The use of platelet-rich fibrin as a hemostatic material in oral soft tissues

(Source: Oral and Maxillofacial Surgery)

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The use of platelet-rich fibrin as a hemostatic material in oral soft tissues

(Source: Oral and Maxillofacial Surgery)

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Correction to: Influence of surface treatment on osseointegration of dental implants: histological, histomorphometric and radiological analysis in vivo

Dear Professor Dr. Matthias Hannig. Editor-in-Chief Clinical Oral Investigations. Following the publication of our paper by Calvo Guirado et al, 2015 [1] in Clinical Oral Investigations, it came to light that a certain part of the text at the materials and methods and results sections were similar.

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Correction to: Influence of surface treatment on osseointegration of dental implants: histological, histomorphometric and radiological analysis in vivo

Dear Professor Dr. Matthias Hannig. Editor-in-Chief Clinical Oral Investigations. Following the publication of our paper by Calvo Guirado et al, 2015 [1] in Clinical Oral Investigations, it came to light that a certain part of the text at the materials and methods and results sections were similar.

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Extra corporeal membrane oxygenation in the critical trauma patient

Purpose of review The purpose of this review is to describe recent evidence regarding the use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for severe cardiac or respiratory failure in patients with trauma. The characteristics of this cohort of patients, including the risk of bleeding and the need for systemic anticoagulation, are generally considered as relative contraindications to ECMO treatment. However, recent evidence suggests that the use of ECMO should be taken in consideration even in this group of patients. Recent findings The recent findings suggest that venous–venous ECMO can be feasible in the treatment of refractory respiratory failure and severe acute respiratory distress syndrome trauma-related. The improvement of ECMO techniques including the introduction of centrifugal pumps and heparin-coated circuits are progressively reducing the amount of heparin required; moreover, the application of heparin-free ECMO showed good outcomes and minimal complications. Venous–arterial ECMO has emerged as a salvage intervention in patients with cardiogenic shock and after cardiac arrest. Venous–arterial ECMO provides circulatory support allowing time for other treatments to promote recovery in presence of acute cardiopulmonary failure. Only poor-quality evidence is available, for venous–arterial ECMO in trauma patients. Summary ECMO can be considered as a safe rescue therapy even in trauma patients, including neurological injury, chest trauma as well as burns. However, evidence is still poor; further studies are warranted focusing on trauma patients undergoing ECMO, to better clarify the effect on survival, the type and dose of anticoagulation to use, as well as the utility of dedicated multidisciplinary trauma-ECMO units. Corrispondence to Chiara Robba, Department of Anaesthesia and Intensive Care, San Martino Hospital, Genova, Italy. E-mail: kiarobba@gmail.com Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Extra corporeal membrane oxygenation in the critical trauma patient

Purpose of review The purpose of this review is to describe recent evidence regarding the use of extracorporeal membrane oxygenation (ECMO) as salvage therapy for severe cardiac or respiratory failure in patients with trauma. The characteristics of this cohort of patients, including the risk of bleeding and the need for systemic anticoagulation, are generally considered as relative contraindications to ECMO treatment. However, recent evidence suggests that the use of ECMO should be taken in consideration even in this group of patients. Recent findings The recent findings suggest that venous–venous ECMO can be feasible in the treatment of refractory respiratory failure and severe acute respiratory distress syndrome trauma-related. The improvement of ECMO techniques including the introduction of centrifugal pumps and heparin-coated circuits are progressively reducing the amount of heparin required; moreover, the application of heparin-free ECMO showed good outcomes and minimal complications. Venous–arterial ECMO has emerged as a salvage intervention in patients with cardiogenic shock and after cardiac arrest. Venous–arterial ECMO provides circulatory support allowing time for other treatments to promote recovery in presence of acute cardiopulmonary failure. Only poor-quality evidence is available, for venous–arterial ECMO in trauma patients. Summary ECMO can be considered as a safe rescue therapy even in trauma patients, including neurological injury, chest trauma as well as burns. However, evidence is still poor; further studies are warranted focusing on trauma patients undergoing ECMO, to better clarify the effect on survival, the type and dose of anticoagulation to use, as well as the utility of dedicated multidisciplinary trauma-ECMO units. Corrispondence to Chiara Robba, Department of Anaesthesia and Intensive Care, San Martino Hospital, Genova, Italy. E-mail: kiarobba@gmail.com Copyright © 2019 YEAR Wolters Kluwer Health, Inc. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R6UZJf

Answer controversies about hemostatic properties of platelet-rich fibrin

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How smelling fish while it's cooking can cause an allergic reaction

An 11-year-old boy recently died after having a reaction to the smell of fish. (Source: ABC News: Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CQ3gZt

Answer controversies about hemostatic properties of platelet-rich fibrin

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Vitamin D and childhood asthma: causation and contribution to disease activity

Purpose of review To review the literature of the past 18 months (April 2017 through September, 2018) relating to vitamin D and childhood asthma. Recent findings A combined analysis of two clinical trials of maternal vitamin D supplementation trials showed a significant protective effect of vitamin D supplementation trials in the primary prevention of asthma and recurrent wheeze up to age 3 years. Secondary analyses from these trials have also suggested that initial maternal vitamin D status could affect the response to supplementation during pregnancy, with the biggest protective effect in children born to mothers with initial 25hydroxyvitamin D (25OHD) levels of at least 30 ng/ml. A postnatal, 6-month vitamin D supplementation trial in black, premature babies showed a 34% decreased risk of recurrent wheezing at 1 year among the infants who received supplementation. An individual patient data meta-analysis of published clinical trials concluded that vitamin D supplementation decreased the risk of asthma exacerbations in those with 25OHD levels less than 10 ng/ml. Results of observational analyses on primary prevention of asthma and in prevention of exacerbations remain mixed, with the bulk of the evidence suggesting that there is a protective effect of higher vitamin D levels. Summary Evidence continues to accumulate that vitamin D supplementation helps to prevent the development of asthma and recurrent wheeze in early life, and may also help in the management of asthma. The level(s) of circulating vitamin D that maximizes these effects remains to be identified. Correspondence to Augusto A. Litonjua, MD, MPH, Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY 14642, USA. Tel: +1 585 275 6544; e-mail: augusto_litonjua@urmc.rochester.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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Clinical presentation and characteristics of lymphoma in the head and neck region

The study analyses clinical characteristics of histologically defined head and neck (H&N) lymphoma to raise the awareness of ENT specialists to the leading symptoms.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Qmo2mQ

Clinical presentation and characteristics of lymphoma in the head and neck region

The study analyses clinical characteristics of histologically defined head and neck (H&N) lymphoma to raise the awareness of ENT specialists to the leading symptoms.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Qmo2mQ

Endoscopic Transsphenoidal Pituitary Surgery in Children

With increasing adoption of endoscopic techniques and improved knowledge of skull base anatomy and approaches, transsphenoidal pituitary surgery is now being performed on patients of all ages. Surgical principles are similar between pediatric and adult patients, but there are special considerations for the pediatric population in terms of instrumentation, surgical anatomy, and postoperative care. Wide exposure to the sella, oftentimes to accommodate multiple instruments and the endoscope, is frequently necessary. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R55yfW

Treatment of fibro-osseous lesions at the pediatric skull base

Fibro-osseous lesions of the pediatric skull base are loosely associated group of bony lesions that are all uncommonly occurring clinical entities. Management differs significantly amongst the fibro-osseous lesions but clinical and radiographic presentation can overlap significantly. Fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, osteoma, and aneurysmal bone cyst in addition to even less common lesions such as giant cell tumor of bone and osteosarcoma. In this chapter, the fibro-osseous lesions affecting the pediatric skull base will be reviewed with an emphasis on the clinical, radiographic, and management differences between diagnoses. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Surgical Management of Clival Chordomas in Children

Describe the surgical management of clival chordomas in the pediatric population, with an emphasis on techniques of endoscopic endonasal surgery. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R4OaIe

Surgical Planning in Pediatric Skull Base Surgery

Treatment of pediatric skull base disorders is complex and requires individual planning.   Compared to adult patients, the pathologies are more congenital and benign.  Advanced surgical planning has been shown to improve outcomes and involves a variety of different software platforms to enable sophisticated review of image data sets, including virtual endoscopy and the details of surg ical approach options.  There are greater than 50 open and endoscopic surgical approaches described.  Endoscopic approaches in patients under age 4 are extremely challenging due to the underdeveloped sinuses and overall smaller size of the craniofacial skeleton and nasal cavity.  A multidisciplin ary surgical team should develop and review surgical plan options with the patient and family. (Source: Opera...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BYI9T3

Endoscopic Transsphenoidal Pituitary Surgery in Children

With increasing adoption of endoscopic techniques and improved knowledge of skull base anatomy and approaches, transsphenoidal pituitary surgery is now being performed on patients of all ages. Surgical principles are similar between pediatric and adult patients, but there are special considerations for the pediatric population in terms of instrumentation, surgical anatomy, and postoperative care. Wide exposure to the sella, oftentimes to accommodate multiple instruments and the endoscope, is frequently necessary. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R55yfW

Treatment of fibro-osseous lesions at the pediatric skull base

Fibro-osseous lesions of the pediatric skull base are loosely associated group of bony lesions that are all uncommonly occurring clinical entities. Management differs significantly amongst the fibro-osseous lesions but clinical and radiographic presentation can overlap significantly. Fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, osteoma, and aneurysmal bone cyst in addition to even less common lesions such as giant cell tumor of bone and osteosarcoma. In this chapter, the fibro-osseous lesions affecting the pediatric skull base will be reviewed with an emphasis on the clinical, radiographic, and management differences between diagnoses. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BXUIOH

Surgical Management of Clival Chordomas in Children

Describe the surgical management of clival chordomas in the pediatric population, with an emphasis on techniques of endoscopic endonasal surgery. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R4OaIe

Effect of (Z)- isomer content on [ 11 C]ABP688 binding potential in humans

Abstract

Purpose

To determine how the low-affinity (Z)-isomer of the radiotracer [¹¹C]ABP688 affects binding potential values in vivo in humans.

