The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis

xlomafota13 shared this article with you from Inoreader The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211018576. doi: 10.1177/01455613211018576. Online ahead of print. ABSTRACT OBJECTIVE: Preliminary data have demonstrated long-term efficacy of posterior nasal nerve (PNN) cryoablation in reducing rhinitis symptoms for patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). We sought to evaluate the impact of procedural cryoablation of the PNN on quality of life (QOL) in patients with AR and NAR. METHODS: Adult patients undergoing PNN cryoablation for AR or NAR after appropriate medical therapy were included for analysis. Demographics, medical therapies, baseline rhinitis symptom (total nasal symptom score [TNSS]), and disease-specific QOL (mini-rhinoconjunctivitis quality of life questionnaire [mini-RQLQ]) were recorded. The Wilcoxon signed-rank test was used to test for significant changes in baseline test scores posttreatment. Absolute and relative improvement in outcomes was determined for each participant. Secondary outcomes were assessed with univariate and multivariate analyses. RESULTS: Fourteen patients were enrolled with a mean follow-up of 16.5 weeks. The TNSS and mini-RQLQ scores significantly improved after PNN cryoablation (median δs [interquartile range]: -4 [3] and -1.61 [1.08], respectively; both P = .0002). The minimal clinically important difference for the TNSS and mini-RQLQ was obtained in 92.9% of patients in each category. Relative mean percentage (%) improveme nt after PNN cryoablation in the TNSS and mini-RQLQ was 40.7% and 40.5% (standard deviation = 24.9 and 29.5, respectively), respectively, for all patients. Patients with NAR (n = 10) reported mean improvement of 41.3% (29.1) as measured by the TNSS and 49.6% (25.9) by mini-RQLQ. Patients with AR reported mean percentage improvement in TNSS and mini-RQLQ scores of 39.5% (12.1) and 24.6% (28.5), respectively. Patients who had been prescribed a nasal anticholinergic for management prior to PNN cryoablation had statistically significantly increased improvement in mini-RQLQ scores from pre- to post-procedure (P = .0387). CONCLUSION: Surgical cryoablation of the PNN significantly improves both symptoms and disease-specific QOL in majority of patients with AR and NAR. PMID:34128402 | DOI:10.1177/01455613211018576 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211016896. doi: 10.1177/01455613211016896. Online ahead of print. ABSTRACT OBJECTIVE: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. METHODS: Between January 2016 and May 2017, 199 tinnitus patients were identifi ed from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. RESULTS: Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient's subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient's subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. CONCLUSIONS: Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patien ts are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week. PMID:34128408 | DOI:10.1177/01455613211016896 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of retromolar canal and its association with mandibular molars: study in CBCT

xlomafota13 shared this article with you from Inoreader Prevalence of retromolar canal and its association with mandibular molars: study in CBCT Via radiol anat Surg Radiol Anat. 2021 Jun 15. doi: 10.1007/s00276-021-02787-6. Online ahead of print. ABSTRACT OBJECTIVE: Investigate the presence and characteristics of the retromolar canal and association with mandibular molars using cone-beam computed tomography (CBCT). STUDY DESIGN: CBCT images of 200 consecutive patients were analyzed using the Anatomage Invivo 5® software. Retromolar canal present evaluated the type of trajectory, buccal or lingual location, uni or bilateral, origin and final diameters. Pearson's Chi square test was used to verify the association between the retromolar canal and the presence of the third molar (p ≤ 0.05). RESULTS: The prevalence of the retromolar canal was 24.5%. The oblique trajectory was the most common (33.3% on the right side and 50% on the left side). Buccal location was the most frequent (right side 50% and left side 70%). The unilateral canal was the most frequent (77.6%). As for the caliber, the diameters vary from 1.12 to 2.37 mm. Regarding the association between the retromolar canal and the third molar, there was no statistically significant difference (right side p = 0.60 and left side p = 0.90). CONCLUSION: The retromolar canal is not a rare anatomical variation showing a prevalence of 24.5%. Surgical procedures should consider the presence of the retromolar canal to avoid excessive bleeding, considering its significant caliber. PMID:34129064 | DOI:10.1007/s00276-021-02787-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus

xlomafota13 shared this article with you from Inoreader Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus 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 Jun 15. doi: 10.1007/s00405-021-06933-z. Online ahead of print. ABSTRACT PURPOSE: This study was conducted to evaluate outcomes in patients presenting with fungus ball of the maxillary sinus (MSFB) and frontal sinusitis who were treated via middle meatal antrostomy alone. METHODS: This was a randomized, controlled study with a parallel group design. Patients with MSFB and frontal sinusitis were randomly assigned to the maxillary middle meatal antrostomy (MMMA) or control (MMMA + frontal sinusotomy) groups. Patient demographics, complaints, imaging findings were analyzed, and surgical outcomes were evaluated using the Lund-Kennedy endoscopic score (LKES) and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire. RESULTS: In total, 40 patients were separated into two groups, with similar symptoms including nasal obstruction, mucopurulent rhinorrhea, maxillary or frontal pain, blood staine d nasal discharge, nasal cacosmia and orbital pain being observed in both groups. Total LKES and SNOT-22 scores were significantly improved in both groups at 6 months post-treatment, with no significant differences in these scores between groups within a mean 6.8-month follow-up. CONCLUSION: These results suggest that frontal sinusotomy is not required to resolve frontal sinusitis associated with MSFB. As such frontal sinusitis appears to be a reactive process caused by fungal ball obstruction, it regresses spontaneously following fungus ball removal, drainage of the maxillary sinus, and middle meatal antrostomy. PMID:34129085 | DOI:10.1007/s00405-021-06933-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation

xlomafota13 shared this article with you from Inoreader Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation 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 Jun 15. doi: 10.1007/s00405-021-06936-w. Online ahead of print. ABSTRACT PURPOSE: To compare the effectiveness of chirp and tone burst stimuli in oVEMP and cVEMP testing for healthy adults METHODS: This study was conducted in 56 healthy volunteers (112 ears). Ocular and cervical VEMP (oVEMP, cVEMP) tests were performed for each participant using tone burst and chirp stimuli. VEMP response rates, latency of each peak (p1-n1, n1-p1), peak to peak amplitude (p1-n1 amplitude and n1-p1 amplitude), and rectified amplitudes were measured and compared between these two different stimuli. RESULTS: VEMP response rates with chirp stimuli are higher than the tone burst stimuli for both cVEMP and oVEMP tests (The difference was statistically significant for oVEMP, p = 0.001). Chirp stimuli have higher p1n1 amplitude and rectified amplitude and shorter p1and n1 latency then tone burst stimuli for cVEMP (p = 0.01 5, p = 0.007, p < 0.001, p < 0.001, respectively). Chirp stimuli also have higher n1p1 amplitude and shorter n1and p1 latency then tone burst stimuli for oVEMP (p = 0.006, p < 0.001, p < 0.001, respectively). CONCLUSION: The present findings show that the chirp stimulus triggers earlier VEMP responses with higher amplitudes than the tone burst stimulus during cVEMP and oVEMP testing. VEMP response rate with chirp stimulus is also higher than the tone burst. Therefore chirp stimulus can be used in VEMP testing as effectively as, if not more than, tone burst stimulus in clinical practice. PMID:34129084 | DOI:10.1007/s00405-021-06936-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auswirkungen der COVID-19-Pandemie auf Konsultationen & Diagnosen in den HNO-Praxen in Deutschland

xlomafota13 shared this article with you from Inoreader Auswirkungen der COVID-19-Pandemie auf Konsultationen & Diagnosen in den HNO-Praxen in Deutschland Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1510-9686 Hintergrund Während der ersten Monate der COVID-19-Pandemie kam es zu einer deutlichen Reduktion in der Frequentierung der Institutionen im Gesundheitswesen. Dieser Umstand beeinflusste die rechtzeitige Diagnosestellung und subsequente Therapieeinleitung in nahezu sämtlichen Fachgebieten. Ziel der vorliegenden Untersuchung ist die Evaluation eines hypothetisch veränderten Gesundheitsbewusstseins in Bezug auf die ambulante Konsultation von HNO-Ärzten in Deutschland. Material und Methoden Diese Studie nutzte die anonymisierten Daten aus 146 HNO-Praxen in Deutschland und umfasste 162724 Patienten im 2. Quartal 2019, 158077 im 3. Quartal 2019, 128342 im 2. Quartal 2020 und 149153 im 3. Quartal 2020. Das erste Outcome war der Unterschied in der Anzahl der Patienten mit mindestens einem Besuch in diesen Praxen zwischen dem zweiten und dritten Quartal 2019 und dem zweiten und dritten Quartal 2020. Das zweite Outcome war die Anzahl der Patienten mit neuen Diagnosen pro Praxis, definiert als Diagnosen, die zuvor nicht in der Datenbank für einen bestimmten Patienten dokumentiert waren. Ergebnisse Die Anzahl der Patienten pro Praxis war im 2. Quartal 2020 im Vergleich zum 2. Quartal 2019 signifikant geringer (879 versus 1108; p<0,001). Beim Vergleich des 3. Quartals 2020 mit dem 3. Quartal 2019 zeigten sich keine signifikanten Unterschiede (1022 versus 1083; p=0,261). Diagnosen von Otitis media (-43%), akuten Infektionen der oberen Atemwege (-42%), chronischen Erkrankungen der oberen Atemwege (-21%) und Hörsturz (-20%) nahmen im 2. Quartal 2020 verglichen zum 2. Quartal 2019 signifikant ab. Im 3. Quartal 2020 gab es im Vergleich zum 3. Quartal 2019 darüber hinaus einen signifikanten Rückgang der Patientenzahlen für akute Infektionen der oberen Atemwege (-26%) und Otitis media (-25%). Schlussfolgerungen Die vorliegenden Ergebnisse sind, neben einer Vermeidung von Arztkontakten vonseiten der PatientInnen, sowohl auf die reduzierte Terminvergabe durch die HNO-Praxen als auch auf die konsequente Einhaltung und Umsetzung der Abstands- bzw. Hygieneregeln im Sinne der Verwendung von Atemschutzmasken (FFP2/KN95) zurückzuführen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstra ct  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation: A case report

