Residual Tumor Volume and Tumor Progression after Subtotal Resection and Observation of WHO Grade I Skull Base Meningiomas

xlomafota13 shared this article with you from Inoreader Residual Tumor Volume and Tumor Progression after Subtotal Resection and Observation of WHO Grade I Skull Base Meningiomas Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1733974 Objective This study investigated the impact of residual tumor volume (RTV) on tumor progression after subtotal resection and observation of WHO grade I skull base meningiomas. Study Design This study is a retrospective volumetric analysis. Setting This study was conducted at a single institution. Participants Patients who underwent subtotal resection of a WHO grade I skull base meningioma and postsurgical observation (July 1, 2007–July 1, 2017). Main Outcome Measure The main outcome was radiographic tumor progression. Results Sixty patients with residual skull base meningiomas were analyzed. The median (interquartile range) RTV was 1.3 (5.3) cm3. Tumor progression occurred in 23 patients (38.3%) at a mean duration of 28.6 months postsurgery. The 1-, 3-, and 5-year actuarial progression-free survival (PFS) rates were 98.3, 58.6, and 48.7%, respectively. The Cox multivariate analysis identified increasing RTV (p = 0.01) and history of more than 1 previous surgery (p = 0.03) as independent predictors of tumor progression. In a Kaplan–Meier analysis for PFS, the RTV threshold of 3 cm3 maximized log-rank testing significance between groups of patients dichotomized at 0.5 cm3 thresholds (p < 0.01). The 3-year actuarial PFS rates for meningiomas with RTV ≤3 cm3 and >3 cm3 were 76.2 and 32.1%, respectively. When RTV >3 cm3 was entered as a covariate in the Cox model, it was the only factor independently associated with tumor progression (p < 0.01). Conclusion RTV was associated with tumor progression after subtotal resection of WHO grade I skull base meningioma in this cohort. An RTV threshold of 3 cm3 was identified that minimized progression of the residual tumor when gross total resection was not safe or feasible. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality improvement intervention to reduce time to postoperative radiation in head and neck free flap patients

xlomafota13 shared this article with you from Inoreader Quality improvement intervention to reduce time to postoperative radiation in head and neck free flap patients Via Head & Neck Abstract Background Best-practice guidelines for head and neck cancer patients advise postoperative radiation therapy (PORT) initiation within 6 weeks of surgery. We report our institutional experience improving timeliness of adjuvant radiation in free-flap patients. Methods Thirty-nine patients met inclusion criteria in the 2017–2019 study period. We divided into "Early" (n = 19) and "Late" (n = 20) time-period groups to compare performance over time. The primary endpoint was time to PORT initiation, with success defined as <6 weeks. Results The number of patients achieving timely PORT improved from 10.5% in the Early group to 50.0% in the Late group (p = 0.014). Patients undergoing concurrent adjuvant chemoradiation were more likely to meet the PORT target in the Late group (p = 0.012). Conclusions We ascribe this quality improvement in free-flap patients to increased communication among multidisciplinary care teams, proactive consultation referrals, and a targeted patient-navigator intervention. Though work is needed to further improve performance, insight gained from our experience may benefit other teams. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stability and radioactive gaseous iodine-131 retention capacity of binderless UiO-66-NH(2) granules under severe nuclear accidental conditions

xlomafota13 shared this article with you from Inoreader Stability and radioactive gaseous iodine-131 retention capacity of binderless UiO-66-NH(2) granules under severe nuclear accidental conditions Via radioactive iodine J Hazard Mater. 2021 Aug 15;416:125890. doi: 10.1016/j.jhazmat.2021.125890. Epub 2021 Apr 15. ABSTRACT In the present work, we aim to investigate the ability of the zirconium-based MOF-type compound UiO-66-NH2, to immobilize molecular gaseous iodine under conditions analogous to those encountered in an operating Filtered Containment Venting System (FCVS) line. Typically, the UiO-66-NH2 particles were exposed to 131I (beta and gamma emitters) and sub mitted to air/steam at 120 °C, under gamma irradiation (1.9 kGy h-1). In parallel to this experiment under simulated accidental conditions, the stability of the binderless UiO-66-NH2 granules under steam and gamma irradiation was investigated. In order to fit with the specifications required by typical venting systems, and to compare the efficiency of the selected MOF to porous materials commonly used by the industry, scale-up syntheses and UiO-66-NH2 millimetric-size shaping were realized. For this task, we developed an original binderless method, in order to analyze solely the efficiency of the UiO-66-NH2 material. The shaped MOF particles were then submitted separately to gamma irradiation, steam and temperature, for confirming their viability in a venting process. Their structural, textural and mechanical behaviors were characterized by the means several techniques including gas sorption, powder X-ray diffraction, infrared spectroscop y and crushing tests. Promising results were obtained to trap gaseous molecular iodine in severe accidental conditions. PMID:34492828 | DOI:10.1016/j.jhazmat.2021.125890 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review