Methods

High-resolution [¹¹C]ABP688 PET scans were acquired on 74 healthy volunteers (25 male, 49 female, mean age 20 ± 3.0). The relative contents of (E)- and (Z)-isomers were determined prior to injection using analytical high-performance liquid chromatography [r_t(E) = 10 min, r_t(Z) = 8.5 min]. Mean binding potential [BP_ND = f_ND * (B_avail/K_D)] values were calculated in the striatum, limbic regions, and prefrontal cortex using the simplified reference tissue model with cerebellar grey matter as reference.

Results

Mean ± SD (E)-isomer content in [¹¹C]ABP688 production was 92 ± 3.8% (range 78–97%). Percent (E)-isomer was positively correlated with BP_ND in the striatum (ρ = 0.28, p = 0.015) and limbic regions (ρ = 0.25, p = 0.036). In multiple regression analysis, sex (β = 0.39, p = 0.001) and (E)-isomer content (β = 0.23, p = 0.040) were significant predictors of BP_ND.

Conclusions

Even modest levels of (Z)-[¹¹C]ABP688 can reduce estimates of tracer binding in vivo. Future studies should use production methods that enrich levels of (E)-[¹¹C]ABP688, report tracer isomer ratios, and account for this factor in their analyses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QnoktK

Effect of (Z)- isomer content on [ 11 C]ABP688 binding potential in humans

Abstract

Purpose

To determine how the low-affinity (Z)-isomer of the radiotracer [¹¹C]ABP688 affects binding potential values in vivo in humans.

Methods

High-resolution [¹¹C]ABP688 PET scans were acquired on 74 healthy volunteers (25 male, 49 female, mean age 20 ± 3.0). The relative contents of (E)- and (Z)-isomers were determined prior to injection using analytical high-performance liquid chromatography [r_t(E) = 10 min, r_t(Z) = 8.5 min]. Mean binding potential [BP_ND = f_ND * (B_avail/K_D)] values were calculated in the striatum, limbic regions, and prefrontal cortex using the simplified reference tissue model with cerebellar grey matter as reference.

Results

Mean ± SD (E)-isomer content in [¹¹C]ABP688 production was 92 ± 3.8% (range 78–97%). Percent (E)-isomer was positively correlated with BP_ND in the striatum (ρ = 0.28, p = 0.015) and limbic regions (ρ = 0.25, p = 0.036). In multiple regression analysis, sex (β = 0.39, p = 0.001) and (E)-isomer content (β = 0.23, p = 0.040) were significant predictors of BP_ND.

Conclusions

Even modest levels of (Z)-[¹¹C]ABP688 can reduce estimates of tracer binding in vivo. Future studies should use production methods that enrich levels of (E)-[¹¹C]ABP688, report tracer isomer ratios, and account for this factor in their analyses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QnoktK

How smelling fish while it's cooking can cause an allergic reaction

An 11-year-old boy recently died after having a reaction to the smell of fish. (Source: ABC News: Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CQ3gZt

How smelling fish while it's cooking can cause an allergic reaction

An 11-year-old boy recently died after having a reaction to the smell of fish. (Source: ABC News: Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CQ3gZt

Nuclear Medicine Theranostics: Perspective from Pakistan

Abstract

Nuclear medicine has been offering diagnostic and therapeutic solution since the introduction of radioactive iodine for thyroid diseases since decades. However, the concept of theranostics has given a new found impetus to the use of pairs of radiopharmaceuticals for diagnosis and treatment. Presented here is a perspective on theranostics from Pakistan.

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Nuclear Medicine Theranostics: Perspective from Pakistan

Abstract

Nuclear medicine has been offering diagnostic and therapeutic solution since the introduction of radioactive iodine for thyroid diseases since decades. However, the concept of theranostics has given a new found impetus to the use of pairs of radiopharmaceuticals for diagnosis and treatment. Presented here is a perspective on theranostics from Pakistan.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GTAYBj

Optimization of 3D phase contrast venography for the assessment of the cranio-cervical venous system at 1.5 T

Abstract

Purpose

The aim of this work was to optimize a three-dimensional (3D) phase-contrast venography (PCV) product MR pulse sequence in order to obtain clinically reliable images with less artifacts for an improved depiction of the cranio-cervical venous vessels.

Methods

Starting from the product sequence, the 3D PCV protocol was optimized in eight steps with respect to the velocity encoding (V_enc) direction and value, slice thickness, reduction of susceptibility artifacts and arterial contamination, gradient mode and radio-frequency (RF)-spoiling, B₀-Shimming, asymmetric echo technique and RF-pulse type, and flip angle. The product and optimized protocol was used to perform 3D PCV in 12 healthy male volunteers with a median age of 50 years using a state-of-the-art 1.5-T MR system. For evaluation, the cranio-cervical venous system was divided into 15 segments. These segments were evaluated by three radiologists with experience in neuroradiology. An ordinal scoring system was used to access the overall diagnostic quality, arterial contamination, and the quality of visualization.

Results

Image quality in the optimized 3D PCV was graded as "excellent" by all readers in 65.3% of the cases (p < 0.0001). The visualization of venous segments was strongly improved: it was considered diagnostic in 81.8% of all cases using the optimized sequence and in 47.6% for the product 3D PCV (p < 0.0001), respectively. The optimized protocol improved the imaging of all venous segments (p < 0.0001).

Conclusion

The optimized 3D PCV pulse sequence showed superior results compared to the product 3D PCV for the visualization and evaluation of the venous system in all healthy volunteers.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QjupaI

Optimization of 3D phase contrast venography for the assessment of the cranio-cervical venous system at 1.5 T

Abstract

Purpose

The aim of this work was to optimize a three-dimensional (3D) phase-contrast venography (PCV) product MR pulse sequence in order to obtain clinically reliable images with less artifacts for an improved depiction of the cranio-cervical venous vessels.

Methods

Starting from the product sequence, the 3D PCV protocol was optimized in eight steps with respect to the velocity encoding (V_enc) direction and value, slice thickness, reduction of susceptibility artifacts and arterial contamination, gradient mode and radio-frequency (RF)-spoiling, B₀-Shimming, asymmetric echo technique and RF-pulse type, and flip angle. The product and optimized protocol was used to perform 3D PCV in 12 healthy male volunteers with a median age of 50 years using a state-of-the-art 1.5-T MR system. For evaluation, the cranio-cervical venous system was divided into 15 segments. These segments were evaluated by three radiologists with experience in neuroradiology. An ordinal scoring system was used to access the overall diagnostic quality, arterial contamination, and the quality of visualization.

Results

Image quality in the optimized 3D PCV was graded as "excellent" by all readers in 65.3% of the cases (p < 0.0001). The visualization of venous segments was strongly improved: it was considered diagnostic in 81.8% of all cases using the optimized sequence and in 47.6% for the product 3D PCV (p < 0.0001), respectively. The optimized protocol improved the imaging of all venous segments (p < 0.0001).

Conclusion

The optimized 3D PCV pulse sequence showed superior results compared to the product 3D PCV for the visualization and evaluation of the venous system in all healthy volunteers.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QjupaI

Sialolipoma of Parotid Gland a Rare Histological Presentation

We report a case of 62  years old female who presented with the complaint of swelling in the right parotid region for 5 years duration. Apart from cosmetic reason she had no other complain. All specific investigations done were inconclusive and suggested a benign tumor. Histopathological examination after superficial pa rotidectomy suggested sialolipoma. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LPqUIv

The Goat Model for Exclusive Two Handed Endoscopic Middle Ear Surgery Training: A Novel Technique

We describe a novel, exclusively two handed endoscopic approach in an ex vivo animal model for middle ear surgery. The proposed surgical program will guide the trainee endoscopic ear surgeon for a step by step through the main otologic procedures to enhance his or her surgical skills. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s8mQtK

Efficacy of Multicomponent Tympanometry in Identifying Middle Ear Disorder

AbstractMulti component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000  Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226 Hz probe tone and Susceptancec and Conductance tympanograms for 1000 Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identi...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQDRSm

Auditory Brainstem Response in Patients of Tinnitus with Sensorineural Hearing Loss

AbstractTinnitus is defined as phantom auditory perception without corresponding acoustic or mechanical correlates in cochlea. Existing evidence on its physiological basis is wide ranging, but its origin is still under exploration. To objectify this subjective phenomenon, Auditory Brainstem response test is used. The primary purpose of our study was to ascertain any significant difference in auditory electrophysiological response parameters in sensorineural hearing loss with tinnitus group when compared to controls (normal hearing subjects). Secondary aim was to find correlation of these parameters with degree of hearing loss and severity of tinnitus. This was a case control study conducted in the department of Otorhinolaryngology in tertiary care hospital, New Delhi over a period of one a...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sbnMha

Tracheal Stenosis: Evaluation of an Institutional Protocol and Introduction of Novel Surgical Criteria and Scoring System

AbstractTreatment modalities for treatment of post intubation and post tracheostomy tracheal stenosis are many. However, well defined surgical criteria and prognostic classification eluding us till date. A prospective study of 57 cases of post intubation and post tracheostomy tracheal stenosis managed as per well defined surgical criteria followed in our institution. Patients were divided into three groups as per the primary surgical procedure used. The stenosis was classified into mild, moderate and severe based on our proposed prognostic classification. The success rate of endoscopic procedure was 81% with average 1.6 number of procedures per patient, for tracheoplasty success rate was 63% with 1.4 number of procedure per patient, and similarly for tracheal resection and anastomosis was ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQJdNA

