Clinical Biomarkers in Otolaryngology-Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Message: The number of biomarkers in use in otolaryngology is rapidly expanding representing a new diagnostic modality for our field. This review defines the key biomarkers that are currently or likely to be soon translated into clinical use within the field of otolaryngology. The majority of these biomarkers are in the form of proteins such as beta-2 transferrin, thyroglobulin, and P16. Given their growing impact on diagnosis, management and surveillance of otolaryngologic disorders periodic surveys are needed for education and to guide further advances and applications of otolaryngologic biomarkers. What is a beta 2 transferrin test? Beta-2-transferrin is a form of the protein transferrin that is present in cerebrolspinal fluid (CSF), but not usually found in blood, nasal secretions or other body fluids. It is used to distinguish CSF from other watery discharge from the nose or ear after a traumatic injury to the brain and or spine. What does a high thyroglobulin mean? Your thyroglobulin levels are high and/or have increased over time. This may mean thyroid cancer cells are growing, and/or cancer is starting to spread. Little or no thyroglobulin was found. This may mean that your cancer treatment has worked to remove all thyroid cells from your body. What is p16 positive mean? Abstract. Expression of p16INK4A (p16 positive) is highly correlated with human papilloma virus (HPV) infection in head and neck squamous cell carcinoma (HNSCC), however, p16-positivity is not limited to HPV positive tumors and therefore, not a perfect surrogate for HPV. Clinical Biomarkers in Otolaryngology-Head and Neck Surgery Via ear nose throat Ear Nose Throat J. 2021 Oct 25:1455613211050698. doi: 10.1177/01455613211050698. Online ahead of print. ABSTRACT OBJECTIVE: The purpose of this paper is to review the literature and compile promising and clinically relevant biomarkers in otolaryngology-head & neck surgery not related to autoimmune disorders. STUDY DESIGN: Narrative review. METHODS: PubMed and Google Scholar were queried using combined key words such as "biomarkers" and "otolaryngology." Addit ional queries were made with combined key words such as "biomarkers" and a particular subspecialty such as "rhinology" or "otology" to maximize yield of relevant titles. Subsequently, specific biomarkers identified, such as "beta-2 transferrin," were used as key words. Relevant titles were reviewed and selected for abstract review. Applicable abstracts were then selected for review of the full text. RESULTS: Biomarkers currently in clinical use within the field of otolaryngology were included in this review. The compiled biomarkers were then detailed individually regarding their molecular characteristics, function, and clinical significance. CONCLUSIONS: The number of biomarkers in use in otolaryngology is rapidly expanding representing a new diagnostic modality for our field. This review defines the key biomarkers that are currently or likely to be soon translated into clinical use within the field of otolaryngology. The majority of these biomarkers are in the form of p roteins such as beta-2 transferrin, thyroglobulin, and P16. Given their growing impact on diagnosis, management and surveillance of otolaryngologic disorders periodic surveys are needed for education and to guide further advances and applications of otolaryngologic biomarkers. PMID:34694171 | DOI:10.1177/01455613211050698 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer

xlomafota13 shared this article with you from Inoreader Real-World Efficacy and Safety of Multi-Tyrosine Kinase Inhibitors in Radioiodine Refractory Thyroid Cancer Via liebertpub1 Thyroid, Volume 31, Issue 10, Page 1531-1541, October 2021. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Human papilloma virus in the etiopathogenesis of allergic nasal polyposis: A prospective study

xlomafota13 shared this article with you from Inoreader Human papilloma virus in the etiopathogenesis of allergic nasal polyposis: A prospective study Via American Journal of Otolaryngology Publication date: January–February 2022 Source: American Journal of Otolaryngology, Volume 43, Issue 1 Author(s): Avinash Shekhar Jaiswal, Pranay Tanwar, David Victor Kumar Irugu, Kapil Sikka, Rabia Monga, Alok Thakar, Hitesh Verma View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Access and Polarization Electrode Impedance Changes in Electric-Acoustic Stimulation Cochlear Implant Users with Delayed Loss of Acoustic Hearing

xlomafota13 shared this article with you from Inoreader Access and Polarization Electrode Impedance Changes in Electric-Acoustic Stimulation Cochlear Implant Users with Delayed Loss of Acoustic Hearing Via Journal of the Association for Research in Otolaryngology Abstract Acoustic hearing can be preserved after cochlear implant (CI) surgery, allowing for combined electric-acoustic stimulation (EAS) and superior speech understanding compared to electric-only hearing. Among patients who initially retain useful acoustic hearing, 30–40 % experience a delayed hearing loss that occurs 3 or more months after CI activation. Increases in electrode impedances have been associated with delayed loss of residual acoustic hearing, suggesting a possible role of intracochlear inflammation/fibrosis as reported by Scheperle et al. (Hear Res 350:45–57, 2017) and Shaul et al. (Otol Neurotol 40(5):e518–e526, 2019). These studies measured only total impedance. Total impedance consists of a composite of access resistance, which reflects resistance of the intracochlear environment, and polarization impedance, which reflects resistive and capacitive properties of the electrode–electrolyte interface as described by Dymond (IEEE Trans Biomed Eng 23(4):274–280, 1976) and Tykocinski et al. (Otol Neurotol 26(5):948–956, 2005). To explore the role of access and polarization impedance components in loss of residual acoustic hearing, these measures were collected from Nucleus EAS CI users with stable acoustic hearing and subsequent precipitous loss of hearing. For the hearing loss group, total impedance and access resistance increased over time while polarization impedance remained stable. For the stable hearing group, total impedance and access resistance were stable while polarization impedance declined. Increased access resistance rather than polarization impedance appears to drive the increase in total impedances seen with loss of hearing. Moreover, access resistance has been correlated with intracochlear fibrosis/inflammation in animal studies as observed by Xu et al. (Hear Res 105(1–2):1–29, 1997) and Tykocinski et al. (Hear Res&n bsp;159(1–2):53–68, 2001). These findings thus support intracochlear inflammation as one contributor to loss of acoustic hearing in our EAS CI population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Use of an Autoinflation Device Does Not Lead to a Clinically Meaningful Change in Hearing Thresholds in Children With Otitis Media With Effusion

