Stapes Surgery in Far-Advanced Otosclerosis

xlomafota13 shared this article with you from Inoreader Stapes Surgery in Far-Advanced Otosclerosis Via ear nose throat Ear Nose Throat J. 2021 May 11:1455613211013093. doi: 10.1177/01455613211013093. Online ahead of print. ABSTRACT INTRODUCTION: Surgical treatment of patients with far-advanced otosclerosis (FAO) has not yet been standardized. Patients with FAO are the candidates for stapes surgery or cochlear implant (CI). Although many surgeons consider stapes surgery as the first choice, other authors prefer CI because of the excellent hearing results. OBJECTIVE: The authors discuss their experience in the treatment of patients with FAO, potentially candidates for CI, who underwent stapedotomy. MATERIALS AND METHODS: Eleven adult patients with FAO underwent stapedotomy from 2006 to 2016. Pure-tone average (PTA) between 0.5-1-2-3 kHz and speech perception test with hearing aids were determined before and after stapedotomy. RESULTS: The results show a statistically significant improvement in air condition threshold (PTA) and satisfactory results with regard to speech recognition in 9 (81.8%) cases. Postoperative results are not influenced by the type of stapedotomy prosthesis employed and do not change during follow-up (3 years). CONCLUSIONS: The authors suggest first performing stapes surgery in patients with FAO and reserving CI in case of failure. PMID:33971751 | DOI:10.1177/01455613211013093 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Use of Coblation in the Treatment of Tracheal Tumors

xlomafota13 shared this article with you from Inoreader A Novel Use of Coblation in the Treatment of Tracheal Tumors Via ear nose throat Ear Nose Throat J. 2021 May 11:1455613211015739. doi: 10.1177/01455613211015739. Online ahead of print. ABSTRACT Radiofrequency coblation is a new method of electrosurgical intervention. Most recently, its use has been reported in the treatment of laryngotracheal pathology. However, studies on coblation for tracheal tumors have not been reported. In this article, we described a novel use of coblation technology, in which a new type of airway-specific wand was used to ablate tracheal benign or malignant tumors in 3 cases. The results suggest the possibility of usage of coablation in the treatment of tracheal tumors. More studies that are larger and have longer follow-up are needed to further evaluate the use of this technique in the treatment of tracheal tumors. PMID:33971752 | DOI:10.1177/01455613211015739 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cancer predisposition syndromes

xlomafota13 shared this article with you from Inoreader Pediatric Head and Neck Tumors Associated with Li-Fraumeni Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 10:34894211014786. doi: 10.1177/00034894211014786. Online ahead of print. ABSTRACT INTRODUCTION: Cancer predisposition syndromes are germline pathogenic variants in genes that greatly raise the risk of developing neoplastic diseases. One of the most well-known is Li-Fraumeni syndrome (LFS), which is due to pathogenic variants in the TP53 gene. Children with LFS have higher risks for multiple malignancies before adulthood, often with rare and aggressive subtypes. OBJECTIVE: To examine head and neck manifestations of LFS in children treated at a tertiary children's hospital over a 20-year period. METHODS: A retrospective review of LFS children with neoplastic disease presenting in traditional Otolaryngologic head and neck subsites from 2000 to 2019, with patient charts reviewed for relevant clinical, imaging, and operative data. RESULTS: Of the 40 LFS patients initially identified, 27 neoplastic tumors were identified in 20 children within this cohort (20 primary, 7 second primary). Head and neck subsites aside from the brain or orbit were involved in 22% (6/27) of these tumors, representing 20% (4/20) of primary tumors and 29% (2/7) of second primary tumors. Both second primaries within the head and neck were within the radiation fields of the first primary tumor. The mean ages at primary and second primary diagnosis were 4.6 years (SD 3.5) and 12 years (SD 1.4), respectively. The male/female r atio was 1:6 among all patients with head and neck tumors. All 6 head and neck tumors were sarcomas. Rhabdomyosarcoma (N = 3, 50%) was the most common pathology, and the other 3 demonstrated rare tumor pathological subtypes (synovial cell sarcoma, pleomorphic myxoid liposarcoma, mandibular osteosarcoma). The neck was the most common subsite (75%) within this group for primary tumor presentation. CONCLUSION: This study identifies a high potential for head and neck involvement in children with LFS, which has not been previously described in the literature. Otolaryngological care should be included in a multidisciplinary care team surveilling these patients. PMID:33971750 | DOI:10.1177/00034894211014786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Head and Neck Tumors Associated with Li-Fraumeni Syndrome

