Αρχειοθήκη ιστολογίου

Τετάρτη 14 Δεκεμβρίου 2016

A 45-Second Self-Test for Cardiorespiratory Fitness: Heart Rate-Based Estimation in Healthy Individuals

http://otorhinolarygology.blogspot.com/2016/12/a-45-second-self-test-for.html


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Indian Journal of Medical and Paediatric Oncology (Indian J Med Paediatr Oncol)

EDITORIAL COMMENTARY

Classical or pylorus-preserving pancreatoduodenectomy in pancreatic and periampullary cancer: "The jury is still out!" [pg. 209]
Savio George Barreto
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REVIEW ARTICLES

Should every patient with pancreatic cancer receive perioperative/neoadjuvant therapy? [pg. 211]
Ulrich Nitsche, Bo Kong, Alexander Balmert, Helmut Friess, Jörg Kleeff
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Skin: A mirror of internal malignancy [pg. 214]
Rita V Vora, RahulKrishna S Kota, Nilofar G Diwan, Nidhi B Jivani, Shailee S Gandhi
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Status of barium studies in the present era of oncology: Are they a history? [pg. 223]
Abhishek Mahajan, Subash Desai, Nilesh Pandurang Sable, Meenakshi Haresh Thakur
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ORIGINAL ARTICLES

Protection behaviors for cytotoxic drugs in oncology nurses of chemotherapy centers in Shiraz hospitals, South of Iran [pg. 227]
Khadijeh Abbasi, Maryam Hazrati, Abolfazl Mohammadbeigi, Jasem Ansari, Mahboubeh Sajadi, Azam Hosseinnazzhad, Esmail Moshiri
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Outcomes, cost comparison, and patient satisfaction during long-term central venous access in cancer patients: Experience from a Tertiary Care Cancer Institute in South India [pg. 232]
K Govind Babu, MC Suresh Babu, D Lokanatha, Gita R Bhat
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Effect of areca nut chewing and maximal mouth opening in schoolgoing children in Ahmedabad [pg. 239]
Azizfatema Munawer Khan, Megha S Sheth, Romsha R Purohit
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Clinicopathological features and outcomes in advanced nonsmall cell lung cancer with tailored therapy [pg. 242]
Stalin Bala, Sadashivudu Gundeti, Vijay Gandhi Linga, Lakshmi Srinivas Maddali, Raghunadha Rao Digumarti, Shantveer G Uppin
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Clinicopathological profile of gastrointestinal lymphomas in Kashmir [pg. 251]
Mehnaaz Sultan Khuroo, Summyia Farooq Khwaja, Ajaz Rather, Zhahid Hassan, Ruby Reshi, Naira Sultan Khuroo
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Metabolic toxicities in patients undergoing treatment for nonhematological malignancy: A cross-sectional study [pg. 256]
Subhash Gupta, Kunhi Parambath Haresh, Soumyajit Roy, Lakhan Kashyap, Narayan Adhikari, Rambha Pandey, Dayanand Sharma, Pramod Kumar Julka, Goura Kishor Rath
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Managing metastatic renal cell carcinoma-challenges, pitfalls, and outcomes in the real world [pg. 260]
Karnam Ashok Kumar, Gundeti Sadashivudu, KV Krishnamani, Vijay Gandhi Linga, Lakshmi Srinivas Maddali, Raghunadha Rao Digumarti
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Evaluation of thyroid lesions by fine-needle aspiration cytology based on Bethesda system for reporting thyroid cytopathology classification among the population of South Bihar [pg. 265]
Richa Bhartiya, Mahasweta Mallik, Nawanita Kumari, Brijendra Narayan Prasad
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Oxaliplatin-related neuropathy in Indian patients – no difference between generic and original molecules [pg. 271]
Bhawna Sirohi, Vikas Ostwal, Shaheenah Dawood, Gilberto Lopes, Sanjay Talole, Chaitali Nashikkar, Shailesh Shrikhande
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Burden of cervical cancer and role of screening in India [pg. 278]
Saurabh Bobdey, Jignasa Sathwara, Aanchal Jain, Ganesh Balasubramaniam
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Cognizance and utilization about breast cancer screening among the health professional female students and staffs of University Kuala Lumpur, Royal College of Medicine Perak, Malaysia [pg. 286]
ATM Emdadul Haque, Muhammad Afif Bin Mohd Hisham, Noor Azwa Laili Binti Ahmad Adzman, Nur Atiqah Binti Azudin, Nursakinah Binti Shafri, Mainul Haque
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CASE REPORTS

Juvenile granulosa cell tumor associated with Ollier disease [pg. 293]
Abhilasha Ashok Sampagar, Rahul R Jahagirdar, Vibha Sanjay Bafna, Sandip P Bartakke
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Thymoma masquerading as transfusion dependent anemia [pg. 296]
Javvid Muzamil, Aejaz Aziz Shiekh, Gull Mohammad Bhat, Abdul Rashid Lone, Shuaeb Bhat, Firdousa Nabi
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PRACTITIONER SECTION