Labyrinthectomy: Our Experience in a Tertiary Care Centre

AbstractLabyrinthectomy is an effective surgical procedure for the management of poorly compensated unilateral peripheral vestibular dysfunction in the presence of a nonserviceable hearing. It involves removal of labyrinthine portion of the inner ear and exenteration of the neuroepithelium. In our institution, 8 cases underwent surgical labyrinthectomy from a period of 2013 –2018 for various extensive disease manifestations, age ranges from 2 to 48 years. Includes, a child of 2 years age presented with bilateral foul smelling otorrhoea with external auditory canal cartilaginous stenosis, 5 cases of extensive cholesteatoma with labrynthitis and 2 cases of purulent l abrynthitis among them 1 were suffering from Tuberculosis and was on Category 1 ATT and other one suffering from extensive...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s7tPTN

Clinical and Audiometric Assessment of Hearing Loss in Diabetes Mellitus

AbstractHyperglycemia has been reported to cause hearing loss. We evaluated hyperglycemic subjects with controls undergoing pure tone audiometry. Hundred subjects were divided into case (n  = 50, diabetes mellitus patients) and control (n = 50, non DM subjects). Pure tone audiometry was performed for subjects. Degree of hearing loss was categorized as mild, moderate, moderately severe, severe and profound hearing loss. Out of 50 cases, 26% had normal hearing, 20% had moderatel y and 28% had moderately severe hearing loss. Longer duration of diabetes (p = 0.031) was significant predictor of moderately severe, severe and profound SNHL. Profound SNHL was more common in those with >  200 fasting blood sugar (p = 0.001) and severe and profound SNHL was common in those hav...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LROpAD

Sialolipoma of Parotid Gland a Rare Histological Presentation

We report a case of 62  years old female who presented with the complaint of swelling in the right parotid region for 5 years duration. Apart from cosmetic reason she had no other complain. All specific investigations done were inconclusive and suggested a benign tumor. Histopathological examination after superficial pa rotidectomy suggested sialolipoma. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LPqUIv

The Goat Model for Exclusive Two Handed Endoscopic Middle Ear Surgery Training: A Novel Technique

We describe a novel, exclusively two handed endoscopic approach in an ex vivo animal model for middle ear surgery. The proposed surgical program will guide the trainee endoscopic ear surgeon for a step by step through the main otologic procedures to enhance his or her surgical skills. (Source: Indian Journal of Otolaryngology and Head and Neck Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s8mQtK

Efficacy of Multicomponent Tympanometry in Identifying Middle Ear Disorder

AbstractMulti component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000  Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226 Hz probe tone and Susceptancec and Conductance tympanograms for 1000 Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identi...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQDRSm

Auditory Brainstem Response in Patients of Tinnitus with Sensorineural Hearing Loss

AbstractTinnitus is defined as phantom auditory perception without corresponding acoustic or mechanical correlates in cochlea. Existing evidence on its physiological basis is wide ranging, but its origin is still under exploration. To objectify this subjective phenomenon, Auditory Brainstem response test is used. The primary purpose of our study was to ascertain any significant difference in auditory electrophysiological response parameters in sensorineural hearing loss with tinnitus group when compared to controls (normal hearing subjects). Secondary aim was to find correlation of these parameters with degree of hearing loss and severity of tinnitus. This was a case control study conducted in the department of Otorhinolaryngology in tertiary care hospital, New Delhi over a period of one a...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sbnMha

Tracheal Stenosis: Evaluation of an Institutional Protocol and Introduction of Novel Surgical Criteria and Scoring System

AbstractTreatment modalities for treatment of post intubation and post tracheostomy tracheal stenosis are many. However, well defined surgical criteria and prognostic classification eluding us till date. A prospective study of 57 cases of post intubation and post tracheostomy tracheal stenosis managed as per well defined surgical criteria followed in our institution. Patients were divided into three groups as per the primary surgical procedure used. The stenosis was classified into mild, moderate and severe based on our proposed prognostic classification. The success rate of endoscopic procedure was 81% with average 1.6 number of procedures per patient, for tracheoplasty success rate was 63% with 1.4 number of procedure per patient, and similarly for tracheal resection and anastomosis was ...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQJdNA

Labyrinthectomy: Our Experience in a Tertiary Care Centre

AbstractLabyrinthectomy is an effective surgical procedure for the management of poorly compensated unilateral peripheral vestibular dysfunction in the presence of a nonserviceable hearing. It involves removal of labyrinthine portion of the inner ear and exenteration of the neuroepithelium. In our institution, 8 cases underwent surgical labyrinthectomy from a period of 2013 –2018 for various extensive disease manifestations, age ranges from 2 to 48 years. Includes, a child of 2 years age presented with bilateral foul smelling otorrhoea with external auditory canal cartilaginous stenosis, 5 cases of extensive cholesteatoma with labrynthitis and 2 cases of purulent l abrynthitis among them 1 were suffering from Tuberculosis and was on Category 1 ATT and other one suffering from extensive...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s7tPTN

Clinical and Audiometric Assessment of Hearing Loss in Diabetes Mellitus

AbstractHyperglycemia has been reported to cause hearing loss. We evaluated hyperglycemic subjects with controls undergoing pure tone audiometry. Hundred subjects were divided into case (n  = 50, diabetes mellitus patients) and control (n = 50, non DM subjects). Pure tone audiometry was performed for subjects. Degree of hearing loss was categorized as mild, moderate, moderately severe, severe and profound hearing loss. Out of 50 cases, 26% had normal hearing, 20% had moderatel y and 28% had moderately severe hearing loss. Longer duration of diabetes (p = 0.031) was significant predictor of moderately severe, severe and profound SNHL. Profound SNHL was more common in those with >  200 fasting blood sugar (p = 0.001) and severe and profound SNHL was common in those hav...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LROpAD

Penetrating facial trauma from a Taser barb

We describe a 15-year-old boy who had a penetrating midfacial injury after deployment of a Taser, the barb of which became embedded in the subtarsal region of his left cheek. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VsEPsp

Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in “surgery first”?

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QlKmxh

Non-tuberculous Mycobacterium infection after transfer of autologous fat to the face: a rare case

Autologous fat has long been used as a filler in the face, and has recently gained popularity in plastic surgery with a wound infection rate of 1% − 5%. The incidence of mycobacterial infections has increased over recent decades, which is attributed in part to the increased popularity of these procedures.2 Infections by non-tuberculosis mycobacteria often cause chronic inflammation and progressive infection that may eventually manifest thems elves as severe scars, fistulas, and hollows, and irregular facial contours. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VsEPbT

Penetrating facial trauma from a Taser barb

We describe a 15-year-old boy who had a penetrating midfacial injury after deployment of a Taser, the barb of which became embedded in the subtarsal region of his left cheek. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VsEPsp

Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in “surgery first”?

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QlKmxh

Non-tuberculous Mycobacterium infection after transfer of autologous fat to the face: a rare case

Autologous fat has long been used as a filler in the face, and has recently gained popularity in plastic surgery with a wound infection rate of 1% − 5%. The incidence of mycobacterial infections has increased over recent decades, which is attributed in part to the increased popularity of these procedures.2 Infections by non-tuberculosis mycobacteria often cause chronic inflammation and progressive infection that may eventually manifest thems elves as severe scars, fistulas, and hollows, and irregular facial contours. (Source: The British Journal of Oral and Maxillofacial Surgery)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VsEPbT

"Ears of the Lynx" MRI Sign Is Associated with SPG11 and SPG15 Hereditary Spastic Paraplegia [PEDIATRICS]

BACKGROUND AND PURPOSE:

The "ears of the lynx" MR imaging sign has been described in case reports of hereditary spastic paraplegia with a thin corpus callosum, mostly associated with mutations in the spatacsin vesicle trafficking associated gene, causing Spastic Paraplegia type 11 (SPG11). This sign corresponds to long T1 and T2 values in the forceps minor of the corpus callosum, which appears hyperintense on FLAIR and hypointense on T1-weighted images. Our purpose was to determine the sensitivity and specificity of the ears of the lynx MR imaging sign for genetic cases compared with common potential mimics.

MATERIALS AND METHODS:

Four independent raters, blinded to the diagnosis, determined whether the ears of the lynx sign was present in each of a set of 204 single anonymized FLAIR and T1-weighted MR images from 34 patients with causal mutations associated with SPG11 or Spastic Paraplegia type 15 (SPG15). 34 healthy controls, and 34 patients with multiple sclerosis.

RESULTS:

The interrater reliability for FLAIR images was substantial (Cohen , 0.66–0.77). For these images, the sensitivity of the ears of the lynx sign across raters ranged from 78.8 to 97.0 and the specificity ranged from 90.9 to 100. The accuracy of the sign, measured by area under the receiver operating characteristic curve, ranged from very good (87.1) to excellent (93.9).

CONCLUSIONS:

The ears of the lynx sign on FLAIR MR imaging is highly specific for the most common genetic subtypes of hereditary spastic paraplegia with a thin corpus callosum. When this sign is present, there is a high likelihood of a genetic mutation, particularly associated with SPG11 or SPG15, even in the absence of a family history.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ra75BC

A Deep Learning-Based Approach to Reduce Rescan and Recall Rates in Clinical MRI Examinations [ADULT BRAIN]

BACKGROUND AND PURPOSE:

MR imaging rescans and recalls can create large hospital revenue loss. The purpose of this study was to develop a fast, automated method for assessing rescan need in motion-corrupted brain series.

