Extracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome

xlomafota13 shared this article with you from Inoreader Extracranial/Intracranial Vascular Bypass in the Treatment of Head and Neck Cancer ‐ Related Carotid Blowout Syndrome Via The Laryngoscope Objective/Hypothesis To investigate the endovascular intervention or extracranial/intracranial (EC/IC) vascular bypass in the management of patients with head and neck cancer‐related carotid blowout syndrome (CBS). Study Design Retrospective case series. Methods Retrospective analysis of clinical data of patients with head and neck cancer‐related CBS treated by endovascular intervention and/or EC/IC vascular bypass, analysis of its bleeding control, neurological complications, and survival results. Results Thrity‐seven patients were included. Twenty‐five were associated with external carotid artery (ECA); twelve were associated with internal or common carotid artery (ICA/CCA). All patients with ECA hemorrhage were treated with endovascular embolization. Of the 12 patients with ICA/CCA hemorrhage, 9 underwent EC/IC bypass, 1 underwent endovascular embolization, and 3 underwent endovascular stenting. For patients with ECA‐related CBS, the median survival was 6 months, and the 90‐day, 1‐year, and 2‐year survival rates were 67.1%, 44.7%, and 33.6%, respectively; the estimated rebleeding risk at 1‐month, 6‐month, and 2‐year was 7.1%, 20.0%, and 31.6%, respectively. For patients with ICA/CCA‐related CBS, the median survival was 22.5 months, and the 90‐day, 1‐year, and 2‐year survival rates were 92.3%, 71.8%, and 41.0%, respectively; the estimated rebleeding risk at 1 month, 6 months, and 2 years is 7.7%,15.4%, and 15.4%, respectively. ICA/CCA‐related CBS patients have significantly longer survival time and lower risk of rebleeding, which may be related to the more use of EC/IC vascular bypass as a definite treatment. Conclusions For patients with ICA/CCA‐related CBS, if there is more stable hemodynamics, longer expected survival, EC/IC vascular bypass is preferred. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sirolimus Therapy for Intractable Lymphatic Malformations

xlomafota13 shared this article with you from Inoreader Efficacy of Initial Sirolimus Therapy for 27 Patients with Intractable Lymphatic Malformations Via The Laryngoscope Objective/Hypothesis To evaluate the efficacy of initial sirolimus therapy in the treatment of intractable head and neck lymphatic malformations (LMs) in children. Study Design Prospective open‐label study. Methods In this study, Twenty‐seven children diagnosed with LMs were given oral sirolimus as primary treatment over a minimum 6‐month trial. The major parameter to evaluate therapeutic outcome was percentage of lesion volume change compared with baseline. Average serum sirolimus concentrations, and adverse side effects, were monitored throughout the study period. Results Fifteen girls and twelve boys, average age 27 months (16 days–171 months), constitute the study group. Treatment was deemed effective for twenty‐three participants, judged as fair in seven, good in nine, and excellent in seven. Two patients had minimal improvement, and two had increased volume to some degree. Effectiveness differed among LMs subtypes with responsiveness of macrocystic LMs exceeding that of microcystic LMs (P < .05). Adverse drug reactions totaled 27 events in ten patients, the majority being mild with upper respiratory infections being most common. Conclusions Sirolimus as initial therapy is effective in decreasing lesion volume in intractable LMs in head and neck region, especially in macrocystic subtypes. Although most cases cannot be completely cured, side effects are few and tolerable. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Simultane Implantation von Epithesenankern und Bonebridge zur Versorgung großer Ohrmissbildungen

