Facial Nerve Schwannoma Extending to Jugular Foramen: A Case Report

xlomafota13 shared this article with you from Inoreader Facial Nerve Schwannoma Extending to Jugular Foramen: A Case Report Via ear nose throat Ear Nose Throat J. 2021 Mar 18:1455613211000292. doi: 10.1177/01455613211000292. Online ahead of print. ABSTRACT Facial nerve schwannoma (FNS) is a benign, slow-growing schwannoma that originates from Schwann cells. Facial nerve schwannoma is the most common tumor of the facial nerve but rare and only accounts for 0.15% to 0.8% of intracranial neurinomas. It may be manifested as asymmetric hearing loss, facial palsy, and hemifacial spasm. A 56-year-old woman was transferred to our department, because of pain behind the right ear and spasm of the right lateral muscle for more than 2 years and pulsatile tinnitus for half a year. Based on the preoperative medical history, physical signs, and auxiliary examination, it was diagnosed with jugular foramen (JF) space-occupying lesion. We removed the tumor through the infratemporal fossa type A approach and found that the tumor originated from the facial nerve. After the tumor resection, sural nerve transplantation was performed. The patient demonstrated postoperative facial palsy (House-Brackman grade VI) and was smoothly discharged after good recovery. Facial nerve schwannoma rarely invades the JF, and the most common tumor in the JF is the glomus jugular tumor, followed by the posterior cranial schwannoma. They have common symptoms, making it difficult to obtain a correct diagnosis. Clinical data, medical history, and auxiliary examinations should be carefully analyzed to avoid misdiagnosis or mistreatment. Infratemporal fossa type A approach is an effective method for treating FNS of JF. PMID:33734878 | DOI:10.1177/01455613211000292 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Case of Hodgkin Lymphoma of the Maxillary Sinus

xlomafota13 shared this article with you from Inoreader A Rare Case of Hodgkin Lymphoma of the Maxillary Sinus Via ear nose throat Ear Nose Throat J. 2021 Mar 18:145561321993599. doi: 10.1177/0145561321993599. Online ahead of print. ABSTRACT Hodgkin lymphoma (HL) is an uncommon B-cell malignant disease. It usually presents with mediastinal and/or laterocervical lymph node localization, while primary extranodal HL is a rare entity giving rise to diagnostic and therapeutic challenges. It rarely presents as just extranodal localization, so its presence within the maxillary sinus without any lymphadenopathy is exceptional. Given the rarity of this localization, there is no standard treatment for maxillary sinus HL. We present a case of a patient with extranodal HL of the right maxillary sinus treated with primary surgery followed by adjuvant sequential chemoradiation therapy. PMID:33734885 | DOI:10.1177/0145561321993599 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Percutaneous Tracheostomy With a Demistifier Canopy in the COVID-19 Era: A Safe Technique in the Intensive Care Unit

xlomafota13 shared this article with you from Inoreader Percutaneous Tracheostomy With a Demistifier Canopy in the COVID-19 Era: A Safe Technique in the Intensive Care Unit Via ear nose throat Ear Nose Throat J. 2021 Mar 18:1455613211001595. doi: 10.1177/01455613211001595. Online ahead of print. ABSTRACT BACKGROUND: Endoscopic percutaneous tracheostomy (PT) is a safe technique that is performed frequently by otolaryngologists and intensivists. New challenges have been identified in order to maintain the safety of this procedure during the COVID-19 pandemic. A novel approach, using a modified demistifier canopy, was developed during the first wave of the pandemic a nd implemented for 17 consecutive percutaneous tracheostomies in order to enhance procedural safety. METHODS: A protocol was developed after performing a literature review of tracheostomy in COVID-19 patients. A multidisciplinary tracheostomy team was established, including the departments of otolaryngology, critical care, and respiratory therapy. Simulation was performed prior to each PT, and postoperative debriefings were done. RESULTS: A protocol and technical description of PT using a modified demistifier canopy covering was written and video documented. Data were collected on 17 patients who underwent this procedure safely in our tertiary care hospital. There were no procedure-related complications, and no evidence of COVID-19 transmission to any member of the health care team during the study period. CONCLUSION: As patients continue to recover from COVID-19, their need for tracheostomy will increase. The technique described provides a safe, multidisciplinary method of performing PT in COVID-19 patients. PMID:33734882 | DOI:10.1177/01455613211001595 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Oral Steroids on Tonsillectomy Postoperative Complications and Pain

