Traitement des nécroses du tendon d’Achille sans reconstruction tendineuse : à propos de quatre cas

Publication date: Available online 8 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Monnerie, D. Le Nen, W. Hu, H. Letissier, N. Kerfant

Résumé

Introduction

La prise en charge des pertes de substances combinées du tendon d'Achille et de la peau est difficile. Il ne s'agit pourtant pas de situations exceptionnelles après chirurgie du tendon d'Achille. Les données de la littérature sont vastes et il n'existe actuellement pas de consensus quant à la technique de reconstruction du tendon.

Cas cliniques

Nous rapportons quatre cas de nécrose purulente du tendon d'Achille compliquant un peignage ou la suture d'une rupture tendineuse. Après parage de l'ensemble des tissus nécrotiques, la perte de substance a été couverte par un lambeau perforant fascio-cutané ou par une greffe de peau mince sans reconstruction du tendon sous-jacent.

Discussion et conclusion

Les résultats fonctionnels sont très satisfaisants avec de bonnes mobilités articulaires et une reprise de la marche sans boiterie pour tous les patients. La fibrose permet de reconstituer un véritable néotendon confirmé à l'IRM. Les avantages sont nombreux par rapport à d'autres méthodes : un seul temps opératoire est nécessaire, la gestion postopératoire est simple et elle permet d'éviter certaines difficultés techniques liées à la reconstruction tendineuse. Une plus large série serait nécessaire pour conforter ces résultats.

Summary

Introduction

Management of the combined loss of Achilles tendon and skin is difficult. However, these are not exceptional situations after Achilles tendon surgery. Data from the literature are extensive and there is currently no consensus on the technique of tendon reconstruction.

Case reports

We report four cases of purulent necrosis of the Achilles tendon complicating longitudinal incision or suturing of a tendon rupture. After debridement of necrotic tissue, the defect was covered either by a fasciocutaneous perforating flap or a thin skin graft without reconstruction of the underlying tendon.

Discussion and conclusion

The functional results are very satisfactory with good joint mobilities and a resumption of walking without lameness for all patients. Fibrosis can reconstitute a true neo-tendon confirmed on MRI. The advantages are many compared to other methods: a single operating time is necessary, the postoperative management is simple and it avoids certain technical difficulties related to tendon reconstruction. A larger series would be needed to support these results.

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Traitement des nécroses du tendon d’Achille sans reconstruction tendineuse : à propos de quatre cas

Publication date: Available online 8 February 2019

Source: Annales de Chirurgie Plastique Esthétique

Author(s): C. Monnerie, D. Le Nen, W. Hu, H. Letissier, N. Kerfant

Résumé

Introduction

La prise en charge des pertes de substances combinées du tendon d'Achille et de la peau est difficile. Il ne s'agit pourtant pas de situations exceptionnelles après chirurgie du tendon d'Achille. Les données de la littérature sont vastes et il n'existe actuellement pas de consensus quant à la technique de reconstruction du tendon.

Cas cliniques

Nous rapportons quatre cas de nécrose purulente du tendon d'Achille compliquant un peignage ou la suture d'une rupture tendineuse. Après parage de l'ensemble des tissus nécrotiques, la perte de substance a été couverte par un lambeau perforant fascio-cutané ou par une greffe de peau mince sans reconstruction du tendon sous-jacent.

Discussion et conclusion

Les résultats fonctionnels sont très satisfaisants avec de bonnes mobilités articulaires et une reprise de la marche sans boiterie pour tous les patients. La fibrose permet de reconstituer un véritable néotendon confirmé à l'IRM. Les avantages sont nombreux par rapport à d'autres méthodes : un seul temps opératoire est nécessaire, la gestion postopératoire est simple et elle permet d'éviter certaines difficultés techniques liées à la reconstruction tendineuse. Une plus large série serait nécessaire pour conforter ces résultats.

Summary

Introduction

Management of the combined loss of Achilles tendon and skin is difficult. However, these are not exceptional situations after Achilles tendon surgery. Data from the literature are extensive and there is currently no consensus on the technique of tendon reconstruction.

Case reports

We report four cases of purulent necrosis of the Achilles tendon complicating longitudinal incision or suturing of a tendon rupture. After debridement of necrotic tissue, the defect was covered either by a fasciocutaneous perforating flap or a thin skin graft without reconstruction of the underlying tendon.

Discussion and conclusion

The functional results are very satisfactory with good joint mobilities and a resumption of walking without lameness for all patients. Fibrosis can reconstitute a true neo-tendon confirmed on MRI. The advantages are many compared to other methods: a single operating time is necessary, the postoperative management is simple and it avoids certain technical difficulties related to tendon reconstruction. A larger series would be needed to support these results.

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Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of ...

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Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of ...

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Does procalcitonin have a role in the pathogenesis of nasal polyp?

Abstract

Purpose

The aim of this study is to investigate serum and tissue procalcitonin (PCT) levels in patients with nasal polyps.

Methods

The study was designed to be prospectively controlled and included 26 patients chronic rhinosinusitis with nasal polyp (CRSwNP) endoscopically diagnosed and as a control group 25 chronic rhinosinusitis without nasal polyp (CRSsNP). NP specimens, nasal mucosal tissue and venous blood samples of both groups were collected and PCT levels determined by Elisa method. The results were compared statistically.

Results

Serum PCT values were 1319.5 pg/mL in the NP group and 818.8 pg/mL in the control group. The difference between the groups was statistically significant (p = 0.0001). In the NP group, the average PCT value of the polyp tissue was 1521.5 pg/gr, while the mean PCT value of the control group in the nasal mucosa was 414.6 pg/gr. There was a statistically significant difference between the groups (p = 0.0001). The tissue cut-off value of PCT 750 was significant [area under curve 0.940 (0.863–1.00)]. Serum PCT 950 cut-off value was significant [area under curve 0.860 (0.748–0.972)] activity (CI: 95%).

Conclusions

This is the first study of its kind to objectively examine PCT in the polyp and serum of CRSwNP patients. PCT may serve as a diagnostic biomarker in nasal polyps.

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Does procalcitonin have a role in the pathogenesis of nasal polyp?

Abstract

Purpose

The aim of this study is to investigate serum and tissue procalcitonin (PCT) levels in patients with nasal polyps.

Methods

The study was designed to be prospectively controlled and included 26 patients chronic rhinosinusitis with nasal polyp (CRSwNP) endoscopically diagnosed and as a control group 25 chronic rhinosinusitis without nasal polyp (CRSsNP). NP specimens, nasal mucosal tissue and venous blood samples of both groups were collected and PCT levels determined by Elisa method. The results were compared statistically.

Results

Serum PCT values were 1319.5 pg/mL in the NP group and 818.8 pg/mL in the control group. The difference between the groups was statistically significant (p = 0.0001). In the NP group, the average PCT value of the polyp tissue was 1521.5 pg/gr, while the mean PCT value of the control group in the nasal mucosa was 414.6 pg/gr. There was a statistically significant difference between the groups (p = 0.0001). The tissue cut-off value of PCT 750 was significant [area under curve 0.940 (0.863–1.00)]. Serum PCT 950 cut-off value was significant [area under curve 0.860 (0.748–0.972)] activity (CI: 95%).

Conclusions

This is the first study of its kind to objectively examine PCT in the polyp and serum of CRSwNP patients. PCT may serve as a diagnostic biomarker in nasal polyps.

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Comment on “Nonsurgical Management of Medication-Related Osteonecrosis of the Jaws Using Local Wound Care” by Hadaya et al

Publication date: Available online 8 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Takako Nishida, Yoshinori Fujita, Yoshinari Myoken

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Comment on “Nonsurgical Management of Medication-Related Osteonecrosis of the Jaws Using Local Wound Care” by Hadaya et al

Publication date: Available online 8 February 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Takako Nishida, Yoshinori Fujita, Yoshinari Myoken

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Pediatric Tracheostomy First Tube Change: When is it Safe?