xlomafota13 shared this article with you from Inoreader Anterior cervical surgery to treat diffuse idiopathic skeletal hypertrophic combined with cervical disc herniation: A case report Via Traditional dysphagia therapy Medicine (Baltimore). 2021 Jun 4;100(22):e26097. doi: 10.1097/MD.0000000000026097. ABSTRACT RATIONALE: Diffuse idiopathic skeletal hyperostosis (DISH) is a skeletal disease characterized by calcification of anterolateral ligaments of the spine and the rest of the body. DISH combined with disc herniation induces complex symptoms and is more difficult to treat. Here, we describe a complicated case of a patient diagnosed with DISH as well as cervical disc herniation that was successfully treated using anterior cervical surgery. PATIENTS CONCERN: A 69-year-old Asian male experienced dysphagia and weakness in his left limbs. He also experienced a stiff neck and right slant over a 6-month period. DIAGNOSIS: An X-ray revealed calcification of the C4-7 vertebral front edge and a narrowed intervertebral space between C5/6. Coronal and sagittal computerized tomography (CT) and magnetic resonance imaging (MRI) both showed compression of the spinal cord at the cervical 5/6. Esophagography revealed that osteophytes in the anterior margin of vertebral body (C4-C7) oppressed the esophagus. INTERVENTIONS: An operation focused on anterior cervical C5/6 disc fusion and anterior vertebral C4-7 osteophyte removal was performed. OUTCOMES: After the operation, X-ray and CT showed that most osteophytes were removed and spinal cord compression was relieved. One day following the operation, both dysphagia and numbness in limbs were improved. Strong recovery was observed at the three-month follow-up exam. LESSONS: This complex DISH combined with disc herniation case is rarely observed in patients. Anterior cervical disc fusion and anterior vertebral osteophyte removal were effective treatment measures. This case study provides insight into treating cases presented with cervical spine complications associated with DISH combined with other ailments. PMID:34087855 | PMC:PMC8183831 | DOI:10.1097/MD.0000000000026097 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thresholds, Firing Rates, and Order of Recruitment of Anterior Temporalis Muscle Single-Motor Units During Experimental Masseter Muscle Pain