MATERIALS AND METHODS:

A deep learning–based approach was developed, outputting a probability for a series to be clinically useful. Comparison of this per-series probability with a threshold, which can depend on scan indication and reading radiologist, determines whether a series needs to be rescanned. The deep learning classification performance was compared with that of 4 technologists and 5 radiologists in 49 test series with low and moderate motion artifacts. These series were assumed to be scanned for 2 scan indications: screening for multiple sclerosis and stroke.

RESULTS:

The image-quality rating was found to be scan indication– and reading radiologist–dependent. Of the 49 test datasets, technologists created a mean ratio of rescans/recalls of (4.7 ± 5.1)/(9.5 ± 6.8) for MS and (8.6 ± 7.7)/(1.6 ± 1.9) for stroke. With thresholds adapted for scan indication and reading radiologist, deep learning created a rescan/recall ratio of (7.3 ± 2.2)/(3.2 ± 2.5) for MS, and (3.6 ± 1.5)/(2.8 ± 1.6) for stroke. Due to the large variability in the technologists' assessments, it was only the decrease in the recall rate for MS, for which the deep learning algorithm was trained, that was statistically significant (P = .03).

CONCLUSIONS:

Fast, automated deep learning–based image-quality rating can decrease rescan and recall rates, while rendering them technologist-independent. It was estimated that decreasing rescans and recalls from the technologists' values to the values of deep learning could save hospitals $24,000/scanner/year.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BWVThb

"Ears of the Lynx" MRI Sign Is Associated with SPG11 and SPG15 Hereditary Spastic Paraplegia [PEDIATRICS]

BACKGROUND AND PURPOSE:

The "ears of the lynx" MR imaging sign has been described in case reports of hereditary spastic paraplegia with a thin corpus callosum, mostly associated with mutations in the spatacsin vesicle trafficking associated gene, causing Spastic Paraplegia type 11 (SPG11). This sign corresponds to long T1 and T2 values in the forceps minor of the corpus callosum, which appears hyperintense on FLAIR and hypointense on T1-weighted images. Our purpose was to determine the sensitivity and specificity of the ears of the lynx MR imaging sign for genetic cases compared with common potential mimics.

MATERIALS AND METHODS:

Four independent raters, blinded to the diagnosis, determined whether the ears of the lynx sign was present in each of a set of 204 single anonymized FLAIR and T1-weighted MR images from 34 patients with causal mutations associated with SPG11 or Spastic Paraplegia type 15 (SPG15). 34 healthy controls, and 34 patients with multiple sclerosis.

RESULTS:

The interrater reliability for FLAIR images was substantial (Cohen , 0.66–0.77). For these images, the sensitivity of the ears of the lynx sign across raters ranged from 78.8 to 97.0 and the specificity ranged from 90.9 to 100. The accuracy of the sign, measured by area under the receiver operating characteristic curve, ranged from very good (87.1) to excellent (93.9).

CONCLUSIONS:

The ears of the lynx sign on FLAIR MR imaging is highly specific for the most common genetic subtypes of hereditary spastic paraplegia with a thin corpus callosum. When this sign is present, there is a high likelihood of a genetic mutation, particularly associated with SPG11 or SPG15, even in the absence of a family history.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ra75BC

A Deep Learning-Based Approach to Reduce Rescan and Recall Rates in Clinical MRI Examinations [ADULT BRAIN]

BACKGROUND AND PURPOSE:

MR imaging rescans and recalls can create large hospital revenue loss. The purpose of this study was to develop a fast, automated method for assessing rescan need in motion-corrupted brain series.

MATERIALS AND METHODS:

A deep learning–based approach was developed, outputting a probability for a series to be clinically useful. Comparison of this per-series probability with a threshold, which can depend on scan indication and reading radiologist, determines whether a series needs to be rescanned. The deep learning classification performance was compared with that of 4 technologists and 5 radiologists in 49 test series with low and moderate motion artifacts. These series were assumed to be scanned for 2 scan indications: screening for multiple sclerosis and stroke.

RESULTS:

The image-quality rating was found to be scan indication– and reading radiologist–dependent. Of the 49 test datasets, technologists created a mean ratio of rescans/recalls of (4.7 ± 5.1)/(9.5 ± 6.8) for MS and (8.6 ± 7.7)/(1.6 ± 1.9) for stroke. With thresholds adapted for scan indication and reading radiologist, deep learning created a rescan/recall ratio of (7.3 ± 2.2)/(3.2 ± 2.5) for MS, and (3.6 ± 1.5)/(2.8 ± 1.6) for stroke. Due to the large variability in the technologists' assessments, it was only the decrease in the recall rate for MS, for which the deep learning algorithm was trained, that was statistically significant (P = .03).

CONCLUSIONS:

Fast, automated deep learning–based image-quality rating can decrease rescan and recall rates, while rendering them technologist-independent. It was estimated that decreasing rescans and recalls from the technologists' values to the values of deep learning could save hospitals $24,000/scanner/year.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BWVThb

Prevention of Food Allergy: Beyond Peanut

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GTQhdt

Prevention of Food Allergy: Beyond Peanut

(Source: Journal of Allergy and Clinical Immunology)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GTQhdt

Subperiosteal new bone formation with the distal tibial classic metaphyseal lesion: prevalence on radiographic skeletal surveys

Abstract

Background

The classic metaphyseal lesion (CML) is a strong indicator of infant abuse, and the distal tibia is one of the most common sites for this injury.

Objective

To determine the prevalence of subperiosteal new bone formation accompanying the distal tibial CMLs identified on infant skeletal surveys.

Materials and methods

Skeletal surveys performed for suspected infant abuse (2005–2017) were reviewed. Inclusion criteria were 1) anteroposterior (AP) and lateral radiographs of a distal tibial CML from the initial survey, 2) AP radiograph from the 2-week follow-up survey, 3) additional fractures, 4) child protection team consults and 5) mandated report filing for suspected abuse. We identified 22 distal tibial CMLs from 16 infants. Radiographs of these lesions were shown on the picture archiving and communication system to two blinded pediatric radiologists. Readers indicated the presence/absence of subperiosteal new bone formation on individual and combinations of images.

Results

Inter-reader agreements were fair (kappa=0.47). The prevalence of subperiosteal new bone formation on initial AP radiograph was 34%. Significant increases in the prevalence were found with the addition of follow-up AP radiograph (57%; P<0.001), initial lateral radiograph (57%; P=0.002) and follow-up AP plus initial lateral radiographs (71%; P<0.001). Statistically significant increases in prevalence were also noted when the third view was added to the other two views (increase of 14%; P=0.024).

Conclusion

Even when skeletal surveys include initial AP, lateral and follow-up AP radiographs of the tibia, nearly one-third of distal tibial CMLs will fail to demonstrate subperiosteal new bone formation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TlWyzU

Subperiosteal new bone formation with the distal tibial classic metaphyseal lesion: prevalence on radiographic skeletal surveys

Abstract

Background

The classic metaphyseal lesion (CML) is a strong indicator of infant abuse, and the distal tibia is one of the most common sites for this injury.

Objective

To determine the prevalence of subperiosteal new bone formation accompanying the distal tibial CMLs identified on infant skeletal surveys.

Materials and methods

Skeletal surveys performed for suspected infant abuse (2005–2017) were reviewed. Inclusion criteria were 1) anteroposterior (AP) and lateral radiographs of a distal tibial CML from the initial survey, 2) AP radiograph from the 2-week follow-up survey, 3) additional fractures, 4) child protection team consults and 5) mandated report filing for suspected abuse. We identified 22 distal tibial CMLs from 16 infants. Radiographs of these lesions were shown on the picture archiving and communication system to two blinded pediatric radiologists. Readers indicated the presence/absence of subperiosteal new bone formation on individual and combinations of images.

Results

Inter-reader agreements were fair (kappa=0.47). The prevalence of subperiosteal new bone formation on initial AP radiograph was 34%. Significant increases in the prevalence were found with the addition of follow-up AP radiograph (57%; P<0.001), initial lateral radiograph (57%; P=0.002) and follow-up AP plus initial lateral radiographs (71%; P<0.001). Statistically significant increases in prevalence were also noted when the third view was added to the other two views (increase of 14%; P=0.024).

