Δευτέρα 26 Ιουλίου 2021

Automated alternate cover test for 'HINTS' assessment: a validation study

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Eur Arch Otorhinolaryngol. 2021 Jul 23. doi: 10.1007/s00405-021-06998-w. Online ahead of print.

ABSTRACT

OBJECTIVE: The alternate cover test (ACT) in patients with acute vestibular syndrome is part of the 'HINTS' battery test. Although quantitative, the ACT is highly dependent on the examiner's experience and could theoretically vary greatly between examiners. In this study, we sought to validate an automated video-oculography (VOG) system based on eye tracking and dedicated glasses.

METHODS: We artificially induced a vertical strabismus to simulate a skew deviation on ten healthy subjects, aged from 26 to 66, using different press-on Fresnel prisms on one eye while recording eye position with VOG of the contralateral eye. We then compared the system's performance to that of a blinded trained orthoptist using conventional, semi-quantitative method of skew measurement known as the alternate prism cover test (APCT) as a gold standa rd.

RESULTS: We found a significant correlation between the reference APCT and the Skew VOG (Pearson's R2 = 0.606, p < 0.05). There was a good agreement between the two tests (intraclass correlation coefficient 0.852, 95 CI 0.728-0.917, p < 0.001). The overall accuracy of the VOG was estimated at 80.53% with an error rate of 19.46%. There was no significant difference in VOG skew estimations compared with the gold standard except for very small skews.

CONCLUSIONS: VOG offers an objective and quantitative skew measurement and proved to be accurate in measuring vertical eye misalignment compared to the ACT with prisms. Precision was moderate, which mandates a sufficient number of tests per subject.

PMID:34302212 | DOI:10.1007/s00405-021-06998-w

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A comprehensive study of right and left inferior phrenic artery variations in 1000 patients with multidetector computed tomography angiography: an important study for HCC

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Surg Radiol Anat. 2021 Jul 23. doi: 10.1007/s00276-021-02805-7. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the anatomic variations in the origins of the right and left inferior phrenic arteries (IPAs) using multidetector computed tomography and to classify their combined variations.

METHODS: This retrospective study included patients undergoing abdominal aorta angiography between January 2015 and October 2019. The RIPA and LIPA origins were evaluated both separately and combined on three-dimensional images. The variant patterns of the IPAs were determined and classified. The numerical evaluation of the data was performed with SPSS 21.

RESULTS: In total, 1000 patients (478 women, 522 men) were evaluated. The IPAs originated from a common trunk or a common root in 360 (36.00%) patients, while the IPAs originated independently without a common trunk in 609 (60.90%) patients. The most common combined variant detected in the present study was IPAs originating as a common trunk from the coeliac trunk in 197 (19.70%) patients; 14 (1.40%) patients had no inferior phrenic artery (IPA), and 17 (1.70%) patients had only one IPA.

CONCLUSION: Fifty-two different types of variations in the combined origin of the inferior phrenic arteries were described in this study for the first time in the literature. Awareness of the anatomic variations in the IPAs, which is critical for hepatocellular carcinoma origins, may benefit various clinical procedures, such as transcatheter arterial chemoembolization, organ transplantations, laparoscopic surgical procedures, and radiological procedures.

PMID:34302198 | DOI:10.1007/s00276-021-02805-7

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Suicide Incidence and Risk Among Patients With Head and Neck Cancer in Rural vs Urban Areas

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This cross-sectional study uses data from the Surveillance, Ep idemiology, and End Results database to evaluate whether the risk of suicide among patients with head and neck cancer differs by rural vs urban or metropolitan residence status.
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Oncocytic Salivary Gland Tumours: Cytological Features and Diagnostic Pitfalls

