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Κυριακή 27 Δεκεμβρίου 2015
OtoRhinoLaryngology & Medicine,New Articles,December 28th,2015
Peroral endoscopic myotomy in the endoscopy unit: location, location, location.
Peroral endoscopic myotomy in the endoscopy unit: location, location, location.
Gastrointest Endosc. 2016 Jan;83(1):126-8
Authors: Pannu D, White JD, Draganov PV
PMID: 26706301 [PubMed - in process]
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Moral considerations in non-EXIT airway management.
Moral considerations in non-EXIT airway management.
Int J Pediatr Otorhinolaryngol. 2015 Dec 10;
Authors: Walker P
Abstract
The case report "Management of the critical airway when an EXIT procedure is not an option" has important moral decision-making implications. If intubation was not quickly successful, then significant hypoxic brain injury may have resulted. A full discussion of the moral implications in cases such as this, prior to delivery, is important - both to the family and to the clinicians involved. Our contemporary era is characterised by a pronounced disparity of values and belief systems. An active process for moral decision-making based upon dialogic consensus, is seen as more appropriate than contemplation of ethical frameworks alone. This is increasingly important as the armamentarium of life-sustaining technology available to clinicians steadily increases.
PMID: 26706315 [PubMed - as supplied by publisher]
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Letter to the Editor regarding "Tympanic membrane perforation in children: Endoscopic type I tympanoplasty, a newly technique, is it worthwhile?"
Letter to the Editor regarding "Tympanic membrane perforation in children: Endoscopic type I tympanoplasty, a newly technique, is it worthwhile?"
Int J Pediatr Otorhinolaryngol. 2015 Dec 8;
Authors: Bakshi SS
PMID: 26706314 [PubMed - as supplied by publisher]
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Kinematic analysis of swallowing in the patients with esophagectomy for esophageal cancer.
Kinematic analysis of swallowing in the patients with esophagectomy for esophageal cancer.
J Electromyogr Kinesiol. 2015 Nov 30;
Authors: Kim SJ, Cheon HJ, Lee HN, Hwang JH
Abstract
The aim of this study is to reveal the mechanism of esophagectomy-mediated swallowing motion disorders. Forty-seven patients who underwent 3-stage esophagectomy with cervical anastomosis and VFSS for esophageal cancer were selected. Twenty-three patients displayed subglottic aspiration (aspiration group) and the other 24 patients did not show any aspiration or penetration in the videofluoroscopic swallowing study after esophagectomy (no aspiration group). For comparison, 27 healthy volunteers (normal group) were included. Maximal anterior displacement of the hyoid (MADH), maximal superior displacement of the hyoid (MSDH), maximal rotation of the epiglottis (MRE) and pharyngeal delay time (PDT) were measured by image J software. MADH, MRE, and PDT in normal group were significantly different from those in aspiration and no aspiration groups (P<0.001). The normal group displayed a significantly different PDT compared to the no aspiration and aspiration groups, and the no aspiration group had a significantly different PDT compared to the aspiration group (P<0.001). The mechanism of swallowing motion disorders caused by the esophagectomy in esophageal cancer includes the decreased anterior movement of the hyoid and rotation of the epiglottis caused by the prolonged operation time and delayed pharyngeal reflex caused by the laryngeal sensory disturbance. Among them, the main mechanism of subglottic aspiration after esophagectomy is the delayed pharyngeal reflex.
PMID: 26705964 [PubMed - as supplied by publisher]
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Irradiation of localized squamous cell carcinoma of the nasal vestibule.
Irradiation of localized squamous cell carcinoma of the nasal vestibule.
Head Neck. 2015 Dec 26;
Authors: Vanneste BG, Lopez-Yurda M, Tan IB, Balm AJ, Borst GR, Rasch CR
Abstract
BACKGROUND: The purpose of this study was to evaluate the long-term results of primary radiotherapy treatment for squamous cell carcinoma (SCC) of the nasal vestibule.
METHODS: Eighty-one patients were treated with external beam radiotherapy (EBRT) and/or interstitial radiotherapy (IRT) for a primary, localized, Wang classified SCC of the nasal vestibule.
