Τρίτη 24 Αυγούστου 2021

Voice Outcomes Following Colon Interposition

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Ear Nose Throat J. 2021 Aug 24:1455613211041786. doi: 10.1177/01455613211041786. Online ahead of print.

ABSTRACT

SIGNIFICANCE STATEMENT: This case highlights the consequences of colon interposition on phonation and swallowing. Findings in this patient included laryngopharyngeal reflux, vocal fold paralysis, poor esophageal peristalsis, failed bolus transfers, and others. The mechanical and functional differences between the colon and the esophagus can impact bolus transfer, reflux, and phonation. Further research is required to identify the mechanisms by which colon interposition can impact voice and swallowing.

PMID:34427138 | DOI:10.1177/01455613211041786

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Clinical Approaches to External Auditory Canal Hemangiomas: A Systematic Review

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Ear Nose Throat J. 2021 Aug 24:1455613211042449. doi: 10.1177/01455613211042449. Online ahead of print.

ABSTRACT

OBJECTIVES: Hemangioma is a common soft tissue tumor that can be categorized mainly into cavernous, capillary, and venous subtypes. It usually develops in the head and neck and rarely in the external auditory canal (EAC).

METHODS: A systematic review of patients with capillary hemangioma of the EAC was performed. A computerized systematic search was conducte d in PubMed, Scopus, and Web of Science to extract relevant studies for a qualitative review.

RESULTS: A total of 38 patients were included in the systematic review, and half of them were men. Hearing loss was the most common presenting feature (n = 19; 50%), followed by aural fullness (n = 15; 39.4%). Cavernous hemangioma was the predominant type (n = 22, 57.8%). Endaural and transcanal surgical approaches were the most frequent, with 10 (26.3%) and 9 (23.6%) cases, respectively. Most of the patients (n = 31, 81.5%) had no recurrence.

CONCLUSIONS: Hemangioma of the EAC may not be uncommon, as health care professionals may expect. Hearing loss, aural fullness, and tinnitus are possible symptoms, but many patients remain asymptomatic. Surgical excision is the main effective management option, and complete resolution is the most prevalent outcome. Computed tomography assists in the diagnosis, but histopathological examination after resection is mandatory for the definitive diagnosis.

PMID:34427123 | DOI:10.1177/01455613211042449

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CT Findings of Firework Injuries to the Head and Neck

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Ear Nose Throat J. 2021 Aug 24:1455613211036242. doi: 10.1177/01455613211036242. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study is to review the CT imaging findings of injuries in the head and neck caused by fireworks through a case series.

METHODS: The imaging database from the University of Chicago Medicine was searched with "fireworks," "firecrackers," and "mortar" as keywords and CT as the imaging modality. Cases without acute CT findings or initial CT scans were excluded.

RESULTS: Eighteen cases with acute CT findings of head and neck firework injuries were identified and included. The associated injuries included skull fractures (5, 28%), ocular injuries (7, 39%), soft tissue trauma (18, 100%), retained foreign bodies (8, 44%), and intracranial trauma (2, 11%).

CONCLUSIONS: Fireworks can cause injuries of varying severity in the head and neck, including blunt and penetrating trauma, that warrant CT evaluation.

PMID:34427141 | DOI:10.1177/01455613211036242

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Dural Bleeding After Endoscopic Sinus Surgery

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Ear Nose Throat J. 2021 Aug 24:1455613211039038. doi: 10.1177/01455613211039038. Online ahead of print.

ABSTRACT

We present a case of an 80-year-old female patient who had an extensive dural bleed after endoscopic sinus surgery. A review of the literature regarding the surgical tools and materials used to treat dural hemorrhage was performed. We describe our preferred method of using the combination of endoscopic bipolar, DuraGen Plus, and DuraMatrix to stop significant dura l bleeding and show effective hemostatic regulation.

PMID:34427140 | DOI:10.1177/01455613211039038

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Multidisciplinary Simulation Training for Surgical Tracheostomy in Patients Mechanically Ventilated Secondary to Severe Acute Respiratory Syndrome Coronavirus 2

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Ear Nose Throat J. 2021 Aug 24:1455613211042119. doi: 10.1177/01455613211042119. Online ahead of print.

ABSTRACT

OBJECTIVE: A proportion of patients with coronavirus disease (COVID) and severe respiratory manifestations of disease will require admission to intensive care for intubation and ventilation. When anticipating prolonged ventilation, the patient may proceed to surgical tracheostomy to afford safe respiratory wean. As surgical tracheostomy is an aerosol-generating pr ocedure, it poses a high risk of viral transmission and ultimately may prompt anxiety and caution in participating staff members. We aimed to mitigate these risks by providing staff with appropriate training and experience, to improve their confidence as well as practical ability.

