Diagnostic accuracy of conventional oral examination for detecting oral cavity cancer and potentially malignant disorders in patients with clinically evident oral lesions: Systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Diagnostic accuracy of conventional oral examination for detecting oral cavity cancer and potentially malignant disorders in patients with clinically evident oral lesions: Systematic review and meta‐analysis Via Head & Neck Abstract This systematic review evaluates the diagnostic accuracy of conventional oral examination (COE) versus incisional or excisional biopsy for the diagnosis of malignant and/or dysplastic lesions in patients with clinically evident lesions. Searches were conducted across five electronic databases from inception to January 2020. Meta-analyses were undertaken, where appropriate. Among 18 included studies, 14 studies were included in the meta-analysis, giving summary estimates for COE of 71% sensitivity and 85% specificity for the diagnosis of dysplastic and/or malignant lesions. The pooled diagnostic accuracy of identifying malignant-only lesions was reported in seven studies, giving a pooled estimate of 88% sensitivity and 81% specificity. Diagnostic accuracy of different types of dental/medical professionals in identifying dysplastic or malignant lesions gave varying estimates of sensitivity and specificity across three studies. Further research is needed to improve the diagnostic acc uracy of COE for early detection of dysplastic and malignant oral lesions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study

xlomafota13 shared this article with you from Inoreader Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 26:34894211072987. doi: 10.1177/00034894211072987. Online ahead of print. ABSTRACT BACKGROUND: Laryngeal cancer accounts for 1% of all cancers in men and 0.3% of all cancers in women. Pharyngolaryngectomy (TPL) and total laryngectomy (TL) are central surgical techniques in the management of advanced laryngeal malignancies but are associated with significant morbidity. In addition, optimal reconstruction following TPL remains an area of acti ve research. METHODS: Here, we compared speech and swallowing outcomes following circumferential and partial pharyngeal resection alongside total laryngectomy in patients with laryngeal and hypolaryngeal tumors. We performed a systemic analysis of patient demographics, tumor characteristics, treatment modality, and pharyngeal reconstruction technique following TPL and TL, leveraging data collected over a 20-year period at a large tertiary referral center. RESULTS: Analyzing 155 patients the results show circumferential pharyngeal defects and prior radiotherapy have a significant impact on surgical complications. CONCLUSION: Pharyngeal resection carries a substantial risk of incurring impaired speech and swallowing in patients. Moreover, our results support poorer functional outcomes with more radical pharyngeal resections and show a clear trend toward worse swallowing outcomes in salvage surgery. PMID:35081778 | DOI:10.1177/00034894211072987 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Birth of the Beta-knife Thyroidectomy: The Radiance of Saul Hertz

xlomafota13 shared this article with you from Inoreader Birth of the Beta-knife Thyroidectomy: The Radiance of Saul Hertz Via radioactive iodine Am Surg. 2022 Jan 26:31348211060463. doi: 10.1177/00031348211060463. Online ahead of print. ABSTRACT This is the story of how one man's life's work allowed for Iodine-131 (I-131) to become a therapy for hyperthyroidism and thyroid cancer. What is now a standard in our times arose from Saul Hertz's rather challenging and humble beginnings. Thyroid lobectomy and total thyroidectomy were therapeutic mainstays for thyroid disease until Hertz treated his first patient with radioactive i odine (RAI) ablation therapy at Massachusetts General Hospital (MGH) on March 31, 1941. His concepts for using beta particle emission from RAI to ablate thyroid tissue were revolutionary. Hertz's RAI therapy translated to research with thyroid cancer by the mid-1940s. The high-energy beta particles produced cytolethal effects on remnant thyroid tissue left behind by total thyroidectomy, thereby accomplishing completion thyroidectomy in some patients. Progressive surgeons from the Hertz era incorporated RAI into their practice. MGH surgery resident Francis Moore took sabbatical from clinical training to do translational research with RAI and other radioisotopes. Irving Ariel of New York became known as a nuclear surgeon in the wake of Hertz's work. George Crile Jr of Cleveland became an RAI advocate for the surgical community, implementing several paradigm-changing concepts in thyroid disease along the way. Hertz was a visionary who sparked this movement, predicting many of the molec ular dilemmas with RAI-tumor avidity that clinical researchers continue to navigate today. This timely history for surgical oncologists and endocrine surgeons traces the development of RAI therapy through the life of Saul Hertz, a biographical window influenced by social stigma, political controversy, and mainstream media. PMID:35081787 | DOI:10.1177/00031348211060463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A submandibular mass with cystic component