Conclusion

Even when skeletal surveys include initial AP, lateral and follow-up AP radiographs of the tibia, nearly one-third of distal tibial CMLs will fail to demonstrate subperiosteal new bone formation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TlWyzU

Sialolipoma of Parotid Gland a Rare Histological Presentation

Abstract

Sialolipoma is a rare tumour found within both major and minor salivary glands, it is recently described as a variant of salivary gland lipoma. Sialolipoma was first described by Pusiol et al. (Indian J Pathol Microbiol 52(3):379–382, 2009). Sialolipoma is well circumscribed and contains mature adipose tissue admixed with benign salivary gland component. We report a case of 62 years old female who presented with the complaint of swelling in the right parotid region for 5 years duration. Apart from cosmetic reason she had no other complain. All specific investigations done were inconclusive and suggested a benign tumor. Histopathological examination after superficial parotidectomy suggested sialolipoma. As newly described tumor type, care should be taken to distinguish oncocytic sialolipoma from other salivary gland neoplasms such as simple lipoma, pleomorphic adenoma, or oncocytoma.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TlTnZ0

Efficacy of Multicomponent Tympanometry in Identifying Middle Ear Disorder

Abstract

Multi component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000 Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226 Hz probe tone and Susceptancec and Conductance tympanograms for 1000 Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identified as having middle ear pathology using 226 Hz probe tone whereas the percentage of correct identification increased to 94.87% when 1000 Hz probe tone was used. They are in accordance with the concept that subtle changes in the middle ear which cannot be detected by 226 Hz tympanogram can be identified using 1000 Hz multicomponent tympanogram. These findings highlight the efficiency of 1000 Hz probe tone in detecting mass dominant middle ear pathology.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CNRYVK

Tracheal Stenosis: Evaluation of an Institutional Protocol and Introduction of Novel Surgical Criteria and Scoring System

Abstract

Treatment modalities for treatment of post intubation and post tracheostomy tracheal stenosis are many. However, well defined surgical criteria and prognostic classification eluding us till date. A prospective study of 57 cases of post intubation and post tracheostomy tracheal stenosis managed as per well defined surgical criteria followed in our institution. Patients were divided into three groups as per the primary surgical procedure used. The stenosis was classified into mild, moderate and severe based on our proposed prognostic classification. The success rate of endoscopic procedure was 81% with average 1.6 number of procedures per patient, for tracheoplasty success rate was 63% with 1.4 number of procedure per patient, and similarly for tracheal resection and anastomosis was 90% with 1.1 procedure per patient. The patient score as per our proposed classification correlated well with the prognosis. Our surgical criteria correlates well with success rate reported by other authors and can be helpful for institutions or surgeons dealing with tracheal stenosis occasionally. Our prognostic classification can be used to predict prognosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ToBrNi

Auditory Brainstem Response in Patients of Tinnitus with Sensorineural Hearing Loss

Abstract

Tinnitus is defined as phantom auditory perception without corresponding acoustic or mechanical correlates in cochlea. Existing evidence on its physiological basis is wide ranging, but its origin is still under exploration. To objectify this subjective phenomenon, Auditory Brainstem response test is used. The primary purpose of our study was to ascertain any significant difference in auditory electrophysiological response parameters in sensorineural hearing loss with tinnitus group when compared to controls (normal hearing subjects). Secondary aim was to find correlation of these parameters with degree of hearing loss and severity of tinnitus. This was a case control study conducted in the department of Otorhinolaryngology in tertiary care hospital, New Delhi over a period of one and half years. The study comprised of one hundred and sixty patients out of which, fifty-five patients were sensorineural hearing loss with tinnitus and fifty-one patients were normal hearing subjects. General medical and audiological assessment was done. Significant increase in latency of wave I, III, V and increase in inter peak latency of I–III, III–V, I–V was observed in tinnitus with sensorineural hearing loss group when compared to controls. It was reported that on increasing degree of hearing loss, there was increase in latency of wave I, III, V and increase in inter peak latency of wave I–III, I–V in the former group.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2COHt4y

The Goat Model for Exclusive Two Handed Endoscopic Middle Ear Surgery Training: A Novel Technique

Abstract

With the popularity of exclusive transcanal endoscopic ear surgery, the need for a suitable and affordable surgical training model has grown. To develop an ex vivo animal model for exclusive endoscopic ear surgery. In an experimental study, we studied goat middle ear anatomy in 8 specimens to assess the similarity with the human middle ear as a model for two handed endoscopic ear surgery with endoscope holders. After confirming its suitability, we have developed a surgical training program for grommet insertion, canaloplasty, myringoplasty, butterfly tympanoplasty, ossiculoplasty, atticotomy. The goat model is suitable for two handed endoscopic ear surgery using endoscope holder. We describe a novel, exclusively two handed endoscopic approach in an ex vivo animal model for middle ear surgery. The proposed surgical program will guide the trainee endoscopic ear surgeon for a step by step through the main otologic procedures to enhance his or her surgical skills.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrhB41

Labyrinthectomy: Our Experience in a Tertiary Care Centre

Abstract

Labyrinthectomy is an effective surgical procedure for the management of poorly compensated unilateral peripheral vestibular dysfunction in the presence of a nonserviceable hearing. It involves removal of labyrinthine portion of the inner ear and exenteration of the neuroepithelium. In our institution, 8 cases underwent surgical labyrinthectomy from a period of 2013–2018 for various extensive disease manifestations, age ranges from 2 to 48 years. Includes, a child of 2 years age presented with bilateral foul smelling otorrhoea with external auditory canal cartilaginous stenosis, 5 cases of extensive cholesteatoma with labrynthitis and 2 cases of purulent labrynthitis among them 1 were suffering from Tuberculosis and was on Category 1 ATT and other one suffering from extensive granulation at the tympanomastoid area which was inconclusive of the diagnosis even after histopathological examination, so treated as tuberculosis and started on prophylactic antitubercular treatment in addition to surgery. All patients except the child gave past history of giddiness, but at the time of presentation they were not having giddiness or noticeable nystagmus and all had profound unilateral sensorineural hearing loss. Thus all the patients underwent a radical mastoidectomy with total labyrinthectomy and blind sac closure in 2 patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TlT6Fs

Efficacy of Multicomponent Tympanometry in Identifying Middle Ear Disorder

Abstract

Multi component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000 Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226 Hz probe tone and Susceptancec and Conductance tympanograms for 1000 Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identified as having middle ear pathology using 226 Hz probe tone whereas the percentage of correct identification increased to 94.87% when 1000 Hz probe tone was used. They are in accordance with the concept that subtle changes in the middle ear which cannot be detected by 226 Hz tympanogram can be identified using 1000 Hz multicomponent tympanogram. These findings highlight the efficiency of 1000 Hz probe tone in detecting mass dominant middle ear pathology.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CNRYVK

Tracheal Stenosis: Evaluation of an Institutional Protocol and Introduction of Novel Surgical Criteria and Scoring System

Abstract

Treatment modalities for treatment of post intubation and post tracheostomy tracheal stenosis are many. However, well defined surgical criteria and prognostic classification eluding us till date. A prospective study of 57 cases of post intubation and post tracheostomy tracheal stenosis managed as per well defined surgical criteria followed in our institution. Patients were divided into three groups as per the primary surgical procedure used. The stenosis was classified into mild, moderate and severe based on our proposed prognostic classification. The success rate of endoscopic procedure was 81% with average 1.6 number of procedures per patient, for tracheoplasty success rate was 63% with 1.4 number of procedure per patient, and similarly for tracheal resection and anastomosis was 90% with 1.1 procedure per patient. The patient score as per our proposed classification correlated well with the prognosis. Our surgical criteria correlates well with success rate reported by other authors and can be helpful for institutions or surgeons dealing with tracheal stenosis occasionally. Our prognostic classification can be used to predict prognosis.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2ToBrNi

Auditory Brainstem Response in Patients of Tinnitus with Sensorineural Hearing Loss

Abstract

Tinnitus is defined as phantom auditory perception without corresponding acoustic or mechanical correlates in cochlea. Existing evidence on its physiological basis is wide ranging, but its origin is still under exploration. To objectify this subjective phenomenon, Auditory Brainstem response test is used. The primary purpose of our study was to ascertain any significant difference in auditory electrophysiological response parameters in sensorineural hearing loss with tinnitus group when compared to controls (normal hearing subjects). Secondary aim was to find correlation of these parameters with degree of hearing loss and severity of tinnitus. This was a case control study conducted in the department of Otorhinolaryngology in tertiary care hospital, New Delhi over a period of one and half years. The study comprised of one hundred and sixty patients out of which, fifty-five patients were sensorineural hearing loss with tinnitus and fifty-one patients were normal hearing subjects. General medical and audiological assessment was done. Significant increase in latency of wave I, III, V and increase in inter peak latency of I–III, III–V, I–V was observed in tinnitus with sensorineural hearing loss group when compared to controls. It was reported that on increasing degree of hearing loss, there was increase in latency of wave I, III, V and increase in inter peak latency of wave I–III, I–V in the former group.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2COHt4y

The Goat Model for Exclusive Two Handed Endoscopic Middle Ear Surgery Training: A Novel Technique

Abstract

With the popularity of exclusive transcanal endoscopic ear surgery, the need for a suitable and affordable surgical training model has grown. To develop an ex vivo animal model for exclusive endoscopic ear surgery. In an experimental study, we studied goat middle ear anatomy in 8 specimens to assess the similarity with the human middle ear as a model for two handed endoscopic ear surgery with endoscope holders. After confirming its suitability, we have developed a surgical training program for grommet insertion, canaloplasty, myringoplasty, butterfly tympanoplasty, ossiculoplasty, atticotomy. The goat model is suitable for two handed endoscopic ear surgery using endoscope holder. We describe a novel, exclusively two handed endoscopic approach in an ex vivo animal model for middle ear surgery. The proposed surgical program will guide the trainee endoscopic ear surgeon for a step by step through the main otologic procedures to enhance his or her surgical skills.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TrhB41

Clinical and Audiometric Assessment of Hearing Loss in Diabetes Mellitus

Abstract

Hyperglycemia has been reported to cause hearing loss. We evaluated hyperglycemic subjects with controls undergoing pure tone audiometry. Hundred subjects were divided into case (n = 50, diabetes mellitus patients) and control (n = 50, non DM subjects). Pure tone audiometry was performed for subjects. Degree of hearing loss was categorized as mild, moderate, moderately severe, severe and profound hearing loss. Out of 50 cases, 26% had normal hearing, 20% had moderately and 28% had moderately severe hearing loss. Longer duration of diabetes (p = 0.031) was significant predictor of moderately severe, severe and profound SNHL. Profound SNHL was more common in those with > 200 fasting blood sugar (p = 0.001) and severe and profound SNHL was common in those having > 300 random blood sugar (p = 0.004). To conclude age, duration and severity of diabetes was the significant predictor of hearing loss in patients of diabetes mellitus.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2COnByi

