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Αλέξανδρος Γ. Σφακιανάκης

Sunday, March 27, 2022

New ENT Abstracts


Thyroid tumor ratio: Improving the assessment of the impact of size in pediatric thyroid cancer
3d
by
Connie Paik, Beth Osterbauer, Grace Sahyouni, Soyun Park, Gabriel Gomez, Daniel Kwon, Juliana Austin
via
Head & Neck
Abstract
Background
The impact of thyroid nodule size is less useful in children who have smaller thyroid volumes than in adults. We investigate using a novel thyroid tumor ratio measurement in children with thyroid cancer.

Methods
Patient and pathologic characteristics were investigated via Student's t-test in a univariate analysis for any correlation with the log-transformed tumor ratio, followed by a multivariate linear regression.

Results
Of 75 patients with malignancy and tumor ratio information, mean ratio decreased with increasing age (p = 0.04). Out of several clinical factors, patients with lymph node metastases and those treated with postoperative radioactive iodine had significantly higher mean tumor ratios on multivariate analysis (p = 0.04 for both factors).

Conclusions
Our study is the first to describe thyroid tumor volume in pediatric thyroid cancer and shows that increased tumor ratio was associated with indicators of more advanced disease such as lymph node metastases and use of radioactive iodine.

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Efficacy and safety of preoperative embolization in carotid body tumor treatment: A propensity score matching retrospective cohort study
3d
by
Zhaoyu Wu, Peng Qiu, Hongji Pu, Kaichuang Ye, Guang Liu, Weimin Li, Xiaobing Liu, Minyi Yin, Mier Jiang, Jinbao Qin, Xinwu Lu, Zhen Zhao
via
Head & Neck
Abstract
Background
To assess the efficacy and safety of preoperative embolization (PE) in patients with carotid body tumor (CBTs).

Methods
In a single-center retrospective cohort study, 127 patients underwent surgical resection of CBTs from January 2003 to December 2019. One-to-one propensity score matching was conducted between patients with or without PE.

Results
Thirty-two (25.2%) patients received PE. After propensity score matching, no statistically significant differences were found in the baseline characteristics of 28 patients in each group. Compared with NPE group, operative time and estimated blood loss (EBL) were significantly reduced in the PE group. The incidence of stroke, perioperative complications, intraoperative blood transfusion, vascular reconstruction, hospital stay, tumor recurrence, and all-cause mortality were not different between the PE and NPE group.

Conclusions
Preoperative embolization was efficient and safe with a reduction of intraoperative blood loss and operative time during CBT resection.

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Post‐acute health care needs of people with head and neck cancer: Mapping health care services, experiences, and the impact of rurality
3d
by
Jasmine Foley, Clare L. Burns, Elizabeth C. Ward, Rebecca L. Nund, Laurelie R. Wishart, Lizbeth M. Kenny, Maurice Stevens
via
Head & Neck
Abstract
Background
People with head and neck cancer (HNC) have complex health care needs; however, limited evidence exists regarding the nature or patterns of service access and use. This study explored the post-discharge health care needs and experiences of individuals with HNC from metropolitan and rural areas.

Methods
Health care appointments and services accessed by people with HNC were collated for 6-month post-treatment. Data analysis of the whole cohort examined patterns of access while journey mapping integrated participants' experiences of recovery.

Results
The 6-month service access journey was mapped for 11 people. Rural participants attended a significantly greater number of appointments (p = 0.012), higher canceled/missed appointments (p = 0.013), and saw more professionals (p = 0.007). Rural participants reported higher stress and burden due to service access barriers and unmet needs.

Conclusions
Multiple challenges and inequities exist for rural people with HNC. Findings inform opportunities to enhance the post-treatment recovery of people with HNC in rural areas.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
Telephone consultation 11855 int 1193,

Effects and influencing factors of vestibular rehabilitation in 171 cases

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):263-269. doi: 10.3760/cma.j.cn115330-20210601-00321.