xlomafota13 shared this article with you from Inoreader A submandibular mass with cystic component Via ear nose throat Ear Nose Throat J. 2022 Jan 27:1455613221074134. doi: 10.1177/01455613221074134. Online ahead of print. ABSTRACT Not required. PMID:35081804 | DOI:10.1177/01455613221074134 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A structured ICA-based process for removing auditory evoked potentials

xlomafota13 shared this article with you from Inoreader A structured ICA-based process for removing auditory evoked potentials Via cortical auditory Sci Rep. 2022 Jan 26;12(1):1391. doi: 10.1038/s41598-022-05397-3. ABSTRACT Transcranial magnetic stimulation (TMS)-evoked potentials (TEPs), recorded using electroencephalography (EEG), reflect a combination of TMS-induced cortical activity and multi-sensory responses to TMS. The auditory evoked potential (AEP) is a high-amplitude sensory potential-evoked by the "click" sound produced by every TMS pulse-that can dominate the TEP and obscure observation of other neural components. The AEP is peripherally evoked and therefore should not be stimulation site specific. We address the problem of disentangling the peripherally evoked AEP of the TEP from components evoked by cortical stimulation and ask whether removal of AEP enables more accurate isolation of TEP. We hypothesized that isolation of the AEP using Independent Components Analysis (ICA) would reveal features that are stimulation site specific and unique individual features. In order to i mprove the effectiveness of ICA for removal of AEP from the TEP, and thus more clearly separate the transcranial-evoked and non-specific TMS-modulated potentials, we merged sham and active TMS datasets representing multiple stimulation conditions, removed the resulting AEP component, and evaluated performance across different sham protocols and clinical populations using reduction in Global and Local Mean Field Power (GMFP/LMFP) and cosine similarity analysis. We show that removing AEPs significantly reduced GMFP and LMFP in the post-stimulation TEP (14 to 400 ms), driven by time windows consistent with the N100 and P200 temporal characteristics of AEPs. Cosine similarity analysis supports that removing AEPs reduces TEP similarity between subjects and reduces TEP similarity between stimulation conditions. Similarity is reduced most in a mid-latency window consistent with the N100 time-course, but nevertheless remains high in this time window. Residual TEP in this window has a time-c ourse and topography unique from AEPs, which follow-up exploratory analyses suggest could be a modulation in the alpha band that is not stimulation site specific but is unique to individual subject. We show, using two datasets and two implementations of sham, evidence in cortical topography, TEP time-course, GMFP/LMFP and cosine similarity analyses that this procedure is effective and conservative in removing the AEP from TEP, and may thus better isolate TMS-evoked activity. We show TEP remaining in early, mid and late latencies. The early response is site and subject specific. Later response may be consistent with TMS-modulated alpha activity that is not site specific but is unique to the individual. TEP remaining after removal of AEP is unique and can provide insight into TMS-evoked potentials and other modulated oscillatory dynamics. PMID:35082350 | DOI:10.1038/s41598-022-05397-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic

xlomafota13 shared this article with you from Inoreader Sudden Sensorineural Hearing Loss During the COVID-19 Pandemic Via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study compares the incidence of sudden sensorineur al hearing loss during the COVID-19 pandemic with that during 2018 and 2019 and assesses the association of lockdowns during the pandemic with sudden sensorineural hearing loss. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A dose-neutral image quality comparison of different CBCT and CT systems using paranasal sinus imaging protocols and phantoms

