Αρχειοθήκη ιστολογίου

Τρίτη 23 Μαρτίου 2021

A Case of Cochlear Implant Replacement Requiring Full-Thickness Skin Grafting

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Ear Nose Throat J. 2021 Mar 23:145561321996837. doi: 10.1177/0145561321996837. Online ahead of print.

ABSTRACT

Cochlear implants improve the quality of life of patients with bilateral severe sensorineural hearing loss. Normally, patients with cochlear implants can continue to use the devices for years without any complications. However, equipment failure or infection at the implant site could develop in some patients, and this might often necessitate implant replacement. Alt hough cochlear implant replacement surgery itself is not a major risk in most cases, extensive tissue resection will be required in cases involving infection, and the insertion site of the temporal bone implant will need to be changed. We encountered a case of skin necrosis at the temporal bone implant site caused by constant external irritation from the temple of an eyeglass frame. The patient underwent cochlear implant replacement surgery involving full-thickness skin grafting from the abdomen. Thereafter, the patient's condition improved. Full-thickness skin grafting can be useful in cases of extensive skin defects encountered during cochlear implant replacement.

PMID:33752464 | DOI:10.1177/0145561321996837

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Anxio-depressive symptoms in Moroccan women with gynecological cancer: Relief factors

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Bull Cancer. 2021 Mar 19:S0007-4551(21)00071-0. doi: 10.1016/j.bulcan.2020.12.011. Online ahead of print.

ABSTRACT

INTRODUCTION: Psychosocial determinants can affect the mental health of women who have been diagnosed with gynecological cancer. The aim of this study was to examine how social support and self-esteem are associated with anxiety and depression symptoms in women with gynecological cancer, and who are treated by radical surgery.

METHODS: A cross-sectional study was performed, within the oncology department of Ibn Rochd University Hospital, Casablanca, on 100 Moroccan women. They all had undergone radical surgery for gynecological cancer, hysterectomy and/or oophorectomy.

RESULTS: Our results showed that patients with gynecological cancer treated by radical surgery exhibited high prevalence rates of anxiety (66%) and depression symptoms (59%). Associations showed that age, having children, medical coverage system, area of residence, working status and socioeconomic status were significantly related to the prevalence of anxiety and depression symptoms (P<0.05). The general social support, family support and significant other support besides high self-esteem reduce significantly the risk of getting anxiety and depression symptoms (P-values<0.05).

DISCUSSION: Among patients with gynecological cancer treated by radical surgery, high prevalence of anxiety and depression symptoms was found. Social support and high self-esteem could help improve mental health issues related to this type of cancer.

PMID:33752868 | DOI:10.1016/j.bulcan.2020.12.011

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Melatonin Exerts Anti-Inflammatory, Antioxidant, and Neuromodulatory Effects That Could Potentially Be Useful in the Treatment of Vertigo

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The acute phase of vertigo involves multiple neurotransmitters, inflammatory mediators, and products of oxidative stress. The vestibular pathway has multiple melatonin receptors distributed along its path, both centrally and peripherally. In addition, melatonin has been shown to be a powerful antioxidant and anti-inflammatory agent against factors related to vertigo, such as Bax/caspases, interleukins, and chemokines. Likewise, it exerts central GABAergic, antidopaminergic, and anti-migraine functions and regulates sympathetic activity in a similar way to the drugs classically used in acute vestibular crisis. In this review, the role of melatonin as a potential treatment of the acute phase of vertigo is discussed.
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USPSTF Recommendation for Hearing-Loss Screening Among Older Adults

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The United States Preventive Services Task Force (USPSTF) recently revisited and reviewed the evidence on assessing the balance of benefit and harm for screening older adults for hearing loss and reaffirmed the conclusion from its last review in 2012 that there is "insufficient evidence" to make a recommendation (I statement). The USPSTF report is based on an updated evidence report and systematic review performed by Feltner and colleagues. The group conducted a rigorous review of major databases and found that relatively few studies had reported on the benefits of hearing care intervention and those that had were not generalizable to the general population because they were mostly performed in veteran populations with no subpopulation analyses. Moreover, no studies assessed for evidence of the presence of unintended harms and consequences of hearing screening and intervention. Lastly, the review did conclude that multiple screening methods can accurately detect hearing loss in older adults.
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Does Submandibular Gland Sacrificing Neck Dissection Decrease Salivary Output and Quality of Life?

