PET/CT Poorly Predicts AJCC 8th Edition Pathologic Staging in HPV‐Related Oropharyngeal Cancer

xlomafota13 shared this article with you from Inoreader PET/CT Poorly Predicts AJCC 8th Edition Pathologic Staging in HPV‐Related Oropharyngeal Cancer Via The Laryngoscope Objective The American Joint Committee on Cancer (AJCC) 8th edition introduced distinct clinical and pathological staging paradigms for human papilloma virus positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC). Treatment planning for OPSCC often utilizes positron emission tomography/computed tomography (PET/CT) to assess clinical stage. We hypothesize that PET/CT will accurately predict final pathologic AJCC 8th edition staging in patients with HPV+ OPSCC. Methods All patients with primary HPV+ OPSCC with preoperative PET/CT who underwent transoral robotic surgery and neck dissection between 2011 and 2017 were identified. Data were collected via chart review. Two neuroradiologists performed blinded re‐evaluation of all scans. Primary tumor size and cervical nodal disease characteristics were recorded and TNM staging was extrapolated. Cohen's kappa statistic was used to assess interrater reliability. Test for symmetry was performed to analyze discordance between radiologic and pathologic staging. Results Forty‐nine patients met inclusion criteria. Interrater reliability was substantial between radiologists for nodal (N) and overall staging (OS) (κ = 0.715 and 0.715). Radiologist A review resulted in identical OS for 67% of patients, overstaging for 31%, and understaging for 2%. Radiologist B review resulted in 61% identical OS, 39% overstaging, and 0% understaging. In misclassified cases, the test of symmetry shows strong bias toward overstaging N stage and OS (P < .001). Radiologic interpretation of extracapsular extension showed poor interrater reliability (κ = 0.403) and poor accuracy. Conclusion PET/CT predicts a higher nodal and overall stage than pathologic staging. PET/CT should not be relied upon for initial tumor staging, as increased FDG uptake is not specific for nodal metastases. PET/CT is shown to be a poor predictor of ECE. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transnasal endoscopic skull base and brain surgery: Surgical anatomy and its applications. Aldo C. Stamm Joao Mangussi‐Gomes New York, NY: Thieme, 2019, 690 pp., $229.99.

xlomafota13 shared this article with you from Inoreader Transnasal endoscopic skull base and brain surgery: Surgical anatomy and its applications. Aldo C. Stamm Joao Mangussi‐Gomes New York, NY: Thieme, 2019, 690 pp., $229.99. Via Head & Neck View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer

xlomafota13 shared this article with you from Inoreader The importance of smoking status at diagnosis in human papillomavirus‐associated oropharyngeal cancer Via Head & Neck Abstract Background Smoking status at point of diagnosis is not used in defining risk groups for human papillomavirus (HPV)‐associated oropharyngeal cancer (OPC) despite its prognostic value in head and neck cancer. Methods Retrospective analysis of consecutive patients treated with chemoradiotherapy between January 2005 and July 2017 was performed with multivariable analysis to explore the impact of smoking status at diagnosis (current/former/never) on overall survival (OS), cancer‐specific survival (CSS) and progression‐free survival (PFS). Results Median follow‐up was 61 months. Four hundred and four patients were included. Current smokers had inferior OS versus never and former smokers [adjusted HR 2.37 (95% CI 1.26–4.45, p < 0.01) and 2.58 (95% CI 1.40–4.73, p < 0.01), respectively] and inferior PFS versus never smokers [adjusted HR 1.83 (95% CI 1.00–3.35, p = 0.04)]. Smoking status did not predict for CSS. Conclusion Detailed smoking behavior should be considered in refining risk groups in HPV‐associated OPC treated with radiotherapy and in future trial design eligibility and stratification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of early‐life gut microbiome and lifestyle factors in the development of eczema in Hong Kong infants

