Using the PRAAT software to describe dependence of speech intelligibility on tongue mobility in 6 patients after salvage glossectomy and reconstruction with a serratus anterior free flap

xlomafota13 shared this article with you from Inoreader Using the PRAAT software to describe dependence of speech intelligibility on tongue mobility in 6 patients after salvage glossectomy and reconstruction with a serratus anterior free flap Via Clinical Otolaryngology Abstract The serratus anterior free flap (SAFF) represents an ideal free flap for tongue reconstruction providing enormous flexibility, low donor site morbidity and adequate bulk for excellent functional restoration. Speech intelligibility is higher for meaningful words compared to syllables before (89.6% vs. 81.3%) and after (67.7% vs. 51.9%) salvage glossectomy highlighting the necessity of content for intelligibility. We used the free available PRAAT software for evaluation of the formant (F1 and F2) frequencies of the vowels /a:/, /i:/ and /u:/. Data showed that particularly protrusion, elevation and retroflexion of the tongue were affected resulting in characteristic changes of vowel pronunciation. Using the PRAAT software further allows transduction of objective phonetic variables (formants) into functional parameters and visualization of (impaired) tongue mobility. An improved understanding of the dependence of tongue mobility and functionality may be helpful to achieve better functional outcome in future tongue reconstructions. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Stapler closure versus manual closure in total laryngectomy for laryngeal cancer: A systematic review and meta‐analysis Via Clinical Otolaryngology Abstract Objective Total laryngectomy (TL) is a life‐saving procedure for individuals with advanced laryngeal cancer and those suffering from recurrence after initial treatment. The present study aimed to evaluate the differences between stapler closure (SC) and manual closure (MC) of the pharynx during TL for patients with laryngeal cancer. Design/Setting A systematic literature search was performed using the PubMed, EMBASE and Cochrane Library databases. The data were analysed using Comprehensive Meta‐Analysis software (Version 3; Biostat). Dichotomous data were calculated as odds ratios (ORs), and continuous data were calculated as mean differences (MD) with 95% confidence intervals (CI). Main Outcome/Results A total of seven studies (535 patients) were included in this meta‐analysis. Pooled analysis showed that the operative time of TL was significantly reduced in the SC group (MD, −63.2; 95% CI, −106.0 to −20.4). Moreover, the SC group had a lower incidence of pharyngocutaneous fistula (OR = 0.38; 95% CI, 0.18 to 0.83; P = .016) and hospital stay (MD, −2.9; 95% CI, −5.6 to −0.1). The incidence of postoperative surgical site infection (OR = 0.41; 95% CI, 0.02 to 8.73; P = .565) was comparable between the two groups. Conclusion Based on these results, SC may be a useful option for patients who need TL. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Automated assessment of cortical mastoidectomy performance in virtual reality

xlomafota13 shared this article with you from Inoreader Automated assessment of cortical mastoidectomy performance in virtual reality Via Clinical Otolaryngology Abstract Introduction Cortical mastoidectomy is a core skill that Otolaryngology trainees must gain competency in. Automated competency assessments have the potential to reduce assessment subjectivity and bias, as well as reducing the workload for surgical trainers. Objectives This study aimed to develop and validate an automated competency assessment system for cortical mastoidectomy. Participants Data from 60 participants (Group 1) were used to develop and validate an automated competency assessment system for cortical mastoidectomy. Data from 14 other participants (Group 2) were used to test the generalisability of the automated assessment. Design Participants drilled cortical mastoidectomies on a virtual reality temporal bone simulator. Procedures were graded by a blinded expert using the previously validated Melbourne Mastoidectomy Scale: a different expert assessed procedures by Groups 1 and 2. Using data from Group 1, simulator metrics were developed to map directly to the individual items of this scale. Metric value thresholds were calculated by comparing automated simulator metric values to expert scores. Binary scores per item were allocated using these thresholds. Validation was performed using random sub‐sampling. The generalisability of the method was investigated by performing the automated assessment on mastoidectomies performed by Group 2, and correlating these with scores of a second blinded expert. Results The automated binary score compared with the expert score per item had an accuracy, sensitivity and specificity of 0.9450, 0.9547 and 0.9343, respectively, for Group 1; and 0.8614, 0.8579 and 0.8654, respectively, for Group 2. There was a strong correlation between the total scores per participant assigned by the expert and calculated by the automatic assessment method for both Group 1 (r = .9144, P < .0001) and Group 2 (r = .7224, P < .0001). Conclusion This study outlines a virtual reality‐based method of automated assessment of competency in cortical mastoidectomy, which proved comparable to the assessment provided by human experts. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The impact of frailty on epistaxis admission, a retrospective cohort study