RESULTS: Median follow-up was 38 months. T1 tumors were treated with IRT: we observed 1 local failure (at 13 months) among 48 patients (5-year local control rate of 97%). Most T2 tumors (20 of 26) were treated with EBRT. There were 8 local recurrences among 26 patients (5-year local control rate of 68%). For the T3 tumors (n = 7; all treated with EBRT), we observed local recurrence in 2 patients (5-year local control rate of 53%). The late-term side effects were relatively mild.
CONCLUSION: Local primary radiotherapy (either IRT for T1 or EBRT for T2/3) is an adequate treatment for SCC of the nasal vestibule with little late sequelae. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26706779 [PubMed - as supplied by publisher]
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Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma.
Prognostic value of the neutrophil-to-lymphocyte ratio in patients with laryngeal squamous cell carcinoma.
Head Neck. 2015 Dec 26;
Authors: Wong BY, Stafford ND, Green VL, Greenman J
Abstract
BACKGROUND: The neutrophil/lymphocyte ratio (NLR) has been found to be predictive of survival outcome in a range of tumors. The purpose of this study was to investigate the prognostic value of pretreatment (NLR) in patients with laryngeal squamous cell carcinoma (SCC).
METHODS: A retrospective analysis of 140 patients with laryngeal SCC treated between 2005 and 2010 in the Hull and East Yorkshire Hospitals NHS Trust was carried out. Patient records were evaluated and both pretreatment neutrophil and lymphocyte counts were documented together with survival data, sex, smoking status, nodal classification, and disease staging.
RESULTS: An elevated NLR was significantly associated with advanced disease stage (eg, node-positive and tumors stage III and IV). In addition, a high NLR was significantly associated with poor overall survival (OS) but not disease-free survival (DFS) on multivariate analysis, with the greatest significance seen in patients with the highest NLR.
CONCLUSION: Pretreatment NLR may serve as a useful prognostic marker in laryngeal SCC; however, a large prospective study is required to determine an optimal NLR cutoff value. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26706179 [PubMed - as supplied by publisher]
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Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes.
Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes.
Head Neck. 2015 Dec 26;
Authors: Lewis GD, Holliday EB, Kocak-Uzel E, Hernandez M, Garden AS, Rosenthal DI, Frank SJ
Abstract
BACKGROUND: Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes.
METHODS: Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records.
RESULTS: There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%.
CONCLUSION: We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26705956 [PubMed - as supplied by publisher]
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Intensity-modulated radiotherapy for head and neck surgeons.
Intensity-modulated radiotherapy for head and neck surgeons.
Head Neck. 2015 Dec 26;
Authors: Gutiontov SI, Shin EJ, Lok B, Lee NY, Cabanillas R
Abstract
The development of intensity-modulated radiotherapy (IMRT) has played a major role in improving outcomes and decreasing morbidity in patients with head and neck cancer. This review addresses this vital modality with a focus on the important role of the head and neck surgeon. The technique as well as its benefits and points of caution are outlined, the definitions of tumor and treatment volumes are discussed, and the dose and fractionation are detailed. Following this are several sections dedicated to the role of the head and neck surgeon in the planning of both definitive and postoperative radiotherapy to the primary site and neck. There is a focus throughout on anatomic and surgical considerations; commonly encountered situations are illustrated. With a deeper understanding of this technique and their own pivotal contribution to target delineation, head and neck surgeons will be poised to expand their role and improve cancer care for their patients. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26705685 [PubMed - as supplied by publisher]
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Multiple analyses of factors related to complications in endoscopic sinus surgery.
Multiple analyses of factors related to complications in endoscopic sinus surgery.
J Chin Med Assoc. 2015 Dec 16;
Authors: Chou TW, Chen PS, Lin HC, Lee KS, Tsai HT, Lee JC, Leu YS, Wang YP
Abstract
BACKGROUND: This study was undertaken to evaluate whether endoscopic sinus surgery (ESS) with a microdebrider had an impact on complication rates, and to facilitate the determination of factors associated with complications in patients who underwent ESS at a tertiary referral center in Taiwan.
METHODS: This investigation was a retrospective study and literature review. We analyzed 997 consecutive patients who underwent ESS at Mackay Memorial Hospital in Taipei, Taiwan from January 2006 through February 2010. All data including those of patient medical information, and peri- and postoperative complications were provided by the surgeons involved in patient medical care. We analyzed the complication rates using the following 10 variables by univariate analysis and multivariate logistic regression: gender, age, Lund-Mackay score, polyp grading, previous sinonasal surgery, surgeon skill, adjunctive sinonasal surgery, mesenteric type of anterior ethmoid artery, Keros skull base type, and the use of a microdebrider.
