Revision Surgery for Symptomatic Adjacent Segment Disc Degeneration after Initial Anterior Cervical Fusion: Is ROI-C Better than Plate-Cage Construct?

xlomafota13 shared this article with you from Inoreader Revision Surgery for Symptomatic Adjacent Segment Disc Degeneration after Initial Anterior Cervical Fusion: Is ROI-C Better than Plate-Cage Construct? Via Traditional dysphagia therapy Biomed Res Int. 2021 Dec 21;2021:6597754. doi: 10.1155/2021/6597754. eCollection 2021. ABSTRACT The optimal revision surgical strategy for patients who develop symptomatic adjacent segment disc degeneration (ASD) is controversial. The risks of intraoperative complications, especially the incidence of dysphagia, were relatively high for revision surgeries. This study was aimed at comparing the efficacy of revision surgery using a traditional plate-cage construct and zero-profile anchored spacer (ROI-C) device in treating symptomatic ASD after initial anterior cervical discectomy and fusion (ACDF) surgery. Forty-two patients who developed symptomatic ASD were retrospectively analyzed and classified into two groups (plate-cage group and ROI-C group). The clinical and radiological results were compared. We further evaluated the complication of dysphagia and dysphagia-related risk factors in these patients. The JOA and NDI scores, C2-7 lordotic an gle, and intervertebral space height were significantly improved after revision surgery in both groups. The operative time and intraoperative blood loss both significantly decreased in the ROI-C group. The incidence of postoperative dysphagia was much lower in the ROI-C group than in the plate-cage group (18.75% vs. 57.69%; P = 0.01). The presence of dysphagia after initial surgery (P = 0.003) and revision surgery type (P = 0.01) was significantly related to the presence of dysphagia after revision surgery. These results indicated that both the plate-cage construct and ROI-C are effective in treating symptomatic ASD. However, compared with the traditional plate-cage construct, ROI-C with less operative time, less blood loss, and lower incidence of dysphagia is more suitable. Furthermore, ROI-C should preferably be used for patients who present with dysphagia after initial cervical surgery. This study will provide clinical guidance for spinal surgeons to choose t he zero-profile device in treating specific and complicated cases, which will significantly improve the therapeutic efficacy of symptomatic adjacent segment degeneration. PMID:34970626 | PMC:PMC8714349 | DOI:10.1155/2021/6597754 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Electrical and Immunohistochemical Properties of Cochlear Fibrocytes in 3D Cell Culture and in the Excised Spiral Ligament of Mice

xlomafota13 shared this article with you from Inoreader Electrical and Immunohistochemical Properties of Cochlear Fibrocytes in 3D Cell Culture and in the Excised Spiral Ligament of Mice Via Journal of the Association for Research in Otolaryngology Abstract Fibrocyte degeneration in the cochlear lateral wall is one possible pathology of age-related metabolic hearing loss (presbycusis). Within the lateral wall fibrocytes play a role in potassium recycling and maintenance of the endocochlear potential. It has been proposed that cell replacement therapy could prevent fibrocyte degeneration in the CD/1 mouse model of hearing loss. For this to work, the replacement fibrocytes would need to take over the structural and physiological role of those lost. We have grown lateral wall fibrocytes from neonatal CD/1 mice in a 3D-collagen gel culture with the aim of assessing their functional similarity to native lateral wall fibrocytes, the latter in a slice preparation and in excised spiral ligament pieces. We have compared cultured and native fibrocytes using both immuno-labelling of characteristic proteins and single cell electrophysiology. Cultured fibrocytes exhibited rounded cell bodies with extending processes. They labell ed with marker antibodies targeting aquaporin 1 and calcium-binding protein S-100, precluding an unambiguous identification of fibrocyte type. In whole-cell voltage clamp, both native and cultured fibrocytes exhibited non-specific currents and voltage-dependent K+ currents. The non-specific currents from gel-cultured and excised spiral ligament fibrocytes were partially and reversibly blocked by external TEA (10 mM). The TEA-sensitive current had a mean reversal potential of + 26 mV, suggesting a permeability sequence of Na+  > K+. These findings indicate that 3D-cultured fibrocytes share a number of characteristics with native spiral ligament fibrocytes and thus might represent a suitable population for transplantation therapy aimed at treating age-related hearing loss. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Parotidectomy and neck dissection in locally advanced and relapsed cutaneous squamous cell carcinoma of the head and neck region