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Purpose: Our study aimed to quantify the impact of submandibular gland (SMG) resection during Level I neck dissection (ND) on stimulated salivary output (SSO) and xerostomia-related quality of life in patients with head and neck cancer (HNC). Methods: A retrospective cohort was formed from 32 patients that underwent unilateral or bilateral Level I ND and a control group of 23 patients that had level II–IV ND. SSO (Saxon test) and University of Washington Quality of Life survey results for both groups were compared. Results: Mean SSO was 3.41 g in the SMG resection group and 3.86 g in the control group, with no significant statistical difference. There was no difference in mean SSO between patients with 2 SMGs, a single remaining SMG, or no glands. The mean SSO of SMG resection cases with a history of adjuvant RT was 2.61 g which was below the xerostomia threshold for the Saxon test (2.75 g) and control group patients with RT had a significantly higher mean SSO (4.07 g). The lowest UW-QoL saliva domain score average (53.8) was in the SMG-resected, RT-positive group. Conclusion: Results indicate unilateral or bilateral resection of SMG does not reduce SSO to a significant extent. Adjuvant radiotherapy and SMG resection are additive risk factors for xerostomia and the related loss in quality of life. SMG sparing may be necessary in HNC patients with higher risk for the need of adjuvant radiation.
ORL
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Symptoms of Depression in Patients with Chemosensory Disorders

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Introduction: Patients with chemosensory dysfunction frequently report symptoms of depression. The current study aims to clarify whether the type (smell dysfunction, taste dysfunction, and mixed smell and taste dysfunction), severity, duration, or cause of dysfunction have differential impacts on the symptoms of depression. Methods: 899 patients with chemosensory disorders and 62 controls were included. Following a structured interview and an otorhinolaryngological examination, subjects underwent olfactory tests (Sniffin' Sticks), gustatory tests (taste sprays) and an assessment of depressive symptoms (Beck Depression Inventory). Information on the cause and duration of disorders was also collected. Results: Patients with combined olfactory/gustatory dysfunction had higher depression scores than patients with smell dysfunction only and controls, and no significant difference was found between the smell dysfunction and controls. Anosmi a patients, but not hyposmia patients, exhibited higher depression scores than controls. Among various causes of chemosensory disorders, patients from the posttraumatic group had higher depression scores than patients with other causes of chemosensory dysfunction (sinonasal, idiopathic, or postinfectious). Multiple linear regression analyses suggested that reduced olfactory function was associated with enhanced depression scores in the olfactory disorders group (B = −0.326, t = −2.294, and p = 0.02) and in all patients with chemosensory disorders (B = −0.374, t = −2.550, p = 0.017). Discussion/Conclusion: Simultaneously decreased input of olfaction and gustation seems to have an additive effect on the exacerbation of emotional dysfunction. Early intervention should be considered for depression symptoms in patients with mixed olfactory/gustatory dysfunction in clinical practice.
ORL
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pT3 N0 Laryngeal Squamous Cell Carcinoma: Oncologic Outcomes and Prognostic Factors of Surgically Treated Patients

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Objectives/Hypothesis

To assess the disease control, survival rates, and prognostic factors of exclusive surgical treatment for patients with pT3 N0 laryngeal squamous cell carcinoma (LSCC).

Study Design

Multicentric retrospective cohort study.

Methods

Multicentric retrospective case series of previously untreated patients with pT3 R0N0 LSCC, who received exclusive surgery between 2011 and 2019. Tumor location; subsite involvement; grading; and lymphatic, vascular, and perineural invasion were reported. Overall survival (OS), disease‐specific survival (DSS), and disease‐free survival (DFS) were measured.

Results

Fifty‐four patients (mean age 67.1; male sex 83.3%; mean follow‐up period 37 months) underwent total laryngectomy (48.1%) or partial laryngectomy (51.9%). Ipsilateral or bilateral neck dissection was performed in 46 (85.2%) cases. Perineural invasion was more frequent in case of supraglottic involvement than glottic involvement (85.7% vs. 14.3%, P = .03). Five (9.3%) patients experienced recurrence (3 local recurrences, 1 nodal recurrence, 1 distant recurrence). Rate of recurrence differed between glottic (0%), supraglottic (80%), and transglottic (20%) tumors (P = .01), with a lower risk yielded by glottic involvement (odds ratio [OR], 0.05, 95% confidence interval [95% CI], 0.01–0.56, P = .01). A higher risk was recorded in case of perineural invasion (OR, 66.0, 95% CI, 1.41–3085.3, P = .03). The OS, DSS, and DFS were 79.6%, 96.3%, and 90.7%, without differences regarding the type of surgery. The DFS was lower in case of supraglottic involve ment when compared to purely glottic LSCC (83.9% vs. 100%, P = 0.02).

Conclusions

Exclusive surgery is a safe option for patients with pT3 R0N0 LSCC. Adjuvant treatments or closer follow‐up monitoring might be considered in case of supraglottic involvement or perineural invasion.