Labyrinthectomy: Our Experience in a Tertiary Care Centre

Abstract

Labyrinthectomy is an effective surgical procedure for the management of poorly compensated unilateral peripheral vestibular dysfunction in the presence of a nonserviceable hearing. It involves removal of labyrinthine portion of the inner ear and exenteration of the neuroepithelium. In our institution, 8 cases underwent surgical labyrinthectomy from a period of 2013–2018 for various extensive disease manifestations, age ranges from 2 to 48 years. Includes, a child of 2 years age presented with bilateral foul smelling otorrhoea with external auditory canal cartilaginous stenosis, 5 cases of extensive cholesteatoma with labrynthitis and 2 cases of purulent labrynthitis among them 1 were suffering from Tuberculosis and was on Category 1 ATT and other one suffering from extensive granulation at the tympanomastoid area which was inconclusive of the diagnosis even after histopathological examination, so treated as tuberculosis and started on prophylactic antitubercular treatment in addition to surgery. All patients except the child gave past history of giddiness, but at the time of presentation they were not having giddiness or noticeable nystagmus and all had profound unilateral sensorineural hearing loss. Thus all the patients underwent a radical mastoidectomy with total labyrinthectomy and blind sac closure in 2 patients.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TlT6Fs

Smartphone-assisted monitoring of masticatory muscle activity in freely moving individuals

Abstract

Objectives

To test a smartphone-assisted wireless device for assessing electromyographic (EMG) activity of the masseter muscle in freely moving individuals undertaking routine activities.

Materials and Methods

EMG activity was detected unilaterally from the masseter muscle in 12 volunteers using surface electrodes connected to both a smartphone-assisted wireless EMG device and a fixed-wired EMG equipment (reference standard). After performing a series of standardized tasks in the laboratory, participants wore the wireless device for 8 h while performing their normal routine.

Results

The wireless device reliably detected masseter muscle contraction episodes under both laboratory and natural environment conditions. The intraclass correlation coefficients for the muscle contraction episode amplitude and duration detected by the wireless and the wired equipment ranged from 0.94–1.00 to 0.82–1.00, respectively. Most masseter contraction episodes during normal routine were of low amplitude (< 10% MVC) and short duration (< 10 s), with no significant differences between sexes or facial side.

Conclusions

Within the limitations of the study, smartphone-assisted monitoring of the jaw muscles represents a promising tool to investigate oral behavior patterns in free moving individuals.

Clinical relevance

Smartphone-assisted monitoring of masticatory muscle activity may enable possible associations between excessive muscle activity, bruxism, dysfunction, and pain to be investigated, and managed via biofeedback.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RtSct1

Smartphone-assisted monitoring of masticatory muscle activity in freely moving individuals

Abstract

Objectives

To test a smartphone-assisted wireless device for assessing electromyographic (EMG) activity of the masseter muscle in freely moving individuals undertaking routine activities.

Materials and Methods

EMG activity was detected unilaterally from the masseter muscle in 12 volunteers using surface electrodes connected to both a smartphone-assisted wireless EMG device and a fixed-wired EMG equipment (reference standard). After performing a series of standardized tasks in the laboratory, participants wore the wireless device for 8 h while performing their normal routine.

Results

The wireless device reliably detected masseter muscle contraction episodes under both laboratory and natural environment conditions. The intraclass correlation coefficients for the muscle contraction episode amplitude and duration detected by the wireless and the wired equipment ranged from 0.94–1.00 to 0.82–1.00, respectively. Most masseter contraction episodes during normal routine were of low amplitude (< 10% MVC) and short duration (< 10 s), with no significant differences between sexes or facial side.

Conclusions

Within the limitations of the study, smartphone-assisted monitoring of the jaw muscles represents a promising tool to investigate oral behavior patterns in free moving individuals.

Clinical relevance

Smartphone-assisted monitoring of masticatory muscle activity may enable possible associations between excessive muscle activity, bruxism, dysfunction, and pain to be investigated, and managed via biofeedback.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RtSct1

Factors related to relapse after mandibular setback surgery with minimal presurgical orthodontics

The aims of this study were to compare the presurgical conditions, surgical changes, and postsurgical changes between skeletal Class III patients with different degrees of horizontal relapse after mandibular setback surgery (MS) with minimal presurgical orthodontics (MPO), and to identify the factors contributing to this relapse.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BVtdVQ

Tracking accuracy of a stereo-camera-based augmented reality navigation system for orthognathic surgery

Tracking accuracy is critical to successful augmented reality (AR) in the diagnosis and surgical correction of maxillofacial deformities. The present study investigated the tracking accuracy of an AR navigation system combined with a stereo camera during repositioning of the maxilla after Le Fort I osteotomy, using a three-dimensional skull model, and compared the tracking accuracy with that of an existing infrared (IR)-based optical tracking system (OTS) navigation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C2LlwT

Incidence Pattern of bear-inflicted injuries to the Maxillo-Facial region- Soft and hard tissue injuries their Management and Sequelae

Abstract

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R5sA6t

Child with food allergy dies after inhaling fish fumes, father says

Cameron Jean-Pierre, who had a known fish allergy, had a severe reaction to fumes from cooking cod, his father said. (Source: Washington Post: To Your Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQGQub

Medical News Today: How pulmonary function tests work

Pulmonary function tests check the lungs for issues including asthma, allergies, and bronchitis. Learn more about what pulmonary functions tests are for, and how they work, here. (Source: Health News from Medical News Today)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s6KFlR

Commensal-specific T cell plasticity promotes rapid tissue adaptation to injury

Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including commensal-specific T cells. We found that skin-resident commensal-specific T cells harbor a paradoxical program characterized by a type 17 program associated with a poised type 2 state. Thus, in the context of injury and exposure to inflammatory mediators such as interleukin-18, these cells rapidly release type 2 cytokines, thereby acquiring contextual functions. Such acquisition of a type 2 effector program promotes tissue repair. Aberrant type 2 responses can also be unleashed in the context of local defects in immunoregulation. Thus, commensal-specific T cells co-opt tissue residency and cell-intrinsic flexibility as a means to promo...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LPSaqb

Factors related to relapse after mandibular setback surgery with minimal presurgical orthodontics

The aims of this study were to compare the presurgical conditions, surgical changes, and postsurgical changes between skeletal Class III patients with different degrees of horizontal relapse after mandibular setback surgery (MS) with minimal presurgical orthodontics (MPO), and to identify the factors contributing to this relapse.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BVtdVQ

Tracking accuracy of a stereo-camera-based augmented reality navigation system for orthognathic surgery

Tracking accuracy is critical to successful augmented reality (AR) in the diagnosis and surgical correction of maxillofacial deformities. The present study investigated the tracking accuracy of an AR navigation system combined with a stereo camera during repositioning of the maxilla after Le Fort I osteotomy, using a three-dimensional skull model, and compared the tracking accuracy with that of an existing infrared (IR)-based optical tracking system (OTS) navigation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C2LlwT

Incidence Pattern of bear-inflicted injuries to the Maxillo-Facial region- Soft and hard tissue injuries their Management and Sequelae

Abstract

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R5sA6t

Decreases in oral tissue blood flow induced by remifentanil is not accompanied by deterioration of oral tissue oxygen tension in rabbits

The purpose of this study was to investigate the effects of remifentanil infusion on tissue blood flow and tissue oxygen tension in the mandibular bone marrow and the masseter muscle in rabbits. In addition, the changes in tissue oxygen consumption in those tissues during remifentanil infusion was investigated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R7aRM8

Risk factors for surgical site infection in patients undergoing free and pedicled myocutaneous flap reconstruction after oral cancer resection

The aim of the study was to investigate risk factors for surgical site infection (SSI) at the recipient site in oral cancer resection surgery with neck dissection and reconstruction using a free or pedicled myocutaneous flap.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R4vVCI

Child with food allergy dies after inhaling fish fumes, father says

Cameron Jean-Pierre, who had a known fish allergy, had a severe reaction to fumes from cooking cod, his father said. (Source: Washington Post: To Your Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQGQub

Medical News Today: How pulmonary function tests work

Pulmonary function tests check the lungs for issues including asthma, allergies, and bronchitis. Learn more about what pulmonary functions tests are for, and how they work, here. (Source: Health News from Medical News Today)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s6KFlR

Incidence Pattern of bear-inflicted injuries to the Maxillo-Facial region- Soft and hard tissue injuries their Management and Sequelae

Abstract

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R5sA6t

Tracking accuracy of a stereo-camera-based augmented reality navigation system for orthognathic surgery

Tracking accuracy is critical to successful augmented reality (AR) in the diagnosis and surgical correction of maxillofacial deformities. The present study investigated the tracking accuracy of an AR navigation system combined with a stereo camera during repositioning of the maxilla after Le Fort I osteotomy, using a three-dimensional skull model, and compared the tracking accuracy with that of an existing infrared (IR)-based optical tracking system (OTS) navigation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C2LlwT

Decreases in oral tissue blood flow induced by remifentanil is not accompanied by deterioration of oral tissue oxygen tension in rabbits

The purpose of this study was to investigate the effects of remifentanil infusion on tissue blood flow and tissue oxygen tension in the mandibular bone marrow and the masseter muscle in rabbits. In addition, the changes in tissue oxygen consumption in those tissues during remifentanil infusion was investigated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R7aRM8

Risk factors for surgical site infection in patients undergoing free and pedicled myocutaneous flap reconstruction after oral cancer resection

The aim of the study was to investigate risk factors for surgical site infection (SSI) at the recipient site in oral cancer resection surgery with neck dissection and reconstruction using a free or pedicled myocutaneous flap.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R4vVCI

