Falx Cerebelli Meningioma: Case Report of a Rarely Occurring Tumor, Management Nuances, and Literature Review

xlomafota13 shared this article with you from Inoreader Falx Cerebelli Meningioma: Case Report of a Rarely Occurring Tumor, Management Nuances, and Literature Review Via leak of cerebrospinal fluid J Neurol Surg Rep. 2021 Sep 29;82(3):e32-e35. doi: 10.1055/s-0041-1735905. eCollection 2021 Jul. ABSTRACT The falx cerebelli is a small crescent fold of dura mater that is attached to the internal occipital crest and projects forward into the posterior cerebellar notch between the cerebellar hemispheres. We report a rare case of a 61-year-old female who presented with a 1-month history of headache and gait instability. Imaging findings were suggestive of a meningioma arising from the falx cerebelli. Complete surgical resection was achieved with a standard posterior fossa midline approach. Duraplasty was performed using animal allograft dura (Duraguard) and additional layers of oxidized cellulose preparation (Surgicel), fibrin sealant, and nonsuturable collagen matrix (Duragen) were utilized to reduce the risk of a cerebrospinal fluid leak. Pathology confirmed a World Health Organization (WHO) grade-I meningioma. Postoperatively, patient with asymptomatic thrombosis of the left transverse/sigmoid sinuses and later with a pseudomeningocele managed with a lumbar drain. To our knowledge, this is the second documented case in the literature. We discuss intraoperative nuances and unique aspects in the postoperative care and management of these patients. PMID:34603931 | PMC:PMC8481004 | DOI:10.1055/s-0041-17359 05 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of the Neutrophil-to-Lymphocyte Ratio with the Middle Ear Risk Index in Patients with Chronic Otitis Media

xlomafota13 shared this article with you from Inoreader Correlation of the Neutrophil-to-Lymphocyte Ratio with the Middle Ear Risk Index in Patients with Chronic Otitis Media Via Otolaryngology Indian Abstract This study aimed to investigate the neutrophil-to-lymphocyte ratio (NLR) and severity of the chronic otitis media according to middle ear risk index (MERI) scores. The NLR and middle ear risk index were calculated for 210 chronic otitis media (COM) patients retrospectively. NLR compared between COM patients and 159 participants in control group. Pearson correlation analysis was performed for NLR and MERI. In addition, The cut-off value, sensitivity, and specificity for NLR were determined in COM according to the severity of the disease with ROC analysis. The average of NLR in all patients was 1.94 ± 0.89. NLR was calculated as 2.05 ± 1.03 in the patients with COM and 1.79 ± 0.64 in the control group (p = 0.006, 95% CI 0.07–0.44, t test). According to the ROC analysis, the cut-off point was determined as 1.95 for moderate and severe disease in MERI. For the cut of a NLR = 1.95, sensitivity was calculated as 48.5% and the specifici ty 57.1% for moderate and severe COM. MERI score was found significantly higher in patients with postoperative graft perforation (p < 0.001, 95% CI 0.7–1.8). NLR has not related significantly with the MERI score according to linear regression analysis (p = 0.927). NLR was found to be significantly higher in chronic otitis media patients compared to the control group. But NLR was not related to the severity of the disease classified with MERI. The cut-off value, sensitivity and sensitivity rates of NLR obtained was not available for clinically use. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vocal Cord Hemangioma: A Common Tumor in an Unusual Localization. A Case Report with Short Review of Literature

xlomafota13 shared this article with you from Inoreader Vocal Cord Hemangioma: A Common Tumor in an Unusual Localization. A Case Report with Short Review of Literature Via Otolaryngology Indian Abstract Laryngeal adult-type hemangiomas are very rare lesions, more frequent in men, whose optimal treatment consists of microlaryngoscopical excision. We herein report a case of larynx cavernous hemangioma in a 64-year-old woman with hoarseness for about six months. Histologically, the tumor was composed of multiple vessels embedded in an edematous stroma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hydatid Cyst in Left Sub-Mandibular Space, an Unusual Location