A rare case of lung cancer presenting as an ischioanal fossa mass [pg. 300]
Nishitha Shetty, Ranvijay Singh, Maryam Naveed, Ashwini M Ronghe, Falguni Shashikant Barot
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Multiple solitary extramedullary anaplastic plasmacytomas [pg. 303]
Sandesh Madi, Vishnu Senthil, Monappa Naik, Sandeep Vijayan
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LETTERS TO EDITOR

Folate supplementation in transfusion-dependent thalassemia: Do we really need such high doses? [pg. 305]
Gaurav Tripathi, Manas Kalra, Amita Mahajan
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Early tumor shrinkage as an "on-treatment" clinical predictor of long-term outcome in solid organ cancers [pg. 306]
Pratishtha Banga Chaudhari
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Cancer risk of general people due to using joss stick for religious worshiping [pg. 307]
Beuy Joob, Viroj Wiwanitkit
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A rare case of hepatoid carcinoma of the ovary with pancytopenia and hypocellular marrow [pg. 307]
Manoj Lakhotia, Hans Raj Pahadiya, Akanksha Choudhary, Ronak Gandhi, Ramesh Chand Purohit
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Multiple cutaneous malignancies in a child with xeroderma pigmentosum: A case report [pg. 309]
Rita V Vora, RahulKrishna SureshKumar Kota, Nilofar G Diwan
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The masquerading splenic lesion [pg. 311]
Mansoor C Abdulla, Jemshad Alungal, Ram Naryan, Neena Mampilly
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ASCO 2016 GI CANCER UPDATE

Focused update on Gastrointestinal (GI) Oncology from ASCO 2016 [pg. 314]
Ravi Kumar Paluri
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ERRATUM

Erratum: Evaluation of myeloid cells (tumor associated tissue eosinophils and mast cells) infiltration in different grades of oral squamous cell carcinoma [pg. 319]

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Erratum: Isolated humeral recurrence in endometrial carcinoma [pg. 320]

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Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Thank You

Σχετική εικόνα

--
Αλέξανδρος Γ. Σφακιανάκης
Αναπαύσεως 5 Άγιος Νικόλαος Λασιθίου 72100
2841026182
6948891480

Παρασκευή 7 Οκτωβρίου 2016

Surgical Strategy and Facial Nerve Outcomes in Petrous Bone Cholesteatoma.

Surgical Strategy and Facial Nerve Outcomes in Petrous Bone Cholesteatoma.

Audiol Neurootol. 2016 Oct 7;21(5):275-285

Authors: Prasad SC, Piras G, Piccirillo E, Taibah A, Russo A, He J, Sanna M

Abstract
OBJECTIVE: To review the classification and management of petrous bone cholesteatomas (PBCs) at our center and the outcomes of facial nerve (FN) management in these lesions.
METHODS: This was a retrospective study. The setting was a quaternary referral center for skull base pathology in Italy. A total of 200 patients with 201 PBCs were included in the study. All patients diagnosed radiologically with PBCs were classified according to the Sanna classification. All patients were surgically treated and followed up with radiology. The main outcome measures - classification of PBCs, the surgical approach used, disease control, and FN outcomes - were analyzed.
RESULTS: Supralabyrinthine PBCs were the most common type with 92 cases (45.8%) followed by the massive PBCs with 72 cases (35.8%). Preservation of preoperative FN function was highest in the infralabyrinthine (72.2%) and infralabyrinthine-apical (73.3%) types. The transotic approach was used in 66 cases (32.8%) in this series. The modified transcochlear approach type A was applied in 55 cases (27.3%). Active management of the nerve (rerouting, anastomosis, or grafting) was required in 53 cases (26.4%). Postoperatively, of the 116 cases with FN House-Brackmann grade I and II, 107 cases (92.2%) retained the same grade or improved. Recurrence was seen in 7 cases (3.5%). The mean duration of follow-up was 6.3 years.
CONCLUSIONS: Radical disease clearance must take precedence over hearing and FN preservation in PBCs. Active FN management, including rerouting, end-to-end anastomosis, and cable nerve grafting, routinely come to play in the surgical management of PBCs, and the postoperative FN results after such interventions can be satisfactory in most cases.

PMID: 27710980 [PubMed - as supplied by publisher]



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R2* Map by IDEAL IQ for Acute Cerebral Infarction: Compared with Susceptibility Vessel Sign on T2*-Weighted Imaging.

Related Articles

R2* Map by IDEAL IQ for Acute Cerebral Infarction: Compared with Susceptibility Vessel Sign on T2*-Weighted Imaging.

