Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss

xlomafota13 shared this article with you from Inoreader Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss Via JAMA Otolaryngology–Head & Neck Surgery Current Issue The treatment of idiopathic sudden sensorineural hearing loss (SSNHL) continues to be a substantial clinical challenge, in part because of the heterogeneity of the patient population and in part because of the difficulty of studying a disorder with no known causes and no defined, proven, or widely accepted course of clinical intervention. We read with interest the systematic review and meta-analysis by Joshua and colleagues on hyperbaric oxygen therapy (HBOT) for patients with SSNHL. Rhee and colleagues published a review of the same topic i n 2019; however, their conclusions were criticized for significant heterogeneity of the pooled studies, which introduced potentially unsurmountable bias. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of Descending Necrotizing Mediastinitis, a Severe Complication of Deep Neck Infection, Based on Multidisciplinary Approaches and Departmental Co-Ordination

xlomafota13 shared this article with you from Inoreader Management of Descending Necrotizing Mediastinitis, a Severe Complication of Deep Neck Infection, Based on Multidisciplinary Approaches and Departmental Co-Ordination Via ear nose throat Ear Nose Throat J. 2022 Jan 13:1455613211068575. doi: 10.1177/01455613211068575. Online ahead of print. ABSTRACT OBJECTIVES: Descending necrotizing mediastinitis (DNM) developing after deep neck infection (DNI) is a potentially lethal disease of the mediastinum with a mortality rate as high as 40% prior to the 1990s. No standard treatment protocol is available. Here, we present the outcomes of our multidisciplinary approaches for treating DNM originating from a DNI. MET HODS: Between June 2016 and July 2021, there were 390 patients with DNIs admitting to our tertiary hospital. A total 21 patients with DNIs complicated with DNM were enrolled. The multidisciplinary approaches included establishment of airway security, appropriate surgery and antibiotics, extracorporeal membrane oxygenation, and intensive care unit management. The clinical variables were analyzed. RESULTS: Two patients died and 19 survived (mortality 9.5%). The patients who died had a higher mean C-reactive protein (CRP) level than did those who survived (420.0 ± 110.3 vs 221.8 ± 100.6 mg/L) (P = .038). The most common pathogens were Streptococcus constellatus and Streptococcus anginosus. From 2001 to 2021, the average mortality rate of studies enrolling more than 10 patients was 16.1%. CONCLUSION: Multidisciplinary approaches, early comprehensive medical treatment, and co-ordination among departments significantly reduce mortality. Patients with severe inf lammation and high CRP levels require intensive and aggressive interventions. PMID:35023759 | DOI:10.1177/01455613211068575 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of preoperative and postoperative cardiac function in children with adenotonsillar hypertrophy: a prospective cohort study

xlomafota13 shared this article with you from Inoreader Assessment of preoperative and postoperative cardiac function in children with adenotonsillar hypertrophy: a prospective cohort 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. 2022 Jan 12. doi: 10.1007/s00405-022-07255-4. Online ahead of print. ABSTRACT PURPOSE: Chronic upper airway obstruction caused by adenotonsillar hypertrophy is one of the major cause of morbidity in children. It can lead to Obstructive Sleep Apnoea Syndrome, Pulmonary Hypertension, Cor Pulmonale and right heart failure. The study aimed to evaluate and compare various parameters of cardiac function with the help of echocardiography preoperatively and postoperatively in children undergoing adenotonsillectomy. METHODOLOGY: A prospective cohort study was conducted on 23 patients at an apex care institute, under the age group of 4-12 years, who were diagnosed with adenotonsillar hypertrophy. Preoperative symptom analysis and Echocardiographic examination were done. After the assessment, all patients underwent surgery in the form of adenotonsillectomy. Follow-up symptom analysis and echocardiographic examinat ion was done after 3 months postoperatively. RESULTS: Significant improvement in the obstructive symptoms were noted in postoperative group as expected (p = < 0.001) and also in parameters such as mPAP (p = < 0.001), TAPSE (p = < 0.001), TAV (p = 0.001), Ejection fraction (p = 0.027) and RVMPI (p = 0.044) were improved in postoperative group. 4 patients had Grade 1 Right ventricular diastolic dysfunction, which disappeared in three patients postoperatively. CONCLUSION: We have concluded that there can be subclinical cardiac dysfunctions which occurs as a result of chronic upper airway obstruction due to untreated adenotonsillar hypertrophy. Routine cardiac screening in children presenting with sleep disordered breathing associated with adenotonsillar hypertrophy may be helpful in identifying and preventing the development of cardiopulmonary complication. These changes can be reversed by performing adenotonsillectomy. PMID:35022863 | DOI:10.1007/s00405-022-07255-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosis of ulnar nerve entrapment anterior to the medial epicondyle by ultrasound elastography and diffusion tensor imaging with fiber tractography: a case report

