Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique

xlomafota13 shared this article with you from Inoreader Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort. Several protocols recommend blocking the path to the oropharynx via gauze or leaving a tracheotomy in place to protect the airway. This report pre­sents a novel technique f or intraoral hirudotherapy that is safe and simple for treatment of free flap venous congestion. The base of a clear cup or a plastic lid is utilized, and the leech is attached onto the inside of the lid with 2 sutures near each end. Several cups with leeches attached are made at a time to reduce delay and difficulty of application by less experienced clinical staff. The leech is then applied onto the compromised flap and then simply removed once it has unlatched from the flap. This method allows the leech to be applied with ease by multiple members of the healthcare team, decreases the need for intraoral manipulation, and reduces the risk of migration into the aerodigestive tract. Future prospective studies are warranted to assess the efficacy of this technique. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ninety‐day mortality after radiotherapy for head and neck cancer: A population‐based comparison between rural and urban patients

xlomafota13 shared this article with you from Inoreader Ninety‐day mortality after radiotherapy for head and neck cancer: A population‐based comparison between rural and urban patients Via Head & Neck Abstract Background This study assesses whether 90-day mortality differs between patients living in rural and urban areas, as lower access to supportive care services in rural areas could result in higher mortality. Methods All patients with head and neck cancer (HNC) treated between 1998 and 2014 with radiotherapy in British Columbia were included. Patients were divided into rurality areas according to the Modified Statistics Canada (mSC) definition, which classifies a population <30 000 as rural and ≥30 000 as urban. Results Five thousand five hundred and fifty-four patients were included in this study, of which 68% lived in urban centers. The 90-day mortality for rural versus urban patients were 3.0% and 3.9% (p = 0.09), respectively. Univariate and multivariate analyses showed no association with 90-day mortality and rurality. Conclusion After controlling for potentially confounding factors, we did not find a significant association between 90-day mortality and rurality in patients who were treated with radiotherapy for HNC in British Columbia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival impact of angiotensin‐converting enzyme inhibitors and angiotensin II receptor antagonists in head and neck cancer

xlomafota13 shared this article with you from Inoreader Survival impact of angiotensin‐converting enzyme inhibitors and angiotensin II receptor antagonists in head and neck cancer Via Head & Neck Abstract Background Preclinical evidence suggests a link between the renin-angiotensin system and oncogenesis. We aimed to explore the impact of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in head and neck cancer (HNC). Methods Over 5000 patients were identified from the Surveillance, Epidemiology, and End Results-Medicare linked dataset and categorized according to ACEi and ARB and diagnoses of chronic kidney disease (CKD) or hypertension (HTN). Overall survival (OS) and cancer-specific survival (CSS) were compared using Cox multivariable regression (MVA), expressed as hazard ratios (HR) with 95% confidence intervals (95%CI). Results No significant MVA associations for OS or CSS were found for ACEi. Compared to patients with CKD/HTN taking ARB, those with CKD/HTN not taking ARB experienced worse OS (HR 1.28, 95%CI 1.09–1.51, p = 0.003) and CSS (HR 1.23, 95%CI 1.00–1.50, p = 0.050). Conclusions ARB usage is associated with improved OS and CSS among HNC patients with CKD or HTN. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Face Masks on Speech Acoustics and Vocal Effort in Healthcare Professionals