METHODS: We developed a multidisciplinary simulation training experience and checklist in order to optimize team performance during the high-stakes procedure. We evaluated staff confidence before and after the training with questionnaires.

RESULTS: Post-simulation, surgeons were more confident with donning the high level personal protective equipment, and nurses were more confident in performing their role.

CONCLUSIONS: Simulation allows the multidisciplinary team an opportunity to practice high-risk procedures and prompts the team to assess staff knowledge base, troubleshoot queries, and teach roles and responsibilities in a safe environment. In the context of COVID-19, simulation encour ages staff sense of preparedness and protection for true participation during a high-risk procedure.

PMID:34427150 | DOI:10.1177/01455613211042119

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Intravascular Guidewire Residue After Endovascular Embolization for Intractable Epistaxis: A Case Report

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Ear Nose Throat J. 2021 Aug 24:1455613211040581. doi: 10.1177/01455613211040581. Online ahead of print.

ABSTRACT

Endovascular embolization (EE) has become an effective method for the treatment of intractable epistaxis (IE). However, complications such as facial pain, headaches, aphasia, hemiplegia, and transient blindness can also occur during or after surgery. In this article, we report a rare case of IE with residual intravascular guidewire after EE. Open surgery was used t o remove the guidewire. However, to avoid serious complications such as massive hemorrhage, only part of the guidewire was removed.

PMID:34427152 | DOI:10.1177/01455613211040581

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Clinical Trial to Reconfirm the Efficacy and Safety of Cefetamet Pivoxil Treatment in Sinusitis Patients: A Double-Blind, Randomized, Parallel Designed, Multicenter, Active Comparator Study (CASIS Study)

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Ear Nose Throat J. 2021 Aug 24:1455613211036236. doi: 10.1177/01455613211036236. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and safety of cefetamet pivoxil for the treatment of acute bacterial rhinosinusitis in Korean patients compared to treatment with cefdinir.

METHODS: A prospective, multicenter, randomized double-blind, comparative study was conducted by the Departments of Otorhinolaryngology-Head and Neck Surgery at 17 hospitals o r universities in the Republic of Korea from March 2017 to April 2019. A total of 309 patients were screened and 249 patients participated in the study.

RESULTS: Treatment with cefetamet pivoxil for 2 weeks showed 82.4% clinical cure and improvement rates in patients with acute bacterial rhinosinusitis compared to 84.68% in those taking cefdinir for 2 weeks, showing that cefetamet pivoxil administered twice a day for 2 weeks was as effective as cefdinir 3 times a day for 2 weeks for the treatment of acute bacterial rhinosinusitis. The overall adverse reaction rates of both drugs were 10.56% in the cefetamet pivoxil group and 15.49% in the cefdinir group, without serious adverse events or drug reactions.

CONCLUSIONS: Cefetamet pivoxil twice a day was as efficacious and safe as cefdinir 3 times a day for the treatment of acute bacterial rhinosinusitis, which suggested that cefetamet pivoxil may be a suitable alternative to cefdinir.

PMID:34427151 | DOI:10.1177/01455613211036236

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Subjective Voice Outcomes in Surgeon Versus Technician-Monitored Recurrent Laryngeal Nerves in Thyroidectomy

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Ear Nose Throat J. 2021 Aug 24:1455613211037635. doi: 10.1177/01455613211037635. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare subjective voice outcomes and postoperative laryngoscopic examination findings of patients with subjective voice complaints between surgeon-monitored and certified technician-monitored thyroidectomies.

METHODS: Patients who underwent hemithyroidectomy, total thyroidectomy, and completion thyroidectomy using a nerve monitoring system be tween November 2015 and June 2018 were included in the study. Retrospective chart review was carried out to assess how often patients reported voice changes and to record postoperative flexible laryngoscopic findings of patients when that examination was performed. Data were analyzed using the χ2 test to identify significant differences in outcomes for the 2 groups.

RESULTS: A total of 293 procedures was performed among 3 surgeons. Surgeons monitored the nerves in 147 cases and a certified technician monitored the nerves in 146 cases. Subjective voice changes were identified in 11 (7.48%) cases in the surgeon-monitored group and in 20 (13.70%) cases in the technician-monitored group (P = .084). Among the patients who expressed subjective voice changes, 7 patients were identified with vocal cord hypomobility or immobility in the surgeon-monitored group and 13 patients had an abnormal examination in the technician-monitored group (P = .234).

CONCL USIONS: Subjective voice changes or proven vocal cord mobility problems were not different between surgeon-monitored patients and technician-monitored patients in thyroidectomies.

