Τετάρτη 2 Ιουνίου 2021

Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion

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Ann Otol Rhinol Laryngol. 2021 Jun 2:34894211015582. doi: 10.1177/00034894211015582. Online ahead of print.

ABSTRACT

OBJECTIVE: We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF).

METHODS: About 56 patients who underwent ACDF between May 2017 to February 2 019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks-3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records.

RESULTS: Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 (P = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively.

CON CLUSION: Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.

PMID:34075815 | DOI:10.1177/00034894211015582

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Social Representation of ‘Vocal Hygiene’ in India and Bhutan: A Cross-Sectional Survey

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The study aimed to explore the professional and recreational and/or personal voice use patterns and social representation of 'vocal hygiene' in two culturally and geographically diverse societies: India and Bhutan.
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The Controversy of Pepsinogen A/Pepsin A in Detecting Extra-Gastroesophageal Reflux

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Pepsinogen A (PGA)/pepsin A is often used as a diagnostic marker of extra-gastroesophageal reflux. We aimed to explore whether its positivity in upper aerodigestive tract (UADT) was specific enough to diagnose reflux.
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Loudness and Pitch of Emotional Stage Speech in Kunqu Opera

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Equivalent sound level (Leq), sound pressure level (SPL) and fundamental frequency (F0) were analyzed in the stage speech of six Kunqu Opera roles, Young woman, Old woman, Young man, Old man, Colorful face and Clown. The roles differ in gender, age, personality and phonation types. Differences among emotions (neutral, sad, angry and happy), singers and roles were examined. For most roles, more similarities were observed between neutral and sad stage speech and between angry and happy stage speeches.
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Is Immobile vocal fold Related to the Spinal Accessory Nerve Agenesis?: A Case Report

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The spinal accessory nerve innervates the sternocleidomastoid and trapezius muscles, but the internal branch from the spinal accessory nerve is also contributing to the motor innervation of the larynx. For the first time, we report a case of an impairment of sternocleidomastoid, trapezius, and thyroarytenoid muscles from the same side. In our case, the anatomical variant that can explain this situation implies the cranial roots and some fibers from the spinal roots of the spinal accessory nerve to form the internal branch.
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Standardization of terminology, imaging features, and interpretation of CBCT sialography of major salivary glands: a clinical review

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Quintessence Int. 2021 Jun 2;0(0):0. doi: 10.3290/j.qi.b1492217. Online ahead of print.

ABSTRACT

Sialography combined with cone beam computerized tomography (sialo-CBCT) is an imaging technique that demonstrates the ductal system of the major salivary glands and allows evaluation of gland function. This review describes the sialo-CBCT technique, terminology, common pitfalls and limitations, as well as radiographic features and suggested pathogenicity of various salivary gland disor ders, based on 1,758 sialo-CBCT examinations conducted over the last decade in one institution, and the current literature. The adoption of standardized terminology is proposed to prevent miscommunication, facilitate formulation of differential diagnoses, and thereby promote patient management: (1) Sialo-CBCT requires specific training, and operator experience is required for adequate glandular filling with minimal extravasation; (2) Limit injection-to-scan time to avoid premature emptying; (3) The sialo-CBCT report should include a description of the morphology of the primary duct as well as the secondary, tertiary, and descending branches, the maximal branching level, the presence of sialectasis, overall glandular size, and parenchymal findings; (4) Functional evaluation is based on assessment of iodine clearance in the post evacuation image; (5) Sialectasis and ductopenia are the main findings in Sjogren syndrome and recurrent juvenile parotitis; (6) Sialodochitis with or with out fillings defects or hyperdense calcifications characterize obstructive sialadenitis and sialolithiasis; (7) The findings following radioactive-iodine-induced damage are similar to obstructive sialadenitis, with atrophy in late stages; (8) In chronic graft-versus-host disease (cGVHD), variable presentations of ductopenia, sialectasis, and sialodochitis may be evident; (9) The red flags indicating a space-occupying lesion include areas of no filling, splaying of ducts, and primary duct deviation.

PMID:34076380 | DOI:10.3290/j.qi.b1492217

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Beurteilung von im Internet verfügbaren deutschsprachigen Patienteninformationen zum Hörsturz

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Laryngorhinootologie
DOI: 10.1055/a-1472-6130

Hintergrund Durch die Digitalisierung hat sich das Internet zu einem wesentlichen Informationsmedium für Patienten entwickelt. Patienten mit Hörsturz haben aufgrund unsicherer wissenschaftlicher Erkenntnisse einen besonders großen Informationsbedarf. In der vorliegenden Arbeit wurden daher die Ergebnisse einer Internetsuche zum Thema Hörsturz untersucht. Material und Methoden Die ersten 30 Treffer einer Google-Suche mit dem Begriff „Hörsturz" wurden kategorisiert, eine Lesbarkeitsstatistik anhand verschiedener Formeln (Flesch-Reading-Ease-Score; 0=schwer, 100=leicht lesbar) berechnet und falsche Informationen dokumentiert. Eine strukturierte inhaltliche Bewertung erfolgte mit dem DISCERN-Fragebogen (1=niedrige, 5=hohe Qualität) getrennt durch 2 verblindete Untersucher. Die Einhaltung empfohlener Standards wurde anhand einer Health-On-The-Net-Zertifizierung erfasst. Ergebnisse 18 Internetseiten (60,0%) waren Informationsportale, 7 (23,3%) von Medizinprodukteunternehmen (davon 3 Hörgerätehersteller), 2 (6,7%) von öffentlichen Einrichtungen und je 1 (3,3%) von einem Ärzteverband und einer Selbsthilfeorganisation sowie ein wissenschaftlicher Artikel. Im Mittel lag die Wortanzahl bei 1307,0±840,2 Wörtern, die letzte Aktualisierung war vor 17,1±32,5 Monaten und der Flesch-Reading-Ease-Score lag bei 36,1±13,9. Am schwierigsten lesbar war der wissenschaftliche Artikel (13,7). Insgesamt lag der DISCERN bei 2,2±0,7 mit schlechtester Bewertung von Medizinprodukteunternehmen (1,6±0,5). Zwei Internetseiten (6,7%) hatten ein Health-On-The-Net-Zertifikat, 14 (46,7%) zeigten falsche Informationen. Schlussfolgerung Patienteninformation im Internet sind aufgrund geringer Lesbarkeit, potenzieller Interessenkonflikte, niedriger Qualität oder falscher Informationen kritisch zu bewerten. Eine mögliche Konsequenz wäre eine Bereitstellung verlässlicher Gesundheitsinformationen im Internet durch medizinische Leistungserbringer und Fachgesellschaften.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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