“Fact or fiction?”: Oral cavity cancer in nonsmoking, nonalcohol drinking patients as a distinct entity—Scoping review

xlomafota13 shared this article with you from Inoreader "Fact or fiction?": Oral cavity cancer in nonsmoking, nonalcohol drinking patients as a distinct entity—Scoping review Via Head & Neck Abstract Oral cavity cancer is often described as a lifestyle-related malignancy due to its strong associations with habitual factors, including tobacco use, heavy alcohol consumption, and betel nut chewing. However, patients with no genetically predisposing conditions who do not indulge in these risk habits are still being encountered, albeit less commonly. The aim of this review is to summarize contemporaneous reports on these nonsmoking, nonalcohol drinking (NSND) patients. We performed database searching to identify relevant studies from January 1, 2000 to March 31, 2021. Twenty-six articles from 20 studies were included in this study. We found that these individuals were mostly females in their eighth decade with tumors involving the tongue and gingivobuccal mucosa. This review also observed that these patients were likely diagnosed with early stage tumors with overexpression of programmed death-ligand 1 (PD-L1) and increased intensity of tumor infiltrating lymphocytes. Treatment resp onse and disease-specific prognosis were largely comparable between NSND and smoking/drinking patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Silver Nitrate Cauterisation of Nasal Mucosa on Quality-of-Life and Histology in Patients with Intractable Chronic Rhinitis

xlomafota13 shared this article with you from Inoreader Effect of Silver Nitrate Cauterisation of Nasal Mucosa on Quality-of-Life and Histology in Patients with Intractable Chronic Rhinitis Via Otolaryngology Indian Abstract Patients with chronic rhinitis causing intractable sneezing which is non-responsive to conventional medication require alternative therapies. The aim of the study was to ascertain the effect of topical 10% silver nitrate solution on the inferior turbinate mucosa as well as quality of life in such patients. Patients with severe chronic rhinitis who failed conventional therapy had application of 10% silver nitrate solution to inferior turbinate mucosa. The number of sneezes/day and mini Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score was noted before and 8 to 16 weeks after treatment. Pre- and post treatment turbinate biopsies were performed to assess histological changes. At baseline, 67 patients had a mean of 36.6 sneezes/day and mean mini RQLQ score of 4.0 ± 0.7. Pre-treatment biopsies showed epithelial denudation and hyalinization of basement membrane. Following 10% silver nitrate application, 64/67 (95.5%) patients showed signific ant reduction in number of sneezes both at 1 week (p < 0.001) and 8–16 weeks (mean = 5.5 ± 7.8; p < 0.001). Post- treatment mean global mini RQLQ score was also significantly reduced (mean = 1.3 ± 1.1; p < 0.001). A single application was sufficient in 70.1% patients. There were no complications. Squamous metaplasia (p = 0.005) and epithelial hyperplasia (p = 0.013) as well as epithelial and basement membrane restoration occurred following therapy. 10% silver nitrate solution application is an effective and safe office- based procedure which significantly reduces sneezing improves QoL with corresponding histological changes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Surgical Outcomes Between Staged and Simultaneous Decompression of Discontinuous Thoracic Ossification of the Ligamentum Flavum: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Comparison of Surgical Outcomes Between Staged and Simultaneous Decompression of Discontinuous Thoracic Ossification of the Ligamentum Flavum: A Retrospective Study Via leak of cerebrospinal fluid World Neurosurg. 2021 Jul 24:S1878-8750(21)01082-2. doi: 10.1016/j.wneu.2021.07.075. Online ahead of print. ABSTRACT BACKGROUND: Discontinuous thoracic ossification of the ligamentum flavum (TOLF) is diagnosed according to the number and distribution of involved segments seen on magnetic resonance images. When TOLF causes thoracic myelopathy, surgical intervention for these lesions becomes unavoidable. However, there are few reports on the outcomes of surgery for discontinuous TOLF. METHODS: The study included 26 patients of mean age 55.0 years who underwent simultaneous (n=16) or staged (n=10) decompression of discontinuous TOLF between July 2006 and June 2016. Final neurological status was evaluated using the modified Japanese Orthopaedic Association (JOA) score. The surgical data and incidence of complications were compared. The mean follow-up duration was 73.3 months. RESULTS: There was no between-group difference in number of levels decompressed or the amount of intraoperative blood loss. There was a significant improvement in the JOA score from 4.0 before surgery to 8.0 postoperatively, with an average recovery rate of 58.3%. The JOA recovery rate was significantly better in the staged group than in the simultaneous group (68.4% vs. 52.0%, P<0.05). However, the incidence of complications was similar between the staged and simultaneous groups, including for dural tear (1 vs. 6, P=0.19), cerebrospinal fluid leak (4 vs. 6, P=1.00), and transient neurological deterioration (0 vs. 2, P=0.51). CONCLUSIONS: The surgical outcome of staged decompression for discontinuous TOLF seems to be better than that of simultaneous decompression. The complication rates of these two strategies are similar. PMID:34314912 | DOI:10.1016/j.wneu.2021.07.075 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Analysis of Tracheostomy Complications in Pediatric Patients With Scoliosis