RESULTS: Of the 997 patients in our study, 78 (7.8%) had complications. Major complications occurred in five patients (0.5%): two with cerebrospinal fluid rhinorrhea, one with medial rectus muscle damage, and two with retrobulbar hematoma. Minor complications were found in 73 patients (7.3%), which included 32 patients with perioperative estimated blood loss > 15% of the total estimated blood volume, 26 with lamina papyracea damage, two with orbital cellulitis, and 13 with postoperative bleeding. Univariate analysis showed that risk factors related to complication rate were advanced Lund-Mackay scores (scores 19-24), advanced polyp grading (Grades 2 and 3), inexperienced surgeon (resident), and microdebrider usage. However, multivariate analysis revealed that complication rate was linked to advanced Lund-Mackay scores (Scores 19-24), mesenteric type of anterior ethmoid artery, and inexperienced surgeon.
CONCLUSION: Overall, the results of our study showed that the ESS complication rate was 7.8%, with risk factors including advanced Lund-Mackay scores (19-24, odds ratio 10.4) and inexperienced surgeon. It was also noted that ESS with a microdebrider had no impact on complication rates, although the presence of a mesenteric type of anterior ethmoid artery proved to be a protective factor.
PMID: 26706826 [PubMed - as supplied by publisher]
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Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.
Low-frequency sound exposure causes reversible long-term changes of cochlear transfer characteristics.
Hear Res. 2015 Dec 16;
Authors: Drexl M, Otto L, Wiegrebe L, Marquardt T, Gürkov R, Krause E
Abstract
Intense, low-frequency sound presented to the mammalian cochlea induces temporary changes of cochlear sensitivity, for which the term 'Bounce' phenomenon has been coined. Typical manifestations are slow oscillations of hearing thresholds or the level of otoacoustic emissions. It has been suggested that these alterations are caused by changes of the mechano-electrical transducer transfer function of outer hair cells (OHCs). Shape estimates of this transfer function can be derived from low-frequency-biased distortion product otoacoustic emissions (DPOAE). Here, we tracked the transfer function estimates before and after triggering a cochlear Bounce. Specifically, cubic DPOAEs, modulated by a low-frequency biasing tone, were followed over time before and after induction of the cochlear Bounce. Most subjects showed slow, biphasic changes of the transfer function estimates after low-frequency sound exposure relative to the preceding control period. Our data show that the operating point changes biphasically on the transfer function with an initial shift away from the inflection point followed by a shift towards the inflection point before returning to baseline values. Changes in transfer function and operating point lasted for about 180 s. Our results are consistent with the hypothesis that intense, low-frequency sound disturbs regulatory mechanisms in OHCs. The homeostatic readjustment of these mechanisms after low-frequency offset is reflected in slow oscillations of the estimated transfer functions.
PMID: 26706707 [PubMed - as supplied by publisher]
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Sodium salicylate reduces the level of GABAB receptors in the rat's inferior colliculus.
Sodium salicylate reduces the level of GABAB receptors in the rat's inferior colliculus.
Neuroscience. 2015 Dec 16;
Authors: Butt S, Ashraf F, Porter L, Zhang H
Abstract
Previous studies have indicated that sodium salicylate can cause hearing abnormalities through affecting the central auditory system. In order to understand central effects of the drug, we examined how a single intraperitoneal injection of the drug changed the level of subunits of the type-B γ-aminobutyric acid receptor (GABAB receptor) in the rat's inferior colliculus. Immunohistochemical and western blotting experiments were conducted three hours following a drug injection, as previous studies indicated that a tinnitus-like behavior could be reliably induced in rats within this time period. Results revealed that both subunits of the receptor, GABABR1 and GABABR2, reduced their level over the entire area of the inferior colliculus. Such a reduction was observed in both cell body and neuropil regions. In contrast, no changes were observed in other brain structures such as the cerebellum. Thus, a coincidence existed between a structure-specific reduction in the level of GABAB receptor subunits in the inferior colliculus and the presence of a tinnitus-like behavior. This coincidence likely suggests that a reduction in the level of GABAB receptor subunits was involved in the generation of a tinnitus-like behavior and/or used by the nervous system to restore normal hearing following application of sodium salicylate.
