Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills

xlomafota13 shared this article with you from Inoreader Cochlear Implantation in Inner Ear Malformations: Considerations Related to Surgical Complications and Communication Skills Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: There are particular challenges in the implantation of malformed cochleae, such as in cases of facial nerve anomalies, cerebrospinal fluid (CSF) leaks, erroneous electrode insertion, or facial stimulation, and the outcomes may differ depending on the severity of the malformation. The aim of this study was to assess the impact of inner ear malformations (IEMs) on surgical complications and outcomes of cochlear implantation. Methods: In order to assess the impact of IEMs on cochlear implant (CI) outcomes, 2 groups of pati ents with similar epidemiological parameters were selected from among 863 patients. Both the study group (patients with an IEM) and control group (patients with a normal inner ear) included 25 patients who received a CI and completed at least 1 year of follow-up. Auditory performance, receptive and expressive language skills, and production and use of speech were evaluated preoperatively and at least 1 year after implantation. Types of surgical complications and rates of revision surgeries were determined in each group. Results: In the study group, the most common malformation was an isolated enlarged vestibular aqueduct (EVA) (44.8%). Overall, the patients with IEMs showed significant improvement in auditory-verbal skills. In general, the patients who had normal cochleae scored significantly better compared to patients with IEMs (p #x3c; 0.05). The complication rate was significantly lower in the control group compared to the study group (p = 0.001), but the rate of revision surgeries did not differ significantly (p = 0.637). Conclusion: It is possible to improve communication skills with CIs in patients with IEMs despite the variations in postoperative performances. Patients with EVA, incomplete partition type 2, and cochlear hypoplasia type 2 were the best performers in terms of auditory-verbal skills. Patients with IEMs scored poorly compared to patients with normal cochleae. CSF leak (gusher or oozing) was the most common complication during surgery, which is highly likely in cases of incomplete partition type 3. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment delay and tumor size in patients with oral cancer during the first year of the COVID‐19 pandemic

xlomafota13 shared this article with you from Inoreader Treatment delay and tumor size in patients with oral cancer during the first year of the COVID‐19 pandemic Via Head & Neck Abstract Background We set out to investigate how the ongoing coronavirus pandemic affected the size of tumors and the duration of treatment delay in patients with surgically treated oral squamous cell carcinoma. Methods Patients with surgically treated oral cavity squamous cell carcinoma were assessed retrospectively and divided into two groups depending on when they had first presented at our clinic. Patients presenting from 2010 to 2019, that is, before COVID-19 onset (n = 566) were compared to patients presenting in 2020 (n = 58). Results A total of 624 patients were included. Treatment delay was significantly longer in 2020 (median = 45 days) versus 2010–2019 (median = 35 days) (p = 0.004). We observed a higher pathological T classification in 2020 (p = 0.046), whereas pathological N classification was unchanged between groups (p = 0.843). Conclusions While extraordinary efforts continue to be made in the context of the pandemic, it is imperative that this does not lead to significant disadvantages for many people with oral cancer. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application and Efficiency of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange in Laryngeal Microsurgery

xlomafota13 shared this article with you from Inoreader Application and Efficiency of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange in Laryngeal Microsurgery Via The Laryngoscope Objectives/Hypothesis This study aimed to analyze the feasibility of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) during laryngeal microsurgery (LMS) and investigated its efficiency and application according to the location of the lesion. Study Design Retrospective chart review. Methods Patients over 20 years of age who underwent LMS without underlying cardiac, pulmonary, or cerebrovascular disease were retrospectively reviewed. Overall, 54 patients with endotracheal intubation (ETI) and 44 patients with THRIVE were included. The operation and anesthesia time, induction and emergence time, oxygen saturation (SpO2), and transcutaneous carbon dioxide (TcCO2) levels were analyzed and compared between the two ventilation methods according to disease subsite. Results Compared with ETI, patients with THRIVE presented reduced operation time (16.3 ± 9.69 min vs. 21.9 ± 12.0 min), anesthesia time (33.6 ± 11.4 min vs. 45.4 ± 13.9 min), emergence time (6.73 ± 2.49 min vs. 8.52 ± 3.17 min), without significant decreases in SpO2 but with increased TcCO2 (10.9 ± 6.12% vs. 7.33 ± 3.86%). Comparing THRIVE to ETI for lesions at the glottis yielded similar findings, which were particularly more significant. However, lesions above the glottis presented no significant difference for any parameters between THRIVE and ETI groups. Lesions involving multiple subsites and prolonged operation time were risk factors for the intraoperative conversion of ventilation method. Conclusion THRIVE is reliable for maintaining oxygenation during LMS and is efficient in reducing the operation and emergence times, leading to shorter anesthesia time, especially for lesions at the glottis. However, caution is required administering THRIVE, when lesion involves multiple subsites, and when operation time is prolonged. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pain Management Following Otological Surgery: A Prospective Study of Different Strategies