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Abstract

Oncocytes are epithelial cells having abundant eosinophilic cytoplasm. The presence of oncocytes in salivary glands pose a diagnostic challenge since they can be present in lesions ranging from non-neoplastic, benign to malignant. FNAC is a simple procedure which can aid in the pre-operative diagnosis of these lesions. This study is an eight year retrospective study in which salivary gland aspiration cytology cases having oncocytic cells and with available corresponding histopathology were included. These slides were reviewed for features like cellularity, presence of oncocytic cells, glandular elements, squamoid cells, nuclear atypia, mitosis, lymphoid tissue, necrosis. Twenty cases were included in the study. The mean age of presentation was 60 years showing male preponderance with parotid gland being the most common site of involvement. Concordant diagnosis on cytology and histopathology was seen in 1 6 cases and discordance was seen in 4 cases. All the discordant cases were reported as benign on cytology but on histopathology they were labelled as acinic cell carcinoma, squamous cell carcinoma, mucoepidermoid carcinoma and an intraparotid lymph node respectively. Review of discordant cases showed subtle findings like ill-formed acini, cytoplasmic vacuolation, goblet cells and dysplastic foci raising suspicion of a different diagnosis. The potential areas of pitfall and cause of discrepancy have been discussed in this study. It is crucial to be aware of the spectrum of lesions in which oncocytes are seen, to enable an accurate diagnosis on cytology. Careful evaluation of smears for subtle clues can minimize errors.

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The Usefulness of Multi Voice Evaluation for Measuring Voice Recovery After Endolaryngeal Phonomicrosurgery in Patients with Vocal Fold Polyps

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The purpose of this study was to the usefulness of a five-variable model predicting perceived voice severity and incorporating acoustic analysis based on cepstral analysis and self-reported questionnaires, for measuring voice recovery after endolaryngeal phonomicrosurgery in patients with vocal fold polyps.
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Perceptions of Vocal Performance Impairment in Singers with and without Hearing Loss

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It is well understood that hearing plays an important role in accurate vocal production. Singers in particular rely on auditory cues and auditory feedback to reproduce specific pitch contours. Therefore, even mild hearing loss may have a detrimental effect on a singer's ability to perform. This study investigates the effect of hearing loss on self-reported vocal production in singers, specifically in the domains of pitch matching, pitch maintenance, vowel production, and dynamic control as well as the effect of hearing loss on vocal handicap.
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A Predictor of Difficult Airway: The Tasli Classification in Transnasal Flexible Laryngoscopy

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Difficult airway is defined as difficulty or failure in one or more steps in upper airway management. Evaluation of the upper airway with physical examination methods and endoscopic devices is crucial in predicting difficult airway. The aim of this study was to evaluate bedside tests, Cormack Lehane (CL) and Tasli Classification (TC) scores of the patients and it was aimed to reveal the role of TC which will be performed preoperatively as a predictor of difficult tracheal intubation (DTI).
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Asymmetry of inferior turbinate in patients with nasal septum deviation and its significance for nasal ventilation surgery

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Eur Arch Otorhinolaryngol. 2021 Jul 24. doi: 10.1007/s00405-021-07012-z. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the asymmetry of the inferior turbinate (IT) in patients with nasal septum deviation (NSD).

METHODS: The paranasal sinus computed tomography (CT) of 100 patients with NSD were retrospectively investigated from February 2018 to December 2019. The thickness of IT, IT mucosa and IT bone, the distance between the IT and the midline were measured on both the concave and convex sides, and which correlation with NSD was analyzed.

RESULTS: The widths of the IT, IT bone and IT medial mucosa on the concave side were larger than those on the convex side (all P < 0.05). The distance from the IT and IT bone to the midline on the concave side was smaller than those on the convex side (P < 0.05, respectively). The degree of NSD had a negative correlation with the widths of the IT and IT bone on the convex side, and the distance between the IT and the midline on the concave side; and a positive correlation with the distance from IT and IT bone to the midline on the convex side, and IT mucosa thickness on the concave side (all P < 0.05).

CONCLUSION: The asymmetric IT width is mainly caused by both hypertrophies of the IT mucosa on the concave side and atrophy of the IT bone on the convex side. Therefore, during the surgery of nasal ventilation reconstruction, the IT on the convex side are suggested to be protected from intervention. In contrast, it is necessary to lateralize the IT bone and reduce the IT submucosal tissue on the concave side. However, routine excision of the IT bone is not recommended.

PMID:34302496 | D OI:10.1007/s00405-021-07012-z

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A comparative study of functional outcomes following surgical treatment of early tongue cancer

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Abstract

Background

Speech and swallowing are important outcomes following resection in early tongue cancers.