xlomafota13 shared this article with you from Inoreader An Analysis of Tracheostomy Complications in Pediatric Patients With Scoliosis Via The Laryngoscope Objectives/Hypothesisal To analyze tracheostomy-related complications in pediatric patients with scoliosis. Study Design Retrospective chart review. Methods A retrospective chart review of all patients with tracheostomy and scoliosis was performed at a single institution. The charts were reviewed for variables including difficulties with tracheostomy tube changes, poor positioning of tube, abnormal appearance of trachea, and emergency room visits and admissions for complications. Decannulation rates were also identified. Results About 102 patients met inclusion criteria, 96 (94.1%) had scoliosis involving the thoracic spine, and 4 had scoliosis involving the cervical spine; 13 (12.8%) patients had documented poor positioning on tracheoscopy; 31 patients (30.3%) had at least one emergency room visit or admission for complications, such as accidental decannulation or bleeding from the tracheostomy; 19 (18.6%) patients required at least one tube change due to poor positioning, with 7 (6.9%) requiring multiple changes; 18 (17.7%) had reported difficulties with home tube changes. Custom length tubes were required in 9 patients (8.8%). The level of scoliosis was not associated with any of these complications. Abnormalities of the trachea, such as tortuosity, obstructive granulomas, or tracheomalacia, were seen in 35 patients (34.3%) on bronchoscopy. Scoliosis repair was performed in 18 patients (17.65%), of which two achieved decannulation. Ten patients (9.8%) overall were decannulated. Conclusion A portion of patients with scoliosis who are tracheostomy-dependent have anatomical abnormalities of the trachea and poor positioning of the tracheostomy tube. Decannulation rates are also lower in this population compared to the literature. Further work is required to elucidate if scoliosis predisposes patients toward tracheostomy-related complications. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of Aspiration Pneumonia and Mortality in Patients with Dysphagia

