Feasibility of robotic thyroidectomy via hairline incision using da Vinci single port system: Initial experience with 40 consecutive cases

alexandrossfakianakis shared this article with you from Inoreader Feasibility of robotic thyroidectomy via hairline incision using da Vinci single port system: Initial experience with 40 consecutive cases via Head & Neck Abstract Background This study aimed to introduce our robotic technique, which can minimize dissection extent using the da Vinci SP robotic system via hairline incision. Methods Forty patients underwent robotic thyroidectomy using the da Vinci SP robotic system via a hairline incision between February 2020 and April 2021 at Ulsan University Hospital. All procedures were performed successfully by one surgeon using the SP robotic system. Results Hemithyroidectomies were performed in 32 patients and total thyroidectomies in eight patients. Central neck dissection was performed in 32 patients. The overall mean operative time was 140.2 ± 50.7 min, and the mean console time was 74.0 ± 42.7 min. All patients were discharged on the second or third day after operation without any complications. Conclusions Robotic thyroidectomy using the SP robotic system via hairline incision is technically feasible and safe, with a shorter incision length when compared with that of the Xi system. View on Web

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Effects of baloxavir and oseltamivir antiviral therapy on the transmission of seasonal influenza in China: a mathematical modeling analysis

alexandrossfakianakis shared this article with you from Inoreader Effects of baloxavir and oseltamivir antiviral therapy on the transmission of seasonal influenza in China: a mathematical modeling analysis via Journal of Medical Virology Abstract New antiviral influenza treatments can effectively alleviate illness while reducing viral shedding. However, how such effects can translate into lower population infections of seasonal influenza in China remains unknown. To shed light on the public health impacts of novel antiviral agents for influenza, we constructed a dynamic transmission model to simulate the seasonal influenza epidemics in China. Two antivirus treatments, baloxavir and oseltamivir, were evaluated by estimating their impacts on the incidences of influenza infection in a single flu season. In the base-case analysis of 10% antiviral treatment uptake rate, 2,760 and 3,420 per 10,000 persons contracted influenza under the treatment of baloxavir and oseltamivir, respectively. These incidence rates amounted to a 18.90% relative risk reduction (RRR) of infection associated with baloxavir in relation to oseltamivir. The corresponding RRR was 82.16% when the antiviral treatment uptake rate was inc reased to 35%. In addition, the peak of the prevlance of infected individuals (per 10,000 persons) under the baloxavir treatment was 177 (Range: 93 to 274) fewer than that of oseltamivir. Our analyses suggest that the baloxavir treatment strategy reduces the incidence of influenza in China compared with oseltamivir in the setting of a seasonal flu epidemic. Also, increasing the uptake rate of antiviral treatment can potentially prevent millions of infections during a single flu season. This article is protected by copyright. All rights reserved. View on Web

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Morphology of Peri‐Implant Tissues around Permanent Prostheses with Various Emergence Angles Following Free Gingival Grafting

alexandrossfakianakis shared this article with you from Inoreader Morphology of Peri‐Implant Tissues around Permanent Prostheses with Various Emergence Angles Following Free Gingival Grafting via Journal of Prosthodontics Abstract Purpose To analyze the tissue morphology around implant-supported prostheses by digital technology and to evaluate the effect of prosthetic contours on the changes in tissues following free gingiva graft procedure. Material and Methods A total of 53 implants in 32 patients receiving free gingiva grafts were selected. These had previously presented insufficient keratinized mucosa width (KMW). At the follow-up visits (mean: 16.66 ±9.97 months), the implant position and tissue condition were documented with an oral scanner. Vertical soft tissue thickness (VT), measured from the implant-abutment connection to the marginal tissues, and horizontal soft tissue thickness (HT), at the level of the platform, were calculated. The VT, HT and emergence angle (EA) of prostheses were assessed by 3Shape analyzing software. The final KMW was measured by clinical assessment. Marginal bone loss (MBL) was calculated in the follow-up bitewing radiographs. Results The mean VT in the study was 2.65 ±0.75 mm at the mid-buccal sites, 3.74 ±1.22 mm at the mesial, 3.16 ±1.08 mm at the distal, and 2.53 ±0.92 at the mid-lingual aspects. The mid-buccal HT was 1.45 ±0.53 mm while the mid-lingual was 1.05 ±0.43 mm (P = 0.008). Interestingly, prostheses with mid-buccal EA>30∘ exhibited slightly lower VT, but higher HT, than the ones with EA≤30∘. Prostheses with proximal EA>30∘ displayed slightly more MBL, compared to prostheses with EA≤30∘. The mean KMW was 4.08 ±1.10 mm. Conclusions Free gingival grafting is a predictable treatment approach to augmenting soft tissue 3-dimensionally. Prostheses with EA≤30∘ were preferable for preserving the maximal VT and maintaining crestal bone stability. This article is protected by copyright. All rights reserved View on Web