xlomafota13 shared this article with you from Inoreader Association of early‐life gut microbiome and lifestyle factors in the development of eczema in Hong Kong infants Via Experimental Dermatology Abstract Childhood eczema is common but its prevalence is variable in different regions of the world. In this study, we explore the associations of various risk factors such as the microbiome, environment, lifestyle, diet and maternal stress with the development of eczema among infants in Hong Kong. Upon enrolment in the study, the infants' parents provided demographic data by self‐reporting. At enrolment and 1 year after birth, the infants' allergic conditions, lifestyles and dietary factors and the degree of maternal stress were assessed using various questionnaires. The infants' gut microbiomes were analysed by 16S RNA sequencing, and the longitudinal changes in various bacterial strains were compared between control and eczema‐affected groups. Multivariate analyses (after adjustment for other significant factors) revealed that the changes in the abundance of Hungatella hathewayi in the gut were significantly associated with the development of eczema (p = 0.005). In conclusion, the increased abundance of Hungatella hathewayi was associated with an increased risk of developing eczema by 1 year of age. This study thus explored the potential risk factors for the development of eczema in Hong Kong infants, and sheds light on the possible association between early‐life gut microbiome and other environmental factors. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic Value of Third Cervical Vertebra Skeletal Muscle Index in Oral Cavity Cancer: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Prognostic Value of Third Cervical Vertebra Skeletal Muscle Index in Oral Cavity Cancer: A Retrospective Study Via The Laryngoscope Objectives/Hypothesis To assess the prognostic utility of third cervical vertebra skeletal muscle index (C3 SMI) measured from preoperative head and neck computed tomography (CT) in patients with oral cavity squamous cell carcinoma (OSCC). Study Design Retrospective study. Methods We retrospectively reviewed the medical records of 125 patients who underwent primary curative surgery for OSCC between 2009 and 2017. Their preoperative C3 SMI was calculated by adjusting the C3 cross‐sectional area delineated on head and neck CT by body height squared. A Cox proportional hazard model was employed to identify prognostic factors, and a novel nomogram based on C3 SMI was built for individualized survival prediction. Results In Kaplan–Meier analysis, high C3 SMI was significantly associated with higher 5‐year disease‐free survival (DFS) and overall survival (OS) than low C3 SMI. In multivariate analysis, low C3 SMI was an independent risk factor for poor DFS and OS (hazard ratio [HR]: 2.197; 95% confidence interval [CI], 1.170–4.512, P = .032 and HR: 2.143; 95% CI, 1.232–3.728, P = .007, respectively). The concordance‐index (C‐index) of the nomogram based on C3 SMI was 0.814 for OS, higher than that of the nomogram based on tumor–node–metastasis staging alone (C‐index = 0.731). Conclusions C3 SMI might serve as a novel prognosticator in OSCC patients undergoing curative surgery, and the nomogram based on C3 SMI might provide good prognostic discrimination ability for individualized survival prediction. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bypass grafting in recurrent nasopharyngeal carcinoma patients with internal carotid artery invasion

xlomafota13 shared this article with you from Inoreader Clinical efficacy of bypass grafting in recurrent nasopharyngeal carcinoma patients with internal carotid artery invasion Via American Journal of Otolaryngology Publication date: Available online 12 January 2021 Source: American Journal of Otolaryngology Author(s): Zhouyang Zhao, Lijin Huang, Jinhua Chen, Weijia Huang, Xiaobin Zhang, Yue Ma, Hongshen Zhu, Zhang Liu View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intra-operative parathyroid hormone evaluation is superior to frozen section analysis in parathyroid surgery

xlomafota13 shared this article with you from Inoreader Intra-operative parathyroid hormone evaluation is superior to frozen section analysis in parathyroid surgery Via American Journal of Otolaryngology Publication date: Available online 12 January 2021 Source: American Journal of Otolaryngology Author(s): Süleyman Özkan Aksoy, Süleyman Cem Adiyaman, Ali Durubey Çevlik, Merih Güray Durak, Mustafa Seçil, Ali İbrahim Sevinç View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Edoscopic posterior nasal neurectomy with submucosal turbinectomy for the treatment of intractable severe chronic rhinitis

xlomafota13 shared this article with you from Inoreader Long-term effectiveness, safety, and quality of life outcomes following endoscopic posterior nasal neurectomy with submucosal turbinectomy for the treatment of intractable severe chronic rhinitis Via Auris Nasus Larynx Publication date: Available online 11 January 2021 Source: Auris Nasus Larynx Author(s): Serika Sonoda, Daisuke Murakami, Yuichi Saito, Yusuke Miyamoto, Ryota Higuchi, Yoshikazu Kikuchi, Motohiro Sawatsubashi, Takashi Nakagawa View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oscillatory biomarkers of early auditory information processing predict cognitive gains following targeted cognitive training in schizophrenia patients.

xlomafota13 shared this article with you from Inoreader Oscillatory biomarkers of early auditory information processing predict cognitive gains following targeted cognitive training in schizophrenia patients. Via cortical auditory Related Articles Oscillatory biomarkers of early auditory information processing predict cognitive gains following targeted cognitive training in schizophrenia patients. Schizophr Res. 2020 01;215:97-104 Authors: Hochberger WC, Thomas ML, Joshi YB, Molina J, Treichler EBH, Nungaray J, Cardoso L, Sprock J, Swerdlow N, Light GA Abstract Auditory-based targeted cognitive training (TCT) is an effective and well-validated intervention for the treatment of cognitive impairment in schizophrenia patients. Improvements in higher-order cognition, reductions in symptom severity, and increases in psychosocial functioning secondary to TCT are thought to be driven by "bottom-up" enhancement of early auditory information processing (EAIP). Despite strong evidence of efficacy at the group level, there is significant variability in response to TCT, with few well-delineated biomarkers for predicting individual benefit. EEG biomarkers of EAIP are indicators of early-treatment sensitivity that predict full-course TCT outcome; however, further characterization is necessary for biomarker-guided clinical trials. The current study examined baseline and early-treatment sensitivity (i.e., change from baseline after 1 h) in theta band oscillatory activity to deviant stimuli as moderators of full course (30 h) TCT response in tre atment-refractory schizophrenia patients randomly assigned to receive either treatment-as-usual (TAU; n = 22) or TAU augmented with TCT (n = 30). Theta evoked power and phase locking at baseline predicted patient improvements in global cognitive function after 30 h of TCT. Decrease in theta activity to deviant stimuli after 1 h of TCT predicted improvements in verbal learning after 30 h. Exploratory analyses using EEG composite scores had high levels of sensitivity and specificity for identifying patients most likely to benefit from TCT. The integrity of baseline neurophysiologic activity associated with EAIP, as well as the sensitivity of the underlying circuity to change, likely reflects an intermediate therapeutic process underlying the effectiveness of TCT that can be used to predict patient response to treatment. PMID: 31759809 [PubMed - indexed for MEDLINE] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of the temporoparietal fascia free flap in salvage total laryngectomy

