Extra-oral cause of restricted mouth opening in the oncology setting.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 13;
Authors: Satheeshkumar PS
PMID: 26682519 [PubMed - as supplied by publisher]
Molar root-incisor malformation: considerations of diverse developmental and etiologic factors.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Sep 28;
Authors: Wright JT, Curran A, Kim KJ, Yang YM, Nam SH, Shin TJ, Hyun HK, Kim YJ, Lee SH, Kim JW
Abstract
OBJECTIVE: The objective of this study was to evaluate the variation in the condition referred to as molar root-incisor malformation (MRIM) and elucidate the distribution of affected teeth. This study further aimed to identify associated environmental stressors.
STUDY DESIGN: Individuals were identified through retrospective review of dental radiographs and through referral to the investigators. Histologic evaluation included examination of mineralized and decalcified sections of affected first permanent molar teeth.
RESULTS: Thirty cases of MRIM were identified, with all having affected first permanent molars with dysplastic root formation. The primary second molars were affected in 57% of the cases, with permanent anterior teeth being involved in 40% of the cases. A variety of medical conditions were associated with MRIM, the most common being neurologic. Several affected individuals reported no significant past medical history or environmental stressors.
CONCLUSIONS: The etiology of MRIM remains unclear, and this unique developmental defect of the first permanent molar roots appears to occur in populations throughout the world. Clinicians identifying the MRIM phenotype should carefully evaluate the permanent incisors for associated developmental defects that could result in pulpal necrosis.
PMID: 26682518 [PubMed - as supplied by publisher]
Postradiation trismus and its impact on quality of life in patients with head and neck cancer: a commentary.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Dec 9;
Authors: Bansal D, Vineetha R, Pai KM
PMID: 26682517 [PubMed - as supplied by publisher]
Clinicopathologic features, microvessel density, and immunohistochemical expression of ICAM-1 and VEGF in 15 cases of secondary syphilis with oral manifestations.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 13;
Authors: Pires FR, da Silva PJ, Natal RF, Alves FA, Pinto CA, Rumayor A, Miranda ÁM, de Almeida OP
Abstract
BACKGROUND: Several studies have reported the clinical aspects of oral syphilis, but few papers have considered the involved immunoinflammatory mechanisms.
OBJECTIVE: To analyze the clinicopathologic features and expression of immunoinflammatory and vascular proteins in oral secondary syphilis.
STUDY DESIGN: Fifteen patients with oral secondary syphilis were included; histologic features were analyzed using hematoxylin-eosin-stained histologic slides and immunohistochemical reactions were performed against intercellular adhesion molecule 1 (ICAM-1), vascular endothelial growth factor (VEGF), and CD34.
RESULTS: Lesions presented as multiple plaques and ulcers mostly located on the tongue, lips, and palate. They were covered by a stratified epithelium of irregular thickness showing exocytosis associated with a subjacent plasma cell infiltrate arranged in perivascular and perineural patterns. ICAM-1 and VEGF were expressed on endothelial cells and leukocytes, and microvessel density was similar on the superficial and deep regions of the connective tissue.
CONCLUSIONS: Expression of immunoinflammatory and vascular proteins was intense, suggesting their participation on the pathogenesis of oral secondary syphilis.
PMID: 26682516 [PubMed - as supplied by publisher]
Massive enlargement of the anterior mandible.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct 13;
Authors: Betz SJ, Green PT, Madden RN, Blakey GH, Padilla RJ
PMID: 26682515 [PubMed - as supplied by publisher]
Non-linear difference imaging approach to three-dimensional electrical impedance tomography in the presence of geometric modeling errors.
IEEE Trans Biomed Eng. 2015 Dec 17;
Authors: Liu D, Kolehmainen V, Siltanen S, Laukkanen AM, Seppanen A
Abstract
OBJECTIVE: To evaluate the recently proposed nonlinear difference imaging approach to electrical impedance tomography (EIT) in realistic 3D geometries.
METHODS: In this paper, the feasibility of non-linear difference approach based EIT is tested using simulation studies in 3D geometries of thorax and larynx, and with an experimental study of a thorax shaped water tank. All test cases exhibit severe modeling errors due to uncertainty in the boundary shape of the body.