xlomafota13 shared this article with you from Inoreader Hydatid Cyst in Left Sub-Mandibular Space, an Unusual Location Via Otolaryngology Indian Abstract Hydatid cysts in the neck area are considered as very rare and few cases have been reported in endemic areas. In the present study, we reported a 38-year-old female that underwent surgical operation for extraction of simple cyst in the submandibular area and the diagnosis of hydatid cyst was established by laboratory examinations. The patient was later diagnosed with hepatic hydatid cyst and received systemic treatments. We recommend that physicians should pay more attention to the possibilities of hydatid cysts in unusual areas in endemic regions especially Middle East. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19, Diabetes and Steroids: The Demonic Trident for Mucormycosis

xlomafota13 shared this article with you from Inoreader COVID-19, Diabetes and Steroids: The Demonic Trident for Mucormycosis Via Otolaryngology Indian Abstract Coronavirus disease 2019 (COVID-19) has been found to be associated with mucormycosis in few parts of the world, especially India. It is important to look for reasons for this upsurge of cases so that other countries may take proper steps to prevent it. A prospective clinico-demographic study was conducted in SMS Medical College, Jaipur, India from April to May 2021. All patients (235) with COVID associated mucormycosis (CAM) were studied in detail with reference to their diabetic status and steroid intake during treatment of COVID-19. Steroid usage was in 84.3% of patients with methylprednisolone being the most commonly used steroid (66.8%). Majority of the patients had taken steroids for 7–14 days. Diabetes was found in 204 patients and 42.1% of patients were newly diagnosed during/after COVID-19 treatment. The HbA1c levels of diabetic patients ranged from 6.0% to 16.3%. This is perhaps the biggest study in the world shows that the triad of COVID-19, dia betes and steroid usage is a major contributing factor towards mucormycosis. Proper steps should be taken to prevent CAM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantifying head acceleration exposure via instrumented mouthguards (iMG): a validity and feasibility study protocol to inform iMG suitability for the TaCKLE project

xlomafota13 shared this article with you from Inoreader Quantifying head acceleration exposure via instrumented mouthguards (iMG): a validity and feasibility study protocol to inform iMG suitability for the TaCKLE project Via swallowing exercises BMJ Open Sport Exerc Med. 2021 Sep 12;7(3):e001125. doi: 10.1136/bmjsem-2021-001125. eCollection 2021. ABSTRACT Instrumented mouthguards (iMGs) have the potential to quantify head acceleration exposures in sport. The Rugby Football League is looking to deploy iMGs to quantify head acceleration exposures as part of the Tackle and Contact Kinematics, Loads and Exposure (TaCKLE) project. iMGs and associated software platforms are novel, thus limited validation studies exist. The aim o f this paper is to describe the methods that will determine the validity (ie, laboratory validation of kinematic measures and on-field validity) and feasibility (ie, player comfort and wearability and practitioner considerations) of available iMGs for quantifying head acceleration events in rugby league. Phase 1 will determine the reliability and validity of iMG kinematic measures (peak linear acceleration, peak rotational velocity, peak rotational acceleration), based on laboratory criterion standards. Players will have three-dimensional dental scans and be provided with available iMGs for phase 2 and phase 3. Phase 2 will determine the on-field validity of iMGs (ie, identifying true positive head acceleration events during a match). Phase 3 will evaluate player perceptions of fit (too loose, too tight, bulky, small/thin, held mouth open, held teeth apart, pain in jaw muscles, uneven bite), comfort (on lips, gum, tongue, teeth) and function (speech, swallowing, dry mouth). Phase 4 will evaluate the practical feasibility of iMGs, as determined by practitioners using the system usability scale (preparing iMG system and managing iMG data). The outcome will provide a systematic and robust assessment of a range of iMGs, which will help inform the suitability of each iMG system for the TaCKLE project. PMID:34603742 | PMC:PMC8438841 | DOI:10.1136 /bmjsem-2021-001125 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Needle Fracture During Injection Medialization Laryngoplasty

xlomafota13 shared this article with you from Inoreader Needle Fracture During Injection Medialization Laryngoplasty Via Journal of Voice Awake injection medialization laryngoplasty is one of the most common therapeutic procedures done by laryngologists in the office or at the bedside. Complications of injection needle fracture are rarely reported. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Slide Tracheoplasty Technique on Postoperative Anatomic Outcomes in Three‐Dimensional Printed Models

