Pneumolabyrinth: a systematic review

xlomafota13 shared this article with you from Inoreader Pneumolabyrinth: 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 Apr 21. doi: 10.1007/s00405-021-06827-0. Online ahead of print. ABSTRACT PURPOSE: The aim of this study is to provide a systematic review of the literature about the etiology, clinical and radiological presentation, surgical management, and outcomes of pneumolabyrinth (PNL). METHODS: A systematic review of the literature was performed including studies published up to September 2020 in electronic databases (PubMed/MEDLINE, EMBASE, Cochrane Library, and Scopus). The PRISMA standard was applied to identify English, Italian, or French-language studies mentioning PNL. Full texts lacking information on the etiology were excluded. Data concerning the cause, site of air bubbles/fistula, clinical presentation, treatment, and outcome were collected. A qualitative synthesis of the results was performed. RESULTS: Seventy-eight articles were eventually included; 132 patients were involved in the qualitat ive synthesis. The most common causes were: stapes surgery (24/132, 18.2%), temporal bone fracture (42/132, 31.8%), head trauma without temporal bone fracture (19/132, 14.4%), penetrating trauma (21/132, 15.9%), and barotrauma (15/132, 11.4%). The site most commonly involved was the vestibule (102/107, 95.3%), followed by cochlea (43/107, 40.2%) and semicircular canals (25/107, 23.4%). CONCLUSION: The etiopathogenesis of PNL can be summarized in traumatic, iatrogenic, or inflammatory/infective. Its management consists in exploratory tympanotomy and sealing the fistula, but also conservative treatments can be attempted. Vestibular symptoms disappear in the majority of cases. Instead, the prognosis of hearing function is widely variable, and complete recovery is less probable. The certainty of evidence is still too low to make it useful for clinical decision-making. PMID:33881577 | DOI:10.1007/s00405-021-06827-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Functional and oncological outcomes of salvage transoral robotic surgery: a comparative study

xlomafota13 shared this article with you from Inoreader Functional and oncological outcomes of salvage transoral robotic surgery: a comparative study 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 Apr 20. doi: 10.1007/s00405-021-06812-7. Online ahead of print. ABSTRACT PURPOSE: Transoral robotic surgery (TORS) as a first-line therapy has been well-documented but evidence is missing regarding salvage therapy. The aim of this study is to compare the oncological and functional outcomes of TORS as a primary and salvage therapy. METHODS: This retrospective monocentric study included 74 patients operated by a single surgeon and sorted out into two groups: primary treatment (PT) or Salvage treatment (ST) in case of previous history of radiation therapy. Patients were further stratified by tumour location: larynx and pharynx (lST vs lPT and pST vs pPT). RESULTS: Forty-eight patients were included in PT group (64.9%) and 26 in ST group (35.1%). ST patients had more frequent cTis/T1 tumours (57.7% vs 29.2%, p = 0.0164) and no clinical lymph disease (3.8% vs 37.5%, p = 0.0016). Tracheostomy was m ore often performed in the ST group (57.7% vs 16.7%, p = 0.0003) and the lST subgroup (88.9% vs 9.1%, p < 0.0001). Gastric feeding tube placement was more frequent in the ST group (76.9% vs 33.3%, p = 0.0003), the pST subgroup (64.7% vs 15.4%, p = 0.0009) and the lST subgroup (100% vs 54.5%, p = 0.0297). We observed a trend for more postoperative complications in the ST group (69.2% vs 47.9%, p = 0.0783). The overall survival was lower in the ST group (p = 0.0004), and in the pST subgroup (p < 0.0001). The disease-free survival rate was lower in the ST group (p = 0.0001), the pST subgroup (p = 0.0002) and the lST subgroup (p = 0.0328). CONCLUSION: This study confirms that survival and functional outcomes after salvage TORS are worse than in first line surgery. PMID:33880636 | DOI:10.1007/s00405-021-06812-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Treatment of Esophageal Achalasia in the Era of Minimally Invasive Surgery

