Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma Via Head & Neck Abstract Background Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis. Methods Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded. Results One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level. Conclusion SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sound Opportunities: Factors That Impact Referral for Pediatric Cochlear Implant Evaluation

xlomafota13 shared this article with you from Inoreader Sound Opportunities: Factors That Impact Referral for Pediatric Cochlear Implant Evaluation Via The Laryngoscope Objectives/Hypothesis To identify barriers to and opportunities for referral among children who could be considered for cochlear implantation. Study Design Retrospective review. Methods Audiological and medical records were reviewed on all children who had diagnostic or hearing aid care through a statewide healthcare system over 5-year span to identify children who met newly established clinical cochlear implant (CI) referral criteria. Data were collected for 869 potential CI candidates regarding demographic, socio-economic, audiological, medical, and family factors that may influence referral. A binomial logistic regression was completed to investigate the potential contributions of these predictors toward referral for a CI evaluation. Results Children who met traditional candidacy criteria of severe-to-profound bilateral hearing loss were referred at very high rates, while nontraditional candidates were referred less frequently. Factors influencing referral included race, age, insurance source, hearing thresholds, audiologist, physician, and family request. Conclusions Results suggest that bilateral traditional candidates are being referred at high percentages; however, current practices and trends in pediatric cochlear implantation should be shared with families and providers to increase referral rates for nontraditional candidates.  Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A rare case of Hidradenoma of the lower lip

xlomafota13 shared this article with you from Inoreader A rare case of Hidradenoma of the lower lip Via American Journal of Otolaryngology Publication date: Available online 15 June 2021 Source: American Journal of Otolaryngology Author(s): Isabel Park, Esther Lee, Stephanie Barak, Punam G. Thakkar View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effect of laryngeal elevation training on swallowing function in patients with dysphagia

xlomafota13 shared this article with you from Inoreader The effect of laryngeal elevation training on swallowing function in patients with dysphagia Via swallowing exercises J Laryngol Otol. 2021 Jun 16:1-5. doi: 10.1017/S0022215121001481. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the effect of laryngeal elevation training without highly loaded head lifting on swallowing function in patients with dysphagia. METHODS: Fifty-seven patients with dysphagia (36 men; mean age, 78.5 ± 11.4 years) were included. All participants performed the swallowing forehead exercise and the chin push-pull manoeuvre for two months. Videoendoscopy to a ssess swallowing function, the peak expiratory flow test and the hand grip strength test were performed at the initial visit (time 1) and two months after the start of the intervention (time 2). We used the Hyodo score, a scoring method for videoendoscopic assessment, for evaluation of swallowing function. RESULTS: The linear mixed model showed a significant main effect of time (the Hyodo score at time 1 was greater than the score at time 2). The effects of the co-variates were not significant. CONCLUSION: The present study demonstrated the significant effect of laryngeal elevation training without head lifting on the Hyodo score. PMID:34130763 | DOI:10.1017/S0022215121001481 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic posterior cricoid split with costal cartilage graft (with video)

xlomafota13 shared this article with you from Inoreader Endoscopic posterior cricoid split with costal cartilage graft (with video) Via European Annals of Otorhinolaryngology, Head and Neck Diseases Publication date: Available online 16 June 2021 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): D. Bressan Pazinatto, F. Lima Peixoto Costa, R. Maunsell View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 and plastic surgery: lessons from a national speciality review in the United Kingdom

