Adaptation and Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing: DIGEST-FEES

xlomafota13 shared this article with you from Inoreader Adaptation and Validation of the Dynamic Imaging Grade of Swallowing Toxicity for Flexible Endoscopic Evaluation of Swallowing: DIGEST-FEES Via swallowing exercises J Speech Lang Hear Res. 2021 May 25:1-9. doi: 10.1044/2021_JSLHR-21-00014. Online ahead of print. ABSTRACT Purpose While flexible endoscopic evaluation of swallowing (FEES) is a common clinical procedure used in the head and neck cancer (HNC) population, extant outcome measures for FEES such as bolus-level penetration-aspiration and residue scores are not well suited as global patient-level endpoint measures of dysphagia severity in cooperative group trials or clinical outcomes res earch. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) was initially developed and validated for use during videofluoroscopic evaluations as a way to grade safety, efficiency, and overall pharyngeal swallowing impairment. The purpose of this study was to adapt and validate DIGEST for use with FEES. Method A modified Delphi exercise was conducted for content validation, expert consensus, adaptation, and operationalization of DIGEST-FEES. Three blinded, expert raters then evaluated 100 de-identified post-HNC treatment FEES examinations. Intra- and interrater reliability were tested with quadratic weighted kappa. Criterion validity against the MD Anderson Dysphagia Inventory, Functional Oral Intake Scale, Secretion Severity Scale, and Yale Residue Rating Scale was assessed with Spearman correlation coefficients. Results Interrater reliability was almost perfect for overall DIGEST-FEES grade (κw = 0.83) and safety grade (κw = 0.86) and substantial for e fficiency grade (κw = 0.74). Intrarater reliability was excellent for all raters (0.9-0.91). Overall DIGEST-FEES grade correlated with MD Anderson Dysphagia Inventory (r = -.43, p < .0001), Functional Oral Intake Scale (r = -.43, p < .0001), Secretion Severity Scale (r = .47, p < .0001), Yale Vallecular Residue (r = .73, p < .0001), and Yale Pyriform Sinus Residue (r = .65, p < .0001). Conclusion DIGEST-FEES is a valid and reliable scale to describe the severity of pharyngeal dysphagia in patients with HNC. Supplemental Material https://doi.org/10.23641/asha.14642787. PMID:34033498 | DOI:10.1044/2021_JSLHR-21-00014 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Defining current practice patterns of vestibular schwannoma management in Italy: results of a nationwide survey

xlomafota13 shared this article with you from Inoreader Defining current practice patterns of vestibular schwannoma management in Italy: results of a nationwide survey Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):185-191. doi: 10.14639/0392-100X-N1107. ABSTRACT OBJECTIVE: Despite the increasing incidence rate of vestibular schwannomas (VS), controversies in their management are still present. METHODS: A 35-item multiple-choice survey investigating the current practice patterns of VS care was sent to the members of the Italian Society of Otolaryngology, Head and Neck Surgery (SIO) and of the Italian Society of Neurosurgery (SINCH). < p>RESULTS: Among 66 respondents, 37 (56.0%) claimed to be actively involved in VS management. Most interviewees (35.1%) declared > 20 years of experience and 59.5% claimed to work in an academic practice. The number of cases evaluated in each centre per year varied widely, with 54.0% evaluating > 25 cases/year and only 13.6% > 100 cases/year. Multidisciplinary care for VS evaluation was confirmed by 50.0% of respondents, and multidisciplinary surgical care by 62.2%. Observation and surgery were the most common management options proposed. Further details regarding VS care are presented. CONCLUSIONS: The present study provides the first overview on the current practice patterns of VS care in Italy. Although integrated in most centres, a multidisciplinary model of care needs to be encouraged. Wide heterogeneity in experience and practices is mostly influenced by the surgeon's different specialties and by the lack of shared guidelines. PMID:34028465 | DOI:10.14639/0392-100X-N1107 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of early detection of ENT symptoms in mild-to-moderate COVID-19

