Taste Dysfunction in Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader A Systematic Review and Meta‐Analysis of Taste Dysfunction in Chronic Rhinosinusitis Via The Laryngoscope Objectives Patients with chronic rhinosinusitis (CRS) often describe alterations in sense of taste. These complaints have historically been attributed to olfactory dysfunction; however, there is evidence of direct, objective, gustatory disturbances in the setting of CRS that are not thoroughly characterized. This study sought to investigate and summarize gustatory dysfunction experienced by patients with CRS. Methods PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were reviewed following PRISMA guidelines. English language, original studies investigating objective taste in adult patients with CRS were included. A meta‐analysis with inverse variance, random‐effects model was performed. Results Of 2750 studies screened, 11 articles with 471 unique patients were included. Patients with CRS exhibit worse gustatory function compared to healthy controls (standardized mean difference 0.94 [95% CI, 0.44–1.45]). Hypogeusia was identified in 32/95 (33.7%) patients from three studies that used methods with a validated definition of hypogeusia. Older age, male gender, and smoking history were associated with taste dysfunction, while objective gustatory and olfactory dysfunction were not correlated. Subjective taste and quality of life measures were also not associated with objective taste. The impact of sinus surgery on objective taste is unclear. Conclusion Approximately 34% of patients with CRS experience hypogeusia. Neither olfactory function nor subjective taste were associated with objective gustatory function. Given the substantial prevalence of taste dysfunction patients with CRS, there is significant potential for growth in understanding of pathogenesis, impact on quality of life, and potential treatment strategies of taste impairment in the CRS patient population. Level of Evidence 1 Laryngoscope, 131:482–489, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Embolization of Internal Carotid Artery Branches in Juvenile Nasopharyngeal Angiofibroma

xlomafota13 shared this article with you from Inoreader Embolization of Internal Carotid Artery Branches in Juvenile Nasopharyngeal Angiofibroma Via The Laryngoscope Objective Preoperative embolization of juvenile nasopharyngeal angiofibroma (JNA) is usually performed by the occlusion of branches of the external carotid artery (ECA). However, a significant proportion of JNAs also receive blood from the internal carotid artery (ICA). The objective of this study was to report on the feasibility and clinical impact of superselective embolization of ICA branches in complex cases of JNA. Methods This was a single‐center retrospective study of all patients operated on for JNA between 2000 and 2018. The patients treated with embolization of branches of the ICA were identified. The results in terms of complications, intraoperative blood loss, and rate of residual disease were analyzed and compared to those of a control group of patients treated only with embolization of ECA branches and matched by age, stage, angiographic pattern, surgical approach, and previous surgery. Results Ninety‐two patients were included. Embolization of branches of the ICA was attempted in 14 cases of advanced or recurrent tumors and was ultimately possible in nine cases. There were no complications after embolization. The mean intraoperative blood loss was 1428 mL. Residual disease was found in three cases (33%). There was no significant difference compared with the control group (mean intraoperative blood loss = 1355 mL, residual disease = 4 (44%); all P > .05). Conclusion In this retrospective study, we report the feasibility of superselective embolization of ICA branches in selected cases of JNA. There was no observed benefit of this technique in terms of intraoperative bleeding or decreased risk of residual disease. Level of Evidence 4 Laryngoscope, 131:E775–E780, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoperative Fluorescence‐Guided Surgery in Head and Neck Squamous Cell Carcinoma

xlomafota13 shared this article with you from Inoreader Intraoperative Fluorescence‐Guided Surgery in Head and Neck Squamous Cell Carcinoma Via The Laryngoscope The rate of positive margins in head and neck cancers has remained stagnant over the past three decades and is consistently associated with poor overall survival. This suggests that significant improvements must be made intraoperatively to ensure negative margins. We discuss the important role of fluorescence imaging to guide surgical oncology in head and neck cancer. This review includes a general overview of the principles of fluorescence, available fluorophores used for fluorescence imaging, and specific clinical applications of fluorescence‐guided surgery, as well as challenges and future directions in head and neck surgical oncology. Laryngoscope, 131:529–534, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Cause of Extremely Loud Expiratory Stridor in a 11‐Year‐Old Patient