ABSTRACT

Objective: To explore the effect of vestibular rehabilitation and to identify factors that can affect rehabilitation outcomes. Methods: From December 2018 to October 2020, patients who underwent vestibular rehabilitation in the Eye, Ear, Nose and Throat Hospital of Fudan University were prospectively followed up. A battery of vestibular function examinations and psychological status evaluations were applied before and after rehabilitation initiation. The main outcomes were vertigo/dizziness and unsteadiness, measured by visual analogue scale (VAS); Secondary outcomes were daily activities and participation, assessed by vestibular activities and participation measure (VAP). Paired t-test was used to compare the effects before and after rehabilitation. Binary logistic regressions were applied to anal yze the influencing factors of rehabilitation outcomes. Results: A total sample of 171 patients was followed up regularly with a median time of 11 months. Of the 171 patients evaluated, 72 were males and 99 were females; age ranged from 10 to 89 years old with a median age of 55 years old. At 6-month follow-up, the difference of VAS score of vertigo/dizziness and unsteadiness pre-post rehabilitation was 1.79±1.80 and 1.56±1.76, respectively; The difference of activity and participation domain of VAP score was 2.51±13 and 1.27±3.75, respectively. All differences pre-post rehabilitation exhibited statistically significant with P values<0.01. Regression analysis demonstrated that the length of symptom onset was a significant predictor of poor balance recovery (OR=6.52; 95%CI:2.10, 20.27). Visual dependence (OR=5.44; 95%CI: 1.38, 21.47) and suspectable anxiety (OR=6.45; 95%CI: 1.49, 28.30) were identified as risk factors for poor recovery of vertigo/dizziness. Conclusions: Vestibular rehabilitation effectively reduces dizziness, promotes balance, and improves the function of daily activities. Time from the onset, visual dependence and suspectable anxiety are the main factors hindering a desirable rehabilitation outcome.

PMID:35325936 | DOI:10.3760/cma.j.cn115330-20210601-00321

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Analysis of whole-mouth taste function test results in 584 healthy adults

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):289-294. doi: 10.3760/cma.j.cn115330-20210409-00190.

ABSTRACT

Objective: To assess the taste function of healthy Chinese adults with the reliable whole-mouth taste test, and to analyze the correlation of taste function with age and gender. Methods: The clinical data of 584 participants reporting the normal sense of smell and taste from March 2019 to January 2020 in the Physical Examination Center of Beijing Anzhen Hospital were analyzed in the study, including 297 males and 287 females, aging (46.9±16.6) years. The subjects were divided into youth group (19-35 years old), middle aged group (36-50 years old), middle-elderly aged group (51-65 years old) and elderly group (66-80 years old). The taste test involved 5 tastants (sour, sweet, salty, umami and bitter) and 7 concentrations. The perception and recognition scores of five tastes were obtained through th e whole-mouth taste test. SPSS 22.0 software was used for statistical analysis. Results: The intra-class correlation coefficients of the whole-mouth taste test were 0.751 to 0.828, which showed high test-retest reliability. The total score of perception and recognition of five tastes showed the significant negative correlation with age (r value was -0.49 and -0.44, respectively, both P<0.001). Compared with the other two groups, taste function of middle-elderly aged and elderly group decreased significantly (all P<0.001). There was no significant difference in total perception scores and total recognition scores between youth and middle aged group (all P>0.05). The perception scores and recognition scores of sour, salty, umami, bitter and total scores in females were higher than those in males (all P<0.05), but there was no significant difference in perception scores and recognition scores for sweet between them (P value w as 0.584 and 0.223, respectively). Conclusions: The taste function is significantly negatively correlated with age. Except the sweet, females are more sensitive to the sour, salty, umami and bitter tastes than males.

PMID:35325940 | DOI:10.3760/cma.j.cn115330-20210409-00190

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Using the external auditory canal skin graft of the healthy side to treat unilateral congenital aural atresia: preliminary results of clinical research

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):338-344. doi: 10.3760/cma.j.cn115330-20211117-00744.