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Association Between Inferior Turbinate Hypertrophy and Extraesophageal Reflux

alexandrossfakianakis shared this article with you from Inoreader Association Between Inferior Turbinate Hypertrophy and Extraesophageal Reflux via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study examines the association between inferior turbinate hypertrophy and extraesophageal reflux in patients at 3 referral centers. View on Web

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Dysphagia in a Patient With Sarcoidosis

alexandrossfakianakis shared this article with you from Inoreader Dysphagia in a Patient With Sarcoidosis via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a woman in her 70s with a medical history of sarcoidosis, atrial fibrillation, asthma, gastroesophageal reflux disease, Schatzki's ring status after multiple dilations, pulmonary hypertension, and hypothyroidism who presented with a more than 10-year history of dysphagia and was found to have sarcoid involvement of the upper esophageal sphincter. View on Web

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Prevalence of anti‐Parvovirus B19 IgG and IgM and Parvovirus B19 viremia in pregnant women in an urban area of northern Italy

alexandrossfakianakis shared this article with you from Inoreader Prevalence of anti‐Parvovirus B19 IgG and IgM and Parvovirus B19 viremia in pregnant women in an urban area of northern Italy via Journal of Medical Virology Abstract Parvovirus B19 (B19V) infection in pregnancy is mostly asymptomatic, but can cause complications including abortion and foetal hydrops. Although its infection is ubiquitous, seroprevalence among pregnant women varies according to different geographical areas. Since seroprevalence data in Italy are limited, the prevalence of antibodies and DNA in pregnant women was evaluated retrospectively, correlating the clinical situation of mothers and newborns. One thousand eight hundred and ninety-three sequential sera were examined from pregnant women (60.8% in the first trimester, 16.6% in the second one and 22.6% in the third one, respectively) for anti-B19V IgG and IgM (confirmed by immunoblot); 1402 (74.1%) were of Italian origin and 491 (25.9%) non-Italian women. Molecular tests were used to search for viral genome. One thousand three hundred and fifteen (69.5%) samples were IgG-positive, 21 (1.1%) IgM-positive for and 578 (30.5%) non-immune. The difference in Ig G seroprevalence between Italian (71.1%) and non-Italian women (64.8%) was statistically significant. Of the 21 IgM-positive women, 16 were confirmed positive also by immunoblot (prevalence: 0.8%), of which 11 were viraemic (prevalence: 0.6%; mean 1.3x104 geq/mL). Mothers were asymptomatic, and the newborns had no clinical signs of congenital infection. IgG seroprevalence in Italy is high, with differences between Italian women and non-Italian women from geographic areas with lower endemic levels of B19V. The consistent migratory flows in place could lead to an increase in the number of susceptible women. The prevalence of viremia is low, and has not been associated with evident foetal damage at birth. This article is protected by copyright. All rights reserved. View on Web

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Voice Therapy Improves Acoustic and Auditory‐Perceptual Outcomes in Children

