Donor site sequelae and patient satisfaction after head and neck reconstruction with a radial forearm free flap

xlomafota13 shared this article with you from Inoreader Donor site sequelae and patient satisfaction after head and neck reconstruction with a radial forearm free flap 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 15. doi: 10.1007/s00405-021-06649-0. Online ahead of print. ABSTRACT PURPOSE: Radial forearm free flap (RFFF) being a workhorse flap in head and neck reconstruction, we investigated its donor site delayed consequences. METHODS: Multicentric case series evaluating 189 patients who underwent RFFF for carcinologic reasons at least 6 months before. Patients and surgeon's appreciation regarding the aesthetic and functional consequences of the flap harvest on their daily life were evaluated by questionnaires using likert scales. Medical data were collected from patients' charts retrospectively. RESULTS: Thirty percent of patients had at least one sequelae. Experiencing a graft necrosis did not worsen long-term results. Cosmetic satisfaction was significantly worst for women, according to patients' and surgeons' opinion. For 81% and 92% patients, respectively, the flap harvest had no impact on d aily life nor sport practice. Ratio between the benefits of reconstruction and the sequelae at the donor site was judged "excellent" for 77% patients. CONCLUSIONS: Although objectively important, RFFF morbidity has little impact in head and neck cancer patient's life. PMID:33721068 | DOI:10.1007/s00405-021-06649-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles

xlomafota13 shared this article with you from Inoreader Surgical Treatment and Reconstruction of Nasal Defects According to the Aesthetic Subunits Principles Via Otolaryngology Indian Abstract The aim of this study was to determine the prevalence of nasal skin cancer, its location by facial aesthetic subunits and the type of reconstructive procedures performed for each nasal subunit after excision for nasal skin tumors. Observational cross-sectional study of all consecutive patients with the diagnosis of skin tumor located in the nasal unit, treated from 2018 to 2019 by the department of head and neck surgery of a general hospital. 60 patients were treated with nasal skin tumors excisions. A total of 52 patients (86,6%) had basal cell skin cancer, 7 (11,6%) had squamous cell skin cancer and 1 (1,6%) had melanoma. Fifty-nine patients (98.33%) presented a primary tumor and just 1 case (1,66%) recived a previous surgical treatment. Regardless of the type of tumor, the tip subunit was the most often involved with 29 (48,33%) cases in total. Despite of the nasal aesthetic subunit affected, the most frequent type of procedure used for reconstruction was the rotation or advancement flap, based on aesthetic nasal subunits, which was performed in 39 cases (65%). Nasal reconstruction after skin cancer can be very complex, especially since all patients have high expectations about the results. In order to achieve good results, there is a necessity for careful analysis of the defect, correct planning and excellent technical execution of the procedures Frequently, staged procedures will be needed to achieve an optimal result. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie

xlomafota13 shared this article with you from Inoreader Aufbau und Entwicklung eines interdisziplinären Zentrums für hereditäre hämorrhagische Teleangiektasie Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1402-0543 Hintergrund Die hereditäre hämorrhagische Teleangiektasie (HHT) ist eine seltene, systemische Erbkrankheit, die durch mukokutane und viszerale Gefäßmalformationen gekennzeichnet ist. Ein interdisziplinäres Behandlungskonzept in HHT-Zentren wird empfohlen. Material und Methoden In einer retrospektiven Studie wurden Strukturen, Prozesse und die Daten aller Patienten analysiert, die von April 2014 bis August 2019 in unserem neu gegründeten HHT-Zentrum behandelt wurden. Ergebnisse Innerhalb des Universitätsklinikums Essen wurde zunächst ein Netzwerk von über 20 verschiedenen Fachabteilungen zur Behandlung von Patienten mit HHT aufgebaut. Von den 282 Patienten, die sich seit der Zentrumsgründung mit möglicher HHT im Westdeutschen Morbus-Osler-Zentrum vorstellten, wurde bei 261 Patienten (93 %) die Diagnose als möglich angesehen. Die meisten Patienten wiesen multiple Symptome auf (Epistaxis und/oder Teleangiektasien: je > 80 %, viszerale Beteiligung: 65 %), welche häufiger eine Behandlung im interdisziplinären Rahmen erforderten. Über 900 E-Mails fielen jährlich für die direkte Behandlung der Patienten mit HHT, deren Koordination, Kooperationen und Öffentlichkeitsarbeit an. Durch den internationalen Austausch innerhalb des Europäischen Referenznetzwerks für multisystemische vaskuläre Erkrankungen (VASCERN) ist eine Behandlung auf aktuellem Stand auch bei komplexen Fragestellungen gewährleistet. Schlussfolgerungen Ein HHT-Zentrum beinhaltet ein interdisziplinäres Netzwerk von medizinischen Fachrichtungen, bei denen die Abläufe durch Prozesse definiert und durch eine wirksame Öffentlichkeitsarbeit, Schulungs- und Veröffentlichungstätigkeit gekennzeichnet sind. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer

