The biomechanical role of the lacertus fibrosus of the biceps brachii Muscle

xlomafota13 shared this article with you from Inoreader The biomechanical role of the lacertus fibrosus of the biceps brachii Muscle Via radiol anat Surg Radiol Anat. 2021 Mar 22. doi: 10.1007/s00276-021-02739-0. Online ahead of print. ABSTRACT PURPOSE: The lacertus fibrosus (LF) is involved in various surgeries. However, the biomechanical contribution of the LF remains unclear. The aim of this study was to determine the role of the lacertus fibrosus on the elbow and forearm kinematics and on the biceps brachii muscle lever arms. METHODS: This biomechanical study was performed on seven fresh-frozen upper limbs of c adavers. Elbow flexion, forearm supination, and biceps brachii muscle lever arms were analyzed in the intact conditions (I) and after superficial (R) and deep part (R2) of the lacertus fibrosus release, respectively. RESULTS: Elbow flexion shows a significant difference (p < 0.0001) between I, R, R2. Abduction/adduction shows a significant difference between I-R (p < 0.0001) and I-R2 (p < 0.0001). Supination does not show a significant difference in mean maximum amplitude, but between 40 and 70%, there are significant differences. There is a significant mean decrease of lever arm in flexion (28%) and supination (50%) after superficial and deep part of the lacertus fibrosus release. CONCLUSION: The results of this study show that the lacertus fibrosus increases the lever arm during flexion and supination. It limits the flexion and abduction of the elbow and supination of the forearm. Lacertus fibrosus maintains the rhythmicity between the elbow flexion and supina tion of the forearm. LEVEL OF EVIDENCE: Basic science study, biomechanics. PMID:33751178 | DOI:10.1007/s00276-021-02739-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between Laryngopharyngeal Reflux and Vocal Fold Leukoplakia

xlomafota13 shared this article with you from Inoreader Association between Laryngopharyngeal Reflux and Vocal Fold Leukoplakia Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Vocal fold leukoplakia (VFL) has a risk of malignant transformation, and the underlying mechanisms are currently unrecognized. Some clinical evidence has indicated that laryngopharyngeal reflux (LPR) probably plays a critical role. Objective: To explore the risk factors associated with the occurrence of VFL and to investigate the importance of LPR in VFL and its different pathological types using 24-h multichannel intraluminal impedance-pH monitoring. Materials and Methods: Eighty-one patients with VFL and 27 healthy volunteers were recruited. General information and LPR parameters were analyzed. Results: The monitoring showed that 35.8% (29/81) of patients had acidic LPR and that 43.2% (35/81) had weakly acidic LPR. Heavy drinking (odds ratio = 4.004, p = 0.037) and acidic LPR (odds ratio = 4.471, p = 0.029) were independent risk factors for the occurrence of VFL. Acidic LPR showed a strong correlation with the Reflux Finding Score (p #x3c; 0.05) in patients suspected of having LPR based on the scale score. Meanwhile, weakly acidic LPR parameters increased with the severity of pathological degrees which were higher in high-grade dysplasia (p #x3c; 0.05). Conclusion: Our study confirms the importance of LPR in VFL. Heavy drinking patients with VFL, particularly those with acidic LPR, should undergo intensive treatment. Meanwhile, weakly acidic LPR may play a c ritical role in the pathological changes in VFL. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intratympanic steroid injection versus hyperbaric oxygen therapy in refractory sudden sensorineural hearing loss: a meta-analysis

xlomafota13 shared this article with you from Inoreader Intratympanic steroid injection versus hyperbaric oxygen therapy in refractory sudden sensorineural hearing loss: a meta-analysis 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 Mar 22. doi: 10.1007/s00405-021-06616-9. Online ahead of print. ABSTRACT OBJECTIVE: The present meta-analysis aims to compare the efficacy of intratympanic steroid (ITS) injection and hyperbaric oxygen (HBO) therapy as salvage treatments for refractory sudden sensorineural hearing loss (SSNHL). DATA SOURCES: Comprehensive searches were performed in PubMed, EMBASE and the Cochrane Library from the date of the database inception to June 2020. All studies reporting the use of salvage ITS and HBO treatments in refractory SSNHL patients were included. Subsequently, the full texts of the eligible studies were evaluated. METHODS: The quality and bias of the studies were assessed using the Newcastle-Ottawa Scale and Cochrane's risk of bias tools for nonrandomized and randomized studies, respectively. The data were analyzed using Comprehensive Meta-Analysis software (Version 3; Biostat, Englewood, NJ) . RESULTS: Three hundred and fourteen subjects in 3 observational studies and 1 randomized controlled trial met our inclusion criteria. The pooled results demonstrated that there were no significant differences in the mean posttreatment hearing gain between the ITS and HBO groups. The changes in word discrimination and hearing gain at 250, 500, 1000, 2000, 4000 and 8000 Hz were also comparable between the two salvage treatment groups. CONCLUSIONS: The pooled results demonstrated that there were no significant differences in hearing improvements between salvage ITS injection and salvage HBO therapy after failed primary systemic steroid treatment in patients with SSNHL. However, spontaneous recovery could bias the treatment outcomes, and these results should be interpreted with caution. Clinicians may choose these salvage treatments according to personal experience and treatment availability. In cases in which specialized HBO facilities are difficult to access, salvage ITS injection can be provided with comparable responses. PMID:33751195 | DOI:10.1007/s00405-021-06616-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of Brandt Daroff, Semont and Epley maneuvers in the treatment of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Clinical Trial