xlomafota13 shared this article with you from Inoreader The impact of frailty on epistaxis admission, a retrospective cohort study Via Clinical Otolaryngology Abstract Objectives Epistaxis is frequently managed with intra‐nasal packing devices, traditionally requiring patient admission. Current COVID‐19 guidelines encourage ambulatory care where possible in this patient cohort. This paper aims to establish the impact of the Clinical Frailty Scale, anticoagulant/antiplatelet therapeutics and season variation on pre‐pandemic admissions to help identify patients suitable for ambulatory epistaxis management. Design Retrospective cohort study Setting Scottish Regional Health Board Participants Adult patients attending secondary care with epistaxis between March 2019 and March 2020. Main outcome measures Likelihood of epistaxis hospital admission based on Clinical Frailty Scale. Results 299 epistaxis presentations were identified, of which 122 (40.8%) required admission. Clinical Frailty Scale of ≥4 had an increased likelihood of admission (OR 3.15 (95% CI:1.94–5.16), P < .05). In the majority of presentations (66.2%), patients were taking either an antiplatelet or anticoagulant. Of these presentations, the use of an anticoagulant (OR: 2.00 (95% CI: 1.20‐3.33), P < .05 and dual antiplatelet (OR: 2.82 (95% CI: 1.02‐7.86), P < .05) demonstrated increased likelihood of admission. Conclusions We have shown that frailty increases the risk of admission in adult patients presenting with epistaxis. Clinical Frailty Scale (CFS) could be utilised in risk stratification to identify suitable patients for outpatient management. Patients with CFS ≤ 3 could be considered for outpatient management of their epistaxis. It is likely that patients with CFS ≥4 on anticoagulant or dual antiplatelet will require admission. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A systematic review of outcomes of remote consultation in ENT

xlomafota13 shared this article with you from Inoreader A systematic review of outcomes of remote consultation in ENT Via Clinical Otolaryngology Abstract Aims Remote or tele‐consultation has become an emerging modality of consultation in many specialities, including ENT. Advantages include increasing accessibility, potential to reduce costs and, during the COVID‐19 pandemic, reduced risk of infection transmission. Here, we systematically collate and synthesise the evidence base on outcomes from remote consultation in adult and paediatric ENT services. Methods We performed a review in accordance with PRISMA guidelines. We searched Medline and Embase for relevant articles. Outcomes include specific patient pathway efficiency measures (including number of healthcare visits, lead time, touch time and handoff), patient/clinician satisfaction, cost analysis and safety implications. Results From 6325 articles screened, 53 met inclusion criteria. Publications included studies on remote consultation for initial, preoperative and follow‐up assessment (including postoperative). In most instances, remote consultation reduced costs and time from referral to assessment and was associated with high patient satisfaction. However, a face‐to‐face follow‐up appointment was required in 13%‐72% of initial consultations, suggesting that remote consultation is only appropriate in selected cases. Conclusion Remote consultation is appropriate and preferable for ENT consultation in specific conditions and circumstances. Future research should look to better define those conditions and circumstances, and report using recognised quality standards and outcome measures. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patient perspectives on recall period and response options in patient reported outcome measures for chronic rhinosinusitis symptomatology

xlomafota13 shared this article with you from Inoreader Patient perspectives on recall period and response options in patient reported outcome measures for chronic rhinosinusitis symptomatology Via Clinical Otolaryngology Abstract Objective Patient reported outcome measures (PROMs) for assessment of chronic rhinosinusitis (CRS) employ a variety of recall periods and response scales for reporting CRS symptom burden. CRS patient perspective is unknown with respect to recall periods and response scales in PROMs. Design Cross‐sectional study. Setting Tertiary rhinology clinic. Participants 63 adults with CRS. Main outcome measures Participants were asked to choose which CRS symptom recall period – one day, two weeks, one month, or greater than one month – was most reflective of their current disease state and best to base treatment recommendations (including surgery) upon. Participants were also asked to report on which of six response scales (one visual analogue scale [VAS] and five Likert scales ranging from four to eight items) was easiest to use and understand, and most preferred. Results A majority of participants felt the current state of their CRS symptoms was best reflected by a recall period of two weeks to one month; however, patients preferred that recommendations about treatments, including endoscopic sinus surgery, be determined by symptoms experienced over at least a one‐month period. Participants generally found the VAS and seven‐item Likert scale to be the easiest to use and understand, and their most preferred scales. No patient characteristics associated with preferences for recall periods or response scales. Conclusion Future PROMs for CRS symptoms should consider assessment of symptoms over a one‐month time frame and use either a VAS or seven‐item Likert response scale to optimally balance reflection of current disease state, need for intervention and patient preference. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Referral pattern of oral and maxillofacial surgery cases