xlomafota13 shared this article with you from Inoreader Impact of Face Masks on Speech Acoustics and Vocal Effort in Healthcare Professionals Via The Laryngoscope Objectives/Hypothesis We investigated speech acoustics and self-reported vocal symptoms in mask-wearing healthcare professionals. We hypothesized that there would be an attenuation of spectral energies and increase in vocal effort during masked speech compared to unmasked speech. Study Design Within and between subject quasi-experimental design. Methods We prospectively enrolled 21 healthcare providers (13 cisgender female, 8 cisgender male; M = 32.9 years; SD = 7.9 years) and assessed acoustics and perceptual measures with and without a face mask in place. Measurements included: 1) acoustic Vowel Articulation Index (VAI); 2) cepstral and spectral acoustic measures; 3) traditional vocal measures (e.g., fundamental frequency, intensity); 4) relative fundamental frequency (RFF); and 5) self-reported ratings of vocal effort and dyspnea. Results During masked speech, there was a significant reduction in VAI, high-frequency information (>4 kHz), and RFF offset 10, as well as a significant increase in cepstral peak prominence and perceived vocal effort. Further analysis showed that high-frequency attenuation was more pronounced when wearing an N95 mask compared to a simple mask. Conclusions Face masks pose an additional barrier to effective communication that primarily impacts spectral characteristics, vowel space measures, and vocal effort. Future work should evaluate how long-term mask use impacts vocal health and may contribute to vocal problems. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Presentation of dizziness in individuals with chronic otitis media: data from the multinational collaborative COMQ-12 study

xlomafota13 shared this article with you from Inoreader Presentation of dizziness in individuals with chronic otitis media: data from the multinational collaborative COMQ-12 study Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jul 21. doi: 10.1007/s00405-021-06993-1. Online ahead of print. ABSTRACT PURPOSE: In chronic otitis media (COM), disease chronicity and severity of middle ear inflammation may influence the development of inner ear deficits, increasing the risk of vestibular impairment. This secondary analysis of the multinational collaborative Chronic Otitis Media Questionnaire-12 (COMQ-12) dataset sought to determine the prevalence of vestibular symptoms in patients with COM and identify associated disease-related characteristics. METHODS: Adult patients with a diagnosis of COM in outpatient settings at nine otology referral centers across eight countries were included. We investigated the presence of vestibular symptoms (dizziness and/or disequilibrium) using participant responses to item 6 of a native version of the COMQ-12. Audiometric data and otoscopic assessment were also recorded. RESULTS: This analy sis included 477 participants suffering from COM, with 56.2% (n = 268) reporting at least mild inconvenience related to dizziness or disequilibrium. There was a significant association between air conduction thresholds in the worse hearing ear and presence of dizziness [adjusted odds ratio (AOR), 1.01; 95% CI 1.00-1.02; p = 0.0177]. Study participants in European countries (AOR 1.53; 95% CI 1.03-2.28; p = 0.0344) and Colombia (AOR 2.48; 95% CI 1.25-4.92; p = 0.0096) were more likely to report dizziness than participants in Asian countries. However, ear discharge and cholesteatoma showed no association with dizziness in the adjusted analyses. CONCLUSION: Vestibular symptoms contribute to burden of disease in patients with COM and associates with hearing disability in the worse hearing ear. Geographical variation in presentation of dizziness may reflect financial barriers to treatment or cultural differences in how patients reflect on their health state. PMID:34291348 | DOI:10.1007/s00405-021-06993-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Proposing a surgical algorithm for graduated orbital decompression in patients with Graves' orbitopathy

xlomafota13 shared this article with you from Inoreader Proposing a surgical algorithm for graduated orbital decompression in patients with Graves' orbitopathy Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jul 21. doi: 10.1007/s00405-021-07003-0. Online ahead of print. ABSTRACT PURPOSE: To determine the outcome after orbital decompression using a graduated technique, adapting the surgical technique according to individual patients' disease characteristics. METHODS: We retrospectively examined the postoperative outcome in patients treated with a graduated balanced orbital decompression regarding reduction of proptosis, new onset diplopia and improvement in visual function. 542 patients (1018 orbits) were treated between 2012 and 2020 and included in the study. Clinical examinations including visual acuity, exophthalmometry (Hertel) and orthoptic evaluation were performed preoperatively and at minimum 6 weeks postoperatively. Mean follow-up was 22.9 weeks. RESULTS: Mean proptosis values have significantly decreased after surgery (p < 0.01). In 83.3% of the patients Hertel measurement normalize d (≤ 18 mm) after surgery, New onset diplopia within 20° of primary position occurred in 33.0% of patients, of whom 16.0% had preoperative double vision in secondary gaze. Patients suffering from dysthyroid optic neuropathy (DON) had a significant increase in visual acuity (p < 0.01). CONCLUSION: We demonstrated that individually adapted graduated orbital decompression successfully improves key disease parameters of Graves' orbitopathy with low morbidity. PMID:34291345 | DOI:10.1007/s00405-021-07003-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term efficacy and safety of 3D printed implant in patients with nasal septal deformities