Yonago Acta Med. 2016 Sep;59(3):204-209

Authors: Shinohara Y, Kato A, Yamashita E, Ogawa T

Abstract
BACKGROUND: To evaluate the detectability of arterial acute thrombus on R2* map by iterative decomposition of water and fat with echo asymmetry and least-squares estimation (IDEAL) IQ compared with T2*-weighted imaging (T2*WI).
METHODS: Twenty-six patients with acute cerebral infarction who underwent R2* map and T2*WI were reviewed. We performed visual assessment of each sequence regarding the visibility of susceptibility effect reflecting acute thrombus and quantitative evaluation of the thrombus on R2* map.
RESULTS: Both R2* map and T2*WI showed susceptibility effect reflecting acute thrombi at the occluded site of magnetic resonance angiography (MRA) in 9 patients. R2* map revealed positive while T2*WI showed equivocal findings in 3 patients due to the surrounding vessel signal intensity. Acute thrombus at distal internal carotid artery (ICA) on R2* map was more clearly detected than that on T2*WI without any apparent susceptibility artifact from the skull base in 4 patients. Most of cardiogenic embolic infarction (CEI) and artery-to-artery embolic infarction (A-to-A) demonstrated positive and most of atherothrombotic infarction (ATI) revealed negative findings on R2* map, although quantitative R2* values of thrombi did not show significant differences between CEI (136.6 /msec) and A-to-A (189.9 /msec) (P = 0.332).
CONCLUSION: The detectability of acute thrombus on R2* map is comparable to that on T2*WI. Regarding thrombus at distal ICA, its detectability on R2* map is superior to that on T2*WI. R2* map provide additional information to distinguish between embolic and atherothrombotic infarctions.

PMID: 27708535 [PubMed - in process]



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Platelet-rich fibrin: a boon in regenerative endodontics.

Platelet-rich fibrin: a boon in regenerative endodontics.

Minerva Stomatol. 2016 Dec;65(6):385-392

Authors: Rebentish PD, Umashetty G, Kaur H, Doizode T, Kaslekar M, Chowdhury S

Abstract
Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

PMID: 27711028 [PubMed - in process]



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Quantification of the amount of dental material removed by selective grinding in wax dentures with photogrammetric measurements.

Quantification of the amount of dental material removed by selective grinding in wax dentures with photogrammetric measurements.

Minerva Stomatol. 2016 Dec;65(6):335-342

Authors: Ravasini F, Fornari M, Bonanini M

Abstract
BACKGROUND: The use of photogrammetry may be a new method to quantify the amount of artificial dental material removed from the surface of each teeth during the grind procedure (SG). SG is necessary in each denture to reach a correct occlusion. It consists in a refine action on the prosthesis teeth's surface using milling machine tools, aimed to remove the interferences (pre-contacts) between upper and lower teeth during chewing. This measure is achieved after a comparison between pre and post-grinding 3D models. This new application could be of interest for both dentists and dental technicians because it could be used to evaluate, with a accurate numerical description, the action applied on teeth surfaces during the grinding process. Furthermore, results of the analysis could have some value for the dental industry, since the use of photogrammetry can improve the process, reducing costs during the design of artificial teeth and eventually this method could be used as a teaching tool both for dental and "dental technician" high school students. The purpose of this work is to measure the thickness of the artificial enamel removed during grinding phases. Usually, the dental technician adjusts the dental plate on the mount of the patient following the traditional method, without a quantitative evaluation of the material removed. The photogrammetric method (PM) proposed here allows to measure the amount of material removed during the grinding process. This measure is achieved after a comparison between pre and post-grinding 3D models.
METHODS: Under control of three teachers (experts of dentures performed according to the Gerber method) ten complete dentures arrangements (upper and inferior arches) performed by dental students at the Prosthodontic Department of the University of Parma, Italy were analyzed with PM before and after SG.
RESULTS: The average thickness variation between the pre and post-grinding dentures is within the range of 0.1÷0.4 mm. For the upper arches, the mean value of the SG process is 223 µm while for the inferior arches is 240 µm. Results show that the most important grind process in all models appear in correspondence of cusps, with values up to 1660 µm. On the other hand, in correspondence of the fossae the results show a moderate grind action: the value is around 200-300 µm. Conversely to guidelines thought to students: cusps undergo a greater grinding process than fossae, consequently cusps should be revisioned at least on their technical and morphological aspects. The average thickness variation between the pre and post-grinding dentures is within the range of 0.1÷0.4 mm, this mean an equal value loss of vertical dimension. Furthermore, the knowledge of the gauge material removed during the SG could be useful for dental industries, giving important information, that could be considered for project and design of artificial teeth.
CONCLUSIONS: The FM implemented in this article has given satisfactory preliminary results, showing good accuracy, low costs and high versatility. It is necessary to highlight that this is an experimental method and that the present analysis is a pilot study that needs further evaluation. Nevertheless results obtained could be of some value for medical companies, in order to improve the artificial teeth's design and project. Moreover, such a method may serve as educational tool for dental students.

PMID: 27711027 [PubMed - in process]



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Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

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Acoustic analysis of snoring sounds recorded with a smartphone according to obstruction site in OSAS patients.

