Αρχειοθήκη ιστολογίου

Κυριακή 30 Ιανουαρίου 2022

A Tissue Engineered Construct for Laryngeal Regeneration: A Proof‐of‐Concept Device Design Study

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Objectives/Hypothesis

Develop a patient-specific tissue engineered construct for laryngeal reconstruction following a partial laryngectomy.

Study Design

Bench and animal research.

Methods

A construct made from a porous polyethylene scaffold shaped in a canine-specific configuration and seeded with autologous canine adipose-derived stem cells in fibrin glue was implanted in a canine following a partial laryngectomy. After 1 year, the construct was first evaluated in vivo with high-speed imaging and acoustic–aerodynamic measures. It was then explanted and evaluated histologically.

Results

The canine study at 1 year revealed the construct provided voicing (barking) with acoustic and aerodynamic measures within normal ranges. The canine was able to eat and breathe normally without long-term support. The construct was integrated with epithelialization of all areas except the medial portion of the vocal fold structure. No anti-infective agents were needed after the standard perioperative medications were completed.

Conclusion

This study provided a successful first step toward developing a patient-specific composite construct for patients undergoing partial laryngectomies.

Level of Evidence

Not Applicable Laryngoscope, 2022

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The music-related quality of life: Italian validation of MuRQoL into MUSQUAV questionnaire and preliminary data from a cohort of postlingually deafened cochlear implant users

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Eur Arch Otorhinolaryngol. 2022 Jan 28. doi: 10.1007/s00405-022-07258-1. Online ahead of print.

ABSTRACT

PURPOSE: Cochlear implant (CI) users do not receive much of the auditory information necessary for an accurate perception of music. This usually entails a dissatisfaction with the music they hear, so that their quality of life may potentially be affected. The main aim of this paper was to translate and validate into Italian an instrument to evaluate these aspects-The Music-Related Quality of Life Questionnaire (MuRQoL)-to help the work of clinicians and therapists.

METHODS: The translation of the MuRQoL into "Questionario Musica e Qualità della Vita" (MUSQUAV) was done according to the international guidelines. The translated questionnaire was administered to normal hearing (NH) and CI users adults. Exploratory factor analysis, confirmatory factor analysis and known group method were used to confirm construct validity and app licability of MUSQUAV.

RESULTS: We retrieved 225 results. The MUSQUAV questionnaire was acceptable according to the goodness-of-fit indices. The correlation between the items, evaluated using Cronbach's α coefficient, indicates a good internal consistency (> 0.80). The non-parametric Mann-Whitney test showed significant differences in the distinct populations tested.

CONCLUSIONS: The MUSQUAV questionnaire is a valid, low-cost and rapid instrument for professional workers in the audiological field, especially useful in the assessment of the patients' perception and musical engagement.

PMID:35089391 | DOI:10.1007/s00405-022-07258-1

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Intraoral Approach for Parapharyngeal Branchial Cleft Cysts

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Ear Nose Throat J. 2022 Jan 28:1455613211067846. doi: 10.1177/01455613211067846. Online ahead of print.

ABSTRACT

Branchial cleft cyst (BCC) most frequently arises from the second branchial cleft and is located anterior to the sternocleidomastoid muscle at the mandibular angle. However, very rarely, this may occur in the parapharyngeal space. Interestingly, the parapharyngeal BCC is frequently misdiagnosed as a peritonsillar abscess. In this study, we reported 2 cases of para pharyngeal BCC misdiagnosed as peritonsillar abscess.

PMID:35088618 | DOI:10.1177/01455613211067846

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A new classification of maxillary defect and simultaneous accurate reconstruction

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):8-14. doi: 10.3760/cma.j.cn115330-20210724-00484.

