Relationship between inferior fascicle of anterior talofibular ligament and articular capsule in lateral ankle ligament complex

xlomafota13 shared this article with you from Inoreader Relationship between inferior fascicle of anterior talofibular ligament and articular capsule in lateral ankle ligament complex Via radiol anat Surg Radiol Anat. 2021 Nov 5. doi: 10.1007/s00276-021-02851-1. Online ahead of print. ABSTRACT PURPOSE: The lateral ankle ligament complex (LALC) is composed of anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular (PTFL) ligaments, all of which have a connection/continuous fiber. However, the structural link between the LALC and the articular capsule remains unknown. The goal of our study was to determine the connection between ATFL's inferior fascic le and the articular capsule. METHODS: In this study, we utilized 84 formalin-fixed ankles to elucidate the structure of LALC. Between ATFL and CFL, the bundle number of ATFL and arciform fiber was investigated. The specimens were decalcified and sectioned coronally using a freezing microtome, in the case of double bundles of ATFL, to study the connection between the inferior fascicle of ATFL and the articular capsule. RESULTS: ATFL had a single (25%), double (74%), and triple (1%) bundle number, respectively. The arciform fiber connecting the ATFL and the CFL was found in the superficial layer of all ankles (100%). There were two types of relationships between the inferior fascicle of ATFL and the articular capsule: 36 ankles (58%) were extracapsular, and 26 of 62 ankles (42%) were integrated with the inferior-lateral articular capsule. There are two kinds of relationships between the inferior fascicle of the ATFL and the articular capsule: extracapsular and integrated- capsular. CONCLUSIONS: The inferior fascicle of ATFL has a variant and integrated-capsular type is reinforced inferior-lateral articular capsule and enters the joint to form continuous fibers with PTFL, making LALC. These anatomical findings are helpful in ultrasonography diagnosis and arthroscopic ankle surgery. PMID:34738180 | DOI:10.1007/s00276-021-02851-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Nomograms predicting prognosis for locally advanced hypopharyngeal squamous cell carcinoma 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 Nov 5. doi: 10.1007/s00405-021-07165-x. Online ahead of print. NO ABSTRACT PMID:34739576 | DOI:10.1007/s00405-021-07165-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of the COVID-19 pandemic on head and neck cancer diagnosis: data from a single referral center, South Tyrol, northern Italy

xlomafota13 shared this article with you from Inoreader Impact of the COVID-19 pandemic on head and neck cancer diagnosis: data from a single referral center, South Tyrol, northern Italy 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 Nov 5. doi: 10.1007/s00405-021-07164-y. Online ahead of print. ABSTRACT OBJECTIVE: The aim of the study was to evaluate the impact of the COVID-19 pandemic on new diagnoses of head and neck cancer (HNC) in South Tyrol, northern Italy in terms of the number of new diagnoses and worsening disease stage due to diagnostic delay. METHODS: Patients were divided into two groups: the control group with a first diagnosis of HNC in 10 months before the national lockdown (March 9th, 2020) and the study group with a first diagnosis of HNC in 10 months after lockdown. RESULTS: A total of 124 patients were included in the study. Before the spread of COVID-19, 79 new diagnoses of HNCs were registered, while in the period after the lockdown, 45 new cancers cases were diagnosed and the difference was statistically significant (p = 0.01278). Early clinical T-stage results showed 52 cases in the control group a nd 21 in the study group, again with a significant difference (p = 0.03711). Advanced T-stage results showed 27 cases in the control group and 24 in the study group. CONCLUSIONS: This study highlights the impact of the COVID-19 pandemic on HNCs, showing a statistically significant difference in the number of diagnoses before and after the lockdown which was related to the spread of the SARS-CoV-2 virus, and with a relevant decrease in early cT-staged HNCs. PMID:34739577 | DOI:10.1007/s00405-021-07164-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Large thyroid nodules: should size alone matter?

