Application of computed tomography angiography-assisted classification of arterial branches in the first web space of the foot for thumb reconstruction

xlomafota13 shared this article with you from Inoreader Application of computed tomography angiography-assisted classification of arterial branches in the first web space of the foot for thumb reconstruction Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jan 10:S1748-6815(21)00034-6. doi: 10.1016/j.bjps.2020.12.100. Online ahead of print. ABSTRACT BACKGROUND: Computed tomography angiography (CTA) has become a widely used imaging modality in vascular surgery. The first web arterial branches of the foot are significant for surgical planning of the donor site for thumb reconstruction. METHODS: We retrospectively analysed 30 thumb reconstructions with free second toe/great toe wrap-around flap transfer, performed between January 2016 and January 2019. The mean patient age was 30 (2-45) years. The causes of hand injury were: 20 machine strangulation injuries, 6 heavy weight smash injuries, and 4 crush injuries. Patients with iodine allergy were excluded preoperatively. We evaluated the effectiveness of CTA in visualizing first web arterial branches and compared it with intraoperative findings. Surgical plan for donor sites was prepared based on the classification of the first web arterial branches. RESULTS: The arterial branches of the patients were classified based on CTA findings as follows: (1) fork type: 24 patients (48 feet, 80%); (2) main trunk type: four patients (8 feet, 13.33%); and (3) side branch type: one patient (2 feet, 3.33%). One case of poor vascular continuity and artifacts in CTA underwent thumb reconstruction with free great toe wrap-around flap transfer. Tissue survival was achieved in all reconstructed thumbs. During the follow-up period (average, 12 months), all reconstructed thumbs exhibited good outcomes. The donor sites on the feet of all patients recovered well. CONCLUSION: CTA allows preoperative assessment of blood supply and planning of donor site. Our results can serve as a reference for surgical planning of the donor site while reducing the occurrence of adverse events. PMID:33648867 | DOI:10.1016/j.bjps.2020.12.100 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sublesional Bevacizumab Injection for Recurrent Respiratory Papillomatosis: Evaluation of Utility in a Typical Clinical Practice

xlomafota13 shared this article with you from Inoreader Sublesional Bevacizumab Injection for Recurrent Respiratory Papillomatosis: Evaluation of Utility in a Typical Clinical Practice Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 1:3489421998215. doi: 10.1177/0003489421998215. Online ahead of print. ABSTRACT OBJECTIVES: The goal of this study was to evaluate the benefit of sublesional bevacizumab injection for recurrent respiratory papillomatosis (RRP) as used in a typical clinical practice. METHODS: A retrospective review of patients with RRP treated between 2011 and 2016 was undertaken. All patients were treated with in-office potassium titanyl phosphate (KT P) laser photoablation. Sublesional bevacizumab injection was used based on joint patient-physician decision making. Papilloma burden was objectively measured on prior recordings by 2 blinded reviewers and described as vocal fold segments affected (VFSA) by papilloma. Each patient served as their own control by comparing times when bevacizumab was or was not used. Mixed model for longitudinal data was used to determine if the previous use of bevacizumab decreased the disease burden. RESULTS: A total of 19 patients met inclusion criteria and all prior laryngoscopic exams were reviewed for VFSA as described above. The mean (SD) number of VFSA when bevacizumab was not used at the prior procedure was 15 (14) as compared to 8 (11) when bevacizumab was used. When adjusted for age, time from initial presentation and baseline disease burden, mixed model showed a decrease of 11 VFSA (95% CI 6.5, 15.5, P < .0001) when bevacizumab was used as compared to when bevacizumab was no t used at the prior procedure. In mixed model analysis, there was not a significant association between bevacizumab dose used and VFSA at the subsequent visit (P = .8). CONCLUSION: Using sublesional bevacizumab intermittently based on clinical findings appears to be effective in improving disease control. Papilloma burden is significantly decreased at the subsequent clinical follow-up following injection of sublesional bevacizumab. The beneficial effect of sublesional bevacizumab may be not be dose-dependent. PMID:33648353 | DOI:10.1177/0003489421998215 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Speech therapy in head and neck cancer

xlomafota13 shared this article with you from Inoreader Speech therapy in head and neck cancer Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00019-7. doi: 10.1016/j.bjorl.2021.02.002. Online ahead of print. NO ABSTRACT PMID:33648852 | DOI:10.1016/j.bjorl.2021.02.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Otological Assessment in Head Injury Patients: A Prospective Study and Review of Literature