xlomafota13 shared this article with you from Inoreader The importance of early detection of ENT symptoms in mild-to-moderate COVID-19 Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):101-107. doi: 10.14639/0392-100X-N1038. ABSTRACT OBJECTIVES: Patients with coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present with a wide range of symptoms. In this paper, a detailed characterisation of mild-to-moderate ear, nose nd throat (ENT) symptoms is presented with the aim of recognising the disease early to help reduce further spread and progression. MET HODS: A total of 230 cases testing positive for SARS-CoV-2 and 134 negative controls were recruited for a case-control analysis. Symptoms were analysed using the Acute Respiratory Tract Infections Questionnaire, while other symptoms were investigated by ad hoc questions. RESULTS: Among the study samples (n = 364), 149 were males and 215 were females with age ranging from 20 to 89 years (mean 52.3). Four main groups of symptoms were obtained: influenza-like symptoms, ENT-symptoms, breathing issues and asthenia-related symptoms, representing 72%, 69%, 64% and 53% of overall referred clinical manifestations, respectively. ENT symptoms, breathing issues and influenza-like symptoms were associated with positivity to SARS-CoV-2, whereas asthenia-related symptoms did not show a significant association with SARS-CoV-2 infection after controlling for other symptoms, comorbidities and demographic characteristics. CONCLUSIONS: ENT symptoms are equally represented with influe nza-like ones as presenting symptoms of COVID-19. Patients with ENT symptoms should be investigated for early identification and prevention of SARS-CoV-2 spread. PMID:34028454 | DOI:10.14639/0392-100X-N1038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oral cancer: changing the aim of the biopsy in the age of precision medicine. A review

xlomafota13 shared this article with you from Inoreader Message: Abstract Il cancro del cavo orale: ridefinizione del ruolo delle biopsie nell'era della medicina di precisione. Review della letteratura. Il cancro orale è una malattia eterogenea che origina ed evolve con un processo complesso e multifasico. La medicina di precisione permette di pianificare un trattamento personalizzato sulla base delle caratteristiche biologiche e molecolari delle singole neoplasie. Le informazioni oggi più affidabili sono fornite dalla valutazione post-operatoria dei biomarcatori, ma per pianificare un trattamento personalizzato è necessario valutare questi marcatori sulla biopsia. Per questo abbiamo rivisto la letteratura dell'ultimo quinquennio ed abbiamo identificato 6/184 articoli che valutano i marcatori sulla biopsia confrontandone i valori con quelli misurati sul pezzo operatorio di ciascun paziente o valutandone la predittività per lo sviluppo di metastasi linfonodali. I dati che emergono da questi studi suggeriscono che la valutazione dei marcatori sul campione bioptico potrebbe fornire indicazioni utili per programmare trattamenti personalizzati. Tuttavia, a causa della eterogeneità e del basso livello di evidenza dei lavori considerati, questi risultati devono essere confermati da studi clinici su un'ampia popolazione per standardizzare e validare i biomarcatori e la loro affidabilità in altre procedure mini-invasive, ad esempio radiomica e biopsia liquida. Keywords: depth of invasion; liquid biopsy; precision medicine; radiomics; surgical biopsy. Plain Language Summary Oral cancer is a heterogeneous disease that develops through a complex, multi-step process. Precision medicine should help to better understand its molecular basis, integrate traditional classifications and have a positive impact on cancer management. To apply this information in clinical practice, we need to define its histology and identify biomarkers expressed by the tumour that provide useful information for planning tailored treatment. The most reliable information currently derives from evaluation of biomarkers on post-operative samples. To plan personalised treatment, oncologists need to assess these markers on biopsy samples. We reviewed the recent literature and identified 6 of 184 publications that compared markers measured on biopsy and post-operative samples or assessed their predictivity for the development of lymph node metastases. Data from these studies suggest that markers measured on biopsy samples can provide useful indications for tailoring treatments. However, du e to their heterogeneity and low level of evidence, these results need to be confirmed by clinical studies on a large population to standardise and validate biomarkers in biopsies and to assess their reliability in other diagnostic mini-invasive procedures such as radiomics and liquid biopsy. Oral cancer: changing the aim of the biopsy in the age of precision medicine. A review Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):108-119. doi: 10.14639/0392-100X-N1056. NO ABSTRACT PMID:34028455 | DOI:10.14639/0392-100X-N1056 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hashimoto's thyroiditis in papillary thyroid carcinoma: a 22-year study

