Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection

xlomafota13 shared this article with you from Inoreader Endoscopic and fluoroscopic-guided closure of the eustachian tube using a biliary cytology brush and liquid embolic agent for a persistent CSF leak after schwannoma resection Via leak of cerebrospinal fluid BMJ Case Rep. 2021 Aug 10;14(8):e241861. doi: 10.1136/bcr-2021-241861. ABSTRACT Vestibular schwannoma is a known cause of progressive sensorineural hearing loss. Treatment options include observation, radiation therapy and surgical resection. Cerebrospinal fluid (CSF) fistula is a known postsurgical complication that can lead to CSF otorrhoea, rhinorrhoea or CSF leakage from the surgical wound. We present a case report of a patient who underwent vestibular schwannoma resection and postoperatively developed CSF rhinorrhoea, which was refractory to multiple attempts at surgical repair. This was successfully treated under endoscopic and fluoroscopic guidance using a biliary cytology brush to disrupt the surface of the eustachian tube followed by injection of n-Butyl cyanoacrylate. PMID:34376411 | DOI:10.1136/bcr-2021-241861 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent Hurthle cell thyroid carcinoma does not preclude long-term survival: a case report and review of the literature

xlomafota13 shared this article with you from Inoreader Recurrent Hurthle cell thyroid carcinoma does not preclude long-term survival: a case report and review of the literature Via radioactive iodine J Med Case Rep. 2021 Aug 11;15(1):399. doi: 10.1186/s13256-021-02987-z. ABSTRACT BACKGROUND: Follicular thyroid carcinoma is the second most common malignancy of the thyroid gland. In 2016, the so-called Hurthle cell thyroid carcinoma, formerly known as the oxyphilic variant of the follicular thyroid carcinoma, was reclassified by the World Health Organization as a separate pathological entity, which accounts for approximately 3% of all thyroid cancers. Although Hurthle cell thyroi d carcinomas are known for their more aggressive tumor biology, metastases are observed in a minority of cases, and long-term survival can be expected. However, disseminated disease is often associated with poor outcome. CASE PRESENTATION: In the presented case, a 63-year-old Caucasian female was incidentally diagnosed with Hurthle cell thyroid carcinoma after undergoing hemithyroidectomy for a nodular goiter. Following completion thyroidectomy, two courses of radioactive iodine therapy were administered. After 4 years of uneventful follow-up, the patient gradually developed metastases in five different organs, with the majority representing unusual sites, such as heart, kidney, and pancreas over a course of 14 years. The lesions were either treated with radioactive iodine therapy or removed surgically, depending on iodine avidity. CONCLUSION: Follicular and Hurthle cell thyroid carcinoma are known to potentially spread hematogenously to typical sites, such as lung or bo nes, however; unusual metastatic sites as presented in our case can also be observed. A search of the literature revealed only scattered reports on patients with multiple metastases in unusual locations. Furthermore, the observed long-term survival of our patient is contradictory to the existing data. As demonstrated, recurrent disease may appear years after the initial diagnosis, emphasizing the importance of consistent aftercare. Radioactive iodine therapy, extracorporeal radiation therapy, and surgical metastasectomy are central therapeutic components. In summary, our case exemplifies that thorough aftercare and aggressive treatment enables long-term survival even in recurrent Hurthle cell thyroid carcinoma displaying unusual multisite metastases. PMID:34376229 | DOI:10.1186/s13256-021-02987-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiology perspective on anatomy teaching in Australia and New Zealand

xlomafota13 shared this article with you from Inoreader Radiology perspective on anatomy teaching in Australia and New Zealand Via radiol anat Surg Radiol Anat. 2021 Aug 10. doi: 10.1007/s00276-021-02811-9. Online ahead of print. ABSTRACT INTRODUCTION: Anatomy pedagogy and radiologists involvement in teaching undergraduate anatomy varies widely. We surveyed radiologists practising in Australia and New Zealand to establish their opinions on their own experience of undergraduate anatomy and their view on the role of radiology in anatomy teaching. We also sought their views on the role of radiologists in anatomy teach ing. METHODS: A short survey was designed on the Survey Monkey platform using the website surveymonkey.com. The survey was distributed to members of the Royal Australian and New Zealand College of Radiologists (RANCZR) as a link attached to a monthly e-newsletter with a short paragraph outlining its aim. RESULTS: Sixty-seven responses were eligible for analysis. 33% (22/67) were dissatisfied with their own anatomy training and 55% (38/67) felt that current graduates had an inadequate level of anatomy. 55% (38/67) indicated that radiology had not been a major part of their own undergraduate anatomy training. 58% (39/67) of respondents felt that non-radiology medical and para-medical professionals were not suitably qualified to teach radiologic anatomy. 75% (42/67) were of the opinion that radiology with 3-D support platforms may replace cadaveric dissection in the future, yet most were not familiar with 3-D platforms in current usage. PMID:34378106 | DOI:10.1007/s00276-021-02811-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity

xlomafota13 shared this article with you from Inoreader Anatomical locations of the motor endplates of sartorius muscle for botulinum toxin injections in treatment of muscle spasticity Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02813-7. Online ahead of print. ABSTRACT PURPOSE: This study aimed to detect the idyllic locations for botulinum neurotoxin injection by analyzing the intramuscular neural distributions of the sartorius muscles. METHODS: An altered Sihler's staining was conducted on sartorius muscles (15 specimens). The nerve entry points and intramuscular arborization areas were measured as a percentage of the total distance from the most prominent point of the anterior superior iliac spine (0%) to the medial femoral epicondyle (100%). RESULTS: Intramuscular neural distribution were densely detected at 20-40% and 60-80% for the sartorius muscles. The result suggests that the treatment of sartorius muscle spasticity requires botulinum neurotoxin injections in particular locations. CONCLUSIONS: These locations, corresponding to the locations of maximum arborization, are suggested as the most suggestive points for botulinum neurotoxin injection. PMID:34378107 | DOI:10.1007/s00276-021-02813-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngopharyngeal symptoms are insufficient to diagnose laryngopharyngeal reflux

xlomafota13 shared this article with you from Inoreader Laryngopharyngeal symptoms are insufficient to diagnose laryngopharyngeal reflux 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 Aug 11. doi: 10.1007/s00405-021-07034-7. Online ahead of print. NO ABSTRACT PMID:34378056 | DOI:10.1007/s00405-021-07034-7 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impressive finding in a case of pharyngeal foreign body sensation

xlomafota13 shared this article with you from Inoreader Impressive finding in a case of pharyngeal foreign body sensation Via hno HNO. 2021 Aug 10. doi: 10.1007/s00106-021-01093-2. Online ahead of print. NO ABSTRACT PMID:34378057 | DOI:10.100 7/s00106-021-01093-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux

xlomafota13 shared this article with you from Inoreader Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication in Patients with Refractory Proven Gastroesophageal Reflux Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Aug 11:34894211037414. doi: 10.1177/00034894211037414. Online ahead of print. ABSTRACT OBJECTIVE: Patients with laryngopharyngeal reflux (LPR) symptoms may not respond to proton pump inhibitors (PPI) if they have an alternative laryngeal diagnosis or high-volume reflux. Transoral incisionless fundoplication (TIF) or TIF with concomitant hiatal hernia repair (cTIF) are effective in decreasing symptoms of gastroesophageal reflux disease (GERD) bu t are not well studied in patients with LPR symptoms. This prospective multicenter study assessed the patient-reported and clinical outcomes after TIF/cTIF in patients with LPR symptoms and proven GERD. METHODS: Patients with refractory LPR symptoms (reflux symptom index [RSI] > 13) and with erosive esophagitis, Barrett's esophagus, and/or pathologic acid reflux by distal esophageal pH testing were evaluated before and after a minimum of 6 months after TIF/cTIF. The primary outcome was normalization of RSI. Secondary outcomes were >50% improvement in GERD-Health-Related Quality of Life (GERD-HRQL), normalization of esophageal acid exposure time, discontinuation of PPI, and patient satisfaction. RESULTS: Forty-nine patients had TIF (n = 26) or cTIF (n = 23) with at least 6 months follow-up. Mean pre- and post TIF/cTIF RSI were 23.6 and 5.9 (mean difference: 17.7, P < .001). Post TIF/cTIF, 90% of patients had improved GERD-HQRL score, 85% normalized RSI, 75 % normalized esophageal acid exposure time, and 80% discontinued PPI. No serious procedure-related adverse events occurred. Patient satisfaction was 4% prior to TIF/cTIF and 73% after TIF/cTIF (P < .001). CONCLUSION: In patients with objective evidence of GERD, TIF, or cTIF are safe and effective in controlling LPR symptoms as measured by normalization of RSI and improvement in patient satisfaction after TIF/cTIF. LEVEL OF EVIDENCE: Level 4. PMID:34378427 | DOI:10.1177/00034894211037414 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CT texture analysis of tonsil cancer: Discrimination from normal palatine tonsils

xlomafota13 shared this article with you from Inoreader CT texture analysis of tonsil cancer: Discrimination from normal palatine tonsils Via Head and neck cancers by Tae-Yoon Kim, Ji Young Lee, Young-Jun Lee, Dong Woo Park, Kyung Tae, Yun Young Choi The purposes of the study were to determine whether there are differences in texture analysis parameters between tonsil cancers and normal tonsils, and to correlate texture analysis with 18F-FDG PET/CT to investigate the relationship between texture analysis and metabolic parameters. Sixty-four patients with squamous cell carcinoma of the palatine tonsil were included. A ROI was drawn, including all slices, to involve the entire tumor. The contralateral normal tonsil was used for comparison with the tumors. Texture analysis parameters, mean, standard deviation (SD), entropy, mean positive pixels, skewness, and kurtosis were obtained using commercially available software. Parameters were compared between the tumor and the normal palatine tonsils. Comparisons were also performed among early tonsil cancer, advanced tonsil cancer, and normal tonsils. An ROC curve analysis was performed to assess discrimination of tumor from normal tonsils. Correlation between texture analysis and 18F-FDG PET/CT was performed. Compared to normal tonsils, the tumors showed a significantly lower mean, higher SD, higher entropy, lower skewness, and higher kurtosis on most filters (p View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Laryngocarcinoma at Different Sites in 16,255 Individuals