xlomafota13 shared this article with you from Inoreader Pain Management Following Otological Surgery: A Prospective Study of Different Strategies Via The Laryngoscope Objectives The aim of this study was to prospectively assess pain and associated analgesic consumption after otological surgery comparing two prescription patterns. Study Design A prospective nonrandomized consecutive cohort study. Methods 125 adult patients undergoing ambulatory otologic surgery-cochlear implantation and endaural middle ear surgery, were assigned (according to surgeon's preference) and prospectively studied in two arms: 1) acetaminophen 500 mg + ibuprofen 400 mg; 2) acetaminophen 500 mg + codeine 30 mg. Pain levels, medication dose, disposal patterns of opioids, and suspected side effects were evaluated. Results All patients reported mild to moderate pain. There was a statistically significant reduction of pain from day to day, which was on average 0.26 lower than the day before. Sufficient pain control could be achieved with both drug regimens with no significant difference in pain levels. Only 50% of patients who were prescribed opioids used them. Additionally, the median tablet intake was 3 tablets while 10 to 20 tablets were prescribed. The majority of patients (97%) did not dispose of these drugs safely. Conclusion Adequate analgesia was achieved in both arms of this study. Pain control following otologic surgery with a combination of acetaminophen and nonsteroidal anti-inflammatory drugs is recommended unless contraindications or chronic opioid use are present. If opioids such as codeine (30 mg) are prescribed, the amount should be reduced as low as possible, such as five tablets, based on our studied population. Level of Evidence Level 3—a prospective nonrandomized consecutive cohort study Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Τhe combined HT-SVV and HU-SVV test could be a powerful neuro-otologic examination for detecting pathologies in the vestibular otolithic pathway.

xlomafota13 shared this article with you from Inoreader Message: https://doi.org/10.1016/j.anl.2021.08.010 Abstract Objective We previously established the head-tilt subjective visual vertical (HT-SVV) test to evaluate head-tilt perception gain (HTPG) in addition to the original head-upright SVV (HU-SVV) test (Wada-Y et al.: Laryngoscope Investig Otolaryngol, 2020). In this study, we aimed to investigate the HU-SVV and HT-SVV abnormality rates among patients with vertigo/dizziness. Methods Between July 2014 and December 2020, 357 patients were hospitalized for examining the HU-SVV and HT-SVV at our vertigo/dizziness center. Among these patients, 120 had Meniere's disease (MD), 99 had unilateral vestibular disease (UVD), 76 had benign paroxysmal positional vertigo (BPPV), 14 had vestibular migraine (VM), 13 had orthostatic dysfunction (OD), 12 had bilateral vestibular disease (BVD), 12 had central dizziness (CD), 7 had vestibular schwannoma (VS), and 4 had psychogenic dizziness (PD). We determined the reference values of the absolute HU-SVV (<2.5°) and HTPG (0.80–1.25) for the sitting position and used these for calculating the HU-SVV and HT-SVV abnormality rates in each type of vertigo/dizziness. Results Among the 357 patients, 111 had abnormal HU-SVV results (31.1%), 132 had abnormal HT-SVV results (37.0%), and 185 had abnormal HU-SVV and/or HT-SVV results (51.8%). The modified HT-SVV test in combination with the original HU-SVV test could detect gravity perception disturbance in patients with vertigo/dizziness significantly better than the original test alone (chi-square: p=0.00019). The HU-SVV, HT-SVV, and HU-SVV and/or HT-SVV abnormality rates were significantly higher in patients with peripheral vestibular diseases, i.e., MD, UVD, BPPV, and BVD than in those with other types of vertigo/dizziness, i.e., VM, OD, CD, VS, and PD (chi-square: p=0.010, p=0.020, and p=0.0025, respectively). Conclusion These findings suggest that the combined HT-SVV and HU-SVV test could be a powerful neuro-otologic examination for detecting pathologies in the vestibular otolithic pathway. Keywords Gravity perceptionOtolith functionSubjective visual verticalHead-tilt perception gainMeniere's diseaseBenign paroxysmal positional vertigo Results of subjective visual vertical tests in patients with vertigo/dizziness Via Auris Nasus Larynx Publication date: Available online 8 September 2021 Source: Auris Nasus Larynx Author(s): Masaharu Sakagami, Yoshiro Wada, Tomoyuki Shiozaki, Ichiro Ota, Tadashi Kitahara View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of the pretreatment geriatric nutritional risk index for predicting severe adverse events in patients with head and neck cancer treated with chemoradiotherapy: Efficacy of the pretreatment Geriatric Nutritional Risk Index for predicting severe adverse events

