MRI. Statistical analysis was performed to assess for interaction of age, sex, location, and obesity. Results Mean(SD) OWT measured 3.4(0.6) mm posteriorly, 3.7(2.0) mm between the styloglossus and stylopharyngeus, and 5.3(0.8) mm laterally. OWT was greater in men, correlated with obesity, decreased posteriorly and laterally in the 60–80 versus 40–59 year age groups, and increased when styloglossus/stylopharyngeus were closer. OWT was <5 mm in 36.7%–97.9% of locations, with the largest percentage below this threshold located posteriorly. Conclusions OWT is frequently <5 mm, particularly in the posterior and intermuscular areas, suggesting that a smaller surgical margin may need to be accepted in transoral tonsil cancer surgery for anatomic reasons. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the Acoustic Voice Quality Index (AVQI) Correlate with Perceived Creak and Strain in Normophonic Young Adult Finnish Females?

xlomafota13 shared this article with you from Inoreader Does the Acoustic Voice Quality Index (AVQI) Correlate with Perceived Creak and Strain in Normophonic Young Adult Finnish Females? Via Folia Phoniatrica et Logopaedica Background: The Acoustic Voice Quality Index (AVQI) is a correlate of dysphonia. It has been found to differentiate between dysphonic and normophonic speakers and to indicate the effects of voice therapy. This study investigates how the AVQI reacts towards creak and strain, which are common in normophonic speakers. Methods: The material was obtained from an earlier study on 104 Finnish female university students (mean age 24.3 years, SD 6.3 years) with no known pat hology of voice or hearing and a perceptually normal voice (G = 0 in GRBAS), who were recorded while reading aloud a standard text and sustaining the vowel [a:]. Perceptual analysis for the amount of creak and strain was carried out by 2 expert listeners. In this study, the AVQI v03.01 was analyzed and correlated with perceptual evaluations. Samples with low and high amounts of creak and strain were compared with t tests. Results: On average, the AVQI was below the threshold value of dysphonia in the Finnish population. The AVQI (ρ = 0.35, p = 0.000) and its subparameters, smoothed cepstral peak prominence (CPPS; ρ = –0.35, p = 0.000) and harmonics-to-noise ratio (HNR; ρ = –0.30, p = 0.002) showed low but significant correlations with creak. Strain had low but significant correlations with spectral Slope (ρ = 0.38, p = 0.000) and Tilt (ρ = –0.40, p = 0.009). The AVQI was lower (better) in samples that were evaluated as having a high amount of strain, but the difference was not significant. Only CPPS differentiated significantly between low and high amounts of creak. Conclusion: The AVQI does not seem to differentiate between high and low amounts of creak and strain in normophonic speakers. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New Visionary in Upper Airway Surgeries–THRIVE, a Tubeless Ventilation

xlomafota13 shared this article with you from Inoreader New Visionary in Upper Airway Surgeries–THRIVE, a Tubeless Ventilation Via Otolaryngology Indian Abstract THRIVE stands for Transnasal Humidified Rapid Insufflation Ventilatory Exchange. Usage of THRIVE technique is common in emergency settings and of late its usage in upper airway surgeries is gaining popularity. (1) To determine the operative time, total anaesthesia time, safety and efficacy of THRIVE in patients undergoing upper airway surgeries for varied pathologies. (2) To assess the surgeon's satisfaction and patients post-operative comfort. An observational study was from May 2019 to Oct 2020. Study was conducted through a detailed proforma which consists of patient demographic details, physical status, co-morbidities and various domains to assess the safety and efficacy of THRIVE. A total of 32 patients were divided into four groups depending on the type of surgery. We had 18 patients in microlaryngeal excision, six in direct laryngoscopy and biopsy, four in tracheostomy and four in balloon dilatation for subglottic stenosis groups. The mean operation time was 16 ± 2 min in the first three groups and 29 ± 0.8 in the fourth group. All the patients underwent successful surgeries without any episodes of desaturation, without complications and with good surgical satisfaction. THRIVE with appropriate safety precautions can be tried in patients undergoing various upper airway surgeries of short duration. All the patients in our study maintained stable vital parameters throughout the surgery. Initial results with the use of THRIVE as per our study and other studies are definitely encouraging to use THRIVE in upper airway surgeries with varied pathologies. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin?