xlomafota13 shared this article with you from Inoreader Predictors of Aspiration Pneumonia and Mortality in Patients with Dysphagia Via The Laryngoscope Objectives/Hypothesis To identify risk factors for pneumonia incidence in patients with dysphagia undergoing a videofluoroscopic swallow study (VFSS) in an outpatient tertiary-care center. Study Design Historical cohort study. Methods All individuals undergoing a VFSS between 10/02/13 and 07/30/15 were identified and followed historically for 2 years. Demographic information, medical history, and fluoroscopic data were collected. The 2-year incidence of pneumonia was obtained from the medical records and telephone interview. The incidence of pneumonia and death were calculated and risk factors for pneumonia and mortality were ascertained. Results 689 patients were followed for 2 years. The mean age (±standard deviation) of the cohort was 65 (±15.5) years. 49% (338/689) were female. The most common causes of dysphagia were cricopharyngeus muscle dysfunction (270/689), head and neck cancer (175/689), and neurodegenerative disease (56/689). The incidence of pneumonia was 22% (153/689). The incidence of death was 11%. Multivariable logistic regression revealed that chronic obstructive pulmonary disorder [COPD] (odds ratio [OR] = 2.36, 95% confidence interval [CI]: 1.33–4.19), hypertension (OR = 1.82, 95% CI: 1.23–2.73), tracheotomy status (OR = 2.96, 95% CI: 1.09–7.99), and vallecular residue (OR = 1.88, 95% CI: 1.24–2.85) were all significantly associated with an elevated risk of pneumonia. Kidney disease (OR = 1.27, 95% CI: 1.02–9.9), COPD (OR = 3.27, 95% CI: 1.65–6.49), vallecular residue (OR = 2.35, 95% CI: 1.35–4.1), male gender (OR&nb sp;= 2.21, 95% CI: 1.25–3.92), and low body mass index (OR: 1.12, 95% CI: 1.06–1.19) were independent adjusted risk factors for death. Conclusions The incidence of aspiration pneumonia (22%) and death (11%) within 2-years of a VFSS was high. The greatest adjusted risk factors for incident pneumonia were tracheotomy (OR = 3.0), COPD (OR = 2.4) and vallecular residue (OR = 1.9). The greatest adjusted risk factors for death were COPD (OR = 3.3), vallecular residue (OR = 2.3), and male gender (OR = 2.2). Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Graves' disease and recurrence in ectopic thyroid tissue after total thyroidectomy

xlomafota13 shared this article with you from Inoreader Graves' disease and recurrence in ectopic thyroid tissue after total thyroidectomy Via radioactive iodine BMJ Case Rep. 2021 Jul 27;14(7):e243313. doi: 10.1136/bcr-2021-243313. ABSTRACT We report a case of a 46-year-old woman who presented with a midline neck mass 2 years after total thyroidectomy for Graves' disease. Despite levothyroxine treatment withdrawal, she remained biochemically with subclinical hyperthyroidism. Her thyroid stimulating hormone receptor antibodies were consistently elevated. Neck ultrasonography revealed an infrahyoid solid nodule and pertechnetate scintigraphy confirmed an increased uptake at the same level, without any uptake in the thyroid bed. Treatment with methimazole 5 mg/day was initiated with clinical improvement and achievement of euthyroidism. After that, she received 10 mCi of radioactive iodine. Since then, she experienced regression of the neck mass and is doing well on a replacement dose of levothyroxine. Recurrence of Graves' disease in ectopic thyroid following total thyroidectomy is extremely rare. This diagnose should be considered in patients who underwent total thyroidectomy and remained with thyrotoxicosis despite decreasing the levothyroxine dose. PMID:34315743 | DOI:10.1136/bcr-2021-243313 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Desmoplastic Small Round Cell Tumor of the Submandibular Gland: A Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Desmoplastic Small Round Cell Tumor of the Submandibular Gland: A Case Report and Literature Review Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Desmoplastic small round cell tumor (DSRCT) is a rare and aggressively malignant tumor mostly occurring in the abdominal and pelvic cavity of young patients. However, few cases had been reported concerning DSRCT occurring in the head and neck region. We presented a rare case of DSRCT of the right submandibular in a 25-year-old man. MRI revealed a 3 × 2-cm solid nodule located in the right submandibular, and physical examination showed no other occupying lesion elsewhere. Histologically, the tumor was composed of various-sized small round cell nests, embedded in an abundant desmoplastic stroma. Immunohistochemically, the tumor cells were typically positive for epithelial (CK and EMA), mesenchymal (vimentin and desmin), and neuroendocrine (CD56, NSE, Syn, and CgA) markers, but negative for WT1. Fluorescence in situ hybridization revealed the presence of a break apart involving the Ewing sarcoma (EWS) gene. The patient received chemotherapy and radiotherapy and relapsed after 19 months of follow-up. DSRCT of the submandibular gland is rare, and the diagnosis of this tumor in an uncommon location relies on the histomorphology, immunophenotype, and EWS gene translocation detection. Differential diagnosis including primary salivary gland tumors and the other small round cell tumors needs to be excluded. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy and Safety of Long-Term Low-Dose Clarithromycin in Patients With Refractory Chronic Sinusitis After Endoscopic Sinus Surgery: A Prospective Clinical Trial