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): R. Woods, L. Geyer, R. Mehanna, J. Russell

Abstract

Objectives

The first tracheostomy tube change is typically performed on days 5-7 post-operatively, however recent international consensus guidelines suggested that, with maturation sutures, days 3-5 is appropriate. We evaluate whether a first tube change on day 2 post-operatively is safe and effective.

Methods

We carried out a retrospective review of all patients undergoing tracheostomy between 2009 and 2018. Exclusion criteria were patients on whom the senior authors did not operate, operations done elsewhere, cases where maturation sutures were not used or a patient died prior to first tube change. We noted patient details, indication for tracheostomy, the need for long-term ventilation, timing of the first tube change, decannulation and need for surgical closure of persistent tracheocutaneous fistula.

Results

93 patients were identified, of which 83 were included. The age range was 0-16 years, with the youngest day one of life and an overall mean age of 1.91 years. 59% of patients required long-term ventilation due to various co-morbidities. 26 patients (31%) underwent a first tube change on day 2 post-operatively. All these were uneventful and were irrespective of the patient's need for ventilation. Of the 42 patients who have subsequently been decannulated, 33 (79%) were noted to have a persistent tracheocutaneous fistula requiring surgical closure, four of whom needed revision closure.

Conclusions

This study shows that a first tube change on day 2 post-operatively is safe, facilitating earlier discharge from intensive care, allowing shorter length of sedation, earlier start to parent/carer training and wound assessment.

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The relationship between health-related quality of life and speech in patients with cleft palate

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Laura Bruneel, Kim Bettens, Kristiane Van Lierde

Abstract

Introduction

In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire.

Materials and methods

Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients.

Results

Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (r_s= -0.476), speech understandability (r_s= -0.657), passive CSC's (r_s= -0.654), speech acceptability (r_s= -0.591) and the need for C(L)P-related speech therapy (r_s= -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire.

Discussion and conclusion:Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.

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Radiologic Recognition of Cochlear Implant Magnet Displacement- A Case Report

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Madison V. Epperson, Hayley L. Born, John Greinwald

Abstract

Despite various studies that have demonstrated risk of cochlear implant magnet displacement following MRI, minimal literature is available on radiologic recognition of magnet displacement. Current literature emphasizes the status and placement of the electrode component of the implant. This case report examines the consequences of a delay in radiologic diagnosis of a displaced magnet including hospital admission, unnecessary radiation, and prolonged patient discomfort. Additionally, it provides a framework for successful radiologic recognition of a displaced magnet, detailing specific imaging modalities and magnet characteristics that should be evaluated to expedite and facilitate radiologic recognition of displacement.

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The relationship between health-related quality of life and speech in patients with cleft palate

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Laura Bruneel, Kim Bettens, Kristiane Van Lierde

Abstract

Introduction

In health-care, current efforts focus on providing patient-centered care. Specifically for patients with velopharyngeal insufficiency, and by extent patients with cleft palate, the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) questionnaire (Skirko et al., 2012; 2013) allows the clinician to map the impact of speech and swallowing difficulties on the patient's health-related quality of life (HRQoL). The current study evaluated the hypothesized association between this speech-related HRQoL measure and perceptually and instrumentally assessed speech variables, to provide evidence for the construct validity of the Dutch version of the VELO questionnaire.

Materials and methods

Thirty participants, twenty-five patients with cleft palate and five controls, were enrolled. Perceptual speech assessment was conducted following the recently developed Dutch outcome tool for perceptual speech assessment in patients with cleft palate. In addition, nasalance values and the Nasality Severity Index (NSI) 2.0 were determined. The relationship between these speech outcomes and the scores on the VELO parent report was determined using Spearman rank-order correlation coefficients.

Results

Moderate to strong correlations were found between the total score on the VELO parent report and five speech variables: the VPC-SUM score (r_s= -0.476), speech understandability (r_s= -0.657), passive CSC's (r_s= -0.654), speech acceptability (r_s= -0.591) and the need for C(L)P-related speech therapy (r_s= -0.711). Furthermore, these variables were associated with at least one subscale of the VELO questionnaire.

Discussion and conclusion:Correlations between speech outcomes and the Dutch version of the VELO questionnaire provide evidence for the construct validity of this version of the instrument. Furthermore, insights in these associations may lead the way to efficient therapy approaches, targeting speech features with the greatest impact on the patient's health-related quality of life.

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Genetic diversity of Streptococcus mutans serotype c isolated from white spot and cavitated caries lesions from schoolchildren

Publication date: Available online 8 February 2019

Source: Archives of Oral Biology

Author(s): Ramiro Javier Rincón-Rodríguez, Monica Tatiana Parada-Sanchez, Claudia María Bedoya-Correa, David Arboleda-Toro

Abstract

Objective

To determine the genetic diversity ofStreptococcus mutans (S. mutans) serotype c isolated from white spot and cavitated caries lesions of schoolchildren.

Methods

S. mutans isolates were obtained and identify by Polymerase Chain Reaction (PCR) from 28 schoolchildren. A total of 92 S. mutans isolates, identified as serotype c by PCR, were analyzed by pulsed field gel electrophoresis after digestion of genomic DNA with SmaI enzyme. 62 isolates were obtained from white spot and cavitated caries lesions of schoolchildren that presented both lesions simultaneously and 30 isolates were from saliva and biofilm samples of schoolchildren without dental caries. Cluster analyses were performed using the Dice coefficient of the BioNumerics software version 6.0.

Results

It was possible to determine the serotype in 190 isolates out of 255 isolates identified as S. mutans. Serotype c was the most frequent (n = 139), followed by serotype f (n = 31) and serotype e (n = 20). After analyzing the dendograms of the 92 serotype c isolates, this study identified three strains present in both types of lesions, two strains specific to the type of lesion: one strain from the white spot lesion and one strain from the cavitated caries lesion, and five strains specific to children with caries versus four strains for children without caries.

Conclusion

S. mutans serotype c genetic variability is similar in terms of the number of strains present according to the caries status and type of lesion.

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

Radiologic Recognition of Cochlear Implant Magnet Displacement- A Case Report

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Madison V. Epperson, Hayley L. Born, John Greinwald

Abstract

Despite various studies that have demonstrated risk of cochlear implant magnet displacement following MRI, minimal literature is available on radiologic recognition of magnet displacement. Current literature emphasizes the status and placement of the electrode component of the implant. This case report examines the consequences of a delay in radiologic diagnosis of a displaced magnet including hospital admission, unnecessary radiation, and prolonged patient discomfort. Additionally, it provides a framework for successful radiologic recognition of a displaced magnet, detailing specific imaging modalities and magnet characteristics that should be evaluated to expedite and facilitate radiologic recognition of displacement.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SnZEY0

Pediatric Tracheostomy First Tube Change: When is it Safe?

Publication date: Available online 8 February 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): R. Woods, L. Geyer, R. Mehanna, J. Russell

Abstract

Objectives

The first tracheostomy tube change is typically performed on days 5-7 post-operatively, however recent international consensus guidelines suggested that, with maturation sutures, days 3-5 is appropriate. We evaluate whether a first tube change on day 2 post-operatively is safe and effective.

Methods

We carried out a retrospective review of all patients undergoing tracheostomy between 2009 and 2018. Exclusion criteria were patients on whom the senior authors did not operate, operations done elsewhere, cases where maturation sutures were not used or a patient died prior to first tube change. We noted patient details, indication for tracheostomy, the need for long-term ventilation, timing of the first tube change, decannulation and need for surgical closure of persistent tracheocutaneous fistula.