xlomafota13 shared this article with you from Inoreader Comparison of Slide Tracheoplasty Technique on Postoperative Anatomic Outcomes in Three‐Dimensional Printed Models Via The Laryngoscope Objectives/Hypothesis We hypothesized that the use of three-dimensional (3D) printed tracheal models to reproducibly simulate surgical technique variations in slide tracheoplasty would demonstrate the quantitative impact of surgical variables on postoperative tracheal dimensions. Study Design Prospective analysis of three-dimensional printed surgical simulation models. Methods Slide tracheoplasty was performed on 3D printed long segment tracheal stenosis models with combinations of tracheal transection incision angle (90°, 45° beveled superior to inferior, 45° beveled inferior to superior) and tracheal transection location relative to the stenosis (at midpoint, 2 mm each superior and inferior to midpoint). Postoperative computed tomography (CT) scans measured changes in tracheal length, volume, and cross-sectional area compared to controls. Statistical analysis was performed using one-way analysis of variance and unpaired two-tailed t-tests. Results Slide tracheoplasty yielded 27 reconstructed tracheas. On average, slide tracheoplasty reduced total tracheal length by 36%. Beveled tracheal incisions yielded 9.5% longer final tracheas than straight transection incisions (P < .0001). Cross-sectional area at the stenosis midpoint increased from 9.0 mm2 to 45 mm2 but did not vary with technique (P > .05). Total tracheal luminal volume increased from 900 mm3 to 1378 mm3 overall and was largest with beveled incisions (P = .03). More material was discarded with straight incisions compared to beveled (89 mg vs. 19 mg, P < .0001). Conclusions Beveled tracheal transection incisions resulted in increased tracheal length, longer anastomotic segments, increased volume, and reduced tissue waste as compared to straight incisions. Offsetting the incision from the midpoint of stenosis did not significantly affect reconstructed tracheal morphology. Using 3D printed models for surgical simulation can be helpful for the quantitative study of the effect isolated surgical variables on technical outcomes. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Medical Management for Eustachian Tube Dysfunction in Adults: A Systematic Review and Meta‐Analysis

xlomafota13 shared this article with you from Inoreader Medical Management for Eustachian Tube Dysfunction in Adults: A Systematic Review and Meta‐Analysis Via The Laryngoscope Objective Medical treatment for eustachian tube dysfunction (ETD) is varied, with physician preference driving treatment choice and limited guidance for these options. An evaluation of the efficacy of medical management (MM) for ETD is warranted. Methods A systematic review of three databases (PubMed, Scopus, and Embase) was performed through December 2020. Adults treated nonsurgically for ETD were included. Exclusion criteria were as follows: patulous ETD, ETD deriving from craniofacial anomalies, or surgical treatment. Data were extracted independently by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis of continuous measures, proportions, and risk ratio was conducted. Results Twelve articles were identified by systematic review, with either level 2 or 3 evidence. A meta-analysis of available data was performed on nine studies. A pooled cohort found 50.3% (95% confidence interval [CI], 41.7–59.0) of patients experienced symptomatic improvement with MM. ETDQ-7 scores improved in a clinically nonsignificant manner by −0.88 (95% CI, −1.12 to −0.64) following medical treatment. Further, MM benefited from subacute and chronic symptoms in 30% to 64% and 11% to 50% of cases, respectively. Intranasal corticosteroids (INCS) were not efficacious, improving only 11% to 18% of chronic cases. Therapies such as Politzer devices and Valsalva therapy had minimally beneficial results. Conclusion Our review did not find any level 1 evidence for MM of ETD in adults. Available evidence indicates INCS are ineffective for chronic symptoms and the efficacy of nonsurgical options for subacute ETD has yet to be determined. Further randomized controlled trials are needed to discern efficacy of single-agent medical therapies. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nusinersen by subcutaneous intrathecal catheter for symptomatic spinal muscular atrophy patients with complex spine anatomy

