Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis

xlomafota13 shared this article with you from Inoreader Preliminary Clinical Outcomes of VOIS‐Implant in Patients With Unilateral Vocal Fold Paralysis Via The Laryngoscope Objectives/Hypothesis Evaluation of the clinical outcomes after 6 months of treatment with a novel adjustable implant, the APrevent® Vocal-Implant-System (VOIS), in conjunction with medialization thyroplasty (MT) in patients with unilateral vocal fold paralysis. Study Design Prospective case series study at single tertiary referral center. Methods Preoperative and 1 week, 7 weeks, and 6 months postoperative glottal efficiency (maximum phonation time [MPT]), voice quality (including GRBAS-scores and acoustic parameters) and self-perceived voice-related handicap (voice handicap index [VHI-30]) were measured and analyzed, whereas type of vocal fold closure was evaluated and determined by flexible videolaryngoscopy based on Södersten and Lindestad classification (Wilcoxon signed-rank test). Results Thirteen patients underwent MT with VOIS under local anesthesia. Six months after surgery, the VHI-30 and MPT had improved from a preoperative mean of 75.0 ± 22.9 and 2.7 ± 2.1 s to a postoperative mean of 20.6 ± 19.7 and 6.3 ± 4.0 s, respectively. The mean GRBAS score improved from preoperative scores of Gpreop = 2.7, Rpreop = 2.6, Bpreop = 2.6, Apreop = 2.2, and Spreop = 2.0 to Gpostop = 0.3, Rpostop = 0.3, Bpostop = 0.2, Apostop = 0.2, and Spostop = 0.3 at 6 months postoperatively. Improved glottal closure was achieved in all patients (n = 13). Five patients received postoperative adjustment for the optimization of voice quality and glottal closure. No intra- or postoperative complications were observed. Significant improvements in acoustic parameters, i ncluding percentage jitter, percentage shimmer, and signal-to-noise ratio, were also observed after MT. All results were statistically significant (P < .05, Cohen's d > .8). Conclusions APrevent® VOIS-Implantation is a safe procedure with good voice outcomes. Postoperative adjustments can be performed smoothly to optimize voice quality and glottal closure. Level of Evidence III Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dupilumab in CRSwNP: Responder Analysis Using Clinically Meaningful Efficacy Outcome Thresholds

xlomafota13 shared this article with you from Inoreader Dupilumab in CRSwNP: Responder Analysis Using Clinically Meaningful Efficacy Outcome Thresholds Via The Laryngoscope Objectives/Hypothesis Dupilumab, a fully human monoclonal antibody that blocks the shared interleukin (IL)-4/IL-13 receptor component, significantly improved outcomes for patients with chronic rhinosinusitis with nasal polyps (CRSwNP) in the SINUS-24 and SINUS-52 studies. This post hoc analysis evaluated dupilumab's effect on patient-reported symptoms and objective outcome measures using thresholds of clinically meaningful within-patient change from baseline. Methods Patients with CRSwNP receiving subcutaneous dupilumab or placebo every 2 weeks in SINUS-24/SINUS-52 were analyzed. Patients recorded severity of nasal congestion (NC), loss of smell (LoS), and anterior/posterior rhinorrhea (each within range 0–3) daily. Total Symptom Score (TSS) was calculated as a composite severity score (0–9) for these symptoms. Objective measures included University of Pennsylvania Smell Identification Test (UPSIT; 0–40), nasal polyps score (NPS; 0–8), and Lund–Mackay computed tomography score (LMK-CT; 0–24). Thresholds of within-patient change in scores from baseline at weeks 24 and 52 considered clinically meaningful were ≥1.0 (NC, LoS), ≥3.0 (TSS), ≥8.0 (UPSIT), ≥1.0 (NPS), and ≥5.0 (LMK-CT). Results A total of 724 and 303 patients were included in the week 24 and 52 analyses, respectively. Responder rates were significantly higher with dupilumab versus placebo at week 24 for NC (64% vs. 24%), LoS (63% vs. 14%), TSS (62% vs. 15%), UPSIT (54% vs. 6%), NPS (63% vs. 14%), and LMK-CT (59% vs. 3%); all P < .0001. Results were consistent at week 52. Conclusion Significantly greater proportions of dupilumab-treated patients with CRSwNP compared with placebo demonstrated clinically meaningful improvements in patient-reported sinonasal symptoms and objective outcomes. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses

xlomafota13 shared this article with you from Inoreader Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211058922. doi: 10.1177/01455613211058922. Online ahead of print. ABSTRACT BACKGROUND: Fine needle aspiration (FNA) is a common diagnostic tool used in the initial evaluation of parotid masses. In the literature, variable diagnostic accuracy of FNA is reported. Therefore, when considering clinical management of these patients, the utility of FNA is unclear. The aim of this study was to determine the capability of ultrasound-guided FNA to differentiate between benign and malignant neoplasms. Further, the way in which FNA results affect clinical decision-making was assessed. METHODS: Retrospective data were collected for all patients who underwent parotidectomy at a large Canadian tertiary care center between 2011 and 2016. Patient demographics, preoperative imaging reports, preoperative FNA results, and final pathological diagnosis were analyzed. RESULTS: Of the 199 patients who underwent parotidectomy, 184 had preoperative ultrasound-guided FNA. There were a total of 13 non-diagnostic FNAs. In diagnosing malignancy, FNA had a sensitivity and specificity of 71.4% and 98.7%, respectively. The positive predictive value (PPV) was 83.3%. The negative predictive value was 97.5%. Of the non-diagnostic FNAs, 2 out of 13 (15.4%) were deemed malignant neoplasms on final pathology. CONCLUSION: FNA is a useful adjunct in the work-up of parotid masses, but it should be used with caution. Due to limited sensiti vity, it should not be relied upon as the sole determinant of a surgeon's management plan. PMID:34818946 | DOI:10.1177/01455613211058922 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery

xlomafota13 shared this article with you from Inoreader Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211058491. doi: 10.1177/01455613211058491. Online ahead of print. ABSTRACT OBJECTIVES: Predicting the need for surgical treatment among patients with chronic rhinosinusitis (CRS) is challenging. The delta neutrophil index (DNI) has been proposed as a useful laboratory marker of immature granulocytes, which indicates infection or severe inflammation in several diseases. This study evaluated DNI as an early predictor of the need for surger y in patients with CRS. METHODS: A total of 117 patients diagnosed with CRS were enrolled in this retrospective and observational study. Medical records, including symptoms data, WBC count, ESR level, LUC count, Lund-Mackay scores, and DNI, were reviewed. The receiver operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for predicting surgery. RESULTS: Among 117 patients, 49 patients (41.9%) needed surgical intervention. The areas under the WBC, ESR, LUC, and DNI ROC curves were .571, .600, .592, and .782, respectively. The optimal cut-off value of DNI to predict surgery was .9%. The prognostic precision of DNI showed that the sensitivity was 59.2% and the specificity was 98.5%. In the analysis of risk factors, DNI levels were significantly associated with surgical intervention (odds ratio, 2.22; 95% confidence interval, 1.48-3.34; P < .01). CONCLUSIONS: The level of DNI, which reflects the severity of the disease, may be a useful predictor for determining the need for surgical intervention in patients with CRS. This is the first literature to verify the role of DNI in upper airway disease. PMID:34818928 | DOI:10.1177/01455613211058491 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Squamous cell papilloma-like presentation of multiple neurovascular hamartomas of the oral cavity

xlomafota13 shared this article with you from Inoreader Squamous cell papilloma-like presentation of multiple neurovascular hamartomas of the oral cavity Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211061623. doi: 10.1177/01455613211061623. Online ahead of print. ABSTRACT Significance Statement: Neurovascular hamartomas (NVH) is an uncommon tumor-like developmental anomaly. We hereby report the case of a 28-year-old woman presenting with multiple millimetric excrescences in the oral cavity that were clinically interpreted as squamous cell papilloma and histologically consistent with NVHs. Neurovascular hamartomas is rare in the oral cavity. To the best of our knowledge, multiple NVHs have never been reported at this site. PMID:34818931 | DOI:10.1177/01455613211061623 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Risk of primary breast cancer in patients with differentiated thyroid cancer undergoing radioactive iodine therapy: a systematic review and meta-analysis Via radioactive iodine Eur J Nucl Med Mol Imaging. 2021 Nov 25. doi: 10.1007/s00259-021-05625-4. Online ahead of print. ABSTRACT PURPOSE: Although it has been proven that radioactive iodine (RAI) treatment is an effective and well-tolerated procedure in patients with differentiated thyroid cancer (DTC), there is still some concern regarding the risk of developing a second primary malignancy after RAI administration. We performed a systematic review and meta-analysis to investigate the risk of primary bre ast cancer in patients with DTC undergoing RAI therapy. METHODS: A comprehensive literature search of the PubMed, Scopus, and Web of Science databases was conducted according to the PRISMA statement. RESULTS: The final analysis included 14 studies accounting for a total of 200,247 patients with DTC (98,368 treated with RAI and 101,879 not treated with RAI). The relative risk of primary breast cancer in patients with DTC treated with RAI to those not treated with RAI among studies ranged from 0.45 to 2.55, the pooled relative risk was 0.83 (95% confidence interval, 0.70-0.99), and the heterogeneity was 71.5%. CONCLUSION: The present meta-analysis indicates that patients with DTC treated with RAI do not have a higher risk of primary breast cancer compared to those not treated with RAI. These findings suggest that RAI therapy does not increase the risk of breast cancer. PMID:34820683 | DOI:10.1007/s00259-021-05625-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The impact of trans-arterial embolization on the result of chemoradiotherapy in oral cavity cancer