xlomafota13 shared this article with you from Inoreader COVID-19 and plastic surgery: lessons from a national speciality review in the United Kingdom Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00214-X. doi: 10.1016/j.bjps.2021.03.109. Online ahead of print. ABSTRACT BACKGROUND: Ramifications of coronavirus disease 2019 (COVID-19) on the re-structuring of healthcare are widespread, including delivery of surgical services across all specialties, including plastic surgery. Re-deployment of personnel and cessation of elective services are commonplace. However, there is a continued need for both emergency and oncological surgery. A national review of practice was conducted during the COVID-19 pandemic, to assess impact on services, staffing and training. METHODS: Key aspects of current plastic surgery practice in the United Kingdom were examined in this cross-sectional study; operating capacity, location of theatre lists (national health service or outsourced private institutions (PIs)), differences across sub-specialties, change in anaesthesia practices, staffing, re -deployment, on-call provision and impact on training. RESULTS: Three-hundred and forty-four plastic surgeons in the United Kingdom provided practice data across 51 units. Theatre capacity and outpatient services were markedly reduced. Outsourcing of operating lists to PIs was widely utilised. Increased use of local anaesthetic hand procedures, the prioritisation of shorter operations with reduced microsurgery in both head and neck/lower limb and almost complete cessation of breast reconstruction were noted, together with marked regional variations. Re-deployment occurred at all staffing levels, whilst telemedicine played a critical role in both patient management and training. CONCLUSIONS: COVID-19 has enforced unprecedented changes to surgical care delivery and training, as identified by examination of plastic surgery nationally in the United Kingdom. Novel means to support continued elective and emergency services, including oncology have been identified. Lessons lear ned will allow phased return of services and improved preparation for the future. PMID:34130913 | DOI:10.1016/j.bjps.2021.03.109 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The smaller the frequency-to-place mismatch the better the hearing outcomes in cochlear implant recipients?

xlomafota13 shared this article with you from Inoreader The smaller the frequency-to-place mismatch the better the hearing outcomes in cochlear implant recipients? 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 15. doi: 10.1007/s00405-021-06899-y. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the effect of frequency-to-place mismatch, i.e. the mismatch between the tonotopic frequency map in the cochlea and the frequency band that is assigned to an electrode contact of a cochlear implant (CI) at the same cochlear location on speech perception outcomes, using postoperative CT images. STUDY DESIGN: Retrospective observational single-centre study. METHODS: Retrospective pre- and postoperative clinical CT data of 39 CI recipients with normal cochlear anatomy were analysed in an otological surgical planning software. The tonotopic frequency at each electrode position was estimated using the Greenwood function. For each patient, frequency-to-place mismatch between the tonotopic frequency and the fitted centre frequency for each electrode contact was calculated. The influence of frequency-to -place mismatch on speech perception in noise at 6 and 12 months after CI activation was studied. RESULTS: A significant linear correlation was found between the frequency-to-place mismatch and speech perception in noise 6 months after cochlear implantation (p < 0.05). The smaller the frequency-to-place mismatch, the better the initial speech perception in noise results of the CI recipients. The significant effect disappeared after 12 months CI experience. CONCLUSION: The study findings support the idea of minimizing the frequency-to-place mismatch in CI recipients in order to pursue better initial speech perception in noise. Further research is needed to investigate the prospect of tonotopic fitting strategies based upon postoperative CT images of the exact locations of the electrode contacts. PMID:34131770 | DOI:10.1007/s00405-021-06899-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of Mastoidectomy With Antibiotic Catheter Irrigation for Patients With Draining Ventilation Tubes

xlomafota13 shared this article with you from Inoreader Outcomes of Mastoidectomy With Antibiotic Catheter Irrigation for Patients With Draining Ventilation Tubes Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211025742. doi: 10.1177/01455613211025742. Online ahead of print. ABSTRACT OBJECTIVES: To evaluate the effectiveness of mastoidectomy with antibiotic catheter irrigation in patients with chronic tympanostomy tube otorrhea. METHODS: A chart review of adult and pediatric patients with persistent tympanostomy tube otorrhea who had failed outpatient medical management and underwent mastoidectomy with placement of a temporary indwelling catheter for antibiotic instillation was performed. Patients were retrospectively followed for recurrent drainage after 2 months and outcomes were categorized as resolution (0-1 episodes of otorrhea or otitis media with effusion during follow-up), improvement (2-3 episodes), or continued episodic (>3 episodes). RESULTS: There were 22 patients and 23 operated ears. Median age was 46 years (interquartile range, IQR = 29-65). The median duration of otorrhea from referral was 5.5 months (IQR = 2.8-12). Following surgery, 14 ears had resolution of drainage, 6 had improvement, and 3 had episodic. The observed percentage of resolved/improved ears (87%) was significant (P = .0005, 95% CI = 67.9%-95.5%). Median follow-up time was 25 months (IQR = 12-59). Pre and postoperative pure tone averages improved (difference of medians = -3.3 dB, P = .02) with no significant difference in word recognition scores (P = .68). Methicillin-resistant Staphylococcus aureus was the most common isolated microbe while no growth was most frequently noted on intraoperative cultures. CONCLUSIONS: Mastoidectomy with antibiotic catheter irrigation may be an effective surgical strategy, and single stage alternative to intravenous antibiotics, for select patients with persistent tube otorrhea who have failed topical and oral antibiotics. PMID:34130511 | DOI:10.1177/01455613211025742 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Upregulation of ACE/ACE2 Balance in Nasal Mucosa: A Working Hypothesis to Explain the Absence of Nasal Inflammatory Symptoms in COVID-19 Disease