ABSTRACT

Objective: To investigate whether the contralateral normal external auditory canal (EAC) skin graft can maintain the ear canal health after EAC reconstruction in unilateral congenital aural atresia (CAA) cases. Methods: A Zelen design randomized controlled study was used to collect unilateral CAA patients for EAC reconstruction prospectively (clinical trial registration number: ChiCTR2000032103). The patients were randomly divided into the control group and the trial group. The trial group used the contralateral normal EAC skin graft group (transplant part of the contralateral normal EAC skin to repair the atresia side for unilateral CAA patients), the control group all used scalp blade thick skin. We observed the EAC health and hearing results of the two groups after EAC reconstruction. Results : A total of 13 cases were enrolled from July 2020 to August 2021. There were eight patients in the trial group, including six males and two females, with an average age of 22.3 years (14-36 years). There were two patients with CAA on the left and six patients on the right. The average follow-up time was 8.8 months (4-14 months). There were five patients in the control group, all cases were male with an average age of 16.2 years (12-20 years). There were four patients with CAA on the left and one patient on the right. The average follow-up time was 7.0 months (2-14 months). In the trial group, eight cases of reconstructed EAC epithelium were healthy, one patient had cicatricial stenosis of EAC opening and lateralization of the tympanic membrane. The other patient had cicatricial stenosis of reconstructed EAC, this case also had scar hyperplasia of the contralateral EAC opening but recovered after soft packing and triamcinolone acetonide injection treatment. The healthy side EAC of the rest trial group had no scarring stenosis or local bone hyperplasia during long-term follow-up. In the control group, one patient was lost to follow-up and the other four patients had dry ears of reconstructed EAC, but easily to form crusts and needed to be cleaned repeatedly, one patient had lateralization of the tympanic membrane, the EAC epithelium was not healthy for long-term follow-up. The incidence of complications related to EAC reconstruction was lower than previous studies (χ²=5.55, P=0.018), and the average postoperative Air-Bone Gap increased (18.8±10.0)dB. Conclusion: By optimizing the EAC reconstruction technology, the health of the reconstructed EAC is improved compared with the previous study. After active intervention and treatment, there should be no scarring stenosis or local bone hyperplasia on the contralateral side EAC.

PMID:35325947 | DOI:10.3760/cma.j.cn115330-20211117-00744

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Two cases of subglottic inflammatory myofibroblastic tumor

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):347-349. doi: 10.3760/cma.j.cn115330-20210507-00256.

NO ABSTRACT

PMID:35325949 | DOI:10.3760/cma.j.cn115330-20210507-00256

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Correlation analysis of smell and taste loss with COVID-19 outbreak trend based on big data of internet

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):282-288. doi: 10.3760/cma.j.cn115330-20210808-00536.

ABSTRACT

Objective: To analyze the correlation between loss of smell/taste and the number of real confirmed cases of coronavirus disease 2019 (COVID-19) worldwide based on Google Trends data, and to explore the guiding role of smell/taste loss for the COVID-19 prevention and control. Methods: "Loss of smell" and "loss of taste" related keywords were searched in the Google Trends platform, the data were obtained from Jan. 1 2019 to Jul. 11 2021. The daily and newly confirmed COVID-19 case number were collected from World Health Organization (WHO) since Dec. 30 2019. All data were statistically analyzed by SPSS 23.0 software. The correlation was finally tested by Spearman correlation analysis. Results: A total of data from 80 weeks were collected. The retrospective analysis was performed on the new tre nd of COVID-19 confirmed cases in a total of 186 292 441 cases worldwide. Since the epidemic of COVID-19 was recorded on the WHO website, the relative searches related to loss of smell/taste in the Google Trends platform had been increasing globally. The global relative search volumes of "loss of smell" and "loss of taste" on Google Trends was 10.23±2.58 and 16.33±2.47 before the record of epidemic while 80.25±39.81 and 80.45±40.04 after (t value was 8.67, 14.43, respectively, both P<0.001). In the United States and India, the relative searches for "loss of smell" and "loss of taste" after the record of epidemic were also much higher than before (all P<0.001). The correlation coefficients between the trend of weekly new COVID-19 cases and the Google Trends of "loss of smell" in the global, United States, and India was 0.53, 0.76, and 0.82 respectively (all P<0.001), the correlation coefficients with Google Trends of "loss of taste" was 0.54, 0.78, and 0.82 respectively (all P<0.001). The lowest and highest point of loss of smell/taste search curves of Google Trends in different periods appeared 7 to 14 days earlier than that of the weekly newly COVID-19 confirmed cases curves, respectively. Conclusions: There is a significant positive correlation between the number of newly confirmed cases of COVID-19 worldwide and the amount of keywords, such as "loss of smell" and "loss of taste", retrieved in Google Trends. The trend of big data based on Google Trends might predict the outbreak trend of COVID-19 in advance.