xlomafota13 shared this article with you from Inoreader Three-Dimensional Exoscopic Temporal Bone Resections for Advanced Head and Neck Cancer Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1725037 Objectives The three-dimensional (3D) exoscope has several advantages over the operative microscope (OM) but has not been extensively reported for its use in malignant temporal bone resections (TBR). We sought to demonstrate the feasibility of performing TBR, both lateral (LTBR) and subtotal (STBR), using the 3D exoscope for head and neck cancers. Design present study is a retrospective chart review from August 2016 until August 2019. Setting The study was conducted at a tertiary care center. Participants Patients were undergoing TBR with the Karl Storz VITOM 3D exoscope. Main Outcome Measures Demographics, tumor and surgical characteristics, patient outcomes were the primary measurements of this study. Results Fifty-five patients underwent 3D exoscopic TBR from 2016 through 2019 of which 18% (n = 10) underwent STBR. The 3D exoscope was used uninterruptedly in all procedures with no intraoperative complications. Most tumors were primarily T3 (42%, n = 23) or T4 (55%, n = 30) and of cutaneous (62%, n = 34) and parotid (27%, n = 15) origin. These TBR were often accompanied by infratemporal fossa resections (87%, n = 48), auriculectomies (47%, n = 26), mandibulectomies (53%, n = 29), and parotidectomies (96%, n = 53). On final pathology, 24% (n = 13) had microscopically positive margins. Over the study period, 20% (n = 11) of patients had recurrences with a median recurrence time of 5 months (range: 2–30 months). Conclusion In the largest case series of LTBR and STBR under exclusive 3D exoscopic visualization to date, we demonstrate the 3D exoscope is a feasible alternative to the operative microscope for LTBR and STBR. While oncologic outcomes remain to be clarified, it carries significant potential for use in complex oncologic procedures. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract&n bsp; |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of systemic corticosteroids in orbital cellulitis: a meta-analysis and literature review

xlomafota13 shared this article with you from Inoreader Role of systemic corticosteroids in orbital cellulitis: a meta-analysis and literature review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 6:S1808-8694(21)00024-0. doi: 10.1016/j.bjorl.2021.02.003. Online ahead of print. ABSTRACT INTRODUCTION: The standard management of orbital cellulitis is to administer a combination of intravenous broad-spectrum antibiotics along with treatment of associated sinusitis. OBJECTIVE: The purpose of this study was to evaluate whether the addition of corticosteroids could lead to earlier resolution of inflammation and improve disease outcome. METHODS: We independently searched five databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) for studies published as recent as December 2019. Of the included studies, we reviewed orbital cellulitis and disease morbidity through lengths of hospitalization, incidence of surgical drainage, periorbital edema, vision, levels or C-reactive protein, and serum WBC levels in order to focus on comparing steroid with antibiotics treated gr oup and only antibiotics treated group. RESULTS: Lengths of hospitalization after admission as diagnosed as orbital cellulitis (SMD=-4.02 [-7.93; -0.12], p-value=0.04, I2=96.9%) decrease in steroid with antibiotics treated group compared to antibiotics only treated group. Incidence of surgical drainage (OR=0.78 [0.27; 2.23], p-value=0.64, I2=0.0%) was lower in the steroid with antibiotics treated group compared to the antibiotics only treated group. CONCLUSION: Use of systemic steroids as an adjunct to systemic antibiotic therapy for orbital cellulitis may decrease orbital inflammation with a low risk of exacerbating infection. Based on our analysis, we concluded that early use of steroids for a short period can help shorten hospitalization days and prevent inflammation progression. PMID:33722520 | DOI:10.1016/j.bjorl.2021.02.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study