xlomafota13 shared this article with you from Inoreader Upregulation of ACE/ACE2 Balance in Nasal Mucosa: A Working Hypothesis to Explain the Absence of Nasal Inflammatory Symptoms in COVID-19 Disease Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211025747. doi: 10.1177/01455613211025747. Online ahead of print. NO ABSTRACT PMID:34130518 | DOI:10.1177/01455613211025747 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Resection of Huge Nasal Septal Chondroma Via Endoscopic Septoplasty Approach Through Modified Killian Incision

xlomafota13 shared this article with you from Inoreader Resection of Huge Nasal Septal Chondroma Via Endoscopic Septoplasty Approach Through Modified Killian Incision Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211026436. doi: 10.1177/01455613211026436. Online ahead of print. ABSTRACT Chondromas are benign cartilaginous tumors that frequently occur in the long bones, pelvis, sternum, ribs, and scapula. They seldom develop in the head and neck region, and there have been rare reports of them arising in the nasal septum. Although the mainstay of management is surgery, surgical treatment strategies vary depending on the size, location, and extent of the disease. Herein, we describe a case of huge chondroma originated from the anterior nasal septum, which was completely removed by endoscopic septoplasty approach thorough modified Killian incision. PMID:34130516 | DOI:10.1177/01455613211026436 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Factors Associated With the Outcomes of Long-Term Middle Ear Ventilation Tube Insertion in Pediatric Patients

xlomafota13 shared this article with you from Inoreader Clinical Factors Associated With the Outcomes of Long-Term Middle Ear Ventilation Tube Insertion in Pediatric Patients Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211026437. doi: 10.1177/01455613211026437. Online ahead of print. ABSTRACT BACKGROUND: Ventilation tube (VT) insertion is the most common treatment for otitis media with effusion (OME). However, OME recurrence and persistent tympanic membrane (TM) perforation after VT removal are encountered in a certain percentage of such children. METHODS: This study was performed to determine the outcomes of children who underwent long-term VT in sertion. A total of 326 ears from 192 patients were analyzed. The associations among the patient age, sex, history of OME, history of repeated acute otitis media, placement duration, whether the VT had been removed intentionally or spontaneously, and the outcome (persistent TM perforation or OME recurrence) were analyzed. The outcomes of multiple VT tube insertions were also reviewed. We also analyzed whether or not local or general anesthesia was associated with the early spontaneous extrusion of the VT. RESULT: The OME recurrence and TM perforation rates were 29% (96/326 sides) and 17% (57/326 sides), respectively, for first insertions. In addition, 96 (29%) sides underwent ≥2 insertions. The shorter the duration for which the VT was retained in the middle ear, the more significant the rate of increase in OME recurrence. The OME recurrence was observed more often when VT was spontaneously removed than when intentionally removed. The rate of persistent TM perforation was si gnificantly associated with male sex. Persistent TM perforation was not observed in patients who underwent 4 or 5 insertions. The anesthesia method did not significantly influence the timing of spontaneous extrusion of VT. CONCLUSION: The retention period of VT should be at least 2 years, and VT removal at the age of 7 might be a viable strategy. Multiple VT insertions are recommended for patients with recurrent OME. Ventilation tube under local anesthesia is an effective option for tolerable children. PMID:34130509 | DOI:10.1177/01455613211026437 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.