Πέμπτη 5 Αυγούστου 2021

Microanatomic analyses of extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve

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Braz J Otorhinolaryngol. 2021 Jul 20:S1808-8694(21)00129-4. doi: 10.1016/j.bjorl.2021.06.006. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate microanatomic organizations of the extratemporal facial nerve and its branches, hypoglossal nerve, sural nerve, and great auricular nerve.

METHODS: Nerve samples were dissected in 12 postmortem autopsies, and histomorphometric analyses were conducted.

RESULTS: There was no significant difference between the right and left sides of the nerve samples for the nerve area, fascicle area, number of fascicles and average number of axons. The lowest mean fascicle number was found in the hypoglossal nerve (4.9 ± 1.4) while the highest was in great auricular nerve (11.4 ± 6.8). The highest nerve area (3,182,788 ± 838,430 μm2), fascicle area (1,573,181 ± 457,331 μm2) and axon number (14,772 ± 4402) were in hypoglossal nerve (p < 0.05). The number of axon s per unit nerve area was higher in the facial nerve, truncus temporofacialis, truncus cervicofacialis and hypoglossal nerve, which are motor nerves, compared to the sural nerve and great auricular nerve, which are sensory nerves (p < 0.05). The number of axons per unit fascicle area was also higher in motor nerves than in sensory nerves (p < 0.05).

CONCLUSION: In the present study, it was observed that each nerve contained a different number of fascicles and these fascicles were different both in size and in the number of axons they contained. All these variables could be the reason why the desired outcomes cannot always be achieved in nerve reconstruction.

PMID:34348859 | DOI:10.1016/j.bjorl.2021.06.006

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Validation of a classification and scoring system for the diagnosis of laryngeal and pharyngeal squamous cell carcinomas by confocal laser endomicroscopy

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Braz J Otorhinolaryngol. 2021 Jul 20:S1808-8694(21)00124-5. doi: 10.1016/j.bjorl.2021.06.002. Online ahead of print.

ABSTRACT

INTRODUCTION: Confocal laser endomicroscopy is an optical imaging technique that allows in vivo, real-time, microscope-like images of the upper aerodigestive tract's mucosa. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignant suspected mucosa requires strict evaluation criteria.

OBJECTIVE: This study aims to validate an eight-point score for the correct assessment of malignancy.

METHODS: We performed confocal laser endomicroscopy between March and October 2020 in 13 patients. 197 sequences (11.820 images) originated from the marginal area of pharyngeal and laryngeal carcinomas. Specimens were taken at corresponding locations and analyzed in H&E staining as a standard of reference. A total of six examiners evaluated the sequences bas ed on a scoring system; they were blinded to the histopathological examination. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are interrater reliability and receiver operator characteristics.

RESULTS: Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. Confocal laser endomicroscopy of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 83.2%, 81.3%, 85.5%, 86.7%, and 79.7%, respectively, with a κ-value of 0.64, and an area under the curve of 0.86.

CONCLUSION: The results confirm that this scoring system is applicable in the laryngeal and pharyngeal mucosa to classify benign and malignant tissue. A scoring system based on defined and reproducible characteristics can help translate this experimental method to broad clinical practice in head and neck diagnosis.

PMID:34348858 | DOI:10.1016/j.bjorl.2021.06.002

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Olfactory neuroepithelium in the middle turbinate: is there any impact on olfaction function after lateral marsupialization for concha bullosa surgery?

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Braz J Otorhinolaryngol. 2021 Jul 20:S1808-8694(21)00128-2. doi: 10.1016/j.bjorl.2021.06.005. Online ahead of print.

ABSTRACT

INTRODUCTION: The effect of the quantity of olfactory neuroepithelium in the middle turbinate on the postoperative olfactory function for middle turbinate concha bullosa patients has not yet been evaluated.

OBJECTIVE: The primary aim of this study was to investigate the olfactory structures in the middle turbinate by immunohistochemical analysis of the olfactory marker protein and to correlate the immunostaining results with the olfaction test results for patients with middle turbinate concha bullosa.

METHODS: Surgical materials of 18 middle turbinate concha bullosa patients who had undergone lateral marsupialization surgery were immunostained with olfactory marker protein antibodies. Smell diskettes olfaction test was applied to all of the study group patients both preoperatively and three months po stoperatively. A visual analog scale was used to quantify the sense of nasal obstruction.

RESULTS: It was observed that the postoperative smell scores and the nasal obstruction visual analog scale values were significantly improved as compared to the preoperative values (p < 0.05). In addition, there was a significant correlation between the smell score gain and the visual analog scale gain values (r = 0.682). Results also indicated no significant correlation between the olfactory marker protein staining scores and the smell scores (p > 0.05).

