Management strategies for chronic rhinosinusitis with nasal polyps

xlomafota13 shared this article with you from Inoreader Management strategies for chronic rhinosinusitis with nasal polyps Via hno HNO. 2022 Jan 7. doi: 10.1007/s00106-021-01127-9. Online ahead of print. ABSTRACT Chronic rhinosinusitis with (CRwNP) or without (CRsNP) nasal polyps can have a great impact on quality of life. Typical symptoms include nasal obstruction, olfactory dysfunction, nasal discharge, and facial pain or pressure. Diagnostic gold standard is nasal endoscopy followed by CT scan of the paranasal sinuses. Besides first-line treatment with topical or systemically applied glucocorticoids, nasal rinsing, and surgical therapy, monoclonal antibodies have been approved in Germany since 2019. PMID:34994808 | DOI:10.1007/s00106-021-01127-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Hearing Loss in Congenital Hypothyroid Children at a Tertiary Care Hospital in Central India

xlomafota13 shared this article with you from Inoreader Evaluation of Hearing Loss in Congenital Hypothyroid Children at a Tertiary Care Hospital in Central India Via Otolaryngology Indian Abstract Hearing loss has long been associated with congenital hypothyroidism and, if not noticed and treated early, may result in delayed language acquisition and difficulties in comprehension. In light of the implications of congenital hypothyroidism and its associated hearing loss, we decided to conduct this study. The aim of this study was to identify the prevalence of hearing loss in congenital hypothyroidism and its relation to the severity of the disease and age of initiation of treatment. This study was conducted from July 2016 to June 2021 at a tertiary care hospital in Bhopal. The hearing status of congenital hypothyroid children and matched controls was assessed by pure tone audiometry or free field audiometry and, in selected cases, with brainstem evoked response audiometry. Eight children (25%) with congenital hypothyroidism had hearing loss, compared to one (3.12%) in the control group (p < 0.05). No statistically significant difference has b een found in the gender, mean age of diagnosis, mean age of initiation of levothyroxine treatment, mean screening FT4 levels, and mean screening TSH levels between congenital hypothyroid children with and without hearing loss. Due to the high prevalence of hearing loss in congenital hypothyroidism and its impact on language and cognitive development, it is critical to create awareness among healthcare professionals that children diagnosed with congenital hypothyroidism must undergo audiological evaluation at the time of diagnosis and periodically thereafter. Alternatively, children with unexplained hearing loss must be screened for congenital hypothyroidism. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Non‐Squamous Cell Malignancies of the Larynx

xlomafota13 shared this article with you from Inoreader Non‐Squamous Cell Malignancies of the Larynx Via The Laryngoscope Objectives/Hypothesis Non-squamous cell carcinoma (SCC) malignancies are rare, but well described laryngeal pathologies. However, the epidemiology and clinical behavior of these tumors is not well studied. Study Design Retrospective cohort study. Methods Patients diagnosed with non-squamous cell larynx cancer from 2004 to 2017 in the National Cancer Database were selected. Demographic, clinicopathologic factors, treatments, and survival were analyzed. Univariable and multivariable cox regression were performed. Survival was compared with a propensity score-matched (PSM) population of laryngeal SCC patients. Results A total of 136,235 cases of larynx cancer were identified. After excluding SCC variants, 2,172 (1.6%) patients met inclusion criteria. The most common histology was chondrosarcoma (374, 17.2%), followed by small cell (345, 15.9%), and spindle cell carcinoma (268, 12.3%). The most common treatment was surgery (683, 31.4%) followed by chemoradiation (409, 18.8%) and surgery and adjuvant radiation (288, 13.3%). Overall, 3- and 5-year survival was 67.9% and 59.4%, respectively. In multivariate analysis controlling for age, stage, comorbidity, histology, and treatment modality; chondrosarcoma had the best survival (hazard ratio [HR] 0.11, confidence interval [CI] 0.07–0.19, P < .001). In a PSM population, matched for age, stage, comorbidity, and treatments; non-SCC patients had significantly lower survival (51.5% vs. 59.9%, P < .001). Conclusion A diverse range of non-squamous cell malignancies occur in the larynx. In general, these tumors have poor survival, with few exceptions such as chondrosarcoma. While the majority of these histologies undergo surgical-based treatments in other sites, only 53% of patients underwent surgical-based treatment in the larynx. These data could guide clinicians in determining the outcome of treatment in these patients. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathophysiology and Management of Tongue Involvement in COVID-19 Patients