Eur Arch Otorhinolaryngol. 2016 Oct 5;:

Authors: Koo SK, Kwon SB, Kim YJ, Moon JI, Kim YJ, Jung SH

Abstract
Snoring is a sign of increased upper airway resistance and is the most common symptom suggestive of obstructive sleep apnea. Acoustic analysis of snoring sounds is a non-invasive diagnostic technique and may provide a screening test that can determine the location of obstruction sites. We recorded snoring sounds according to obstruction level, measured by DISE, using a smartphone and focused on the analysis of formant frequencies. The study group comprised 32 male patients (mean age 42.9 years). The spectrogram pattern, intensity (dB), fundamental frequencies (F 0), and formant frequencies (F 1, F 2, and F 3) of the snoring sounds were analyzed for each subject. On spectrographic analysis, retropalatal level obstruction tended to produce sharp and regular peaks, while retrolingual level obstruction tended to show peaks with a gradual onset and decay. On formant frequency analysis, F 1 (retropalatal level vs. retrolingual level: 488.1 ± 125.8 vs. 634.7 ± 196.6 Hz) and F 2 (retropalatal level vs. retrolingual level: 1267.3 ± 306.6 vs. 1723.7 ± 550.0 Hz) of retrolingual level obstructions showed significantly higher values than retropalatal level obstruction (p < 0.05). This suggests that the upper airway is more severely obstructed with retrolingual level obstruction and that there is a greater change in tongue position. Acoustic analysis of snoring is a non-invasive diagnostic technique that can be easily applied at a relatively low cost. The analysis of formant frequencies will be a useful screening test for the prediction of occlusion sites. Moreover, smartphone can be effective for recording snoring sounds.

PMID: 27709292 [PubMed - as supplied by publisher]



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Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections.

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Antibiotic Prescribing by Physicians Versus Nurse Practitioners for Pediatric Upper Respiratory Infections.

Ann Otol Rhinol Laryngol. 2016 Oct 5;:

Authors: Ference EH, Min JY, Chandra RK, Schroeder JW, Ciolino JD, Yang A, Holl J, Shintani Smith S

Abstract
BACKGROUND: This study investigates differences in antibiotic prescribing rates for pediatric upper respiratory infections (URIs) between physicians and nurse practitioners (NPs).
METHODS: Visits by children <18 years old diagnosed with URI to physicians or NPs between 2001 and 2010 were abstracted from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey. Logistic regression analyses examined variations in antibiotic prescribing rates.
RESULTS: Upper respiratory infections accounted for approximately 439 ± 21.5 million visits. Patients seen by NPs were more likely to have Medicaid, live in the lowest median household income quartile zip codes and micropolitan locations, and live in the South compared to patients seen by physicians. Nurse practitioners prescribed antibiotics 66.7% ± 4.2% of the time versus physicians at 52.8% ± 0.8% for URI visits (unadjusted P-value = .002). Adjusted by specialty, URI type, and chronic diseases, NPs had marginally significantly different odds of prescribing antibiotics (OR = 1.6, 95% CI, 1.0-2.6, P-value = .048), but the association with prescribing broad-spectrum antibiotics is not as strong (adjusted P-value = .063). Patient visits to a pediatric (OR = 0.54, 95% CI, 0.43-0.67) or ENT/surgery practice (OR = 0.11, 95% CI, 0.06-0.18) had lower odds of antibiotic prescribing compared to general/family medicine practices. Year (2001-2010) was not significantly associated with antibiotic or broad-spectrum antibiotic prescribing rates for physicians, but rates for NPs fell for otitis media (P-value = .007) from 90.2% ± 8.2% (2001-2002) to 74.8% ± 6.8% (2009-2010) of visits.
CONCLUSIONS: Nurse practitioners have higher rates of antibiotic prescribing compared to physicians for pediatric patients with URIs; however, this difference is less after adjusting for specialty. Examining comparative antibiotic prescribing is important to promote evidence-based practice and adoption of clinical guidelines.

PMID: 27707916 [PubMed - as supplied by publisher]



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Airway observations during upper endoscopy predicting obstructive sleep apnea.

Related Articles

Airway observations during upper endoscopy predicting obstructive sleep apnea.

Ann Gastroenterol. 2016 Oct-Dec;29(4):481-486

Authors: Harvin G, Ali E, Raina A, Leland W, Abid S, Vahora Z, Movahed H, Kachru S, Tee R

Abstract
BACKGROUND: This pilot study examined airway characteristics during upper endoscopy to determine who is at high risk for obstructive sleep apnea.
METHODS: Patients undergoing routine upper endoscopy were divided into 2 groups according to the Berlin Questionnaire (high and low risk for sleep disordered breathing). Patients underwent routine upper endoscopy using propofol sedation. The airway was then evaluated for no, partial, or complete collapse at the levels of the palate/uvula/tonsils, the tongue base, the hypopharynx, and the larynx. They were given a score of 0 for no collapse, 1 for partial collapse, and 2 for complete collapse. The score for each of these levels was added to give a total score or severity index. The larynx was also evaluated for lateral pharyngeal collapse (minimal, up to 50%, >50%, or 100%).
RESULTS: We found that patients with a partial obstruction at the level of the palate/uvula/tonsils, tongue base, hypopharynx, or larynx, or complete obstruction at any level more often had a positive Berlin questionnaire. Patients with a positive Berlin questionnaire were more often of increased weight (mean 197 vs 175 lbs, P=0.19), increased body mass index (31.2 vs 27.42 kg/m(2), P=0.11), increased neck circumference (36.7 vs 34.7 cm, P=0.23), and had a higher total airway score (2.61 vs 1.67, P=0.09).
CONCLUSIONS: The results of our pilot study represent preliminary data regarding the use of upper endoscopy as a potential tool to evaluate patients for obstructive sleep apnea.