xlomafota13 shared this article with you from Inoreader The effectiveness of propranolol, flunarizine, amitriptyline and botulinum toxin in vestibular migraine complaints and prophylaxis: a non-randomized controlled study Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 7:S1808-8694(21)00026-4. doi: 10.1016/j.bjorl.2021.02.005. Online ahead of print. ABSTRACT INTRODUCTION: Vestibular migraine is the most common cause of spontaneous episodic vertigo in adult patients and the second most common cause of vertigo in patients of all ages. OBJECTIVE: To assess the effectiveness of oral medication type (propranolol, flunarizine, and amitriptyline) and botulinum toxin A application on vestibular symptoms, headache severity and attack frequency for vestibular migraine patients. METHODS: Sixty patients with vestibular migraine were enrolled. Thirty patients received botulinum toxin A treatment (B+ group) in addition to the oral medication, whereas 30 patients received only oral medication (B- group). Headache severity was evaluated with Migraine Disability Assessment Scale and vertigo severity was evaluated with Dizziness Handicap Inventory scale. Vestibular migrain e attack frequencies in the last three months were also evaluated. RESULTS: There was a statistically significant decrement in mean Dizziness Handicap Inventory scores, Migraine Disability Assessment Scale scores and vertigo attack frequencies after treatment for all patients, B+ and B- group patients (p<0.001 for all). The mean Migraine Disability Assessment Scale score gains (p<0.001) and vertigo attack frequency gains (p= 0.003) were significantly higher in the B+ patients than B- patients. CONCLUSIONS: Both B+ and B- group patients exhibited significant improvement in vestibular migraine attack frequencies, Dizziness Handicap Inventory score and Migraine Disability Assessment Scale score values. However, botulinum toxin A application had a more pronounced effect for Migraine Disability Assessment Scale score gain and vestibular migraine attack frequency values, but not for Dizziness Handicap Inventory score gain values. Thus, botulinum toxin A application shoul d be considered for vestibular migraine patients whose headache severity degrees are more profound. The oral medication type (propranolol, flunarizine or amitriptyline) did not differ in influencing the vestibular migraine attack frequency, Dizziness Handicap Inventory score gain and Migraine Disability Assessment Scale score gain values. PMID:33722518 | DOI:10.1016/j.bjorl.2021.02.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic evolution of vestibular neuritis after long-term monitoring

xlomafota13 shared this article with you from Inoreader Diagnostic evolution of vestibular neuritis after long-term monitoring Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Mar 5:S1808-8694(21)00025-2. doi: 10.1016/j.bjorl.2021.02.004. Online ahead of print. ABSTRACT INTRODUCTION: The diagnosis of vestibular neuritis is based on clinical and laboratory findings after exclusion of other disease. There are occasional discrepancies between clinical impressions and laboratory results. It could be the first vertigo episode caused by other recurrent vestibular disease, other than vestibular neuritis. OBJECTIVE: This study aimed to analyze the clinical features and identify the diagnostic evolution of patients with clinically suspected vestibular neuritis. METHODS: A total of 201 patients clinically diagnosed with vestibular neuritis were included in this study. Clinical data on the symptoms and signs of vertigo along with the results of vestibular function test were analyzed retrospectively. Patients were categorized in terms of the results of caloric testing (CP - cana l paresis) group; canal paresis ≥25%; (MCP -minimal canal paresis) group; canal paresis <25%). Clinical features were compared between the two groups and the final diagnosis was reviewed after long-term follow up of both groups. RESULTS: Out of 201 patients, 57 showed minimal canal paresis (CP<25%) and 144 showed definite canal paresis (CP≥25%). A total of 48 patients (23.8%) experienced another vertigo episode and were re-diagnosed. Recurring vestibular symptoms were seen more frequently in patients with minimal canal paresis (p=0.027). Repeated symptoms were observed on the same affected side more frequently in the CP group. The proportion of final diagnosis were not different between two groups. CONCLUSIONS: Patients with minimal CP are more likely to have recurrent vertigo than patients with definite CP. There was no significant difference in the distribution of the final diagnoses between two groups when the vertigo recurs. PMID:33722519 | DOI:10.1016/j.bjorl.2021.02.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The PROfound study or the arrival of personalised medicine in the treatment of prostate cancer