CONCLUSION: This first paper demonstrated that the quantity of the olfactory mucosa in the middle turbinate was not a determining factor for the postoperative smell function degree for middle turbinate concha bullosa patients. The underlying cause of the olfactory deficit for middle turbinate concha bullosa patients seems to be obstruction related rather than the middle turbinate's olfactory mucosa containing status.

PM ID:34348856 | DOI:10.1016/j.bjorl.2021.06.005

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Small interfering RNA-induced inhibition of epithelial Cell transforming sequence 2 suppresses the proliferation, migration and invasion of osteosarcoma cells

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Exp Ther Med. 2021 Sep;22(3):976. doi: 10.3892/etm.2021.10408. Epub 2021 Jul 9.

ABSTRACT

[This retracts the article DOI: 10.3892/etm.2015.2306.].

PMID:34349847 | PMC:PMC8290433 | DOI:10.3892/etm.2021.10408

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MicroRNA-212 suppresses the proliferation and migration of osteosarcoma cells by targeting forkhead box protein A1

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Exp Ther Med. 2021 Sep;22(3):977. doi: 10.3892/etm.2021.10409. Epub 2021 Jul 9.

ABSTRACT

[This retracts the article DOI: 10.3892/etm.2016.3880.].

PMID:34349848 | PMC:PMC8290419 | DOI:10.3892/etm.2021.10409

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MicroRNA-101 has a suppressive role in osteosarcoma cells through the targeting of c-FOS

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Exp Ther Med. 2021 Sep;22(3):978. doi: 10.3892/etm.2021.10410. Epub 2021 Jul 9.

ABSTRACT

[This retracts the article DOI: 10.3892/etm.2016.3085.].

PMID:34349849 | PMC:PMC8290395 | DOI:10.3892/etm.2021.10410

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Observations and Considerations for Implementing Remote Acoustic Voice Recording and Analysis in Clinical Practice

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Remote voice recording and acoustic analysis allow for comprehensive voice assessment and outcome tracking without the requirements of travel to the clinic, in-person visit, or expensive equipment. This paper delineates the process and considerations for implementing remote voice recording and acoustic analysis in a high-volume university voice clinic.
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Non-invasive Fungal Sinusitis as a Complication of a Steroid-Eluting Stent Following Endoscopic Sinus Surgery: A Case Report

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Ann Otol Rhinol Laryngol. 2021 Aug 5:34894211036844. doi: 10.1177/00034894211036844. Online ahead of print.

ABSTRACT

OBJECTIVE: Steroid eluting stents have proven to be a highly useful adjunctive therapy for chronic rhinosinusitis (CRS) and play an important role in the treatment of many inflammatory diseases of the sinuses. Few reports of adverse events were reported in clinical trials and are described in the literature. However, we describe the first known case of an immun ocompetent patient developing non-invasive fungal tissue infection as a sequelae of stent-related tissue necrosis requiring surgical debridement.

METHODS: A 69-year-old immunocompetent male with CRS had Propel™ stents placed in the bilateral frontal sinus outflow tracts during revision endoscopic sinus surgery. He presented 2 weeks post-operatively with severe facial pain without vision changes, fevers, mental status changes, or evidence of cranial neuropathies. On rigid nasal endoscopy, necrotic tissue and gross fungal elements were visualized in the left frontal sinus outflow tract at the area of previous steroid stent position.

RESULTS: The patient was taken for urgent endoscopic sinus surgery and debridement given significant symptoms and concern for invasive fungal infection. A revision left maxillectomy, ethmoidectomy, and draf 2b frontal sinus drillout were performed, with healthy bleeding tissue encountered beneath necrotic tissue. Pathology revealed tissue nec rosis, exudative lumenal debris, and extensive fungal elements with no evidence of tissue invasion, and cultures yielded growth of aspergillus niger. The patient's symptoms improved significantly on post-operative day 1, he had normal post-operative changes at 2 weeks following debridement, and had no recurrence of fungal infection with complete healing at 4 months.

CONCLUSION: While likely rare, steroid-eluting stents may pose a risk of saprophytic tissue infection as a result of tissue necrosis and local immunosuppression. Caution should be taken in using these devices in immunocompromised patients.

PMID:34350789 | DOI:10.1177/00034894211036844

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Cross-cultural adaptation and validation of the 22-item sinonasal outcome test (SNOT-22) in German-speaking patients: a prospective, multicenter cohort study

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Eur Arch Otorhinolaryngol. 2021 Aug 5. doi: 10.1007/s00405-021-07019-6. Online ahead of print.