Results

93 patients were identified, of which 83 were included. The age range was 0-16 years, with the youngest day one of life and an overall mean age of 1.91 years. 59% of patients required long-term ventilation due to various co-morbidities. 26 patients (31%) underwent a first tube change on day 2 post-operatively. All these were uneventful and were irrespective of the patient's need for ventilation. Of the 42 patients who have subsequently been decannulated, 33 (79%) were noted to have a persistent tracheocutaneous fistula requiring surgical closure, four of whom needed revision closure.

Conclusions

This study shows that a first tube change on day 2 post-operatively is safe, facilitating earlier discharge from intensive care, allowing shorter length of sedation, earlier start to parent/carer training and wound assessment.

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

Genetic diversity of Streptococcus mutans serotype c isolated from white spot and cavitated caries lesions from schoolchildren

Publication date: Available online 8 February 2019

Source: Archives of Oral Biology

Author(s): Ramiro Javier Rincón-Rodríguez, Monica Tatiana Parada-Sanchez, Claudia María Bedoya-Correa, David Arboleda-Toro

Abstract

Objective

To determine the genetic diversity ofStreptococcus mutans (S. mutans) serotype c isolated from white spot and cavitated caries lesions of schoolchildren.

Methods

S. mutans isolates were obtained and identify by Polymerase Chain Reaction (PCR) from 28 schoolchildren. A total of 92 S. mutans isolates, identified as serotype c by PCR, were analyzed by pulsed field gel electrophoresis after digestion of genomic DNA with SmaI enzyme. 62 isolates were obtained from white spot and cavitated caries lesions of schoolchildren that presented both lesions simultaneously and 30 isolates were from saliva and biofilm samples of schoolchildren without dental caries. Cluster analyses were performed using the Dice coefficient of the BioNumerics software version 6.0.

Results

It was possible to determine the serotype in 190 isolates out of 255 isolates identified as S. mutans. Serotype c was the most frequent (n = 139), followed by serotype f (n = 31) and serotype e (n = 20). After analyzing the dendograms of the 92 serotype c isolates, this study identified three strains present in both types of lesions, two strains specific to the type of lesion: one strain from the white spot lesion and one strain from the cavitated caries lesion, and five strains specific to children with caries versus four strains for children without caries.

Conclusion

S. mutans serotype c genetic variability is similar in terms of the number of strains present according to the caries status and type of lesion.

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

Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study

Publication date: Available online 8 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): H. Yoshikawa, M. Yoshida, M. Yasaka, H. Yoshida, Y. Murasato, D. Fukunaga, A. Shintani, Y. Okada

Abstract

The aim of this study was to compare the safety of tooth extraction in patients receiving direct oral anticoagulants (DOACs) or warfarin without cessation of their antithrombotic treatment. This prospective observational study included 367 patients undergoing tooth extraction (119 receiving DOACs and 248 receiving warfarin). All extractions in DOAC patients were performed 6–7 h after taking DOACs in consideration of the half-life in blood under continued antithrombotic treatment. To examine the potential postoperative bleeding risk related to the time of extraction and the drug concentration of blood, activated partial thromboplastin time (APTT) in dabigatran and prothrombin time (PT) in rivaroxaban were measured three times after administration. A total of 390 tooth extractions were performed: 128 in the DOAC patients and 262 in warfarin patients. Postoperative bleeding occurred in four extractions (3.1%) in the DOAC group and in 23 (8.8%) in the warfarin group. There was no statistically significant difference between the two groups (odds ratio: 2.362, 95% confidence interval (CI) 0.819–6.815, p = 0.112). APTT and PT prolongation in almost all cases decreased with time after taking the medicine. Our findings suggest that interruption of DOAC therapy is not necessary for tooth extraction if the procedure is performed at least 6 h after the last dose.

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Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study

Publication date: Available online 8 February 2019

Source: International Journal of Oral and Maxillofacial Surgery

Author(s): H. Yoshikawa, M. Yoshida, M. Yasaka, H. Yoshida, Y. Murasato, D. Fukunaga, A. Shintani, Y. Okada

Abstract

The aim of this study was to compare the safety of tooth extraction in patients receiving direct oral anticoagulants (DOACs) or warfarin without cessation of their antithrombotic treatment. This prospective observational study included 367 patients undergoing tooth extraction (119 receiving DOACs and 248 receiving warfarin). All extractions in DOAC patients were performed 6–7 h after taking DOACs in consideration of the half-life in blood under continued antithrombotic treatment. To examine the potential postoperative bleeding risk related to the time of extraction and the drug concentration of blood, activated partial thromboplastin time (APTT) in dabigatran and prothrombin time (PT) in rivaroxaban were measured three times after administration. A total of 390 tooth extractions were performed: 128 in the DOAC patients and 262 in warfarin patients. Postoperative bleeding occurred in four extractions (3.1%) in the DOAC group and in 23 (8.8%) in the warfarin group. There was no statistically significant difference between the two groups (odds ratio: 2.362, 95% confidence interval (CI) 0.819–6.815, p = 0.112). APTT and PT prolongation in almost all cases decreased with time after taking the medicine. Our findings suggest that interruption of DOAC therapy is not necessary for tooth extraction if the procedure is performed at least 6 h after the last dose.

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Drop attacks, hydrops severity, and disease duration in hydropic ear disease (Menière’s)

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The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Abstract

Purpose

The sino-nasal outcomes test-22 (SNOT-22) represents the reference questionnaire to assess patients with chronic rhinosinusitis (CRS). As weak correlations between objective CRS parameters and SNOT-22 total score have been observed, factor analyses have aimed to identify underlying factorial structures. However, ambiguous factor loadings and problematic item-domain assignments have resulted. Moreover, such factor analyses have mainly been performed in non-European CRS patients, while European data remain sparse. This study thus sought to address these issues.

Methods

Principal component analysis and confirmatory factor analysis were performed from SNOT-22 questionnaires completed by European CRS patients. Goodness of fit, internal consistencies, and factor loadings were calculated. Item-domain assignment was based on statistical grounds and clinical meaningfulness. Additionally, this study investigated correlations between SNOT-22 domains and external reference criteria, including Lund–Mackay score, Lund–Naclerio score and the brief symptom inventory 18 (BSI-18).

Results

One hundred and thirty-four European CRS patients were included. Principal component analysis proposed four SNOT-22 domains ("nasal symptoms", "otologic symptoms", "sleep symptoms", "emotional symptoms"), which explained 63.6% of variance. Observed item-domain-assignment differed from previously proposed item-domain assignments. All factor loadings were > 0.5, except "cough" (0.42) and "facial pain or pressure" (0.49). For confirmatory factor analysis, satisfactory goodness of fit (RMSEA = 0.66; CFI = 0.92; TLI = 0.90) and internal consistencies (Cronbach-α: total score = 0.93; domains = 0.75–0.91) were observed. Significant positive correlations were found between the "nasal symptoms" domain and both the Lund–Mackay score (r = 0.48; p < 0.001) and the Lund–Naclerio score (r = 0.27, p < 0.01). Significant positive correlations were also identified between "emotional symptoms" and BSI-18 total score (r = 0.64, p < 0.001).

Conclusions

Principal component analysis performed for SNOT-22 questionnaires completed by European CRS patients indicated a different item-domain-assignment than previously reported. Confirmatory factor analysis suggested acceptable and clinically plausible psychometric properties for the resulting factorial structure. Significant correlations between the "nasal symptoms" and the "emotional symptoms" domains were observed with objective CRS parameters. The resulting factorial structure with different item-domain assignments may thus be more suitable for European CRS patients.

