Effects of carbonation of liquids on penetration-aspiration and residue management

xlomafota13 shared this article with you from Inoreader Effects of carbonation of liquids on penetration-aspiration and residue management 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 Jul 22. doi: 10.1007/s00405-021-06987-z. Online ahead of print. ABSTRACT OBJECTIVE: Carbonation as a sensory enhancement strategy for prevention of aspiration of thin liquids has not been thoroughly studied. The aim of our study was to examine the effect of carbonation on penetration-aspiration and pharyngeal residue in dysphagia patients using Fiber-Optic Endoscopic Evaluation of Swallowing (FEES) and to identify parameters associated with a response to carbonation. METHODS: A cross-sectional study of patients undergoing FEES in a dysphagia clinic. Patients were offered 100 cc of dyed water. Penetration-aspiration was scored using the penetration-aspiration scale (PAS). Residue was scored using the Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS). Patients with a PAS ≥ 2 for water were subsequently offered 100 cc of carbonated water. PAS, YPR-SRS and residue clearance were compared betwee n thin and carbonated liquids. Multivariate logistic regression analysis was used to identify predictors for good response to carbonation. RESULTS: 84 patients were enrolled, 77.4% males, with diverse dysphagia etiologies (58.3% neurogenic, 11.9% radiation-induced, 23.8% deconditioning-induced, and 6% neck surgery induced). Median PAS was 7 (IQR 4-8) for thin liquids and 4.5 (IQR 2-8) for carbonated liquids (P = 0.0001). YPR-SRS was reduced for carbonated compared to thin liquids in the vallecula (1.58 ± 0.83 vs 1.76 ± 0.93, P = 0.001) and piriform sinuses (1.5 ± 0.87 vs 1.67 ± 0.9, P = 0.002). 31 patients had improvement in PAS with carbonation. Deconditioning as a dysphagia etiology was found to predict good response to carbonation on multivariate logistic regression analysis. CONCLUSION: Carbonation may prevent aspiration and improve residue management for some patients with dysphagia for liquids. LEVEL OF EVIDENCE: IV. PMID:34292401 | DOI:10.1007/s00405-021-06987-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The integrity and barrier function of porcine vocal fold epithelium: its susceptibility to damage by deoxycholic acid compared with pepsin

xlomafota13 shared this article with you from Inoreader The integrity and barrier function of porcine vocal fold epithelium: its susceptibility to damage by deoxycholic acid compared with pepsin 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 Jul 22. doi: 10.1007/s00405-021-06997-x. Online ahead of print. ABSTRACT PURPOSE: In this study, we aim to systematically evaluate the damaging role of gastric (pepsin and acid) and duodenal ingredients (bile acids) on vocal fold epithelium in excised porcine larynges. METHODS: Fresh ex vivo porcine larynges were exposed to one of five experimental conditions for 1 h. These conditions will be referred to as alkaline deoxycholic acid, acidic pepsin, acid pH3 only, acid pH5 only, and control, respectively. A Franz diffusing cell was used to evaluate the barrier function of vocal fold epithelium by measuring the permeability to fluorescein isothiocyanate dextran of 4 kDa. Histological changes were observed using transmission electron microscopy. RESULTS: After immersing the fresh porcine larynges in the five solution groups, we found that the vocal fold epithelium in the deoxycholic acid group h ad more permeability to FD4 than the pepsin group (P < 0.001). Fragmentation and desquamation of dead cell layers were observed in both the pepsin and deoxycholic acid groups, but were more severe in the deoxycholic acid group than the pepsin group. The thickness of the dead epithelial cell layer gradually increased with increasing acid concentration (P < 0.05). Additionally, the thickness of the dead epithelial cell layer in the deoxycholic acid group was significantly higher than that in the pepsin group (P < 0.01). CONCLUSION: Deoxycholic acid in a weakly acidic condition is more likely than pepsin to induce apoptosis in ex vivo porcine vocal fold epithelium, destroy the link proteins between epithelial cells, and affect their integrity and barrier function. PMID:34292400 | DOI:10.1007/s00405-021-06997-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of Prosody Rehabilitation on Acoustic Analysis of Prosodic Features in Hearing-Impaired Children: A Randomized Controlled Trial