RESULTS: In all test cases, the conductivity change reconstructed with non-linear difference imaging outperforms the conventional reconstructions qualitatively and quantitatively.
CONCLUSION: The results demonstrate that the non-linear difference reconstructions tolerate geometrical modeling errors at least to the same extent as the conventional linear approach and produce quantitatively more accurate information on the conductivity change.
SIGNIFICANCE: Physiological processes that produce changes in the electrical conductivity of the body can be monitored with difference imaging based on EIT. The wide popularity of linearized difference imaging in EIT is mainly based on its good tolerance for the ubiquitous modeling errors, which are predominantly caused by inexact knowledge of the body geometry. However, the linearized difference imaging produces only qualitative information on the conductivity change, and the feasibility of the estimates also depends on the selection of the linearizion point which ideally should be equal to the conductivity of the initial state. Based on the findings of this paper, these problems can be avoided by non-linear difference imaging, and potentially the approach can enable quantitative imaging of conductivity change in medical applications.
PMID: 26685224 [PubMed - as supplied by publisher]
A comparison of the Miller laryngoscope versus the prototype neonatal offset-blade laryngoscope in a manikin.
Anaesthesia. 2015 Dec 18;
Authors: Doreswamy SM, Fusch C, Selvaganapathy R, Matharoo H, Shivananda S
Abstract
Laryngoscope blades used to intubate newborn babies are relatively bulky and frequently exert high pressure on the upper jaw. We tested a prototype neonatal offset-blade laryngoscope (NOBL) developed to overcome these limitations. Our aims were to compare the pressure on the upper jaw exerted by a size 0 Miller laryngoscope and the NOBL on a neonatal manikin, as well as the time taken to intubate the trachea and the area of view of the larynx. Twenty healthcare professionals with more than five years of experience in neonatal intensive care took part; the findings were assessed using pressure-sensitive film and photographs. High-pressure indentation occurred in 17 (85%) attempts using the Miller versus 1 (5%) using the NOBL (p = 0.0001). The median (IQR [range]) pressure exerted with the Miller laryngoscope was 455 (350-526 [75-650]) kPa vs 80 (0-133 [0-195]) kPa with the NOBL (p < 0.0001). The area of pressure exerted with the Miller laryngoscope was 68 (32-82 [0-110]) mm(2) vs 8 (0-23 [0-40]) mm(2) with the NOBL (p < 0.0001). The time to intubate was 8.3 (7.3-10.1[4-19]) s for the Miller and 8.0 (5.6-9.6 [4-13.5]) s for the NOBL (p < 0.0001). The area of view blocked by the Miller laryngoscope was 38% of the oral orifice versus 12% with the NOBL. We conclude that the NOBL significantly reduced undesired pressure on the upper jaw during tracheal intubation and improved the view of the larynx compared with a conventional laryngoscope.
PMID: 26685066 [PubMed - as supplied by publisher]
Comparison of three different concurrent chemoradiation regimens for treatment of laryngeal cancer.
Eur Arch Otorhinolaryngol. 2015 Dec 18;
Authors: Aydil U, Akmansu M, Gumusay Ö, Bakkal FK, Yazıcı Ö, Kızıl Y, Köybaşıoğlu A, Yıldız R, Büyükberber S, İnal E
Abstract
During last decades, laryngeal organ preservation strategies have emerged. The data about the oncological outcomes mainly come from multi-institutional prospective studies. In this study, we aimed to determine the oncological outcomes of different organ preservation regimens applied in routine practice. Patients who had definitive concurrent chemoradiation (CRT) for treatment of laryngeal cancer between January 2001 and June 2013 were retrospectively reviewed. There were 139 subjects who met the inclusion criteria. Three groups were defined: group A (n = 59) consisted of subjects who had concurrent cisplatin and radiotherapy (RT), group B (n = 47) consisted of subjects who had cisplatin/docetaxel-based concurrent CRT, and group C (n = 33) had induction chemotherapy before concurrent cisplatin and RT. The Kaplan-Meier estimated 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence-free survival (LRFS) rates for the whole study group were 66.5, 69.2, 69.6, and 88.9 %, respectively. None of these survival rates were statistically different when the treatment arms were compared. The 3- and 5-year LRFS rates were significantly lower in subjects with a T4a tumor (p = 0.030). According to our results, the oncological outcomes of three different platinum-based concurrent chemotherapy schemes were similar and high local control rates could be achieved with the use of these protocols. Neoadjuvant chemotherapy before concurrent CRT was not superior to conventional concurrent treatment.
