Up‐front neck dissection followed by chemoradiotherapy for T1–T3 hypopharyngeal cancer with advanced nodal involvement

xlomafota13 shared this article with you from Inoreader Up‐front neck dissection followed by chemoradiotherapy for T1–T3 hypopharyngeal cancer with advanced nodal involvement Via Head & Neck Abstract Background The advantage of up-front neck dissection (UFND) followed by chemoradiotherapy (CRT) for hypopharyngeal cancer (HPC) with advanced neck involvement remains controversial. We aimed to determine the indications. Methods The data of 41 and 14 patients with stage IVA/B (T1–T3 and ≥N2a) HPC who underwent UFND followed by CRT and received CRT, respectively, were retrospectively analyzed and compared. Results The 5-year overall survival (OS) and disease-specific survival rates for the UFND and CRT groups were 61% and 52% (p = 0.1019), and 89% and 74% (p = 0.2333), respectively. Moreover, patients aged ≥70 years or those with a pulmonary disease history had a significantly poorer prognosis due to aspiration pneumonia in the UFND group. The 5-year regional control (RC) for the UFND and CRT groups were 92% and 57%, respectively (p = 0.0001). Conclusions UFND followed by CRT was feasible with satisfactory RC. To further improve OS, aspiration pneumonia prevention is essential. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Treatment of a Gastrointestinal Sarcoidosis Flare: A Multidisciplinary Approach for a Multisystem Disease

xlomafota13 shared this article with you from Inoreader Treatment of a Gastrointestinal Sarcoidosis Flare: A Multidisciplinary Approach for a Multisystem Disease Via Traditional dysphagia therapy Am J Case Rep. 2021 Sep 23;22:e932494. doi: 10.12659/AJCR.932494. ABSTRACT BACKGROUND Sarcoidosis is a multisystem granulomatous disease with predominant pulmonary involvement and rare gastrointestinal (GI) involvement. The stomach is the most common site when there is GI involvement. Symptomatic gastric sarcoidosis with biopsy-proven disease has rarely been reported and much of the knowledge is from case reports involving white patients. CASE REPORT Our unique case involves a flare of gastric sarcoid in an African American patient with biopsy-proven disease and we highlight our unique broad, multidisciplinary treatment approach that has not been described previously. A 68-year-old woman with pulmonary sarcoidosis presented with epigastric pain, nausea, vomiting, and dysphagia. The diagnosis of gastric sarcoid was made several years prior based on an upper endoscopy biopsy showing non-caseating granulomas in the antrum. She had previously exp erienced minimal relief of gastric symptoms with corticosteroids. In addition to a steroid taper, the patient experienced improvement in symptoms with a PPI (proton pump inhibitor), bowel regimen, and speech therapy techniques. CONCLUSIONS Gastric symptoms can be a presenting sign for a sarcoid flare in a patient with pulmonary sarcoidosis, which is important for both pulmonologists and gastroenterologists to recognize. In addition to traditional therapy with corticosteroids, our unique broader, multidisciplinary approach with PPI, bowel regimen, and speech therapy techniques such as a liquid wash are important components of treatment for gastric sarcoid that have not been described in previous case reports. PMID:34552042 | D OI:10.12659/AJCR.932494 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rapidly Enlarging Neck Mass in a Patient With Testicular Cancer

xlomafota13 shared this article with you from Inoreader Rapidly Enlarging Neck Mass in a Patient With Testicular Cancer Via JAMA Otolaryngology–Head & Neck Surgery Online First A 40-year-old man presented with a large left neck mass after recent treatment of mixed testicular nonseminomatous germ cell tumor with metastasis to the retroperitoneal and mediastinal lymph nodes. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing Loss and Impaired Physical Function, Frailty, and Disability in Older Adults

xlomafota13 shared this article with you from Inoreader Hearing Loss and Impaired Physical Function, Frailty, and Disability in Older Adults Via JAMA Otolaryngology–Head & Neck Surgery Online First This cross-sectional study examines the association between he aring loss and impaired lower extremity function, frailty syndrome, and disability in older adults View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Videofluoroscopic Swallow Studies and Diagnostic Outcomes in Otherwise Healthy Infants With Dysphagia