xlomafota13 shared this article with you from Inoreader A Rare Cause of Extremely Loud Expiratory Stridor in a 11‐Year‐Old Patient Via The Laryngoscope Stridor can be a very alarming symptom in children, as it is typically caused by turbulent airflow through a partially obstructed airway, due to an organic cause. An abnormal respiratory sound can induce the suspicion of a life‐threatening clinical condition and requires an immediate diagnostic assessment. The aim of this article is to describe a very peculiar case of loud expiratory stridor, with an abrupt onset and no other associated symptoms, occurring in an 11‐year‐old girl. The stridor sounds ceased only during sleep at night. Videolaryngoscopy demonstrated that the anatomy and patency of the larynx were normal, and expiratory noise was generated by vibration of the supraglottic structures. Voice therapy led to remission of stridor within 3 weeks. To the best of our knowledge, this is the first reported case of expiratory stridor with such striking volume and characteristics related to psychological causes. This peculiar clinical condition need s to be taken into consideration in the differential diagnosis of pediatric stridor to avoid unnecessary and invasive procedures and treatments. Laryngoscope, 131:E929–E931, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Iatrogenic Cholesteatoma Presenting as Neck Mass

xlomafota13 shared this article with you from Inoreader Iatrogenic Cholesteatoma Presenting as Neck Mass Via The Laryngoscope We present a rare iatrogenic cholesteatoma of the neck in a ten year old male four years after tympanomastoidectomy, an entity that to our knowledge has not been published in the literature for over 30 years. Furthermore, we discuss the diagnostic uncertainty of typical magnetic resonance imaging protocols for pediatric neck lesions and the improved diagnostic specificity of diffusion weighted magnetic resonance imaging. En bloc surgical extirpation was performed. Laryngoscope, 131:E882–E884, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients

xlomafota13 shared this article with you from Inoreader Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients Via The Laryngoscope Objectives/Hypothesis Antimalarial drugs (chloroquine and hydroxychloroquine) are widely used for the treatment of systemic lupus erythematosus (SLE). However, these drugs may have side effects such as hearing loss. This study aimed to describe the hearing function in SLE patients using antimalarials. Secondarily, this study aimed to investigate whether SLE causes hearing loss and if there are any serological or clinical aspects of this diseases associated with inner ear damage. Study Design Cross‐sectional study. Methods This study included 84 individuals (43 SLE patients and 41 controls) with audiometry and tympanometry tests. Epidemiological, clinical, serological, and treatment profiles of SLE patients were extracted from the charts. Results SLE patients had more sensorineural hearing loss than controls (23.2% vs. 0; P = .001). Pure‐tone averages in SLE patients using antimalarials and not using antimalarials were similar (8.75 vs. 8.75; P = .63). At 8,000 Hz, antimalarial dug nonusers performed worse than users (10.00 vs. 22.50; P = .03). Tympanometry was normal in all participants. SLE serological and clinical profiles in patients with and without hearing loss were the same (all P = nonsignificant). Conclusions There is a high prevalence of hearing loss in SLE that is not affected by antimalarial drug use. Level of Evidence 3b Laryngoscope, 131:E957–E960, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting the Premorbid Shape of a Diseased Mandible

xlomafota13 shared this article with you from Inoreader Predicting the Premorbid Shape of a Diseased Mandible Via The Laryngoscope Objectives/Hypothesis Virtual surgical planning (VSP) for reconstructions of advanced mandibular neoplasms that have distorted the contour of the mandible is challenging, as the premorbid shape of the mandible is unknown. We introduce a novel modeling technique, based on a statistical shape model (SSM), that has learned the shape of a normal mandible from a set of 84 mandibles, such that given a diseased mandible, the model can determine its premorbid shape. Methods Eighty‐four control mandibles were used to generate an SSM. Various mandibular defects were created, and the SSM was applied to predict the shape of the original mandible. The predicted and original shape of the defect were compared for accuracy using volumetric overlap and Hausdorff distance. All mandibular VSP cases in the past 2 years were reviewed to identify those that required virtual preprocessing due to significantly distorted mandibular contours. The SSM was compared to those cases requiring preprocessing and highlighted in one prospective VSP. Results The average volumetric overlap and Hausdorff distance between the defect replacement and the defect are 73.9% ± 13.3% and 4.51 mm ± 2.65 mm, respectively. The SSM is more accurate for smaller defects, and those not including the condyle. Ten out of 40 VSP cases required preprocessing using four different techniques. Qualitatively, the SSM outperformed those preprocessing techniques applied in the retrospective cases. Conclusions The SSM can accurately predict the premorbid shape of a distorted mandible and is superior to current preprocessing techniques. The SSM was successfully applied to a retrospective series and one prospective index case. Level of Evidence 4 Laryngoscope, 131:E781–E786, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.