PMID: 26683470 [PubMed - as supplied by publisher]
Angioleiomyoma of the larynx: beware the subglottic lesion.
BMJ Case Rep. 2015;2015
Authors: Hope N, Smith CP, McCluney N
Abstract
Angioleiomyomas are a benign group of tumours rarely documented in the head and neck region. We present a case of a 47-year-old man attending the ear, nose and throat outpatient clinic, with a history of hoarseness over many years. Investigation revealed a left-sided subglottic lesion. He underwent microlaryngoscopy and biopsy, and the lesion was sent for histological analysis. Postoperatively, the patient began to expectorate fresh red blood that continued for several hours, requiring surgical intervention. Haemostatic control was achieved and a tracheostomy was sited for airway protection. Histopathology identified angioleiomyoma as the cause of his symptoms. Following multidisciplinary team discussion, this was managed with injection of bleomycin and subsequent surgical excision. This case is a reminder that subglottic lesions are often vascular in nature, and should be investigated with imaging and angiography prior to surgery, to avoid complications.
PMID: 26682845 [PubMed - as supplied by publisher]
Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo.
ORL J Otorhinolaryngol Relat Spec. 2015 Dec 19;78(1):36-45
Authors: Tian L, Wang J, Sheng HB, Luo X, Yu J, Jia XH, Cheng X, Han Z, Chi FL
Abstract
AIMS: This study aims to investigate the roles of the number of accelerations and rotation angle in the treatment of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV).
METHODS: We enrolled 344 patients with unilateral PC-BPPV. Of these, 167 patients in the simple-step maneuver (SSM) group were accelerated twice and rotated 120° per step, whereas 177 patients in the multi-step maneuver (MSM) group were accelerated 4 times and rotated 60° per step. Dix-Hallpike (DH) tests were performed to categorize the treatment outcome as follows: 'symptom free' if the result was negative, 'symptom persistent' if the result remained positive after performing the maneuver 3 times or 'canal conversion' if horizontal nystagmus was evoked.
RESULTS: Of the patients in the SSM and MSM groups, 78.4 and 91.5% became symptom free, respectively, while canal conversion occurred in 13.8 and 5.1%, respectively (p = 0.003, x03C7;2 test). The success rate after performing the maneuver once was 57.1% in the MSM and 32.3% in the SSM symptom-free patients (p = 0.001, x03C7;2 test). One month after the treatment, 22.0 and 9.6% of the SSM and MSM patients had symptom relapse, respectively (p = 0.007, x03C7;2 test).
CONCLUSIONS: More accelerations and a smaller rotation angle improved the effectiveness and efficiency of the repositioning maneuvers and reduced canal conversion.
PMID: 26682914 [PubMed - as supplied by publisher]
Pseudotumor-like syndrome and cerebrospinal fluid leak in meningiomas involving the posterior third of the superior sagittal sinus: report of 4 cases.
J Neurosurg. 2015 Dec 18;:1-5
Authors: Shah AH, Ivan ME, Komotar RJ
Abstract
Meningiomas that partially or completely occlude the superior sagittal sinus may create a pseudotumor-like syndrome in certain patients. These patients may have impaired CSF absorption as a result of higher proximal venous pressure. Higher pressures after resection may encumber adequate wound healing and worsen symptoms. Here, the authors present a small series of patients with meningiomas involving the posterior third of the superior sagittal sinus, with documented high intracranial pressure prior to surgery. This paper aims to address the proposed etiology of high intracranial pressure in these patients and its associated complications, including CSF leak, wound dehiscence, pressure-related headaches, and visual complaints. In this paper, the authors propose a management plan to avoid wound complications and pseudotumor-related complications. When considering surgical intervention for patients with compromise of the posterior third of the superior sagittal sinus, careful attention must be paid to addressing potentially elevated intracranial pressure perioperatively.
PMID: 26684779 [PubMed - as supplied by publisher]
How common is normal cerebrospinal fluid pressure in spontaneous intracranial hypotension?