xlomafota13 shared this article with you from Inoreader Efficacy of the pretreatment geriatric nutritional risk index for predicting severe adverse events in patients with head and neck cancer treated with chemoradiotherapy: Efficacy of the pretreatment Geriatric Nutritional Risk Index for predicting severe adverse events Via Auris Nasus Larynx Publication date: Available online 9 September 2021 Source: Auris Nasus Larynx Author(s): Masahiro Nakayama, Kayoko Ohnishi, Masahiro Adachi, Rieko Ii, Shin Matsumoto, Masatoshi Nakamura, Hidetaka Miyamoto, Yuki Hirose, Bungo Nishimura, Shuho Tanaka, Tetsuro Wada, Keiji Tabuchi View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bench testing of tracheostomy tube-related insults using an instrumented manikin

xlomafota13 shared this article with you from Inoreader Bench testing of tracheostomy tube-related insults using an instrumented manikin 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 Sep 9. doi: 10.1007/s00405-021-07054-3. Online ahead of print. ABSTRACT PURPOSE: Choosing the right tracheal tube for the right patient is a daily preoccupation for intensivists and emergency physicians. Tracheal tubes can generate severe complications, which are chiefly due to the pressures applied by the tube to the trachea. We designed a bench study to assess the frequency of pressure levels likely to cause tracheal injury. METHODS: We tested the pressure applied on the trachea by 17 tube models of a given size range. To this end, we added a pressure sensor to the posterior tracheal wall of a standardized manikin. RESULTS: Only 2 of the 17 tubes generated pressures under the threshold likely to induce tracheal injury (30 mmHg/3.99 kPa). The force exerted on the posterior wall of the trachea varied widely across tube models. CONCLUSION: Most models of tracheal tubes resulted in forces applied to the trachea that are usually considered capable of causing tracheal tissue injury. LEVEL OF EVIDENCE: Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence: How common is the problem?: step 1; Is this diagnostic or monitoring test accurate? (Diagnosis) step 5; What will happen if we do not add a therapy? (Prognosis) n/a; Does this intervention help? (Treatment Benefits) step 5; What are the COMMON harms?(Treatment Harms) step 5; What are the RARE harms? (Treatment Harms) step 5; Is this (early detection) test worthwhile? (Screening) step 5. PMID:34499203 | DOI:10.1007/s00405-021-07054-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

SARS-CoV-2 vaccine-induced subacute thyroiditis

xlomafota13 shared this article with you from Inoreader SARS-CoV-2 vaccine-induced subacute thyroiditis Via American Journal of Otolaryngology Publication date: Available online 9 September 2021 Source: American Journal of Otolaryngology Author(s): Krupa R. Patel, Mary E. Cunnane, Daniel G. Deschler View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Submental Flap in the Reconstruction of Palatal Defects

xlomafota13 shared this article with you from Inoreader Submental Flap in the Reconstruction of Palatal Defects Via Otolaryngology Indian Abstract Amongst oral cancers, malignancies of the palate and the upper gingivo-buccal complex are relatively uncommon. Following resection, defects in the palate lead to a nasal speech and nasal regurgitation on swallowing. This is best overcome with a prosthetic obturator which occludes the palatal defect and has dentures for the upper alveolus. It may not be possible to fit a prosthetic obturator in edentulous patients and in patients with trismus. Microvascular free flaps though commonly used for such defects, are time consuming, expensive and require a specialised setup. This study assesses the submental flap for its feasibility to repair palatal defects, the sturdiness of the flap, its functional outcome and the oncological safety in using the flap. This is a retrospective analysis of 46 patients, where palatal defects for oral cancers were reconstructed with the submental flap. Oncological safety was studied in 41 patients with a median follow-up of 34.5 month s. 20 patients were studied for their functional outcomes using the parameters, adopted from the University of Washington-Quality of Life questionnaire. Complete flap loss was seen in 4 (8.7%) patients while 2 (4.35%) patients had minor dehiscence. No donor site morbidity was reported. Locoregional Recurrences and distant metastasis were noted in 13 of the 41 patients studied. The mean score was highest for speech at 95.5% while the lowest mean score was for mouth opening at 42.5%. The submental flap is an effective and reliable alternative for the reconstruction of palatal defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent Giant Mucoepidermoid Carcinoma of the Parotid: A Case Report and Review of Literature

