Τρίτη 24 Νοεμβρίου 2020

Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension.

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Nodular Oncocytic Hyperplasia of Bilateral Parotid Glands With Parapharyngeal Space Extension.

Ear Nose Throat J. 2020 Nov 20;:145561320973786

Authors: Hung CJ, Liu YH, Liao JB

Abstract
Oncocytic tumors comprise a group of rare benign neoplasm of salivary glands, accounting for less than 1% of all salivary gland tumors. Nodular oncocytic hyperplasia characterized by multiple unencapsulated oncocytic nodules in the salivary glands is an extremely rare condition. We report a case of bilateral nodular oncocytic hyperplasia of parotid glands with parapharyngeal space extension in an 80-year-old woman whose initial presentation was recurrent parotitis. Our case may be the first report of nodular oncocytic hyperplasia in the parapharyngeal space, arising from the parotid gland. The patient underwent total parotidectomy and excision of parapharyngeal tumors using a transparotid transcervical approach, and at the 2-year follow-up, no evidence of recurrence was found.

PMID: 33215532 [PubMed - as supplied by publisher]

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Primary Heterotopic Meningioma of Nasal Cavity: Case Report and Literature Review.

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Primary Heterotopic Meningioma of Nasal Cavity: Case Report and Literature Review.

Ear Nose Throat J. 2020 Nov 20;:145561320974863

Authors: Hu X, Jiang M, Feng Z, Wang J, Wang P, Cai J

Abstract
Primary heterotopic meningiomas are lesions that are not associated with a cranial nerve foramen, vertebral canal, or intracranial structure. The most common histopathological subtype is meningeal epithelioma. In clinical practice, primary heterotopic nasal meningioma occurs relatively rarely, and its most common pathological type is psammomatous meningioma, whereas nasal fibrous meningioma is infrequent. In our case, a 31-year-old male patient was admitted to the hospital with "progressive nasal obstruction on the right side for half a year." Computed tomography examination of the paranasal sinuses revealed a polyploid mass in the right nasal cavity. The patient underwent surgical resection of the mass under nasal endoscopy. Histopathological examination confirmed that the mass was an ectopic meningioma of the nasal cavity. The patient was regularly followed up for 2 years without recurrence of the tumor. Primary heterotopic fibrous meningioma of the nasal cavity is clinical ly rare but should be considered as a differential diagnosis for hemangioma of the nasal cavity, inverted papilloma, and nasal polyp. The final diagnosis is based on pathology and immunohistochemistry analysis results.

PMID: 33215534 [PubMed - as supplied by publisher]

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Hypertrophic Pachymeningitis of the Internal Auditory Canal Induced by a Labyrinthine Fistula Complicated With Cholesteatoma.

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Hypertrophic Pachymeningitis of the Internal Auditory Canal Induced by a Labyrinthine Fistula Complicated With Cholesteatoma.

Ear Nose Throat J. 2020 Nov 20;:145561320972612

Authors: Park KS, Shin BJ, Jang CH

Abstract
Hypertrophic pachymeningitis (HP) is defined by inflammation and thickening of the dura mater, and the etiologic factors are idiopathic or secondary to various conditions. To date, HP in the internal auditory canal (IAC) has rarely been reported. There have only been 3 reports of HP in the IAC. Magnetic resonance imaging showed enhancement of along the IAC and vestibule. After antibiotic treatment, enhancement was reduced with visible seventh and eighth nerves. The patient underwent tympanomastoidectomy. To our knowledge, this is the first case of HP associated with a labyrinth fistula complicated by cholesteatoma. We report MRI image with literatures.

PMID: 33215535 [PubMed - as supplied by publisher]

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A Rare Case of Prostate Carcinoma Metastasis in the Orbital Apex.

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A Rare Case of Prostate Carcinoma Metastasis in the Orbital Apex.