PMID: 26705739 [PubMed - as supplied by publisher]
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Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.
Altered vesicular glutamate transporter distributions in the mouse cochlear nucleus following cochlear insult.
Neuroscience. 2015 Dec 16;
Authors: Heeringa AN, Stefanescu RA, Raphael Y, Shore SE
Abstract
Vesicular glutamate transporters 1 and 2 (VGLUT1 and VGLUT2) have distinct distributions in the cochlear nucleus that correspond to the sources of the labeled terminals. VGLUT1 is mainly associated with terminals of auditory nerve fibers, whereas VGLUT2 is mainly associated with glutamatergic terminals deriving from other sources that project to the cochlear nucleus (CN), including somatosensory and vestibular terminals. Previous studies in guinea pig have shown that cochlear damage results in a decrease of VGLUT1-labeled puncta and an increase in VGLUT2-labeled puncta. This indicates cross-modal compensation that is of potential importance in somatic tinnitus. To examine whether this effect is consistent across species and to provide a background for future studies, using transgenesis, the current study examines VGLUT expression profiles upon cochlear insult by intracochlear kanamycin injections in the mouse. Intracochlear kanamycin injections abolished ipsilateral ABR responses in all animals and reduced ipsilateral spiral ganglion neuron densities in animals that were sacrificed after four weeks, but not in animals that were sacrificed after three weeks. In all unilaterally deafened animals, VGLUT1 density was decreased in CN regions that receive auditory nerve fiber terminals, i.e. in the deep layer of the dorsal cochlear nucleus (DCN), in the interstitial region where the auditory nerve enters the CN, and in the magnocellular region of the antero- and posteroventral CN. In contrast, density of VGLUT2 expression was upregulated in the fusiform cell layer of the DCN and in the granule cell lamina, which are known to receive somatosensory and vestibular terminals. These results show that a cochlear insult induces cross-modal compensation in the cochlear nucleus of the mouse, confirming previous findings in guinea pig, and that these changes are not dependent on the occurrence of spiral ganglion neuron degeneration.
PMID: 26705736 [PubMed - as supplied by publisher]
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Σάββατο 26 Δεκεμβρίου 2015
Meningiomas With Rhabdoid Features Lacking Other Histologic Features of Malignancy: A Study of 44 Cases and Review of the Literature.
Meningiomas With Rhabdoid Features Lacking Other Histologic Features of Malignancy: A Study of 44 Cases and Review of the Literature.
J Neuropathol Exp Neurol. 2016 Jan;75(1):44-52
Authors: Vaubel RA, Chen SG, Raleigh DR, Link MJ, Chicoine MR, Barani I, Jenkins SM, Aleff PA, Rodriguez FJ, Burger PC, Dahiya S, Perry A, Giannini C
Abstract
The behavior of rhabdoid meningiomas otherwise lacking malignant features remains unknown as most of the originally reported aggressive cases showed anaplastic histologic features independently of rhabdoid phenotype. We studied 44 patients with rhabdoid meningiomas lacking anaplastic features. Median age at diagnosis was 48.6 years (range 10-79). Location was supratentorial in 28 (63.6%), skull base in 15 (34.1%), and spinal in 1 (2.3%). Tumor grade was otherwise World Health Organization grade I (n = 22, 50%) or II (n = 22, 50%). Rhabdoid cells represented <20% of the tumor in 12 cases (27.3%), 20% to 50% in 18 (40.9%), and >50% in 14 (31.8%). Median clinical follow-up, available for 38 patients, was 5.0 years (range 0.17-14.2). Recurrence occurred in 9 patients (5-year recurrence-free survival, 73.7%) with a significantly higher risk in subtotally resected tumors (p = 0.043). Rhabdoid cell percentage was not associated with recurrence. Six patients died (4 of disease, 2 of unclear causes); 5-year overall survival was 86.7%, a mortality in excess of that expected in grade I-II meningiomas but much lower than originally reported. Review of 50 similar previously reported cases confirmed our findings. We suggest that rhabdoid meningiomas be graded analogously to nonrhabdoid tumors, with caution that some may still behave aggressively and close follow-up is recommended.