xlomafota13 shared this article with you from Inoreader Effects of Prosody Rehabilitation on Acoustic Analysis of Prosodic Features in Hearing-Impaired Children: A Randomized Controlled Trial Via Folia Phoniatrica et Logopaedica Background: The role of prosody in language acquisition and effective communication is documented in research. Nevertheless, rehabilitation of prosodic skills in children with hearing impairment using hearing aids or cochlear implants is relatively neglected compared to other speech and language areas. Objective: To detect the effect of prosodic rehabilitation using the adapted translated version of the "Prosody Treatment Program" on expression of prosodic feat ures in Egyptian Arabic-speaking hearing-impaired school-age children fitted with hearing aids or cochlear implant devices in comparison to conventional auditory and language rehabilitation. Methods: This study was conducted on 34 children with sensorineural hearing loss in a randomized controlled trial design. Children were randomly divided into 2 groups, group A (cases) and group B (control), by block randomization. Both groups were initially evaluated for their prosodic skills using objective measures. Group A received rehabilitation for prosody using the Prosody Treatment Program for 1 h, once per week for 3 months, while group B received conventional auditory and language training and served as their control. Both groups were re-evaluated using the same protocol after 3 months of therapy. Results: A statistically significant improvement of most of the assessed prosodic parameters in group A was shown when comparing the pretherapy and posttherapy scor es, as well as comparing between both studied groups after therapy. Conclusions: Prosody is amenable to motor learning. The Prosody Treatment Program seems to be an effective rehabilitation tool in improving some prosodic skills of hearing-impaired children. Prosodic rehabilitation showed superiority to conventional auditory and language training in improving the expression of some prosodic features and pragmatic language skills. Folia Phoniatr Logop View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epidemiologic distinctions between base of tongue and tonsil oropharyngeal carcinomas

xlomafota13 shared this article with you from Inoreader Epidemiologic distinctions between base of tongue and tonsil oropharyngeal carcinomas Via Head & Neck Abstract Background Human papillomavirus (HPV)-positive tonsil and base of tongue (BOT) cancers have been considered together. However, important differences may exist. Methods Demographic and tumor characteristics, and survival, were compared by oropharyngeal cancer subsite from 2004 to 2016 in the National Cancer Database (NCDB). Trends in tonsillectomy from the National Health and Nutrition Examination Survey (NHANES) 2011–2014 were examined. Results HPV-positive BOT (N = 13 081) were older than HPV-positive tonsil patients (N = 16 874; mean 61.5 vs. 58.4 years, p < 0.001), and individuals 70+ years were significantly more likely to have BOT tumors compared with individuals <50 (adjusted odd ratio [aOR] = 2.9, 95% confidence interval = 2.6–3.2). BOT patients were also more likely to be white, male, and have advanced tumor classification. Among 7418 NHANES participants, tonsillectomy was associated with older age and white race. Conclusions There are epidemiologic and tumor-related differences among HPV-positive tonsil and BOT carcinomas. Demographic differences may be attributable to tonsillectomy trends. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical interventions for management of benign parotid tumors: A systematic review and network meta‐analysis

xlomafota13 shared this article with you from Inoreader Surgical interventions for management of benign parotid tumors: A systematic review and network meta‐analysis Via Head & Neck Abstract The impact of the extent of parotid surgery on postoperative complications has long been considered a topic of controversy. The aim of the current network meta-analysis (NMA) is to answer the following questions: (1) Does the extent of surgical resection of benign parotid tumors increase the risk of postoperative complications? (2) What is the best surgical intervention for treatment of benign parotid tumors that can provide an acceptable balance between tumor recurrence rate and other postoperative complications? A comprehensive search on PubMed, Embase, Scopus, and Cochrane library was conducted to identify the eligible studies. The outcome was the incidence of tumor recurrence, facial nerve weakness (temporary [TFW] or permanent [PFP]), Frey's syndrome (FS), sialocele, and salivary fistula. The Bayesian network meta-analysis (NMA) accompanied by a random effect model and 95% credible intervals (CrI) were calculated using the GeMTC R package. Forty-four studies with a total of 7 841 participants were included in the current NMA comparing five surgical interventions, namely enucleation, extracapsular dissection (ECD), partial superficial parotidectomy (PSP), superficial parotidectomy (SP), and total parotidectomy (TP). Enucleation showed the highest recurrence rate compared to ECD, SPS, SP, and TP. No statistical differences were observed concerning the recurrence rate when ECD, PSP, SP, and TP were compared together. There was an increased incidence of TFW and FS with the increase in the extent of parotid resection, while no significant difference was found when comparing enucleation with ECD and PSP. SP showed the highest incidence of PFP, and salivary fistula compared to ECD, PSP, and TP. The tumor recurrence rates in enucleation, ECD, PSP, SP, and TP were 14.3%, 3.6%, 3.7%, 2.8%, and 1.4%, respectively. The current NMA demonstrated that the risk of TFW and FS increases with the increase in the extent of parotid resection and that ECD and PSP can be consi dered the treatment of choice for benign parotid tumors, as both provide an acceptable balance between the incidence of tumor recurrence and facial nerve dysfunction. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Feasibility of lateral sentinel lymph node biopsy in medullary thyroid cancer: A surrogate tool for determining prophylactic lateral neck dissection—A pilot study

