Surgical Outcome of Potassium-Titanyl-Phosphate (KTP) Laser Photocoagulation for Vocal Fold Vascular Lesions

xlomafota13 shared this article with you from Inoreader Surgical Outcome of Potassium-Titanyl-Phosphate (KTP) Laser Photocoagulation for Vocal Fold Vascular Lesions Via Journal of Voice Laser technology is used in microscopic direct laryngeal surgery for a variety of indications. Lasers are categorized broadly as photoangiolytic or cutting/ablating lasers, based on the chromophores that absorb their energy. Photoangiolytic lasers such as the 532 nm Potassium-Titanyl-Phosphate (KTP) laser are absorbed selectively by the chromophore hemoglobin, facilitating controlled intravascular coagulation, with preservation of the overlying epithelium and adjacent tissue. Efficacy of the KTP laser has been demonstrated for incision, coagulation, and ablation in vocal fold (VF) surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic and Computed Tomography Evaluation of Posterior Glottic Closure During Phonation

xlomafota13 shared this article with you from Inoreader Endoscopic and Computed Tomography Evaluation of Posterior Glottic Closure During Phonation Via The Laryngoscope Objectives/Hypothesis The anatomy of the posterior glottis, specifically the states of the posterior glottis during phonation, has not been thoroughly explored in laryngology. Conventional wisdom about the posterior glottis indicates that it tends to be completely closed in men but may be open in women. Furthermore, professional singers are expected to have a completely closed posterior glottis. The aim of this study was to investigate whether these generalizations are true by comparing rigid videolaryngostroboscopy results with high-resolution computed tomography (HRCT) and three-dimensional (3D) reconstruction findings. Study Design Prospective study. Methods Of the 90 volunteers (58 women, 32 men) examined, 48 were female professional singers, 10 were female nonsingers, 22 were male professional singers, and 10 were male nonsingers. Rigid videolaryngostroboscopy as well as HRCT scans were performed during singing at the average singing fundamental frequency. HRCT images of the larynx and air-column were 3D visualized using the software MIMICS®. The states of the posterior glottis were assessed in both examinations and compared among participants. Results The sensitivity of endoscopy was 67.5%. Complete closure of the posterior glottis was observed in 62.5% men and 52% women (P = .33). Complete closure of the posterior glottis was observed in 35% nonsingers and 61% professional singers (P = .036). Conclusions The closure of the posterior glottis seen on videolaryngostroboscopy does not always correlate with actual closure. There seems to be no link between sex and complete closure of the glottis. However, there is strong evidence that posterior glottis closure can be influenced, to some degree, by vocal training. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Plate Contouring With Hardware Complications Following Mandibular Reconstruction

xlomafota13 shared this article with you from Inoreader Association of Plate Contouring With Hardware Complications Following Mandibular Reconstruction Via The Laryngoscope Objectives/Hypothesis Despite considerable effort being dedicated to contouring reconstruction plates, there remains limited evidence demonstrating an association between contour and reconstructive outcomes. We sought to evaluate whether optimizing mandibular reconstruction plate contouring is associated with reduced postoperative hardware complications. Study Design Retrospective cohort study. Methods A cohort study was performed with adult patients (age ≥18 years) who underwent mandibulectomy and osseous free flap reconstruction following oncologic ablation at the University Health Network in Toronto, Canada, between January 1, 2003 and December 31, 2014. Patients with computed tomography scans performed within 1 year of reconstruction were included. Computer-based three-dimensional models were generated and used to calculate the mean plate-to-bone gap (mm). The primary outcome was plate exposure. Secondary outcome included a composite of plate exposure or intraoral dehiscence. Logistic regression models were fitted for each outcome accounting for other patient and surgical characteristics associated with the primary outcome. Results Ninety-four patients met inclusion criteria, with a mean age of 60.4 (standard deviation [SD] 14.9). The mean follow-up time was 31.4 months (range 3–94). Reconstruction was performed with fibular (57%) and scapular free flaps (43%). In the multivariable model, small mean plate-to-bone gap (<1 mm) was independently associated with 86% reduced odds of plate exposure (odds ratio [OR] 0.12; 95% confidence interval [CI] 0.02–0.55). Mean plate-to-bone gap less than 1 mm was also independently associated with reduced odds of developing a composite of plate exposure or intraoral dehiscence (OR, 0.29; 95%CI, 0.11–0.75). Conclusion Optimizing plate contouring during mandibular reconstruction may decrease the development of postoperative hardware complications. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of Cough Suppression Therapy on Voice Disorder Severity