PMID: 26705409 [PubMed - in process]
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Additional Prone 18F-FDG PET/CT Acquisition to Improve the Visualization of the Primary Tumor and Regional Lymph Node Metastases in Stage II/III Breast Cancer.
Additional Prone 18F-FDG PET/CT Acquisition to Improve the Visualization of the Primary Tumor and Regional Lymph Node Metastases in Stage II/III Breast Cancer.
Clin Nucl Med. 2015 Dec 22;
Authors: Teixeira SC, Koolen BB, Vogel WV, Wesseling J, Stokkel MP, Vrancken Peeters MT, van der Noort V, Rutgers EJ, Valdés Olmos RA
Abstract
PURPOSE: To prospectively compare prone and supine acquired F-FDG PET/CT for visualization of primary tumors and regional lymph nodes in stage II/III breast cancer patients.
MATERIALS AND METHODS: One hundred ninety-eight patients were included consecutively from August 2010 to April 2012. One hour after administration of 180-240 MBq F-FDG, PET/CT images of the thorax were firstly acquired in prone position. Subsequently, a standard PET/CT in supine position from skull base to thighs was made. Both sets of images were tested in a univariate and a multivariate analysis for the number of lesions per breast or lymph node (LN) region and anatomical mismatch between PET and CT images.
RESULTS: Images in prone position showed less compression of breast tissue, more primary tumor (PT) multifocality (P < 0.001) and more avid axillary LNs (P < 0.001) compared with supine position. Anatomical mismatch of the axillary LN metastases was found more often on supine PET/CT images compared with prone (P = 0.004). Prone images showed a smaller PT functional volume compared with supine position (P < 0.001).
CONCLUSIONS: Prone position PET/CT improved the visualization of PT multifocality and the number of detected axillary lymph nodes. Therefore, it is a valuable addition to standard supine PET/CT in the protocol for locoregional assessment in stage II/III breast cancer patients.
PMID: 26704731 [PubMed - as supplied by publisher]
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Value of cephalic part of lateral crus in functional rhinoplasty.
Value of cephalic part of lateral crus in functional rhinoplasty.
Eur Arch Otorhinolaryngol. 2015 Dec 24;
Authors: Sazgar AA, Amali A, Peyvasty MN
Abstract
Reshaping of the nasal tip is the most difficult part of rhinoplasty. Over the years, there have been many advances in the field of rhinoplasty, including tip plasty. The goal of these continuous refinements in existing procedures has been to improve both aesthetic and functional outcomes. The cephalic part of the lateral crus of the lower lateral cartilage is what mainly contributes to nasal tip deformity. Various surgical techniques have been reported that used the cephalic part of lateral crus to refine the nasal tip and preserve alar integrity and nasal breathing function. In this review article, we have attempted to show the evolution of these methods while focusing on development of approaches that are basic for "modern rhinoplasty" and presenting our personal preferences. We have also endeavored to categorize these methods and clarify some misconceptions and inaccuracies in their descriptions.
PMID: 26704927 [PubMed - as supplied by publisher]
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Traumatic arteriovenous fistula of the superficial temporal artery.
Traumatic arteriovenous fistula of the superficial temporal artery.
J Surg Case Rep. 2015;2015(12)
Authors: Asai K, Tani S, Imai Y, Mineharu Y, Sakai N
Abstract
Traumatic arteriovenous fistula (AVF) of the superficial temporal artery (STA) is rare. We report a case of surgically treated, histopathologically confirmed traumatic AVF of the STA. A 24-year-old male was admitted to our hospital after a traffic accident. Computed tomography scan on admission showed an acute epidural hematoma on the right surface of frontal lobe, which was emergently treated by surgical evacuation. One month later, he was aware of pulsatile tinnitus around the left ear. Digital subtraction angiogram showed an AVF, mainly fed by the left STA. After total removal of the fistula, his tinnitus immediately disappeared. Histopathological examination demonstrated that the artery was connected to the vein through the thin-walled vessels lacking internal elastic lamina and muscularized media, suggesting that the connecting vessels were newly formed.
PMID: 26703929 [PubMed]
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Microvascular Decompression Surgery for Hemifacial Spasm.
Microvascular Decompression Surgery for Hemifacial Spasm.