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Drop attacks, hydrops severity, and disease duration in hydropic ear disease (Menière’s)

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

The SNOT-22 factorial structure in European patients with chronic rhinosinusitis: new clinical insights

Abstract

Purpose

The sino-nasal outcomes test-22 (SNOT-22) represents the reference questionnaire to assess patients with chronic rhinosinusitis (CRS). As weak correlations between objective CRS parameters and SNOT-22 total score have been observed, factor analyses have aimed to identify underlying factorial structures. However, ambiguous factor loadings and problematic item-domain assignments have resulted. Moreover, such factor analyses have mainly been performed in non-European CRS patients, while European data remain sparse. This study thus sought to address these issues.

Methods

Principal component analysis and confirmatory factor analysis were performed from SNOT-22 questionnaires completed by European CRS patients. Goodness of fit, internal consistencies, and factor loadings were calculated. Item-domain assignment was based on statistical grounds and clinical meaningfulness. Additionally, this study investigated correlations between SNOT-22 domains and external reference criteria, including Lund–Mackay score, Lund–Naclerio score and the brief symptom inventory 18 (BSI-18).

Results

One hundred and thirty-four European CRS patients were included. Principal component analysis proposed four SNOT-22 domains ("nasal symptoms", "otologic symptoms", "sleep symptoms", "emotional symptoms"), which explained 63.6% of variance. Observed item-domain-assignment differed from previously proposed item-domain assignments. All factor loadings were > 0.5, except "cough" (0.42) and "facial pain or pressure" (0.49). For confirmatory factor analysis, satisfactory goodness of fit (RMSEA = 0.66; CFI = 0.92; TLI = 0.90) and internal consistencies (Cronbach-α: total score = 0.93; domains = 0.75–0.91) were observed. Significant positive correlations were found between the "nasal symptoms" domain and both the Lund–Mackay score (r = 0.48; p < 0.001) and the Lund–Naclerio score (r = 0.27, p < 0.01). Significant positive correlations were also identified between "emotional symptoms" and BSI-18 total score (r = 0.64, p < 0.001).

Conclusions

Principal component analysis performed for SNOT-22 questionnaires completed by European CRS patients indicated a different item-domain-assignment than previously reported. Confirmatory factor analysis suggested acceptable and clinically plausible psychometric properties for the resulting factorial structure. Significant correlations between the "nasal symptoms" and the "emotional symptoms" domains were observed with objective CRS parameters. The resulting factorial structure with different item-domain assignments may thus be more suitable for European CRS patients.

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MRI estimates of brown adipose tissue in children – Associations to adiposity, osteocalcin, and thigh muscle volume

Publication date: Available online 8 February 2019

Source: Magnetic Resonance Imaging

Author(s): Jonathan Andersson, Josefine Roswall, Emma Kjellberg, Håkan Ahlström, Jovanna Dahlgren, Joel Kullberg

Abstract

Context

Brown adipose tissue is of metabolic interest. The tissue is however poorly explored in children.

Methods

Sixty-three 7-year old subjects from the Swedish birth-cohort Halland Health and Growth Study were recruited. Care was taken to include both normal weight and overweight children, but the subjects were otherwise healthy. Only children born full term were included.

Water-fat separated whole-body MRI scans, anthropometric measurements, and measurements of fasting glucose and levels of energy homeostasis related hormones, including the insulin-sensitizer osteocalcin, were performed. The fat fraction (FF) and effective transverse relaxation time (T₂*) of suspected brown adipose tissue in the cervical-supraclavicular-axillary fat depot (sBAT) and the FFs of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) were measured. Volumes of sBAT, abdominal VAT and SAT, and thigh muscle volumes were measured.

Results

The FF in the sBAT depot was lower than in VAT and SAT for all children. In linear correlations including sex and age as explanatory variables, sBAT FF correlated positively with all measures of adiposity (p < 0.01), except for VAT FF and weight, positively with sBAT T₂* (p = 0.036), and negatively with osteocalcin (p = 0.017). When adding measures of adiposity as explanatory variables, sBAT FF also correlated negatively with thigh muscle volume (p < 0.01).

Conclusions

Whole-body water-fat MRI of children allows for measurements of sBAT. The FF of sBAT was lower than that of VAT and SAT, indicating presence of BAT. Future studies could confirm whether the observed correlations corresponds to a hormonally active BAT.

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MRI estimates of brown adipose tissue in children – Associations to adiposity, osteocalcin, and thigh muscle volume

Publication date: Available online 8 February 2019

Source: Magnetic Resonance Imaging

Author(s): Jonathan Andersson, Josefine Roswall, Emma Kjellberg, Håkan Ahlström, Jovanna Dahlgren, Joel Kullberg

Abstract

Context

Brown adipose tissue is of metabolic interest. The tissue is however poorly explored in children.

Methods

Sixty-three 7-year old subjects from the Swedish birth-cohort Halland Health and Growth Study were recruited. Care was taken to include both normal weight and overweight children, but the subjects were otherwise healthy. Only children born full term were included.

Water-fat separated whole-body MRI scans, anthropometric measurements, and measurements of fasting glucose and levels of energy homeostasis related hormones, including the insulin-sensitizer osteocalcin, were performed. The fat fraction (FF) and effective transverse relaxation time (T₂*) of suspected brown adipose tissue in the cervical-supraclavicular-axillary fat depot (sBAT) and the FFs of abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) were measured. Volumes of sBAT, abdominal VAT and SAT, and thigh muscle volumes were measured.

Results

The FF in the sBAT depot was lower than in VAT and SAT for all children. In linear correlations including sex and age as explanatory variables, sBAT FF correlated positively with all measures of adiposity (p < 0.01), except for VAT FF and weight, positively with sBAT T₂* (p = 0.036), and negatively with osteocalcin (p = 0.017). When adding measures of adiposity as explanatory variables, sBAT FF also correlated negatively with thigh muscle volume (p < 0.01).

Conclusions

Whole-body water-fat MRI of children allows for measurements of sBAT. The FF of sBAT was lower than that of VAT and SAT, indicating presence of BAT. Future studies could confirm whether the observed correlations corresponds to a hormonally active BAT.

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Percutaneous CT guided bone biopsy for suspected osteomyelitis: diagnostic yield and impact on patient’s treatment change and recovery

Publication date: Available online 8 February 2019

Source: European Journal of Radiology

Author(s): Diana Hoang, Stephen Fisher, Orhan K. Oz, Javier La Fontaine, Avneesh Chhabra

ABSTRACT

Aim

To evaluate the utility of percutaneous CT guided bone biopsy (PCBB) for suspected osteomyelitis (OM) and its eventual impact on patient management and recovery.

Material and methods

Patients who received a PCBB for suspected osteomyelitis from years 2012-2018. Patient demographics, lesion location, ulcer grade, signs of toxemia, serology, wound and blood cultures, bone biopsy and cross-sectional imaging results were recorded. Diagnostic yield of the bone biopsy and its role in influencing the final treatment plan and patient recovery were evaluated. Chi-square test was used. P-value less than 0.05 was considered statistically significant.

Results

115 patients with mean age 50.86 ± 14.49 years were included. The common locations were sacrum/ischium (49/115, 43%) and spine (35/115, 30%). Clinically, 40/115 (35%) had toxemia and 67/115 (58%) had ulcers. Per serology, 17/111 (15%), 95/106 (90%), and 86/98 (88%) had an elevated WBC, CRP, and sedimentation rate, respectively. 22/91 (24%) had a positive blood culture and all 23/23 had a positive wound culture. On imaging, definitive and possible OM were reported in 84.1% and 14.2%, respectively, with 1.8% as no OM. Only 24/115 (21%) had a positive bone biopsy culture and only 10/24 (42%) total positive bone cultures impacted the treatment plan. There was no significant effect of antibiotics on the diagnostic yield of culture (p = 0.08). No statistical significance was found when comparing treatment change based on bone culture results versus all other factors combined (p = 0.33), or when comparing clinical improvement with and without positive bone cultures (p = 0.12).

