Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy.

xlomafota13 shared this article with you from Inoreader Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy. Via ear nose throat Related Articles Maxillary Sinus Lobular Capillary Hemangioma in a 15-Year-Old Boy. Ear Nose Throat J. 2021 Feb 09;:145561321993597 Authors: Vukadinović T, Labus M, Spasić S, Đurđević BV, Perić A Abstract Lobular capillary hemangioma (LCH) is a benign capillary proliferation with a microscopically distinctive lobular architecture, composed of small to medium-sized vessels of capillary type. Rarely, it originates from the mucosa of the nasal cavity, most frequently from the anterior nasal septum, turbinates, and nasal vestibule. Etiology is unclear, but previous investigations suggest that this lesion is associated with injury, hormonal factors, some viral infections, and therapy with some drugs. We present a case of LCH arising from the medial wall of the maxillary sinus in a 15-year-old boy, which was completely excised by preoperative embolization and endoscopic sinus surgery. To our knowledge, this is the second reported case of an LCH originating from the maxillary antrum. Etiology, pathogenesis, diagnosis, and treatment modalities of LCH were also discussed. PMID: 33559499 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot.

xlomafota13 shared this article with you from Inoreader Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Surgical management and postoperative evaluation based on morphological classification in central polydactyly of the foot. J Plast Reconstr Aesthet Surg. 2021 Jan 09;: Authors: Oshima J, Sasaki K, Sasaki M, Aihara Y, Nishijima A, Sekido M Abstract PURPOSE: Central polydactyly of the foot is rare, with few reports on surgical methods and treatment indications. In this study, based on the experience of central polydactyly in our department, we will consider morphological classification and describe our treatment plan. METHOD: In this retrospective study, 11 patients (11 digits) with central polydactyly were identified among 136 patients of polydactyly of the foot (2009-2018). They were classified according to morphologic characteristics: type I, the duplicated digits are independent of each other; type II, digits of the same size are duplicated; and type III, digits of different sizes are duplicated. RESULTS: In morphologic classification, there were 4 cases of type II and 7 cases of type III, but there was no case of type I. For type II, surgery was performed using the Bilhaut-Cloquet (BC) procedure in 2 patients, bone-removing flap (flap) method in 1 patient, and simple ablation in 1 patient. For type III, surgery was performed using the BC procedure in 1 patient, flap method in 3 patients, simple ablation in 2 patients, and ligation in 1 patient with floating type. CONCLUSION: In order to obtain good cosmetic results in digits of morphologic classifications type II and III, it is necessary to select the surgical approach with careful consideration of every feature. PMID: 33558104 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation and comparison of the efficacy of long-acting betamethasone and dexamethasone as injections in the treatment of idiopathic sudden hearing loss

xlomafota13 shared this article with you from Inoreader Evaluation and comparison of the efficacy of long-acting betamethasone and dexamethasone as injections in the treatment of idiopathic sudden hearing loss Via American Journal of Otolaryngology Publication date: Available online 10 February 2021 Source: American Journal of Otolaryngology Author(s): Hakima Abdullah, Reza Erfanian, Nasrin Yazdani, Shima Hajibeiglu, Ardavan Tajdini View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases.

xlomafota13 shared this article with you from Inoreader Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases. Via Sociedad Luso-Española de Neurocirugía Related Articles Spinal cord stimulation and cauda equina syndrome: Could it be a valid option? A report of two cases. Neurocirugia (Astur). 2021 Feb 05;: Authors: Rascón-Ramírez FJ Abstract Spinal cord stimulation (SCS) consists of the application of electrical stimuli to the dorsal columns of the spinal cord or to the posterior nerve roots in order to modulate the pain signals carried by the ascending pain pathways to the brain. Two cases of SCS in patients with cauda equina syndrome after lumbar surgery are presented. They were treated for persistent neuropathic pain but also experienced improvement in their motor and urinary symptoms after this treatment. Although the primary indication for SCS is neuropathic pain control, its application can also lead to improvement of motor deficits, sensory disorders, and urinary incontinence, as shown in these two cases. SCS will likely play a fundamental role in rehabilitative therapies in different neurological diseases. Further investigation in the field is needed. PMID: 33558146 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