PMID: 27708514 [PubMed - in process]



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Foreign Body Granuloma of the Epiglottic Vallecula Mimicking Malignancy on MRI and FDG PET/CT.

http:--pt.wkhealth.com-pt-pt-core-templa Related Articles

Foreign Body Granuloma of the Epiglottic Vallecula Mimicking Malignancy on MRI and FDG PET/CT.

Clin Nucl Med. 2016 Mar;41(3):227-9

Authors: Dong A, Bai Y, Wang Y, Zuo C

Abstract
A 66-year-old man complained of foreign body sensation of the throat and progressive dysphagia without any trigger. Videolaryngoscopy showed a whitish lesion in the epiglottic vallecula. Neck enhanced MRI showed a lesion in epiglottic vallecula with remarkable enhancement. FDG PET/CT showed intense FDG uptake of the lesion with SUVmax of 28. Malignant tumor was suspected. The patient underwent microlaryngoscopic surgery. Histopathologic findings of the specimen were consistent with foreign body granuloma.

PMID: 26447384 [PubMed - indexed for MEDLINE]



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Vocal fold tear in an operatic tenor.

Related Articles

Vocal fold tear in an operatic tenor.

Ear Nose Throat J. 2014 Sep;93(9):E41-2

Authors: Portnoy JE, Sataloff RT

PMID: 25255360 [PubMed - indexed for MEDLINE]



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[Conjunctival impression cytology in patients with normal and impaired OSDI scores].

http:--http://ift.tt/1LFUhH3 Related Articles

[Conjunctival impression cytology in patients with normal and impaired OSDI scores].

Arch Soc Esp Oftalmol. 2014 Oct;89(10):391-6

Authors: Zuazo F, López-Ponce D, Salinas-Toro D, Valenzuela F, Sans-Puroja J, Srur M, López-Solís RO, Traipe-Castro L

Abstract
PURPOSE: To describe goblet cell density and Nelson grading in different areas of the ocular surface using conjunctival impression cytology (CIC) among patients with normal and impaired Ocular Surface Disease Index (OSDI) scores.
MATERIAL AND METHODS: Patients (n=166) under assessment for dry eye were recruited between 2011 and 2012 and classified according to the OSDI score in 4 categories (normal and impaired). Cytological study (CIC plus Papanicolaou staining) using the Nelson grading system, with modifications in staging, and goblet cell counting were performed on the nasal, temporal, inferior, and superior bulbar conjunctival surfaces.
RESULTS: Nelson grading was significantly higher in patients with a severely impaired OSDI score (1.41±0.14) compared to normal patients (0.86±0.09) (P<.01). Goblet cell density was significantly reduced in patients with a severely impaired OSDI score (310.24±56.24 cells per sample) compared with normal subjects (497.31±50.07 cells per sample) (P<.001). Compared with the photoexposed bulbar conjunctiva, goblet cell density on the non-photoexposed conjunctiva was significantly higher both in patients with mild (P<.01) and moderate (P<.001) OSDI scores.
CONCLUSION: Patients with severely impaired OSDI scores have less goblet cells and a higher Nelson grade. Goblet cells are more abundant on the non-photoexposed conjunctiva.

PMID: 24993073 [PubMed - indexed for MEDLINE]



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Πέμπτη 6 Οκτωβρίου 2016

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Eur Arch Otorhinolaryngol. 2016 Oct 4;:

Authors: Torres R, Kazmitcheff G, De Seta D, Ferrary E, Sterkers O, Nguyen Y

Abstract
It has previously reported that alignment of the insertion axis along the basal turn of the cochlea was depending on surgeon' experience. In this experimental study, we assessed technological assistances, such as navigation or a robot-based system, to improve the insertion axis during cochlear implantation. A preoperative cone beam CT and a mastoidectomy with a posterior tympanotomy were performed on four temporal bones. The optimal insertion axis was defined as the closest axis to the scala tympani centerline avoiding the facial nerve. A neuronavigation system, a robot assistance prototype, and software allowing a semi-automated alignment of the robot were used to align an insertion tool with an optimal insertion axis. Four procedures were performed and repeated three times in each temporal bone: manual, manual navigation-assisted, robot-based navigation-assisted, and robot-based semi-automated. The angle between the optimal and the insertion tool axis was measured in the four procedures. The error was 8.3° ± 2.82° for the manual procedure (n = 24), 8.6° ± 2.83° for the manual navigation-assisted procedure (n = 24), 5.4° ± 3.91° for the robot-based navigation-assisted procedure (n = 24), and 3.4° ± 1.56° for the robot-based semi-automated procedure (n = 12). A higher accuracy was observed with the semi-automated robot-based technique than manual and manual navigation-assisted (p < 0.01). Combination of a navigation system and a manual insertion does not improve the alignment accuracy due to the lack of friendly user interface. On the contrary, a semi-automated robot-based system reduces both the error and the variability of the alignment with a defined optimal axis.