xlomafota13 shared this article with you from Inoreader Large thyroid nodules: should size alone matter? 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 Nov 5. doi: 10.1007/s00405-021-07151-3. Online ahead of print. ABSTRACT BACKGROUND: The management of thyroid nodules ≥ 4 cm is controversial due to conflicting evidence on the prevalence of malignancy and diagnostic accuracy of fine-needle aspiration cytology (FNAC). Some literature recommends routine excision of large thyroid nodules due to high cytology false negative rates (FNR). We aim to investigate the diagnostic accuracy of FNAC, prevalence of malignancy in large (≥ 4 cm) thyroid nodules compared to nodules < 4 cm, and the clinical and ultrasound characteristics of those large nodules with false negative cytology. METHODS: This was a retrospective case-log review in a tertiary referral hospital. All thyroid nodules subjected to Ultrasound (US)-guided FNAC by the Interventional Radiology department between December 2011 and November 2017 were included. Data on patient demographics, th yroid US features, cytology findings, and surgical histology were collected and analyzed. Sensitivity, specificity, and FNR were calculated based on FNAC results and final post-operative histology. Factors associated with a false negative result were analyzed using univariate and multivariate analyses. RESULTS: A total of 4982 nodules were studied, including 4419 < 4 cm and 563 ≥ 4 cm. Malignancy rates were similar in both groups. For nodules ≥ 4 cm, FNAC sensitivity was 40%, specificity 100%, and FNR 6.6% compared to 4.2% in nodules < 4 cm. Within malignant nodules, there was a significantly higher proportion of follicular and Hurthle cell carcinomas in nodules ≥ 4 cm. Amongst nodules ≥ 4 cm, multivariate analysis revealed male gender to be an independent predictor of FNR (OR 3.32; 95% CI 1.29-8.59). CONCLUSION: Larger nodules ≥ 4 cm have a similar malignancy rate as nodules < 4 cm, and FNAC FNR is low at 6.6%. Management of large thyroid nodules shou ld be individualized based on their clinical, sonographic and cytological features rather than routine surgery. LEVEL OF EVIDENCE: 3. PMID:34739578 | DOI:10.1007/s00405-021-07151-3 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sensitivity to Envelope Interaural Time Differences: Modeling Auditory Modulation Filtering

xlomafota13 shared this article with you from Inoreader Sensitivity to Envelope Interaural Time Differences: Modeling Auditory Modulation Filtering Via Journal of the Association for Research in Otolaryngology Abstract For amplitude-modulated sound, the envelope interaural time difference (ITDENV) is a potential cue for sound-source location. ITDENV is encoded in the lateral superior olive (LSO) of the auditory brainstem, by excitatory-inhibitory (EI) neurons receiving ipsilateral excitation and contralateral inhibition. Between human listeners, sensitivity to ITDENV varies considerably, but ultimately decreases with increasing stimulus carrier frequency, and decreases more strongly with increasing modulation rate. Mechanisms underlying the variation in behavioral sensitivity remain unclear. Here, with increasing carrier frequency (4–10 kHz), as we phenomenologically model the associated decrease in ITDENV sensitivity using arbitrarily fewer neurons consistent across populations, we computationally model the variable sensitivity across human listeners and modulation rates (32–800 Hz) as the decreasing range of membrane f requency responses in LSO neurons. Transposed tones stimulate a bilateral auditory-periphery model, driving model EI neurons where electrical membrane impedance filters the frequency content of inputs driven by amplitude-modulated sound, evoking modulation filtering. Calculated from Fisher information in spike-rate functions of ITDENV, for model EI neuronal populations distinctly reflecting the LSO range in membrane frequency responses, just-noticeable differences in ITDENV collectively reproduce the largest variation in ITDENV sensitivity across human listeners. These slow to fast model populations each generally match the best human ITDENV sensitivity at a progressively higher modulation rate, by membrane-filtering and spike-generation properties producing realistically less than Poisson variance. Non-resonant model EI neurons are also sensitive to interaural intensity differences. With peripheral filters centered between carrier frequen cy and modulation sideband, fast resonant model EI neurons extend ITDENV sensitivity above 500-Hz modulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A hitchhiking approach to reconstruct the finger pulp and the subsequent 1st toe hemi-pulp donor site defect

