Diagnosis of upper airways collapse in moderate-to-severe OSAHS patients: a comparison between drug-induced sleep endoscopy and the awake examination

xlomafota13 shared this article with you from Inoreader Diagnosis of upper airways collapse in moderate-to-severe OSAHS patients: a comparison between drug-induced sleep endoscopy and the awake examination 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 Nov 28. doi: 10.1007/s00405-021-07184-8. Online ahead of print. ABSTRACT PURPOSE: Compare awake evaluation (modified Mallampati score-MMs, Müller maneuver-MM) to drug-induced sleep endoscopy (DISE) findings according to NOHL (nose-oropharynx-hypopharynx-larynx) classification in moderate-to-severe OSAHS patients. METHODS: 43 moderate-to-severe OSAHS patients referred to our ENT department were enrolled over a 2-year period. In this observational prospective study, each patient was evaluated by the same ENT team both in wakefulness and during pharmacologically induced sleep. Level and severity of the obstruction were described. RESULTS: The comparison of degree of collapsibility was statistically significative only at hypopharyngeal level: 41.8% of the patients showed a hypopharyngeal obstruction in wakefulness whereas 88.3% in DISE (p = 0.000). Laryngeal level was found in 18.6% patients dur ing awake examination, conversely DISE demonstrated laryngeal obstruction in 4.6%. DISE identified significantly higher incidence of multilevel collapses (p = 0.001). However, the incidence of oropharyngeal obstruction in patients classified as MMs I and II was significantly higher in DISE compared to MM (p = 0.021). CONCLUSION: DISE is the best predictor of hypopharyngeal obstruction, whereas MM underestimates the severity of the collapse at this level. DISE is more reliable than MM to identify the obstruction in patients with MMs score I and II. PMID:34839405 | DOI:10.1007/s00405-021-07184-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A retrospective analysis of rates of allergic reaction to Patent V blue dye used in sentinel lymph node biopsies for melanoma

xlomafota13 shared this article with you from Inoreader A retrospective analysis of rates of allergic reaction to Patent V blue dye used in sentinel lymph node biopsies for melanoma Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 14:S1748-6815(21)00570-2. doi: 10.1016/j.bjps.2021.11.023. Online ahead of print. ABSTRACT Sentinel lymph node biopsies are a well-established component of the assessment and treatment pathway for patients with cutaneous melanoma in the UK. Commonly utilised techniques involve the use of blue dye which has an established risk of inducing allergic reactions in patients. Such reactions can be life-threatening, and this risk is important to highlight to patients. We conducted a retrospective review of all patients who had undergone this procedure at our melanoma centre in Cambridge, UK. From a group of 715 patients who received blue dye as part of the procedure, six patients suffered an allergic reaction (0.84%) with one of these treated as anaphylaxis. Our incidence of anaphylaxis is almost ten times greater than that reported in the NAP6 report led by the National Institute of Academic Anaesthesia and significantly higher than reported by others. We propose several reasons why our results differ from previous estimates. This study has focused only on patients undergoing a sentinel node procedure for melanoma, others have focused on such procedures performed on patients with breast cancer and some have combined the two. The administration technique, volume and anatomical distribution of disease all differ significantly from melanoma, possibly influencing rates and severity of allergic reactions. PMID:34840115 | DOI:10.1016/j.bjps.2021.11.023 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Cepstral Peak Prominence (CPP) Voice Analysis in Post-lingual Deaf Adult Cochlear Implant Users

xlomafota13 shared this article with you from Inoreader A Cepstral Peak Prominence (CPP) Voice Analysis in Iranian Post-lingual Deaf Adult Cochlear Implant Users Via Journal of Voice In standardized connected speech samples, cepstral peak prominence (CPP) and smoothed CPP (CPPS) have been described as accurate parameters to evaluate voice quality. Lack of normal auditory feedback in post-lingually deaf CI users might influence tuning the acoustic parameters in speech production. Based on shreds of evidence, normal hearing results in suitable vocal control through the sensory-motor linkage. The main aim of the present study was to compare the cepstral values between the Iranian cochlear implant group and normal peers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of airway ultrasonography and laryngoscopy findings in adults with subglottic stenosis: a pilot study

xlomafota13 shared this article with you from Inoreader Correlation of airway ultrasonography and laryngoscopy findings in adults with subglottic stenosis: a pilot study 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 Nov 29. doi: 10.1007/s00405-021-07195-5. Online ahead of print. ABSTRACT PURPOSE: Ultrasonography of the airway has potential as an alternative, non-invasive, method to monitor patients with subglottic stenosis in an outpatient setting. This prospective, interventional, double-blinded study aimed to correlate ultrasound-based and laryngoscopy-based subglottic stenosis assessment in adults. METHODS: The study was conducted between July 2020 and March 2021 at a tertiary referral center. Consecutive adult patients with subglottic stenosis were evaluated using airway ultrasonography 1 day prior to scheduled laryngoscopy. The radiologist was blinded to the preoperative endoscopic findings, and the primary surgeon was blinded to the ultrasonographic measurements. The intraoperative subglottic diameter was defined as the outer diameter of an endotracheal tube passing through the subglottis without produci ng an air leak. RESULTS: Sixteen patients (11 females; age range, 17-66 years; mean = 44.06, SD = 12.79) were included. The ultrasonographic subglottic diameter ranged from 5.20 mm to 8.00 mm (mean = 6.24 mm, SD = 0.90). In 15 of 16 patients, the diameter difference between the ultrasonographic and intraoperative measurements ranged from -0.80 mm to 0.30 mm (mean = -0.20 mm, SD = 0.35). However, patient 6 had a difference of - 2.10 mm between the two measurements, which was attributed to thick laryngotracheal secretions interfering with the ultrasonographic air shadow. Data analysis of all 16 patients showed a statistically significant correlation between the readings obtained by the two techniques (r = 0.84, P = 0.000051). CONCLUSION: This study found a significant correlation between ultrasonography-based and laryngoscopy-based subglottic stenosis assessment in adult patients. It provides a basis for an alternative and potentially reliable method to monitor patients wi th subglottic stenosis. PMID:34842971 | DOI:10.1007/s00405-021-07195-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.