PMID: 27704279 [PubMed - as supplied by publisher]



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Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome.

Impact of gender and sleep position on relationships between anthropometric parameters and obstructive sleep apnea syndrome.

Sleep Breath. 2016 Oct 5;:

Authors: Jeong JI, Gu S, Cho J, Hong SD, Kim SJ, Dhong HJ, Chung SK, Kim HY

Abstract
OBJECTIVE: Considering the mechanisms by which obesity affects obstructive sleep apnea syndrome (OSAS) and the differences of fat distribution depending on gender, associations between anthropometric parameters, and OSAS may differ depending on gender or sleep position. We analyzed the impact of gender and sleep position on the relationship between fat distribution and development of OSAS.
METHODS: One thousand thirty-two consecutive subjects were analyzed. Recorded anthropometric measurements and overnight polysomnographic data of the subjects were reviewed retrospectively. The presence of OSAS was defined by the respiratory disturbance index (RDI) ≥5 with documented symptoms of excessive daytime sleepiness.
RESULTS: Eight hundred fifty-eight males and 174 females were included. Male subjects had significantly higher body mass index (BMI), larger waist circumference (WC), and lower percent of overall body fat (P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The severity of OSAS was significantly higher in male subjects (RDI 26.9 ± 22.4 in males vs. 10.2 ± 13.8 in females, P < 0.0001). In male subjects, BMI, WC, and overall body fat were significantly associated with severity of OSAS and had larger impacts on supine RDI than lateral RDI. Overall body fat was not associated with severity of OSAS in female subjects, and there were no significant differences of the associations between all anthropometric parameters and RDIs depending on sleep position.
CONCLUSIONS: Evaluation of the correlation of anthropometric data with severity of OSAS should consider sleep position as well as gender.

PMID: 27704328 [PubMed - as supplied by publisher]



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Improvement of the insertion axis for cochlear implantation with a robot-based system.

Improvement of the insertion axis for cochlear implantation with a robot-based system.

Eur Arch Otorhinolaryngol. 2016 Oct 4;:

Authors: Torres R, Kazmitcheff G, De Seta D, Ferrary E, Sterkers O, Nguyen Y

Abstract
It has previously reported that alignment of the insertion axis along the basal turn of the cochlea was depending on surgeon' experience. In this experimental study, we assessed technological assistances, such as navigation or a robot-based system, to improve the insertion axis during cochlear implantation. A preoperative cone beam CT and a mastoidectomy with a posterior tympanotomy were performed on four temporal bones. The optimal insertion axis was defined as the closest axis to the scala tympani centerline avoiding the facial nerve. A neuronavigation system, a robot assistance prototype, and software allowing a semi-automated alignment of the robot were used to align an insertion tool with an optimal insertion axis. Four procedures were performed and repeated three times in each temporal bone: manual, manual navigation-assisted, robot-based navigation-assisted, and robot-based semi-automated. The angle between the optimal and the insertion tool axis was measured in the four procedures. The error was 8.3° ± 2.82° for the manual procedure (n = 24), 8.6° ± 2.83° for the manual navigation-assisted procedure (n = 24), 5.4° ± 3.91° for the robot-based navigation-assisted procedure (n = 24), and 3.4° ± 1.56° for the robot-based semi-automated procedure (n = 12). A higher accuracy was observed with the semi-automated robot-based technique than manual and manual navigation-assisted (p < 0.01). Combination of a navigation system and a manual insertion does not improve the alignment accuracy due to the lack of friendly user interface. On the contrary, a semi-automated robot-based system reduces both the error and the variability of the alignment with a defined optimal axis.

PMID: 27704279 [PubMed - as supplied by publisher]



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A systematic review of resonant voice therapy.

A systematic review of resonant voice therapy.