Ear Nose Throat J. 2020 Nov 20;:145561320973783

Authors: Wada K, Tsuda T, Hanada Y, Maeda Y, Mori K, Nishimura H

Abstract
Prostate cancer (PC) is prone to bone metastases, but very rarely it can spread to soft tissues. In the head and neck region, PC can metastasize to the orbital soft tissue, causing various symptoms such as vision loss. In this report, we describe the case of a 79-year-old man with PC metastasis in the orbital apex. He presented to an ophthalmologist at our hospital with progressively worsening vision in his left eye over 3 to 4 months. He complained of a drooping eyelid in the same eye; thus, intracranial disease was suspected. Closer inspection with head computed tomography revealed a space-occupying lesion from the orbit to the posterior ethmoid sinus, and he was referred to our department. He had a history of PC, and we performed endoscopic sinus surgery for the diagnosis of malignancy, including metastasis of PC. As a result, the mass was diagnosed as PC metastasis by pathological examination. The patient began androgen blockade therapy and 3 months postoperatively, magne tic resonance imaging revealed that the extraconal orbital mass had decreased significantly. It is important to determine the metastases of PC in the paranasal region when the patient has a preexisting medical history.

PMID: 33215539 [PubMed - as supplied by publisher]

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Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature.

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Rigid External Distractors in Midface Fractures: A Review of Relevant and Related Literature.

Eplasty. 2020;20:e11

Authors: Gala Z, Halsey J, Kogan S, Hoppe I, Ciminello FS, Granick MS

Abstract
INTRODUCTION: Literature discussing the use of rigid external distraction devices in midfacial trauma is limited. Rigid external distraction devices have been described for use in craniofacial surgery, allowing for distraction and stabilization of bony segments. In complex facial trauma, bony fragments are often comminuted and unstable, making traditional approaches with internal fixation difficult. Moreover, these approaches require subperiosteal dissection, limiting blood supply that is important for bone healing.
OBJECTIVE: The goal of this study was to evaluate the role of rigid external distraction devices for the treatment of complex facial trauma.
METHODS: We performed a literature review of rigid external distraction devices, as relevant both for facial trauma and for other craniofacial indications, to better elucidate their use and efficacy in complex facial fractures.
RESULTS: The review revealed only 2 articles explicitly describing rigid external distraction devices for facial trauma, while 6 other articles describing its use for other craniofacial cases. An important benefit associated with the use of rigid external distraction devices is their ability to provide controlled traction of bony segments while also allowing for movement as needed for fracture reduction. Various articles describe performing internal fixation following rigid external distraction device usage, while others emphasize that internal fixation is not necessarily indicated if the rigid external distraction device is left intact long enough to ensure bony healing. One potential setback described is unfamiliarity with using the rigid external distraction device, which can preclude its use by many surgeons. In addition, the literature review did not provide any uniform guidelines or recommendations about how long rigid external distraction devices should remain intact.< br> CONCLUSION: Based on relevant literature, rigid external distraction devices have been shown to be useful in the stabilization and treatment of complex facial fractures. Further studies should be conducted to better elucidate the specific indications for rigid external distraction devices in complex facial trauma.

PMID: 33214802 [PubMed]

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Surface Landmarks to Provide a Safe Ulnar Nerve Block in the Wrist: Anatomical Study and Literature Review.

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Surface Landmarks to Provide a Safe Ulnar Nerve Block in the Wrist: Anatomical Study and Literature Review.

Eplasty. 2020;20:e12

Authors: Kachare SD, Meredith LT, Kachare MD, Vivace BJ, Kapsalis CN, Muresan C, Choo JH, Kasdan ML, Wilhelmi BJ

Abstract
Introduction: Use of local anesthesia in awake patients undergoing hand surgery has become increasingly popular. A thorough understanding of local anatomy, such as the distal wrist for ulnar nerve block, is required to provide safe blockade. We sought to conduct an anatomic study of the distal wrist and review cadaveric studies describing various techniques for ulnar nerve block. Methods: Dissection of fresh-frozen cadaver forearms at the University of Louisville Robert Acland Fresh Tissue Lab assessing relationships between the flexor carpi ulnaris tendon and the ulnar nerve and the ulnar artery was performed. Three cadaveric studies on ulnar nerve blockade using the ulnar, volar, and/or transtendinous technique were identified and reviewed. Results: A total of 16 cadaver forearms of equal male to female ratio were obtained. The ulnar nerve was noted to be directly posterior to the flexor carpi ulnaris tendon in 15 (93.8%) forearms, with 1 (6.3%) specimen having the nerve ex tend along the ulnar border of the flexor carpi ulnaris. The ulnar artery was radial to the ulnar nerve 1 cm proximal to the pisiform in all specimens. In all 3 cadaveric studies, only the ulnar technique was associated with no ulnar artery and/or ulnar nerve injury. Conclusion: Knowledge of distal wrist anatomy can help minimize risk of iatrogenic injury during local blockade. On review, the ulnar approach provides the safest method for ulnar nerve block.