Conclusion

Despite positive cross-sectional imaging findings of OM, bone biopsy yield of positive culture is low, and it leads to a small impact in changing the treatment plan or altering the course of patient recovery.

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Percutaneous CT guided bone biopsy for suspected osteomyelitis: diagnostic yield and impact on patient’s treatment change and recovery

Publication date: Available online 8 February 2019

Source: European Journal of Radiology

Author(s): Diana Hoang, Stephen Fisher, Orhan K. Oz, Javier La Fontaine, Avneesh Chhabra

ABSTRACT

Aim

To evaluate the utility of percutaneous CT guided bone biopsy (PCBB) for suspected osteomyelitis (OM) and its eventual impact on patient management and recovery.

Material and methods

Patients who received a PCBB for suspected osteomyelitis from years 2012-2018. Patient demographics, lesion location, ulcer grade, signs of toxemia, serology, wound and blood cultures, bone biopsy and cross-sectional imaging results were recorded. Diagnostic yield of the bone biopsy and its role in influencing the final treatment plan and patient recovery were evaluated. Chi-square test was used. P-value less than 0.05 was considered statistically significant.

Results

115 patients with mean age 50.86 ± 14.49 years were included. The common locations were sacrum/ischium (49/115, 43%) and spine (35/115, 30%). Clinically, 40/115 (35%) had toxemia and 67/115 (58%) had ulcers. Per serology, 17/111 (15%), 95/106 (90%), and 86/98 (88%) had an elevated WBC, CRP, and sedimentation rate, respectively. 22/91 (24%) had a positive blood culture and all 23/23 had a positive wound culture. On imaging, definitive and possible OM were reported in 84.1% and 14.2%, respectively, with 1.8% as no OM. Only 24/115 (21%) had a positive bone biopsy culture and only 10/24 (42%) total positive bone cultures impacted the treatment plan. There was no significant effect of antibiotics on the diagnostic yield of culture (p = 0.08). No statistical significance was found when comparing treatment change based on bone culture results versus all other factors combined (p = 0.33), or when comparing clinical improvement with and without positive bone cultures (p = 0.12).

Conclusion

Despite positive cross-sectional imaging findings of OM, bone biopsy yield of positive culture is low, and it leads to a small impact in changing the treatment plan or altering the course of patient recovery.

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Commentary on Jauhar and Hayes

Publication date: Available online 8 February 2019

Source: Addictive Behaviors

Author(s): Michael P. Hengartner

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Commentary on Jauhar and Hayes

Publication date: Available online 8 February 2019

Source: Addictive Behaviors

Author(s): Michael P. Hengartner

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Change in gray matter volume and cerebral blood flow in patients with burning mouth syndrome

Abstract

Background

The purpose of this study was to evaluate alterations in gray matter volume (GMV) and cerebral blood flow (CBF) using structural MRI and arterial spin labeling (ASL) perfusion MRI, respectively, in burning mouth syndrome (BMS) patients.

Methods

We prospectively enrolled 12 patients with BMS and 14 healthy controls. Volumetric T1‐weighted magnetization‐prepared rapid gradient‐echo imaging and pseudo‐continuous ASL were performed to obtain GMV and CBF, respectively. We analyzed differences in the GMV and CBF between the two groups, and their correlations with clinical parameters.

Results

The GMV was smaller in the left thalamus and left middle temporal gyrus in the BMS group when compared to controls. Regional CBF in the BMS group was significantly decreased in the left middle temporal gyrus, left insula, right middle temporal gyrus and right insula compared with controls. In BMS patients, there was a significant correlation between GMV and pain severity in the left middle temporal gyrus.

Conclusion

The reduced GMV seen in the thalami of BMS patients is consistent with the pattern observed in those with chronic pain disease, which implies that the pathogenesis of BMS may be associated with atrophy of the brain structures associated with thalamocortical processing. In addition, changes in CBF in the insula and middle temporal gyrus were also observed.

This article is protected by copyright. All rights reserved.

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Stromal fibronectin expression in patients with resected pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an extremely dense stroma, which has a fundamental role in tumor progression. Fibronectin (FN1) is the main constituent of the tumor stroma in pancre...

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Stromal fibronectin expression in patients with resected pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is characterized by an extremely dense stroma, which has a fundamental role in tumor progression. Fibronectin (FN1) is the main constituent of the tumor stroma in pancre...

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Plaque‐like myofibroblastic tumor, a rare entity of childhood: possible pitfalls in differential diagnosis

Plaque‐like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis.

This article is protected by copyright. All rights reserved.

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Clinical Factors Associated with Cutaneous Histopathologic Findings in Dermatomyositis

Background

Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited.

Methods

Using 228 dermatomyositis skin biopsies and statistical analyses including Chi‐squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings.

Results

In biopsies taken from sites of visible rash interface dermatitis was seen in 91% and 95% had at least one of perivascular inflammation, mucin or basal vacuolization. Vascular abnormalities were not closely associated with epidermal or inflammatory findings. Concomitant prednisone significantly decreased the odds of basal vacuolization (OR 0.34, 95% CI 0.12‐0.98, p‐value = 0.05), perivascular inflammation (OR 0.19, 95% CI 0.07‐0.53, p‐value = 0.002) and vessel damage (OR 0.81, 95% CI 0.68‐0.96, p‐value = 0.02).

Conclusions

Vasculopathy and classic findings of interface dermatitis may be driven by unique pathways in dermatomyositis. Corticosteroid use may impact skin biopsy findings. There is a need for clinicopathologic correlation when diagnosing dermatomyositis.

This article is protected by copyright. All rights reserved.

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Plaque‐like myofibroblastic tumor, a rare entity of childhood: possible pitfalls in differential diagnosis

Plaque‐like myofibroblastic tumor is a rare and benign pediatric soft tissue tumor. It presents as a slowly growing plaque reaching several centimeters in diameter, made up of multiple nodules. The clinical and histological features of this benign entity are similar to other fibrohistiocytic or myofibroblastic tumors occuring in childhood, so the diagnosis can be difficult. The correlation between clinical data, histopathology and immunohistochemistry is necessary for the correct diagnosis.

This article is protected by copyright. All rights reserved.

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Clinical Factors Associated with Cutaneous Histopathologic Findings in Dermatomyositis

Background

Common histopathologic findings in cutaneous dermatomyositis include vacuolar interface with dyskeratosis, mucin, and perivascular inflammation. Data examining the relationships between these and other histologic abnormalities, or their dependence on biopsy site, and medications is limited.

Methods

Using 228 dermatomyositis skin biopsies and statistical analyses including Chi‐squared analyses, calculations of relative risk, and adjusted GEE regressions we investigated relationships between 14 histopathologic findings and the impact of clinical factors on these findings.

Results

In biopsies taken from sites of visible rash interface dermatitis was seen in 91% and 95% had at least one of perivascular inflammation, mucin or basal vacuolization. Vascular abnormalities were not closely associated with epidermal or inflammatory findings. Concomitant prednisone significantly decreased the odds of basal vacuolization (OR 0.34, 95% CI 0.12‐0.98, p‐value = 0.05), perivascular inflammation (OR 0.19, 95% CI 0.07‐0.53, p‐value = 0.002) and vessel damage (OR 0.81, 95% CI 0.68‐0.96, p‐value = 0.02).