In vivo diagnosis of skin cancer with a portable Raman spectroscopic device

xlomafota13 shared this article with you from Inoreader In vivo diagnosis of skin cancer with a portable Raman spectroscopic device Via Experimental Dermatology Abstract In this study we performed in vivo diagnosis of skin cancer based on implementation of a portable low‐cost spectroscopy setup combining analysis of Raman and autofluorescence spectra in the near infrared region (800 – 915 nm). We studied 617 cases of skin neoplasms (615 patients, 70 melanomas, 122 basal cell carcinomas, 12 squamous cell carcinomas and 413 benign tumors) in vivo with a portable setup. The studies considered the patients examined by GPs in local clinics and directed to a specialized Oncology Dispensary with suspected skin cancer. Each sample was histologically examined after excisional biopsy. The spectra were classified with a projection on latent structures and discriminant analysis. To check the classification models stability, a 10‐fold cross‐validation was performed. We obtained ROC AUCs of 0.75 (0.71 – 0.79; 95% CI), 0.69 (0.63‐0.76; 95% CI), and 0.81 (0.74 – 0.87; 95% CI) for classification of a) malignant and benign tumors, b) mel anomas and pigmented tumors and c) melanomas and seborrheic keratosis respectively. The positive and negative predictive values ranged from 20% to 52% and from 73% to 99% respectively. The biopsy ratio varied from 0.92:1 to 4.08:1 (at sensitivity levels from 90% to 99%). The accuracy of automatic analysis with the proposed system is higher than the accuracy of GPs and trainees, and is comparable or less to the accuracy of trained dermatologists. The proposed approach may be combined with other optical techniques of skin lesion analysis, such as dermoscopy‐ and spectroscopy‐based computer‐assisted diagnosis systems to increase accuracy of neoplasms classification. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status.

xlomafota13 shared this article with you from Inoreader Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status. Via Laryngologie Related Articles Oropharyngeal squamous cell carcinoma: p16/p53 immunohistochemistry as a strong predictor of HPV tumor status. Histopathology. 2021 Feb 09;: Authors: Benzerdjeb N, Tantot J, Blanchet C, Philouze P, Mekki Y, Lopez J, Devouassoux-Shisheboran M Abstract AIMS: Oropharyngeal squamous cell carcinomas (OPSCC) related to human papillomavirus (HPV) infection have a better prognosis than those without HPV infection. Although p16INK4a overexpression is used as a surrogate marker for HPV infection, 5%-20% of p16-positive OPSCC are described as being unrelated to HPV infection, with worse overall survival compared to OPSCC-related HPV. There is, therefore, a risk of undertreating a proportion of OPSCC patients falsely considered as HPV-driven because of p16 positivity. TP53 mutations are highly prevalent in OPSCC driven by mutagens in tobacco and alcohol. We describe herein a combined p16/p53 algorithm to predict HPV tumor status in OPSCC. METHODS AND RESULTS: 110 OPSCC were identified in the database of the pathology department and were studied using p16 and p53 immunohistochemistry. For p16-positive or p16-negative/wild-type patterns-p53 (WT-p53) cases (n = 63), DNA in-situ hybridization for high-risk HPV was performed and if negative, the HPV status was controlled by HPV DNA PCR (n=19). A significant association between TP53 mutation and pattern of p53 expression was found (WT-p53, 7/16, P<0.001). The p16-positive/WT-p53 was significantly associated with HPV+ tumor status (p16-positive/WT-p53, 50/110, P<0.001). Interestingly, a subset of p16-positive OPSCC was unrelated to HPV (13.5%, 8/59) and showed mutant-type staining of p53 expression. CONCLUSIONS: The p16 protein immunopositivity in conjunction with the mutant-type pattern of p53 staining helped to reclassify a subset of p16-positive OPSCC as OPSCC-unrelated HPV. This approach could be routinely applied by pathologists involved in the management of OPSCC, because of their potential therapeutic implications. PMID: 33560536 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory and Gustatory Dysfunction in COVID-19 Patients