xlomafota13 shared this article with you from Inoreader Impact of Oral Steroids on Tonsillectomy Postoperative Complications and Pain Via ear nose throat Ear Nose Throat J. 2021 Mar 18:1455613211000832. doi: 10.1177/01455613211000832. Online ahead of print. ABSTRACT OBJECTIVES: To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management. METHODS: Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided po stoperatively to patients undergoing tonsillectomy with or without adenoidectomy. The study population was separated into 2 groups: patients who received steroids (3 days of either dexamethasone or prednisolone), postoperative steroid (POS), versus patients who did not receive steroids (PONS). RESULTS: The questionnaire had a return rate of 27.3% (254/931). Nine of the 254 responses were disqualified for lack of information; therefore, the total number of responses was 245. Of these, 115 were POS and 130 were PONS. The groups were similar in mean age (POS: 13.2 ± 10.4 years, PONS: 14.7 ± 12.1 years, P = .32) and sex (POS: Male 40.0%, PONS: Male 40.0%, P = .97). There was an overall decrease of pain and nausea/vomiting (N/V) in the steroid group (P = .0007). There was reduction in pain (P < .05) from postoperative day (POD) 2, 3, 4, and 6 in the POS group. Otherwise, there was no significant reduction in pain from POD 7 to 14, day-by-day rate of N/V, bleeding, or rate of emergency department (ED) or clinic visit (P > .05). CONCLUSION: Postoperative steroid reduced overall pain and N/V, as well as daily pain on POD 2, 3, 4, and 6. Pain from POD 7 to 14, rate of ED or clinic visit, or daily N/V and bleeding rate were not significantly different between cohorts. PMID:33734886 | DOI:10.1177/01455613211000832 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sudden Sensorineural Hearing Loss in 6 Patients Following Dental Procedure

xlomafota13 shared this article with you from Inoreader Sudden Sensorineural Hearing Loss in 6 Patients Following Dental Procedure Via ear nose throat Ear Nose Throat J. 2021 Mar 18:1455613211001597. doi: 10.1177/01455613211001597. Online ahead of print. ABSTRACT This study investigated the etiology and treatment outcome in sudden sensorineural hearing loss (SSHL) patients following dental procedure. During the past 2 decades, only 6 patients with SSHL following dental procedure were experienced including tooth extraction in 5 and endodontic treatment in 1. Three were males and 3 were females, with ages ranging from 10 to 75 years (median, 47 years). All patients underwent an inner ear test battery. Types of audiogram consisted of total deafness in 3 ears, flat-type loss in 2 ears, and high-tone loss in 1 ear. The pretreatment mean hearing level from 4 frequencies was 76 ± 37 dB for the lesion ears, significantly higher than 23 ± 15 dB for the opposite healthy ears. The treatment outcome is unsatisfactory. Five patients remained hearing unchanged 3 months after treatment. Only 1 (17%) patient had hearing improvement who was proved as having reactivation of the varicella-zoster virus. In conclusion, reactivation of the varicella-zoster virus may be one of the etiologies for SSHL patients following dental procedure. Serological assay coupled with MR imaging may help identify the etiology, determine the medication, and predict the outcome. PMID:33734880 | DOI:10.1177/01455613211001597 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie

xlomafota13 shared this article with you from Inoreader Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1402-0543 Hintergrund Die hereditäre hämorrhagische Teleangiektasie (HHT) ist eine seltene, systemische Erbkrankheit, die durch mukokutane und viszerale Gefäßmalformationen gekennzeichnet ist. Ein interdisziplinäres Behandlungskonzept in HHT-Zentren wird empfohlen. Material und Methoden In einer retrospektiven Studie wurden Strukturen, Prozesse und die Daten aller Patienten analysiert, die von April 2014 bis August 2019 in unserem neu gegründeten HHT-Zentrum behandelt wurden. Ergebnisse Innerhalb des Universitätsklinikums Essen wurde zunächst ein Netzwerk von über 20 verschiedenen Fachabteilungen zur Behandlung von Patienten mit HHT aufgebaut. Von den 282 Patienten, die sich seit der Zentrumsgründung mit möglicher HHT im Westdeutschen Morbus-Osler-Zentrum vorstellten, wurde bei 261 Patienten (93 %) die Diagnose als möglich angesehen. Die meisten Patienten wiesen multiple Symptome auf (Epistaxis und/oder Teleangiektasien: je > 80 %, viszerale Beteiligung: 65 %), welche häufiger eine Behandlung im interdisziplinären Rahmen erforderten. Über 900 E-Mails fielen jährlich für die direkte Behandlung der Patienten mit HHT, deren Koordination, Kooperationen und Öffentlichkeitsarbeit an. Durch den internationalen Austausch innerhalb des Europäischen Referenznetzwerks für multisystemische vaskuläre Erkrankungen (VASCERN) ist eine Behandlung auf aktuellem Stand auch bei komplexen Fragestellungen gewährleistet. Schlussfolgerungen Ein HHT-Zentrum beinhaltet ein interdisziplinäres Netzwerk von medizinischen Fachrichtungen, bei denen die Abläufe durch Prozesse definiert und durch eine wirksame Öffentlichkeitsarbeit, Schulungs- und Veröffentlichungstätigkeit gekennzeichnet sind. [...] 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.

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725037 Objectives The three-dimensional (3D) exoscope has several advantages over the operative microscope (OM) but has not been extensively reported for its use in malignant temporal bone resections (TBR). We sought to demonstrate the feasibility of performing TBR, both lateral (LTBR) and subtotal (STBR), using the 3D exoscope for head and neck cancers. Design present study is a retrospective chart review from August 2016 until August 2019. Setting The study was conducted at a tertiary care center. Participants Patients were undergoing TBR with the Karl Storz VITOM 3D exoscope. Main Outcome Measures Demographics, tumor and surgical characteristics, patient outcomes were the primary measurements of this study. Results Fifty-five patients underwent 3D exoscopic TBR from 2016 through 2019 of which 18% (n = 10) underwent STBR. The 3D exoscope was used uninterruptedly in all procedures with no intraoperative complications. Most tumors were primarily T3 (42%, n = 23) or T4 (55%, n = 30) and of cutaneous (62%, n = 34) and parotid (27%, n = 15) origin. These TBR were often accompanied by infratemporal fossa resections (87%, n = 48), auriculectomies (47%, n = 26), mandibulectomies (53%, n = 29), and parotidectomies (96%, n = 53). On final pathology, 24% (n = 13) had microscopically positive margins. Over the study period, 20% (n = 11) of patients had recurrences with a median recurrence time of 5 months (range: 2–30 months). Conclusion In the largest case series of LTBR and STBR under exclusive 3D exoscopic visualization to date, we demonstrate the 3D exoscope is a feasible alternative to the operative microscope for LTBR and STBR. While oncologic outcomes remain to be clarified, it carries significant potential for use in complex oncologic procedures. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract&n bsp; |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of systemic corticosteroids in orbital cellulitis: a meta-analysis and literature review

xlomafota13 shared this article with you from Inoreader Role of systemic corticosteroids in orbital cellulitis: a meta-analysis and literature review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 6:S1808-8694(21)00024-0. doi: 10.1016/j.bjorl.2021.02.003. Online ahead of print. ABSTRACT INTRODUCTION: The standard management of orbital cellulitis is to administer a combination of intravenous broad-spectrum antibiotics along with treatment of associated sinusitis. OBJECTIVE: The purpose of this study was to evaluate whether the addition of corticosteroids could lead to earlier resolution of inflammation and improve disease outcome. METHODS: We independently searched five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) for studies published as recent as December 2019. Of the included studies, we reviewed orbital cellulitis and disease morbidity through lengths of hospitalization, incidence of surgical drainage, periorbital edema, vision, levels or C-reactive protein, and serum WBC levels in order to focus on comparing steroid with antibiotics treated gr oup and only antibiotics treated group. RESULTS: Lengths of hospitalization after admission as diagnosed as orbital cellulitis (SMD=-4.02 [-7.93; -0.12], p-value=0.04, I2=96.9%) decrease in steroid with antibiotics treated group compared to antibiotics only treated group. Incidence of surgical drainage (OR=0.78 [0.27; 2.23], p-value=0.64, I2=0.0%) was lower in the steroid with antibiotics treated group compared to the antibiotics only treated group. CONCLUSION: Use of systemic steroids as an adjunct to systemic antibiotic therapy for orbital cellulitis may decrease orbital inflammation with a low risk of exacerbating infection. Based on our analysis, we concluded that early use of steroids for a short period can help shorten hospitalization days and prevent inflammation progression. PMID:33722520 | DOI:10.1016/j.bjorl.2021.02.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study