xlomafota13 shared this article with you from Inoreader Surgical Treatment of Esophageal Achalasia in the Era of Minimally Invasive Surgery Via Traditional dysphagia therapy JSLS. 2021 Jan-Mar;25(1):e2020.00099. doi: 10.4293/JSLS.2020.00099. ABSTRACT INTRODUCTION: We have analyzed the short- and long-term results of various surgical therapies for achalasia, especially changes in postoperative esophageal function. PATIENTS AND METHODS: Between January 1, 2008 and December 31, 2017, 54 patients with esophageal achalasia were treated in our institution. Patients scheduled for surgery underwent a comprehensive gastroenterological assessment pre- and post-surgery. Forty-eight of the elective cases involved a laparoscopic cardiomyotomy with Dor's semifundoplication, while two cases entailed an esophageal resection with an intrathoracic gastric replacement for end-stage achalasia. Torek's operation was performed on two patients for iatrogenic esophageal perforation, and two others underwent primary suture repair with Heller-Dor surgery as an emergency procedure. The results of the different surgical treatments, as well as changes in the patients' pre- and post-operative complaints were evaluated. RESULTS: No intra-operative complications were observed, and no mortalities resulted. During the 12 to 24-month follow-up period, recurrent dysphagia was observed mostly in the spastic group (TIII: 33%; diffuse esophageal spasm: 60%), while its occurrence in the TI type did not change significantly (14.5%-20.8%). As a result of the follow-up of more than two years, good symptom control was achieved in 93.7% of the patients, with only four patients (8.3%) developing postoperative reflux. CONCLUSIONS: The laparoscopic Heller-Dor procedure provides satisfactory long-term results with low morbidity. In emergency and advanced cases, traditional surgical procedures are still the recommended therapy. PMID:33879995 | PMC:PMC8035823 | DOI:10.4293/JSLS.2020.00099 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Osseous Choristoma of the Tongue: A Case Report

xlomafota13 shared this article with you from Inoreader Osseous Choristoma of the Tongue: A Case Report Via Otolaryngology Indian Abstract We report a case of a 40-year-old Japanese woman with a benign tongue tumor diagnosed as osseous choristoma of the tongue. Resection of the tongue tumor was performed under general anesthesia. The gross examination of the resected specimen showed a bone-like mass measuring 5 × 5 × 3 mm, surrounded by soft tissue. Based on the findings, a histopathological diagnosis of osseous choristoma was established. There was no evidence of tumor recurrence or distant metastasis during the 3-year follow-up. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The anconeus muscle revisited: double innervation pattern and its clinical implications

xlomafota13 shared this article with you from Inoreader The anconeus muscle revisited: double innervation pattern and its clinical implications Via radiol anat Surg Radiol Anat. 2021 Apr 21. doi: 10.1007/s00276-021-02750-5. Online ahead of print. ABSTRACT PURPOSE: The aim of the present study is to describe in detail the morphology and innervation pattern of the anconeus muscle, bearing in mind clinical implications such as iatrogenic injuries during surgical elbow approaches. METHODS: A cadaveric study was performed; 56 elbows from 28 formalin-fixed cadavers belonging to the Anatomy Department of Universidad Complutense of M adrid were dissected. The triceps-anconeus nerve was located and dissected. A second innervation to the anconeus muscle from a branch of the posterior interosseous nerve (PIN) was occasionally detected. Taking the lateral epicondyle as a landmark, the entry points of both nerves in the muscle were referenced, the triceps-anconeus nerve was referenced at 0°, 30°, 45°, 70° and 90° of elbow flexion, and the PIN branch at 0°. RESULTS: Anconeus muscle was present in all specimens. The triceps-anconeus nerve was present in all of the dissected elbows. A branch from PIN to the anconeus muscle was present in 38 of the 54 elbows (70.4%). There were statistically significant differences in all measurements regarding the specimens' gender, being higher for men. CONCLUSIONS: There is evidence of a high frequency of a double innervation pattern for the anconeus muscle: the main branch of triceps-anconeus muscle depending on the radial nerve, which is liable to being damaged dur ing posterior elbow approaches, and a secondary branch depending on the PIN. There are very few references to this finding in Anatomical literature and none with such a large sample size. PMID:33881559 | DOI:10.1007/s00276-021-02750-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Direct N-butyl-2-cyanoacrylate injections to the head and neck for percutaneous embolized devascularization