Int J Speech Lang Pathol. 2016 Oct 5;:1-13

Authors: Yiu EM, Lo MC, Barrett EA

Abstract
PURPOSE: The purpose of this study is to systematically review the literature on resonant voice therapy and to evaluate the level of evidence on the effectiveness of using resonant voice therapy in treating dysphonia.
METHOD: Refereed journal papers from 1974 to 2014 were retrieved and reviewed by two independent reviewers using the keywords "Humming, Resonance, Resonant Voice, Semi-occluded or closed tube phonation" using available database systems. Quality of evidence was evaluated by using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULT: Thirteen papers met the search criteria. Nine papers were selected by the two reviewers. Two of the papers were randomised-controlled studies and the other seven were observational studies. At least four types of resonant voice therapies were described. They included the Lessac-Madsen Resonant Voice Therapy, Y-Buzz, Resonance Therapy and Humming. The overall level of quality of evidence was graded as "moderate".
CONCLUSION: There were limited studies that investigated the effectiveness of resonant voice therapy. Most studies were small-scale uncontrolled observational studies with the inclusion of only small samples or specific populations. There is clearly a need for more large-scale randomised controlled studies with a wider range of populations to provide further evidence on the effectiveness of resonant voice training for different populations.

PMID: 27705008 [PubMed - as supplied by publisher]



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Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience.

Extracapsular dissection versus superficial parotidectomy in benign parotid gland tumors: The Vienna Medical School experience.

Head Neck. 2016 Oct 5;:

Authors: Kadletz L, Grasl S, Grasl MC, Perisanidis C, Erovic BM

Abstract
BACKGROUND: The purpose of this study was to evaluate the clinical outcome in patients with benign parotid gland tumors after extracapsular dissection or superficial parotidectomy (SP).
METHODS: Eight hundred ninety-four patients with primary pleomorphic adenoma or Warthin's tumor were included from this study. Type and length of surgery, tumor size, resection margins, and complication rates were assessed.
RESULTS: Three hundred ninety-five (44.2%) extracapsular dissections and 499 SPs (55.8%) were performed. The rate of positive margins was significantly higher in the extracapsular dissection compared to the SP group (29.4% vs 10.2%; p < .0001). Recurrent disease (extracapsular dissection = 7.2% vs SP = 2.2%; p = .0003) and permanent facial palsy were significantly more frequent after extracapsular dissection than SP (2.2% vs 0.6%; p = .0396). Significant prolonged surgery time was observed after SP (146 vs 94 minutes; p < .0001).
CONCLUSION: Because extracapsular dissection led to a significantly higher percentage of permanent facial palsy, recurrent disease, and positive resection margins compared to SP, we recommend SP for treating benign parotid gland tumors. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704717 [PubMed - as supplied by publisher]



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Weight loss after head and neck cancer: A dynamic relationship with depressive symptoms.

Weight loss after head and neck cancer: A dynamic relationship with depressive symptoms.

Head Neck. 2016 Oct 5;:

Authors: Van Liew JR, Brock RL, Christensen AJ, Karnell LH, Pagedar NA, Funk GF

Abstract
BACKGROUND: Weight loss and depressive symptoms are critical head and neck cancer outcomes, yet their relation over the illness course is unclear.
METHODS: Associations between self-reported depressive symptoms and objective weight loss across the year after head and neck cancer diagnosis were examined using growth curve modeling techniques (n = 564).
RESULTS: A reciprocal covariation pattern emerged-changes in depressive symptoms over time were associated with same-month changes in weight loss (t [1148] = 2.05; p = .041), and changes in weight loss were associated with same-month changes in depressive symptoms (t [556] = 2.43; p = .015). To the extent that depressive symptoms increased, patients lost incrementally more weight than was lost due to the passage of time and vice versa. Results also suggested that pain and eating-related quality of life might explain the reciprocal association between depressive symptoms and weight loss.
CONCLUSION: In head and neck cancer, a transactional interplay between depressive symptoms and weight loss unfolds over time. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704695 [PubMed - as supplied by publisher]



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Versatility of the facial artery myomucosal island flap in neopharyngeal reconstruction.

Versatility of the facial artery myomucosal island flap in neopharyngeal reconstruction.

Head Neck. 2016 Oct 5;:

Authors: Frisch T

Abstract
BACKGROUND: The facial artery myomucosal (FAMM) island flap is a cheek flap, pedicled on the facial artery and suitable for small to medium-sized reconstructions of the oral cavity and neighboring areas. A novel transposition of the flap to the hypopharynx after laryngectomy is presented in this report.
METHODS: A 58-year-old man, previously irradiated, was laryngopharyngectomized because of a new supraglottic carcinoma. An unexpected need for a flap was solved by tunneling a FAMM island flap lateral to the mandible. The reach and size of the flap were sufficient to close the defect.
RESULTS: Vitality of the flap was ascertained by fiber endoscopy. No donor-site morbidity was seen. Postoperatively, the patient had a minor stomal fistula with spontaneous healing.
CONCLUSION: The pedicled FAMM island flap may be considered for smaller reconstructions of the upper hypopharynx. Accessibility, low donor-site morbidity, and recipient tissue similarity count among the advantages. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704666 [PubMed - as supplied by publisher]



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Efficacy of ultrasound-guided fine-needle aspiration performed by surgeons newly trained in thyroid ultrasound.

Efficacy of ultrasound-guided fine-needle aspiration performed by surgeons newly trained in thyroid ultrasound.