xlomafota13 shared this article with you from Inoreader Videofluoroscopic Swallow Studies and Diagnostic Outcomes in Otherwise Healthy Infants With Dysphagia Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 23:34894211047786. doi: 10.1177/00034894211047786. Online ahead of print. ABSTRACT OBJECTIVES: To evaluate videofluoroscopic swallow study (VFSS) findings in infants with dysphagia and without prior diagnoses, and to characterize the outcomes and any diagnoses that follow. METHODS: A chart review of all pediatric patients who received a VFSS at a tertiary children's hospital from November 2008 to March 2017 was performed. RESULT S: There were 106 infants (57 males and 49 females) with 108 VFSS. VFSS was normal in 18 (16.98%) infants. Regarding airway protection, 50 (47.17%) infants had laryngeal penetration, and 8 (7.55%) had tracheal aspiration; 3 (2.83%, 37.5% of all aspirators) exhibited silent aspiration. Of the 75 infants with minimum 2-year follow-up, 35 (46.67%) had no sequelae of disease and received no diagnoses. The most common diagnoses and pathologic sequelae were gastroesophageal reflux (n = 18, 24.00%), asthma (n = 8, 10.67%), laryngomalacia (n = 6, 8.00%), and tracheomalacia (n = 4, 5.33%), all consistent with United States pediatric data on prevalence. All infants (n = 51) with follow-up for dysphagia had resolution of symptoms within 9 months from VFSS order date. CONCLUSIONS: Otherwise healthy infants may show signs of dysphagia and not develop later illness. Parents can thus be counseled on the implications of dysphagia in a previously healthy infant. Our findings provide comparativ e statistics for future research in pediatric dysphagia. PMID:34553623 | DOI:10.1177/00034894211047786 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Downward Trend in Resident Myringotomy and Tympanostomy Tube Experience

xlomafota13 shared this article with you from Inoreader Downward Trend in Resident Myringotomy and Tympanostomy Tube Experience Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 23:34894211047478. doi: 10.1177/00034894211047478. Online ahead of print. ABSTRACT INTRODUCTION/OBJECTIVE: Historically, myringotomy, and the insertion of tympanostomy tubes has served as one of the initial surgical training experiences for residents. Resident experience with this procedure since the introduction of pneumococcal conjugate vaccines has not been well described in the literature. The objective of this study was to identify tre nds in resident training experience with chronic otitis media-related surgeries, such as myringotomy and tympanostomy tube placement. While multiple factors influence resident experience, we hypothesize that resident experience has decreased since the introduction of the pneumococcal 13-valent conjugate vaccine (PCV13). METHODS AND MATERIALS: In a retrospective review of Accreditation Council for Graduate Medical Education (ACGME) National Data Reports, mean number of myringotomy and tympanostomy tube cases logged in the Resident Case Log System from 2006 to 2019 were collated and plotted against years to identify monotonic trends. Mann-Whitney U test was used to compare pre-PCV13 era and post-PCV13 era data. RESULTS: Since the introduction of PCV13, there is a national decreasing trend in the myringotomy and tympanostomy tube placement by otolaryngology residents (P = .001). CONCLUSIONS: Otologic surgeries are an important part of resident education and historically have served as one of the initial surgical training experiences for residents. There has been a significant reduction in the number of myringotomy and tympanostomy procedures performed by otolaryngology residents in the past decade. While multiple factors influence resident experience, it is possible that introduction of PCV13 has impacted resident exposure to myringotomy and tympanostomy tube placement. Resident proficiency with this procedure has likely not been affected by introduction of PCV13. Data should be reassessed in 5 years to determine if an impact of the PCV13 vaccine on resident training is evident. PMID:34553634 | DOI:10.1177/00034894211047478 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Orocutaneous Fistula After Oral Cavity Resection and Reconstruction: Systematic Review and Meta-Analysis

xlomafota13 shared this article with you from Inoreader Orocutaneous Fistula After Oral Cavity Resection and Reconstruction: Systematic Review and Meta-Analysis Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 23:34894211047463. doi: 10.1177/00034894211047463. Online ahead of print. ABSTRACT OBJECTIVE: Orocutaneous fistula (OCF) after reconstruction for oral cavity resection can lead to prolonged hospitalization and adjuvant treatment delay. Few studies have examined factors leading to OCF after oral cavity resection. Primary objective: evaluate overall incidence and factors associated with OCF after oral cavity reconstruction. DATA SOURCES : Scopus 1960-database was searched for terms: "orocutaneous fistula," "oro cutaneous fistula," "oral cutaneous fistula," "orocervical fistula," "oral cavity salivary fistula." REVIEW METHODS: English language studies with >5 patients undergoing reconstruction after oral cavity cancer resection were included. About 1057 records initially screened; 214 full texts assessed; 78 full-texts included. PRISMA guidelines were followed, and MINORS criteria used to assess risk of bias. Data were pooled using random-effects model. Primary outcome was OCF incidence. Meta-analysis to determine the effect of preoperative radiation on OCF conducted on 12 eligible studies. Pre-collection hypothesis was that prior radiation therapy is associated with increased OCF incidence. Post-collection analyses: free versus pedicled flaps; mandible-sparing versus segmental mandibulectomy. RESULTS: Seventy-eight studies were included in meta-analysis of overall OCF incidence. Pooled effect size sh owed overall incidence of OCF to be 7.71% (95% CI, 6.28%-9.13%) among 5400 patients. Meta-analysis of preoperative radiation therapy on OCF showed a pooled odds ratio of 1.68 (95% CI, 0.93-3.06). OCF incidence was similar between patients undergoing free versus pedicled reconstruction, or segmental mandibulectomy versus mandible-sparing resection. CONCLUSION: Orocutaneous fistula after oral cavity resection has significant incidence and clinical impact. Risk of OCF persists despite advances in reconstructive options; there is a trend toward higher risk after prior radiation. PMID:34553635 | DOI:10.1177/000348942 11047463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior Glottic Web Secondary to Bioenzyme Toxicity

