The impact of close surgical margins on recurrence in oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader The impact of close surgical margins on recurrence in oral squamous cell carcinoma Via Journal of Otolaryngology - Head & Neck Surgery Close margins influence treatment and outcome in patients with oral squamous cell carcinoma (OSCC). This study evaluates 187 cases of surgically treated OSCC regarding the impact of close margins on recurrence... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two-step treatment of a giant skull vault hemangioma: A rare case report and literature review.

xlomafota13 shared this article with you from Inoreader Two-step treatment of a giant skull vault hemangioma: A rare case report and literature review. Via Sociedad Luso-Española de Neurocirugía Related Articles Two-step treatment of a giant skull vault hemangioma: A rare case report and literature review. Neurocirugia (Astur). 2021 Feb 08;: Authors: Anagnostou E, Lagos P, Plakas S, Mitsos A, Samelis A Abstract Skull vault hemangiomas are benign vascular tumours of the calvaria that are usually asymptomatic or present as firm, painless lumps. We present a case of a 59-year-old female with a giant intraosseous calvarial hemangioma that was admitted in our department with a palpable mass over the left frontoparietal region, personality changes and impaired emotional and cognitive functions. The patient was treated with a two-step approach involving endovascular and surgical treatment, and suffered two rare, but recognized complications, a contrecoup intracerebral haemorrhage and valproate-induced stupor and parkinsonism. At the 6-month follow-up, the patient had complete recovery with a good neurological outcome. PMID: 33573868 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of a Comprehensive Dysphagia Intervention Program Tailored for the Residents of Nursing Homes.

xlomafota13 shared this article with you from Inoreader Efficacy of a Comprehensive Dysphagia Intervention Program Tailored for the Residents of Nursing Homes. Via swallowing exercises Related Articles Efficacy of a Comprehensive Dysphagia Intervention Program Tailored for the Residents of Nursing Homes. J Frailty Aging. 2021;10(2):156-159 Authors: Fong R, Wong SWK, Chan JKL, Tong MCF, Lee KYS Abstract Oropharyngeal dysphagia is a widespread condition in older people and thus poses a serious health threat to the residents of nursing homes. The management of dysphagia relies mainly on compensatory strategies, such as diet and environmental modification. This study investigated the efficacy of an intervention program using a single-arm interventional study design. Twenty-two participants from nursing homes were included and had an average of 26 hours of intervention, including oromotor exercises, orosensory stimulation and exercises to target dysphagia and caregiver training. Four of the 22 participants exhibited improvement in functional oral intake scale (FOIS) but was not statistically significant as a group. All oromotor function parameters, including the range, strength, and coordination of movements, significantly improved. These results indicate that this intervention program could potentially improve the oromotor function, which were translated into functional improve ments in some participants' recommended diets. The validity of this study could be improved further by using standardized swallowing and feeding assessment methods or an instrumental swallowing assessment. PMID: 33575705 [PubMed - in process] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of Synchronous ESCN in Head and Neck Cancer: A Single‐Institution Perspective

xlomafota13 shared this article with you from Inoreader Prevalence of Synchronous ESCN in Head and Neck Cancer: A Single‐Institution Perspective Via The Laryngoscope Objectives The primary objective was to determine the prevalence of synchronous esophageal squamous cell carcinoma in head and neck squamous cell carcinoma (HNSCC) patients. The secondary objective was to determine risk factors for the development of synchronous esophageal squamous cell carcinoma (ESCN). Study Design: Cross sectional observation study. Methods A prospective cross sectional, observational study on consecutive 300 newly diagnosed oral cavity, oropharynx, hypopharynx, and laryngeal squamous cell carcinoma patients who underwent trans‐nasal esophageal endoscopy with white light imaging and narrow band imaging. Results Among 300 patients, index HNSCCs were located in the oral cavity (n = 154, 51.3%), oropharynx (n = 63, 21%), larynx (n = 53, 17.7%), and hypopharynx (n = 30, 10%). The prevalence of synchronous ESCN was 2.7% (n = 8), including four low‐grade, two high‐grade dysplasia, and two squamous cell carcinomas. On logistic regression analysis, moderate to heavy alcohol consumption (OR 8.7, P = .01) and primary HNSCC involving supraglottis [(OR 12.5, P = .02) were risk factors for synchronous ESCN. The association of pyriform sinus carcinoma and synchronous ESCN was of borderline significance (P = .054, OR 10.92). Conclusion The prevalence of synchronous ESCN in HNSCC was 2.7%. Routine trans‐nasal esophagoscopy should be performed in all newly diagnosed patients with carcinoma of the supraglottis and pyriform sinus, and those with consumption of moderate to heavy alcohol for the screening of synchronous ESCN. Level of Evidence 2b Laryngoscope, 131:E807–E814, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Cranial Fossa Repair of Temporal Bone Spontaneous CSF Leaks With Hydroxyapatite Bone Cement