xlomafota13 shared this article with you from Inoreader Referral pattern of oral and maxillofacial surgery cases in Sudan: A retrospective age-and sex-specific analysis of 3,478 patients over four years Via Head and neck cancers by Musadak Ali Karrar Osman, Mohammed Hassan Ibrahem Aljezoli, Mohamed Alfatih Mohamed Alsadig, Ahmed Mohamed Suliman Oral and maxillofacial surgery (OMFS) is a specialty widening in its scope. An objective analysis of the referral pattern can provide essential information to improve healthcare. This four-year retrospective study was implemented in Khartoum Teaching Dental Hospital. Data (age, sex, diagnosis, and type of treatment) were collected from patient records. Disease frequency, as well as the effect of sex and age, were analyzed for each group. The frequency of treatment types was also assessed. Data were collected from a total of 3,478 patients over the four-year study period. There was a male predominance with the third decade of life being the most common age group. Pathological diseases were the most common (37%) reason for referral, followed by trauma (31%). Temporomandibular joint (TMJ) disorders and dentoalveolar extraction were the least frequently observed. Open reduction and internal fixation (ORIF) was the most commonly performed procedure (28%). These data represent the epidemio logy of oral and maxillofacial diseases in Sudan. Given that the third decade of life is the most represented age group, it is beneficial to learn the long-term consequences of these diseases in these young patients and to use modern surgical techniques to improve their lives. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Preventing cerebral spinal fluid leakage following endoscopy through a burr hole using a novel watertight closure: technical note

xlomafota13 shared this article with you from Inoreader Preventing cerebral spinal fluid leakage following endoscopy through a burr hole using a novel watertight closure: technical note Via leak of cerebrospinal fluid Br J Neurosurg. 2021 Mar 29:1-3. doi: 10.1080/02688697.2021.1903392. Online ahead of print. ABSTRACT BACKGROUND: Cerebrospinal fluid (CSF) leakage is a common complication after neuroendoscopic surgery through a burr hole and can lead to further complications including infection. METHODS: We describe the use of a dural substitute larger than the burr hole itself, placed over the burr hole and then secured underneath a burr hole cover by microscrews running through the graft itself into the underlying skull. RESULTS: This simple technical modification contributes to achieving a watertight seal to aid in preventing CSF leakage in this setting. CONCLUSIONS: Our technical modification of endoscopy through a burr hole may help to prevent postoperative CSF leak and secondary CSF infections. PMID:33779446 | DOI:10.1080/02688697.2021.1903392 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus

paythelady.612 shared this article with you from Inoreader Bedside cardiopulmonary ultrasonography evaluates lung water content in very low-weight preterm neonates with patent ductus arteriosus Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1827-1834. doi: 10.12998/wjcc.v9.i8.1827. ABSTRACT BACKGROUND: Patent ductus arteriosus (PDA) is a common congenital heart abnormality in preterm neonates with a high incidence in neonates with very low birth weights. When PDA persists, interstitial lung water content increases, which could lead to abnormal circulation hemodynamics and pulmonary edema. It is important to perform early and reliable assessment of lung water content in very low-weight preterm neonates with persistent PDA. AIM: To evaluate the role of bedside cardiopulmonary ultrasonography in the lung water content assessment in very low-weight preterm neonates with persistent PDA. METHODS: From January 2018 to March 2020, 69 very low-weight preterm neonates with echocardiography-confirmed PDA were selected as the PDA group. At the same time, 89 very low-weight preterm neonates without PDA were randomly selected as the cont rol group. All neonates underwent echocardiography and 6-segment lung ultrasonography on the fourth day after birth. The clinical characteristics and main ultrasonography results were compared between the two groups. Pearson's analysis was used to analyze the correlation between lung ultrasonography score (LUS) and other related clinical and ultrasonography results in all neonates. In the PDA group, PDA diameters were recorded, and the correlation with LUS and left atrium to aortic (LA/AO) dimension ratio were also analyzed. LA/AO ratio is one of the ultrasonic diagnostic criteria for hemodynamically significant PDA. When the ratio is ≥ 1.5, it suggests the possibility of hemodynamic changes in persistent PDA. A receiver operating characteristic curve was established using the sensitivity of LUS to predict the hemodynamic changes in neonates with PDA as the ordinate and 1-specificity as the abscissa. RESULTS: A total of 158 neonates were enrolled in this study, including 69 in the PDA group and 89 in the control group. There were no statistical differences in sex, gestational age, birth weight, ventilator dependence, hospitalization length and left ventricular ejection fraction between the two groups (P > 0.05). The LUS and LA/AO ratio in the PDA group were higher than those in the control group (P < 0.05), but there was no difference of LUS in neonates with or without use of the ventilator (t = 0.58, P = 0.16). In all cases, LUS was negatively correlated with gestational age (r = -0.28, P < 0.01) and birth weight (r = -0.36, P < 0.01), while positively correlated with the LA/AO ratio (r = 0.27, P < 0.01). In the PDA group, PDA diameter was positively correlated with the LA/AO ratio (r = 0.39, P < 0.01) and LUS (r = 0.31, P < 0.01). Receiver operating characteristic results showed that LUS had the moderate accuracy for predicting hemod ynamic changes in PDA (area under the curve = 0.741; sensitivity = 93.75%; specificity = 50.94%). CONCLUSION: Bedside cardiopulmonary ultrasonography can evaluate lung content in neonates with PDA and predict the possibility of hemodynamic changes in persistent PDA. PMID:33748231 | PMC:PMC7953406 | DOI:10.12998/wjcc.v 9.i8.1827 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association between homeobox protein transcript antisense intergenic ribonucleic acid genetic polymorphisms and cholangiocarcinoma