xlomafota13 shared this article with you from Inoreader Effects of Cough Suppression Therapy on Voice Disorder Severity Via The Laryngoscope Objectives//Hypothesis To determine changes in voice severity when treating chronic cough refractory to medical treatment with cough suppression therapy (CST) in patients with chronic cough and voice complaints. Chronic cough has been reported to be refractory to medical treatment and frequently co-occurs with voice disorders. The possible effects of CST on self-assessed changes in chronic cough and voice disorders have not been demonstrated. Study Design Retrospective analysis of the effects of cough suppression therapy (CST) on self-assessed changes in chronic cough and voice disorder severity in patients with both chronic cough and voice disorders. Methods Forty-three adult patients with the primary complaint of chronic refractory cough underwent pre- and post-treatment diagnostic examinations, completed pre- and post-treatment Voice Handicap Index-10 (VHI-10) and Cough Severity Index assessments, and were treated by a licensed speech-language pathologist using CST. Twenty-seven subjects were assigned to the cough (C) group and 16 to the cough-voice (CV) group based on the severity of their VHI-10 scores. Results Post-test analysis showed significant improvement in cough severity for both groups and significant improvement in voice severity for the CV group. The VHI-10 scores for the C group did not change significantly. The median number of treatment sessions was 3, with a range of 1–13 sessions. Correlation between changes in severity and number of treatment sessions was not found to be significant at the tested level. Conclusions CST represents a unifying approach for treatment of patients with CRC and comorbid voice disorders. CST offered cross-over effects to the voice when subjects were treated for their primary complaint of chronic cough. This treatment of the primary complaint improves function in systems that share a common pathway. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality of life comparison in thyroxine hormone withdrawal versus triiodothyronine supplementation prior to radioiodine ablation in differentiated thyroid carcinoma: a prospective cohort study in the Indian population

xlomafota13 shared this article with you from Inoreader Quality of life comparison in thyroxine hormone withdrawal versus triiodothyronine supplementation prior to radioiodine ablation in differentiated thyroid carcinoma: a prospective cohort study in the Indian population 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 Jun 24. doi: 10.1007/s00405-021-06948-6. Online ahead of print. ABSTRACT BACKGROUND: Thyroid withdrawal in preparation for radioiodine ablation (RIA) may have a profound impact on health-related quality of life (HRQL). Cost implications and scheduling limit the use of recombinant TSH and triiodothyronine (T3) with its shorter half-life is a conceptually attractive alternative. METHODS: Prospective cohort study design with patients having withdrawal of thyroxine (n = 37) or T3 supplementation (n = 33). HRQL was assessed using EORTC QLQ-C30, QLQ-H&N35 and modified Billewicz questionnaires. Time interval to achieve optimal TSH levels (at least 30 mIU/ml) prior to RIA was determined. RESULTS: With the exception of emotional domain (QLQ-C30 p = 0.045), LT3 supplementation did not confer significant benefit when compared to LT4 withdrawal. Target serum TSH levels was achieved in 95% of patients by week 4 post thyroidectomy. CONCLUSIONS: LT3 supplementation delivered equivocal benefit and therefore the alternate strategies to minimize the impact on HRQL of reduction in the duration of hypothyroidism in T4 withdrawal are suggested. PMID:34165625 | DOI:10.1007/s00405-021-06948-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evolution of Topic Corticosteroid Therapy for the Management of Sinonasal Inflammatory Disease

xlomafota13 shared this article with you from Inoreader Evolution of Topic Corticosteroid Therapy for the Management of Sinonasal Inflammatory Disease Via ear nose throat Ear Nose Throat J. 2021 Jun;100(5):293-294. doi: 10.1177/01455613211015746. NO ABSTRACT PMID:34166128 | DOI:10.1177/01455613211015746 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study

xlomafota13 shared this article with you from Inoreader Socioeconomic Status and Survival in Nasopharyngeal Carcinoma: A Population‐Based Study Via The Laryngoscope Objectives/Hypothesis To evaluate survival for nasopharyngeal carcinoma in relation to socioeconomic status. Study Design Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) Census Tract-level Socioeconomic Status Database (2000–2016). Methods Patients with nasopharyngeal carcinoma diagnosed between 2000 and 2016 were identified. Data were stratified based on socioeconomic status, divided into three groups: group 1 being the poorest and group 3 the wealthiest. Univariate analysis as well as multivariate Cox regression analysis adjusted for individual variables was performed. Results A total of 5,527 patients were included in the study, with 33% in group 1, 34% in group 2, and 33% in group 3. There was a significant difference between groups in regard to age at diagnosis, race, histologic subtype, overall stage, tumor stage, nodal stage, and whether or not they received radiation. Patients in group 1, the poorest socioeconomic status, were more likely to be young (P = .003), black (P < .0001), present with higher overall stage (P = .009), tumor stage (P = .01), and nodal stage (P = .02), and less likely to receive radiation (P = .005). In multivariate analysis, there was a significant difference in survival between the groups, with group 1 patients less likely to survive compared to group 3 (hazard ratio = 1.28; 95% CI 1.07–1.57). Conclusions Patients in the poorest socioeconomic status presented with more advanced nasopharyngeal cancer and were less likely to receive radiation when compared with individuals of higher socioeconomic status. The poorest socioeconomic status groups were less likely to survive from their disease when controlling for other variables. Level of Evidence NA Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sclerotherapy Versus Cautery/Laser Treatment for Epistaxis in Hereditary Hemorrhagic Telangiectasia