xlomafota13 shared this article with you from Inoreader Hashimoto's thyroiditis in papillary thyroid carcinoma: a 22-year study Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):142-145. doi: 10.14639/0392-100X-N1081. ABSTRACT OBJECTIVE: We retrospectively investigated whether there is a relationship between Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma and studied the effect of HT on prognostic factors. METHODS: 1080 patients, who underwent thyroidectomy in our hospital and received a diagnosis of papillary thyroid carcinoma, were included in the study. In histopathological specimens, the diagnosis of papillary thyroid carcinoma was reconfirmed and non-neoplastic areas in the same specimen were evaluated in terms of HT. RESULTS: HT was detected in non-neoplastic areas of specimens in 36.1% (n = 390) of 1080 patients with a diagnosis of papillary thyroid carcinoma whereas HT was not observed in 63.9% (n = 690). There was a significant positive correlation between presence of HT and multifocal location (p < 0.05, χ2 = 38.5). There was no significant relationship between extrathyroidal tissue invasion and HT (p > 0.05). CONCLUSION: We assume that patients with HT developing papillary thyroid carcinoma have an increased risk of having multifocal tumour, and thus surgical intervention should be tailored according to this risk. PMID:34028458 | DOI:10.14639/0392-100X-N1081 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of vocal rehabilitation after chemoradiation for non-laryngeal head and neck cancers

xlomafota13 shared this article with you from Inoreader Effect of vocal rehabilitation after chemoradiation for non-laryngeal head and neck cancers Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):131-141. doi: 10.14639/0392-100X-N0977. ABSTRACT OBJECTIVE: This study evaluated the effect of voice intervention in patients who received chemoradiation to the neck for non-laryngeal head and neck malignancies. METHODS: Twenty individuals with non-laryngeal malignancies of the head and neck who received chemoradiation were divided by block randomisation into an intervention group that received voice rehabilitation and a contr ol group without rehabilitation. All patients underwent acoustic analysis, perceptual and subjective analysis of voice before the commencement of chemoradiotherapy and at 1, 3 and 6 months after chemoradiotherapy. RESULTS: In both groups, all parameters were significantly altered at one month follow-up except for fundamental frequency (females in control group and males in intervention group). In the intervention group, all parameters returned to pretreatment levels (no statistical differences) at 6 months. In the control group, all except for a few subjective parameters (grade, breathiness and asthenia) remained significantly altered at 6 months compared to the levels before radiotherapy. CONCLUSIONS: In non-laryngeal head and neck malignancies, voice rehabilitation offered at 1 month after treatment ameliorates chemoradiation-induced dysphonia within 6 months. PMID:34028457 | DOI:10.14639/0392-100X-N0977 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tracheo-bronchial recurrent respiratory papillomatosis: role of powered instruments in overcoming surgical challenges

xlomafota13 shared this article with you from Inoreader Tracheo-bronchial recurrent respiratory papillomatosis: role of powered instruments in overcoming surgical challenges Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):146-150. doi: 10.14639/0392-100X-N0822. ABSTRACT OBJECTIVE: Respiratory papillomatosis involving the trachea is a challenging problem. In this paper, we present our experience in the management of 13 cases of tracheal papillomatosis and the difficulties encountered in the procedure. The surgical technique and results are discussed. METHODS: A modified transoral trans-stomal approach was employed for the removal of papillomas b y using microdebrider. All patients were operated on under general anaesthesia with intermittent removal of intubation tube and apnoea. All patients required repeated surgeries. Tracheostomy removal was considered after adequate surgery and recurrence-free interval. The follow-up period was 12-24 months. RESULTS: The total number of surgeries per patient ranged from 3-35 (mean 10). Decannulation could be successfully achieved in 9 patients. There were no procedure-related complications. CONCLUSIONS: Transoral trans-stomal microdebrider assisted excision of tracheal papilloma showed excellent results without procedure-related complications. It can be used as a routine procedure for tracheal papillomas. The prognosis of tracheal involvement is fair and most patients can be decannulated. PMID:34028459 | DOI:10.14639/0392-100X-N0822 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The SWI/SNF complex in eosinophilic and non eosinophilic chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader The SWI/SNF complex in eosinophilic and non eosinophilic chronic rhinosinusitis Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):159-167. doi: 10.14639/0392-100X-N0760. ABSTRACT INTRODUCTION: Chronic rhinosinusitis (CRS) can be classified as eosinophilic (eCRS) or non-eosinophilic (neCRS) based on infiltration type. The SWI/SNF complex may be involved in the pathophysiology of CRS. AIM: To assess the expression of the SWI/SNF complex in both CRS groups; to correlate blood eosinophil count (BEC), and histopathology eosinophil count (HPEC) with the SWI/SN F expression level in eCRS and neCRS. MATERIALS AND METHODS: The study population consisted of 96 patients (68 eCRS, 28 neCRS). Immunohistochemical staining was performed on sinonasal mucosa for assessment of SWI/SNF protein expression. Type of tissue infiltration was assessed in samples obtained from examined groups (HPEC). The diagnostic value of eCRS was 10 cells/HPF (high power field). Complete blood count was analysed in order to calculate BEC. RESULTS: BEC and HPEC correlated negatively with all the SWI/SNF subunits. HPEC and BEC correlated positively with clinical findings (L-M and SNOT-22), while SWI/SNF correlated negatively with clinical findings (L-M and SNOT-22). CONCLUSIONS: The SWI/SNF was observed in both eCRS and neCRS, with lower expression in former. The meaning of its negative correlation with BEC, HPEC and clinical findings in eCRS group remains to be understood. PMID:34028461 | DOI:10.14639/0392-100X-N0760 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results