xlomafota13 shared this article with you from Inoreader Long-term efficacy and safety of 3D printed implant in patients with nasal septal deformities Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jul 21. doi: 10.1007/s00405-021-06996-y. Online ahead of print. ABSTRACT PURPOSE: To investigate the long-term safety and efficacy of a 3D-printed bioresorbable polycaprolactone (PCL) nasal implant for nasal septal deformity reconstruction. METHODS: Fourteen patients who had undergone nasal septum reconstruction surgery using 3D-printed PCL nasal septal implants were enrolled. The primary outcome was the change in total Nasal Obstruction Symptom Evaluation (NOSE) scale scores between postoperative 3 months and current status (3.59 ± 0.51 years). The secondary outcomes were changes in the minimum cross-sectional area (MCA) and volume of both nasal cavities based on acoustic rhinometry, the cross-sectional area of the ostiomeatal unit, and the nasal septum angle of the paranasal sinus (PNS) in computed tomography (CT) images, and a visual analog scale (VAS) of the patients' subjective satisfaction.< /p> RESULTS: The results showed no significant changes in the MCAs (Cohen's d:0.09; p = 0.711) or nasal volume (Cohen's d:0.26; p = 0.356), the area of the ostiomeatal unit (Cohen's d:0.49; p = 0.064), septum angles (Cohen's d:0.18; p = 0.831), the NOSE scale (Cohen's d:0.14; p = 0.621), or patients' subjective satisfaction (Cohen's d:0.52; p = 0.076) during the follow-up period. CONCLUSIONS: This homogeneous composite microporous PCL nasal septal implant demonstrated long-term clinical efficacy and safety in human tissues that required maintenance of mechanical strength. Therefore, the indications for this implant could extend to various other craniofacial reconstructions in the future. PMID:34291346 | DOI:10.1007/s00405-021-06996-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An epidemiological survey of gastroesophageal reflux disease at the digestive endoscopy center in Guangzhou

xlomafota13 shared this article with you from Inoreader An epidemiological survey of gastroesophageal reflux disease at the digestive endoscopy center in Guangzhou Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jul 21. doi: 10.1007/s00405-021-06999-9. Online ahead of print. ABSTRACT OBJECTIVE: This study aims to investigate the detection rates, common symptoms and risk factors of gastroesophageal reflux disease (GERD), and laryngopharyngeal reflux disease (LPRD) at the digestive endoscopy center. METHODS: A multicenter cross-sectional survey conducted at three hospitals and a total of 565 eligible participants were enrolled. All the patients completed routine ENT examination, gastroscopy, gastroesophageal reflux questionnaire (GerdQ), reflux symptom index (RSI) and a self-designed 25-item symptoms table survey. RESULTS: Among the 565 eligible participants, the detection rates of GERD and LPRD were 18.41% (104/565) and 9.91% (56/565), respectively. The detection rate of GERD combined with LPRD was 3.19% (18/565). Among GERD and LPRD patients, males (vs. females), middle-aged and elderly patients (vs. young people), BMI ≥ 24.0 kg/m2 (vs. BMI < 24.0 kg/m2), with current smoking history (vs. no smoking), and current drinking history (vs. no drinking), lying down immediately after meal (vs. no lying down immediately after meal) were significantly higher (all p < 0.05). The most common extraesophageal symptoms in patients with GERD were dry mouth (66.35%), globus sensation (56.73%), dry throat and pharyngeal itching (55.77%). The most common extraesophageal symptoms in patients with LPRD were globus sensation (91.07%), dry throat and pharyngeal itching (83.93%), and dry mouth (82.14%). CONCLUSION: GERD and LPRD had a high detection rate at the digestive endoscopy center in Guangzhou, China. Older age, BMI ≥ 24.0 kg/m2, smoking and drinking history were risk factors for both GERD and LPRD. Neither GerdQ nor RSI scores included common extraesophageal symptoms. PMID:34291347 | DOI:10.1007/s00405-021-06999-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic third ventriculostomy before surgery of third ventricle and posterior fossa tumours decreases the risk of secondary hydrocephalus and early postoperative complications