xlomafota13 shared this article with you from Inoreader A dose-neutral image quality comparison of different CBCT and CT systems using paranasal sinus imaging protocols and phantoms 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. 2022 Jan 27. doi: 10.1007/s00405-022-07271-4. Online ahead of print. ABSTRACT PURPOSE: To compare the image quality produced by equivalent low-dose and default sinus imaging protocols of a conventional dental cone-beam computed tomography (CBCT) scanner, an extremity CBCT scanner and a clinical multidetector computed tomography (MDCT) scanner. METHODS: Three different phantoms were scanned using dose-neutral ultra-low-dose and low-dose sinus imaging protocols, as well as default sinus protocols of each device. Quantified parameters of image quality included modulation transfer function (MTF) to characterize the spatial response of the imaging system, contrast-to-noise ratio, low contrast visibility, image uniformity and Hounsfield unit accuracy. MTF was calculated using the line spread and edge spread functions (LSF and ESF). RESULTS: The dental CBCT had superior performance over the extremity CBC T in each studied parameter at similar dose levels. The MDCT had better contrast-to-noise ratio, low contrast visibility and image uniformity than the CBCT scanners. However, the CBCT scanners had better resolution compared to the MDCT. Accuracy of HU values for different materials was on the same level between the dental CBCT and MDCT, but substantially poorer performance was observed with the extremity CBCT. CONCLUSIONS: The studied dental CBCT scanner showed superior performance over the studied extremity CBCT scanner when using dose-neutral imaging protocols. In case a dental CBCT is not available, the given extremity CBCT is still a viable option as it provides the benefit of high resolution over a conventional MDCT. PMID:35084532 | DOI:10.1007/s00405-022-07271-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material

xlomafota13 shared this article with you from Inoreader Comparison of Outcomes of Surgical Repair of Spontaneous Temporal Bone CSF Leaks and Encephaloceles Using Bone Cement and Autologous Material Via leak of cerebrospinal fluid Otol Neurotol. 2022 Jan 27. doi: 10.1097/MAO.0000000000003467. Online ahead of print. ABSTRACT OBJECTIVE: To compare outcomes transmastoid repair of spontaneous middle fossa cerebrospinal fluid (CSF) leak using only bone cement (BC) versus only autologous material (AM) or combined materials (CM) with both bone cement and autologous material. STUDY DESIGN: Retrospective Chart Review. SETTING: Tertiary Care Hospital. PATIENTS: Forty-three adult patients undergoing transmastoid repair of spontaneous middle fossa CSF leak between 2014 and 2020 (BC:12, AM:15, CR:16). INTERVENTIONS: Cortical mastoidectomy, identification of defect, and repair with BC (Cranios® hydroxyapatite), AM (local bone, fascia, fat, and/or cartilage), or CM (Cranios® combined with autologous materials). MAIN OUTCOME MEASURES: Successful repair without recurrent CSF leak or encephalocele throughout follow up. RESULTS: Fifty-one percent of subjects were female. Mean age at repair was 58.6 years (SD 10.9). Mean BMI was 35.4 (SD 7.6; BC:36.3, AM:36.5, CM:33.6). Forty (93%) patients had successful repair without known recurrent CSF leak or encephalocele since surgery (BC:11, 91.6%; AM:14, 93.3%; CM:15, 93.8%; p = 0.49) over a mean length of follow up of 49.6 months (BC: 37.9, AM: 59.2, CR: 49.5). The difference in mean operative time amongst the groups was faster for patients using bone cement (BC: 100.2 min, AM: 182.8, CM: 133.2; p < 0.00001). CONCLUSIONS: BC, AM, and CM techniques each demonstrate effective and sustained means of repair for middle fossa CSF leak and encephalocele, even in the presence of multiple defects. Use of isolated BC offers a significant decrease in operative time with a noninferior outcome. Active CSF leak at the time of surgery is associated with increased risk of recurrence. PMID:35085113 | DOI:10.1097/MAO.0000000000003467 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sensitizing TRAIL response via differential modulation of anti- and pro-apoptotic factors by AZD5582 combined with ER nanosomal TRAIL in neuroblastoma