alexandrossfakianakis shared this article with you from Inoreader Voice Therapy Improves Acoustic and Auditory‐Perceptual Outcomes in Children via The Laryngoscope This study examined the effects of voice therapy in 129 children diagnosed with benign vocal fold lesions. Significant improvements were observed in auditory-perceptual assessments, jitter, Noise-to-Harmonic Ratio (NHR), and cepstral peak prominence (CPP) on sustained vowels, as well as CPP and Low-to-High Ratio (LHR) on connected speech. CPP effectively quantified voice therapy gains and allowed for analysis of connected speech. These findings demonstrate the value of CPP as a tool in assessing pediatric voice therapy outcomes and support the efficacy of voice therapy for children presenting with benign vocal fold lesions. Purpose This study employed acoustic measures as well as auditory-perceptual assessments to examine the effects of voice therapy in children presenting with benign vocal fold lesions. Methods A retrospective, observational cohort design was employed. Sustained vowels produced by 129 children diagnosed with benign vocal fold lesions were analyzed, as well as connected speech samples produced by 47 children. Treatment outcome measures included Consensus of Auditory-Perceptual Evaluation of Voice (CAPE-V), jitter, shimmer, Noise-to-Harmonic Ratio (NHR), cepstral peak prominence (CPP), and Low-to-High Ratio (LHR) on sustained vowels, and CPP and LHR on connected speech. Results Following voice therapy, significant improvements in CAPE-V ratings (p < 0.001) were observed. Additionally, jitter (p = 0.041), NHR (p = 0.019), and CPP (p < 0.01) on sustained vowels, and CPP (p = 0.002), and LHR (p = 0.008) on connected speech significantly improved following voice therapy. CPP increased with age in males but did not change in females. CAPE-V ratings and perturbation measures indicated that dysphonia was more severe in younger children pre and post-therapy. Conclusions Auditory-perceptual and acoustic measures demonstrated improved voice quality following voice therapy in children with dysphonia. CPP effectively quantified voice therapy gains and allowed for analysis of connected speech, in addition to sustained vowels. These findings demonstrate the value of CPP as a tool in assessing therapy outcomes and support the efficacy of voice therapy for children presenting with vocal fold lesions. Level of Evidence 4 Laryngoscope, 2022 View on Web

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Magnetic Targeting of Gadolinium Contrast to Enhance MRI of the Inner Ear in Endolymphatic Hydrops

alexandrossfakianakis shared this article with you from Inoreader Magnetic Targeting of Gadolinium Contrast to Enhance MRI of the Inner Ear in Endolymphatic Hydrops via The Laryngoscope This is the first study to magnetically target gadolinium contrast to the inner ear as an effective, minimally-invasive, local delivery technique that can be tracked by magnetic resonance imaging (MRI). Better accumulation of gadolinium contrast allows better visualization and quantification of endolymphatic hydrops. Objectives 1. Determine the feasibility and efficiency of local magnetic targeting delivery of gadolinium (Gad) contrast to the inner ear in rodents. 2. Assess any potential ototoxicity of magnetic targeting delivery of Gad in the inner ear. 3. Study the utility of magnetic targeting delivery of Gad to visualize and quantify endolymphatic hydrops (EH) in a transgenic mouse model. Study Design Controlled in vivo animal model study. Methods Paramagnetic Gad was locally delivered to the inner ear using the magnetic targeting technique in both rat and mouse models. Efficiency of contrast delivery was assessed using magnetic resonance imaging (MRI). Ototoxicity of Gad was examined with histology of the cochlea and functional audiological tests. The Phex mouse model was used to study EH, hearing loss, and balance dysfunction. Magnetic targeting delivery of Gad contrast was used in the Phex mouse model to visualize the effects of EH using MRI. Results Magnetic targeting improved the delivery of Gad to the inner ear and the technique was reproducible in both rat and mouse models. The delivery method did not result in microstructural damage or any significant hearing loss in a normal animal. Magnetic targeting of Gad in the Phex mouse model allowed detailed visualization and quantification of EH. Conclusion This study provided the first evidence of the effectiveness and efficiency of the local magnetic targeting delivery of gadolinium contrast to the inner ear and its application to the visualization and quantification of EH. Laryngoscope, 2022 View on Web

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The impact of midazolam used in cataract surgery sedation on frontal QRS‐T angle