xlomafota13 shared this article with you from Inoreader Simultane Implantation von Epithesenankern und Bonebridge zur Versorgung großer Ohrmissbildungen Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1369-9530 Hintergrund Die chirurgische Versorgung mit einem Hörimplantat und Epithesen bei Ohrmissbildungen bietet eine gute Kombination aus Hörrehabilitation und kosmetischer Rekonstruktion. Oft wird die Versorgung in 2-zeitigen Operationsschritten durchgeführt. Ziel der Arbeit war es, Erfahrungswerte mit einem Vorgehen zu gewinnen, bei dem das Hörimplantat und die Epithesenanker simultan eingesetzt werden. Material und Methoden Vier Ohren von 3 Patienten (nw = 1, nm = 2) mit großen Ohrmissbildungen (Typ III nach Weerda) erhielten jeweils in einer Operation eine MedEL Bonebridge und einen Epithesenanker mit 3 Basispfosten. Zuvor war die Indikation mithilfe des Active Middle Ear Implant (aMEI) -Scores nach Frenzel (2013) gestellt worden. Ergebnisse Alle Patienten erzielten jeweils 4 Punkte im aMEI-Score, was auf eine ungünstige Prognose für eine erfolgreiche Implantation eines aktiven Mittelohrimplantats hinwies. Die Versorgung mit der Bonebridge und einem Epithesenanker konnte daraufhin komplikationslos durchgeführt werden. Postoperativ erfolgten nach 4 Wochen die audiologische Erstanpassung und die Bestückung mit Magneten. In der Audiometrie bestand ein funktioneller Gewinn von bis zu 30 dB sowie ein verbessertes Sprachverständnis. Die Epithese wurde dem gesunden Ohr nachgebildet. Nach der Versorgung waren die Patienten mit dem audiologischen und kosmetischen Ergebnis zufrieden. Schlussfolgerungen Das simultane chirurgische Vorgehen mit einem Hörimplantat und Epithesenankern stellt eine gute Option in der Versorgung von Ohrmissbildungen dar. Der aMEI-Score war ein hilfreiches Instrument zur Indikationsstellung. Durch das Vorgehen konnten das Operationsrisiko und der Aufwand der Versorgung reduziert werden. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract & nbsp;|  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extracranial & Intracranial Complications in Chronic Suppurative Otitis Media

xlomafota13 shared this article with you from Inoreader To Study the Prevelance of Extracranial & Intracranial Complications in Chronic Suppurative Otitis Media Via Otolaryngology Indian Abstract Prior to antibiotic era, complications rate of CSOM was 2.3 to 4% cases. With advent of newer antibiotics, radiological surgical techniques the complication greatly reduced to 0.15–0.04% and mortality decreases from 25 to 8% 5, still early diagnoses and management is still the cornerstone of prevention of CSOM complications. To study the prevalence of extracranial and intracranial complications in CSOM. It is a prospective cross sectional study done in one year from January 2018 to January 2019, at Department of ENT, G R Medical College, Gwalior, M P, India. In our study 50 patients presented with complications of CSOM during January 2018 to January 2019, ECC was found more common than ICC ECC—52%, ICC—46%, mastoid abscess was found most commonly in ECC 50%, brain abscess was the most common found intracranial complication of CSOM. Continuous negligence of CSOM leads to various extracranial complications lethal intracranial complications like brain abscess, meningitis, etc. hence it is recommended that health education program should be provided as prevalence is still higher in younger age group and low socioeconomic class especially in rural and tribal regions. In spite of newer antibiotics, radiological modalities and surgical advancement. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy.

xlomafota13 shared this article with you from Inoreader Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy. Via ear nose throat Related Articles Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy. Ear Nose Throat J. 2021 Feb 09;:145561321993597 Authors: Vukadinović T, Labus M, Spasić S, Đurđević BV, Perić A Abstract Lobular capillary hemangioma (LCH) is a benign capillary proliferation with a microscopically distinctive lobular architecture, composed of small to medium-sized vessels of capillary type. Rarely, it originates from the mucosa of the nasal cavity, most frequently from the anterior nasal septum, turbinates, and nasal vestibule. Etiology is unclear, but previous investigations suggest that this lesion is associated with injury, hormonal factors, some viral infections, and therapy with some drugs. We present a case of LCH arising from the medial wall of the maxillary sinus in a 15-year-old boy, which was completely excised by preoperative embolization and endoscopic sinus surgery. To our knowledge, this is the second reported case of an LCH originating from the maxillary antrum. Etiology, pathogenesis, diagnosis, and treatment modalities of LCH were also discussed. PMID: 33559499 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot.