xlomafota13 shared this article with you from Inoreader Diagnosis of ulnar nerve entrapment anterior to the medial epicondyle by ultrasound elastography and diffusion tensor imaging with fiber tractography: a case report Via radiol anat Surg Radiol Anat. 2022 Jan 13. doi: 10.1007/s00276-021-02881-9. Online ahead of print. ABSTRACT Ulnar/cubital tunnel syndrome is the second most common compressive neuropathy of the upper limb. Permanent location of the ulnar nerve anterior to the medial epicondyle is extremely rare, with only five cases reported in the literature. Using ultrasound elastography and diffusion tensor imaging with fiber tractography, we diagnosed a case in which ulnar nerve entrapment was assoc iated with anterior nerve location. Surgical release confirmed the diagnosis and the patient was symptom free 3 months after surgery. PMID:35024904 | DOI:10.1007/s00276-021-02881-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative respiratory adverse events in children after endoscopic laryngeal cleft repair

xlomafota13 shared this article with you from Inoreader Postoperative respiratory adverse events in children after endoscopic laryngeal cleft repair 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 13. doi: 10.1007/s00405-021-07250-1. Online ahead of print. ABSTRACT PURPOSE: Due to the serious nature of respiratory adverse events, understanding their incidence can help in decisions regarding safe postoperative disposition. There have been no studies, however, evaluating the risk of postoperative respiratory adverse events (PRAEs) in children undergoing endoscopic laryngeal cleft (LC) repair, which is the primary objective of this study. METHODS: We conducted a retrospective chart review of all patients who underwent LC repair at a large tertiary children's hospital from 2015 to 2020. PRAEs were defined as having at least one of the following: remained intubated, required reintubation, required positive pressure ventilation, required high flow O2 nasal cannula, or required more than one dose of racemic epinephrine. Univariate analyses compared demographic, preoperative character istics, and intraoperative characteristics between those with and without a PRAE. RESULTS: Overall, 8/26 (31%) patients had a PRAE and there were no differences between patients who did and did not have a PRAE and most comorbidities. Younger age (p = 0.03), being male (p = 0.07), and being admitted preoperatively (p = 0.07) were potentially associated with PRAEs. Need for intraoperative intubation for any reason or duration was associated with increased incidence of PRAEs (p = 0.02). CONCLUSION: The overall 31% incidence of postoperative respiratory adverse events reaffirms the appropriateness of PICU disposition for a large proportion of children undergoing endoscopic LC repair. Further studies with increased sample sizes are needed to tease apart patient or procedure-specific factors that significantly increase the risk of respiratory adverse events to have more definitive evidence regarding safe postoperative disposition. PMID:35024957 | DOI:10.1007/s00405-021-07250-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term auditory follow-up in the management of pediatric platinum-induced ototoxicity

xlomafota13 shared this article with you from Inoreader Long-term auditory follow-up in the management of pediatric platinum-induced ototoxicity 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 13. doi: 10.1007/s00405-021-07225-2. Online ahead of print. ABSTRACT PURPOSE: Irreversible bilateral sensorineural hearing loss is a common side effect of platinum compounds. Because of the extended overall survival, a prolonged hearing surveillance and management of hearing impairments are emerging concerns for pediatric oncology. METHODS: In this retrospective observational study, we enrolled 38 children out of 116 treated at our institution by chemotherapy (cisplatin and/or carboplatin) with or without irradiation between 2007 and 2014, submitted to hearing monitoring before every cycle of chemotherapy, and who completed a 5-year long-term audiological follow-up. Chemotherapy regimens, demographic findings, cumulative doses, and cranial irradiation were compared. RESULTS: At the end of 5-year follow-up, ototoxicity was significantly increased compared to that observed at the end of che motherapy (52.5% vs 39.5%, p < 0.001). A late onset of hearing loss was experienced in 13.1% of children, while in 26.3% progressive hearing loss was measured. Deafness at the end of chemotherapy and irradiation were significant prognostic factors for late ototoxicity outcomes (Odds Ratio 7.2-CI 1.67-31.1-p < 0.01 and 5.25-CI 1.26-21.86-p < 0.01 respectively). No significant differences were found between cisplatin and combined treatment (i.e., cisplatin shifted to carboplatin during monitoring for the onset of ototoxicity) and ototoxicity was not associated with platinum compounds cumulative dose (p > 0.05). 13.1% of children needed hearing aids at the end of follow-up. CONCLUSION: Long-term monitoring of at least 5 years prevents the harmful effects of hearing deprivation identifying late onset/progressive hearing loss after platinum compound chemotherapy in children thanks to early hearing rehabilitation, especially in those who underwent multimodal therapy or s ubjected to irradiation. PMID:35024956 | DOI:10.1007/s00405-021-07225-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lenvatinib Plus Anti-PD-1 Combination Therapy for Advanced Cancers: Defining Mechanisms of Resistance in an Inducible Transgenic Model of Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Lenvatinib Plus Anti-PD-1 Combination Therapy for Advanced Cancers: Defining Mechanisms of Resistance in an Inducible Transgenic Model of Thyroid Cancer Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.