xlomafota13 shared this article with you from Inoreader Parotidectomy and neck dissection in locally advanced and relapsed cutaneous squamous cell carcinoma of the head and neck region Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Dec 10:S1808-8694(21)00210-X. doi: 10.1016/j.bjorl.2021.11.007. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the prognostic factors to developing parotid and neck metastasis in locally advanced and relapsed Cutaneous Squamous Cell Carcinoma (CSCC) of the head and neck region. METHODS: Single-center retrospective cohort study enrolling consecutive patients with advanced CSCC from 2009 to 2019. Seventy-four cases were identified. Study variables demographic data, clinical skin tumor stage, neck stage, parotid stage (P stage), surgical treatment features, and parotid, regional, and distant metastases. Survival measures: Overall Survival (OS) and Disease-Specific Survival (DSS). RESULTS: The study group included 72.9% men (median age, 67 years); 67.5% showed T2/T3 tumors, 90.5% comorbidities, 20.2% immunosuppressed, with median follow-up: 35.8 months. The most frequent skin primary wer e auricular and eyelid regions, 75% underwent primary resection with flap reconstruction. Parotid metastasis was present in 50%, 32.4% showing parotid extracapsular spread, multivariate analysis found OR = 37.6 of positive parotid metastasis evolving into positive neck metastasis, p = 0.001. Occult neck metastasis, neck metastasis, and neck extracapsular spread were observed in 13.5%, 51.3%, and 37.8%, respectively. Kaplan-Meier survival: Clinical T4 versus T1, p = 0.028, P1 stage: 30% and 5% survival at 5 and 10 years, P3 stage: 0%, p = 0.016; OS and DSS showed negative survival for the parotid metastasis group, p = 0.0283. CONCLUSION: Our outcomes support a surgically aggressive approach for locally advanced and relapsed CSCC, with partial parotidectomy for P0, total parotidectomy for P1-3, selective I-III neck dissection for all patients and adjuvant radiochemotherapy to appropriately treat these patients with advanced CSCC of the head and neck region. LEVEL OF EVIDEN CE: II b - Retrospective Cohort Study - Oxford Centre for Evidence-Based Medicine (OCEBM). PMID:35042657 | DOI:10.1016/j.bjorl.2021.11.007 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rhinoplasty in a 3 Week Old: Surgical Challenges in the Setting of Severe Congenital Frontonasal Dysplasia

xlomafota13 shared this article with you from Inoreader Rhinoplasty in a 3 Week Old: Surgical Challenges in the Setting of Severe Congenital Frontonasal Dysplasia Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 19:34894211072640. doi: 10.1177/00034894211072640. Online ahead of print. ABSTRACT OBJECTIVES: Congenital frontonasal dysplasia (CFND) is a rare heterogeneous collection of facial deformities. Due to the range of complexity, surgical management is not standardized. METHODS: We present a severe case of CFND and approach to managing multiple defects with a focus on rhinoplasty. RESULTS: This infant was born full term with a large mass instead of a nose, a bilateral cleft lip and palate, and hypertelorbitism. Our primary concerns initially were to address communication with the intracranial cavity, preserve a nasal lining, and improve nasal appearance and airway function in the short term without interfering with subsequent rhinoplasty and adult nasal appearance. CONCLUSIONS: This complex case of CFND is more severe than anything we encountered in our literature review and demonstrates the necessity for multidisciplinary approach to multiple craniofacial defects. Future plans for this patient include rhinoplasty with auricular graft, scar revision, and addressing tip support. PMID:35043659 | DOI:10.1177/00034894211072640 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Suture Ligation of Pyriform Sinus Fistulas Following Cauterization to Treat Branchial Cleft Anomalies