PMID: 33214803 [PubMed]

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Orbital Roof Blowout Fracture With an Intact Orbital Rim: A Case Report.

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Orbital Roof Blowout Fracture With an Intact Orbital Rim: A Case Report.

Eplasty. 2020;20:e13

Authors: Hwang K, Oh SY

Abstract
Background: Fractures of the orbital roof not associated with fractures of the orbital rim are unusual. We describe the case of a blowout fracture of the orbital roof with an intact orbital rim, which was found after craniotomy for removal of epidural hematoma. Case: A 64-year-old man was referred to our emergency department from a local hospital. He fell down from a 3-m stepladder while pruning branches of a tree. Brain computed tomographic scan revealed acute epidural hematoma in both frontal convexities, and he underwent craniotomy at the local hospital. On follow-up brain computed tomography, an orbital roof fracture with a displaced bony fragment and hemorrhage was noticed in the left superior extraconal space. Thereafter, he was transferred to our department. Upon examination, movement of the extraocular muscles was normal. He did not complain of diplopia or decreased sensation of the face. He also did not have nasal stuffiness. Exophthalmometry revealed the same findin gs for both eyes (18 mm/18 mm). Facial computed tomographic scan before the second operation revealed a displaced orbital roof fracture segment. Under general anesthesia, craniotomy was performed and the epidural hematoma was evacuated. The displaced bony fragment was removed from the left anterior cranial fossa, and the anterior skull base was reconstructed with a titanium mesh plate. Conclusion: Through this case of blowout fracture of the orbital roof with an intact orbital rim, found after craniotomy, we should be aware of the possibility that an orbital roof fracture can be missed on conventional brain computed tomography.

PMID: 33214804 [PubMed]

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Nodular Fasciitis-A Rare Cause of a Rapidly Growing Ear Lesion in a 19-Month-Old Child.

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Nodular Fasciitis-A Rare Cause of a Rapidly Growing Ear Lesion in a 19-Month-Old Child.

Eplasty. 2020;20:ic13

Authors: Halsey JN, Hohenleitner J, Ciminello FS

PMID: 33214805 [PubMed]

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Tinnitus to Alpha Burst Transcranial Magnetic Stimulation.

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A Chart Review to Assess the Response of Veterans Suffering from Tinnitus to Alpha Burst Transcranial Magnetic Stimulation.

Int Tinnitus J. 2020 Nov 18;24(1):40-48

Authors: Ring A, Crowder C, Wyer SL, Phillips B

Abstract
OBJECTIVE: The purpose of this chart review was to assess the response of veterans suffering from tinnitus to Magnetic EEG/EKGguided resonance therapy and Alpha Burst Stimulation (ABS), while also investigating the safety profile of this therapy combination. EEG/EKG-guided Repetitive Transcranial Magnetic Stimulation (rTMS) delivers high-energy electromagnetic pulses to induce current flow in the neocortex. ABS provides rTMS pulses in short, high-frequency bursts.
MATERIALS AND METHODS: All equipment used to evaluate and treat participants are either FDA-cleared or are exempt from clearance and listed with the United States FDA. Stimulation was delivered with a MagPro R30 and an MCF-B65 butterfly coil. Charts were reviewed from patients who had received a combination of EEG/EKG-guided rTMS and ABS therapy to relieve symptoms of tinnitus. Paired samples t-tests were performed on the Tinnitus Functional Index (TFI) and Neurobehavioral Symptom Inventory (NSI) scales. Treatment logs and therapy notes were reviewed for safety data. Adverse events or side effects were extracted from therapy notes. Linear regression was used to analyze the relationship between number of therapy sessions, and reported patient symptoms.
RESULTS: Eighteen of the 23 patients reported significant improvements in tinnitus symptoms. For patients reporting improvements, there was an average 44% reduction in tinnitus symptoms and a 60% reduction in NSI scores following intervention. No patients experienced adverse side effects. The most common side effects were headache and fatigue.
CONCLUSION: Based on the results from this study, noninvasive neuromodulation holds promise as a potential treatment for tinnitus. Additional investigation in controlled studies may be warranted.