ABSTRACT

Objective: To select the preferred flaps for the reconstruction of different maxillary defects and to propose a new classification of maxillary defects. Methods: A total of 219 patients (136 males and 83 females) underwent the simultaneous reconstruction of maxillary defects in the Beijing Tongren Hospital, Capital Medical University, between January 2005 and December 2018 were reviewed. Age ranged from 16 to 78 years. Based on the proposed new classification of the maxillary defects, 22 patients with class Ⅰ defects (inferior maxillectomy), 44 patients with class Ⅱ defects (supperior maxillectomy), 132 patients with class Ⅲ defects (total maxillectomy) and 21 patients with class Ⅳ defects (extensive maxillectomy) were enrolled. Survival rate, functional and aesthetic outcomes of flaps were ev aluated. Survival analysis was performed in 169 patients with malignant tumor, Kaplan-Meier method was used to calculate the survival rate, and Log-rank method was used to compare the difference of survival rate in each group. Results: A total of 234 repairs for maxillary defects were performed in 219 patients. Fibula flaps were used in 4/13 of class Ⅰ defects; temporal muscle flaps (11/24, 45.8%) and anterolateral thigh flaps (6/24, 25.0%) used in class Ⅱ defects; temporal muscle flaps (71/128, 55.5%), anterolateral thigh flaps (6/24, 25.0%) and fibula flaps (12/128, 9.4%) used in class Ⅲ defects; and anterolateral thigh flaps (8/20, 40.0%) and rectus abdominis flaps (8/20, 40.0%) used in class Ⅳ defects. The success rate of local pedicled flaps was 95.6% (109/114) and that of free flaps was 95.8% (115/120). Thrombosis(10/234,4.3%) was a main reason for repair failure. Among the followed-up 88 patients, swallowing and speech functions recovered, 82 (93.2%) of them we re satisfied with appearance, and 75 (85.2%) were satisfied with visual field. The 3-year and 5-year overall survival rates were 66.5% and 63.6%, and the 3-year and 5-year disease-free survival rates were 57.1% and 46.2%, respectively, in the 169 patients with malignant tumors. Conclusion: A new classification of maxillary defects is proposed, on which suitable flaps are selected to offer patients good functional and aesthetic outcomes and high quality of life.

PMID:35090203 | DOI:10.3760/cma.j.cn115330-20210724-00484

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Spindle cell carcinoma of larynx: a report of 3 cases

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):59-61. doi: 10.3760/cma.j.cn115330-20210304-00106.

NO ABSTRACT

PMID:35090213 | DOI:10.3760/cma.j.cn115330-20210304-00106

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Virtual reality-assisted management of communicated solitary fibrous tumor in skull base: a case report

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):65-68. doi: 10.3760/cma.j.cn115330-20210630-00405.

NO ABSTRACT

PMID:35090215 | DOI:10.3760/cma.j.cn115330-20210630-00405

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Research progress of nasal mucosal epithelial cells in chronic rhinosinusitis

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):78-81. doi: 10.3760/cma.j.cn115330-20210303-00103.

NO ABSTRACT

PMID:35090218 | DOI:10.3760/cma.j.cn115330-20210303-00103

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Evaluation of chemosensory function in patients with upper respiratory tract post-viral olfactory dysfunction

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Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Jan 7;57(1):29-35. doi: 10.3760/cma.j.cn115330-20210331-00163.

ABSTRACT

Objective: To observe the changes of olfactory function, intranasal trigeminal nerve function and taste function in patients with upper respiratory tract post-viral olfactory dysfunction (PVOD), and to explore the correlation of chemosensory function. Methods: The clinical data of 42 patients with PVOD who visited to the Olfactory and Taste Center of Otorhinolaryngology Head and Neck Surgery Department of Beijing Anzhen Hospital from January to December of 2019 were analyzed retrospectively, including 20 males and 22 females, aging (48.86±11.47) years (x¯). Twenty subjects in normal control group were selected according to the sex ratio of PVOD patients. Sniffin' Sticks olfactory tests were performed on the subjects, including threshold test (T), discrimination test (D) and identification test (I), and the sum of the above three test scores was the TDI value. At the same time, olfactory event-related potentials (oERPs), trigeminal event-related potentials (tERPs) and taste function test were performed. According to the taste function test, the patients were divided into normal gustation (NG) group and gustatory dysfunction (GD) group. The results of olfaction, taste and intranasal trigeminal nerve function tests were compared among different groups, and the correlation analysis was carried out. SPSS statistical software was used for statistical analysis. Results: GD was present in 14 (33.3%) of 42 PVOD patients with a course of PVOD of 5 (3, 6) months (M (Q1, Q3)). The gustatory function of patients with PVOD was related to gender (r=0.565, P<0.001), smoking status (r=-0.512, P=0.001), duration (r=-0.357, P=0.020) and olfactory function (all P<0.05). The olfactory function of GD group was worse than that of NG group, and the differences of TDI value and T value between the two groups were statistically significant (10.25±4.58 vs 13.35±3.61, 1.54±0.66 vs 2.10±0.88, t value was 2.40 and 2.10 respectively, both P<0.05). The amplitudes of oERPs and tERPs were significantly lower in GD group than those in NG group (all P<0.05). Conclusion: In patients with PVOD, the subjective and objective olfactory function, intranasal trigeminal nerve function and taste function were decreased, and there was a correlation, suggesting that there was a synergistic effect between the chemosensory functions of PVOD patients.