xlomafota13 shared this article with you from Inoreader A hitchhiking approach to reconstruct the finger pulp and the subsequent 1st toe hemi-pulp donor site defect Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00451-4. doi: 10.1016/j.bjps.2021.09.008. Online ahead of print. ABSTRACT BACKGROUND: The free 1st toe hemi-pulp transfer for finger pulp reconstruction was acknowledged as the optimal one. However, the treatment of the 1st toe donor defect, owning to the impossibility of primary closure, was frequently oversimplified. This study presented a "hitchhiking" approach to resurface finger pulp and the subsequent 1st toe donor site defect in a one-stage procedure. METHODS: From 2014 to 2019, finger pulp amputations (13 digits in 12 patients) were reconstructed with free 1st toe pulp flaps, and the donor site was resurfaced by the 2nd toe pedicled flap with the 2nd toe's primary closure. Therapeutic evaluation of repaired fingers and toes was based on cold intolerance, two-point discrimination (2PD), and gait disturbance. RESULTS: All finger and toe pulp flaps survived uneven tfully. The average size of free 1st toe and pedicled 2nd toe flap was 3.1 cm × 2.0 cm (3.5 cm × 1.4 cm to 4.2 cm × 2.5 cm) and 3.0 cm × 1.1 cm (2.0 cm × 0.9 cm to 3.8 cm × 1.5 cm), respectively. The regained average static 2PD on the finger and 1st toe pulps was 6 mm (ranged 5-10 mm) and 4 mm (ranged 2-6 mm), respectively. All reconstructed 1st toe pulps were qualified for normal gait. One patient complained the mild cold intolerance, and hammer-toe deformities were involved in two cases. CONCLUSION: To fulfill donor site care and cost-effective rule, the toe-to-finger pulp reconstruction can't underestimate the morbidity on 1st toe donor site due to inappropriate intervention. Equally importantly, the hitchhiking pedicled 2nd toe flap should be recruited in the reconstructive scheme. PMID:34740566 | DOI:10.1016/j.bjps.2021.09.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Antibiotic prophylaxis in head and neck cancer surgery: Systematic review and Bayesian network meta‐analysis

xlomafota13 shared this article with you from Inoreader Antibiotic prophylaxis in head and neck cancer surgery: Systematic review and Bayesian network meta‐analysis Via Head & Neck Abstract Postoperative surgical site infections (SSI) are worrisome complications after head and neck cancer surgery. Due to the lack of direct comparisons, it is difficult to indicate the best antibiotic in the setting of SSI prophylaxis for patients with head and neck cancer. For this reason, we decided to conduct a Bayesian network meta-analysis of clinical studies evaluating various antibiotic classes for SSI prophylaxis; thus, we directly and indirectly compared all the available antibiotics in the setting of head and neck oncological surgery. We performed a systematic review and a network meta-analysis according to the PRISMA-NMA checklist. Regarding inclusion criteria, we included articles with retrospective or prospective design recruiting adult participants with head and neck neoplasm of any subsite that compared different antibiotics or that compared different antibiotic treatment duration with sample sizes of more than 10 patients. Overall, 310 citations were identified by the s earch on all databases. Of these, 250 were excluded based on title and abstract, leaving 60 publications for full text examination. Finally, 20 papers were included for data extraction and analysis. In total, 8627 patients were evaluated across the included studies. Results of the Bayesian network meta-analysis showed that when compared to clindamycin short course, the antibiotics effective in preventing SSI were ampicillin/sulbactam or other penicillin short course (OR: 0.37, 95%CrI: 0.19–0.72), cefazolin/metronidazole short course (OR: 0.26, 95%CrI: 0.06–0.93), cefazolin (OR: 0.36, 95%CrI: 0.17–0.79), ampicillin/sulbactam long course (OR: 0.20, 95%CrI: 0.04–0.91), cefazolin/metronidazole long course (OR: 0.27, 95%CrI: 0.09–0.64), cefoperazone (OR: 0.05, 95%CrI: 0.002–0.89), cefotaxime (OR: 0.04, 95%CrI: 0.002–0.85). There was no significant difference between clindamycin and no antibiotic (OR: 2.3, 95%CrI: 0.59–9.9). Clindamycin plus aminoglycoside seemed to give a slight protection from SSI compared to clindamycin alone (OR: 0.30, 95%CrI: 0.09–0.99) or no antibiotic (OR: 0.13, 95%CrI: 0.02–067). Antibiotic prophylaxis is important in preventing SSI in head and neck cancer setting. Current evidence suggests that penicillins and cephalosporins are the best choice. Moreover, long duration course does not give any advantage compared to short course prophylaxis. Finally, it is important to implement appropriate antibiotic prophylaxis in patients that are labeled as penicillin allergic, in this regard clindamycin seems to be ineffective and, for this reason, further research is needed to provide a better care for this subset of patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anthracosis, a Distinct Cause of Vocal Fold Paralysis: Case Series