xlomafota13 shared this article with you from Inoreader Direct N-butyl-2-cyanoacrylate injections to the head and neck for percutaneous embolized devascularization Via leak of cerebrospinal fluid Surg Neurol Int. 2021 Mar 30;12:131. doi: 10.25259/SNI_154_2021. eCollection 2021. ABSTRACT BACKGROUND: N-butyl-2-cyanoacrylate (NBCA) has been used for vascular malformations since the 1980s; however, few studies have looked at applications, procedural techniques, and outcome throughout many institutions. Herein, we review applications, procedural techniques, previous literature, and outcomes for the use of NBCA specifically through percutaneous technique in treating head and neck vascular pathology. METHODS: An extensive literature review using PubMed database with published literature containing "N-butyl-2-cyanoacrylate embolization," was performed. No date restrictions were used. Cross-checking of articles was conducted to exclude duplicate articles. The articles were screened for their full text and English language availability. We finalized those articles pertaining to the topic. RESULTS: The search yielded 1124 related art icles. When comparing surgical resection to embolization with NBCA for cerebral AVMs, complications were similar in both groups and included hemorrhage (15%), residual AVM (6%), and cerebrospinal fluid leak (3%). Their mortality rate was 3% in both groups. Preoperative percutaneous embolization does show improved surgical outcomes. CONCLUSION: NBCA is a fast-acting liquid embolic material used in the treatment of a variety of vascular malformations and lesions of the head and neck. Investigations surrounding the use of NBCA injections as a new alternative embolic agent began in the 1980's. Administration of NBCA has been shown to be useful in minimizing intraoperative blood loss and controlling acute hemorrhage. Performing percutaneous embolization with NBCA provides a successful alternative for surgeons when transcatheter embolization techniques may prove to be too difficult to perform. Embolization using NBCA will continue to play in integral role in the treatment of maligna nt lesions and vascular malformations. Continued research is warranted to improve safety, outcomes, and further develop clinical applications of NBCA. PMID:33880236 | PMC:PMC8053456 | DOI:10.25259/SNI_154_2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Percutaneous fetoscopic spina bifida repair: effect on need for postnatal cerebrospinal fluid diversion, ambulation and bladder catheterization

xlomafota13 shared this article with you from Inoreader Percutaneous fetoscopic spina bifida repair: effect on need for postnatal cerebrospinal fluid diversion, ambulation and bladder catheterization Via leak of cerebrospinal fluid Ultrasound Obstet Gynecol. 2021 Apr 20. doi: 10.1002/uog.23658. Online ahead of print. ABSTRACT BACKGROUND: A trial comparing prenatal with postnatal open spina bifida (OSB) repair established that prenatal surgery was associated with better postnatal outcome. However, in the trial the fetal surgery was carried out through hysterotomy. Minimally invasive approaches are being developed to mitigate the risks of open maternal fetal surgery. OBJECTIVE: To investigate the impact of a novel neurosurgical technique for repair of feta; OSB, the skin-over-biocellulose for antenatal fetoscopic repair (SAFER) via percutaneous fetoscopy, on long-term postnatal outcomes. STUDY DESIGN: Descriptive data for all patients undergoing fetoscopic OSB repair and available 12- and 30-month follow-up for assessment of need for cerebrospinal fluid (CSF) diversion and bladder catheterization and ambulation, respectively. A total of 170 consecutive patient s were treated prenatally at eight centers via percutaneous fetoscopic OSB repair using a biocellulose patch between the neural placode and skin/myofascial flap, without suture of the duramater. A total of 103 babies had follow-up at 12 months of age and 59 had follow-up at 30 months of age. Univariate and multivariate logistic regression analysis was used to examine the effect on CSF diversion at 12 months, and ambulation and bladder catheterization at 30 months. Potential co-factors were gestational age at fetal surgery and delivery, preoperative ultrasound findings of anatomical level of the lesion, cerebral lateral ventricle diameter, lesion type and presence of bilateral talipes, as well as postnatal findings of CSF leak at birth, motor level, bilateral talipes and reversal of hindbrain herniation. Significance was set at p<0.05. RESULTS: At 12-months of age 53.4% (55/103) of babies did not require ventriculoperitoneal shunt or third ventriculostomy. At 30-months of ag e, 54.2% (32/59) of the children were ambulating independently and 61% (36/59) did not require chronic intermittent catheterization of the bladder. Multiple logistic regression analysis demonstrated that significant prediction for CSF diversion was provided by anatomical and functional motor level of the lesion, lateral ventricle size and type of lesion (myeloschisis). Significant predictors of ambulatory status were prenatal bilateral talipes and anatomical and functional motor level of the lesion. There were no significant predictors for the need of bladder catheterization. CONCLUSION: Children that underwent prenatal OSB repair via the percutaneous fetoscopic SAFER technique achieved long-term neurological outcomes similar to those reported in the literature after hysterotomy-assisted OSB repair. This article is protected by copyright. All rights reserved. PMID:33880811 | DOI:10.1002/uog.23658 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.