xlomafota13 shared this article with you from Inoreader Sensitizing TRAIL response via differential modulation of anti- and pro-apoptotic factors by AZD5582 combined with ER nanosomal TRAIL in neuroblastoma Via histochem Acta Histochem. 2022 Jan 22;124(2):151856. doi: 10.1016/j.acthis.2022.151856. Online ahead of print. ABSTRACT Neuroblastoma is a metastatic brain tumor particularly common in children. The cure rate is below 50% for patients of high-risk condition. Novel therapeutic agents and approaches are needed to improve the cure rate. Tumor necrosis factor-related and apoptosis-inducing ligand (TRAIL) is a promising proapoptotic factor that rapidly induces apoptosis preferentially in t ransformed and cancerous cells. Unfortunately, the common TRAIL resistance in cancers has hampered the clinical application of the ligand. Previously we prepared a novel TRAIL-armed ER derived nanosomal agent (ERN-T) that overcomes TRAIL resistance in some cancer lines when combined with a synthetic antagonist of inhibitors of apoptosis proteins (IAPs), AZD5582. However, how AZD5582 sensitizes cancer cells to ERN-T remains not well understood. In this study we continued to test the therapeutic efficacy of the combinatory therapy of ERN-T and AZD5582 on neuroblastoma, aiming to reveal the molecular mechanism underlying the synergism between AZD5582 and ERN-T. The obtained data revealed that ERN-Ts overcame TRAIL resistance and showed significant cytotoxicity on the resistant neuroblastoma line SH-SH5Y when combined with AZD5582 whilst sparing normal cells. The combination of low doses of ERN-Ts and AZD5582 induced intensive apoptosis in SH-SY5Y but not in normal skin fibroblasts (NSF s). Importantly we discovered that TRAIL sensitization in SH-SY5Y was associated with the concomitant downregulation of antiapoptotic factors cFLIP, MCL-1 and IAPs and upregulation of proapoptotic protein BAX and the death receptor 5 (DR5) by the cotreatment of ERN-T and AZD5582. In vivo study demonstrated that the combination of ERN-T and AZD5582 constituted a highly effective and safe therapy for subcutaneous SH-SY5Y xenograft neuroblastoma in nude mice. In conclusion, we identified that the concomitant regulation of both antiapoptotic and proapoptotic factors and DR5 is an essential molecular mechanism for overcoming TRAIL resistance in SH-SY5Y and the combination of ERN-T and AZD5582 potentially constitutes a novel therapeutic strategy, which is highly effective and safe for neuroblastoma. PMID:35077998 | DOI:10.1016/j.acthis.2022.151856 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Intracranial Neuroendocrine Tumor of the Skull Base Complicated with Tension Pneumocephalus after Radiotherapy

xlomafota13 shared this article with you from Inoreader Primary Intracranial Neuroendocrine Tumor of the Skull Base Complicated with Tension Pneumocephalus after Radiotherapy Via leak of cerebrospinal fluid NMC Case Rep J. 2021 Sep 16;8(1):609-615. doi: 10.2176/nmccrj.cr.2020-0367. eCollection 2021. ABSTRACT Neuroendocrine tumors (NETs) are neoplasms that originate from cells of the endocrine and nervous systems, and are commonly found in the gastrointestinal and respiratory tracts. Primary intracranial NETs are extremely rare and have been the focus of only a few studies thus far. Herein, we report the case of a primary intracranial NET of the skull base complicated with tension pneumocephalus after radiotherapy. An 84-year-old woman visited a local hospital for a head injury, and CT revealed a skull base tumor. MRI showed that the tumor was located mainly on the clivus and extended into the paranasal sinuses and nasal cavity. We biopsied the tumor via the nasal cavity, and the pathological diagnosis was NET, WHO grade 2. We subsequently administered focal intensity-modulated radiation therapy, but the patient developed tension pneumocephalus 1 year after radiotherapy. We therefore performed endoscopic transnasal cerebrospinal fluid leak closure with a nasoseptal flap. The postoperative course was successful, and the patient returned home but died of an unknown cause 2 years after discharge. The optimal postoperative management of primary intracranial NETs remains controversial. Tension pneumocephalus related to radiotherapy is a rare complication. Assessing skull bone erosion before radiotherapy and performing regular radiological follow-up examinations are essential to prevent this rare complication. PMID:35079524 | PMC:PMC8769468 | DOI:10.2176/nmccrj.cr.2020-0367 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Posterior Rotation Flap for Posterior Glottic Insufficiency

xlomafota13 shared this article with you from Inoreader Endoscopic Posterior Rotation Flap for Posterior Glottic Insufficiency Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.