xlomafota13 shared this article with you from Inoreader Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot. J Plast Reconstr Aesthet Surg. 2021 Jan 09;: Authors: Oshima J, Sasaki K, Sasaki M, Aihara Y, Nishijima A, Sekido M Abstract PURPOSE: Central polydactyly of the foot is rare, with few reports on surgical methods and treatment indications. In this study, based on the experience of central polydactyly in our department, we will consider morphological classification and describe our treatment plan. METHOD: In this retrospective study, 11 patients (11 digits) with central polydactyly were identified among 136 patients of polydactyly of the foot (2009-2018). They were classified according to morphologic characteristics: type I, the duplicated digits are independent of each other; type II, digits of the same size are duplicated; and type III, digits of different sizes are duplicated. RESULTS: In morphologic classification, there were 4 cases of type II and 7 cases of type III, but there was no case of type I. For type II, surgery was performed using the Bilhaut-Cloquet (BC) procedure in 2 patients, bone-removing flap (flap) method in 1 patient, and simple ablation in 1 patient. For type III, surgery was performed using the BC procedure in 1 patient, flap method in 3 patients, simple ablation in 2 patients, and ligation in 1 patient with floating type. CONCLUSION: In order to obtain good cosmetic results in digits of morphologic classifications type II and III, it is necessary to select the surgical approach with careful consideration of every feature. PMID: 33558104 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation and comparison of the efficacy of long-acting betamethasone and dexamethasone as injections in the treatment of idiopathic sudden hearing loss

xlomafota13 shared this article with you from Inoreader Evaluation and comparison of the efficacy of long-acting betamethasone and dexamethasone as injections in the treatment of idiopathic sudden hearing loss Via American Journal of Otolaryngology Publication date: Available online 10 February 2021 Source: American Journal of Otolaryngology Author(s): Hakima Abdullah, Reza Erfanian, Nasrin Yazdani, Shima Hajibeiglu, Ardavan Tajdini View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases.

xlomafota13 shared this article with you from Inoreader Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases. Via Sociedad Luso-Española de Neurocirugía Related Articles Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases. Neurocirugia (Astur). 2021 Feb 05;: Authors: Rascón-Ramírez FJ Abstract Spinal cord stimulation (SCS) consists of the application of electrical stimuli to the dorsal columns of the spinal cord or to the posterior nerve roots in order to modulate the pain signals carried by the ascending pain pathways to the brain. Two cases of SCS in patients with cauda equina syndrome after lumbar surgery are presented. They were treated for persistent neuropathic pain but also experienced improvement in their motor and urinary symptoms after this treatment. Although the primary indication for SCS is neuropathic pain control, its application can also lead to improvement of motor deficits, sensory disorders, and urinary incontinence, as shown in these two cases. SCS will likely play a fundamental role in rehabilitative therapies in different neurological diseases. Further investigation in the field is needed. PMID: 33558146 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

In vivo diagnosis of skin cancer with a portable Raman spectroscopic device

xlomafota13 shared this article with you from Inoreader In vivo diagnosis of skin cancer with a portable Raman spectroscopic device Via Experimental Dermatology Abstract In this study we performed in vivo diagnosis of skin cancer based on implementation of a portable low‐cost spectroscopy setup combining analysis of Raman and autofluorescence spectra in the near infrared region (800 – 915 nm). We studied 617 cases of skin neoplasms (615 patients, 70 melanomas, 122 basal cell carcinomas, 12 squamous cell carcinomas and 413 benign tumors) in vivo with a portable setup. The studies considered the patients examined by GPs in local clinics and directed to a specialized Oncology Dispensary with suspected skin cancer. Each sample was histologically examined after excisional biopsy. The spectra were classified with a projection on latent structures and discriminant analysis. To check the classification models stability, a 10‐fold cross‐validation was performed. We obtained ROC AUCs of 0.75 (0.71 – 0.79; 95% CI), 0.69 (0.63‐0.76; 95% CI), and 0.81 (0.74 – 0.87; 95% CI) for classification of a) malignant and benign tumors, b) mel anomas and pigmented tumors and c) melanomas and seborrheic keratosis respectively. The positive and negative predictive values ranged from 20% to 52% and from 73% to 99% respectively. The biopsy ratio varied from 0.92:1 to 4.08:1 (at sensitivity levels from 90% to 99%). The accuracy of automatic analysis with the proposed system is higher than the accuracy of GPs and trainees, and is comparable or less to the accuracy of trained dermatologists. The proposed approach may be combined with other optical techniques of skin lesion analysis, such as dermoscopy‐ and spectroscopy‐based computer‐assisted diagnosis systems to increase accuracy of neoplasms classification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status.