Cephalalgia. 2015 Dec 17;
Authors: Kranz PG, Tanpitukpongse TP, Choudhury KR, Amrhein TJ, Gray L
Abstract
OBJECTIVES: To determine the proportion of patients with spontaneous intracranial hypotension (SIH) who had a cerebrospinal fluid (CSF) pressure >6 cm H2O and to investigate the clinical and imaging variables associated with CSF pressure (PCSF) in this condition.
METHODS: We retrospectively reviewed 106 patients with SIH. PCSF was measured by lumbar puncture prior to treatment. Clinical and imaging variables - including demographic data, brain imaging results, symptom duration, and abdominal circumference - were collected. Univariate and multivariate analyses were performed to determine the correlation of these variables with PCSF.
RESULTS: Sixty-one percent of patients had a PCSF between 6 and 20 cm H2O; only 34% had a PCSF ≤6 cm H2O. The factors associated with increased PCSF included abdominal circumference (p < 0.001), symptom duration (p = 0.015), and the absence of brain magnetic resonance imaging findings of SIH (p = 0.003). A wide variability in PCSF was observed among all patients, which was not completely accounted for by the variables included in the model.
CONCLUSIONS: Normal CSF pressure is common in patients with SIH; the absence of a low opening pressure should not exclude this condition. Body habitus, symptom duration, and brain imaging are correlated with PCSF measurements, but these factors alone do not entirely explain the wide variability in observed pressures in this condition and this suggests the influence of other factors.
PMID: 26682575 [PubMed - as supplied by publisher]
Postoperative antibiotic prophylaxis in clean-contaminated head and neck oncologic surgery: a retrospective cohort study.
Eur Arch Otorhinolaryngol. 2015 Dec 18;
Authors: Busch CJ, Knecht R, Münscher A, Matern J, Dalchow C, Lörincz BB
Abstract
Antibiotic prophylaxis is commonly used in head and neck oncologic surgery, due to the clean-contaminated nature of these procedures. There is a wide variety in the use of prophylactic antibiotics regarding the duration of application and the choice of agent. The purpose of this study was to determine whether short-term or long-term antibiotic prophylaxis has an impact on the development of head and neck surgical wound infection (SWI). Retrospective chart review was carried out in 418 clean-contaminated head and neck surgical oncology cases at our department. More than 50 variables including tumour type and stage, type of surgical treatment, co-morbidities, duration and choice of antibiotic prophylaxis, and the incidence of SWI were analysed. Following descriptive data analysis, Chi square test by Pearson and Fisher's exact test were used for statistical evaluation. Fifty-eight of the 418 patients (13.9 %) developed SWI. Patients with advanced disease and tracheotomy showed a significantly higher rate of SWI than those with early stage disease and without tracheotomy (p = 0.012 and p = 0.00017, respectively). However, there was no significant difference between the SWI rates in the short term and long term treatment groups (14.6 and 13.2 %, respectively; p = 0.689). Diabetes and body weight were not found to be risk factors for SWI. Long-term antibiotic prophylaxis was not associated with a decrease in SWI in the entire cohort of patients undergoing clean-contaminated major head and neck oncologic surgery. Our data confirmed the extent of surgery and tracheotomy as being risk factors for postoperative SWI.
PMID: 26683471 [PubMed - as supplied by publisher]
Comparison of three different concurrent chemoradiation regimens for treatment of laryngeal cancer.
Eur Arch Otorhinolaryngol. 2015 Dec 18;
Authors: Aydil U, Akmansu M, Gumusay Ö, Bakkal FK, Yazıcı Ö, Kızıl Y, Köybaşıoğlu A, Yıldız R, Büyükberber S, İnal E
Abstract
During last decades, laryngeal organ preservation strategies have emerged. The data about the oncological outcomes mainly come from multi-institutional prospective studies. In this study, we aimed to determine the oncological outcomes of different organ preservation regimens applied in routine practice. Patients who had definitive concurrent chemoradiation (CRT) for treatment of laryngeal cancer between January 2001 and June 2013 were retrospectively reviewed. There were 139 subjects who met the inclusion criteria. Three groups were defined: group A (n = 59) consisted of subjects who had concurrent cisplatin and radiotherapy (RT), group B (n = 47) consisted of subjects who had cisplatin/docetaxel-based concurrent CRT, and group C (n = 33) had induction chemotherapy before concurrent cisplatin and RT. The Kaplan-Meier estimated 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence-free survival (LRFS) rates for the whole study group were 66.5, 69.2, 69.6, and 88.9 %, respectively. None of these survival rates were statistically different when the treatment arms were compared. The 3- and 5-year LRFS rates were significantly lower in subjects with a T4a tumor (p = 0.030). According to our results, the oncological outcomes of three different platinum-based concurrent chemotherapy schemes were similar and high local control rates could be achieved with the use of these protocols. Neoadjuvant chemotherapy before concurrent CRT was not superior to conventional concurrent treatment.