xlomafota13 shared this article with you from Inoreader Otological Assessment in Head Injury Patients: A Prospective Study and Review of Literature Via Otolaryngology Indian Abstract Head injuries constitute a tragic problem invariably in under-developed, developed and developing countries. The concomitant otological injuries often go unnoticed. The purpose of this study was to assess the various otological manifestations following head injuries. Prospective study with review of literature using PubMed database was done. All the patients were evaluated for their presenting symptoms and signs. Audiological investigations including PTA (Pure tone audiometry), OAE (Otoacoustic emission), Impedance-Audiometry and BERA were done. HRCT temporal bone was advised in cases of suspicion. Relevant literature was reviewed to calculate the pooled prevalence rates. Random-effects model to synthesize overall effects was used. Heterogeneity was evaluated with the I2 statistic. Of 53 patients enrolled in the study, RTA was the most common mode of injury. The audiometric findings showed SNHL, CHL and mixed HL in 34, 20 and 18% of patients respective ly. HRCT showed Longitudinal fracture (n = 17; 53.12%); isolated mastoid bone fracture (n = 9; 28.12%), transverse (n = 3; 9.37%) and isolated EAC fracture in (n = 3; 9.37%) patients. The pooled prevalence (n = 1106 patients) of SNHL, CHL, Mixed HL and Normal hearing were—35% (95%CI, 18–55%; I2 = 95.20%; P < 0.00), 24% (95%CI, 16–33%; I2 = 80.01%; P < 0.00), 15%(95%CI, 9–23%; I2 = 79.64%; P < 0.00) and 30% (95%CI, 3–66%; I2 = 98.71%; P < 0.00) respectively. The pooled prevalence (n = 4191 patients) of longitudinal, Transverse, mixed and other fractures were—44% (95%CI, 3–66%;I2 = 99.48%; P < 0.00), 9% (95% CI, 4–16%; I2 = 95.95%; P < 0.00), 4% (95%CI, 1–8%; I2 = 94.13%; P < 0.00) and 1% (95%CI, 0–4%; I2 = 90.37% ; P < 0.00) respectively. In patients with head injury coordination between the trauma-surgeon, neurosurgeon and otologist is must to improve the long-term outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic obstructive Eustachian tube dysfunction: CT assessment with Valsalva maneuver and ETS-7 score

xlomafota13 shared this article with you from Inoreader Chronic obstructive Eustachian tube dysfunction: CT assessment with Valsalva maneuver and ETS-7 score Via Ear infections by Diletta Angeletti, Annalisa Pace, Giannicola Iannella, Valeria Rossetti, Andrea Colizza, Irene Claudia Visconti, Giampiero Gulotta, Daniela Messineo, Marco de Vincentiis, Antonio Greco, Ferdinando D'Ambrosio, Giuseppe Magliulo Chronic obstructive Eustachian tube dysfunction (ETD) is a common disorder of the middle ear. In recent years, two main diagnostic tools have become available: Eustachian tube score (ETS-7) and computed tomography (CT) combined with Valsalva maneuver. The aim of this study is to evaluate the outcomes of ETS-7 and CT in a group of patients affected by middle ear atelectasis with a strong suspicion of ETD. Three males and nine females, affected by middle ear atelectasis with retraction of the TM were enrolled. Each patient underwent to Eustachian tube dysfunction evaluation adopting the ETS-7 score and a temporal bone CT with Valsalva maneuver. The ears analyzed at steady state were divided into 2 groups: ETS View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015–2016)

xlomafota13 shared this article with you from Inoreader Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015–2016) Via Tinnitus by Jannike H-L Ausland, Bo Engdahl, Bente Oftedal, Ólöf A. Steingrímsdóttir, Christopher S. Nielsen, Laila A. Hopstock, Magnar Johnsen, Oddgeir Friborg, Jan H. Rosenvinge, Anne E. Eggen, Norun H. Krog Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, an d tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in ti nnitus patients to provide a more comprehensive treatment of tinnitus. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Topical ciprofloxacin as treatment for rhinoscleroma in a series of 23 patients

xlomafota13 shared this article with you from Inoreader Topical ciprofloxacin as treatment for rhinoscleroma in a series of 23 patients Via Clinical Otolaryngology Abstract There is no current consensus on treatment of rhinoscleroma, with no treatment shown to achieve reliable long‐term cure of the disease. Oral ciprofloxacin for three months is currently one of the most favored options for treatment of rhinoscleroma. In a series of 23 patients, Topical ciprofloxacin was investigated as a novel option for treatment of rhinoscleroma and was found to be effective in treating the disease in all patients after 12‐24 weeks. However, 5 cases of recurrence were encountered between 12‐18 months after end of treatment. Topical treatment with ciprofloxacin in cases of rhinoscleroma limited to the nose may be preferable to systemic treatment, with similar efficacy and lower risk of side effects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.