xlomafota13 shared this article with you from Inoreader The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 7:S1808-8694(21)00026-4. doi: 10.1016/j.bjorl.2021.02.005. Online ahead of print. ABSTRACT INTRODUCTION: Vestibular migraine is the most common cause of spontaneous episodic vertigo in adult patients and the second most common cause of vertigo in patients of all ages. OBJECTIVE: To assess the effectiveness of oral medication type (propranolol, flunarizine, and amitriptyline) and botulinum toxin A application on vestibular symptoms, headache severity and attack frequency for vestibular migraine patients. METHODS: Sixty patients with vestibular migraine were enrolled. Thirty patients received botulinum toxin A treatment (B+ group) in addition to the oral medication, whereas 30 patients received only oral medication (B- group). Headache severity was evaluated with Migraine Disability Assessment Scale and vertigo severity was evaluated with Dizziness Handicap Inventory scale. Vestibular migrain e attack frequencies in the last three months were also evaluated. RESULTS: There was a statistically significant decrement in mean Dizziness Handicap Inventory scores, Migraine Disability Assessment Scale scores and vertigo attack frequencies after treatment for all patients, B+ and B- group patients (p<0.001 for all). The mean Migraine Disability Assessment Scale score gains (p<0.001) and vertigo attack frequency gains (p= 0.003) were significantly higher in the B+ patients than B- patients. CONCLUSIONS: Both B+ and B- group patients exhibited significant improvement in vestibular migraine attack frequencies, Dizziness Handicap Inventory score and Migraine Disability Assessment Scale score values. However, botulinum toxin A application had a more pronounced effect for Migraine Disability Assessment Scale score gain and vestibular migraine attack frequency values, but not for Dizziness Handicap Inventory score gain values. Thus, botulinum toxin A application shoul d be considered for vestibular migraine patients whose headache severity degrees are more profound. The oral medication type (propranolol, flunarizine or amitriptyline) did not differ in influencing the vestibular migraine attack frequency, Dizziness Handicap Inventory score gain and Migraine Disability Assessment Scale score gain values. PMID:33722518 | DOI:10.1016/j.bjorl.2021.02.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic evolution of vestibular neuritis after long-term monitoring

xlomafota13 shared this article with you from Inoreader Diagnostic evolution of vestibular neuritis after long-term monitoring Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 5:S1808-8694(21)00025-2. doi: 10.1016/j.bjorl.2021.02.004. Online ahead of print. ABSTRACT INTRODUCTION: The diagnosis of vestibular neuritis is based on clinical and laboratory findings after exclusion of other disease. There are occasional discrepancies between clinical impressions and laboratory results. It could be the first vertigo episode caused by other recurrent vestibular disease, other than vestibular neuritis. OBJECTIVE: This study aimed to analyze the clinical features and identify the diagnostic evolution of patients with clinically suspected vestibular neuritis. METHODS: A total of 201 patients clinically diagnosed with vestibular neuritis were included in this study. Clinical data on the symptoms and signs of vertigo along with the results of vestibular function test were analyzed retrospectively. Patients were categorized in terms of the results of caloric testing (CP - cana l paresis) group; canal paresis ≥25%; (MCP -minimal canal paresis) group; canal paresis <25%). Clinical features were compared between the two groups and the final diagnosis was reviewed after long-term follow up of both groups. RESULTS: Out of 201 patients, 57 showed minimal canal paresis (CP<25%) and 144 showed definite canal paresis (CP≥25%). A total of 48 patients (23.8%) experienced another vertigo episode and were re-diagnosed. Recurring vestibular symptoms were seen more frequently in patients with minimal canal paresis (p=0.027). Repeated symptoms were observed on the same affected side more frequently in the CP group. The proportion of final diagnosis were not different between two groups. CONCLUSIONS: Patients with minimal CP are more likely to have recurrent vertigo than patients with definite CP. There was no significant difference in the distribution of the final diagnoses between two groups when the vertigo recurs. PMID:33722519 | DOI:10.1016/j.bjorl.2021.02.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.