xlomafota13 shared this article with you from Inoreader Efficacy and Safety of Long-Term Low-Dose Clarithromycin in Patients With Refractory Chronic Sinusitis After Endoscopic Sinus Surgery: A Prospective Clinical Trial Via ear nose throat Ear Nose Throat J. 2021 Jul 27:1455613211032020. doi: 10.1177/01455613211032020. Online ahead of print. ABSTRACT OBJECTIVE: To observe the efficacy and safety of postoperative long-term low-dose oral administration of clarithromycin in patients with refractory chronic rhinosinusitis (RCRS), to explore the characteristics of postoperative microbiota in the nasal cavity in patients with RCRS, and to compare the differences and changes in microbiota in the nasal cavity before a nd after medication. METHODS: This was a prospective, self-controlled study. Eighteen patients with RCRS who had persistent symptoms after endoscopic sinus surgery and standard therapy with normal immunoglobulin E and eosinophil level were included. Low dose (250 mg, once daily) clarithromycin was orally administrated for 12 weeks. Symptom severity and endoscopic findings were evaluated before, after 4 weeks, and 12 weeks of treatment, and nasal cavity microbiota was analyzed simultaneously. RESULTS: A total of 18 patients with RCRS were enrolled and 17 patients completed the study. Four weeks after oral administration of clarithromycin, significant improvement was observed in subjective symptoms including nasal congestion, rhinorrhea, postnasal drip, and general discomfort, as well as endoscopic findings including general surgical cavity condition, rhinedema, and rhinorrhea (P < .05). After continuous treatment to the 12th week, symptoms showed significant imp rovement compared with baseline, and endoscopic score showed significant improvement compared with both baseline and 4 weeks after treatment. Analysis of middle nasal meatus flora revealed a significant decrease of Streptococcus pneumoniae after 12 weeks of clarithromycin treatment (P < .05), while the richness, composition, and diversity were similar before and after treatment. Patients enrolled experienced no adverse drug reaction or allergic reaction, nor clinical significant liver function impairment observed. CONCLUSION: Postoperative low-dose long-term oral administration of clarithromycin in patients with RCRS can improve the clinical symptoms and facilitate the mucosal epithelialization, with good tolerance and safety. The efficacy of clarithromycin in patients with RCRS may be related to its regulatory effect on nasal cavity microbiota. PMID:34315239 | DOI:10.1177/01455613211032020 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Using N95 and Surgical Masks on Otoacoustic Emission in Cochlear Outer Hair Cells

xlomafota13 shared this article with you from Inoreader Effect of Using N95 and Surgical Masks on Otoacoustic Emission in Cochlear Outer Hair Cells Via ear nose throat Ear Nose Throat J. 2021 Jul 27:1455613211034600. doi: 10.1177/01455613211034600. Online ahead of print. ABSTRACT INTRODUCTION: Distortion product otoacoustic emission (DPOAE) was measured to investigate the effect of mask use and type on oxygen saturation on cochlear function in health care professionals during the COVID-19 pandemic. MATERIAL AND METHODS: Group 1 participants wore surgical masks; Group 2 participants wore N95 masks. Distortion product otoacoustic emiss ion and oxygen saturation were measured in both groups before and after mask use. RESULTS: Comparison of signal-to-noise ratio (SNR) values before and after surgical mask use in DPOAE measurements of group 1 revealed statistically significant difference in the right and left ears. Comparison of the SNR values in DPOAE measurements of group 2 before and after 8 hours of N95 mask use revealed statistically significant differences in the right ear at 988, 2963, 4444, and 8000 Hz and in the left ear at 8000 Hz. CONCLUSION: We found that prolonged mask use may affect the outer hair cells in the cochlea, causing deterioration in DPOAE values. PMID:34315247 | DOI:10.1177/01455613211034600 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