xlomafota13 shared this article with you from Inoreader Olfactory and Gustatory Dysfunction in COVID-19 Patients from Northern India: A Cross-Sectional Observational Study Via Otolaryngology Indian Abstract Olfactory dysfunction (OD) and gustatory dysfunction (GD) has been reported as one of the presenting symptoms amongst COVID-19 patients. However the literature available is disjunct on this aspect. This study is conducted to identify the prevalence of olfactory and/or gustatory dysfunction in patients with coronavirus disease in Northern part of India. It's a cross-sectional observation study, conducted over 387 COVID-19 positive patients, at ENT dept of tertiary care hospital. A retrospective survey was conducted using a pre designed questionnaire and details of Olfactory and Gustatory dysfunction was collected. The patient's demographic details, disease course and recovery time for olfactory (OD) and/or gustatory dysfunctions (GD) were collected. A total of 387 patients with COVID-19 completed the study. 228 (58.9%) patients suffered from influenza like illness (ILI) (fever, sore throat, dry cough, malaise, and myalgia). There was significant positive assoc iation seen between with ILI and OD and / or GD. 167/387 (43.15%) patients reported OD, and 153/387 (39.53%) reported GD. 43.71% and 50.3% patients had mild OD & GD respectively. Recovery rates for both OD and GD are high and almost similar, with 161 (96.4%) and 148 (96.73%) patients had complete recovery of smell and taste. Maximum recovery was noticed between 4 and 6 weeks. COVID-19 patients with habits have significantly high probability of developing OD &/or GD. There is a significant correlation between OD and GD and there is high probability that patients who reported to have OD will also have GD or vice versa. Prevalence of OD and GD in Indian population may not be as high as mentioned in western literature, however, both are frequent and early symptoms of COVID-19. Recent onset of these should be considered as red flag symptoms for COVID-19. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sudden Sensorineural Hearing Loss in Children—Management and Outcomes: A Meta‐analysis

xlomafota13 shared this article with you from Inoreader Sudden Sensorineural Hearing Loss in Children—Management and Outcomes: A Meta‐analysis Via The Laryngoscope Objective To identify which patient characteristics and treatments are associated with hearing improvement in patients with pediatric sudden sensorineural hearing loss (SSNHL). Methods PubMed, Web of Science, Cochrane Library, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature were systematically searched for articles published before February 5, 2019, and references of relevant articles were screened. Original English‐language case series and cohort studies were included if they addressed SSNHL in patients <20 years of age. Study characteristics, patient demographics, symptoms, treatments, and hearing outcomes were extracted. The primary outcome was hearing improvement. Results Thirteen studies were included, totaling 605 patients (670 ears). Hearing did not improve in 46.7% of ears (95% confidence interval [CI]: 34.4% to 59.0%). Imaging (computed tomography and/or magnetic resonance imaging) results were described in three studies, and 24.2% of ears (95% CI: 7.7% to 40.6%) had abnormal findings. The most common serological finding was cytomegalovirus immunoglobulin (Ig)G or IgM (34.3% of ears tested, 95% CI: −2.9% to 71.6%). Unilateral hearing loss (odds ratio [OR]:3.85, P < .001), tinnitus (OR: 2.20, P = .003), age >12 years (OR: 2.11, P = .002), and ascending audiogram (OR: 3.66, P = .005), but not systemic or intratympanic steroids, were associated with increased odds of partial or complete improvement. In contrast, profound hearing loss (OR: 0.29, P < .001) and treatment delay of >6 days (OR: 0.27, P < .001) were associated with decreased odds of improvement. Conclusions Despite treatment, half of patients had no improvement in hearing. Prognostic factors associated with hearing improvement were generally consistent with those established in the adult population. Further research with consistent definitions for hearing improvement is needed to improve the understanding and treatment of pediatric SSNHL. Level of Evidence   Laryngoscope, 131:425–434, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Z‐plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients

