Is intraoperative margin sampling necessary in inverted papilloma resection?

xlomafota13 shared this article with you from Inoreader Is intraoperative margin sampling necessary in inverted papilloma resection? 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 16. doi: 10.1007/s00405-021-07075-y. Online ahead of print. ABSTRACT PURPOSE: To explore the association between intraoperative surgical margin sampling by the frozen sections and recurrence in inverted papilloma surgery. METHODS: A multicenter, retrospective study of patients who underwent attachment-oriented IP resection in four tertiary care medical centers with a minimal follow-up of 36 months. RESULTS: The study included 220 surgeries with a mean follow-up period of 49 months (range 36-204). The endoscopic approach was used in all but 4 cases; 73% of procedures were primary. Overall recurrence was 10.45% (n = 23). Squamous cell carcinoma was found in 5 cases (2.2%). Intraoperative margin sampling was obtained in 145 cases. There was no difference in the recurrence rate between frozen section and no-frozen section groups (p = 0.44). Furthermore, margin sampling in various sites of tum or origin, in cases with concomitant nasal polyps (p = 0.53) and in revision cases (p = 0.08) showed no correlation with recurrence. In 26 cases when the surgery was extended following a positive frozen section, there was a significantly higher recurrence rate (OR = 6.94). CONCLUSIONS: According to our results, intraoperative margin sampling did not affect the recurrence rate of IP, and therefore, its routine use should be questioned. PMID:34532762 | DOI:10.1007/s00405-021-07075-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional printing in otolaryngology education: a systematic review

xlomafota13 shared this article with you from Inoreader Three-dimensional printing in otolaryngology education: a systematic review 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 17. doi: 10.1007/s00405-021-07088-7. Online ahead of print. ABSTRACT PURPOSE: The progressive expansion of the technology that facilitates the development of three-dimensional (3D) printing within the field of otorhinolaryngology has opened up a new study front in medicine. The objective of this study is to systematically review scientific publications describing the development of 3D models having applications in otorhinolaryngology, with emphasis on subareas with a large number of publications, as well as the countries in which the publications are concentrated. METHODS: In this literature review, specific criteria were used to search for publications on 3D models. The review considered articles published in English on the development of 3D models to teach otorhinolaryngology. The studies with presurgical purposes or without validation of the task by surgeons were excluded from this review. RESULTS: This review considered 39 articles published in 10 countries between 2012 and 2021. The works published prior to 2012 were not considered as per the inclusion criteria for the research. Among the 39 simulators selected for review, otology models comprised a total of 15 publications (38%); they were followed by rhinology, with 12 (31%); laryngology, with 8 (21%); and head and neck surgery, with 4 publications (10%). CONCLUSION: The use of 3D technology and printing is well established in the context of surgical education and simulation models. The importance of developing new technological tools to enhance 3D printing and the current limitations in obtaining appropriate animal and cadaver models signify the necessity of investing more in 3D models. PMID:34533591 | DOI:10.1007/s00405-021-07088-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sleep Endoscopy Findings in Children With Obstructive Sleep Apnea and Small Tonsils

xlomafota13 shared this article with you from Inoreader Sleep Endoscopy Findings in Children With Obstructive Sleep Apnea and Small Tonsils Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 16:34894211045645. doi: 10.1177/00034894211045645. Online ahead of print. ABSTRACT OBJECTIVE: Obstructive Sleep Apnea (OSA) in children is treated primarily with adenotonsillectomy (AT). When clinical exam demonstrates small tonsils, the success of AT in resolving OSA is uncertain. The purpose of this study is to determine the utility of Drug induced Sleep Endoscopy (DISE) for children with OSA and small tonsils (Brodsky scale 1+) and to id entify what obstructive trends exist in this subset of patients and to determine the utility of DISE-directed surgical intervention in patients with small tonsils. METHODS: A retrospective chart review was performed for patients who underwent DISE at a tertiary care center over a 2-year period. Inclusion criteria were 1+ tonsils and a positive sleep study. Data collected included DISE findings, BMI, comorbid conditions, and pre-op PSG data. RESULTS: Forty children were included with a mean age of 5.0 years (range 8 months-16 years). Mean preoperative AHI was 5.46 and mean oxygen saturation nadir was 87.1%. The most common contributor to airway obstruction was the adenoid (29 patients, 72.5%), followed by the tongue base or lingual tonsil (21 patients, 52.5%). The palatine tonsils (10 patients, 25.0%), epiglottis (10.0%), or obstruction intrinsic to the larynx (10.0%) were significantly less frequently identified as contributors to OSA when compared to the adenoid (P < .001). The majority of patients had multilevel obstruction (25 patients, 62.5%). Adenoidectomy (27 patients, 67.5%) was the most commonly performed procedure, followed by tonsillectomy (10 patients, 25.0%, P < .001) and tongue base surgery (9 patient 22.5%, P < .001). CONCLUSION: In this group, small palatine tonsils were infrequently identified as a contributor to airway obstruction and tonsillectomy was avoided in most cases. This study illustrates the utility of DISE as a tool to personalize the surgical management of pediatric patients with OSA and small tonsils on physical exam. PMID:34528454 | DOI:10.1177/00034894211045645 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unilateral Vocal Fold Paralysis With Large Posterior Glottic Gap: Is Arytenoid Procedure Necessary?