xlomafota13 shared this article with you from Inoreader Pediatric Head and Neck Tumors Associated with Li-Fraumeni Syndrome Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 10:34894211014786. doi: 10.1177/00034894211014786. Online ahead of print. ABSTRACT INTRODUCTION: Cancer predisposition syndromes are germline pathogenic variants in genes that greatly raise the risk of developing neoplastic diseases. One of the most well-known is Li-Fraumeni syndrome (LFS), which is due to pathogenic variants in the TP53 gene. Children with LFS have higher risks for multiple malignancies before adulthood, often with rare and aggressive subtypes. OBJECTIVE: To examine head and neck manifestations of LFS in children treated at a tertiary children's hospital over a 20-year period. METHODS: A retrospective review of LFS children with neoplastic disease presenting in traditional Otolaryngologic head and neck subsites from 2000 to 2019, with patient charts reviewed for relevant clinical, imaging, and operative data. RESULTS: Of the 40 LFS patients initially identified, 27 neoplastic tumors were identified in 20 children within this cohort (20 primary, 7 second primary). Head and neck subsites aside from the brain or orbit were involved in 22% (6/27) of these tumors, representing 20% (4/20) of primary tumors and 29% (2/7) of second primary tumors. Both second primaries within the head and neck were within the radiation fields of the first primary tumor. The mean ages at primary and second primary diagnosis were 4.6 years (SD 3.5) and 12 years (SD 1.4), respectively. The male/female r atio was 1:6 among all patients with head and neck tumors. All 6 head and neck tumors were sarcomas. Rhabdomyosarcoma (N = 3, 50%) was the most common pathology, and the other 3 demonstrated rare tumor pathological subtypes (synovial cell sarcoma, pleomorphic myxoid liposarcoma, mandibular osteosarcoma). The neck was the most common subsite (75%) within this group for primary tumor presentation. CONCLUSION: This study identifies a high potential for head and neck involvement in children with LFS, which has not been previously described in the literature. Otolaryngological care should be included in a multidisciplinary care team surveilling these patients. PMID:33971750 | DOI:10.1177/00034894211014786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auricular Perichondrium Graft for Septal Perforation Repair

xlomafota13 shared this article with you from Inoreader Auricular Perichondrium Graft for Septal Perforation Repair Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 10:34894211015738. doi: 10.1177/00034894211015738. Online ahead of print. ABSTRACT OBJECTIVES: Procedures which utilize bilateral mucosal flaps with an interposition graft are frequently used when attempting closure of a septal perforation. Concurrent surgical management of the nasal valve or an aesthetic deformity may be indicated. The objective of this study is to report our experience using auricular perichondrium for the interposition g raft when auricular cartilage is harvested for structural or aesthetic graft material. METHODS: A retrospective medical record review was performed for septal perforation repairs performed at Mayo Clinic in Arizona from January 2010 through January 2020. Patients identified for this study underwent a procedure utilizing bilateral nasal mucosal flaps with an auricular perichondrium interposition graft. RESULTS: Forty-four patients (31 females) with a mean age of 53.3 years met study criteria. The most common presenting symptoms were nasal obstruction, crusting, and epistaxis. Prior septal surgery was the most common perforation etiology (45.5%). Mean perforation length was 11.8 (range, 3-26) mm and height, 9.1 (range, 2-16) mm. Auricular cartilage was harvested for nasal valve surgery in 43 patients. Complete perforation closure was noted in 95.3% (41/43) of patients with a minimum post-operative follow-up of 3 (mean, 20.4) months. Four patients underwent revision surgery for persistent postoperative nasal obstruction. CONCLUSION: The ear can provide both cartilage and perichondrium for use in septal perforation surgery. Our study demonstrates the successful use of auricular perichondrium as the interposition graft for a perforation closure procedure utilizing bilateral nasal mucosal flaps. PMID:33971755 | DOI:10.1177/00034894211015738 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mapping the Risk Factors of Pharyngocutaneous Fistula After Salvage Laryngectomies

xlomafota13 shared this article with you from Inoreader Mapping the Risk Factors of Pharyngocutaneous Fistula After Salvage Laryngectomies Via Otolaryngology Indian Abstract To evaluate the postoperative surgical wound infection prevalence rates of patients undergoing SL, identify the causative organism and determine predisposing factors leading to infection. A retrospective study of all consecutive patients who underwent salvage total laryngectomy at our unit between 2015 and 2020 was performed. The following parameters were also analyzed: age, smoking history, pre and postoperative albumin level, history of radio and chemo-radiotherapy, reconstruction with pectoralis flap, intraoperative tracheoesophageal puncture, and tumor stage. A total of 12 of the 21 patients (57%) experienced a postoperative infection after SL during the study period. 82% of those patients whose preoperative albumin level below 3gm/dl developed postoperative infection. There is a significant increase (p < 0.01) in infection in patients with N1 and 2 stage tumor (68%) compared with the N0 stage tumors (40%). Multivariate analysis showed that preoperativ e albumin and nodal stage were significant risk factors for postoperative infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Can We Conquer Advanced Head and Neck Cancer? Current Status and Future Directions

xlomafota13 shared this article with you from Inoreader Can We Conquer Advanced Head and Neck Cancer? Current Status and Future Directions Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2021 May;14(2):145-146. doi: 10.21053/ceo.2021.00458. Epub 2021 Apr 30. NO ABSTRACT PMID:33971695 | DOI:10.21053/ceo.2021.00458 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Choice of Anesthetic Agents for Endoscopic Sinus Surgery: Can Sinus Surgeons Be Involved?