Conclusions

Vasculopathy and classic findings of interface dermatitis may be driven by unique pathways in dermatomyositis. Corticosteroid use may impact skin biopsy findings. There is a need for clinicopathologic correlation when diagnosing dermatomyositis.

This article is protected by copyright. All rights reserved.

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Involvement of hippocampal subfields and anterior-posterior subregions in encoding and retrieval of item, spatial, and associative memories: Longitudinal versus transverse axis

Publication date: Available online 8 February 2019

Source: NeuroImage

Author(s): Stanislau Hrybouski, Melanie MacGillivray, Yushan Huang, Christopher R. Madan, Rawle Carter, Peter Seres, Nikolai V. Malykhin

Abstract

The functional role of the hippocampal formation in episodic memory has been studied using functional magnetic resonance imaging (fMRI) for many years. The hippocampus can be segmented into three major anteroposterior sections, called head, body and tail, and into the Cornu Ammonis (CA), dentate gyrus (DG), and subiculum (Sub) subfields based on its transverse axis. However, the exact role of these subregions and subfields in memory processes is less understood. In the present study we combined ultra-high resolution structural Magnetic Resonance Imaging (MRI) at 4.7 T with an event-related high-resolution fMRI paradigm based on the 'Designs' subtest of the Wechsler Memory Scale to investigate how the hippocampal subfields and longitudinal subregions are involved in encoding and retrieval of item, spatial, and associative memories. Our results showed that during memory encoding, regardless of the type of memory being learned, all subregions and all subfields were active. During the retrieval phase, on the other hand, we observed an anterior to posterior gradient in hippocampal activity for all subfields and all types of memory. Our findings also confirmed presence of an anterior to posterior gradient in hippocampal activity during spatial learning. Comparing subfield activities to each other revealed that the DG was more active than the CA1-3 and Sub during both encoding and retrieval. Finally, our results showed that for every subfield, encoding vs. retrieval activity differences were larger in the hippocampal head than in the hippocampal body and tail. Furthermore, these encoding vs. retrieval activity differences were similar in all subfields, highlighting the importance of studying both the longitudinal and transverse axis specialization simultaneously. Current findings further elucidate the structure–function relationship between the human hippocampus and episodic memory.

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Transcanal sound recordings as a screening tool in the clinical management of patients with pulsatile tinnitus. A pilot study of twenty patients with pulsatile tinnitus eligible for digital subtraction angiography

Abstract

In pulsatile tinnitus, the differential diagnosis includes neurovascular pathology, which can be occult on non‐invasive imaging techniques. Therefore, if a clear diagnosis is lacking, digital subtraction angiography (DSA) is indicated to rule out a potentially hazardous vascular lesion, particularly a dural arteriovenous fistula (dAVF). However, a DSA carries a procedural risk of 1‐2%.

In a tertiary care setting, the incidence of a dAVF in pulsatile tinnitus patients lacking a diagnosis after non‐invasive imaging is about 25‐35%. Therefore, the majority of this group of patients is unnecessarily exposed to the risks of DSA.

We report on 20 consecutive patients in a tertiary care setting with pulsatile tinnitus who were referred for DSA to rule out neurovascular pathology. We found that the absence of a pulsatile sound detected by transcanal sound recordings, excludes a dAVF (100% sensitivity).

Consequently, the use of transcanal sound recordings as a screening tool may prevent patients for the unnecessary risks of DSA in the diagnostic work‐up of pulsatile tinnitus.

Conventional peri‐auriculair and neck auscultation with stethoscope is not always sufficient to objectify the presence of a pulsatile tinnitus.

This article is protected by copyright. All rights reserved.

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The Effect of Polycythemia Vera on Hearing Functions: Evaluation of Twenty‐one Patients

Abstract

•Patients with PV may present with sensorineural hearing loss, acute hearing loss, and vertigo. The aim of this study was to determine the effect of Polycytemia vera (PV) on hearing functions.

•Patients with known PV (n=21) were compared to healthy controls with no history of otologic or neurologic disorders (n = 20). Cochlear impairment was found to be significantly increased in PV group (p=0,004). There was no statistically significant difference between the groups in means of Hgb and Htc (p=0,629). But

•Platelet count was found to be significantly higher in PV group (p<0,001). The relationship between high platelet counts and cochlear involvement in PV group was found to be statistically significant (p=0,005).

•The degree of cochlear involvement was higher in patients with Hgb value >15,5 g/dL, indicating that high Hgb/Hct levels may cause hearing loss related to cochlear involvement.

•Cochlear involvement was more common in the patients with high platelet counts. The management of PV treatment is important for hearing functions.

This article is protected by copyright. All rights reserved.

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Involvement of hippocampal subfields and anterior-posterior subregions in encoding and retrieval of item, spatial, and associative memories: Longitudinal versus transverse axis

Publication date: Available online 8 February 2019

Source: NeuroImage

Author(s): Stanislau Hrybouski, Melanie MacGillivray, Yushan Huang, Christopher R. Madan, Rawle Carter, Peter Seres, Nikolai V. Malykhin

Abstract

The functional role of the hippocampal formation in episodic memory has been studied using functional magnetic resonance imaging (fMRI) for many years. The hippocampus can be segmented into three major anteroposterior sections, called head, body and tail, and into the Cornu Ammonis (CA), dentate gyrus (DG), and subiculum (Sub) subfields based on its transverse axis. However, the exact role of these subregions and subfields in memory processes is less understood. In the present study we combined ultra-high resolution structural Magnetic Resonance Imaging (MRI) at 4.7 T with an event-related high-resolution fMRI paradigm based on the 'Designs' subtest of the Wechsler Memory Scale to investigate how the hippocampal subfields and longitudinal subregions are involved in encoding and retrieval of item, spatial, and associative memories. Our results showed that during memory encoding, regardless of the type of memory being learned, all subregions and all subfields were active. During the retrieval phase, on the other hand, we observed an anterior to posterior gradient in hippocampal activity for all subfields and all types of memory. Our findings also confirmed presence of an anterior to posterior gradient in hippocampal activity during spatial learning. Comparing subfield activities to each other revealed that the DG was more active than the CA1-3 and Sub during both encoding and retrieval. Finally, our results showed that for every subfield, encoding vs. retrieval activity differences were larger in the hippocampal head than in the hippocampal body and tail. Furthermore, these encoding vs. retrieval activity differences were similar in all subfields, highlighting the importance of studying both the longitudinal and transverse axis specialization simultaneously. Current findings further elucidate the structure–function relationship between the human hippocampus and episodic memory.

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A New Method Using Tissue Expander Makes Auricular Reconstruction Easier In 115 Microtia Patients

Abstract

1、New method using expander makes auricular reconstruction easier.

2、Most patients were satisfied with reconstructed ears.

3、Reconstructed ears showed good three‐dimensional shape with clear anatomical details and symmetric cranioauricular angle.

4、Retroauricular and chest scars were much smaller.

5、Compared with traditional method,new method takes shorter operation time in the second stage.

This article is protected by copyright. All rights reserved.

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Transcanal sound recordings as a screening tool in the clinical management of patients with pulsatile tinnitus. A pilot study of twenty patients with pulsatile tinnitus eligible for digital subtraction angiography

Abstract

In pulsatile tinnitus, the differential diagnosis includes neurovascular pathology, which can be occult on non‐invasive imaging techniques. Therefore, if a clear diagnosis is lacking, digital subtraction angiography (DSA) is indicated to rule out a potentially hazardous vascular lesion, particularly a dural arteriovenous fistula (dAVF). However, a DSA carries a procedural risk of 1‐2%.