Level of Evidence

4 Laryngoscope, 2021

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Hydroxyapatite bone cement in the reconstruction of defects of the long process of the incus: Personal experience and literature review

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Publication date: Available online 22 March 2021

Source: American Journal of Otolaryngology

Author(s): Konstantinos Mantsopoulos, Vivian Thimsen, Felix Wohlleben, Lava Taha, Matti Sievert, Sarina Katrin Müller, Miguel Goncalves, Heinrich Iro, Joachim Hornung

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Diagnosis and management of pharyngoesophageal stenosis: A comprehensive approach to prophylactic, endoscopic, and reconstructive treatment options

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Publication date: Available online 22 March 2021

Source: American Journal of Otolaryngology

Author(s): Sarah L. Spaulding, Edward Ansari, Monica H. Xing, Mykayla L. Sandler, Quinn F. O'Malley, Rebecca Ho, Hannah Spitzer, Juliana Levy, Cindy Ganz, Azita S. Khorsandi, Neil Mundi, Mark L. Urken

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The tracheotomy of Kaiser Friedrich III in the Year of the Three Kaisers, 1888 : Presentation of the original historical image to the DGHNO-KHC

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HNO. 2021 Mar 22. doi: 10.1007/s00106-021-01026-z. Online ahead of print.

ABSTRACT

The current article describes an image depicting an otorhinolaryngologic surgical intervention being performed on Kaiser Friedrich III. The image was captured by the lithography of an unknown artist and originates from a Cologne printing press. Kaiser Friedrich III was the penultimate German Kaiser and died June 15, 1888, in Potsdam, after ruling for only 99 days (the Year of the Three Kaisers ). Toward the end of his period as Prince Regent and during his time on the throne, Kaiser Friedrich III was tracheostomized and wore a silver cannula. This publication on the Kaiser's disease and the background of the lithography marks the occasion of presentation of this historic image to the German Society of Otorhinolaryngology, Head and Neck Surgery by the author.

PMID:33754200 | DOI:10.1007/s00106-021-01026-z

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Photobiomodulation therapy increases collagen II after tendon experimental injury

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Histol Histopathol. 2021 Mar 23:18330. doi: 10.14670/HH-18-330. Online ahead of print.

ABSTRACT

A tendon is a mechanosensitive tissue that transmits muscle-derived forces to bones. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), has been used in therapeutic approaches in tendon lesions, but uncertainties regarding its mechanisms of action have prevented its widespread use. We investigated the response of PBM therapy in experimental lesions of the Achilles tendon in rats. Thirty adult male Wistar rats weighing 250 to 300 g were surgically submitted to bilateral partial transverse section of the Achilles tendon. The right tendon was treated with PBM, whereas the left tendon served as a control. On the third postoperative day, the rats were divided into three experimental groups consisting of ten rats each, which were treated with PBM (Konf, Aculas - HB 750), 780 nm and 80 mW for 20 seconds, three times/week for 7, 14 and 28 days. The rats were sacrificed at the end of the therapeutic time period. The Sca-1 was examined by immunohistochemistry and histomorphometry, and COLA1, COLA2 and COLA3 gene expression was examined by qRT-PCR. COLA2 gene expression was higher in PBM treated tendons than in the control group. The histomorphometric analysis coincided with increased number of mesenchymal cells, characterized by Sca-1 expression in the lesion region (p<0.001). PBM effectively interferes in tendon tissue repair after injury by stimulating mesenchymal cell proliferation and the synthesis of collagen type II, which is suggested to provide structural support to the interstitial tissues during the healing process of the Achilles tendon. Further studies are needed to confirm the role of PBM in tendon healing.

PMID:33755188 | DOI:10.14670/HH-18-330

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Radioactive Iodine Treatment for Children and Young Adults with Thyroid Cancer in South Korea: A Population-Based Study

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J Clin Endocrinol Metab. 2021 Mar 23:dgab192. doi: 10.1210/clinem/dgab192. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated radioactive iodine treatment (RAIT) patterns and the secondary cancer incidence among child and young adult patients receiving RAIT after thyroidectomy for thyroid cancer.

METHODS: This population-based cohort study used the Health Insurance Review and Assessment database of South Korea to identify a total of 18,617 child and young adult p atients (0-29 years) who underwent thyroidectomy for thyroid cancer between 2008 and 2018. We recorded age at surgery, sex, the interval from surgery to RAIT, the doses of RAI, the number of RAIT sessions, and secondary cancer incidence.

RESULTS: A total of 9,548 (51.3%) child and young adult patients underwent one or more RAIT sessions. The initial dose of RAIT was 4.35±2.19 GBq. The overall RAIT frequency fell from 60.9 to 38.5% and the frequency of high-dose RAIT (>3.7 GBq) from 64.2 to 36.5% during the observational period. A total of 124 cases of secondary cancer developed during 120,474 person-years of follow-up; 43 (0.5%) in the surgery cohort and 81 (0.8%) in the RAIT cohort. The RAIT cohort was thus at an increased risk of secondary cancer (adjusted hazard ratio 1.52 [95%CI 1.03-2.24], P = 0.035).

CONCLUSION: The proportion of child and young adult patients receiving RAIT, and the RAI dose, fell significantly over the observational period. RAIT was associate d with secondary cancers. This is of major concern in the context of child and young adult thyroid cancer survivors.

PMID:33755732 | DOI:10.1210/clinem/dgab192

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