xlomafota13 shared this article with you from Inoreader Impact of Laryngocarcinoma at Different Sites in 16,255 Individuals Via ear nose throat Ear Nose Throat J. 2021 Aug 11:1455613211036771. doi: 10.1177/01455613211036771. Online ahead of print. ABSTRACT BACKGROUND: Laryngocarcinoma (LC) is a common malignant tumor of the head and neck, accounting for 1% to 5% of human tumors. The primary objective of the present study was to evaluate the survival time of patients with LC at different sites. METHODS: Information concerning patients with LC was extracted from the Surveillance, Epidemiology, and End Results (S EER) database between 1975 and 2016. RESULTS: In total, 16 255 patients with LC were selected from the SEER database. Among all patients, 80.2% were male; males also predominated in each tumor site subgroup. Most of the patients were aged between 60 and 69 years, had white ethnicity, were single, and had American Joint Committee on Cancer (AJCC) stage I cancer with T1, N0, and M0. The present study investigated the role of interventions in all LCs at different AJCC stages. Across the whole population, regardless of the intervention used, survival increased in patients at any cancer site. CONCLUSIONS: The study found that male sex, age ≥80 years, black ethnicity, single status, T4, N4, M1, and AJCC stage IV were associated with higher mortality rates at all sites of LC. Aggressive interventions, especially surgery and radiotherapy, may improve survival in patients with LC at different sites and with different AJCC stages. PMID:34379550 | DOI:10.1177/01455613211036771 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery

xlomafota13 shared this article with you from Inoreader True terminal pentafurcation of the external carotid artery and terminal trifurcation of the contralateral one, occipitoauricular trunk, retropharyngeal internal carotid artery Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02812-8. Online ahead of print. ABSTRACT The external carotid artery (ECA) commonly ascends in the retromandibular fossa and bifurcates posteromedial to the neck of the mandible into the maxillary (MA) and superficial temporal (STA) arteries. In its course in the neck, the ECA gives off the superior thyroid, lingual (LA), facial (FA), ascending pharyngeal (APA), occipital (OA) and posterior auricular (PAA) arteries. When the computed tomography angiograms of a 65-year-old male were evaluated, extremely rare anatomical variations of both ECAs were found. The right ECA trifurcated terminally at the neck of the mandible into the MA, STA and middle meningeal artery (MMA). A right occipitoauricular trunk was found coursing posterior to the ECA to further divide in the parotid region into the OA and PAA. The left ECA had a terminal pentafurcation, with the FA/APA/OA/MA/STA pattern, and the PAA branched from the STA. This pentafurcation occurred deep to the angle of the mandible and the medial pterygoid muscle, in front of the internal jugular vein. The MA ascended behind the medial pterygoid muscle, deep to the posterior border of the ramus of the mandible and reached the lateral pterygoid muscle to continue normally. The right internal carotid artery (ICA) had a lower medial curvature intercalated between the third cervical vertebra and the pharynx. To the authors' knowledge, a terminally pentafurcated E CA has not been previously recorded, and a terminal trifurcation with an added MMA has only been observed once. Such drastically modified arterial patterns expose the branches emerging from the pentafurcation and pose a risk during surgical approaches within the parotid region. Additionally, a retropharyngeal curvature of the ICA could be subject to compression during deglutition. PMID:34379154 | DOI:10.1007/s00276-021-02812-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Number of fiber bundles in the fetal anterior talofibular ligament

xlomafota13 shared this article with you from Inoreader Number of fiber bundles in the fetal anterior talofibular ligament Via radiol anat Surg Radiol Anat. 2021 Aug 11. doi: 10.1007/s00276-021-02816-4. Online ahead of print. ABSTRACT PURPOSE: For the anterior talofibular ligament (ATFL), a three-fiber bundle has recently been suggested to be weaker than a single or double fiber bundle in terms of ankle plantarflexion and inversion braking function. However, the studies leading to those results all used elderly specimens. Whether the difference in fiber bundles is a congenital or an acquired morphology is impor tant when considering methods to prevent ATFL damage. The purpose of this study was to classify the number of fiber bundles in the ATFL of fetuses. METHODS: This study was conducted using 30 legs from 15 Japanese fetuses (mean weight, 1764.6 ± 616.9 g; mean crown-rump length, 283.5 ± 38.7 mm; 8 males, 7 females. The ATFL was then classified by the number of fiber bundles: Type I, one fiber bundle; Type II, two fiber bundles; and Type III, three fiber bundles. RESULTS: Ligament type was Type I in 5 legs (16.7%), Type II in 21 legs (70%), and Type III in 4 legs (13.3%). CONCLUSION: The present results suggest that the three fiber bundles of the structure of the ATFL may be an innate structure. PMID:34379153 | DOI:10.1007/s00276-021-02816-4 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.