xlomafota13 shared this article with you from Inoreader Suture Ligation of Pyriform Sinus Fistulas Following Cauterization to Treat Branchial Cleft Anomalies Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 19:34894211070144. doi: 10.1177/00034894211070144. Online ahead of print. ABSTRACT OBJECTIVES: Obliteration with cauterization of the internal opening of pyriform sinus fistulas, with or without marsupialization, has been a mainstay for preventing recurrence. However, this procedure predisposes patients to recurrence caused by the reopening of the cauterized orifice. We applied suture ligation to secure the closure of the internal orifice f ollowing cauterization and evaluated treatment. METHODS: A total of 42 patients were diagnosed with third or fourth branchial cleft anomaly with internal pyriform sinus fistula and treated either with cauterization or with cauterization and suture ligation, between January 2008 and December 2020. The medical records were reviewed to assess demographic characteristics, clinical presentations, diagnoses, surgical treatment, and outcomes. Treatment flow characteristics for intractable patients were analyzed. RESULTS: The median age of onset was 9 years (range, 0-57 years). Neck swelling (n = 32, 76.2%) was commonly encountered symptom, and a history of neck infection was found in 27 patients (64.3%). After initial treatment, 11 cases (56.2%) recurred. Younger age (≤9 years) and thyroid involvement were associated with recurrence (P = .034 and P = .046, respectively). Cauterization with suture ligation presented lower recurrence rate (19.2%) than cauterizatio n only (37.5%, P = .037). Cauterization with suture ligation for recurrent cases (n = 11) showed 81.8% (9/11) of cure rate. Intractable fistulas (n = 2) from both groups were also salvaged by suture ligation. CONCLUSIONS: Suture ligation with cauterization for an internal orifice of branchial anomaly showed lower recurrence rate than cauterization only. This method was beneficial for refractory cases. PMID:35043664 | DOI:10.1177/00034894211070144 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What Role Does Thyroglobulin Washout Have in Follow‐Up Algorithm of Differentiated Thyroid Cancer?

xlomafota13 shared this article with you from Inoreader What Role Does Thyroglobulin Washout Have in Follow‐Up Algorithm of Differentiated Thyroid Cancer? Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complications of Gastrostomy Tubes in Patients With Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Complications of Gastrostomy Tubes in Patients With Head and Neck Cancer Via The Laryngoscope Objectives Head and neck cancers (HNCs) include various malignant tumors of the upper aerodigestive tract. Due to their anatomical location, HNCs can cause obstruction, odynophagia, or trismus, leading to dysphagia. In addition, this patient group may be vulnerable to treatment side effects both by surgery and oncological treatment, exposing the patients to an even higher risk of malnutrition. The risk of malnourishment is often resolved by applying a feeding gastrostomy tube. The present study aims to identify complication rates after percutaneous endoscopic gastrostomy (PEG) and open gastrostomy (OG) in patients treated for HNC in a high-volume center. Study Design Retrospective cohort study. Methods A retrospective cohort study of all patients treated for a new diagnosis of HNC at the Department of Otorhinolaryngology and Head and Neck Surgery at Karolinska University Hospital between January 1, 2000 and December 31, 2018 in whom gastrostomy was performed. Results Regarding tumor location, 165 (56.7%) were in the pharynx, 68 (23.4%) in the oral cavity, 57 (19.6%) in the larynx, and 1 (0.3%) in the nasal cavity. PEG was performed in 240 (82.5%) and OG in 51 (17.5%) patients. The overall complication rate was 28.2%: 64 (26.7%) among PEG patients and 18 (35.3%) among OG patients. The incidence of major complications was 3.1%. Conclusions Our study confirms that enteral feeding via gastrostomy is a safe method, regardless of the technique used (PEG or OG), with a low rate of major complications and no mortality linked to the procedure. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Utility of Ultrasonography for Diagnosis of Salivary Gland Sialolithiasis: A Meta‐Analysis