xlomafota13 shared this article with you from Inoreader Recurrent Giant Mucoepidermoid Carcinoma of the Parotid: A Case Report and Review of Literature Via Otolaryngology Indian Abstract Mucoepidermoid carcinoma is the most common salivary gland malignancy and about one third occurs in the parotid gland. The peak incidence is commonly seen between the third and fifth decades of life. It routinely presents as a fixed, painless mass below the ear. However, its presentation as a giant mass is exceedingly rare. Here, we report a case of a recurrent giant exophytic mucoepidermoid carcinoma in a young male. He underwent Revision Total Parotidectomy with Modified Radical neck dissection with Sural nerve grafting and an Anterolateral thigh flap reconstruction followed by Adjuvant radiotherapy. The rarity of the clinical presentation and the management challenges faced in a young male are being discussed in this case report. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study

xlomafota13 shared this article with you from Inoreader Is Revision Surgery Necessary for Patients With High Risk of Recurrence After Parotidectomy? A Multicenter Retrospective Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 8:34894211045269. doi: 10.1177/00034894211045269. Online ahead of print. ABSTRACT OBJECTIVES: Close margin is a frequent situation after parotidectomy. The need for systematic prophylactic revision surgery is a question that arises regularly for malignant tumors, as it exposes to a high risk of facial palsy, while oncological benefits are unclear. STUDY DESIGN: retrospective study. SETTING: Multicentric. SUBJECTS AND METHO DS: We included all patients operated for systematic revision surgery in case of close margins after parotidectomy for a malignant tumor and analyzed the rate of tumor residue and its risk factors. RESULTS: A tumor residue was identified in 43.5% of 23 cases, but none in case of initial complete excision with supra-millimetric margins. Invaded lymph nodes were identified in 6 cases, but none in case of low-grade tumors. CONCLUSIONS: Systematic revision seems mandatory in case of infra-millimetric margins and high-grade tumors or positive lymph node; further studies are needed to confirm whether it can be spared for T1-T2/N0 low-grade tumors, with close margins but complete initial excision. PMID:34496666 | DOI:10.1177/00034894211045269 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neck Mass in an Adolescent

xlomafota13 shared this article with you from Inoreader Message: Neck Mass in an Adolescent Saikrishna C. Gourishetti, MD1; Jamie Hittman, MD2; Kevin D. Pereira, MD, MS1,3 Author Affiliations 1Department of Otorhinolaryngology–Head and Neck Surgery, University of Maryland School of Medicine, Baltimore 2Department of Pathology, University of Maryland School of Medicine, Baltimore 3Department of Pediatrics, University of Maryland School of Medicine, Baltimore JAMA Otolaryngol Head Neck Surg. Published online September 9, 2021. doi:10.1001/jamaoto.2021.2314 Full Text A 13-year-old male presented to the pediatric otolaryngology clinic with a 2-year history of a right neck mass that had slowly increased in size. He denied any associated symptoms of pain, fevers, chills, malaise, night sweats, unintentional weight loss, prior history of neck masses, recent upper respiratory tract infections, or skin lesions. He was the product of a full-term pregnancy with up-to-date immunizations. Physical examination revealed a 2.5-cm firm, ovoid, mobile, and nontender mass at the apex of the posterior triangle of the right neck without any associated overlying skin changes. The remainder of the head and neck examination was unremarkable. Doppler ultrasonography revealed a 1.9 × 1.8 × 0.9-cm hypoechoic mass, and subsequent fine-needle aspirates demonstrated cells with elongated nuclei and eccentric blue cytoplasm in a background of myxoid stroma. The mass was excised in entirety without issue. At the time of surgery, the deep surface of the mass was foun d to be adherent to the sternocleidomastoid muscle. The lesion was resected with a cuff of muscle and sent for permanent histopathological examination. This revealed proliferation of bland spindle cells with plump nuclei and eosinophilic cytoplasm arranged as loose fascicles in a background of myxoid stroma (Figure 1). These cells were positive for mucin 4 (MUC4), epithelial membrane antigen (EMA), and transducing-like enhancer of split 1 (TLE1) immunohistochemical stains. Fluorescence in situ hybridization (FISH) revealed a positive FUS (16p11) gene rearrangement. Neck Mass in an Adolescent Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a 13-year-old male who presented with a 2-year history of a right neck mass that had slowly increased in size. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.