xlomafota13 shared this article with you from Inoreader Middle Cranial Fossa Repair of Temporal Bone Spontaneous CSF Leaks With Hydroxyapatite Bone Cement Via The Laryngoscope Objectives To determine the safety and effectiveness of the middle cranial fossa (MCF) approach in repairing spontaneous cerebrospinal fluid (sCSF) leaks. Study Design Retrospective cohort study. Methods Patient with sCSF leaks repaired by MCF approach between January 1, 2014 and August 31, 2019 were included. Demographic information, clinical and surgical findings, and postoperative outcomes were recorded. Results The cohort (n = 45) included 24 tegmen repairs by multilayer reconstruction using hydroxyapatite cement and 21 cases of multilayer repair without hydroxyapatite cement. Ten MCF repairs were performed on patients ≥65 years old. Twenty (53%) ears had multiple tegmen defects (range, 1–9 tegmen defects) and 78% of patients had ≥1 encephaloceles. All sCSF leaks were resolved with one surgical intervention. There were no major intracranial complications. Transient expressive aphasia occurred in 2 patients. Medical complications occurred in four patients. There were no short‐term postoperative CSF leaks with bone cement reconstruction and two postoperative leaks without bone cement. One resolved with lumbar drain (LD) and the other resolved without treatment. The average (SD) length of stay (LOS) with bone cement was shorter than in patients without bone cement (2.54 [0.83] days vs. 3.52 [1.99] days, P < .05). There have been no long‐term CSF leak recurrences with an average (SD) follow‐up of 13.5 (12.9) months (range 0.25–46 months). Conclusions MCF approach for sCSF repairs demonstrate efficacious outcomes, particularly with tegmen reconstruction using hydroxyapatite cement. The approach exhibited no serious adverse events and few complications requiring intervention. Therefore, MCF is a safe and effective approach to resolve sCSF leaks. Level of Evidence 3 Laryngoscope, 131:624–632, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Effects of Radiofrequency Coblation for Adult Laryngopharyngeal Vascular Lesions

xlomafota13 shared this article with you from Inoreader Clinical Effects of Radiofrequency Coblation for Adult Laryngopharyngeal Vascular Lesions Via The Laryngoscope Objective To explore the feasibility and efficacy of transoral radiofrequency coblation surgery (TRS) in the treatment of adult laryngopharyngeal vascular lesion (LVL). Methods A total of 15 patients with LVL were retrospectively studied, including 11 capillary lesions and five cavernous lesions (there was one case with two separate lesions). All of the lesions were treated with TRS alone (capillary lesion) or with a combination of TRS and sclerotherapy (cavernous lesion). The treatment efficacy was evaluated according to the modified Achauer criteria: grade 1, no change in size; grade 2, a decrease of < 50% in size; grade 3, a decrease of ≥ 50% but < 100%; and grade 4, the disappearance of the lesion with no recurrence for at least 6 months. Results The surgical procedures were successfully completed in all patients. According to the modified Achauer criteria, the treatment outcomes were grade 4 for 10 capillary lesions and one cavernous lesion; grade 3 for one capillary lesion and one cavernous lesion; grade 2 for one cavernous lesion; and grade 1 for two cavernous lesions, respectively. No complications related to the surgery, including bleeding, dysphagia, and infections, occurred after treatment. Conclusion The TRS is an effective treatment option for LVL, especially for patients with laryngopharyngeal capillary lesions. Level of Evidence 4 Laryngoscope, 131:566–570, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine Learning Based Radiomic HPV Phenotyping of Oropharyngeal SCC: A Feasibility Study Using MRI

xlomafota13 shared this article with you from Inoreader Machine Learning Based Radiomic HPV Phenotyping of Oropharyngeal SCC: A Feasibility Study Using MRI Via The Laryngoscope Objectives To investigate whether a radiomic MRI feature‐based prediction model can differentiate oropharyngeal squamous cell carcinoma (SCC) according to the human papillomavirus (HPV) status. Study Design Retrospective cohort study. Methods Pretreatment MRI data from 62 consecutive patients with oropharyngeal SCC were retrospectively reviewed, and chronologically allocated to training (n = 43) and test sets (n = 19). Enhancing tumors were semi‐automatically segmented on each slice of the postcontrast T1WI to span the entire tumor volume, after registration of T2WI to postcontrast T1WI; 170 radiomic features were extracted from the entire tumor volume. Relevant features were selected and radiomics models were trained using least absolute shrinkage and selection operator (LASSO) logistic regression model with 10‐fold cross‐validation, after subsampling of training sets using synthetic minority over‐sampling technique to mitigate data imbalance. The selected features, weighted by their respective coefficients, were combined linearly to yield a radiomics score. The diagnostic performance of the radiomic score was evaluated using the area under the receiver operating characteristic curve (AUC). Results Six radiomic features, which revealed strong association with HPV status of oropharyngeal SCC, were selected using LASSO. The radiomics model yielded excellent performance on the training set (AUC, 0.982 [95% CI, 0.942–1.000]) and moderate performance on the test set (AUC, 0.744 [95% CI, 0.496–0.991]) for differentiating oropharyngeal SCC according to HPV status. Conclusions Radiomics‐based MRI phenotyping differentiates oropharyngeal SCC according to HPV status, and thus, is a potential imaging biomarker. Level of Evidence 3 Laryngoscope, 131:E851–E856, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.