Αρχειοθήκη ιστολογίου

Πέμπτη 25 Φεβρουαρίου 2021

A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

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Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421995037. doi: 10.1177/0003489421995037. Online ahead of print.

ABSTRACT

OBJECTIVE: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition.

DATA SOURCES: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020.

REVIEW METHODS: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed.

RESULTS: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively.

CONCLUSION: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography e stablishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

PMID:33626894 | DOI:10.1177/0003489421995037

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Tympanostomy Tubes-Where We Were, Where We Are, and Where We Will Be: A State-of-The-Art Review

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Ear Nose Throat J. 2021 Feb 24:145561321997612. doi: 10.1177/0145561321997612. Online ahead of print.

NO ABSTRACT

PMID:33626919 | DOI:10.1177/0145561321997612

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Combined treatment of ureteropelvic junction obstruction and renal calculi with Robot Assisted Laparoscopic Pyeloplasty and Laser Lithotripsy in children: case report and non systematic review of the literature

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Summary:

Objective(s)

The incidence of urinary tract stone disease is steadily increasing in both adult and paediatric populations. This condition develops due to different factors: dietary or metabolic alterations, infection and congenital anatomic malformations. Standard indications and treatments for children are analogous to the ones indicated for adults. Extracorporeal shock wave lithotripsy (SWL), ureterorenoscopy (URS), percutaneous nephrolithotomy (PCNL) should be preferred to more invasive techniques. Moreover, the introduction of laparoscopic and robot assisted laparoscopic approaches have improved surgical outcomes, lowering the bleeding risk with higher stone‐free rates, even in complicated cases. Despite these well‐known improvements, there are few reports regarding laparoscopic robot assisted management for urinary tract stone disease in paediatric patients under the age of ten, especially with concomitant treatment of ureteropelvic junction obstruction and multiple calyceal stones.

Patient and Method(s)

A four years old child was referred for recurrent right abdominal flank pain, macroscopic haematuria and a previous history of urinary tract infections. A computed tomography of the abdomen showed right ureteropelvic junction obstruction associated with multiple unilateral stones located in the renal pelvis and in the interpolar renal calyces. Due to its complexity, we held a multidisciplinary meeting with paediatric surgeons and nephrologists to determine optimal treatment. As a result, a combined robot assisted laparoscopic pyeloplasty and renal calculi holmium laser lithotripsy using a digital flexible ureteroscope through an abdominal robotic trocar was performed. No post‐surgical complications were recorded and the patient was discharged within 48 hours following surgery. At subsequent regular follow‐up examinations over a period of 24 months, no signs of recurrence were detected for both ureteropelvic junction obstruction and stone disease.

Result(s)

Robot Assisted Laparoscopic Pyeloplasty with concomitant laser lithotripsy is a reasonable treatment option for designated young paediatric patients with challenging ureteropelvic junction obstruction complicated by urolithiasis, especially in cases where stones are not amenable with standard procedures.

This article is protected by copyright. All rights reserved.

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Association Between Habitual Snoring and Cognitive Performance in Preadolescent Children

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This cross-sectional study uses a baseline data set from the on going Adolescent Brain and Cognitive Development study to examine the extent to which potential confounding factors modify the association between parent-reported habitual snoring and cognitive outcomes among preadolescent children.
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Otolaryngologic Manifestations in Pediatric Inflammatory Multisystem Syndrome Temporally Associated With COVID-19

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This cohort study describes the various otolaryngologic manifes tations in and rates among patients 18 years or younger with pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2.
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Laryngeal and Tracheal Pressure Injuries in Patients With COVID-19

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To the Editor The important study by Fiacchini and colleagues of laryngotracheal complications in ventilated patients with coronavirus disease 2019 (COVID-19) reported a staggering 47% incidence of full-thickness tracheal erosion (FTTE) and tracheoesophageal fistulae (TEF). These findings raise critical questions about ensuring safe, high-quality care for intubated patients. Although intense research has focused on the molecular basis of COVID-19, pathogenesis of pneumonitis, and novel therapeutics; far less work has addressed the prevalence and pathogenesis of iatrogenic injury—particularly with respect to airway device-related pressure injuries. Injury at the level of the tracheal cuff likely accounts for the preponderance of FTTE and TEF reported, and tissue injury may occur at any site where there is contact between a device and the aerodigestive tract. Risk is highest in patients with overzealous cuff inflation, high-dose steroids, prone ventilation, prolonged intubation, feeding tubes, or impaired wound healing from diabetes or radiation—a perfect storm for patients with COVID-19.
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Prematurity: A Prognostic Factor for Increased Severity of Pediatric Obstructive Sleep Apnea