xlomafota13 shared this article with you from Inoreader The PROfound study or the arrival of personalised medicine in the treatment of prostate cancer Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 12:S0007-4551(21)00042-4. doi: 10.1016/j.bulcan.2020.11.016. Online ahead of print. NO ABSTRACT PMID:33722378 | DOI:10.1016/j.bulcan.2020.11.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Adult non-Hodgkin bone lymphomas

xlomafota13 shared this article with you from Inoreader Adult non-Hodgkin bone lymphomas Via Association française pour l'étude du cancer Bull Cancer. 2021 Mar 12:S0007-4551(21)00070-9. doi: 10.1016/j.bulcan.2020.12.010. Online ahead of print. ABSTRACT Two forms of bone lymphomas can be distinguished: the primary bone lymphoma (PBL) and the secondary bone lymphoma (SBL). PBL is a rare disease with a good prognosis. Clinical manifestations and imaging findings are usually non-specific. Patient can present with pain, swelling of affected bone or pathologic fracture. Positron emission tomography-CT scan is a sensitive imaging modality and very useful for staging, restaging, surveillance of recurrence, and monitoring of treatment response of lymphoma. The diagnosis of PBL is often difficult and made after biopsy examination. Most patients have diffuse large B-cell lymphoma. Patients have been treated with radiotherapy, chemotherapy or combination of both. Localized disease, low IPI (International Prognostic Index) and complete remission after initial treatment were associate d with a better outcome. Management of late sequelae deserves particular attention. SBL is more common than PBL; this is a disseminated lymphoma with concomitant involvement of the skeleton. We review the clinical, imaging and pathologic features of bone lymphomas; and discuss therapeutic modalities as well as prognosis of these lymphomas in the era of immunochemotherapy. PMID:33722379 | DOI:10.1016/j.bulcan.2020.12.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delayed facial palsy after cochlear implantation caused by reactivation of Herpesvirus: A case report and review of the literature

xlomafota13 shared this article with you from Inoreader Delayed facial palsy after cochlear implantation caused by reactivation of Herpesvirus: A case report and review of the literature Via Auris Nasus Larynx Publication date: Available online 15 March 2021 Source: Auris Nasus Larynx Author(s): Yui Ishikawa, Makoto Hosoya, Sho Kanzaki, Kaoru Ogawa View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effects of residual parotid volume on symptom-specific quality of life and complications in patients undergoing parotid surgery

xlomafota13 shared this article with you from Inoreader The effects of residual parotid volume on symptom-specific quality of life and complications in patients undergoing parotid surgery 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 15. doi: 10.1007/s00405-021-06742-4. Online ahead of print. ABSTRACT PURPOSE: To measure postoperative residual parotid volumes in parotidectomy patients and to measure the effect of residual parotid volumes on the symptom-specific quality of life (SSQOL) and complications. METHODS: Between January 2010 and December 2016, 148 parotid gland surgeries were performed, and 74 patients were included in the study. Bilateral parotid gland volumes were measured by Magnetic Resonance Imaging (MRI). Parotidectomy Outcome Inventory-8 and aesthetic scale questionnaire were applied to the patients. The volumetric averages obtained were compared with the questions in the SSQOL scale, the aesthetic scale data, and complications. RESULTS: In the volumetric examination performed with MRI, the mean residual volumes of the operated parotid glands were 9.5 cm3, while the non-operated side was 28.8 cm3. The width of the surgery and the residual parotid tissue volume was inversely correlated. There was a statistically significant difference between the residual parotid gland volume and the pain related to the surgical area, depression in the surgical site, Frey's syndrome, incision scar, and numbness. As the residual parotid gland volumes decreased, the patients' cosmetic problems related to the surgical field increased significantly, and their SSQOL decreased. CONCLUSION: Postoperative residual parotid tissue volume could be an objective parameter to measure patients' SSQOL and complications. After parotidectomy, the maximum amount of disease-free tissue of the parotid gland should be left in place to increase patients' quality of life and minimize complications. PMID:33723622 | DOI:10.1007/s00405-021-06742-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.