xlomafota13 shared this article with you from Inoreader Effectiveness of Brandt Daroff, Semont and Epley maneuvers in the treatment of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Clinical Trial Via Otolaryngology Indian Abstract The aim was to compare the effectiveness of Brandt-Daroff, Semont and Epley maneuver in BPPV resolution. A Single Blind RCT in a Secondary Care Center was performed. Inclusion criteria were: patients with unilateral rotatory nystagmus on Dix-Hallpike Maneuver (DHM). Exclusion criteria: other causes of peripheral or central vertigo. Patients were randomized into 4 groups: Brandt-Daroff, "sham", Semont and Epley. Patients underwent allocation, 1st visit (at 1 week with reprise of original maneuver if persistent nystagmus) and 2nd visit (2 to 4 weeks) with repetitions of both DHM and DHI. Main Outcome Measures: Absence of nystagmus on DHM at 1st and 2nd visit evaluations and DHI score. Resolution was defined as the abscence of nystagmus. We included 34 patients (25 females, 9 males). Patients were randomized to Brandt-Daroff (n = 9), "sham" (n = 7), Semont (n = 9) and Epley (n = 9) group. Overall mean age was 59.85 years ( SD ± 13.10). A total of 47.06% patients (n = 16) had negative DHM at 1st visit. Resolution for Brandt-Daroff was 22.22%, "sham" 28.57%, Semont 44.44% and Epley 88.88% (p = 0.024); at 2nd visit follow up, Epley achieved 100% resolution (other maneuvers: 42.86%, 16.67%, 44.44%, respectively. P = 0.006). The DHI improvement at 2nd visit for Brandt-Daroff was 21.17 points, "sham" 8.05, Semont 14.67 and Epley 61.78 (p = 0.001). Epley maneuver was superior to Brandt Daroff, "sham" and Semont maneuvers on nystagmus resolution and DHI improvement in patients with BPPV. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Genetic Screening for 35delG Mutation in Egyptian Patients with Profound Sensorineural Hearing Loss Scheduled for Cochlear Implantation: A Population-Based Study

xlomafota13 shared this article with you from Inoreader Genetic Screening for 35delG Mutation in Egyptian Patients with Profound Sensorineural Hearing Loss Scheduled for Cochlear Implantation: A Population-Based Study Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objectives: The aim of this work was to assess the type and site of the 35delG gene mutation in patients presenting with profound SNHL and scheduled for cochlear implantation. The secondary objectives were to determine their geographical distribution throughout Egypt, screening of the parents for the mutation, and to correlate the type of mutation with clinical severity and outcomes after surgery. Methods: The study was carried out on 100 consecutive patients schedu led for cochlear implantation. Patients with syndromic hearing loss or noncongenital hearing loss (trauma, infections, and ototoxicity) were excluded. All patients were subjected to detailed history taking including geographic tagging for their origins in Egypt, imaging (CT and MRI cochlear implantation protocols), full audiological evaluation (PTA, ABR, and TEOAE), and genetic screening for GJB2 mutation using Invitrogen PCR mix and ApaI restriction enzyme (North America, CA, 10572-014). The parents of mutation-positive patients were also subjected to audiological and genetic analysis. All patients were subjected to postimplantation evaluation of hearing after 6 and 12 months. Results: There were 64 males and 36 females from 98 families. Ages ranged between 1.9 and 7 years (mean 3.72 years). They originated from all over Egypt but the majority came from the Giza and Cairo areas. The 35delG mutations were found in exon 2 in 31% of the cases and all were heterozygous. I n the parents, 18 mothers and 13 fathers were positive but only 8 had mild to moderate SNHL. Hearing evaluation by pure tone and speech discrimination scores at 6 and 12 months showed that the 35delG children had a statistically better result compared to the children without this mutation. Conclusion: The prevalence of the 35delG mutation in nonsyndromic children in this sample was 31% which is different from previous studies in the Egyptian population but close to the values found in other populations in the Mediterranean basin. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats

xlomafota13 shared this article with you from Inoreader The Effects of Round Window Membrane Injury and the Use of a Model Electrode Application on Hearing in Rats Via ear nose throat Ear Nose Throat J. 2021 Mar 23:145561321990188. doi: 10.1177/0145561321990188. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the effects of the mechanical trauma to the round window, a model electrode inserted into the scala tympani on the cochlear reserve, and the efficacy of topical steroids in preventing hearing loss. MATERIALS AND METHODS: 21 male Wistar Albino rats were equally categorized into three groups. In all groups an initial mechanical injury t o round window was created. Only subsequent dexamethasone injection was administrated into the cochlea in the subjects of group 2 while a multichannel cochlear implant guide inserted into the cochlea prior to dexamethasone administration for group 3. Distortion product otoacoustic emissions (DPOAEs) were obtained prior to and immediately after the surgical injury, eventually on postoperative seventh day (d 7). Mean signal/noise ratios (S/Ns) obtained at 2000, 3000, and 4000 Hz were calculated. Data sets were compared with non-parametric statistical tests. RESULTS: The early intraoperative mean S/Ns were significantly less than preoperative measurements for group 1 and 2; however, preoperative and postoperative d 7 average S/Ns did not differ. There was statistically significant difference between preoperative, intraoperative and postoperative d 7 average S/Ns for group 3. CONCLUSION: We observed that hearing was restored approximately to the preoperative levels following early postoperative repair. However, an electrode insertion into the cochlea via round window subsequent to mechanical trauma seems to cause a progressive hearing loss. Therefore, a special care must be taken to avoid the injury to the round window membrane in the course of the placement of a cochlear implant electrode and surgery for the chronic otitis media. PMID:33752466 | DOI:10.1177/0145561321990188 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis

xlomafota13 shared this article with you from Inoreader Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis Via ear nose throat Ear Nose Throat J. 2021 Mar 23:145561321993936. doi: 10.1177/0145561321993936. Online ahead of print. ABSTRACT BACKGROUND: Computed tomography (CT) is the preferred noninvasive method for the evaluation of osteitis in chronic sinusitis. Some scholars believe that the bone changes associated with chronic sinusitis always show high attenuation (high density) and are positively correlated with the severity of the disease. However, sinus bone remodeling is a complex process that may cause high or low attenuation. There have been few reports on the spread of osteitis. Therefore, additional research on sinus CT is necessary. OBJECTIVE: To observe bony changes in chronic maxillary sinusitis (CMS) by CT and reveal the mechanism. METHODS: A retrospective study was conducted in 45 patients with unilateral CMS with bony changes in the sinus walls. The patients' clinical data and CT results were analyzed and compared between the affected and normal sides. We propose the location, involvement, attenuation, and thickness method to evaluate CMS with osteitis. RESULTS: Of the 45 patients, 40 (88.9%), 2, 12, and 7 had posterior external, medial, anterior, and superior lesions, respectively. The nasal region, sphenoid bone, palatine bone, and zygomatic arch were involved in 3, 12, 8, and 18 (40%) patients, respectively. Computed tomography indicated high attenuation in 30 (75.0%) and low attenuation in 10 (25.0%) patients; 6 (15.0%) showed new bone mar row cavities. The bone thickness was significantly different between the affected and normal sides in 40 patients (P < .001), including members of both the high- and low-attenuation groups (high-attenuation group: P < .001; low-attenuation group: P < .01). However, there was no significant difference in the thickness of the affected side between the high- and low-attenuation groups (P > .05). CONCLUSIONS: Chronic rhinosinusitis with bony changes may occur in the maxillary sinus walls and spread to adjacent bones. Both increased and decreased attenuation may occur in these circumstances. Analyzing the CT features of bone changes in unilateral CMS can improve the accuracy of disease diagnosis. PMID:33752463 | DOI:10.1177/0145561321993936 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diffuse-Type Tenosynovial Giant Cell Tumor Arising in the Temporomandibular Joint Extending to the External Auditory Canal: A Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Diffuse-Type Tenosynovial Giant Cell Tumor Arising in the Temporomandibular Joint Extending to the External Auditory Canal: A Case Report and Literature Review Via ear nose throat Ear Nose Throat J. 2021 Mar 23:1455613211002954. doi: 10.1177/01455613211002954. Online ahead of print. ABSTRACT A 74-year-old Japanese woman with a 1-year history of right preauricular pain and a 2-month history of bleeding from the right ear was admitted to our department. Tumor was observed in the anterior wall in the right external auditory canal. Bony swelling of the right preauricular area was palpated. Computed tomography revealed an ill-defined, osteogenic tumor arou nd the mandibular condyle with a destructive bony lesion involving the temporal bone. Magnetic resonance imaging revealed a 2.0 × 1.5 × 1.3-cm solid tumor around the mandibular condyle, exhibiting a low-intensity signal on T1-weighted imaging and an isointense central area surrounded by low-signal intensity on T2-weighted imaging. Histological examination of biopsy specimens revealed diffuse-type tenosynovial giant cell tumor (D-TGCT). After the feeding arteries for the tumor were embolized, the patient underwent surgery with combined temporal craniotomy and mandibular condylectomy. The soft and cystic tumor with calcification located in the extradural space was totally resected along with the mandibular condyle. No facial paralysis or recurrence was evident as of 6 months postoperatively. To date, only 23 cases of D-TGCT arising in the temporomandibular joint (TMJ) with ear involvement have been reported since 2011. We report successful resection of a rare case of D-TGCT arising in the TMJ. PMID:33752465 | DOI:10.1177/01455613211002954 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Case of Cochlear Implant Replacement Requiring Full-Thickness Skin Grafting