xlomafota13 shared this article with you from Inoreader Utility of Ultrasonography for Diagnosis of Salivary Gland Sialolithiasis: A Meta‐Analysis Via The Laryngoscope Objectives We hypothesized that ultrasonography for salivary gland stone detection would have a diagnostic accuracy similar to that confirmed by sialendoscopy, sialography, or surgery. Therefore, we evaluated the diagnostic characteristics of ultrasonography in terms of submandibular and parotid stone detection compared to confirmatory methods. Methods We searched PubMed, Embase, the Web of Science, SCOPUS, and the Cochrane database to October 31, 2021. The risk of bias was evaluated using the QADAS-2 tool. Results Ten studies involving 1393 patients were included in the analysis. The diagnostic odds ratio of ultrasonography was 162.6013 (95% confidence interval [CI] [53.9883; 489.7208] and I 2 value 81.0%). The area under the summary receiver operating characteristic curve was 0.963. The sensitivity, specificity, negative predictive value, and positive predictive value were 0.8992 (95% CI [0.8534; 0.9318]; I 2 = 79.9%), 0.9664 (95% CI [0.9290; 0.9844], I 2 = 65.6%), 0.8076 (95% CI [0.7256; 0.8694]; I 2 = 80.4%), and 0.9853 (95% CI [0.9629; 0.9943]; I 2 = 77.4%), respectively. However, high-level among-study heterogeneity (I 2 ≥ 50%) was evident, attributable to the inclusion of different glands. On subgroup analysis, significant differences in the negative predictive values (parotid gland only [0.9392], submandibular gland only [0.6718], and parotid and submandibular glands [0.8105]) were apparent. We found no significant among-study difference in the sensitivity, specificity, positive predictive value, or diagnostic odds ratio (P > .05). Conclusion Ultrasonography usefully detects submandibular and parotid gland stones. Ultrasonography of the parotid gland was associated with the highest diagnostic accuracy, but further clinical studies are needed. Level of Evidence NA Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Systemic Bevacizumab Treatment for Recurrent Respiratory Papillomatosis: Long‐Term Follow‐Up

xlomafota13 shared this article with you from Inoreader Systemic Bevacizumab Treatment for Recurrent Respiratory Papillomatosis: Long‐Term Follow‐Up Via The Laryngoscope Objectives/Hypothesis Systemic bevacizumab is a new adjuvant therapy for recurrent respiratory papillomatosis (RRP) that has shown promising preliminary results in children. The objective of this study was to report the largest series to date that includes long-term follow-up data on bevacizumab treatment. Study Design Retrospective chart review. Methods Retrospective review of seven pediatric patients treated within the past 6 years with systemic bevacizumab for RRP refractory to traditional debridement. Results All seven patients had a significant reduction in disease burden after initiation of systemic bevacizumab. There have been no major complications associated with systemic therapy so far. Median duration of bevacizumab treatment was 2.13 years. Three of the seven patients have been on treatment for over 3 years with the longest duration of treatment in our first patient now at 5.5 years. One patient experienced significant disease recurrence on two occasions when therapy was temporarily discontinued and was recently diagnosed with squamous cell carcinoma of the lung. Conclusion Systemic bevacizumab is an effective therapy for cases of severe RRP with promising results both in short-term and long-term follow-up. Side effects are minimal. Patients must be followed closely to determine appropriate dosing intervals to control disease and to screen for disease progression. Level of Evidence IV Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: a systematic review

xlomafota13 shared this article with you from Inoreader Quality of life after tonsillectomy in adult patients with recurrent acute tonsillitis: 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. 2022 Jan 19. doi: 10.1007/s00405-022-07260-7. Online ahead of print. ABSTRACT PURPOSE: The aims of this systematic review were to (1) explore the evidence for improved quality of life (QOL) in adult patients undergoing tonsillectomy because of recurrent acute tonsillitis (RT) and (2) evaluate which set of guidelines for tonsillectomy in adult RT patients is preferable, using QOL as outcome measure. METHODS: A systematic search was conducted in the PubMed, Embase, and Scopus databases. RCT/cohort studies exploring the effect of elective tonsillectomy in adult RT patients using any QOL assessment tool no less than 6 months after surgery were included. Studies were divided into two guideline groups based on the number of tonsillitis episodes required for tonsillectomy (Group 1: ≥ 5; Group 2: ≤ 4). RESULTS: A total of 364 unique records were identified. Seven studies (n = 409 patients) were includ ed in a qualitative analysis and four studies were included in a meta-analysis. Patients' QOL rose significantly, primarily because of improvements in the general and physical domains. In the meta-analysis, 96% (293/304) of patients benefitted from tonsillectomy. Patients included in guideline Group 1 studies had significantly higher QOL scores (Glasgow Benefit Inventory (GBI) 39.6) compared to patients in Group 2 studies (GBI 24.9) (p < 0.001). CONCLUSION: Adult patients undergoing tonsillectomy because of RT reported improved QOL 6-84 months after surgery. The benefit of tonsillectomy was higher among patients in studies with a higher minimum number of tonsillitis episodes compared to those included in studies with less strict criteria. Whether the improved QOL outweigh the morbidity associated with surgery in both guideline groups remains unclear. PMID:35044507 | DOI:10.1007/s00405-022-07260-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.