Incidence Pattern of bear-inflicted injuries to the Maxillo-Facial region- Soft and hard tissue injuries their Management and Sequelae

Abstract

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R5sA6t

Tracking accuracy of a stereo-camera-based augmented reality navigation system for orthognathic surgery

Tracking accuracy is critical to successful augmented reality (AR) in the diagnosis and surgical correction of maxillofacial deformities. The present study investigated the tracking accuracy of an AR navigation system combined with a stereo camera during repositioning of the maxilla after Le Fort I osteotomy, using a three-dimensional skull model, and compared the tracking accuracy with that of an existing infrared (IR)-based optical tracking system (OTS) navigation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2C2LlwT

Decreases in oral tissue blood flow induced by remifentanil is not accompanied by deterioration of oral tissue oxygen tension in rabbits

The purpose of this study was to investigate the effects of remifentanil infusion on tissue blood flow and tissue oxygen tension in the mandibular bone marrow and the masseter muscle in rabbits. In addition, the changes in tissue oxygen consumption in those tissues during remifentanil infusion was investigated.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R7aRM8

Factors related to relapse after mandibular setback surgery with minimal presurgical orthodontics

The aims of this study were to compare the presurgical conditions, surgical changes, and postsurgical changes between skeletal Class III patients with different degrees of horizontal relapse after mandibular setback surgery (MS) with minimal presurgical orthodontics (MPO), and to identify the factors contributing to this relapse.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BVtdVQ

Risk factors for surgical site infection in patients undergoing free and pedicled myocutaneous flap reconstruction after oral cancer resection

The aim of the study was to investigate risk factors for surgical site infection (SSI) at the recipient site in oral cancer resection surgery with neck dissection and reconstruction using a free or pedicled myocutaneous flap.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R4vVCI

Child with food allergy dies after inhaling fish fumes, father says

Cameron Jean-Pierre, who had a known fish allergy, had a severe reaction to fumes from cooking cod, his father said. (Source: Washington Post: To Your Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LQGQub

Medical News Today: How pulmonary function tests work

Pulmonary function tests check the lungs for issues including asthma, allergies, and bronchitis. Learn more about what pulmonary functions tests are for, and how they work, here. (Source: Health News from Medical News Today)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s6KFlR

Commensal-specific T cell plasticity promotes rapid tissue adaptation to injury

Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including commensal-specific T cells. We found that skin-resident commensal-specific T cells harbor a paradoxical program characterized by a type 17 program associated with a poised type 2 state. Thus, in the context of injury and exposure to inflammatory mediators such as interleukin-18, these cells rapidly release type 2 cytokines, thereby acquiring contextual functions. Such acquisition of a type 2 effector program promotes tissue repair. Aberrant type 2 responses can also be unleashed in the context of local defects in immunoregulation. Thus, commensal-specific T cells co-opt tissue residency and cell-intrinsic flexibility as a means to promo...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LPSaqb

Morbidity of interventions in previously untreated Dupuytren disease: A systematic review

Abstract

Treatment morbidity in previously untreated, or primary, Dupuytren disease has limited representation in the literature. Despite the clinical importance of stratifying risk of intervention based on treatment history, most articles addressing management complications pool both primary and recurrent disease. The aim of this systematic review was to quantify interventional morbidity in primary Dupuytren disease only and isolate the complication profiles of established interventions in previously untreated patients. A literature search was conducted using keywords on Medline and bibliographic linkage. Excluded papers did not address primary Dupuytren disease complications or did not include separate, primary-only complication data. Rates of morbidity were calculated from pooled data extracted from the included studies. Thirty-five papers met the criteria for inclusion. The review has quantified that open procedures carry higher complication rates than closed in the context of primary Dupuytren disease treatment. Amongst closed procedures, the only rate of skin split was high. It is noteworthy that this review has identified the limited isolated primary disease complication data available in the literature, which should prompt further targeted research. This systematic review addresses quantification of complication rates following treatment of primary Dupuytren disease and demonstrates that open interventions carry greater morbidity than closed. Whilst this study highlights the need for a future investigation, the complication data presented should nonetheless facilitate informed decision-making for clinicians and patients when considering initial treatments for primary Dupuytren disease.

Level of Evidence: Level IV, therapeutic study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VrQx6v

Medical News Today: How pulmonary function tests work

Pulmonary function tests check the lungs for issues including asthma, allergies, and bronchitis. Learn more about what pulmonary functions tests are for, and how they work, here. (Source: Health News from Medical News Today)

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s6KFlR

Commensal-specific T cell plasticity promotes rapid tissue adaptation to injury

Barrier tissues are primary targets of environmental stressors and are home to the largest number of antigen-experienced lymphocytes in the body, including commensal-specific T cells. We found that skin-resident commensal-specific T cells harbor a paradoxical program characterized by a type 17 program associated with a poised type 2 state. Thus, in the context of injury and exposure to inflammatory mediators such as interleukin-18, these cells rapidly release type 2 cytokines, thereby acquiring contextual functions. Such acquisition of a type 2 effector program promotes tissue repair. Aberrant type 2 responses can also be unleashed in the context of local defects in immunoregulation. Thus, commensal-specific T cells co-opt tissue residency and cell-intrinsic flexibility as a means to promo...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LPSaqb

Surgical Management of Clival Chordomas in Children

Describe the surgical management of clival chordomas in the pediatric population, with an emphasis on techniques of endoscopic endonasal surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RsrOzU

Surgical Planning in Pediatric Skull Base Surgery

Treatment of pediatric skull base disorders is complex and requires individual planning.  Compared to adult patients, the pathologies are more congenital and benign.  Advanced surgical planning has been shown to improve outcomes and involves a variety of different software platforms to enable sophisticated review of image data sets, including virtual endoscopy and the details of surgical approach options.  There are greater than 50 open and endoscopic surgical approaches described.  Endoscopic approaches in patients under age 4 are extremely challenging due to the underdeveloped sinuses and overall smaller size of the craniofacial skeleton and nasal cavity.  A multidisciplinary surgical team should develop and review surgical plan options with the patient and family.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R6bXHH

Treatment of fibro-osseous lesions at the pediatric skull base

Fibro-osseous lesions of the pediatric skull base are loosely associated group of bony lesions that are all uncommonly occurring clinical entities. Management differs significantly amongst the fibro-osseous lesions but clinical and radiographic presentation can overlap significantly. Fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, osteoma, and aneurysmal bone cyst in addition to even less common lesions such as giant cell tumor of bone and osteosarcoma. In this chapter, the fibro-osseous lesions affecting the pediatric skull base will be reviewed with an emphasis on the clinical, radiographic, and management differences between diagnoses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RcuD96

Surgical Management of Clival Chordomas in Children

Describe the surgical management of clival chordomas in the pediatric population, with an emphasis on techniques of endoscopic endonasal surgery.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RsrOzU

UNIQUE CONSIDERATIONS IN PEDIATRIC SKULL BASE SURGERY

Pediatric skull base and craniofacial surgery presents a unique challenge since the potential benefits of therapy must be balanced against the cumulative impact of multimodality treatment on craniofacial growth, donor-site morbidity, and the potential for serious psychosocial issues. Skull base reconstruction using locoregional flaps or free flaps may be safely performed in pediatrics. Although the general principles of skull base reconstruction are applicable to nearly all patients, the unique demands of skull base surgery in pediatrics merit special attention.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2H6vy6n

Surgical Planning in Pediatric Skull Base Surgery

Treatment of pediatric skull base disorders is complex and requires individual planning.  Compared to adult patients, the pathologies are more congenital and benign.  Advanced surgical planning has been shown to improve outcomes and involves a variety of different software platforms to enable sophisticated review of image data sets, including virtual endoscopy and the details of surgical approach options.  There are greater than 50 open and endoscopic surgical approaches described.  Endoscopic approaches in patients under age 4 are extremely challenging due to the underdeveloped sinuses and overall smaller size of the craniofacial skeleton and nasal cavity.  A multidisciplinary surgical team should develop and review surgical plan options with the patient and family.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2R6bXHH

Endoscopic Transsphenoidal Pituitary Surgery in Children

With increasing adoption of endoscopic techniques and improved knowledge of skull base anatomy and approaches, transsphenoidal pituitary surgery is now being performed on patients of all ages. Surgical principles are similar between pediatric and adult patients, but there are special considerations for the pediatric population in terms of instrumentation, surgical anatomy, and postoperative care. Wide exposure to the sella, oftentimes to accommodate multiple instruments and the endoscope, is frequently necessary.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BYdDJ5

Treatment of fibro-osseous lesions at the pediatric skull base

Fibro-osseous lesions of the pediatric skull base are loosely associated group of bony lesions that are all uncommonly occurring clinical entities. Management differs significantly amongst the fibro-osseous lesions but clinical and radiographic presentation can overlap significantly. Fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, osteoma, and aneurysmal bone cyst in addition to even less common lesions such as giant cell tumor of bone and osteosarcoma. In this chapter, the fibro-osseous lesions affecting the pediatric skull base will be reviewed with an emphasis on the clinical, radiographic, and management differences between diagnoses.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RcuD96

Prevention of Food Allergy: Beyond Peanut

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s4otsy

Prevention of Food Allergy: Beyond Peanut

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s4otsy

The Use of Laser Speckle Contrast Imaging to predict flap necrosis - an experimental study in a porcine flap model

We have evaluated the use of Laser Speckle Contrast Imaging (LSCI) in the perioperative planning in reconstructive flap surgery. The aim of the study was to investigate if LSCI can predict regions with a high risk of developing postoperative necrosis. Our hypothesis was that, perioperatively, such regions have perfusion values below a threshold value and show a negative perfusion trend.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2F7Mcj3