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Objective/Hypothesis

Studies have suggested preterm birth, defined as gestational age (GA) <37 weeks, is a risk factor for obstructive sleep apnea (OSA) in later childhood. However, little is known about the characteristics, severity, and degree of intervention of childhood OSA in former preterm infants compared to term infants. This study compares polysomnographic characteristics and surgical interventions in former preterm and term infants presenting with sleep disordered breathing.

Study Design

Retrospective cohort study from 2015 to 2019 at a single tertiary referral center.

Methods

Electronic Medical Records of pediatric patients ages 0 to 18 presenting with sleep disordered breathing were reviewed for gestational age, polysomnographic findings, clinical characteristics, and OSA surgical interventions. Association between gestational age, polysomnographic characteristics, and surgical interventions for OSA were reported.

Results

A total of 615 patient records were analyzed. Adjusting for covariates, prematurity was associated with a 2.97× higher likelihood of development of severe OSA (aOR (95%CI): 2.97 (1.40–6.32)), increased apneic‐hypoxic index (AHI) (mean (SD): 6.5 (9.8) vs. 4.6 (6.4), P < .05), increased end tidal CO2 (50.5 (5.11) vs. 48.5 (5.8), P < .05), decreased REM latency (116 (64.7) vs. 132.4 (69.9), P < .05), and increased number of surgeries for OSA (0.65 (.95) vs. 0.45 (0.69), P < .05) compared to children born at term. Children born with GA < 32 weeks presented at a significantly later age with sleep disordered breathing (7.04 (.80) vs. 5.1 (0.15), P < .05) than children born at term.

Conclusions

Prematurity was associated with increased likelihood of severe OSA, increased AHI, as well as increased number of surgical interventions for OSA compared to children born at term. These results suggest an association with preterm birth and increased severity of childhood OSA.

Level of Evidence

III Laryngoscope, 2021

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Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome: Relapse and Tonsillar Regrowth After Childhood Tonsillectomy

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Objectives/Hypothesis

Tonsillectomy is an effective treatment for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome, but the role of adenoidectomy, as well as later tonsillar regrowth, is unclear. To find out if the volume of lymphoid tissue is pivotal to the efficacy, we analyzed the association between the relapse of the symptoms of PFAPA syndrome and regrowth of tonsillar tissue after tonsillectomy or adenotonsillectomy.

Study Design

Prospective cohort study of operated PFAPA pateints.

Methods

We invited all patients that had undergone tonsillectomy or adenotonsillectomy due to PFAPA syndrome at the Oulu University Hospital, Oulu, Finland, between the years 1990 and 2007, at the age of ≤12 years, to a follow‐up visit, after an average period of 9.8 years after their diagnoses. Out of the 132 invited, 94 (71%) participated in the follow‐up study.

Results

At the follow‐up study visit, 5 (5%) of the 94 PFAPA syndrome cases experienced recurrent fevers. The regrowth of palatine tonsillar tissue was seen in four of them (80%) as compared to 19/89 (21%) of symptom‐free patients (P = .006). Two of the patients with clear PFAPA relapse at the time of the study visit were reoperated with clear effect on the symptoms. At the time of the study visit, 59/63 (94%) of the patients who had undergone adenotonsillectomy and 30/31 of the patients (97%) who had undergone tonsillectomy earlier were free of fever flares (P = .99).

Conclusion

Palatine tonsil regrowth was associated with PFAPA syndrome relapse after tonsillectomy. Reoperation might be a treatment option in these patients.

Level of Evidence

4 Laryngoscope, 2021

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Expression of Claudin-1 in laryngeal squamous cell carcinomas (LSCCs) and its significance

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Histol Histopathol. 2021 Feb 25:18320. doi: 10.14670/HH-18-320. Online ahead of print.

ABSTRACT

BACKGROUND: A large body of scientific evidence points to the important roles of tight junction proteins in tumor development, progression and dissemination. The larynx has only a few studies, analyzing the role of this group of junctional proteins in its oncogenesis. In this study, the author sheds some light on the expression and possible role of claudin-1 in laryngeal squamous cell carcinomas.