PMID: 33206487 [PubMed - in process]

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Clinical and morphological results of xenografts to use in myringoplasty.

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Clinical and morphological results of xenografts to use in myringoplasty.

Int Tinnitus J. 2020 Nov 18;24(1):1-6

Authors: Aj B, Khm M, Us K, Sh K, No A, Ja D, Az S, Se A

Abstract
The main aim of our study was to study morphological state of the autograft from the fascia of the temporal muscle in myringoplasty. Until now, there is no consensus on issue of which fabrics are more suitable for use in the eardrum. We decided to study of use of an autograft from the fascia of the temporal muscle for myringoplasty in rabbits in the experiment, and in patients with chronic dry mesotympanitis. An electron microscopic examination of the fascia taken immediately, after 10, 20 min and 1 h after sampling. It was found that there are no gross destructive changes in the fascia structure. Minor changes are detected in the form of a light disorganization of the collagen complex, granular dystrophy with an increase in cell. Inflammatory diseases of the middle ear are widespread among population of all age groups. In the experiment, a positive result was obtained in 29 (82.8%) rabbits. In our research we performed morphological features of xenograft engraftment in an ex perimental animal on 3, 7, 14, 21 days and 1-3 months. In period from 3 days to 3 months after operation, the animals were euthanized by an air embolism and subjected to pathological examination. Then recovered xenograft, was examined macro and microscopically. Pieces were fixed in a 10% solution of neutral formalin. After washing with water, dehydration was carried out in alcohol and chloroform, and after, waxed with paraffin. Histological sections were stained with hematoxylin-eosin. Collagen fibers were detected by method of Vann-Gieson.

PMID: 33206488 [PubMed - in process]

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Influence of Cochlear Implantation on Balance Function in Pediatrics.

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Influence of Cochlear Implantation on Balance Function in Pediatrics.

Int Tinnitus J. 2020 Nov 18;24(1):xxx-xx

Authors: Bayat A, Farhadi M, Emamdjomeh H, Nadimi Z, Mirmomeni G, Saki N

Abstract
BACKGROUND AND OBJECTIVE: Patients with profound Sensorineural Hearing Loss (SNHL) are susceptible to vestibular disturbances following Cochlear Implant (CI) surgery. This study aimed to evaluate vestibular dysfunctions following unilateral CI in the congenitally deaf children.
METHODS: This was a cross-sectional study conducted on 24 children (mean age: 10.56 ± 5.49 years old) who underwent unilateral CI and 24 age-matched controls (mean age: 11.13 ± 6.21 years old). Vestibular functions were assessed by Vestibular Evoked Myogenic Potential (VEMP) and Computerized Dynamic Posturography (CDP). The VEMP test was performed for otolith's function (especially saccule) evaluation. Sensory Organization Test (SOT) protocol of CDP was also utilized to differentiate the role of various sensory systems contributing to postural stability. In addition, total equilibrium score was calculated. The variables were comparatively assessed between the two groups.
RESULTS: The mean p13-n23 amplitude in the CI users was significantly lower than the controls (p<0.05). However, the two groups showed no significant difference in cVEMP latency values (p>0.05). The SOT analysis revealed that 45.83% (11/24) of the CI subjects had some kind of sensory abnormalities: 7 cases (29.17%) vestibular, 2 cases (8.33%) visual, 2 cases (8.33%) vestibular and somatosensory involvements. Furthermore, total equilibrium score was significantly reduced in implanted group than the controls (p<0.001). At least, 70.59% (12/24) CI patients showed abnormal values in the CDP or cVEMP examinations.
CONCLUSION: This study shows functional vestibular impairments in children who underwent CI. These patients showed significantly increased postural instability which was more evident in dynamic conditions. These findings provide the basis for better pre-operative counseling and postoperative vestibular rehabilitation to CI recipients.

PMID: 33206489 [PubMed - in process]

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