PMID: 26683470 [PubMed - as supplied by publisher]
Clinical and surgical implications regarding morphometric variations of the medial wall of the orbit in relation to age and gender.
Eur Arch Otorhinolaryngol. 2015 Dec 18;
Authors: Morales-Avalos R, Santos-Martínez AG, Ávalos-Fernández CG, Mohamed-Noriega K, Sánchez-Mejorada G, Montemayor-Alatorre A, Martínez-Fernández DA, Espinosa-Uribe AG, Mohamed-Noriega J, Cuervo-Lozano EE, Mohamed-Hamsho J, Quiroga-García O, Lugo-Guillen RA, Guzmán-López S, Elizondo-Omaña RE
Abstract
The ethmoidal foramens are located on the medial wall of the orbit and are key reference points for intraoperative orientation. Detailed knowledge of the anatomy, bony landmarks and morphometric characteristics of the medial wall of the orbit is essential for various surgical procedures. The aim of this study was to determine the morphometric variations in the medial wall of the orbit and establish significant variations regarding age and gender. A total of 110 orbits were analyzed and subdivided by age (over or under 40 years) and gender. The distances of the medial wall of the orbit between the anterior lacrimal crest, the ethmoidal foramen, the optic canal and the interforamina were determined. Safe surgical areas were sought. Statistical tests were used to determine the differences between groups. In men, there is a safe surgical area proximal to the anterior and posterior ethmoidal foramen. In women, this area is in the posterior third of the medial wall of the orbit between the posterior ethmoidal foramen and the optic canal. Regarding variation according to age, the results of this study suggested that the anteroposterior diameter of the medial wall increases with age. This study showed that the anteroposterior total length of the medial orbit wall is similar between genders of similar age, increases with age, and has significant variations in the distances between the various structures that make up the medial orbit wall with regard to gender and age.
PMID: 26683469 [PubMed - as supplied by publisher]
The effects of different environmental pH on healing of tympanic membrane: an experimental study.
Eur Arch Otorhinolaryngol. 2015 Dec 18;
Authors: Akkoc A, Celik H, Arslan N, Demirci S, Hucumenoglu S, Caydere M, Oztuna D
Abstract
In this study, we investigated the effect of environmental pH on healing of acute rat tympanic membrane perforations. Twenty Wistar albino rats were divided into four groups and used in the study. A large myringotomy was performed in the posteroinferior quadrants of both tympanic membranes. In left ears, topical pH 4 standard calibration solution was used in groups 1 and 3, and pH 7 standard calibration solution was used in groups 2 and 4. Right ears served as controls, and allowed for spontaneous healing. The solutions were applied for 2 days in groups 1 and 2, and for 7 days in groups 3 and 4. Healing was assessed by macroscopic closure of the tympanic membrane perforation, and histopathological analysis of lamina propria edema, neovascularization, inflammatory cells, and fibroblastic reaction in the temporal bones. pH 7 and pH 4 groups were similar for macroscopic closure of perforation on day 2; however difference was significant on day 7. The fibroblastic activity was significantly less on days 2 and 7 in pH 4 group. On day 7, there were significant differences between pH 4 and pH 7, and pH 7 and control groups for inflammatory cell infiltration. In conclusion, clinical and histopathological results of this study indicated that acidic environmental pH speeded up and shortened wound-healing process. By building up optimum environmental pH, a healthy healing may be achieved in acute tympanic membrane perforations.
PMID: 26683468 [PubMed - as supplied by publisher]