J Craniofac Surg. 2015 Dec 16;
Authors: Qi H, Zhang W, Zhang X, Zhao C
Abstract
OBJECTIVE: This study aims to investigate the operative efficacy, surgical complication rate, and surgical strategy of microvascular decompression (MVD) for hemifacial spasm (HFS).
METHODS: Clinical data of 46 patients with HFS who underwent MVD were retrospectively analyzed.
RESULTS: During surgery, it was found that the facial nerve root exit zone was compressed by the following arterial vessels: anterior inferior cerebellar artery in 24 patients (52.17%); posterior inferior cerebellar artery in 14 patients (30.43%); vertebral artery and a small artery in 7 patients (15.22%); and vertebral artery in 1 patient (2.18%). Symptoms of 38 patients were immediately remitted completely after surgery and symptoms of 8 patients were significantly reduced. Main complications included dizziness and tinnitus in 9 patients, hearing loss in 5 patients, cerebrospinal fluid leakage in 1 patient, and infection in 2 patients. No patient died during surgery.
CONCLUSIONS: MVD is the preferred choice for treating idiopathic hemifacial spasm, and hearing impairment is the main complication. Skilled microsurgical techniques, as well as identifying and completely decompressing offending vessels, are the key to ensuring a successful microvascular decompression.
PMID: 26703065 [PubMed - as supplied by publisher]
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Features and prognostic utility of biopsy in oral squamous cell carcinoma.
Features and prognostic utility of biopsy in oral squamous cell carcinoma.
Head Neck. 2015 Dec 24;
Authors: Dhanda J, Uppal N, Chowlia H, Opie N, Al-Qamachi L, Shelat D, Aslam A, Yuffa A, Martin T, Risk J, Triantafyllou A, Shaw R, Parmar S, Mehanna H
Abstract
BACKGROUND: Traditional approaches in oral squamous cell carcinoma (OSCC) management utilize biopsy tissue for diagnostic purposes only. Adverse prognostic features, such as the tumor depth, are usually determined from final resection specimens, but are seldom studied in biopsy tissue.
METHODS: A preliminary study of 139 consecutive biopsies compared biopsy size with T classification, tumor site, and operator grade, and biopsy tumor depth with the true tumor depth.
RESULTS: This study demonstrated that biopsy size is independent of T classification (p = .44), subsite (p = .86), and operator grade (p = .10). The biopsy tumor depth significantly underrepresented true tumor depth (2.5 mm, 95% confidence interval [CI] = 2.4-2.9 vs 8.2 mm, 95% CI = 6.5-9.9; p < .001), confirming the limited prognostic utility of biopsies in OSCC.
CONCLUSION: A future clinical trial will compare the routine biopsy technique with standardized deeper biopsy techniques using punch biopsy to sample invasive fronts and investigate opportunities for up-front staging using a combination of histological features and epithelial and stromal molecular biomarkers in OSCC. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26705271 [PubMed - as supplied by publisher]
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Role of perioperative antibiotic treatment in parotid gland surgery.
Role of perioperative antibiotic treatment in parotid gland surgery.
Head Neck. 2015 Dec 24;
Authors: Shkedy Y, Alkan U, Roman BR, Hilly O, Feinmesser R, Bachar G, Mizrachi A
Abstract
BACKGROUND: The value of routine prophylactic antibiotic treatment in parotid gland surgery remains undetermined.
METHODS: A retrospective analysis was conducted of all patients who underwent parotidectomy at a university-affiliated tertiary care center between 1992 and 2009. Patients with insufficient data, specifically regarding postoperative complications and antibiotic administration were excluded from the study cohort.
RESULTS: A total of 593 patients underwent parotidectomy during the study period. After exclusion, 464 patients were eligible for the study. Perioperative antibiotic treatment was given to 206 patients (45%). There was no difference in wound infection rates between patients who received perioperative antibiotic therapy and those who did not (p = .168). Multivariate analysis showed that female sex, neck dissection, and drain output >50 cc/24 hours were predictive of postoperative wound infection.
CONCLUSION: Routine prophylactic antibiotic treatment has no role in parotid gland surgery. Perioperative antibiotic treatment is recommended for patients undergoing extensive parotid gland surgery with neck dissection. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.
PMID: 26702565 [PubMed - as supplied by publisher]
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