xlomafota13 shared this article with you from Inoreader Unilateral Vocal Fold Paralysis With Large Posterior Glottic Gap: Is Arytenoid Procedure Necessary? Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 17:34894211045637. doi: 10.1177/00034894211045637. Online ahead of print. ABSTRACT OBJECTIVES: For unilateral vocal fold paralysis (UVFP) with large posterior glottic gap medialization laryngoplasty (ML) + arytenoid adduction (AA), ML + adduction arytenopexy (AApexy), and ML alone using prosthesis with posterior extension are possible solutions. This study was carried out to elucidate the controversy among these solution options. METH ODS: Retrospective cohort. Tertiary referral center. One hundred forty patients with UVFP with large posterior glottic gap. Group 1 had 30 patients with ML + AA; Group 2 had 25 patients with ML + AApexy; Group 3 had 29 patients with ML using Isshiki prosthesis; Group 4 had 26 patients with ML using Montgomery prosthesis; Group 5 had 30 patients with ML using prosthesis with large posterior extension. Glottic closure using videolaryngostroboscopy, GRBAS, VHI-30, EAT-10, acoustic and aerodynamic analysis was carried out pre- and 1-year-postoperatively. RESULTS: Preoperatively there was no significant difference in any parameters studied among all study groups (P > .05). Except F0, speaking F0 and EAT-10, all other parameters in acoustic and aerodynamic analysis, glottic closure, GRBAS, and VHI-30 scores were significantly better postoperatively in Groups 1 and 2 compared to Groups 3 to 5 (P < .05). CONCLUSIONS: In patients with UVFP and large posterior glottic gap, ML + AA and ML + AApexy seem to do better subjectively and objectively, acoustically and aerodynamically, when compared to ML using prosthesis with and without large posterior extension. ML alone does not appear to close posterior glottic gap. Therefore, it is a better and more reasonable option to perform arytenoid procedure when there is large posterior glottic gap in UVFP. PMID:34535066 | DOI:10.1177/00034894211045637 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Traumatic Pediatric Tracheal Rupture After Blunt Force Sporting Injury: Case Report and Review of the Literature

xlomafota13 shared this article with you from Inoreader Traumatic Pediatric Tracheal Rupture After Blunt Force Sporting Injury: Case Report and Review of the Literature Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 19:34894211046707. doi: 10.1177/00034894211046707. Online ahead of print. ABSTRACT OBJECTIVE: This paper presents the case of a traumatic tracheal rupture in a pediatric patient. The body of literature of the clinical features, evaluation, and management of this uncommon presentation is discussed. CASE: A 13-year-old boy sustained an intrathoracic tracheal rupture whilst playing Australian Rules football. He developed hallmark clinica l features of air extravasation and was intubated prior to transfer to a tertiary pediatric center for further management. After a short trial of conservative management, his respiratory status deteriorated and he was taken to the operating theater for open surgical repair of the defect. CONCLUSION: Traumatic rupture of the trachea is a rare injury in children. This case demonstrates the dynamic nature of this serious injury and the need for multidisciplinary care in achieving the optimal outcome. PMID:34541893 | DOI:10.1177/00034894211046707 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Adenoidectomy for the Management of Chronic Rhinosinusitis in Children Older Than 7 Years of Age