xlomafota13 shared this article with you from Inoreader Sclerotherapy Versus Cautery/Laser Treatment for Epistaxis in Hereditary Hemorrhagic Telangiectasia Via The Laryngoscope Objectives/Hypothesis Surgical interventions for epistaxis management in hereditary hemorrhagic telangiectasia (HHT) demonstrate short-term success and require repeated procedures for disease control. Although electrocautery and/or laser photocoagulation (C ± L) are most frequently performed, sodium tetradecyl sclerotherapy (STS) is emerging as a promising newer treatment. We hypothesized that in a 24-month time period, STS would require fewer treatments than C ± L to maintain epistaxis severity within the mild range. Study Design Retrospective study. Methods We retrospectively assessed 67 patients with HHT with moderate and severe epistaxis that were treated periodically with C ± L (34 patients) versus STS (33 patients). The primary outcome was the number of procedures needed to maintain the epistaxis severity score (ESS) as mild. Secondary outcomes assessed for differences in postoperative complications, hemoglobin levels, iron stores, hematologic support, and quality-of-life (QoL) scores. Results To maintain ESS in the mild range, 1.6 STS procedures (range, 1–4) were performed versus 3.6 C ± L procedures (range, 1–8) (P = .003). Significant postoperative differences included reduction in nasal crusting (3% vs. 32%, P = .001), foul odor (3% vs. 35%, P < .001), and septal perforation (3% vs. 29%, P = .006) after STS. There were no significant differences between the two treatments in hemoglobin levels, iron stores, hematologic support, or QoL scores. Conclusion STS is able to attain satisfactory epistaxis control with significantly fewer procedures and lower postoperative complications than C ± L. STS should be considered as the initial surgical intervention for epistaxis in patients with HHT. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma

xlomafota13 shared this article with you from Inoreader Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma Via The Laryngoscope Objectives/Hypothesis To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH). Study Design Retrospective study. Methods From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed. Results Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort. Conclusions Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Acoustics and Aerodynamics During Scripted Reading Compared to Spontaneous Speech

xlomafota13 shared this article with you from Inoreader Vocal Acoustics and Aerodynamics During Scripted Reading Compared to Spontaneous Speech Via Journal of Voice Examination of vocal acoustics and phonatory aerodynamics during connected speech provide a more ecologically valid approach to voice assessment than single phoneme measures. The purpose of the current investigation was to determine if differences exist in vocal acoustics and aerodynamics between reading and spontaneous speech tasks in patients with common voice disorders. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Investigating resistin like beta (RETNLB) as a tumor promoter for oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Investigating resistin like beta (RETNLB) as a tumor promoter for oral squamous cell carcinoma Via Head & Face Medicine Oral cavity cancer ranks the sixth most common malignancy worldwide, of which oral squamous cell carcinoma is the predominant type. This study aimed to investigate the function and the underlying mechanism of ... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy

xlomafota13 shared this article with you from Inoreader Correlation of tumour and treatment characteristics to dose received by cochlea in volumetric arc therapy 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 Jun 23. doi: 10.1007/s00405-021-06950-y. Online ahead of print. ABSTRACT PURPOSE: This is a radiation field simulation study using CT images designed to see the cochlear dosimetry and its correlation with tumour and treatment characteristics during radiotherapy for head and neck cancers (HNC) for identifying the factors associated with a higher dose delivered to the cochlea. METHODS: From 2018 to 2020, 80 patients with HNC underwent volumetric arc therapy (VMAT) to a dose of 66-70 Gy at 2 Gy per fraction with bilateral cochlea contoured for VMAT optimization as an organ at risk. Minimum, mean and maximum planned radiation dose to the cochlea based on tumour and treatment characteristics and dose-volume histogram variables of VMAT plans were analysed. RESULTS: Mean (standard deviation, SD) cochlear volume was 0.14 (0.06) cm3 with maximum and mean planned doses of 10.3 (SD = 11.6) Gy and 8.5 (SD = 9.8) Gy, respectively. We found a statistically significant correlation between mean dose received by bilateral cochlea (P-0.000, rright-0.84, rleft-0.78, rmidline-0.92). Tumours of the paranasal sinuses, and the parotids and more advanced T stages were associated with a higher mean dose to cochlea but was not significant statistically. The dose received by the 95% target nodal volume (D95%) showed a significant correlation with the cochlear mean dose (P-0.000, rright-0.85, rleft-0.77, rmidline-0.93) CONCLUSION: With VMAT we have achieved a better sparing of cochlea. The mean dose to the cochlea of one side significantly differed from the other side in patients with lateralized cancers. D95% of nodal volume also showed a significant correlation with the cochlear mean dose. PMID:34160665 | DOI:10.1007/s00405-021-06950-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.