xlomafota13 shared this article with you from Inoreader Nusinersen by subcutaneous intrathecal catheter for symptomatic spinal muscular atrophy patients with complex spine anatomy Via leak of cerebrospinal fluid Muscle Nerve. 2021 Oct 4. doi: 10.1002/mus.27425. Online ahead of print. ABSTRACT INTRODUCTION/AIMS: Intrathecal administration of nusinersen is challenging in patients with spinal muscular atrophy (SMA) who have spine deformities or fusions. We prospectively studied the safety and efficacy of nusinersen administration via an indwelling subcutaneous intrathecal catheter (SIC) for SMA patients with advanced disease. METHODS: Seventeen participants commenced nusinersen therapy between 2.7 and 31.5 years of age and received 9-12 doses via SIC. Safety was assessed in all participants. A separate efficacy analysis comprised 11 non-ambulatory, treatment-naïve SMA patients (18.1 ± 6.8 years) with three SMN2 copies and complex spine anatomy. RESULTS: In the safety analysis, 14 treatment-related adverse events (AEs) occurred among 12 (71%) participants; all were related to the SIC and not nusinersen. Device-related AEs interfered with 2. 5% of nusinersen doses. Four SICs (24%) required surgical revision due to mechanical malfunction with or without cerebrospinal fluid leak (n = 2), and one (6%) was removed due to Staphylococcus epidermidis meningitis. In the efficacy analysis, mean performance on the Nine Hole Peg Test improved in dominant (15.9%, p = 0.0.012) and non-dominant (19.0%, p = 0.008) hands and grip strength increased 44.9% (p = 0.0.031). We observed no significant changes in motor scales, muscle force, pulmonary function, or SMA biomarkers. All participants in the efficacy cohort reported one or more subjective improvements of endurance, purposeful hand use, arm strength, head control, and/or speech. DISCUSSION: For SMA patients with complex spine anatomy, the SIC allows for reliable outpatient administration of nusinersen that results in meaningful improvements of upper limb function, but introduces risks of technical malfunction and iatrogenic infection. This article is protected by copyright. Al l rights reserved. PMID:34606118 | DOI:10.1002/mus.27425 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Current therapeutic options for low‐risk papillary thyroid carcinoma: A scoping evidence review

xlomafota13 shared this article with you from Inoreader Current therapeutic options for low‐risk papillary thyroid carcinoma: A scoping evidence review Via Head & Neck Abstract Most cases of thyroid carcinoma are classified as low risk. These lesions have been treated with open surgery, remote access thyroidectomy, active surveillance, and percutaneous ablation. However, there is lack of consensus and clear indications for a specific treatment selection. The objective of this study is to review the literature regarding the indications for management selection for low-risk carcinomas. Systematic review exploring inclusion and exclusion criteria used to select patients with low-risk carcinomas for treatment approaches. The search found 69 studies. The inclusion criteria most reported were nodule diameter and histopathological confirmation of the tumor type. The most common exclusions were lymph node metastasis and extra-thyroidal extension. There was significant heterogeneity among inclusion and exclusion criteria according to the analyzed therapeutic approach. Alternative therapeutic approaches in low-risk carcinomas can be cautiously considered. Open thy roidectomy remains the standard treatment against which all other approaches must be compared. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Human microRNA‐182‐5p and kinectin 1: Potential biomarkers for prognosis in oral squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Human microRNA‐182‐5p and kinectin 1: Potential biomarkers for prognosis in oral squamous cell carcinoma Via Head & Neck Abstract Background The prognostic impact of hsa-miRNA-182-5p in oral cancer remains unexplored. Therefore, the aim of this study was to investigate the prognostic value of hsa-miRNA-182-5p and its predicted target kinectin 1 (KTN1) in oral squamous cell carcinoma (OSCC). Method Expression level of hsa-miRNA-182-5p was analyzed in tumor tissue (n = 36) and healthy oral mucosal tissue (n = 17) using quantitative real-time polymerase chain reaction. Protein level of the predicted target KTN1 was detected via immunohistochemistry. Results were validated in a cohort of The Cancer Genome Atlas (TCGA). Results After dividing the data into a subgroup with high and low hsa-miRNA-182-5p expression level, a significant better overall (p = 0.016), recurrence-free (p = 0.009), and progression-free survival (p = 0.004) was observed in an upregulation of hsa-miRNA-182-5p. Staining intensity of KTN1 showed a reciprocal impact on the prognosis. Validation in a TCGA cohort confirmed these results. Conclusion Our results indicate hsa-miRNA-182-5p and KTN1 as potential biomarkers for OSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.