xlomafota13 shared this article with you from Inoreader Efficacy of Adenoidectomy for the Management of Chronic Rhinosinusitis in Children Older Than 7 Years of Age Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 18:34894211045270. doi: 10.1177/00034894211045270. Online ahead of print. ABSTRACT OBJECTIVES: While adenoidectomy is the first-line surgical management of chronic rhinosinusitis (CRS) in young children, evidence regarding its utility in older children is lacking. This study aimed to assess the efficacy of adenoidectomy in children 7 to 18 years old with regard to symptom control, postoperative medication use, and the need for additional su rgery. METHODS: Single-institution retrospective chart review of patients ages 7 to 18 undergoing adenoidectomy for CRS from 2009 to 2019. Patients with cystic fibrosis and ciliary disorders were excluded. Comorbidities, preoperative and postoperative symptoms (rhinorrhea, congestion, anosmia, and facial pain), medication use (antibiotics, antihistamines, nasal steroids, and irrigations), and Lund-Mackay scores were extracted. McNemar's or Wilcoxon Rank Sum Tests were used to assess rates of symptom control and medication use. Fisher's exact or Chi-square tests were used to assess for factors associated with symptom persistence. RESULTS: Ninety-seven patients with a mean age of 9 years (range 7-18) were identified. Patients were shown to experience significantly decreased rates of rhinorrhea (64.9% vs 20.6%, <.001), congestion (95.9% vs 26.8%, <.001), facial pain (17.5% vs 3.1%, .001), use of nasal steroids (79.4% vs 36.1%, <.001), antihistamines (47.4% vs 20.6% , <.001), and number of antibiotics (median 1 vs 0, <.001) after adenoidectomy. No patient or disease factors were associated with symptom persistence. Nine patients (9.3%) required additional nasal surgery. CONCLUSION: In this cohort of older children with CRS with limited follow up, additional surgery is not routinely done following adenoidectomy, the results suggest that adenoidectomy alone may provide adequate symptom control and medication reduction. PMID:34541924 | DOI:10.1177/00034894211045270 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intermittent Vagal Nerve Stimulation-Associated Vocal Fold Movement Impairment

xlomafota13 shared this article with you from Inoreader Intermittent Vagal Nerve Stimulation-Associated Vocal Fold Movement Impairment Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 18:34894211047459. doi: 10.1177/00034894211047459. Online ahead of print. ABSTRACT OBJECTIVES: Implanted vagal nerve stimulators (VNS) are an accepted therapy for refractory seizures. However, VNS have been shown to affect vocal fold function, leading to voice complaints of hoarseness. We present a case of intermittent VNS-related vocal fold paralysis leading to dysphonia and dysphagia with aspiration in a pediatric patient. METHODS: This is a case report of a patient at a tertiary hospital evaluated in pediatric swallow and voice clinics. Patient and mother gave verbal consent to be included in this case report. RESULTS: Indirect laryngeal stroboscopy was performed demonstrating full vocal fold mobility with VNS off and left vocal fold paralysis in lateral position and glottic gap with VNS on. Voice measures were performed demonstrating decreased phonation time, lower pitch, and decreased intensity of voice with VNS on. Flexible endoscopic evaluation of swallowing demonstrated deep penetration alone with VNS off and deep penetration with concern for aspiration with VNS on. CONCLUSIONS: While the majority of cases of vocal fold movement impairment associated with VNS have been noted to have a medialized vocal fold with VNS activation, we describe a case of intermittent vocal fold lateralization associated with VNS activation with resultant voice changes and aspiration. PMID:34541908 | DOI:10.1177/00034894211047459 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auditory Neuropathy/Auditory Synaptopathy

xlomafota13 shared this article with you from Inoreader Auditory Neuropathy/Auditory Synaptopathy Via cortical auditory Otolaryngol Clin North Am. 2021 Sep 14:S0030-6665(21)00161-4. doi: 10.1016/j.otc.2021.07.004. Online ahead of print. ABSTRACT Patients with auditory neuropathy (AN)/auditory synaptopathy (AS) present unique evaluation and management challenges. Communication ability using auditory stimuli varies among patients, with particular difficulty understanding speech in noise. Auditory physiologic responses are key to accurate identification and monitoring of patients with AN/AS. Management approaches should consider individual variation and the possibility of change over time. Many patients with accurately characterized AN/AS demonstrate success with cochlear implants. Areas of discovery, including understanding of synaptic and neural mechanisms, genotype/phenotype relationships, and use of cochlear and cortical evoked potentials, will promote accurate clinical evaluation and management of infants, children, and adults with AN/AS. PMID:34535280 | DOI:10.1016/j.otc.2021.07.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Zipline Into a Case of Spontaneous Cerebrospinal Fluid Rhinorrhea

xlomafota13 shared this article with you from Inoreader Zipline Into a Case of Spontaneous Cerebrospinal Fluid Rhinorrhea Via leak of cerebrospinal fluid Cureus. 2021 Aug 18;13(8):e17277. doi: 10.7759/cureus.17277. eCollection 2021 Aug. ABSTRACT Spontaneous cerebrospinal fluid (CSF) rhinorrhea is an uncommon phenomenon. One of the complications associated with CSF rhinorrhea is meningitis, which is associated with high mortality. Therefore, the prompt diagnosis of CSF rhinorrhea is essential. We present a case of a patient, who after zip-lining, developed CSF rhinorrhea. She had no history of trauma and none of the conventional comorbidities associated with spontaneous CSF rhinorrhea. She was diagnosed with the help of radiological studies and biochemical tests. Our case is unique as there are no published case reports of spontaneous CSF rhinorrhea occurring after atraumatic zip-lining. PMID:34540498 | PMC:PMC8448257 | DOI:10.7759/cureus.17277 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