PMID:34427116 | DOI:10.1177/01455613211037635

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Effects of Gynostemma pentaphyllum on spinal cord motor neurons and microglial cells in vitro

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Via histochem

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Acta Histochem. 2021 Aug 20;123(6):151759. doi: 10.1016/j.acthis.2021.151759. Online ahead of print.

ABSTRACT

The regenerative capability of spinal cord neurons is limited to impossible. Thus, experimental approaches supporting reconstruction/regeneration are in process. This study focused on the evaluation of the protective potency of an extract from Gynostemma pentaphyllum (GP), a plant used in traditional medicine with anti-oxidative and neuroprotective activities, in vit ro on organotypic spinal cord cultures, the motor-neuron-like NSC-34 cell line and the microglial cell line BV-2. Organotypic cultures were mechanically stressed by the slicing procedure and the effect of GP on motor neuron survival and neurite sprouting was tested by immunohistochemistry. NSC-34 cells were neuronal differentiated by using special medium. Afterwards, cell survival (propidium iodide/fluorescein diacetate labeling), proliferation (BrdU-incorporation), and neurite sprouting were evaluated. BV-2 cells were stimulated with LPS/interferon γ and subjected to migration assay and nanoparticle uptake. Cell survival, proliferation and the expression pattern of different microglial activation markers (cFOS, iNOS) as well as transcription factors (PPARγ, YB1) were analyzed. In organotypic cultures, high-dose GP supported survival of motor neurons and especially of the neuronal fiber network. Despite reduced neurodegeneration, however, there was a GP-mediated activation of astr o- and microglia. In NSC-34 cells, high-dosed GP had degenerative and anti-proliferative effects, but only in normal medium. Moreover, GP supported the neuro-differentiation ability. In BV-2 cells, high-dosed GP was toxic. In lower dosages, GP affected cell survival and proliferation when combined with LPS/interferon γ. Nanoparticle uptake, migration ability, and the transcription factor PPARγ, however, GP affected directly. The data suggest positive effects of GP on injured spinal motor neurons. Moreover, GP activated microglial cells. The dual role of microglia (protective/detrimental) in neurodegenerative processes required further experiments to enhance the knowledge about GP effects. Therefore, a possible clinical use of GP in spinal cord injuries is still a long way off.

PMID:34425524 | DOI:10.1016/j.acthis.2021.151759

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Reliability and Correlations Between Overall Severity, Roughness and Breathiness in the Perception of Dysphonic Voices: Investigating Cognitive Aspects

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this study concerns the subjective perception of the quality of the voice, more particularly in the case of dysphonia. Our general objective is to study the perceptual mechanisms, which constitute Hirano's GRBAS multidimensional perceptual rating scale.
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92. Jahresversammlung der DGHNO-KHT 2021 erstmals im Online-Format – eine kritische Bewertung auf Basis der Teilnehmerevaluation

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Laryngorhinootologie
DOI: 10.1055/a-1579-8096

Die 92. Jahresversammlung der DGHNO-KHC wurde im Mai 2021 erstmals aufgrund der Corona-bedingten neuen Rahmenbedingungen komplett in einem Online-Format durchgeführt. Den Teilnehmern aus den Reihen der Mitglieder, Gäste und Industriepartner wurde im Anschluss ein Evaluationsfragebogen der zuständigen Landesärztekammer Nordrhein zugesandt, der inhaltlich um Fragen zu dem neuen virtuellen Format ergänzt wurde. Die Publikation fasst die Auswertung der 187 ärztlichen Rückläufer (10 % der Gesamtteilnehmerzahl) und der 25 Industrieaussteller (60 % der Industrieaussteller) zusammen und stellt ein erstes Fazit auf. In der groben Betrachtung wurde der Kongress von den ärzt lichen und wissenschaftlichen Teilnehmern trotz komplett fehlender sozialer und sehr eingeschränkter fachlicher Interaktion überwiegend positiv bewertet. Auf Seiten der Industrie bot sich ein gegenteiliges Bild. Auf die Frage an die ärztlich/wissenschaftlichen Teilnehmenden nach dem zukünftigen Format der nächsten HNO-Jahreskongresse sprachen sich 16 % für einen reinen Online-Kongress, 67 % für einen Präsenzkongress mit Online-Elementen und lediglich 17 % für einen reinen Präsenzkongress aus. Auf die Frage an die Industrie, welche Art der Ausstellung in Zukunft bevorzugt würde, sprachen sich 68 % für die reine Präsenzausstellung im Rahmen eines Präsenzkongresses aus. 32 % konnten sich für Präsenz mit Online-Elementen erwärmen. Eine zukünftig komplette Online-Industrieausstellung wurde mit 0 % Zustimmung abgewählt.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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