xlomafota13 shared this article with you from Inoreader The impact of trans-arterial embolization on the result of chemoradiotherapy in oral cavity cancer Via ear nose throat Ear Nose Throat J. 2021 Nov 25:1455613211054181. doi: 10.1177/01455613211054181. Online ahead of print. ABSTRACT Objectives: Evaluation of the hemostatic effect of trans-arterial embolization on patients with advanced oral cavity cancer who had bleeding complications while undergoing definitive concurrent chemoradiotherapy (CCRT). Additionally, assess the effect of trans-arterial embolization on treatment response following concurrent chemoradiotherapy, as well as ove rall survival (OS) and progression-free survival (PFS) in the group of patients following the intervention.Method: From September 2018-June 2021, a retrospective descriptive study was conducted on 16 patients with inoperable, locally advanced oral cavity cancer who received definitive concurrent chemoradiotherapy, experienced acute bleeding complications, and received selective intravascular intervention with various embolization materials at Vietnam National Cancer Hospital.Results: After selective embolization, 16/16 patients ceased bleeding; 1 patient re-bled for the second time after 3 weeks. The average duration of chemoradiotherapy interruption due to intervention was 6.7 days. After CCRT, 15/16 (93.75%) patients achieved a response, with 9/16 (56.25%) patients achieving a complete response. The median OS was 14 months (range, 3-26 months), and the median PFS was 10 months (range, 3-20 months). There were no significant complications, particularly neurological si de effects.ConclusionsTumor bleeding is a common and serious complication of CCRT treatment in patients with locally advanced oral cavity cancer. Embolization is a safe and effective method of controlling acute bleeding that has no adverse effect on the outcome of definitive concurrent chemoradiotherapy. PMID:34821166 | DOI:10.1177/01455613211054181 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Machine learning-based voice assessment for the detection of positive and recovered COVID-19 patients

xlomafota13 shared this article with you from Inoreader Machine learning-based voice assessment for the detection of positive and recovered COVID-19 patients Via Journal of Voice Many virological tests have been implemented during the COVID-19 pandemic for diagnostic purposes, but they appear unsuitable for screening purposes. Furthermore, current screening strategies are not accurate enough to effectively curb the spread of the disease. Therefore, the present study was conducted within a controlled clinical environment to determine eventual detectable variations in the voice of COVID-19 patients, recovered and healthy subjects, and also to determine whether machine learning-based voice assessment (MLVA) can accurately discriminate between them, thus potentially serving as a more effective mass-screening tool. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

To patch or not to patch acute isolated traumatic tympanic membrane perforations: a case series and systematic literature review

xlomafota13 shared this article with you from Inoreader To patch or not to patch acute isolated traumatic tympanic membrane perforations: a case series and systematic literature review 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 24. doi: 10.1007/s00405-021-07185-7. Online ahead of print. ABSTRACT OBJECTIVE: To date, there is no consensus about the benefits of paper patching over spontaneous healing in the management of isolated acute traumatic tympanic membrane perforations (IATTMP). In this systematic literature review and case series, we compared paper patching of IATTMP to spontaneous healing in terms of healing rate and time to heal. DATABASES REVIEWED: A systematic literature search of English-language studies published from 1/1975 to 9/2020 was conducted using PubMed via MEDLINE, and 201 studies were identified. Another 346 studies were derived from the references of those articles. Twenty-four studies remained after omitting duplications and articles that did not meet the inclusion criteria. METHODS: Demographics, medical history, physical examination, and audiometric results in the selected publications a nd in a new series of patients treated for IATTMP between 1/2018 and 1/2021 in a single tertiary referral center were retrieved and analyzed. RESULTS: The literature review yielded 2796 ears of which 466 underwent paper patching (intervention arm). Complete perforation healing was documented in 67-97% of control arm and 92-93% of intervention arm. Our new series included 29 ears of which six underwent paper patching. Complete healing was observed in 83% and 78% in the interventional and control arms, respectively. CONCLUSIONS: Although paper patching and watchful waiting had similar success rates in patients with IATTMP, healing after paper patching was slightly quicker among our patients. Patching is a readily applicable and technically simple office-based intervention that should be preferentially considered for IATTMP. PMID:34817658 | DOI:10.1007/s00405-021-07185-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting outcomes in hyperthyroid cats treated with radioiodine

