Oral Somatosensory Sensitivity in Patients With Taste Disturbance

xlomafota13 shared this article with you from Inoreader Oral Somatosensory Sensitivity in Patients With Taste Disturbance Via The Laryngoscope Objective The significance of the human sense of taste is typically underestimated until it is altered or even lost. Hypogeusia, a diminished capacity to taste, has an adverse influence on a patient's quality of life. Similar to interactions between the oral senses and between olfaction and intranasal trigeminal sensitivity, taste disturbance may also affect the mechanosensitivity of the tongue. In this study, we investigated the lingual tactile sensitivity of patients with subjective taste disturbance and people with normogeusia. Study Design Prospective case-control study. Methods Forty-six patients with subjective taste disturbance (mean age 60 years) and 43 participants with normogeusia (mean age 55 years) were enrolled and underwent a stereognostic test of edge and point sensitivity based on 3D-printed letters sized from 2 to 8 mm. Gustatory function and salivary production were also tested. Results Patients with dysgeusia needed significantly bigger letters to recognize them compared with controls (P = .01). Apart from this, patients with dysgeusia had no significant association between gustatory function and salivary production. Duration of dysgeusia and age were not associated with the presently obtained measures of gustatory or oral mechanosensory function. Conclusions The results of this study indicate that taste dysfunction has a negative impact on oral mechanosensitivity and hence possibly on oral texture perception. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Development of Sinonasal Outcome Test (SNOT‐22) Domains in Chronic Rhinosinusitis With Nasal Polyps

xlomafota13 shared this article with you from Inoreader Development of Sinonasal Outcome Test (SNOT‐22) Domains in Chronic Rhinosinusitis With Nasal Polyps Via The Laryngoscope Objectives/Hypothesis The 22-item Sinonasal Outcome Test (SNOT-22) is a validated chronic rhinosinusitis health-related quality-of-life outcome (HRQoL) measure; however, SNOT-22 domains have not been validated specifically for chronic rhinosinusitis with nasal polyps (CRSwNP). Study Design Validation of SNOT-22 domain structure, using data from 3 randomized, placebo-controlled, double-blinded, multicenter clinical trials of dupilumab in adults with moderate-to-severe CRSwNP. Methods Preliminary dimensional structure was derived by exploratory factor analyses of SNOT-22 data from a phase 2 trial (NCT01920893) of dupilumab for the treatment of CRSwNP. Data from 2 phase 3 clinical trials (NCT02912468 and NCT02898454) were then used for confirmatory factor analysis, and evaluated for reliability, construct validity, and responsiveness. In all three trials, the SNOT-22 was administered electronically on a tablet and trial participants were required to answer all items. Results Factor analysis supported five domains: Nasal, Ear/Facial, Sleep, Function, and Emotion. Correlations between domains were moderate to high, ranging from 0.53 (Nasal–Emotion) to 0.88 (Function–Sleep). Construct validity was mostly supported; relationships with other measures were almost always in the intended direction and magnitude. Internal consistency reliability also confirmed questionnaire structure with strong Cronbach's alpha values (all >0.80). Moderate-to-high correlations were observed between change in SNOT-22 domain scores and other study patient-reported outcome measures, along with large effect-size estimates (≥0.7), demonstrating responsiveness of the Nasal, Sleep, and Function domains. Emotion and Ear/Facial domains had small-to-moderate effect sizes. Conclusions Psychometric analyses support the validity, reliability, and responsiveness of five domains of SNOT-22 (Nasal, Ear/Facial, Sleep, Function, and Emotion) for assessing symptoms and impact on HRQoL in patients with CRSwNP. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of 18F-FDG PET/CT on Clinical Management of Suspected Radio-Iodine Refractory Differentiated Thyroid Cancer (RAI-R-DTC)