xlomafota13 shared this article with you from Inoreader The Need for Studies on Oral Corticosteroids After Sialendoscopy for Obstructive Salivary Gland Disease: Systematic Review Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 7:34894211045262. doi: 10.1177/00034894211045262. Online ahead of print. ABSTRACT OBJECTIVES: This qualitative systematic review evaluates the evidence in support of the use of oral corticosteroids in patients undergoing sialendoscopy for the treatment of obstructive sialadenitis. DESIGN: Qualitative systematic review. METHODS: A literature search was conducted from January 1985 and September 2020. Inclusion criteria embraced pe er-reviewed articles in which adult patients undergoing interventional sialendoscopy for obstructive salivary gland disease received oral corticosteroids. The results were initially screened based on title and abstract, and the remaining articles were reviewed for eligibility. RESULTS: About 218 papers were selected by title and abstract, 96 were selected for full-text review, and 9 met the inclusion criteria. Eight published reports were retrospective observational studies and 1 was a prospective comparative study. Overall, the heterogeneity of clinical data stood out in this systematic review. The pooled success rate in the studies was 873/979 (89%). Only 5 studies described a rationale for oral corticosteroid use as part of the post-operative management. In 4 studies, a prednisone total daily dose of 40 to 50 mg was used. One study clearly showed a lower recurrence rate in patients who received oral steroids for more than 7 days in addition to sialendoscopy for management o f ductal stenoses. CONCLUSION: This systematic review showed that most centers that prescribe oral corticosteroids after sialendoscopy are unaware of the specific results with this treatment. For ductal stenoses, only 1 paper clearly showed the benefits of oral corticosteroids after sialendoscopy but more high-quality evidence is required in the form of a comparative study or randomized controlled trial, with appropriate long-term follow up. PMID:34493105 | DOI:10.1177/00034894211045262 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children

xlomafota13 shared this article with you from Inoreader Two Bonebridge bone conduction hearing implant generations: audiological benefit and quality of hearing in children Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Sep 8. doi: 10.1007/s00405-021-07068-x. Online ahead of print. ABSTRACT PURPOSE: The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. METHODS: Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS: The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° a nd from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. CONCLUSION: The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children. PMID:34495 351 | DOI:10.1007/s00405-021-07068-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic endonasal management of skull base defects in pediatric patients

xlomafota13 shared this article with you from Inoreader Endoscopic endonasal management of skull base defects in pediatric patients Via leak of cerebrospinal fluid Int J Pediatr Otorhinolaryngol. 2021 Sep 1;150:110902. doi: 10.1016/j.ijporl.2021.110902. Online ahead of print. ABSTRACT PURPOSE: Skull base defects in children may be the result of congenital anomalies or trauma. They often present as cerebrospinal fluid (CSF) rhinorrhea, meningitis, brain abscess or nasal obstruction. Surgical intervention is predominantly the treatment of choice. Our goal is to assess the efficacy of endoscopic endonasal approach in treating skull base defects in pediatric patients. MATERIAL AND METHODS: In this retrospective study we identified 38 patients (mean age 8.7 ± 5.6 years old, ranging 2 months-18 years) who underwent endoscopic endonasal repair of skull base defects, between March 2010 and February 2020. Patients who had skull base reconstruction after tumor resection, those who were lost to follow-up or did not sign the consent forms were excluded from the study. RESULTS: The clinical indications for endoscopic endonasal repair were trauma (n = 24, 63.1%) and congenital defects (n = 14, 36.9%). Congenital skull base defects included basal meningoencephalocele (n = 5, 35.7%) and frontoethmoidal defects (n = 9, 64.3%). Mean follow up time was 32 ± 29.04 months, ranging 2-103 months. Fat graft (alone or in combination) was the most commonly used material to repair the skull base defects. Thirty-seven patients (97%) showed successful results after endoscopic endonasal surgery and were symptom free. CONCLUSION: The endoscopic endonasal repair of CSF leak and skull base defects proved to be safe and feasible with 97% success rate. PMID:34488041 | DOI:10.1016/j.ijporl.2021.110902 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Superior Laryngeal Nerve Block for the Treatment of Neurogenic Cough: a Retrospective Review