xlomafota13 shared this article with you from Inoreader Feasibility of lateral sentinel lymph node biopsy in medullary thyroid cancer: A surrogate tool for determining prophylactic lateral neck dissection—A pilot study Via Head & Neck Abstract Backgrounds This study aimed to evaluate usefulness of lateral sentinel lymph node biopsy (SLNB) in determining lateral neck dissection (LND) of patients with medullary thyroid cancer (MTC). Methods Sixteen patients with MTC were enrolled in the study from January 2013 to June 2019. Intratumoral injection of technetium (Tc)-99m phytate followed by lymphoscintigraphy was performed preoperatively. Lateral sentinel lymph nodes were detected by a collimated gamma probe and underwent frozen analysis. Ipsilateral LND was performed in all patients to assess lateral LN status. Results The identification rate of sentinel lymph nodes (SLNs) detected by radioisotope was 87.5% (14 of 16 patients). The sensitivity, specificity, positive predictive value, and negative predictive value of frozen analyses were 66.7%, 100%, 100%, and 91.6%, respectively. Based on final histopathology, however, the diagnostic values of lateral SLNB were all 100%. Conclusions This study showed that lateral SLNB can be a promising surgical tool for decisions on LND in patients with MTC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified endoscopic medial maxillectomy for a mixed maxillary inverted papilloma and mycetoma with absent prelacrimal recess

xlomafota13 shared this article with you from Inoreader Modified endoscopic medial maxillectomy for a mixed maxillary inverted papilloma and mycetoma with absent prelacrimal recess Via European Annals of Otorhinolaryngology, Head and Neck Diseases Publication date: Available online 21 July 2021 Source: European Annals of Otorhinolaryngology, Head and Neck Diseases Author(s): C.-Y. Huang, Y.-H. Lin View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis

xlomafota13 shared this article with you from Inoreader Assessment of the Use of Humidified Nasal Cannulas for Oxygen Therapy in Patients with Epistaxis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: In China, nasal cannula oxygen therapy is typically humidified. However, it is difficult to decide whether to suspend nasal cannula oxygen inhalation after the nosebleed has temporarily stopped. Therefore, we conducted a preliminary investigation on whether the use of humidified nasal cannulas in our hospital increases the incidence of epistaxis. Methods: We conducted a survey of 176,058 inpatients in our hospital and other city branches of our hospit al over the past 3 years and obtained information concerning their use of humidified nasal cannulas for oxygen inhalation, nonhumidified nasal cannulas, anticoagulant and antiplatelet drugs, and oxygen inhalation flow rates. This information was compared with the data collected at consultation for epistaxis during these 3 years. Results: No significant difference was found between inpatients with humidified nasal cannulas and those without nasal cannula oxygen therapy in the incidence of consultations due to epistaxis (χ2 = 1.007, p #x3e; 0.05). The same trend was observed among hospitalized patients using anticoagulant and antiplatelet drugs (χ2 = 2.082, p #x3e; 0.05). Among the patients with an inhaled oxygen flow rate ≥5 L/min, the incidence of ear-nose-throat (ENT) consultations due to epistaxis was 0. No statistically significant difference was found between inpatients with a humidified oxygen inhalation flow rate #x3c;5 L/m in and those without nasal cannula oxygen therapy in the incidence of ENT consultations due to epistaxis (χ2 = 0.838, p #x3e; 0.05). A statistically significant difference was observed in the incidence of ENT consultations due to epistaxis between the low-flow nonhumidified nasal cannula and nonnasal cannula oxygen inhalation groups (χ2 = 18.428, p #x3c; 0.001). The same trend was observed between the 2 groups of low-flow humidified and low-flow nonhumidified nasal cannula oxygen inhalation (χ2 = 26.194, p #x3c; 0.001). Discussion/Conclusion: Neither high-flow humidified nasal cannula oxygen inhalation nor low-flow humidified nasal cannula oxygen inhalation will increase the incidence of recurrent or serious epistaxis complications; the same trend was observed for patients who use anticoagulant and antiplatelet drugs. Humidification during low-flow nasal cannula oxygen inhalation can prevent severe and repeated e pistaxis to a certain extent. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome

xlomafota13 shared this article with you from Inoreader Clinicopathological Study of Intradural Extramedullary Spinal Tumors and Its Correlation With Functional Outcome Via leak of cerebrospinal fluid Cureus. 2021 Jun 18;13(6):e15733. doi: 10.7759/cureus.15733. eCollection 2021 Jun. ABSTRACT Introduction Intradural extramedullary (IDEM) spinal cord tumors account for approximately two-thirds of largely benign intraspinal neoplasms. These are amenable to gross total excision and usually carry a good functional outcome. Methods In this study, we reviewed the surgical outcomes of 35 patients who underwent excision of intradural extramedullary tumors. Patient demographics, severity and duration of symptoms, and tumor characteristics (anatomical and pathological) in all operated spinal IDEM tumors were collected. The neurological findings obtained during the preoperative stage and the postoperative follow-up were evaluated according to the Frankel and Nurick grading. The back pain was assessed with help of the Denis pain scale (DPS). Results The histopathological outcomes of the study were as follows: six patients of neurofibroma, 12 cases of s chwannoma, nine cases of meningiomas, three cases of ependymoma, one case of dorsal neurenteric cyst, two cases of epidermoid cyst, one case of cauda equina paraganglioma, and one case of filum terminale dermoid cyst. Paresthesia/numbness were the commonest symptoms (88.6%), weakness of limbs in (80%), sphincter dysfunction in 15 patients (42.9%), and paraplegia was seen in three patients (8.57%). The complications encountered were - one case each of cerebrospinal fluid (CSF) leak, surgical site infection, and pseudomeningocele. The percentage of spinal canal occupied ranged from 71-94%. The mean percentage of the spinal canal occupied by the tumor was 81.8%. In our series, 77.14% of patients (p<0.0001) had good functional outcomes as per improvement in Frankel score. The DPS and Nurick score mean values showed a significant decrease over the follow-up duration as compared to preoperative mean values. Significant functional improvement was noted at the one-week, one-month, and on e-year follow-up, with a p-value of <0.0001. Conclusions The IDEM tumors are usually benign and are readily detected by contrast-enhanced MRI scans. These have excellent surgical outcomes with some exceptions. Greater canal occupancy and a longer duration of symptoms are usually seen to correspond with suboptimal functional outcomes. PMID:34285844 | PMC:PMC8286542 | DOI:10.7759/cureus.15733 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Facial Paresis and Pulsatile Middle Ear Mass

xlomafota13 shared this article with you from Inoreader Facial Paresis and Pulsatile Middle Ear Mass Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211031510. doi: 10.1177/01455613211031510. Online ahead of print. ABSTRACT Head and neck paragangliomas are uncommon pathologies that present with common symptoms such as pulsatile tinnitus and aural pressure. This article highlights an unusual presentation of a patient with facial paresis who was found to have a jugular paraganglioma. Emphasis is placed on how the otologic examination showed a pulsatile middle ear mass that led to the d iagnosis. This case illustrates the importance of maintaining a healthy degree of clinical suspicion when encountering common complaints. PMID:34284609 | DOI:10.1177/01455613211031510 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity

xlomafota13 shared this article with you from Inoreader Middle Ear Adenomatous Neuroendocrine Tumor: A Rare Entity Via ear nose throat Ear Nose Throat J. 2021 Jul 21:1455613211029785. doi: 10.1177/01455613211029785. Online ahead of print. ABSTRACT Middle ear adenomatous neuroendocrine tumors (MEANT) are rare, mainly benign neoplasms and account for less than 2% of the middle and inner ear neoplasms. There are no specific radiological or clinical findings; therefore, the diagnosis is often difficult. Biopsy prior to surgery is often proposed. The definite treatment is the complete surgical resection. We pres ent an uncommon clinical report of a MEANT, which was treated successfully with surgical excision. PMID:34284607 | DOI:10.1177/01455613211029785 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.