xlomafota13 shared this article with you from Inoreader Impact of 18F-FDG PET/CT on Clinical Management of Suspected Radio-Iodine Refractory Differentiated Thyroid Cancer (RAI-R-DTC) Via radioactive iodine Diagnostics (Basel). 2021 Aug 7;11(8):1430. doi: 10.3390/diagnostics11081430. ABSTRACT BACKGROUND: As reported in the literature, [18F]-fluorodeoxyglucose positron emission tomography/computed tomography ([18F]-FDG PET/CT) provides useful qualitative and semi-quantitative data for the prognosis of advanced differentiated thyroid cancer. Instead, there is a lack of data about the real clinical impact of 18F-FDG PET/CT on the choice of the more effective therapeutic approach for advan ced differentiated thyroid cancer (DTC) that starts to lose iodine avidity. The primary aim of this retrospective study was to assess how 18F-FDG PET/CT can guide the choice of the best therapeutic approach to RAI-refractory DTC (RAI-R-DTC) in patients with a doubtful iodine uptake/negative 18F-FDG PET/CT I whole-body scan after several radioactive iodine therapies (RAIT). The secondary aim was to assess the prognostic role of clinical and semi-quantitative metabolic 18F-FDG PET/CT parameters in comparison to published data. MATERIALS AND METHODS: A monocentric retrospective observational study was performed, reviewing the medical records of 53 patients recruited from a database of 208 patients treated at our Institution between 2011 and 2019, with advanced DTC that underwent FDG PET/CT scan for a suspected RAI-R-DTC. Selected patients had to perform a 18F-FDG PET/CT scan after the second RAIT based on a doubtful iodine uptake/negative 131 I whole-body scan and/or persistent e levated thyroglobulin levels. Metabolic response was defined according to positron emission tomography response criteria in solid tumors (PERCIST) guidelines. Standardized uptake value (SUV)max, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated. The association between metabolic features, clinical parameters and progression free survival (PFS) was assessed applying Kruskal-Wallis, chi-square-Pearson correlation tests, and Cox regression analyses when appropriate. RESULTS: Among our sample of 53 patients (mean age 52.0 ± 19.9 years; 31 women and 22 men), 27 (51.0%) presented a positive 18F-FDG PET/CT scan: 16 (59.0%) underwent watchful waiting, 4 (15.0%) received external-beam radiation therapy (EBRT), 4 (15.0%) underwent surgery, 2 (7.4%) received another course of RAI therapy, and 1 underwent surgery + EBRT. PERCIST response was evaluated in 14/27 patients. Median follow-up was 5.8 ± 3.9 years and median PFS was 38.0 ± 21.8 months. At the last follow-up assessment, 14/53 (26.4%) demonstrated disease progression, 13/53 (24.5) persistence of structural disease, 25/53 (47%) persistence of biochemical disease, and 15/53 (28%) had an excellent response. A significant association was found between therapeutic approach, metabolic response, and final disease response evaluation, as well as a linear correlation between MTV and TLG with thyroglobulin level. CONCLUSIONS: Our Institutional experience confirmed the role of 18F-FDG PET/CT as a useful guide in the clinical management of RAI-R-DTC and obviated further unnecessary RAIT. PMID:34441364 | DOI:10.3390/diagnostics11081430 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Early Predictive Response to Multi-Tyrosine Kinase Inhibitors in Advanced Refractory Radioactive-Iodine Differentiated Thyroid Cancer: A New Challenge for [(18)F]FDG PET/CT