alexandrossfakianakis shared this article with you from Inoreader The impact of midazolam used in cataract surgery sedation on frontal QRS‐T angle via Journal of Clinical Pharmacy and Therapeutics Only 177 patients who underwent elective cataract surgery were included in the study. Surgery in patients was planned with at least moderate sedation. This target was determined to be a 5–6 on the Ramsay Sedation Scale. Before the procedure, a venous route from the forearm was used to administer midazolam for sedation. The sedative effect was evaluated 2–3 minutes after a 0.05 mg/kg dose of midazolam was given. Sedation was assessed again by giving 0.5 mg every 2–3 minutes until the desired level of sedation was achieved. Electrocardiographic recordings were taken just before and within the first 5 minutes after surgery. QT, QTc intervals, Tp-e interval, Tp-e/QT, Tp-e/QTc and frontal QRS-T angle measurements got from ECG recordings. There was no significant difference between all values measured before and after the procedure. As a result, providing sedanalgesia using midazolam does not cause any change in ECG markers showing ventricular repolarization. Th erefore, the use of midazolam is safe for developing cardiac arrhythmias. Abstract What is known and objective Midazolam is one of the most commonly used drugs in procedures requiring sedoanalgesia. It affects the myocardium's ventricular depolarization and repolarization. Previous studies examining the arrhythmogenic effects of midazolam yielded conclusive results. These studies are based on QT and Tp -e distances. The frontal QRS-T angle (f-[QRS-T]a) is a new electro cardiac parameter that shows the heterogeneity of ventricular electrical activity. This study aims to examine the effect of midazolam on f-(QRS- T)a and other depolarization-repolarization parameters in patients who have had cataract surgery. Methods The study included 177 patients administered midazolam as a sedoanalgesia during cataract surgery. The sedative effect was evaluated 2–3 minutes after a 0.05 mg/kg dose of midazolam was given. Sedation was assessed again by giving 0.5 mg every 2–3 minutes until the desired level of sedation was achieved. 12-lead electrocardiogram (ECG) recordings of all patients were taken just before and immediately after surgery. ECGs were used to calculate the QT interval, QTc interval, Tp -e interval, Tp -e/QT, Tp -e/ QTc ratios and f-(QRS-T)a. Results and discussion After cataract surgery, f-(QRS-T)a was unchanged compared to presurgery (29.14 ± 4.52 vs. 29.18 ± 5.39, p = 0.852). In addition, no significant change in QT(351.32 ± 21.98 vs. 351.94 ± 22.44, p = 0.091), QTc (384.05 ± 24.52 vs. 385.19 ± 26.12, p = 0.819), Tp -e interval (93.12 ± 9.60 vs. 94.44 ± 8.82, p = 0.179) and Tp -e/QT (0.27 ± 0.02 vs. 0.28 ± 0.03, p = 0.664), Tp -e/ QTc ratios (0.28 ± 0.02 vs. 0.29 ± 0.03, p = 0.655) was observed after surgery when compared to presurgery values. Significant ventricular and supraventricular arrhythmias were not observed in any patient during the operation. What is new and conclusion Midazolam did not affect f -(QRS-T) with classical repolarization parameters in patients who underwent cataract surgery, according to this study. Midazolam has been found to be safe for the heart in sedoanalgesia. These results show that sedation with midazolam can be performed without electrocardiogram monitoring. View on Web

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Endonasal access to the lateral poststyloid space: Far lateral extension of an endoscopic endonasal corridor

alexandrossfakianakis shared this article with you from Inoreader Endonasal access to the lateral poststyloid space: Far lateral extension of an endoscopic endonasal corridor via Head & Neck Abstract The styloid process constitutes the posterolateral boundary for an endonasal exposure of the infratemporal fossa. This study aims to explore the feasibility of a far-lateral extension to the lateral poststyloid space via an endonasal corridor. An endonasal dissection was performed on six cadaveric specimens (12 sides). Following an endoscopic endonasal access to the parapharyngeal space, the styloid process and the tympanic portion of the temporal bone were removed to reveal the jugular bulb and the extratemporal facial nerve. Distances from the anterior nasal spine to the relevant landmarks were measured using a surgical navigation device. Through an endonasal corridor, only the anteroinferior aspect of the jugular bulb was exposed. Conversely, the extratemporal facial nerve could be sufficiently exposed, and the deep temporal nerve could be transposed to the stylomastoid foramen. The average horizontal distances from the nasal spine to the posterior tract of V3, stylo id process, and facial nerve were 79.33 ± 3.41, 97.10 ± 4.74, and 104.77 ± 4.42 mm, respectively. Access to the lateral poststyloid space via an endonasal corridor is feasible, potentially providing an alternative approach to address select lesions extending to this region. The deep temporal nerve has a similar diameter to that of the facial nerve; thus, providing potential reinnervation of the facial nerve. View on Web

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