xlomafota13 shared this article with you from Inoreader Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status. Via Laryngologie Related Articles Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status. Histopathology. 2021 Feb 09;: Authors: Benzerdjeb N, Tantot J, Blanchet C, Philouze P, Mekki Y, Lopez J, Devouassoux-Shisheboran M Abstract AIMS: Oropharyngeal squamous cell carcinomas (OPSCC) related to human papillomavirus (HPV) infection have a better prognosis than those without HPV infection. Although p16INK4a overexpression is used as a surrogate marker for HPV infection, 5%-20% of p16-positive OPSCC are described as being unrelated to HPV infection, with worse overall survival compared to OPSCC-related HPV. There is, therefore, a risk of undertreating a proportion of OPSCC patients falsely considered as HPV-driven because of p16 positivity. TP53 mutations are highly prevalent in OPSCC driven by mutagens in tobacco and alcohol. We describe herein a combined p16/p53 algorithm to predict HPV tumor status in OPSCC. METHODS AND RESULTS: 110 OPSCC were identified in the database of the pathology department and were studied using p16 and p53 immunohistochemistry. For p16-positive or p16-negative/wild-type patterns-p53 (WT-p53) cases (n = 63), DNA in-situ hybridization for high-risk HPV was performed and if negative, the HPV status was controlled by HPV DNA PCR (n=19). A significant association between TP53 mutation and pattern of p53 expression was found (WT-p53, 7/16, P<0.001). The p16-positive/WT-p53 was significantly associated with HPV+ tumor status (p16-positive/WT-p53, 50/110, P<0.001). Interestingly, a subset of p16-positive OPSCC was unrelated to HPV (13.5%, 8/59) and showed mutant-type staining of p53 expression. CONCLUSIONS: The p16 protein immunopositivity in conjunction with the mutant-type pattern of p53 staining helped to reclassify a subset of p16-positive OPSCC as OPSCC-unrelated HPV. This approach could be routinely applied by pathologists involved in the management of OPSCC, because of their potential therapeutic implications. PMID: 33560536 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory and Gustatory Dysfunction in COVID-19 Patients

xlomafota13 shared this article with you from Inoreader Olfactory and Gustatory Dysfunction in COVID-19 Patients from Northern India: A Cross-Sectional Observational Study Via Otolaryngology Indian Abstract Olfactory dysfunction (OD) and gustatory dysfunction (GD) has been reported as one of the presenting symptoms amongst COVID-19 patients. However the literature available is disjunct on this aspect. This study is conducted to identify the prevalence of olfactory and/or gustatory dysfunction in patients with coronavirus disease in Northern part of India. It's a cross-sectional observation study, conducted over 387 COVID-19 positive patients, at ENT dept of tertiary care hospital. A retrospective survey was conducted using a pre designed questionnaire and details of Olfactory and Gustatory dysfunction was collected. The patient's demographic details, disease course and recovery time for olfactory (OD) and/or gustatory dysfunctions (GD) were collected. A total of 387 patients with COVID-19 completed the study. 228 (58.9%) patients suffered from influenza like illness (ILI) (fever, sore throat, dry cough, malaise, and myalgia). There was significant positive assoc iation seen between with ILI and OD and / or GD. 167/387 (43.15%) patients reported OD, and 153/387 (39.53%) reported GD. 43.71% and 50.3% patients had mild OD & GD respectively. Recovery rates for both OD and GD are high and almost similar, with 161 (96.4%) and 148 (96.73%) patients had complete recovery of smell and taste. Maximum recovery was noticed between 4 and 6 weeks. COVID-19 patients with habits have significantly high probability of developing OD &/or GD. There is a significant correlation between OD and GD and there is high probability that patients who reported to have OD will also have GD or vice versa. Prevalence of OD and GD in Indian population may not be as high as mentioned in western literature, however, both are frequent and early symptoms of COVID-19. Recent onset of these should be considered as red flag symptoms for COVID-19. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.