PMID:35325939 | DOI:10.3760/cma.j.cn115330-20210808-00536

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Columnar localization and laminar origin of cortical surface electrical potentials

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J Neurosci. 2022 Mar 23:JN-RM-1787-21. doi: 10.1523/JNEUROSCI.1787-21.2022. Online ahead of print.

ABSTRACT

Electrocorticography (ECoG) methodologically bridges basic neuroscience and understanding of human brains in health and disease. However, the localization of ECoG signals across the surface of the brain and the spatial distribution of their generating neuronal sources are poorly understood. To address this gap, we recorded from rat auditory cortex using customized μECoG, and simulated cortical surface electrical potentials with a full-scale, biophysically detailed cortical column model. Experimentally, μECoG-derived auditory representations were tonotopically organized and signals were anisotropically localized to ≤±200 μm, i.e., a single cortical column. Biophysical simulations reproduce experimental findings, and indicate that neurons in cortical layers V and VI contribute ∼85% of evoked high-gamma signal recorded at the surfa ce. Cell number and synchrony were the primary biophysical properties determining laminar contributions to evoked μECoG signals, while distance was only a minimal factor. Thus, evoked μECoG signals primarily originate from neurons in the infragranular layers of a single cortical column.Significance Statement:Electrocorticography (ECoG) methodologically bridges basic neuroscience and understanding of human brains in health and disease. However, the localization of ECoG signals across the surface of the brain and the spatial distribution of their generating neuronal sources are poorly understood. We investigated the localization and origins of sensory evoked ECoG responses. We experimentally found that ECoG responses were anisotropically localized to a cortical column. Biophysically detailed simulations revealed that neurons in layers V &VI were the primary sources of evoked ECoG responses. These results indicate that evoked ECoG high-gamma responses are primarily generat ed by the population spike rate of pyramidal neurons in layer V/VI of single cortical columns, and highlight the possibility of understanding how microscopic sources produce mesoscale signals.

PMID:35332084 | DOI:10.1523/JNEUROSCI.1787-21.2022

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Human papillomavirus-related multiphenotypic sinonasal carcinoma: A report of two patients and review of the literature

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Publication date: Available online 24 March 2022

Source: Auris Nasus Larynx

Author(s): Satoru Miyamaru, Tetsuji Sanuki, Yusuke Miyamoto, Kohei Nishimoto, Masako Masuda, Yumi Honda, Yoshiki Mikami, Yorihisa Orita

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Treatment, Outcome, and Relapse of Spontaneous and Nonspontaneous Cerebrospinal Fluid Leak

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Brain Sci. 2022 Mar 2;12(3):340. doi: 10.3390/brainsci12030340.