In a tertiary care setting, the incidence of a dAVF in pulsatile tinnitus patients lacking a diagnosis after non‐invasive imaging is about 25‐35%. Therefore, the majority of this group of patients is unnecessarily exposed to the risks of DSA.

We report on 20 consecutive patients in a tertiary care setting with pulsatile tinnitus who were referred for DSA to rule out neurovascular pathology. We found that the absence of a pulsatile sound detected by transcanal sound recordings, excludes a dAVF (100% sensitivity).

Consequently, the use of transcanal sound recordings as a screening tool may prevent patients for the unnecessary risks of DSA in the diagnostic work‐up of pulsatile tinnitus.

Conventional peri‐auriculair and neck auscultation with stethoscope is not always sufficient to objectify the presence of a pulsatile tinnitus.

This article is protected by copyright. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MXSV0X

The Effect of Polycythemia Vera on Hearing Functions: Evaluation of Twenty‐one Patients

Abstract

•Patients with PV may present with sensorineural hearing loss, acute hearing loss, and vertigo. The aim of this study was to determine the effect of Polycytemia vera (PV) on hearing functions.

•Patients with known PV (n=21) were compared to healthy controls with no history of otologic or neurologic disorders (n = 20). Cochlear impairment was found to be significantly increased in PV group (p=0,004). There was no statistically significant difference between the groups in means of Hgb and Htc (p=0,629). But

•Platelet count was found to be significantly higher in PV group (p<0,001). The relationship between high platelet counts and cochlear involvement in PV group was found to be statistically significant (p=0,005).

•The degree of cochlear involvement was higher in patients with Hgb value >15,5 g/dL, indicating that high Hgb/Hct levels may cause hearing loss related to cochlear involvement.

•Cochlear involvement was more common in the patients with high platelet counts. The management of PV treatment is important for hearing functions.

This article is protected by copyright. All rights reserved.

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Changes in Maxillary Sinus Volume and It’s Walls Thickness Due to Chronic Rhinosinusitis: A Prospective Study

Abstract

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.

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Changes in Maxillary Sinus Volume and It’s Walls Thickness Due to Chronic Rhinosinusitis: A Prospective Study

Abstract

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.

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Expectations and Experience of Children with Unilateral Cochlear Implantation: A Parental Perspective

AbstractTo find out parental expectations regarding outcomes of unilateral cochlear implantation prior to surgery and experience received by them after cochlear implantation and 1  year of regular auditory verbal therapy, with respect to the communication abilities, social skills and participation. Total of 200 parents of hearing impaired children participated in the study. A closed ended questionnaire containing 13 questions were used to collect the data. The participants w ere instructed to complete all the questions provided based on their expectations and experiences. The descriptive statistics were used to determine the frequency and percentage. Among 200 parents, almost all (95%) of the parents expected to have improvement in all the subscale of communication abil ities, social skil...

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Motor and cognitive performances in pre-lingual cochlear implant adolescents, related with vestibular function and auditory input.

CONCLUSIONS AND SIGNIFICANCE: Auditory information is a relevant cue when somatosensory and visual inputs are modified and range of vestibular function influence in a dynamic motor activity as gait, facts which must be considered in the neurodevelopment control. PMID: 30729843 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Guaiacol/ β-cyclodextrin for rapid healing of dry socket: antibacterial activity, cytotoxicity, and bone repair—an animal study

ConclusionThe improvement in Gu 's biological properties in vitro and the rapid alveolar repair in comparison with Alvogyl™ in vivo demonstrated the benefits of the Gu/βcd complex as a future alternative for the treatment of DS. (Source: Oral and Maxillofacial Surgery)

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Expectations and Experience of Children with Unilateral Cochlear Implantation: A Parental Perspective

AbstractTo find out parental expectations regarding outcomes of unilateral cochlear implantation prior to surgery and experience received by them after cochlear implantation and 1  year of regular auditory verbal therapy, with respect to the communication abilities, social skills and participation. Total of 200 parents of hearing impaired children participated in the study. A closed ended questionnaire containing 13 questions were used to collect the data. The participants w ere instructed to complete all the questions provided based on their expectations and experiences. The descriptive statistics were used to determine the frequency and percentage. Among 200 parents, almost all (95%) of the parents expected to have improvement in all the subscale of communication abil ities, social skil...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2td949L

Motor and cognitive performances in pre-lingual cochlear implant adolescents, related with vestibular function and auditory input.

CONCLUSIONS AND SIGNIFICANCE: Auditory information is a relevant cue when somatosensory and visual inputs are modified and range of vestibular function influence in a dynamic motor activity as gait, facts which must be considered in the neurodevelopment control. PMID: 30729843 [PubMed - as supplied by publisher] (Source: Acta Oto-Laryngologica)

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Editorial Board

Publication date: February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 1

Author(s):

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Editorial Board

Publication date: February 2019

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 136, Issue 1

Author(s):

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Relationship between sphenoid sinus volume and protrusion of internal carotid artery and optic nerve: a 3D segmentation study on maxillofacial CT-scans

Abstract

Purpose

Anatomy of sphenoid sinuses has acquired a growing importance with the diffusion of transsphenoidal surgical procedures. A common risk in these practices is the damage of internal carotid artery (ICA) and optic nerve (ON), which may protrude into the sphenoid air cavities. This study aims at analysing the relationships between sphenoid sinuses volume and protrusion of ICA and ON.

Methods

260 head CT-scans were retrospectively analysed (equally divided among males and females, age range 20–92 years). Volume was segmented through ITK-SNAP software. In addition, the subjects were classified into four groups: no protrusion of any structure (group 1), protrusion of ICA (group 2), protrusion of ON (group 3), protrusion of both ICA and ON (group 4). Possible statistically significant differences in prevalence of the four groups according to gender were assessed through Chi-squared test (p < 0.05). Differences in volume between the four groups were assessed through one-way ANOVA test (p < 0.05), separately for males and females.

Results

Group 1 was the most frequent (40.0%), followed by group 4 (27.7%) and group 2 (18.5%), without any difference according to gender. For what concerns volume, cases of ICA and concomitant ICA + ON protrusion had significantly larger sinuses, whereas isolated ON protrusion did not modify sinus volume.

Conclusions

Results show that protrusion of ICA is positively related with the volume of sphenoid sinuses, whereas the same relation was not verified for ON: surgeons should accurately consider possible ON protrusion in each case, as it may occur independently from sphenoid sinuses volume.

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Dental injuries in patients associated with fracture of facial bones

Abstract

Purpose

To assess different types of dental injuries associated with facial bone fractures.

Method

One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis.

Results

Dental injuries were more in females than males found to be statistically significant with (p < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant (p < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant.

Conclusion

Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth.

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A competing risk nomogram to predict severe late toxicity after modern re-irradiation for squamous carcinoma of the head and neck

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Matthew C. Ward, Nancy Y. Lee, Jimmy J. Caudell, Alexander Zajichek, Musaddiq J. Awan, Shlomo A. Koyfman, Neal E. Dunlap, Sara J. Zakem, Comron Hassanzadeh, Samuel Marcrom, Drexell H. Boggs, Derek Isrow, John A. Vargo, Dwight E. Heron, Farzan Siddiqui, James A. Bonner, Jonathan J. Beitler, Min Yao, Andy M. Trotti, Nadeem Riaz

Abstract

Purpose

Severe late toxicity is common after re-irradiation for recurrent or second primary (RSP) squamous carcinoma of the head and neck. However, many patients experience complications from tumor progression before manifesting late effects. We constructed a nomogram to examine this relationship between late toxicity and competing risks.