paythelady.612 shared this article with you from Inoreader Association between homeobox protein transcript antisense intergenic ribonucleic acid genetic polymorphisms and cholangiocarcinoma Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1785-1792. doi: 10.12998/wjcc.v9.i8.1785. ABSTRACT BACKGROUND: Cholangiocarcinoma (CCA) represents a rare but highly aggressive malignancy that is often challenging to diagnose, especially in early stages. The role of existing tumor biomarkers for CCA diagnosis, remains controversial due to their low sensitivity and specificity. Increasing evidence has implicated long non-coding ribonucleic acid polymorphisms with cancer susceptibility in a variety of tumor types. The association between long non-coding ribonucleic acid homeobox protein transcript antisense intergenic ribonucleic acid (HOTAIR) polymorphisms and CCA risk has not been reported yet. AIM: To investigate the influence of HOTAIR variants on the risk of CCA development. METHODS: We conducted a case-control study in which three HOTAIR single nucleotide polymorphisms (rs920778, rs4759314 and rs7958904) were genotyped in a Greek c ohort. Our study population included 122 CCA patients (80 males and 42 females) and 165 healthy controls. The polymorphisms under investigation were examined in peripheral blood samples. RESULTS: HOTAIR rs4759314 AG and GG genotypes were associated with a significantly increased CCA risk [P = 0.004, odds ratio: 3.13; 95% confidence interval: 1.65-5.91 and P = 0.005, odds ratio: 12.31; 95% confidence interval: 1.48-101.87, respectively]. However, no significant associations of HOTAIR rs920778, and rs7958904 were detected. Similarly, we found no significant associations between rs4759314 AA genotype and CCA susceptibility. CONCLUSION: HOTAIR rs4759314 AG and GG genotypes may be implicated with CCA development and may serve as a potential diagnostic biomarker. PMID:33748227 | PMC:PMC7953393 | DOI:10.12998/wjcc.v9.i8.1785 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral common peroneal neuropathy due to rapid and marked weight loss after biliary surgery: A case report

paythelady.612 shared this article with you from Inoreader Bilateral common peroneal neuropathy due to rapid and marked weight loss after biliary surgery: A case report Μέσω pubmed: "world j clin cases"... World J Clin Cases. 2021 Mar 16;9(8):1909-1915. doi: 10.12998/wjcc.v9.i8.1909. ABSTRACT BACKGROUND: The causes of peroneal neuropathy are various, but are rarely due to weight loss. Bilateral peroneal neuropathy caused by weight loss after surgery has been reported only after bariatric surgery and there were no reports associated with other abdominal surgery. In this report, we describe a case of the bilateral peroneal neuropathy that occurred due to marked weight loss after biliary surgery. CASE SUMMARY: A 58-year-old male did not receive adequate nutritional support after biliary surgery, and showed a massive weight loss over a short period of time (body mass index; 24.1 kg/m2 to 20.5 kg/m2 for 24 d). Then, foot drop occurred on both sides. Physical examination, electromyography (EMG) and magnetic resonance imaging studies were conducted and he was diagnosed as bilateral common peroneal neuropathy around t he fibular head level. The patient was treated electrical stimulation therapy on both lower legs along with exercise therapy, and received sufficient oral nutritional support. The patient gradually recovered to his original weight, and the power of the dorsiflexor of bilateral ankles improved after conservative treatment. In addition, the follow-up EMG showed signs of improvement. CONCLUSION: Any abdominal surgery that may have rapid and marked weight loss can lead to peroneal neuropathy as a complication. PMID:33748241 | PMC:PMC7953405 | DOI:10.12998/wjcc.v9.i8.1909 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.