xlomafota13 shared this article with you from Inoreader Early Predictive Response to Multi-Tyrosine Kinase Inhibitors in Advanced Refractory Radioactive-Iodine Differentiated Thyroid Cancer: A New Challenge for [(18)F]FDG PET/CT Via radioactive iodine Diagnostics (Basel). 2021 Aug 5;11(8):1417. doi: 10.3390/diagnostics11081417. ABSTRACT Differentiated thyroid cancer (DTC) represents the most common thyroid cancer histotype. Generally, it exhibits a good prognosis after conventional treatments; nevertheless, about 20% of patients can develop a local recurrence and/or distant metastasis. In one-third of advanced DTC, the metastatic lesions lose the ability to take up iodine and become radioactive iodine-refractory (RAI-R) DTC. In this set of patients, the possibility to perform localized treatments should always be taken into consideration before the initiation of systemic therapy. In the last decade, some multi-tyrosine kinase inhibitor (MKI) drugs were approved for advanced DTC, impacting on patient's survival rate, but at the same time, these therapies have been associated with several adverse events. In this clinical context, the role of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) in the early treatment response to these innovative therapies was investigated, in order to assess the potentiality of this diagnostic tool in the early recognition of non-responders, avoiding unnecessary therapy. Herein, we aimed to present a critical overview about the reliability of [18F]FDG PET/CT in the early predictive response to MKIs in advanced differentiated thyroid cancer. PMID:34441351 | DOI:10.3390/diagnostics11081417 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chimeric Anterolateral Thigh Flap in Skull Base Reconstruction: A Case-Based Update and Literature Review

xlomafota13 shared this article with you from Inoreader Chimeric Anterolateral Thigh Flap in Skull Base Reconstruction: A Case-Based Update and Literature Review Via leak of cerebrospinal fluid Brain Sci. 2021 Aug 17;11(8):1076. doi: 10.3390/brainsci11081076. ABSTRACT Oncologic and traumatic neurosurgery may have to cope with the issue of skull base defects, which are associated with increased risk of meningitis, epidural abscess and cerebro-spinal fluid (CSF) leak. The aim of skull base reconstruction is to repair the dural exposure and to separate the intracranial contents from the nonsterile sino-nasal cavities and extracranial space. Currently, many different surgical techniques have been described, and one of the most performed is the use free flap. In the present paper we performed a case-based update and literature review of the use of chimeric anterolateral thigh free flap harvested from rectus femoris, reporting the case of a 68-year-old man with recurrent spheno-ethmoidalis plane meningioma. PMID:34439694 | DOI:10.3390/brainsci11081076 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ototoxicity and Teprotumumab

xlomafota13 shared this article with you from Inoreader Ototoxicity and Teprotumumab Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 27:34894211042740. doi: 10.1177/00034894211042740. Online ahead of print. ABSTRACT OBJECTIVES: Teprotumumab, a novel monoclonal antibody, targets the insulin-like growth factor 1 (IGF-1) receptor. IGF-1 receptors, found in muscle and fat adjacent to the eye and implicated in Graves Ophthalmopathy, are also in the cochlea. In clinical trials, 5 participants reported self-limited audiologic symptoms but there are no objective data in the lite rature. The aim of this report is to describe one of the first known cases of teprotumumab-induced irreversible sensorineural hearing loss. METHODS: Case report at a tertiary referral center. RESULTS: A 61 year old female with Graves ophthalmopathy presented with bilateral hearing loss, sound distortion, and tinnitus following treatment with teprotumumab. Audiogram showed mild sloping to moderately-severe sensorineural hearing loss. Repeat audiometry obtained 4 months after cessation of teprotumumab and treatment with oral corticosteroids was unchanged. CONCLUSIONS: This is one of the first descriptive cases of ototoxicity resulting in irreversible sensorineural hearing loss in the setting of treatment with teprotumumab. Periodic audiologic evaluations should be recommended to patients on teprotumumab. PMID:34448414 | DOI:10.1177/00034894211042740 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Case of Melkersson-Rosenthal Syndrome Treated With 5-FU

xlomafota13 shared this article with you from Inoreader A Case of Melkersson-Rosenthal Syndrome Treated With 5-FU Via ear nose throat Ear Nose Throat J. 2021 Aug 27:1455613211038391. doi: 10.1177/01455613211038391. Online ahead of print. ABSTRACT The rarity of Melkersson-Rosenthal syndrome, or orofacial granulomatosis, can present with persistent midface bogginess. The management for previous reported cases has included corticosteroid injections, antihistamines, and antibiotics. In the current reported case, the patient was treated with 5-fluorouracil and has been responding positively. Additionally, the p atient has not shown signs of steroid atrophy. PMID:34448401 | DOI:10.1177/01455613211038391 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.