xlomafota13 shared this article with you from Inoreader Efficacy of Superior Laryngeal Nerve Block for the Treatment of Neurogenic Cough: a Retrospective Review Via Clinical Otolaryngology Abstract Chronic cough may be multifactorial. A subset of patients may have a neurogenic cough, secondary to irritation of the superior laryngeal nerve. Superior laryngeal nerve blocks may be an efficacious treatment for neurogenic cough. Neuromodulating medications may be used in the treatment of chronic cough, but may have side effects. There are no reported serious adverse effects from superior laryngeal nerve blocks. Prospective, placebo-controlled studies are needed to confirm the efficacy of superior laryngeal nerve blocks for the treatment of chronic cough. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of different imaging methods for the localization of cerebrospinal fluid rhinorrhea: a comparative study

xlomafota13 shared this article with you from Inoreader Application of different imaging methods for the localization of cerebrospinal fluid rhinorrhea: a comparative study Via leak of cerebrospinal fluid Ann Palliat Med. 2021 Aug;10(8):8797-8807. doi: 10.21037/apm-21-1994. ABSTRACT BACKGROUND: CSF rhinorrhea is a type of CSF leakage caused by an aseptic abnormal passage between the subarachnoid space and the adjacent sinus and nasal cavity due to a cranial dural defect. At present, the value of computed tomography cisternography (CTC) in locating CSF rhinorrhea has been widely recognized, and magnetic resonance hydrography (MRH), as a heavy T2-weighted water imaging, plays a pivotal role in showing the location of the leak. In this paper, we retrospectively summarize the imaging manifestations seen at our hospital of patients with clinically confirmed CSF rhinorrhea at the skull base and evaluate the diagnostic value of different imaging methods in the localization of CSF rhinorrhea by means of preoperative imaging analysis using CTC and MRH. METHODS: Fifty-five patients with CSF rhinorrhea admitted to our department from October 2016 t o January 2021 were retrospectively analyzed. The patients' conventional CT, CTC, and MRH imaging data were compared, and the location of the leak determined preoperatively matched the location of the leak found during surgery. Moreover, there was no recurrence during the follow-up period of 4 months to 3 years. RESULTS: There were statistically significant differences between the diagnostic positivity rate of CTC and spiral CT (χ2=16.755, P<0.00), and between the diagnostic positivity rate of cranial MRH and spiral CT (χ2=6.338, 6.338=0.01), and no statistically significant difference between the diagnostic positivity rate of CTC and cranial MRH (χ2=2.625, P=0.1). CONCLUSIONS: The combined use of imaging techniques has important practical significance for the proper treatment and prognostic evaluation of CSF rhinorrhea. CTC has the highest positive rate for the diagnosis of CSF rhinorrhea, followed by MRH, while spiral CT is safer. CTC and MRH can promote the diag nostic rate in determining the location of CSF rhinorrhea, and selective combined application can be an important guide to surgery. PMID:34488368 | DOI:10.21037/apm-21-1994 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic Significance of a Scoring System Combining p16, Smoking, and Drinking Status in a Series of 131 Patients with Oropharyngeal Cancers

