Pembrolizumab Induced Acute Persistent Airway Disease in a Patient with Recurrent Respiratory Papillomatosis (RRP)

xlomafota13 shared this article with you from Inoreader Pembrolizumab Induced Acute Persistent Airway Disease in a Patient with Recurrent Respiratory Papillomatosis (RRP) Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 30:34894211021276. doi: 10.1177/00034894211021276. Online ahead of print. ABSTRACT OBJECTIVE: To present an uncommon but serious, recently identified complication of checkpoint inhibitor therapy in a patient treated with pembrolizumab infusion for disseminated recurrent respiratory papillomatosis (RRP). METHODS: Case report. RESULTS: A 43-year-old woman with underlying asthma developed acute hypoxic respiratory failure within 24 hours of her third infusion of pembrolizumab for treatment of intractable, disseminated recurrent respiratory papillomatosis. Pulmonary function testing revealed a severe intra-thoracic obstructive ventilatory defect. Discontinuation of pembrolizumab, ventilatory support, and treatment with systemic and inhaled corticosteroids resulted in resolution of respiratory failure; however, her underlying asthma remains poorly controlled. CONCLUSION: To our knowledge, this case is the first report of pembrolizumab-induced obstructive respiratory failure in a patient being treated for RRP. PMID:34056952 | DOI:10.1177/00034894211021276 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oropharyngeal Carcinoma Treated with Surgery Alone: Outcomes and Predictors of Failure

xlomafota13 shared this article with you from Inoreader Oropharyngeal Carcinoma Treated with Surgery Alone: Outcomes and Predictors of Failure Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 30:34894211021287. doi: 10.1177/00034894211021287. Online ahead of print. ABSTRACT OBJECTIVE: To analyze the oncologic outcomes and risk factors for recurrence in patients who underwent surgery for oropharyngeal squamous cell carcinoma (OPSCC), and in whom adjuvant therapy was not recommended or was declined. METHODS: Retrospective cohort study of patients with OPSCC who were treated with transoral surgery only at a tertiary care acad emic medical center from April 2010 to March 2019. RESULTS: Seventy-four patients met inclusion criteria. In 16, adjuvant therapy was recommended but declined. There were 8 recurrences, of which 6 had been given recommendations for adjuvant therapy. Of the 8 recurrences, 2 died, 2 are alive with disease, and 4 were successfully salvaged. Five patients died of unrelated causes. Lymphovascular invasion (LVI, P = .016) had a significant impact on recurrence, while other pathologic features of the primary tumor such as size, location, human papillomavirus (HPV) status, and margin status did not. Margins were classified as "positive" in 4 patients, "close" in 54, and "negative" in 16. There were 3 local recurrences (4.1%), each of whom had declined adjuvant therapy. Lymph node features such as N-stage (P = .0004), number of positive nodes (P = .0005), and presence of extra-nodal extension (ENE, P = .0042) had a statistically significant impact on relapse . Smoking history and surgical approach showed no significant impact on recurrence. CONCLUSION: Patients who undergo surgery for HPV-positive OPSCC with negative margins, no PNI, no LVI, and ≤1 positive lymph node without ENE have low risk for recurrence. These patients can likely be safely treated with surgery alone. Patients with these risk factors who decline adjuvant therapy are at risk for recurrence, and should be monitored. PMID:34056954 | DOI:10.1177/00034894211021287 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Clinical Study of Platelet-Rich Fibrin Combined With Autologous High-Density Fat Transplantation in Augmentation Rhinoplasty

xlomafota13 shared this article with you from Inoreader A Clinical Study of Platelet-Rich Fibrin Combined With Autologous High-Density Fat Transplantation in Augmentation Rhinoplasty Via ear nose throat Ear Nose Throat J. 2021 May 31:1455613211016902. doi: 10.1177/01455613211016902. Online ahead of print. ABSTRACT OBJECTIVE: This study was designed to analyze the clinical effect of autologous fat-granule transplantation in augmentation rhinoplasty and explore methods to improve the fat retention rate. METHODS: A total of 70 enrolled patients were randomly divided into 2 groups: the platelet-rich fibrin (PRF) combined with high-density fat transplantation group (combin ed group) and the conventional fat-granule transplantation group (control group; n = 35 in each group). In the combined group, an appropriate amount of autologous fat was extracted and centrifuged, and the lower layer of high-density fat was taken and mixed with PRF isolated from whole blood for autotransplantation. In the control group, only fat was extracted and centrifuged for transplantation. The patients were followed up with for more than one year to observe the short- and long-term effects, complications, safety, and patient satisfaction. RESULTS: Six months after the operation, the nasal shape was stable, the contour was higher and more stereoscopic than before, the average increase of nasal height was 3.0 mm in the combined group and 2.0 mm in the control group. No complications, such as fat embolism, infection, or necrosis occurred during the 1-year follow-up. The satisfaction rate between the 2 groups has statistical significance (P < .05). CONCLUSIO N: Overall, PRF combined with autologous high-density fat transplantation is simple to perform, has a significantly increased fat-retention rate than the control group, and has stable long-term effects without obvious adverse reactions. A sufficient amount of fat and PRF transplantation can achieve a good orthopedic effect. Thus, this method can be widely used in clinical augmentation rhinoplasty. PMID:34056945 | DOI:10.1177/01455613211016902 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis

xlomafota13 shared this article with you from Inoreader Butterfly Cartilage Tympanoplasty as an Alternative to Conventional Surgery for Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis Via ear nose throat Ear Nose Throat J. 2021 May 31:1455613211015439. doi: 10.1177/01455613211015439. Online ahead of print. ABSTRACT OBJECTIVE: To compare the effectiveness of butterfly cartilage tympanoplasty (BCT) with that of conventional surgical approaches in the treatment of tympanic membrane perforations. METHODS: A systematic search was performed by screening the PubMed, Embase, and Cochrane Library databases up to October 31, 2020. Two coauthors independently identified studies i n accordance with the selection criteria. Data were pooled and analyzed via Review Manager version 5.3 and Stata version 12.0 software. The postoperative outcomes were measured and expressed as odds ratios (ORs) and standardized mean differences (SMDs). Additionally, heterogeneity was assessed through the I2 statistic. RESULTS: A total of 15 articles were eligible for final inclusion. The OR values for the graft uptake rate, compared to conventional tympanoplasty, were 1.12 (95%CI: 0.56-2.22, I2 = 52%, P = .75) and 1.22 (95%CI: 0.58-2.59, I2 = 0%, P = .60), and the OR compared to fat plug myringoplasty was 3.02 (95%CI: 1.04-8.77, I2 = 0%, P = .04). The qualitative analysis of the hearing results reflected significant postoperative auditory gains with no significant differences between the BCT and control groups, indicating satisfactory and similar postoperative hearing improvement. Mor eover, the operation time was shortened (SMD = -2.19, 95%CI: -2.79 to -1.59, I2 = 82%, P < .05), and the postoperative pain was less with the BCT approach. CONCLUSION: Butterfly cartilage tympanoplasty has satisfactory efficacy in terms of anatomical and functional results in small to medium perforations. It reduces operation time and postoperative pain. However, the effectiveness on large perforation requires further assessment by well-designed studies. PMID:34056940 | DOI:10.1177/01455613211015439 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transnasal Endoscopic Resection of Torus Tubarius Pleomorphic Adenoma

xlomafota13 shared this article with you from Inoreader Transnasal Endoscopic Resection of Torus Tubarius Pleomorphic Adenoma Via ear nose throat Ear Nose Throat J. 2021 May 31:1455613211014113. doi: 10.1177/01455613211014113. Online ahead of print. NO ABSTRACT PMID:34056942 | DOI:10.1177/01455613211014113 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Resection of a Massive Pleomorphic Adenoma of the Nasal Septum

xlomafota13 shared this article with you from Inoreader Endoscopic Resection of a Massive Pleomorphic Adenoma of the Nasal Septum Via ear nose throat Ear Nose Throat J. 2021 May 31:1455613211020972. doi: 10.1177/01455613211020972. Online ahead of print. ABSTRACT Pleomorphic adenoma is a benign tumor that commonly arises from the major salivary glands, such as the parotid and submandibular glands. However, they rarely originate from the nasal cavity. Herein, we describe the case of a 49-year-old woman who presented with nasal obstruction. Preoperative evaluation revealed a giant pleomorphic adenoma attached to the nasal se ptum. Transnasal endoscopic removal was successfully performed using a specimen retrieval bag. We performed an endoscopic complete en-bloc resection of a large pleomorphic adenoma in the nasal cavity, using a specimen retrieval bag. There were no complications seen, no local recurrences after 2 years of follow-up, and the patient satisfaction was high. We therefore recommend that this technique of using specimen retrieval bags can be favorably utilized for endoscopic removal of large nasal tumors like pleomorphic adenoma. PMID:34056943 | DOI:10.1177/01455613211020972 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rate of Submandibular Gland Atrophy Secondary to Chronic Sialolithiasis

xlomafota13 shared this article with you from Inoreader Rate of Submandibular Gland Atrophy Secondary to Chronic Sialolithiasis Via ear nose throat Ear Nose Throat J. 2021 May 31:1455613211021178. doi: 10.1177/01455613211021178. Online ahead of print. ABSTRACT The rate of salivary gland atrophy secondary to chronic obstructive sialolithiasis has not been well-documented. The combination of 5 imaging studies over 12 years in a patient with repeat imaging for an unrelated pathology provides a unique opportunity to assess glandular atrophy over time. We hope that this case will support previous literature with an in vivo r epresentation of the rate of glandular atrophy. PMID:34056944 | DOI:10.1177/01455613211021178 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.