xlomafota13 shared this article with you from Inoreader Anterior Glottic Web Secondary to Bioenzyme Toxicity Via ear nose throat Ear Nose Throat J. 2021 Sep 23:1455613211044774. doi: 10.1177/01455613211044774. Online ahead of print. NO ABSTRACT PMID:34553632 | DOI:10.1177/01455613211044774 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A contemporary narrative review to guide molecular epidemiology of oral submucous fibrosis

xlomafota13 shared this article with you from Inoreader A contemporary narrative review to guide molecular epidemiology of oral submucous fibrosis Via International Journal of Molecular Epidemiology and Genetics Int J Mol Epidemiol Genet. 2021 Aug 15;12(4):61-70. eCollection 2021. ABSTRACT Oral submucous Fibrosis (OSMF) is a chronic disease that mainly affects the upper part of the aerodigestive tract. Areca nut and betel quid chewing has been established as the most significant causative factor for this condition. While OSMF is a predominantly Asian disease, the migrant populations from the region have taken the disease across the globe. Additionally, areca nut is now easily accessible in flavors and aggressively marketed. Many research activities have been undertaken for decades to understand the etiopathogenesis and risk factors of OSMF. Although OSMF is a slowly progressing disease, it has the potential to transform to an oral malignancy. This article is an attempt to review the literature and provide an update on its prevalence, etiopthogenesis and its diagnosis. We also highlight certain clinical, histopathological and molecular features that aid in the diagnosis and prognostication of OSMF, highlighting the importance of identifying the possibly high risk OSMF that is prone to malignant transformation. Using this information, future directions can be developed to include treatmentof OSMF through a dynamic gene-specific approach. PMID:34552689 | PMC:PMC8449189 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Expression and Regulation of Na+-K+-ATPase in Nasal Epithelial Cells of Chronic Rhinosinusitis with Nasal Polyps

xlomafota13 shared this article with you from Inoreader The Expression and Regulation of Na<sup>+</sup>-K<sup>+</sup>-ATPase in Nasal Epithelial Cells of Chronic Rhinosinusitis with Nasal Polyps Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objective: Na+-K+-ATPase (NKA) is essential in maintaining cell permeability, reserving potential energy, and preventing cellular edema. Nevertheless, how NKA expression is altered and regulated in chronic rhinosinusitis with nasal polyps (CRSwNPs) remain uncertain. Therefore, the present study aimed to explore the expression and regulation of NKA in CRSwNP. Methods: NKA immunolabeling was assessed by the immunohistochemistry method, NKA prote in levels were detected with the Western blotting method, and mRNA levels of NKA and aquaporin-5 (AQP5) were assayed by real-time PCR in nasal tissues from CRSwNP and control subjects. The co-localization of NKA with inflammatory cells was evaluated by immunofluorescence staining. In addition, human nasal epithelial cells (HNECs) were cultured and stimulated using various stimulators to evaluate the regulation of NKA. Results: We found significantly decreased NKA positive cells, NKA protein levels, and mRNA levels of NKA and AQP5 in nasal tissues from CRSwNP patients compared to control subjects, especially in eosinophilic CRSwNP. Furthermore, NKA mRNA levels in HNECs were downregulated by staphylococcal enterotoxin B (SEB), lipopolysaccharides (LPSs), inflammatory cytokine (IFN)-γ, IL-4, IL-13, and IL-1β. Conclusion: NKA and AQP5 expressions were decreased in CRSwNP. NKA in HNECs could be suppressed by SEB, LPS, IFN-γ, IL-4, IL-13, and IL-1β. Impairm ent of NKA may contribute to the genesis and development of CRSwNP via inducing AQP5 downregulation and edema. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of Proton Resonance Frequency Shift Magnetic Resonance Thermography Imaging Quality for Head and Neck Tumors

xlomafota13 shared this article with you from Inoreader Assessment of Proton Resonance Frequency Shift Magnetic Resonance Thermography Imaging Quality for Head and Neck Tumors Via ear nose throat Ear Nose Throat J. 2021 Sep 22:1455613211043673. doi: 10.1177/01455613211043673. Online ahead of print. NO ABSTRACT PMID:34547952 | DOI:10.1177/01455613211043673 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.