xlomafota13 shared this article with you from Inoreader The Choice of Anesthetic Agents for Endoscopic Sinus Surgery: Can Sinus Surgeons Be Involved? Via pubmed: "clin exp otorhinola... Clin Exp Otorhinolaryngol. 2021 May;14(2):147-148. doi: 10.21053/ceo.2021.00395. Epub 2021 Apr 30. NO ABSTRACT PMID:33971696 | DOI:10.21053/ceo.2021.00395 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Length of the Cricoid and Trachea in Children: Predicting Intubation Depth to Prevent Subglottic Stenosis

xlomafota13 shared this article with you from Inoreader Length of the Cricoid and Trachea in Children: Predicting Intubation Depth to Prevent Subglottic Stenosis Via The Laryngoscope Objective Define the length of the subglottis and trachea in children to predict a safe intubation depth. Methods Patients <18 years undergoing rigid bronchoscopy from 2013 to 2020 were included. The carina and inferior borders of the cricoid and true vocal folds were marked on a bronchoscope and distances were measured. Patient age, weight, height, and chest height were recorded. Four styles of cuffed pediatric endotracheal tubes (ETT) were measured and potential positions of each cuff and tip were calculated within each trachea using five depth of intubation scenarios. Multivariate linear regression was performed to identify predictors of subglottic and tracheal length. Results Measurements were obtained from 210 children (141 male, 69 female), mean (SD) age 3.21 (3.66) years. Patient height was the best predictor of subglottic length (R 2: 0.418): Length sg (mm) = 0.058 * height (cm) + 2.8, and tracheal length (R 2: 0.733): Length t (mm) = 0.485 * height (cm) + 21.3. None of the depth of intubation scenarios maintained a cuff‐free subglottis for all ETT styles investigated. A formula for depth of intubation: Length di (mm) = 0.06 * height (cm) + 8.8 found that no ETT cuffs would be in the subglottis and all tips would be above the carina. Conclusion Current strategies for determining appropriate depth of intubation pose a high risk of subglottic ETT cuff placement. Placing the inferior border of the vocal cords 0.06 * height (cm) + 8.8 from the superior border of the inflated ETT cuff may prevent subglottic cuff placement and endobronchial intubation. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice

xlomafota13 shared this article with you from Inoreader A Comparison of an Artificial Intelligence Tool to Fundamental Frequency as an Outcome Measure in People Seeking a More Feminine Voice Via The Laryngoscope Objectives/Hypothesis An artificial intelligence (AI) tool was developed using audio clips of cis‐male and cis‐female voices based on spectral analysis to assess %probability of a voice being perceived as female (%Prob♀). This program was validated with 92% accuracy in cisgender speakers. The aim of the study was to assess the relationship of f o on %Prob♀ by a validated AI tool in a cohort of trans females who underwent intervention to feminize their voice with behavioral modification and/or surgery. Study Design Cohort study. Methods Fundamental frequency (f o) from prolonged vowel sounds (f o/a/) and f o from spontaneous speech (f o‐sp) were measured using the Kay Pentax Computerized Speech Lab (Montvale, NJ) in trans females postintervention. The same voice samples were analyzed by the AI tool for %Prob♀. Chi‐square analysis and regression models were performed accepting >50% Prob♀ as female voice. Results Forty‐two patients were available for analysis after intervention. f o‐sp post‐treatment was positively correlated with %Prob♀ (R = 0.645 [P < .001]). Chi‐square analysis showed a significant association between AI %Prob♀ >50% for the speech samples and f o‐sp >160 Hz (P < .01). Sixteen of 42 patients reached an f o‐sp >160 Hz. Of these, the AI program only perceived nine patients as female (>50 %Prob♀). Conclusion Patients with f o‐sp >160 Hz after feminization treatments are not necessarily perceived as having a high probability of being female by a validated AI tool. AI may represent a useful outcome measurement tool for patients undergoing gender affirming voice care. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intratympanic Steroid Injection Complicated by Iatrogenic Perilymphatic Fistula: A Cautionary Tale

xlomafota13 shared this article with you from Inoreader Intratympanic Steroid Injection Complicated by Iatrogenic Perilymphatic Fistula: A Cautionary Tale Via The Laryngoscope Intratympanic (IT) steroid therapy is a mainstay treatment for sudden sensorineural hearing loss (SSNHL) for both initial therapy and salvage therapy. We report a rare case of iatrogenic perilymphatic fistula that resulted from trauma during an IT steroid injection for SSNHL. We discuss the diagnosis and treatment in the current case and compare it with previous reports from the literature. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.