xlomafota13 shared this article with you from Inoreader A Case of Cochlear Implant Replacement Requiring Full-Thickness Skin Grafting Via ear nose throat Ear Nose Throat J. 2021 Mar 23:145561321996837. doi: 10.1177/0145561321996837. Online ahead of print. ABSTRACT Cochlear implants improve the quality of life of patients with bilateral severe sensorineural hearing loss. Normally, patients with cochlear implants can continue to use the devices for years without any complications. However, equipment failure or infection at the implant site could develop in some patients, and this might often necessitate implant replacement. Alt hough cochlear implant replacement surgery itself is not a major risk in most cases, extensive tissue resection will be required in cases involving infection, and the insertion site of the temporal bone implant will need to be changed. We encountered a case of skin necrosis at the temporal bone implant site caused by constant external irritation from the temple of an eyeglass frame. The patient underwent cochlear implant replacement surgery involving full-thickness skin grafting from the abdomen. Thereafter, the patient's condition improved. Full-thickness skin grafting can be useful in cases of extensive skin defects encountered during cochlear implant replacement. PMID:33752464 | DOI:10.1177/0145561321996837 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anxio-depressive symptoms in Moroccan women with gynecological cancer: Relief factors

xlomafota13 shared this article with you from Inoreader Anxio-depressive symptoms in Moroccan women with gynecological cancer: Relief factors Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 19:S0007-4551(21)00071-0. doi: 10.1016/j.bulcan.2020.12.011. Online ahead of print. ABSTRACT INTRODUCTION: Psychosocial determinants can affect the mental health of women who have been diagnosed with gynecological cancer. The aim of this study was to examine how social support and self-esteem are associated with anxiety and depression symptoms in women with gynecological cancer, and who are treated by radical surgery. METHODS: A cross-sectional study was performed, within the oncology department of Ibn Rochd University Hospital, Casablanca, on 100 Moroccan women. They all had undergone radical surgery for gynecological cancer, hysterectomy and/or oophorectomy. RESULTS: Our results showed that patients with gynecological cancer treated by radical surgery exhibited high prevalence rates of anxiety (66%) and depression symptoms (59%). Associations showed that age, having children, medical coverage system, area of residence, working status and socioeconomic status were significantly related to the prevalence of anxiety and depression symptoms (P<0.05). The general social support, family support and significant other support besides high self-esteem reduce significantly the risk of getting anxiety and depression symptoms (P-values<0.05). DISCUSSION: Among patients with gynecological cancer treated by radical surgery, high prevalence of anxiety and depression symptoms was found. Social support and high self-esteem could help improve mental health issues related to this type of cancer. PMID:33752868 | DOI:10.1016/j.bulcan.2020.12.011 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Melatonin Exerts Anti-Inflammatory, Antioxidant, and Neuromodulatory Effects That Could Potentially Be Useful in the Treatment of Vertigo

xlomafota13 shared this article with you from Inoreader Melatonin Exerts Anti-Inflammatory, Antioxidant, and Neuromodulatory Effects That Could Potentially Be Useful in the Treatment of Vertigo Via International Journal of Otolaryngology The acute phase of vertigo involves multiple neurotransmitters, inflammatory mediators, and products of oxidative stress. The vestibular pathway has multiple melatonin receptors distributed along its path, both centrally and peripherally. In addition, melatonin has been shown to be a powerful antioxidant and anti-inflammatory agent against factors related to vertigo, such as Bax/caspases, interleukins, and chemokines. Likewise, it exerts central GABAergic, antidopaminergic, and anti-migraine functions and regulates sympathetic activity in a similar way to the drugs classically used in acute vestibular crisis. In this review, the role of melatonin as a potential treatment of the acute phase of vertigo is discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.