PMID:35090206 | DOI:10.3760/cma.j.cn115330-20210331-00163

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Place of Linacs in extracranial stereotactic radiotherapy: Are they now equivalent to Cyberknife®?

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Bull Cancer. 2022 Jan 25:S0007-4551(22)00003-0. doi: 10.1016/j.bulcan.2021.10.008. Online ahead of print.

ABSTRACT

Extracranial stereotactic radiotherapy has developed recently, since the years 1990-2000. Devices specifically dedicated to this type of treatment were then developed and shared the favors of radiation oncologists: Tomotherapy® and especially Cyberknife®, which offered the advantage of "tracking" with the possibility of real time motion correction, allowing an increase in the precision of targeting volumes. Recently, the latest generations of linear accelerators (Linac) have been developed, integrating much higher dose rates, an improved ballistic precision with a very short treatment duration time and the possibility of real time motion management (with notably the possibility of adaptive radiotherapy in real time with the development of "MLC tracking"). So are Linacs able to perform equivalent (not inferior) extracrani al stereotactic radiotherapy treatments to those with Cyberknife®, the historical gold standard in this field? This article presents a comparison of these two treatment devices, by successively considering dose distributions in the irradiated volume, distant received doses from this volume (including the "integral dose"), problems linked to the duration of the sessions and those linked to motion management.

PMID:35090720 | DOI:10.1016/j.bulcan.2021.10.008

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The importance of systemic immune-inflammation index in obstructive sleep apnea syndrome

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Eur Arch Otorhinolaryngol. 2022 Jan 29. doi: 10.1007/s00405-021-07227-0. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to explore the importance of systemic immune-inflammation index (SII) in patients diagnosed with obstructive sleep apnea (OSA).

MATERIALS AND METHOD: In this study planned as a retrospective cohort, the files of the patients who presented with sleep apnea/snoring complaint between 10.01.2017 and 10.01.2021 and underwent polysomnography (PSG) and complete blood count analyses were reviewed. PSG findings (age, sex, body mass index (BMI), apnea-hypopnea index (AHI), mean oxygen saturation) were compared with SII in 194 patients meeting study eligibility criteria.

RESULTS: Patients included in this study were divided into 4 groups by AHI value. Statistical difference was detected between the groups in terms of age, sex, body mass index (BMI), and mean oxygen saturation (p < 0.05). There is an ap proximately 30% positive statistically significant correlation between the severity of OSA and SII (p < 0.001). As for the mean SII values of the AHI groups, it was observed that the more severe AHI is, the higher the mean SII value is. The correlation between SII and the severity of OSA was found to be more significant than the correlation with neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR).

CONCLUSION: There is a significant correlation between SII and the severity of OSA. This correlation is stronger compared to NLR and PLR. SII can be used to demonstrate the chronic systemic inflammation observed in OSA patients, and can be utilized as a simple and inexpensive biomarker as it can be easily calculated from the parameters present in routine blood analyses.

PMID:35091830 | DOI:10.1007/s00405-021-07227-0

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Bereavement Practices Among Head and Neck Cancer Surgeons

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Objectives

Head and neck cancer surgeons frequently interact with dying patients with advanced disease and their families, but little is known about their bereavement practices after a patient's death. The aim of this study is to elucidate the frequency of common bereavement practices, cited barriers to bereavement, and predictive physician factors that lead to an increase in bereavement practices among head and neck cancer surgeons.

Methods

A 20-item survey was sent to 827 active surgeons of the American Head and Neck Society. Approval was obtained and the survey was distributed through the American Head and Neck Society. Demographics, frequency of common bereavement practices, empathy, and barriers were assessed. Multiple linear regression was performed to determine physician factors associated with more frequent bereavement follow-up.

Results

There were 156 respondents (18.9% response rate). Overall, surgeons were more likely to usually/always call (48.5%) or send a letter (42.4%) compared with other practices such as attending funerals (0%), offering family meetings (18.6%), or referring family members to counseling (7.7%). Many barriers were cited as being at least somewhat important: being unaware about a patient's death (67.3%) was the most cited, whereas 51.3% cited a lack of mentorship/training in this area. Scoring higher on empathy questions (P ≤ .001) was associated with more frequent surgeon bereavement follow-up with the family of deceased patients.

Conclusion

There is substantial practice variation among surgeons suggesting a lack of consensus on their roles in bereavement follow-up. Having higher empathy was predictive of higher engagement.

Level of Evidence

NA Laryngoscope, 2022

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