Head Neck. 2016 Oct 5;:

Authors: Graciano AJ, Fischer CA, Chone CT, Bublitz GS, Sonagli M, Filho CA

Abstract
BACKGROUND: There are a growing number of thyroid ultrasound courses to train endocrinologists, pathologists, and surgeons to perform ultrasound-guided fine-needle aspiration (FNA). However, there are limited data to support the efficacy of ultrasound-guided FNA performed by nonradiologists.
METHODS: We compared the efficacy of ultrasound-guided FNA performed by surgeons newly trained in thyroid ultrasound with that of the same technique performed by 1 experienced radiologist. The ratio of nondiagnostic examinations was used to compare the 2 groups.
RESULTS: A total of 197 ultrasound-guided FNAs were performed on 172 women (95.53%) and 8 men (4.47%) over a 12-month period. The efficacy of ultrasound-guided FNA did not differ between groups. A nondiagnostic report was found in 23% and 25.7% of the examinations performed by the radiologist and surgeons, respectively.
CONCLUSION: The efficacy of ultrasound-guided FNAs performed by our 2 surgeons was similar to that of our radiologist. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704660 [PubMed - as supplied by publisher]



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High-dose intravenous steroid regimen for radiation-induced hypoglossal nerve palsy.

High-dose intravenous steroid regimen for radiation-induced hypoglossal nerve palsy.

Head Neck. 2016 Oct 5;:

Authors: McDowell LJ, Jacobson MC, Levin W

Abstract
BACKGROUND: Hypoglossal nerve palsies are infrequent complications of head and neck radiotherapy. Treatments focus on maintaining function and prevention of abnormal airway-related swallowing events.
METHODS: A patient with longstanding cranial neuropathies, including bilateral hypoglossal involvement, secondary to chemoradiotherapy for nasopharyngeal carcinoma, experienced repeated episodes of life-threatening complications. Initially, 2 courses of 2 weekly 24-hour intravenous methylprednisolone (IVMP) infusions were administered 2 years apart. We report the results of a third course comprising 5 weekly cycles.
RESULTS: Patient-reported outcomes revealed significant improvement in swallowing function, speech, and psychosocial status. Airway invasion during swallowing and pharyngeal retention were assessed videofluoroscopically and evaluated using the Penetration-Aspiration Scale (PAS) and a residue rating scale, respectively. PAS ratings after infusions 2 and 5, improved dramatically from baseline and were maintained at 1-year follow-up.
CONCLUSION: High doses of IVMP may improve radiation-induced neuropathies. Further testing in similar patients is needed to prove reproducibility. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704653 [PubMed - as supplied by publisher]



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Supratracheal partial laryngectomy with tracheohyoidoepiglottopexy (open partial horizontal laryngectomy type IIIa + cricoarytenoid unit): Surgical technique illustrated in the anatomy laboratory.

Supratracheal partial laryngectomy with tracheohyoidoepiglottopexy (open partial horizontal laryngectomy type IIIa + cricoarytenoid unit): Surgical technique illustrated in the anatomy laboratory.

Head Neck. 2016 Oct 5;:

Authors: Succo G, Crosetti E, Bertolin A, Lucioni M, Rizzotto G

Abstract
The first supratracheal partial laryngectomy (STPL) with tracheohyoidoepiglottopexy was performed in 1972. This procedure entailed preservation of the suprahyoid epiglottis as well as a pexy of the hyoid bone and residual epiglottis to the first tracheal ring; however, this technique was abandoned by the same author in the early 1980s because of poor functional outcomes. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704651 [PubMed - as supplied by publisher]



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Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

Core-needle biopsy versus repeat fine-needle aspiration for thyroid nodules initially read as atypia/follicular lesion of undetermined significance.

Head Neck. 2016 Oct 5;:

Authors: Choi YJ, Baek JH, Suh CH, Shim WH, Jeong B, Kim JK, Song DE, Kim TY, Chung KW, Lee JH

Abstract
BACKGROUND: The purpose of this study was to evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeat fine-needle aspiration (FNA) for thyroid nodules that are initially read as atypia/follicular lesion of undetermined significance (AUS/FLUS) on FNA.
METHODS: Among 2631 initial AUS/FLUS FNA results, 505 consecutive nodules (295 repeat FNAs and 210 CNBs) were retrospectively analyzed. The primary outcome was inconclusive (ie, nondiagnostic or AUS/FLUS). The secondary outcomes included inconclusive results of the subcategory, risk factors for inconclusive results, and diagnostic performance.
RESULTS: CNB demonstrated significantly fewer inconclusive results than repeat FNA for the overall nodules (40.9% vs 63%; p < .001). Repeat FNA and group FLUS were significant risk factors for inconclusive results (odds ratio = 1.92; p =.001 and odds ratio = 2.08; p <.001, respectively). All diagnostic performances using CNB were higher than repeat FNAs.
CONCLUSION: CNB is more useful than repeat FNAs for reducing inconclusive results and improving the diagnostic performance of thyroid nodules with initial AUS/FLUS FNA results. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.

PMID: 27704650 [PubMed - as supplied by publisher]



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