xlomafota13 shared this article with you from Inoreader Endoscopic Z‐plasty for Treatment of Supraglottic Stenosis: Experience on Nine Patients Via The Laryngoscope Objectives Supraglottic stenosis is a rare type of laryngeal stenosis that is caused by congenital laryngotracheal anomalies, iatrogenic instrumentation injuries, autoimmune disorders, infection, irradiation, chemical or thermal burns, and external blunt or penetrating trauma. The author presents his experience on nine patients using this new endoscopic surgical technique for treatment of supraglottic stenosis. Study Design Individual retrospective cohort study, tertiary referral center, university hospital. Methods All cases of supraglottic laryngeal stenosis treated during a 10‐year period at a tertiary academic medical center were reviewed. Nine patients with supraglottic stenosis treated with endoscopic uni‐ or bilateral z‐plasty technique were determined and presented. The etiology of stenosis was iatrogenic surgical trauma in seven patients, laryngeal fracture in one patient, and systemic lupus erythematosus in the other patient. Main outcome measures were respiratory function test results, absence of dyspnea on exertion, and decannulation if tracheotomy was present preoperatively. Results Seven patients with tracheotomy were decannulated 1 month after surgery. All nine patients had adequate airway and were dyspnea‐free. Their preop respiratory function test results improved significantly postoperatively (P < .05). Conclusion For supraglottic stenosis endoscopic surgery using mucosal flaps in the form of z‐plasty should be considered within the available surgical techniques. Although this type of surgery is highly successful, it is technically difficult to apply. Level of Evidence 4 Laryngoscope, 131:E534–E539, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Improving Mortality Attribution in Otolaryngology – Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Improving Mortality Attribution in Otolaryngology – Head and Neck Surgery Via The Laryngoscope Objective/Hypothesis Mortality attribution can have significant implications for reimbursement, hospital/department rankings, and perceptions of safety. This work seeks to compare the accuracy of externally assigned diagnosis‐related group (DRG)‐based service line mortality attribution in otolaryngology to an internal review process that assigns mortality to the teams that cared for a patient during hospitalization. Study Design Retrospective case series. Methods Mortality events at Vanderbilt University Medical Center (VUMC) from 2012 to 2018 were compared. Included events were assigned to the otolaryngology service line (OSL) via the following methods: an external agency (Vizient) using DRG, utilization management assignment based on the service that provided care at admission (admission service), discharge (discharge service), or throughout hospitalization (major service line), or through the internal VUMC mortality review committee. Internal review was considered the standard for comparison. Results Of the 28 mortality events assigned to OSL by the DRG‐based external method, nine (32%) were actually attributable to OSL. Of the 23 total mortality events attributable to OSL at our institution, external DRG‐based review captured nine (39%). The designation of major service during hospitalization was correct 95% of the time and captured 87% of mortality events. Differences between external and internal attribution methods were statistically significant (P < .001). Conclusions DRG‐based models are frequently utilized but can be inaccurate when attributing mortality for an individual otolaryngology department. Otolaryngology mortalities appear to be captured and assigned more accurately by assigning deaths to the service that renders the majority of care during hospitalization. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Otolaryngology Curriculum During Residency Preparation Course Improves Preparedness for Internship

xlomafota13 shared this article with you from Inoreader Otolaryngology Curriculum During Residency Preparation Course Improves Preparedness for Internship Via The Laryngoscope Objectives/Hypothesis Residency preparation courses (RPCs) have become a widely adopted practice to ease the transition of medical students into residency, but these courses often lack training in skills expected of subspecialty interns. To fill this gap, a simulation‐based curriculum in otolaryngology (ORL) was implemented at the University of Michigan Medical School. The curriculum aimed to improve confidence and perceived ability to perform common ORL skills for graduating students prior to internship. Study Design Cross‐sectional study. Methods Six basic simulations (tracheostomy, flexible laryngoscopy, otomicroscopy, myringotomy and tube insertion, epistaxis and peritonsillar abscess management) were included in the first course in 2019. The course was expanded in 2020 with the addition of three advanced simulations (ear foreign body extraction, tracheostomy complications, and "cannot intubate, cannot ventilate" situations). Pre‐ and postsession surveys were collected to assess individual simulations and the course overall. Results A total of 32 students participated in the ORL simulation curriculum in Spring 2019 and 2020. Paired t‐tests showed significant improvement in self‐perception of ability on every simulation. Qualitative feedback revealed that students particularly valued the opportunity for hands‐on learning. Non‐ORL students rated their baseline abilities significantly lower than ORL students on five stations, but they achieved statistically equivalent postsession ratings on all but the otomicroscopy station. Conclusions An ORL‐specific curriculum is a valuable addition to procedural RPCs. The curriculum resulted in increased confidence and perceived ability in skill performance for both students pursuing ORL residencies, as well as those pursuing other procedural specialties. Level of Evidence 4. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.