xlomafota13 shared this article with you from Inoreader Pathophysiology and Management of Tongue Involvement in COVID-19 Patients Via Otolaryngology Indian Abstract Evaluate the lingual manifestations of COVID-19, and provide a clinical guide in managing these symptoms. Electronic databases, such as PubMed/Medline, and Scopus were searched until November 1, 2020, and only randomized controlled trials, cross-sectional and cohort studies, as well as case reports and series, and review articles in English were considered. A total of 40 studies were included in this study. Lingual involvement has been extensively reported in patients with coronavirus disease 2019 (COVID-19). The most common features of lingual involvements were red or light red, yellow coating, and greasy coating tongue, though other complications, such as pale, purple, white coating, grayish-black coating, rough, tender, puffy, spotty, prickles, fissured, and tooth-marked tongue was also reported. Poor oral hygiene, opportunistic infections (OIs), medications, and hyper-inflammatory response to infection are the most common predisposing factors for the onset of oral lesions in patients with COVID-19. In conclusion, the current review described the lingual manifestations of COVID-19, and as oral complaints are relatively common in COVID-19 patients, an intraoral examination should be conducted in all suspected cases of SARS-CoV-2 infection. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Deltopectoral Flap Reconstruction of the Posterior Pharyngeal Wall: A Single Stage Pedicle Flap Alternative Solution to the Free Flap Reconstruction of Circumferential Laryngopharyngeal Defects

xlomafota13 shared this article with you from Inoreader Deltopectoral Flap Reconstruction of the Posterior Pharyngeal Wall: A Single Stage Pedicle Flap Alternative Solution to the Free Flap Reconstruction of Circumferential Laryngopharyngeal Defects Via Otolaryngology Indian Abstract The first option for reconstruction of a circumferential pharyngeal defect following extensive pharyngo-laryngectomy is free tissue transfer. Despite that, pedicled flaps can be used when microsurgical expertise is not available or if other patient related or region related issues deem free tissue transfer unfavourable. The aim of this study was to review the operative feasibility and functional outcomes following dual flap reconstruction of circumferential pharyngeal defects.This was a retrospective study of all patients (n = 8) who underwent either primary (n = 5) or salvage (n = 3) circumferential laryngopharyngectomy + /– cervical oesophagectomy, followed by dual flap reconstruction, with a deltopectoral flap to reconstruct the posterior wall from 2005 to 2020. The main outcome measures were operative complications, hospital stay and functional outcomes (speech and swallowing). The operation was feasible in all patients, with dual flap recon struction using a deltopectoral flap, combined with a pectoralis major flap (n = 5) or a supraclavicular flap (n = 3). All patients developed a small, lateralised, self-healing fistula at the site of the deltopectoral flap 3-point junction. This did not require any intervention, or impact on adjuvant treatment. Functional outcomes were favourable, with all patients achieving oral diet. One patient required gastrostomy diet supplementation, and one patient required stricture dilatation. Of the patients able to receive a speech valve (n = 4), all achieved intelligible speech. Dual flap reconstruction of circumferential pharyngeal defects represents a feasible alternative option for a complex reconstructive problem. The predictable operative recovery and favourable functional outcomes indicate that the use of both a deltopectoral flap and a second flap is a robust reconstructive solution. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

New EMA drug approval: Nivolumab in association with chemotherapy as first line treatment for HER2-negative esophageal adenocarcinoma with PD-L1 expression (CPS≥5)

xlomafota13 shared this article with you from Inoreader New EMA drug approval: Nivolumab in association with chemotherapy as first line treatment for HER2-negative esophageal adenocarcinoma with PD-L1 expression (CPS≥5) Via Association française pour l'étude du cancer Bull Cancer. 2022 Jan 4:S0007-4551(21)00576-2. doi: 10.1016/j.bulcan.2021.11.012. Online ahead of print. NO ABSTRACT PMID:34996599 | DOI:10.1016/j.bulcan.2021.11.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

“Fizz Sign” in Acute Sinusitis–A CT Scan Finding

xlomafota13 shared this article with you from Inoreader "Fizz Sign" in Acute Sinusitis–A CT Scan Finding Via Otolaryngology Indian Abstract To study the Computerized Tomography (CT) Paranasal Sinus findings in patients with acute bacterial sinusitis and the clinical symptom associated with it. 120 patients were examined over 2 years with coronal CT images of paranasal sinus with clinical symptoms of acute sinusitis of 2 weeks duration from the onset. Patients with symptoms of more than 2 weeks and patients with chronic sinusitis, immunocompromised status were excluded. Air mixed with fluid is seen like a Fizz of cola drink within the maxillary, frontal or sphenoid sinus, mucosal thickening of more than 5 mm, fluid level and presence of opacifications were used as evidence of acute sinusitis. 28 patients (23.3%) had Fizz sign (Air mixed with fluid seen as bubbles) coronal CT images of the paranasal sinus. The study demonstrated great variation in the CT paranasal findings amongst patients with suspected acute sinusitis. More than one sinus subsite was affected amongst pat ients in whom acute sinusitis was confirmed by CT Paranasal sinus imaging. We hereby highlight a new sign of air mixed with fluid which the senior author had named as Fizz Sign because of its resemblance to the fizz of dark cola drink. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rhino-Cerebral Mucormycosis with Otologic Involvement

xlomafota13 shared this article with you from Inoreader Rhino-Cerebral Mucormycosis with Otologic Involvement Via Otolaryngology Indian Abstract Mucormycosis is an opportunistic invasive fungal infection, recently been detected in Covid-19 due to several underlying conditions. Otologic involvement in such patients though exceptional, should not be simply ignored even when presented without any clinical signs or symptoms. This report manifests the need of evaluating otologic involvement in post-covid mucormycosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Unusual Presentation of Otoacariasis