En Block Versus Separate Management of Cervical Nodes in Tongue and Floor of the Mouth Cancers- Is There a Difference? An Analysis of 85 Cases in a Tertiary Care Institute

xlomafota13 shared this article with you from Inoreader En Block Versus Separate Management of Cervical Nodes in Tongue and Floor of the Mouth Cancers- Is There a Difference? An Analysis of 85 Cases in a Tertiary Care Institute Via Otolaryngology Indian Abstract To evaluate difference in local recurrence, regional (neck) recurrence as well as distant metastases between cases operated with en-block excision of primary cancer and neck nodes versus their separate removal, in squamous cell carcinomas of anterior 2/3 of tongue and floor of the mouth. A total 85 patients of cT1-T4a N0-N2b of carcinoma anterior 2/3 of tongue and floor of mouth were evaluated. Amongst these patients 39 cases of in-continuity en-block neck dissection and 46 cases of discontinuous neck dissection were evaluated for post-operative complications as well as oncological outcome for a follow up period of 3 years. Patient population was similar in both groups with tongue cancers being the commonest site and tobacco being the most common addiction. Primary site hematoma was seen more in the in-continuity en-block neck dissection group with a p-value of 0.0276, which was statistically significant. Post-oper ative oro-cutaneous fistula occurred more in in-continuity enblock neck dissection as compared to discontinuous neck dissection, but the difference was not statistically significant. Local recurrence rate was significantly more in cases of discontinuous neck dissection (19.565) as compared to in-continuity en-block neck dissection (5.12%) with a p-Value 0.0481. A statistically non-significant but higher loco-regional recurrence was observed in cases of discontinuous neck dissection as compared to cases of in-continuity en-block neck dissection (10.56% vs 2.56). In the present study recurrence-free survival RFS 3 year in cases of en-block in-continuity neck dissection (84.06%) cases as compared to discontinuous neck dissection cases (63.04%) with p Value 0.025698. In-continuity en-block in continuity neck dissection has lower loco-regional recurrence and may impact overall distant metastases. Though early postoperative complications are more in in-continuity en-block in continuity neck dissection as compared to discontinuous neck dissection, most are managed conservatively. Further studies with a larger sample size are needed to evaluate its outcome in a comprehensive manner. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parathyroid Carcinoma in a Patient With Secondary Hyperparathyroidism and Thyroid Hemiagenesis: A Case Report and Review of the Literature

xlomafota13 shared this article with you from Inoreader Parathyroid Carcinoma in a Patient With Secondary Hyperparathyroidism and Thyroid Hemiagenesis: A Case Report and Review of the Literature Via ear nose throat Ear Nose Throat J. 2021 Jul 28:1455613211036240. doi: 10.1177/01455613211036240. Online ahead of print. ABSTRACT Parathyroid carcinoma is a rare endocrine tumor. Parathyroid carcinoma in patients with secondary hyperparathyroidism due to chronic kidney disease is also rare. In addition, thyroid hemiagenesis is a rare congenital anomaly. We report an extremely rare case of parathyroid carcinoma in a patient with secondary hyperparathyroidism and thyroid hemiagenesis. We also present a review of the literature of this rare entity. We also discuss the surgical procedure performed for this patient. Our review of the literature found 34 case reports of parathyroid carcinoma in patients undergoing dialysis due to chronic renal failure; 14 reports of thyroid hemiagenesis with parathyroid disease; and no previous reports of thyroid hemiagenesis with secondary hyperparathyroidism and parathyroid carcinoma. Although surgical treatment of parathyroid carcinoma requires combined resection with the thyroid, peritracheal dissection with total parathyroidectomy, and monitoring intact parathyroid hormone as a tumor marker, our procedure preserved the patient's thyroid function. There has been no evidence of recurrence for over 8 years. PMID:34318689 | DOI:10.1177/01455613211036240 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.