Aim

This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers.

Methods

Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery.

Results

SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH.

Conclusion

Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity.

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A comparative study of functional outcomes following surgical treatment of early tongue cancer

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Abstract

Background

Speech and swallowing are important outcomes following resection in early tongue cancers.

Aim

This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers.

Methods

Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery.

Results

SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH.

Conclusion

Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity.

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Risk of surgical site infection in hand trauma, and the impact of the SARS-CoV-2 pandemic: A cohort study

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J Plast Reconstr Aesthet Surg. 2021 Jul 2:S1748-6815(21)00351-X. doi: 10.1016/j.bjps.2021.06.016. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the ubiquity of hand trauma, there remains insufficient published data to reliably inform these patients of surgical site infection (SSI) risk. We describe the risk of SSI in a single-centre cohort of patients with hand trauma, with an analysis of the impact of the coronavirus disease-2019 (COVID-19) pandemic.

METHODS: Retrospective data collection of consecutive patients who underwent surgery for hand and wrist trauma in a single plastic surgery centre over two, three-month periods. Demographic, injury and operative details, alongside prophylactic antibiotic use, were recorded. Burn injuries and wounds infected at presentation were excluded. Presence of SSI at 30 days (90 days if a surgical implant was used) was assessed.

RESULTS: Overall, 556 patients - 'Pre-COVID-19' (n = 3 10) and 'During COVID-19' (n = 246) - were included. Risk of SSI was 3.6% in the aggregated cohort. Female patients were more likely to develop an SSI, even when adjusted for their greater prevalence of bite aetiologies (adj OR 2.5; 95% CI, 1.00-6.37 and p < 0.05). The absolute risk of SSI in the 'Pre-COVID-19' group was 2.3% and 5.3% in the 'During COVID-19' group. The relative risk of developing an SSI in the 'During COVID-19' group was 2.34 (95% CI, 0.95-5.78 and p = 0.06). Baseline characteristics were equivalent between the two groups.

CONCLUSION: The risk of SSI in hand trauma is the same as the nationally estimated risk for all surgeries; 3-5%. Changes in presentation and practice associated with the first wave of the COVID-19 pandemic did not appear to alter the risk of SSI in patients undergoing surgery for hand trauma.

PMID:34303636 | DOI:10.1016/j.bjps.2021.06.016

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Associations among Audiometric, Doppler Hydroacoustic, and Subjective Outcomes of Venous Pulsatile Tinnitus

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Objective: Venous pulsatile tinnitus (PT) has received increasing attention recently. As analyses of psychophysical and neuropsychological dimensions of venous PT are lacking, this study aimed to quantitatively and qualitatively investigate the correlation among audiometric, hydroacoustic, and subjective outcomes in patients with PT. Methods: Fifty-five venous PT patients, with or without sigmoid sinus wall anomalies (SSWAs), were subdivided into SSWAs (n = 30) and non-SSWAs (n = 25) groups. Audiometric and hemodynamic evaluations were assessed. Questionnaires including the Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale (HADS), and Athens Insomnia Scale (AIS) were deployed to evaluate the psychological impacts of PT. Results: Among 55 subjects, PT frequency-related pure-tone audiometry (PTA) was significantly different between ipsilesional non-PT frequency-related PTA (p #x3c; 0.01), ipsilateral jugular vein compression PTA (p #x3c; 0.01), and contralesional ear PTA (p #x3c; 0.01). In contrast with the pulsatility index and flow velocity, bilateral EOET and flow volume were significantly different (p #x3c; 0.01). Of the 3 questionnaire types, there was a strong correlation between HADS anxiety and AIS scores (r = 0.658, p #x3c; 0.01). The duration of PT was not correlated with subjective outcomes, and there was no statistical significance foun d among audiometric, hemodynamic, and subjective outcomes between SSWAs and non-SSWAs groups. Conclusions: (1) The duration of PT was irrelevant to the increase of PTA. (2) Venous PT is the perception of vascular flow sound, in which hydroacoustic characteristics can be highly independent. (3) Anxiety, depression, and sleep disorders commonly prevail among PT patients.
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