ABSTRACT

PURPOSE: Chronic rhinosinusitis (CRS) is a common condition associated with a significant reduction of the health-related quality of life. One of the most widely used assessment tools in CRS is the disease-specific, health-related questionnaire SNOT-22. The aim of this study was to translate and validate the SNOT-22 into the German language.

METHODS: The questionnaire was translated using the forward-backward translation technique. After the translation its reliability, validity, and sensitivity were evaluated. For this purpose, the questionnaire was completed by patients diagnosed with CRS before, 3 months and 1 year after endoscopic sinus surgery and by healthy individuals as controls at three university hospitals in Germany. The individual scores of the questionnaire before surgery was correlated with the Lund-Mackay score a s well as a global disease-specific question.

RESULTS: A total of 139 CRS patients and 31 healthy individuals participated in the study. Internal consistency at all timepoints was very good, with Cronbach's alpha scores of 0.897, 0.941, and 0.945. The questionnaire was able to discriminate between CRS patients and control subjects (p < 0.0001) and scores improved significantly 3 month and 1 year after sinus surgery (p < 0.0001), indicating a good test-retest reliability, validity, and responsiveness. A significant correlation to the single global disease-specific question could be found (p < 0.0001), but no correlation with the Lund-Mackay score.

CONCLUSION: The German Version of the SNOT-22 is a reliable, valid, and sensitive instrument for measuring health-related quality of life in patients with CRS. It can be recommended for clinical practice and outcome research for German-speaking patients.

PMID:34351466 | DOI:10.1007/s00405-021-07019-6

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Carcinosarcomas of the larynx: systematic review of the literature of a rare nosologic entity

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Eur Arch Otorhinolaryngol. 2021 Aug 5. doi: 10.1007/s00405-021-07027-6. Online ahead of print.

ABSTRACT

PURPOSE: Carcinosarcoma, also known as Spindle Cell Carcinoma (SpCC), is a rare type of malignant tumor. Generally, this type of pathology occurs in the urogenital tract, the gastrointestinal tract, respiratory tract and mammary gland; in the larynx, SpCC represents only 2-3% of all malignancies. Due to its rarity, there is currently no generally acceptable treatment guideline for this disease. The aim of this study was to systematically review the literature of SpCC of larynx and report epidemiologic, clinicopathologic and main therapeutic approaches for this entity.

METHODS: A systematic literature review was performed using MEDLINE, EMBASE, PubMed and Scopus databases. For this review, the results were extrapolated in the period between January 1990 to September 2020. Data extraction was performed using a standard registry d atabase. The clinical and pathological staging were recalculated according to the Eight Edition of AJCC Cancer Staging Manual and statistical analyses were performed using SPSS Version 25.0.

RESULTS: A total of 111 patients affected by laryngeal carcinosarcoma were included. From our review arises that surgery is the main treatment for primary laryngeal carcinosarcoma. In this way, various techniques such as minimally invasive laryngoscopy excision, laser CO2 cordectomy, partial laryngectomy (vertical and horizontal) and total laryngectomy. The role of radiotherapy is still controversial. The overall survival (OS) for T1 stage tumor at 5 years of follow-up is 82.9%, the OS for T2 and T3 tumor is 74% and 73.4%. The OS at 5 years of follow-up is 91.7% for supraglottic tumor, 69.3% for glottic tumor and 50% for transglottic site. Subglottic site is described in only 2 cases [12-13], so the OS at 5 years is not statistically significant. The 5-year overall survival in patients wit hout lymph nodes involvement (N0) is 90.2%, 66.7% and 50%, respectively, for N1 and N2 lesions.

CONCLUSION: Primary laryngeal carcinosarcoma is a very rare malignancy. There are no clear guidelines in the management but in the literature, surgery is described as the best modality of therapy; radiation only can be a reasonable alternative with controversial efficacy. The most important prognostic factor is the nodal metastasis.

PMID:34351467 | DOI:10.1007/s00405-021-07027-6

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Pancreatic metastasis from papillary thyroid carcinoma: Case report and literature review

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Hell J Nucl Med. 2021 Aug 6:s002449912354. doi: 10.1967/s002449912354. Online ahead of print.

ABSTRACT

Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Papillary thyroid carcinoma generally spreads locally to the cervical lymph nodes, but distant metastases are seen in 5%-7% of cases. Most distant metastases occur in the bone, lung, and brain. Pancreatic metastases of PTC are extremely rare. Herein we present a patient with PTC treated with total thy roidectomy and two rounds of radioactive iodine (RAI) ablation that was subsequently found to have a pancreaticmetastasis detected on fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) imaging 3 years from the initial diagnosis.

PMID:34352049 | DOI:10.1967/s002449912354

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