xlomafota13 shared this article with you from Inoreader Predicting outcomes in hyperthyroid cats treated with radioiodine Via radioactive iodine J Vet Intern Med. 2021 Nov 24. doi: 10.1111/jvim.16319. Online ahead of print. ABSTRACT BACKGROUND: Radioiodine (131 I) is the treatment of choice for cats with hyperthyroidism. After 131 I, however, euthyroidism is not always achieved, with 5% to 10% of cats remaining persistently hyperthyroid and 20% to 50% developing iatrogenic hypothyroidism. OBJECTIVES: To identify pretreatment factors that may help predict persistent hyperthyroidism and iatrogenic hypothyroidism after treatment of cats using a novel 131 I dosing algorithm. ANIMALS: One thousand and four hundred hyperthyroid cats treated with 131 I. METHODS: Prospective, before-and-after study. Pretreatment predictors (clinical, laboratory, scintigraphic, 131 I dose, 131 I uptake measurements) of treatment failure or iatrogenic hypothyroidism were identified by multivariable logistic regression analysis. RESULTS: Cats that developed iatrogenic hypothyroidism were more likely to be older (odds ratio [OR] = 1.10; 95% confidence interval [CI], 1.04-1.17; P = .001), female (OR = 2.04; 95% CI, 1.54-2.70; P < .001), have detectable serum thyroid-stimulating hormone (TSH) concentrations (OR = 4.19; 95% CI, 2.0-8.81; P < .001), have bilateral thyroid nodules (OR = 1.57; 95% CI, 1.19-2.08; P < .001), have homogeneous, bilateral distribution of 99m Tc-pertechnetate uptake (OR = 2.93; 95% CI, 2.05-4.19; P & lt; .001), have milder severity score (OR = 0.62; 95% CI, 0.49-0.79; P < .001), and have higher 131 I uptake (OR = 2.40; 95% CI, 1.75-3.28; P < .001). In contrast, cats remaining persistently hyperthyroid were more likely to be younger (OR = 0.81; 95% CI, 0.72-0.92; P < .001), have higher severity score (OR = 1.87; 95% CI, 1.51-2.31; P < .001), and have lower 131 I uptake (OR = 3.50; 95% CI, 1.8-6.80; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Age, sex, serum TSH concentration, bilateral and homogeneous 99m Tc-pertechnetate uptake on scintigraphy, severity score, and percent 131 I uptake are all factors that might help predict outcome of 131 I treatment in hyperthyroid cats. Cats with persistent hyperthyroidism had many predictive factors that directly contrasted those of cats that developed 131 I-induced hypothyroidism. PMID:34817910 | DOI:10.1111/jvim.16319 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study

xlomafota13 shared this article with you from Inoreader Analysis of tympanic sinus shape for purposes of intraoperative hearing monitoring: a microCT study Via radiol anat Surg Radiol Anat. 2021 Nov 24. doi: 10.1007/s00276-021-02859-7. Online ahead of print. ABSTRACT PURPOSE: Sinus tympani is the space in the retrotympanum, with variable morphology. Computed tomography is a common tool to investigate sinus tympani anatomy. During cochlear implantation or tympanoplasty, electrocochleography can be used for hearing monitoring. In such a surgical strategy the electrode is placed in the round window's region throughout posterior tympanotomy. Commo n accessible needle-shaped electrodes using is difficult in achieving intraoperative stabilization. The aim of the study is to assess the dimensions and shape of sinus tympani, basing on the micro computed tomography scans for purposes of establishing the possible new electrocochleography electrode shape. MATERIALS AND METHODS: Sixteen fresh frozen cadaveric temporal bones were dissected. MicroCT measurements included the depth and the width of sinus tympani, width of facial canal with stapedius muscle chamber. Obtained data were analyzed statistically with the use of RStudio 1.3.959 software. RESULTS: The highest average width of sinus tympani amounted for 2.68 mm, depth measured at the round window plane for 3.19 mm. Width of facial canal with stapedius muscle chamber highest average values at the round window plane- 3.32 mm. The lowest average minimum and maximum values were calculated at the 1 mm above the round window plane. The highest average posterior tympanotomy width was 2.91 mm. CONCLUSIONS: The shape of the tympanic sinus is like a trough with the narrowest and deepest dimensions in the middle part. The ST shape and dimensions should be taken into account in constructing the ECochG electrode, designed for optimal placement through posterior tympanotomy approach. PMID:34817623 | DOI:10.1007/s00276-021-02859-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.