xlomafota13 shared this article with you from Inoreader Is Working Memory Compromised in Individuals with Sensorineural Hearing Loss with Auditory Neural Origin? Via Otolaryngology Indian Abstract The study aimed to investigate the working memory and speech recognition in noise from individuals with Sensori Neural Hearing Loss (SNHL) with and without auditory neuropathy spectrum disorder (ANSD). The purpose of assessing working memory recommends for a potential intervention program to perceive speech. Twenty participants in the age range of 16–44 years, diagnosed as having mild to moderate SNHL were recruited for the study. The participants were divided into two groups based on the presence and absence of ANSD (10 in each group). The visual working memory was assessed in all the participants using the Operation Span Test, Reading Span Test and Visual Backward Test. Speech perception ability was assessed using the SNR 50 test. There was no significant difference between the scores of Operation Span, Reading Span, and Visual Backward Span for individuals with SNHL with and without ANSD. There was a significant difference between the scores of SNR 50 f or individuals with SNHL with and without ANSD. The visual working memory in individuals with and without ANSD is similar. Speech perception in noise is significantly affected in ANSD than SNHL without ANSD. Thus, it is recommended to use speech reading, which utilizes visual working memory to interpret the message, as previous studies have reported that individuals with ANSD show limited benefit in auditory mode of rehabilitation alone. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear Implantation in Chronic Otitis Media with and without Cholesteatoma: Surgical Considerations and Auditory Outcomes

xlomafota13 shared this article with you from Inoreader Cochlear Implantation in Chronic Otitis Media with and without Cholesteatoma: Surgical Considerations and Auditory Outcomes Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Cochlear implant (CI) surgery is a safe and standardized procedure in the presence of normal temporal bone anatomy. However, in the surgery of patients with chronic otitis media (COM), the surgeon may encounter several problems. The aim of this study was to evaluate the impact of COM with and without cholesteatoma on surgical and auditory outcomes of CIs. Methods: The study group consisted of 39 patients with COM who received CIs. Age- and gender-matc hed 38 standard CI patients served as controls. The surgical techniques and complications, pure tone audiometry (PTA) scores, speech discrimination scores (SDS), and the International Outcome Inventory for Hearing Aids (IOI-HA) questionnaire results of the groups were compared. Results: The presence of COM was associated with a higher rate of complication than controls. Staging the surgeries, presence or absence of cholesteatoma, and type of surgical technique were not associated with surgical outcomes and complications (p #x3e; 0.05). There was no significant difference between the groups in terms of postoperative PTA scores, SDS, and IOI-HA scores (p #x3e; 0.05). Conclusion: Postoperative complications like device failure and skin breakdown are increased in cases of COM compared to standard CI surgeries. However, that increase is not associated with staging the surgeries, presence or absence of cholesteatoma, and type of ear surgery perfor med. It is advocated to close the external ear canal and eustachian tube without mastoid obliteration in the presence of a radical mastoidectomy cavity, which will decrease the postoperative complication rates and allow for radiological follow-up with computed tomography for the possibility of cholesteatoma recurrence. The auditory benefits of CI in patients with and without COM are comparable. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sentinel lymph node biopsy versus elective neck dissection: long-term oncologic outcomes in clinically node-negative tongue cancer

xlomafota13 shared this article with you from Inoreader Sentinel lymph node biopsy versus elective neck dissection: long-term oncologic outcomes in clinically node-negative tongue cancer Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2021 Mar 30. doi: 10.21053/ceo.2020.02411. Online ahead of print. ABSTRACT OBJECTIVES.: To compare the long-term oncologic outcomes of sentinel lymph node biopsy (SLNB) versus elective neck dissection (END) in clinically node-negative (cN0) tongue cancer. METHODS.: This is a retrospective cohort study of patients with cN0 tongue cancer from a single institution, including 91 patients in the SLNB group and 120 patients in the END group. RESULTS.: Overall recurrence rate was no significant difference in the recurrence rate between the two groups. The regional control rate was also comparable between the two groups (p = 0.49). The 5-year RFS was slightly better in the SLNB group (p = 0.427). The 5-year OS was 89.9% in the SLNB group vs. 91.9% in the END group (p = 0.737). In propensity-matched subgroup analysis, the type of neck management did not affect RFS nor OS. CONCLUSION.: . SLNB showed n on-inferior oncologic outcomes compared to END in patients with cN0 tongue squamous cell carcinoma. PMID:33781056 | DOI:10.21053/ceo.2020.02411 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.