xlomafota13 shared this article with you from Inoreader Anthracosis, a Distinct Cause of Vocal Fold Paralysis: Case Series Via Voice Publication date: Available online 6 November 2021 Source: Journal of Voice Author(s): Mohamad Ali Kazemi, Mohaddeseh Shamshiri, Arda Kiani, Amir H. Davarpanah, Hosein Ghanaati, Behnaz Moradi, Mohammadreza Chavoshi View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

BRAF V600E mutation is associated with aggressive features in papillary thyroid carcinomas ≤ 1.5 cm

xlomafota13 shared this article with you from Inoreader BRAF V600E mutation is associated with aggressive features in papillary thyroid carcinomas ≤ 1.5 cm Via Journal of Otolaryngology - Head & Neck Surgery While some studies suggest that the BRAF V600E mutation correlates with a high-risk phenotype in papillary thyroid microcarcinoma (PTMC), more evidence is necessary before this mutation can be used to help guide ... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Salvage surgery for recurrent squamous cell carcinoma of the head and neck: Systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Salvage surgery for recurrent squamous cell carcinoma of the head and neck: Systematic review and meta‐analysis Via Head & Neck Abstract The present study aims to estimate a pooled hazard ratio (HR) comparing overall survival (OS) for salvage surgery compared to nonsurgical management of recurrent head and neck squamous cell carcinoma (HNSCC). PubMed/MEDLINE and Embase-Ovid were searched on March 5, 2020, for English-language articles reporting survival for salvage surgery and nonsurgical management of recurrent HNSCC. Meta-analysis of HR estimates using random effects model was performed. Fifteen studies reported survival for salvage surgery and nonsurgical management of recurrence. Five-year OS ranged from 26% to 67% for the salvage surgery groups, compared to 0% to 32% for the nonsurgical management groups. Six studies reported HRs comparing salvage surgery to nonsurgical management; the pooled HR was 0.25 (95% CI [0.16, 0.38]; p < 0.0001). Selection for salvage surgery was associated with one quarter of the mortality rate associated with nonsurgical management in light of confounding facto rs including subsite and treatment intent. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Airway injury from transoral endoscopic thyroidectomy vestibular approach

xlomafota13 shared this article with you from Inoreader Airway injury from transoral endoscopic thyroidectomy vestibular approach Via Head & Neck Abstract Background The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel technique that eliminates a cervical scar. This procedure carries unique risks, and data on outcomes are needed as more cases are performed. Methods We describe two cases of airway injury during the TOETVA. A description of the procedure and management of the injuries is outlined. Results In one case, a 3-mm injury in the thyrohyoid membrane was identified. The TOETVA was converted to an open approach due to significant inflammation in the setting of Graves' and the repair was performed while open. In the second case, a fracture occurred from the thyroid notch to Broyle's ligament without avulsion. A primary repair was endoscopically performed. Conclusions Airway injury is a possible complication of both open thyroidectomy and TOETVA. For TOETVA, trauma is most likely to occur in the midline during Hegar dilation and trocar placement through the central incision. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.