LINC01094 promotes the invasion of ovarian cancer cells and regulates the Wnt/β-catenin signaling pathway by targeting miR-532-3p

xlomafota13 shared this article with you from Inoreader LINC01094 promotes the invasion of ovarian cancer cells and regulates the Wnt/β-catenin signaling pathway by targeting miR-532-3p Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1228. doi: 10.3892/etm.2021.10662. Epub 2021 Aug 27. ABSTRACT Long non-coding RNAs (lncRNAs) participate in the development of ovarian cancer (OC). The present study aimed to explore the roles of long intergenic non-protein coding RNA 1094 (LINC01094) in OC. LINC01094 and microRNA (miR)-532-3p expression in OC tissues and cells were measured using reverse transcription-quantitative PCR. Cell migration and invasion were detected using wound healing assays and Transwell assays, respectively. The binding of LINC01094 or β-catenin to miR-126-5p was detected using a Dual-luciferase reporter assay, and protein expression was confirmed using western blot analysis. The expression level of LINC01094 in patients with OC was higher in OC tissues compared with in adjacent tissues, and LINC01094 was upregulated in OC cell lines. In addition, LINC01094 overexpression promoted the viability, migration, invasion and cell cycle progression of OC cells, and inhibited OC cell apoptosis. Moreover, LINC01094 negatively regulated miR-532-3p in OC cells and tissues. miR-532-3p overexpression decreased the viability, migration, invasion and cell cycle progression of OC cells alongside downregulation of Wnt/β-catenin signaling pathway protein expression, as well as increasing OC cell apoptosis. Inhibition of LINC01094 with small interfering (si)-LINC01094 and overexpression of LINC01094 respectively reversed the effect of miR-532-3p inhibitor and mimics on OC cells. miR-532-3p could directly target β-catenin, and miR-532-3p inhibitor increased β-catenin expression, while si-LINC01094 attenuated this effect. In addition, LINC01094 overexpression promoted tumor growth in vivo by regulating miR-532-3p. Taken together, LINC01094 promoted the growth, migration, invasion and Wnt/β-catenin signaling pathway expression of OC cells by modulating miR-532-3p. PMID:34539824 | PMC:PMC8438678 | DOI:10.3892/etm.2021.10662 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Real-life Cretan asthma registry focused on severe asthma: On behalf of 'The Cretan registry of the use of Biologics in Severe Asthma'

xlomafota13 shared this article with you from Inoreader Real-life Cretan asthma registry focused on severe asthma: On behalf of 'The Cretan registry of the use of Biologics in Severe Asthma' Via Experimental and therapeutic medicine Exp Ther Med. 2021 Nov;22(5):1239. doi: 10.3892/etm.2021.10674. Epub 2021 Sep 1. ABSTRACT Asthma diagnosis and management remains a challenging task for the medical community. The aim of the present study was to present the functional and inflammatory profiles of patients with difficult-to-treat asthma in a real-life clinical setting referred to the specialized asthma clinic at the University Hospital of Heraklion. The registry included a cohort of 267 patients who were referred to the severe asthma clinic. Patients were assessed with emphasis on the history of allergies, nasal polyposis or other comorbidities. Blood testing for eosinophils counts and total and specific IgE, and pulmonary function tests were performed at baseline. The median age of patients with asthma was 55 years old, 68.5% were women and 58.3% were never smokers. The vast majority presented with late onset asthma (75.7%), whereas eight (3%) patients were on oral cor ticosteroids. The median number of exacerbations during the last 12 months was 1 (0-3). Furthermore, 50.7% of patients had a positive serum allergy test, the median eosinophil count was 300 (188-508.5) cells/µl of blood and median total IgE level was 117.5 (29.4-360.5) IU/ml. Patients were retrospectively grouped in the following categories: Group 1, mild-moderate asthma; group 2, patients prescribed a step 4 or 5 asthma therapy according to Global Initiative for Asthma; and group 3, patients on biologic agents. Group 1 had significantly higher FEV1% than groups 2 and 3 (93.4 vs. 79.9 and 79.4%, respectively; P<0.001). Finally, the median Asthma Control Questionnaire 7 (ACQ7) score was 1.14, with patients from groups 2 and 3 presenting higher ACQ7 scores compared with group 1 patients as expected (1.1 and 2.1 vs. 0.7, respectively; P<0.001). To the best of our knowledge, this was the first real-life asthma study in Crete that demonstrated that severe asthmatics predominantly have late-onset asthma with airflow obstruction and uncontrolled symptoms. PMID:34539835 | PMC:PMC8438657 | DOI:10.3892/etm.2021.10674 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.