MATERIALS AND METHODS: This study analyzed the expression of claudin-1, using immunohistochemistry, in a tissue microarray of 80 cases of laryngeal squamous cell cancers. Clinicopathological parameters were analyzed according to claudin-1 expression in the tissue microarray. Furthermore, the expression of slug/snail1, an Epithelial-Mesenchymal Transition (EMT) linked protein, was analyzed by immunohistochemistry in the same microarray, and the expressions of the two proteins were assessed for correlation.

RESULTS: A significant majority of laryngeal squamous cell cancers exhibited positive expression of claudin-1 proteins. The majority of those tumors expressed claudin-1 in their cytoplasm. The overall majority of those same tumors also exhibited a cytoplasmic shift of the slug-snail-1 protein from the nuclei to the cytoplasm. There was also evidence of correlation of the two proteins' expressions in the cytoplasm of laryngeal tumors.

CONCLUSION: The above may suggest a role for claudin-1 in the development and progression of laryngeal squamous cell carcinoma. Overall, claudin-1's aberrant expression in laryngeal cancer is in line with evidence seen in other head and neck cancers. Its co-expression with slug/snail-1 in LSCC patients should be investigated further to understand the nature of the relationship of the two proteins in LSCC and their possible contribution to its development and progression.

P MID:33629735 | DOI:10.14670/HH-18-320

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Pilot Study of External Beam Radiotherapy for Recurrent Unremitting Tracheal Stenosis

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Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421995064. doi: 10.1177/0003489421995064. Online ahead of print.

ABSTRACT

OBJECTIVE: Tracheal stenosis can have a variety of presentations, severities, causes, and be a difficult condition to treat. Some patients demonstrate recurrent stenosis after multiple endoscopic treatments and are either poor candidates for open procedures or do not desire open surgery. We sought to evaluate low-dose postoperative external beam radiotherapy (EB RT) as a novel therapy for patients with recurrent tracheal stenosis refractory to endoscopic therapies.

METHOD: We performed a retrospective review of patients with recurrent tracheal stenosis who underwent EBRT in addition to endoscopic dilation. We compared the number of endoscopic procedures required in the 6 months before EBRT to the number required in the 6 months after EBRT.

RESULTS: Six patients met criteria for inclusion in our study. The cause of stenosis was variable among the study population. In the 6 months leading up to EBRT, patients underwent an average 6.2 endoscopic procedures. This dropped to an average 1.9 procedures in the 6 months following EBRT (P < .001).

CONCLUSION: Herein, we show that low-dose postoperative external beam radiotherapy (EBRT), a novel therapy for patients with recurrent tracheal stenosis refractory to endoscopic therapies, is effective in decreasing the frequency of endoscopic dilations.

LEVEL OF EVIDENCE: 4.

PMID:33629593 | DOI:10.1177/0003489421995064

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Gray-Scale Inversion on High Resolution Computed Tomography of the Temporal Bone: An Observational Study

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Ann Otol Rhinol Laryngol. 2021 Feb 25:3489421996844. doi: 10.1177/0003489421996844. Online ahead of print.

ABSTRACT

OBJECTIVES: This is a qualitative study to explore the utility of gray-scale inversion or the "invert" function of high-resolution computed tomography (HRCT) scans in the diagnosis of temporal bone anatomy and pathology.

METHODS: This is a case series describing an innovative application of an existing image processing tool to visualize temporal bone anat omy and pathology. Illustrative patients at a tertiary referral center with otologic symptoms and findings leading to HRCT scans of the temporal bone were included. Diagnostic HRCT scans were evaluated utilizing the gray-scale inversion function (invert function).

RESULTS: Nine illustrative cases which demonstrate conditions such as persistent stapedial artery, membranous stapes footplate, total ossicular prosthesis migration into the vestibule, third window syndrome such as superior semicircular canal dehiscence (SSCD) and cochlea-facial nerve dehiscence, otosclerosis, and ossicular chain discontinuity are included. The enhanced visualization was confirmed surgically in 3 cases, and 1 had physiological confirmation using cervical vestibular evoked myogenic potentials (cVEMP).

CONCLUSIONS: Gray-scale inversion can be used to improve visualization of temporal bone anatomy and pathologic changes when diagnoses are in doubt. The invert function is a useful adjunct in the ar mamentarium of both radiologists and otologists when evaluating HRCT of the temporal bone.

PMID:33629604 | DOI:10.1177/0003489421996844

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