xlomafota13 shared this article with you from Inoreader Thresholds, Firing Rates, and Order of Recruitment of Anterior Temporalis Muscle Single-Motor Units During Experimental Masseter Muscle Pain Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):93-104. doi: 10.11607/ofph.2719. ABSTRACT AIMS: To test the hypothesis that, in comparison with control, experimental noxious stimulation of the right masseter muscle would result in significant changes in the firing rates, thresholds, and recruitment orders of single-motor units (SMUs) of the nonpainful, synergistic right anterior temporalis muscle during goal-directed isometric biting task performance. METHODS: Twenty he althy volunteers received an infusion of hypertonic saline (HS; 5% sodium chloride) into the right masseter to produce pain intensity of 40 to 60 on a 100-mm visual analog scale (VAS). Isotonic saline (IS) infusion was a control. Standardized biting tasks were performed with an intraoral force transducer, and intramuscular electromyographic activity was recorded from the right anterior temporalis muscle. Tasks (slow and fast ramp biting tasks, two-step biting task) were performed in 3 blocks: baseline, HS infusion, and IS infusion. Across blocks, SMU thresholds and firing rates were statistically compared, and SMU recruitment sequences were qualitatively compared. Statistical significance was set at P < .05. RESULTS: No significant differences (P > .05) were noted between HS and IS infusion blocks in thresholds or firing rates of anterior temporalis SMUs. Individual SMUs showed increases or decreases in thresholds or firing rates or changes in recruitment sequences mostl y during HS compared to IS infusion. CONCLUSION: The reorganization of SMU activity that has been suggested to occur in both painful and nonpainful agonist jaw muscles may involve not only recruitments and de-recruitments of SMUs, but may also extend to more subtle increases and/or decreases in firing rates, thresholds, and recruitment sequences of individual SMUs in the nonpainful synergistic muscles. PMID:34129654 | DOI:10.11607/ofph.2719 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up

xlomafota13 shared this article with you from Inoreader Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):113-118. doi: 10.11607/ofph.2871. ABSTRACT AIMS: To report the effectiveness of temporomandibular joint (TMJ) arthrocentesis with viscosupplementation for degenerative joint disease (DJD) over a long-term (ie, 10-22 years) follow-up. METHODS: A total of 103 patients aged between 30 and 91 years (13 men and 90 women; mean age 63.7 years) who received a cycle of five arthrocentesis sessions with HA viscosupplementation to ma nage their symptoms related to TMJ DJD during the time period from 1998 to 2010 were recalled for clinical evaluation. After the treatment cycle, clinical outcomes were assessed based on the following parameters: maximum mouth opening (MO), pain with function (PF), pain at rest (PR), and self-reported chewing efficiency (CE). Data were collected at baseline (T0) and at successive follow-up assessments, after at least 3 months (T1) and 1 year (T2), as per previous publications. Patients who had received treatment at least 10 years prior were then recalled for this study (T3: 10 to 22 years follow-up). Analysis of variance for repeated measures was performed to assess changes over time. RESULTS: Significant improvement in all clinical parameters was achieved at T1 and was maintained for up to 10 years (T3), with P < .01 for each parameter. At T3, treatment effectiveness was perceived as excellent by 56% and as good by 26.5% of subjects, while 10.7% perceived a moderate improvement, and 6.8% referred a slight improvement or did not have any improvement. Only seven individuals required additional treatments after T2. CONCLUSION: These findings suggest that the symptomatic management of TMJ DJD achieved in the short or medium term with a cycle of arthrocentesis and viscosupplementation was effectively maintained in the long term. PMID:34129656 | DOI:10.11607/ofph.2871 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association Between Primary Headache and Bruxism: An Updated Systematic Review

xlomafota13 shared this article with you from Inoreader Association Between Primary Headache and Bruxism: An Updated Systematic Review Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Spring;35(2):129-138. doi: 10.11607/ofph.2745. ABSTRACT AIMS: To answer the question: among observational studies, is there any association between primary headaches and bruxism in adults? MATERIALS AND METHODS: A systematic review of observational studies was performed. The search was performed in seven main databases and three gray literature databases. Studies in which samples were composed of adult patients were included. Primary h eadaches were required to be diagnosed by the International Classification of Headache Disorders. Any diagnostic method for bruxism was accepted. Risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Tool and the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool. Associations were analyzed by calculating odds ratios (OR) in Review Manager 5.3 software. The evidence certainty was screened by Grading of Recommendations Assessment, Development, and Evaluation criteria. RESULTS: Of the 544 articles reviewed, 5 met the inclusion criteria for qualitative analysis. The included studies evaluated both awake and sleep bruxism, as well as tension-type headaches and migraines as primary headaches. Among two migraine studies, one showed an OR of 1.79 (95% CI: 0.96 to 3.33) and another 1.97 (95% CI: 1.5 to 2.55). On the other hand, among three tension-type headache studies, there was a positive association only with awake bruxism, with an OR of 5.23 (95% CI: 2.57 to 10.65). All included articles had a positive answer for more than 60% of the risk of bias questions. The evidence certainty varied between low and very low. Due to high heterogeneity among the studies, it was impossible to perform a meta-analysis. CONCLUSION: Patients with awake bruxism have from 5 to 17 times more chance of having tension-type headaches. Sleep bruxism did not have any association with tension-type headache, and the association with migraines is controversial. PMID:34129658 | DOI:10.11607/ofph.2745 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.