xlomafota13 shared this article with you from Inoreader Cochlear implant in prelingually hearing-impaired adults: prognostic factors and results Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):173-179. doi: 10.14639/0392-100X-N1146. ABSTRACT OBJECTIVES: The aim of present study is to evaluate the impact of prognostic factors on the outcome in a group of prelingually hearing-impaired patients submitted to cochlear implantation (CI) at an adult age. METHODS: This is a retrospective study on a cohort of prelingually severe-to-profound hearing-impaired patients cochlear implanted in adulthood and followed by a single au diology centre. We correlated post-CI results in term of speech perception with patients' speech perception with hearing aids before implantation, history of progression of hearing loss (HL), and levels of education and cognition. The study group was composed of 49 patients. RESULTS: Post-CI open-set recognition score in silence and noise was significantly correlated with pre-CI open-set recognition score in silence and with background noise. Patients with a history of progression of HL gained significantly better results. Furthermore, we found higher improvements in patients with a higher level of education. CONCLUSIONS: Prelingually deafened patients implanted in adulthood achieved satisfactory results. Significantly better results were achieved by patients with better pre-operative speech perception scores, progressive HL and higher level of education. PMID:34028463 | DOI:10.14639/0392-100X-N1146 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of rhinophototherapy on nasal congestion in patients with seasonal allergic rhinitis

xlomafota13 shared this article with you from Inoreader Effect of rhinophototherapy on nasal congestion in patients with seasonal allergic rhinitis Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Apr;41(2):151-158. doi: 10.14639/0392-100X-N0907. ABSTRACT OBJECTIVE: The aim of the present study was to objectively and subjectively evaluate the effects of adding rhinophototherapy to intranasal beclomethasone dipropionate to treat nasal congestion in patients with seasonal allergic rhinitis. METHOD: Seventy-five seasonal allergic rhinitis patients were randomly divided into two groups. Patients in Group 1 received intranasal beclome thasone dipropionate for two weeks and patients in Group 2 had rhinophototherapy added to the same medical therapy as Group 1. The effectiveness of treatments was evaluated with the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Nasal Obstruction Symptom Evaluation scale (NOSE) questionnaires and active anterior rhinomanometry. RESULTS: After treatment, significant improvement was observed in Group 2 vs Group 1 in terms of RQLQ (p = 0.011) and NOSE (p = 0.001) scores. In Group 2, significant differences were observed between before and after treatment for inspiratory total nasal resistance (p = 0.004). However, no significant differences vs. baseline were observed in Group 1. CONCLUSION: Our study shows that adding intranasal phototherapy with a combination of UVA, UVB and visible light therapy to nasal beclomethasone dipropionate treatment objectively improves nasal patency in patients with seasonal allergic rhinitis. PMID:34028460 | DOI:10.14639/0392-100X-N0907 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.