xlomafota13 shared this article with you from Inoreader Endoscopic third ventriculostomy before surgery of third ventricle and posterior fossa tumours decreases the risk of secondary hydrocephalus and early postoperative complications Via leak of cerebrospinal fluid Neurosurg Rev. 2021 Jul 22. doi: 10.1007/s10143-021-01570-w. Online ahead of print. ABSTRACT Endoscopic third ventriculostomy (ETV) is an effective treatment for obstructive hydrocephalus (HCP) at the level of third or fourth ventricle. To date, there is no consensus regarding its role as intervention preceding the operation of tumour removal. The aim of this prospective open-label controlled study is to assess if ETV prevents secondary HCP after tumour removal and if ETV influences the early results of tumour surgery. The study was performed on 68 patients operated for tumours of the third ventricle and posterior fossa. In 30 patients, ETV was performed several days before tumour removal, while in 38 patients, the tumour was removed during a one-stage procedure without ETV. Patients who did not receive ETV before the tumour removal procedure had a higher probability of developing postoperative HCP (n = 12, p = 0.03). They also demonstrated a substantially higher rate of early postoperative complications (n = 20, p = 0.002) and a lower Karnofsky score (p = 0.004) than patients in whom ETV was performed before tumour removal. The performance of external ventricular drainage in the non-ETV group did not prevent secondary HCP (p = 0.68). Postoperative cerebellar swelling (p = 0.01), haematoma (p = 0.04), cerebrospinal fluid leak (p = 0.04) and neuroinfection (p = 0.04) were the main risk factors of persistent HCP. Performance of ETV before tumour removal is not only beneficial for control of acute HCP but also prevents the occurrence of secondary postoperative HCP and may also minimize early postoperative complications. PMID:34291350 | DOI:10.1007/s10143-021-01570-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Physical Therapy and Fall Risk Assessment

xlomafota13 shared this article with you from Inoreader Vestibular Physical Therapy and Fall Risk Assessment Via Otolaryngologic Clinics of North America Vestibular physical therapy (VPT) is a specialized form of evidence-based therapy designed to alleviate primary (vertigo, dizziness, imbalance, gait instability, falls) and secondary (deconditioning, cervical muscle tension, anxiety, poor quality of life, fear of falling/fear avoidance behavior) symptoms related to vestibular disorders. This article provides an overview of VPT, highlighting various exercise modalities used to treat a variety of vestibular disorders. Patient safety and fall prevention are paramount; therefore, fall risk assessment and treatment are also addressed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Dizzy Child

xlomafota13 shared this article with you from Inoreader The Dizzy Child Via Otolaryngologic Clinics of North America Dizziness occurs in children with an estimated prevalence of 0.45% to 15.0%. Vestibular disorders in the pediatric population can impact gross motor function development, visual acuity, and contribute to psychological distress. Appropriate case history and focused direct examination can be helpful when determining the etiology of dizziness. Vestibular testing can be completed in children and guide management of suspected vestibular dysfunction. Vestibular dysfunction is commonly seen in patients with sensorineural hearing loss. Migraine disorders are the most common cause of dizziness in childhood. Etiologies of dizziness in children differ from those commonly seen in adults. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.