ABSTRACT

Cerebrospinal fluid (CSF) leak can be spontaneous or nonspontaneous. The management options include conservative treatments, blood patch, and surgical repairs. We compared clinical symptoms, image findings, management options, hospitalization, and relapse rates among different causes of CSF leaks. Eighty-one patients were recruited: 20 with spontaneous and 61 with nonspontaneous CSF leaks. Nonspontaneous causes included lumbar puncture, surgery, and trauma. Surgery sites comprised sphenoid, spine, skull base, and calvaria. Spontaneous CSF leak came from the sphenoid or spine. Age, gender, body mass index, initial symptoms, hospitalization, treatment courses, and recurrence rates showed no difference between the groups. The spontaneous group had higher CSF accumulations on their MRIs. MRI pachymeninge enhancement showed the highest sensitivity (78.6%) for intracranial hyp otension. Meningitis occurred in 1/3 of sphenoid, skull base, and calvarian surgeries. Earlier reoperation was correlated with shorter hospitalization (r = 0.651), but the recurrence rates were similar. Longer intervals between surgery and CSF leak encouraged reoperation. Among the spontaneous spine and lumbar puncture-related CSF leaks, 57.1% of them responded to 4 days of conservative treatment. Among the trauma-related CSF leaks, 90.9% of them required surgical repair. The demographic data and symptoms were similar in various groups of CSF leak. The symptom onset durations and treatment strategies were different. However, the recurrence rates were similar.

PMID:35326296 | DOI:10.3390/brainsci12030340

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Potential effects of lowering the threshold of statistical significance in the field of chronic rhinosinusitis - A meta-research on published randomized controlled trials over last decade

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Braz J Otorhinolaryngol. 2021 Dec 4:S1808-8694(21)00196-8. doi: 10.1016/j.bjorl.2021.11.004. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the impact of change in p-value threshold from 0.05 to 0.005, on published Randomized Controlled Trials (RCTs) over the last ten years in the field of chronic rhinosinusitis.

METHODS: A search of the PubMed database from 1st January 2011 to 31st December 2020 was conducted to include all RCTs that used p-value to determine the effects of an intervention. Data extracted included p-values, type of intervention, publishing journal with indexing, registration, funding, and multi- or single center status. The proportion of primary endpoints having p < 0.005 was determined first, followed by those with p > 0.005 but <0.05. Logistic regression analysis was used to determine if any trial characteristic was associated with reporting of significant p-values.

RESULTS: In total, 16 8 primary endpoints were identified from 123 RCTs. On analysis, 80 had a p-value <0.05, i.e., statistically significant on conventional parameter. Out of these, 53.75% had a p-value <0.005, which would retain significance under the proposed threshold, and the remaining 46.25% to be reclassified as "suggestive". None of the trial characteristics were contributing to reporting of conventional or proposed p-values on logistic regression analysis.

CONCLUSION: Lowering the p-value threshold would render 46.25% of a decade of published RCTs results (in the field of CRS) to be reclassified as merely "suggestive" and not significant. Trial characteristics were not found contributing to reporting of p-value <0.005 or even <0.05.

LEVEL OF EVIDENCE: II.

PMID:35331655 | DOI:10.1016/j.bjorl.2021.11.004

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The Auditory Processing Domains Questionnaire (APDQ): Brazilian-Portuguese version

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Braz J Otorhinolaryngol. 2022 Jan 4:S1808-8694(21)00213-5. doi: 10.1016/j.bjorl.2021.12.001. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to determine the fidelity, reliability, and internal validity of the APDQ when translated from English to Brazilian-Portuguese language.

METHODS: The first phase included the APDQ translation into Brazilian-Portuguese including forward translation, translation assessment and back-translation in a group of 10 students. The second phase involved establishing the internal consistency and reliability of the APDQ Brazilian-Portuguese version. Data was collected from 66 students without any risk factor for auditory processing disorder. Subjects were divided into a younger group (7-10 yrs) and an older group (11-17 yrs).

RESULTS: All items showed appropriate quality in terms of translation. In determining internal consistency, Cronbach's alpha in subscales of auditory proce ssing, attention and language was found to be 0.93, 0.85 and 0.74, respectively. Intraclass Correlation Coefficient for total score was 0.95, ensuring a strong test-retest reliability.

CONCLUSION: The Brazilian-Portuguese version of the APDQ has favorable translation quality, internal validity and reliability. It is now ready for continued study as a differential screening tool for 7- to 17-year-old Brazilian children with listening difficulties who are at risk for auditory processing disorder, attention deficits and language learning challenges.

PMID:35331656 | DOI:10.1016/j.bjorl. 2021.12.001

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