xlomafota13 shared this article with you from Inoreader Role of the temporoparietal fascia free flap in salvage total laryngectomy Via Head & Neck Abstract The procedure for salvage total laryngectomy (STL) is burdened by a high rate of postoperative complications as a result of delayed wound healing in previously irradiated tissue. Several observational studies have investigated the role of prophylactic vascularized flaps to aid pharyngeal closure after STL and prevent the development of PCF. The use of a temporoparietal fascia free flap (TFFF) as an overlay flap for STL has been described previously in two published studies and both sets of authors agreed that the most obvious benefit of the TFFF in STL is a reduced PCF rate with low site morbidity and good functional outcomes. The aim of this video is to illustrate the use of the temporoparietal fascia flap to provide an adjunctive reinforcement layer in the reconstruction of the pharynx. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patterns of Facial Fractures

xlomafota13 shared this article with you from Inoreader Patterns of Facial Fractures in a Major Metropolitan Level 1 Trauma Center: A 10‐year Experience Via The Laryngoscope Objective/Hypothesis To report characteristics and management of facial fractures in a major metropolitan center within the United States. Study Design Retrospective chart review. Methods Retrospective review at a level 1 trauma academic medical center of 3,946 facial fractures in 1,914 patients who presented from 2008 to 2017. Demographics, injury mechanism, associated injuries, and treatment information were collected. Logistic regression analyses were performed to determine factors associated with management. Results There were 1,280 males and 630 females with a median age of 42 years. Orbital fractures were the most common (41.4%) followed by maxilla fractures (21.9%). The most common mechanism was fall (43.6%). Surgical management was recommended for 38% of patients. The odds of surgical management were less for females (OR 0.59, 95% CI 0.48–0.73). Patients over 70 years were significantly less likely to undergo surgery compared to other age groups (OR 0.15–0.36, P < .001). The odds of surgical management were 1.69 times greater for patients with more than three fractures than for a single fracture (95% CI 1.18–2.42) and 2.23 times greater for traffic injuries compared to injuries from activities of daily living (95% CI 1.42–3.5). Conclusions This represents one of the largest comprehensive databases of facial fractures. Our patients were most frequently injured during activities of daily living, most commonly from falls. The majority of patients were managed conservatively. Gender, age, fracture number, and mechanism of injury were independently associated with the decision to treat surgically. Our data are in stark contrast to that from other populations in which assault or motor vehicle accidents predominate. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Glutamine Inhibition Reduces Iatrogenic Laryngotracheal Stenosis

xlomafota13 shared this article with you from Inoreader Glutamine Inhibition Reduces Iatrogenic Laryngotracheal Stenosis Via The Laryngoscope Objective/Hypothesis Glutamine inhibition has been demonstrated an antifibrotic effect in iatrogenic laryngotracheal stenosis (iLTS) scar fibroblasts in vitro. We hypothesize that broadly active glutamine antagonist, DON will reduce collagen formation and fibrosis‐associated gene expression in iLTS mice. Study Design Prospective controlled animal study. Methods iLTS in mice were induced by chemomechanical injury of the trachea using a bleomycin‐coated wire brush. PBS or DON (1.3 mg/kg) were administered by intraperitoneal injection (i.p.) every other day. Laryngotracheal complexes were harvested at days 7 and 14 after the initiation of DON treatment for the measurement of lamina propria thickness, trichrome stain, immunofluorescence staining of collagen 1, and fibrosis‐associated gene expression. Results The study demonstrated that DON treatment reduced lamina propria thickness (P = .025) and collagen formation in trichrome stain and immunofluorescence staining of collagen 1. In addition, DON decreased fibrosis‐associated gene expression in iLTS mice. At day 7, DON inhibited Col1a1 (P < .0001), Col3a1 (P = .0046), Col5a1 (P < .0001), and Tgfβ (P = .023) expression. At day 14, DON reduced Co1a1 (P = .0076) and Tgfβ (P = .023) expression. Conclusions Broadly active glutamine antagonist, DON, significantly reduces fibrosis in iLTS mice. These results suggest that the concept of glutamine inhibition may be a therapeutic option to reduce fibrosis in the laryngotracheal stenosis. Level of Evidence N/A Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.