xlomafota13 shared this article with you from Inoreader Unusual Presentation of Otoacariasis: A Prospective Study at Referral Teaching Hospital Via Otolaryngology Indian Abstract Otoacariasis is the presence of ticks and mites within the ear canal. Though the coexistence of ticks and humans is known for thousands of years, tick infestation is relatively rare in urban population. The most common presenting symptoms are usually itching, otalgia and a foreign body sensation and less frequent ones are tinnitus and otorrhoea. We report cases of otoacariasis with unusual presentation. A total of 43 cases presented to the ENT clinic in our hospital over a period of three years from 2018 to 2021. We present patients who presented with unusual symptoms of conductive hearing loss, ear bleed, and facial palsy. Total of 6 cases of otoacariasis had unusual presentation. 2 cases presented with lower motor neuron palsy, 1 case with ear bleed, and 3 cases with hearing loss. Otocariasis can present with unusual symptoms of hearing loss, ear bleed or facial palsy and this should be included in the differential diagnosis of a patient with history of close p roximity to domestic or wild animals. Detailed examination often reveals the presence of the tick and identification and complete removal along with appropriate medication for associated symptoms often results in complete recovery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Clinical Profile and Various Treatment Modalities in Oral Sub Mucous Fibrosis

xlomafota13 shared this article with you from Inoreader Evaluation of Clinical Profile and Various Treatment Modalities in Oral Sub Mucous Fibrosis in North India: Our Experience Via Otolaryngology Indian Abstract Oral submucous fibrosis is a chronic disease affecting oral cavity and sometimes the pharynx. Etiology seems to be local irritants such as capsaicin, tobacco, areca nut and spicy foods. The main concern in this is the management of trismus and burning sensation of the oral mucosa. The aim of this study was to compare various medical treatment protocol of OSMF. 210 patients were divided randomly in 3 groups. In Group A, patients were given biweekly intralesional Hyaluronidase/Dexamethasone for 6 weeks. Group B patients were given tablet Pentoxifylline 400 mg TDS.Group C patients were given Eprisone hydrochloride. All three groups were given Lycopene 10,000 mcg for period of 6 weeks. All patients were given topical Triamcelone for local application. The examinations for mouth opening were repeated at weekly intervals for a period of 6 weeks.The most common complaint was burning sensation in 75.98% cases, difficulty in mouth opening in77.45% and difficulty in swallowing food in 61.76% cases. Group A showed improvement in 41.17% cases presenting with burning sensation followed by decreased mouth opening 39.70%. Group B showed improvement in 45.58% burning sensation, 17.64% with decreased mouth opening. Group C showed improvement in 48.52% patients having pain with spicy food, 32.35% with decreased mouth opening and 17.64% with difficulty in swallowing. We conclude that patients which received intralesional dexamethasone and hyaluronidase along with oral Lycopene showed better clinical and symptomatic improvement, and at present appears to be best non-surgical treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Palatal Flap: An Optimistic Salvagable Option to Negate the Maxillectomy Defects in COVID Related Rhino-Orbito-Cerebral Mucormycosis

xlomafota13 shared this article with you from Inoreader Palatal Flap: An Optimistic Salvagable Option to Negate the Maxillectomy Defects in COVID Related Rhino-Orbito-Cerebral Mucormycosis Via Otolaryngology Indian Abstract We present three cases diagnosed with COVID-19 associated Rhino-orbito-cerebral mucormycosis, managed by aggressive debridement and resection of the involved maxilla, followed by primary closure with preserved palatal flap, thus trying to establish its versatility for the closure of the maxillectomy defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Induction and generalization of nocebo effects on itch

xlomafota13 shared this article with you from Inoreader Induction and generalization of nocebo effects on itch Via Experimental Dermatology Abstract Nocebo effects, i.e., negative treatment outcomes due to negative expectancies, can increase itch. Moreover, indirect evidence has shown that nocebo hyperknesis can generalize to another itch modality. Knowledge on response generalization can help to prevent and decrease negative effects. The aims of this study were to investigate 1) the efficacy of inducing nocebo effects on cowhage-evoked itch via verbal suggestions and 2) whether these effects can generalize to 2a) mechanically evoked touch and 2b) mechanically evoked itch. Forty-four healthy participants watched a video suggesting that a nocebo solution increases cowhage-evoked itch and that a control solution does not affect itch. Subsequently, cowhage, mechanical itch, and mechanical touch stimuli were applied. Nocebo effects were measured as the difference in both mean and peak of the outcomes itch and urge to scratch between nocebo and control trials. Main analyses revealed significant nocebo effects on mean and peak itch for all stimuli. For urge to scratch, a significant nocebo effect was only observed for mechanical touch (peak). As mechanical stimuli did not induce pure sensations as planned, post-hoc sensitivity analyses were run for mechanical stimuli that individually induced either touch or itch at baseline. These analyses showed similar results for generalization to mechanical itch, but generalization to mechanical touch was nonsignificant. This study showed that merely verbal suggestion can induce nocebo effects on cowhage-evoked itch and that these effects can generalize to another itch modality. Future studies may examine how to prevent negative experiences from generalizing to subsequent encounters. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.