xlomafota13 shared this article with you from Inoreader Prognostic Significance of a Scoring System Combining p16, Smoking, and Drinking Status in a Series of 131 Patients with Oropharyngeal Cancers Via International Journal of Otolaryngology Background. Tobacco and alcohol are two main risk factors associated with head and neck squamous cell carcinoma (HNSCC). Studies showed that human papillomavirus (HPV) plays a role in the etiology of this cancer. HPV-positive oropharyngeal squamous cell carcinoma (OSCC) patients present in general a better response to conventional therapy and better overall survival (OS). However, OSCC is a heterogeneous disease regarding treatment. This study aimed to identify more effective prognostic factors associated with a poor clinical outcome for OSCC patients to improve treatment selection. Materials and Methods. OSCC patients diagnosed between 2007 and 2017, in two Belgian hospitals, were included. Demographic and clinicopathologic data were extracted from medical records. HPV status was determine d through p16 immunohistochemistry. Univariable and multivariable Cox proportional hazard regression analyses allowed to identify variables prognostic for OS and recurrence-free survival (RFS). Kaplan–Meier survival curves have been assessed for survival. Results. The study included 131 patients. Statistics showed that monotherapies were significantly associated with a shorter OS; p16 overexpression was significantly associated with a weak consumption of tobacco or alcohol, and a high p16 expression was significantly associated with both longer RFS and OS. The study validated that tobacco and alcohol consumption were significantly correlated with poorer RFS and poorer OS. Only p16 expression trended to be significant for RFS when compared to smoking and drinking habits, while p16 upregulation and alcohol use were both vital for OS indicating that p16 is an independent and significant prognostic factor in OSCC patients. Finally, a scoring system combining p16, tobacco, and alcohol status was defined and was significantly associated with longer RFS and longer OS for nonsmoker and nondrinker p16-positive OSCC patients. Conclusions. This study confirmed that the overexpression of the p16 protein could be viewed as a factor of good prognosis for RFS and OS of OSCC patients. The prognostic significance of a scoring system combining p16 expression, smoking, and drinking status was evaluated and concluded to be a more effective tool to determine therapeutic orientations based on the risk factors for better treatment relevance and survival. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term aesthetics, patient-reported outcomes, and auricular sensitivity after microtia reconstruction: A systematic review

xlomafota13 shared this article with you from Inoreader Long-term aesthetics, patient-reported outcomes, and auricular sensitivity after microtia reconstruction: A systematic review Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Aug 19:S1748-6815(21)00379-X. doi: 10.1016/j.bjps.2021.08.004. Online ahead of print. ABSTRACT BACKGROUND: Auricular reconstruction for microtia is most frequently performed using autologous costal cartilage (ACC) or porous polyethylene (PPE) implants. Short-term results are generally promising, but long-term results remain unclear. Long-term outcomes were explored in this systematic review, and minimal reporting criteria were suggested for future original data studies. METHODS: A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from inception through October 14, 2020. Articles on auricular reconstruction in patients with microtia using ACC or PPE were included if postsurgical follow-up was at least 1 year. Outcome reporting was split into separate publications, and results on complications were reported previously. This publi cation focused on long-term aesthetic, patient-reported, and sensitivity outcomes. RESULTS: Forty-one publications reported on these outcomes. Both materials led to aesthetically pleasing results and high rates of patient satisfaction. ACC frameworks grew similarly to contralateral ears, and the anterior surface of auricles regained sensitivity. Furthermore, postoperative health-related quality of life (HRQoL) outcomes were generally good. Data synthesis was limited due to considerable variability between studies and poor study quality. No conclusions could be drawn on the superiority of either method due to the lack of comparative analyses. CONCLUSION: Future studies should minimally report (1) surgical efficacy measured using the tool provided in the UK Care Standards for the Management of Patients with Microtia and Atresia; (2) complications including framework extrusion or exposure, graft loss, framework resorption, wire exposure and scalp/auricular scar complication s and (3) HRQoL before and after treatment using the EAR-Q patient-reported outcome measure (PROM). PMID:34489212 | DOI:10.1016/j.bjps.2021.08.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Retrospective Analyses of 18FDG-PET/CT Thyroid Incidentaloma in Adults: Incidence, Treatment, and Outcome in a Tertiary Cancer Referral Center

xlomafota13 shared this article with you from Inoreader Retrospective Analyses of 18FDG-PET/CT Thyroid Incidentaloma in Adults: Incidence, Treatment, and Outcome in a Tertiary Cancer Referral Center Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.