xlomafota13 shared this article with you from Inoreader Use of an Autoinflation Device Does Not Lead to a Clinically Meaningful Change in Hearing Thresholds in Children With Otitis Media With Effusion Via Clinical Otolaryngology Abstract Objectives The objective of this study was to establish whether autoinflation was an effective intervention in a paediatric audiology service. The aims were to evaluate whether there was improvement in hearing thresholds following introduction of an autoinflation device, and whether there was a reduction in further audiology follow-ups, and in referrals to an ear, nose and throat specialist for consideration of ventilation tube insertion. Design This was a pragmatic retrospective study with historical controls using a paired availability design at a single paediatric audiology service in England. Participants All children seen in the clinic over a two-year period who were aged between 3 and 11 years and who had a type B tympanogram in at least one ear were included. The Otovent autoinflation device was available as a treatment option over the second year (Cohort B) but not the first (Cohort A). There were 976 children included in the study: Cohort A comprised 513 children, Cohort B comprised 463 children. Results There was a statistically significant improvement in hearing thresholds in Cohort B compared to Cohort A, however the improvements were clinically minimal with small effect sizes. There was no significant difference in improvement of tympanometry results between the two cohorts. Significantly more children in Cohort B (autoinflation group) were referred to an ear, nose and throat specialist after their second appointment compared to Cohort A. Conclusions It was feasible to introduce autoinflation into the care pathway, however there was no evidence of clinically meaningful improved outcomes for patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Adenoidectomy Training System

xlomafota13 shared this article with you from Inoreader A Novel Adenoidectomy Training System Via The Laryngoscope Objectives/Hypothesis Young residents find mirror-guided adenoidectomy difficult. Inexperienced trainees must learn to focus a headlight beam, work upside-down and backward in a small space and thoroughly ablate adenoid tissue—all new skills. We present an adenoidectomy training system that is low-cost, easy to construct, and is focused on these basic adenoidectomy skills. Study Design Prospective experimental study. Methods This training suite includes three stations each targeting a different skill. The first employs a mannequin head with exposed nasopharynx. It trains the student to coordinate a headlight and mirror while touching a series of targets with a curved probe. At the second station participants electrodessicate (or microdebride) an anchored piece of veal thymus. The third station combines both sets of skills as participants ablate thymus in a simulated nasopharynx (30 mm rectangular aluminum tube) constrained within a Crow-Davis retractor, using a headlight, mirror, and suction electrosurgical electrode (or microdebrider). To evaluate the training system's efficacy, we assessed the performance of 10 surgically naïve medical student volunteers before and after 15 minutes of practice using a validated rating scale used for adenoidectomy. Results There was significant improvement in adenoidectomy skill scores after practicing. Overall scores were higher, time taken to touch a series of targets with a headlight and mirror was less and amount of tissue ablated at the final station was greater (P < .05). Conclusion This novel adenoidectomy training system is inexpensive and easy to build. Practice with the model resulted in statistically significant improvement in adenoidectomy skill scores for inexperienced student surgeons. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lateral border and scapular tip free flaps: Old school versus new school

xlomafota13 shared this article with you from Inoreader Lateral border and scapular tip free flaps: Old school versus new school Via Head & Neck Abstract Free tissue transfer from the subscapular system provides a wide array of options for both soft tissue and bony reconstruction. When bone stock is required for head and neck reconstruction, both the lateral scapular border free flap (LSBFF), supplied by the circumflex scapular artery, and the scapular tip free flap (STFF), supplied by the angular artery, are excellent options. Issues with positioning had previously prevented the widespread use of these bony subscapular system flaps. However, through the use of a Spider Limb Positioner, current clinical practice patterns allow for two team approaches in both of these free flaps. The following pictorial essay compares and contrasts the specific positioning and harvesting technique used for both the LSBFF and STFF, while discussing the clinical advantages and drawbacks of each. Both the lateral border scapula and scapular tip free flaps provide excellent bone stock for head and neck reconstruction. By positioning with currently avail able technology, both of these free flaps can be harvested through a two team approach. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.