Exploring the Mechanisms Underlying Analgesic Properties of Minor Cannabinoids and Terpenes (R21 Clinical Trial Optional)

Funding Opportunity RFA-AT-19-009 from the NIH Guide for Grants and Contracts. Through this funding opportunity announcement (FOA), the National Center for Complementary and Integrative Health (NCCIH) solicits grant research applications to study minor cannabinoids and terpenes in the cannabis plant as it relates to pain and nociception. Minor cannabinoids are defined as any and all cannabinoids from the cannabis plant other than ?9-tetrahydrocannabinol (?9-THC). Cannabinoids and terpenes of particular interest include the following: Cannabidiol (CBD), Cannabigerol (CBG), Cannabinol (CBN), Cannabichromene (CBC), Myrcene, ?-caryophyllene, Limonene, ?-terpineol, Linalool, ?-phellandrene, ?-pinene, ?-pinene, ?-terpinene, and ?-humulene. This initiative intends to support highly innovative ba...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QkkWQr

Exploring the Mechanisms Underlying Analgesic Properties of Minor Cannabinoids and Terpenes (R01 Clinical Trial Optional)

Funding Opportunity RFA-AT-19-008 from the NIH Guide for Grants and Contracts. Through this funding opportunity announcement (FOA), the National Center for Complementary and Integrative Health (NCCIH) solicits grant research applications to study minor cannabinoids and terpenes in the cannabis plant as it relates to pain and nociception. Minor cannabinoids are defined as any and all cannabinoids from the cannabis plant other than ?9-tetrahydrocannabinol (?9-THC). Cannabinoids and terpenes of particular interest include the following: Cannabidiol (CBD), Cannabigerol (CBG), Cannabinol (CBN), Cannabichromene (CBC), Myrcene, ?-caryophyllene, Limonene, ?-terpineol, Linalool, ?-phellandrene, ?-pinene, ?-pinene, ?-terpinene, and ?-humulene. This initiative intends to support highly innovative ba...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VzZQS6

Exploring the Mechanisms Underlying Analgesic Properties of Minor Cannabinoids and Terpenes (R21 Clinical Trial Optional)

Funding Opportunity RFA-AT-19-009 from the NIH Guide for Grants and Contracts. Through this funding opportunity announcement (FOA), the National Center for Complementary and Integrative Health (NCCIH) solicits grant research applications to study minor cannabinoids and terpenes in the cannabis plant as it relates to pain and nociception. Minor cannabinoids are defined as any and all cannabinoids from the cannabis plant other than ?9-tetrahydrocannabinol (?9-THC). Cannabinoids and terpenes of particular interest include the following: Cannabidiol (CBD), Cannabigerol (CBG), Cannabinol (CBN), Cannabichromene (CBC), Myrcene, ?-caryophyllene, Limonene, ?-terpineol, Linalool, ?-phellandrene, ?-pinene, ?-pinene, ?-terpinene, and ?-humulene. This initiative intends to support highly innovative ba...

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2QkkWQr

Exploring the Mechanisms Underlying Analgesic Properties of Minor Cannabinoids and Terpenes (R01 Clinical Trial Optional)

Funding Opportunity RFA-AT-19-008 from the NIH Guide for Grants and Contracts. Through this funding opportunity announcement (FOA), the National Center for Complementary and Integrative Health (NCCIH) solicits grant research applications to study minor cannabinoids and terpenes in the cannabis plant as it relates to pain and nociception. Minor cannabinoids are defined as any and all cannabinoids from the cannabis plant other than ?9-tetrahydrocannabinol (?9-THC). Cannabinoids and terpenes of particular interest include the following: Cannabidiol (CBD), Cannabigerol (CBG), Cannabinol (CBN), Cannabichromene (CBC), Myrcene, ?-caryophyllene, Limonene, ?-terpineol, Linalool, ?-phellandrene, ?-pinene, ?-pinene, ?-terpinene, and ?-humulene. This initiative intends to support highly innovative ba...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2VzZQS6

Non-tuberculous Mycobacterium infection after transfer of autologous fat to the face: a rare case

Autologous fat has long been used as a filler in the face, and has recently gained popularity in plastic surgery with a wound infection rate of 1% − 5%. The incidence of mycobacterial infections has increased over recent decades, which is attributed in part to the increased popularity of these procedures.2 Infections by non-tuberculosis mycobacteria often cause chronic inflammation and progressive infection that may eventually manifest themselves as severe scars, fistulas, and hollows, and irregular facial contours.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LOcjgs

Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in “surgery first”?

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s9Ew8A

Penetrating facial trauma from a Taser barb

The Taser X26® (Axon) is a conducted energy device that is used by the police forces in the United Kingdom to deliver a high voltage shock that will disable a person. Injuries related to its use are uncommon but can be serious, the extent of the damage caused being related to the structures targeted and the length of deployment of the electrical charge. We describe a 15-year-old boy who had a penetrating midfacial injury after deployment of a Taser, the barb of which became embedded in the subtarsal region of his left cheek.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LOcdFC

Non-tuberculous Mycobacterium infection after transfer of autologous fat to the face: a rare case

Autologous fat has long been used as a filler in the face, and has recently gained popularity in plastic surgery with a wound infection rate of 1% − 5%. The incidence of mycobacterial infections has increased over recent decades, which is attributed in part to the increased popularity of these procedures.2 Infections by non-tuberculosis mycobacteria often cause chronic inflammation and progressive infection that may eventually manifest themselves as severe scars, fistulas, and hollows, and irregular facial contours.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LOcjgs

Interproximal bone in maxillary anterior teeth in subjects with Class III facial deformity: Are there options for segmental maxillary osteotomy in “surgery first”?

Our aim was to give a morphometric description of the interproximal bone between the anterior maxillary teeth of subjects with class III facial deformity, who were candidates for segmented Le Fort I osteotomy. We measured the width of the interproximal bone from the upper right canine to the upper left canine in cone-beam computed tomographic images of 35 subjects, and identified five interproximal areas of measurement. The lower and upper measurements were established 5mm and 10mm from the cervical crest of the interproximal bone.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2s9Ew8A

Penetrating facial trauma from a Taser barb

The Taser X26® (Axon) is a conducted energy device that is used by the police forces in the United Kingdom to deliver a high voltage shock that will disable a person. Injuries related to its use are uncommon but can be serious, the extent of the damage caused being related to the structures targeted and the length of deployment of the electrical charge. We describe a 15-year-old boy who had a penetrating midfacial injury after deployment of a Taser, the barb of which became embedded in the subtarsal region of his left cheek.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2LOcdFC

Laryngeal symptoms may be caused by cranial nerve 9 and 10 compression at the brain stem

(Medical University of South Carolina) The Laryngoscope, December 24, 2018 issue, reports Medical University of South Carolina (MUSC) investigator findings that compression of cranial nerves nine and ten is often responsible for unexplained laryngeal symptoms like chronic cough, vocal fold paralysis and hoarseness. Surgical decompression provided highly effective treatment with surgical patients experiencing significant, long-term improvements over medication-treated patients. These findings provide an important option to address the root cause of debilitating laryngeal symptoms that were previously unexplained. (Source: EurekAlert! - Medicine and Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Aqk2fZ

Laryngeal symptoms may be caused by cranial nerve 9 and 10 compression at the brain stem

(Medical University of South Carolina) The Laryngoscope, December 24, 2018 issue, reports Medical University of South Carolina (MUSC) investigator findings that compression of cranial nerves nine and ten is often responsible for unexplained laryngeal symptoms like chronic cough, vocal fold paralysis and hoarseness. Surgical decompression provided highly effective treatment with surgical patients experiencing significant, long-term improvements over medication-treated patients. These findings provide an important option to address the root cause of debilitating laryngeal symptoms that were previously unexplained. (Source: EurekAlert! - Medicine and Health)

MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Aqk2fZ

Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence

Research on quality of life QOL is limited in Brazil and few studies have examined the association between smoking status and quality of life. This study addresses this gap and also examines the association be...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2F3QVDn

Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence

Research on quality of life QOL is limited in Brazil and few studies have examined the association between smoking status and quality of life. This study addresses this gap and also examines the association be...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2F3QVDn

Morbidity of interventions in previously untreated Dupuytren disease: A systematic review

Abstract

Treatment morbidity in previously untreated, or primary, Dupuytren disease has limited representation in the literature. Despite the clinical importance of stratifying risk of intervention based on treatment history, most articles addressing management complications pool both primary and recurrent disease. The aim of this systematic review was to quantify interventional morbidity in primary Dupuytren disease only and isolate the complication profiles of established interventions in previously untreated patients. A literature search was conducted using keywords on Medline and bibliographic linkage. Excluded papers did not address primary Dupuytren disease complications or did not include separate, primary-only complication data. Rates of morbidity were calculated from pooled data extracted from the included studies. Thirty-five papers met the criteria for inclusion. The review has quantified that open procedures carry higher complication rates than closed in the context of primary Dupuytren disease treatment. Amongst closed procedures, the only rate of skin split was high. It is noteworthy that this review has identified the limited isolated primary disease complication data available in the literature, which should prompt further targeted research. This systematic review addresses quantification of complication rates following treatment of primary Dupuytren disease and demonstrates that open interventions carry greater morbidity than closed. Whilst this study highlights the need for a future investigation, the complication data presented should nonetheless facilitate informed decision-making for clinicians and patients when considering initial treatments for primary Dupuytren disease.

Level of Evidence: Level IV, therapeutic study.

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