Methods and materials

Patients with RSP squamous carcinoma originating in a field previously irradiated to ≥40 Gy and treated with IMRT-based re-irradiation to ≥40 Gy were collected. Grade ≥3 late toxicity developing ≥90 days after re-irradiation was collected. A multivariable competing-risk model was fit to the actuarial risk of late toxicity with progression or death as the competing risk. The final bootstrap optimized model was converted into a nomogram.

Results

From 9 institutions, 505 patients were included. The 2-year incidence of grade ≥3 late toxicity was 16.7% (95% CI 13.2–20.2%) whereas progression or death was 64.2% (95% CI 59.7–68.8%). The median freedom from late toxicity, progression or death was 10.7, 5.5 and 3.2 months for RPA class I-III patients respectively, whereas the median OS was 44.9, 15.9 and 7.9 months, respectively. The final model included six clinical factors. Notably, dose, volume and fractionation did not significantly impact toxicity.

Conclusions

After re-irradiation, the risk of progression or death is approximately four times the risk of radiation-related severe late toxicity. The risk of late toxicity may be more dependent on patient and disease factors than modifiable treatment factors. This model is useful for patient selection, pre-treatment consent and post-treatment survivorship following re-irradiation.

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Relationship between sphenoid sinus volume and protrusion of internal carotid artery and optic nerve: a 3D segmentation study on maxillofacial CT-scans

Abstract

Purpose

Anatomy of sphenoid sinuses has acquired a growing importance with the diffusion of transsphenoidal surgical procedures. A common risk in these practices is the damage of internal carotid artery (ICA) and optic nerve (ON), which may protrude into the sphenoid air cavities. This study aims at analysing the relationships between sphenoid sinuses volume and protrusion of ICA and ON.

Methods

260 head CT-scans were retrospectively analysed (equally divided among males and females, age range 20–92 years). Volume was segmented through ITK-SNAP software. In addition, the subjects were classified into four groups: no protrusion of any structure (group 1), protrusion of ICA (group 2), protrusion of ON (group 3), protrusion of both ICA and ON (group 4). Possible statistically significant differences in prevalence of the four groups according to gender were assessed through Chi-squared test (p < 0.05). Differences in volume between the four groups were assessed through one-way ANOVA test (p < 0.05), separately for males and females.

Results

Group 1 was the most frequent (40.0%), followed by group 4 (27.7%) and group 2 (18.5%), without any difference according to gender. For what concerns volume, cases of ICA and concomitant ICA + ON protrusion had significantly larger sinuses, whereas isolated ON protrusion did not modify sinus volume.

Conclusions

Results show that protrusion of ICA is positively related with the volume of sphenoid sinuses, whereas the same relation was not verified for ON: surgeons should accurately consider possible ON protrusion in each case, as it may occur independently from sphenoid sinuses volume.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TE4ay5

Dental injuries in patients associated with fracture of facial bones

Abstract

Purpose

To assess different types of dental injuries associated with facial bone fractures.

Method

One hundred dentate patients were selected randomly of all age and gender who had maxillofacial trauma only and having dental injury in association with facial bones fractures were included. They were thoroughly examined for injury/fracture to facial region as well as for dental injuries (teeth). Tooth injuries were noted according to Ellis classification. The data was collected, compiled, and put to statistical analysis.

Results

Dental injuries were more in females than males found to be statistically significant with (p < 0.05).Crown fracture of maxillary teeth was more as compared to mandibular except molars found to be statistically significant (p < 0.05). Root fracture was more in maxillary incisors followed by canine as compared to mandibular incisors and canines found to be insignificant. Avulsion, extrusion and luxation were more in maxilla as compared to mandible found to be significant.

Conclusion

Different types of tooth injuries associated with facial bone fracture found more in females and maxillary teeth.

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

A competing risk nomogram to predict severe late toxicity after modern re-irradiation for squamous carcinoma of the head and neck

Publication date: March 2019

Source: Oral Oncology, Volume 90

Author(s): Matthew C. Ward, Nancy Y. Lee, Jimmy J. Caudell, Alexander Zajichek, Musaddiq J. Awan, Shlomo A. Koyfman, Neal E. Dunlap, Sara J. Zakem, Comron Hassanzadeh, Samuel Marcrom, Drexell H. Boggs, Derek Isrow, John A. Vargo, Dwight E. Heron, Farzan Siddiqui, James A. Bonner, Jonathan J. Beitler, Min Yao, Andy M. Trotti, Nadeem Riaz

Abstract

Purpose

Severe late toxicity is common after re-irradiation for recurrent or second primary (RSP) squamous carcinoma of the head and neck. However, many patients experience complications from tumor progression before manifesting late effects. We constructed a nomogram to examine this relationship between late toxicity and competing risks.

Methods and materials

Patients with RSP squamous carcinoma originating in a field previously irradiated to ≥40 Gy and treated with IMRT-based re-irradiation to ≥40 Gy were collected. Grade ≥3 late toxicity developing ≥90 days after re-irradiation was collected. A multivariable competing-risk model was fit to the actuarial risk of late toxicity with progression or death as the competing risk. The final bootstrap optimized model was converted into a nomogram.

Results

From 9 institutions, 505 patients were included. The 2-year incidence of grade ≥3 late toxicity was 16.7% (95% CI 13.2–20.2%) whereas progression or death was 64.2% (95% CI 59.7–68.8%). The median freedom from late toxicity, progression or death was 10.7, 5.5 and 3.2 months for RPA class I-III patients respectively, whereas the median OS was 44.9, 15.9 and 7.9 months, respectively. The final model included six clinical factors. Notably, dose, volume and fractionation did not significantly impact toxicity.

Conclusions

After re-irradiation, the risk of progression or death is approximately four times the risk of radiation-related severe late toxicity. The risk of late toxicity may be more dependent on patient and disease factors than modifiable treatment factors. This model is useful for patient selection, pre-treatment consent and post-treatment survivorship following re-irradiation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Dp9azW

Sequential Transplantation of UCBSCs and Islet Cells in Children and Adolescents With Monogenic Immunodeficiency T1DM

Conditions:   Diabetes Mellitus, Type 1;   Immunologic Deficiency Syndromes Intervention:   Procedure: Sequential transplantation Sponsor:   Children's Hospital of Fudan University Not yet recruiting (Source: ClinicalTrials.gov)

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

Sequential Transplantation of UCBSCs and Islet Cells in Children and Adolescents With Monogenic Immunodeficiency T1DM

Conditions:   Diabetes Mellitus, Type 1;   Immunologic Deficiency Syndromes Intervention:   Procedure: Sequential transplantation Sponsor:   Children's Hospital of Fudan University Not yet recruiting (Source: ClinicalTrials.gov)

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Endothelin‐1 mediates Aspergillus fumigatus induced airway inflammation and remodelling

Abstract

Background

Asthma is a chronic inflammatory condition of the airways and patients sensitised to airborne fungi such as Aspergillus fumigatus have more severe asthma. Thickening of the bronchial subepithelial layer is a contributing factor to asthma severity for which no current treatment exists. Airway epithelium acts as an initial defence barrier to inhaled spores, orchestrating an inflammatory response and contributing to subepithelial fibrosis.

Objective

We aimed to analyse the production of profibrogenic factors by airway epithelium in response to A. fumigatus, in order to propose novel anti‐fibrotic strategies for fungal‐induced asthma.

Methods

We assessed the induction of key profibrogenic factors, TGFβ1, TGFβ2, periostin and endothelin‐1, by human airway epithelial cells and in mice exposed to A. fumigatus spores or secreted fungal factors.

Results

A. fumigatus specifically caused production of endothelin‐1 by epithelial cells in vitro but not any of the other profibrogenic factors assessed. A. fumigatus also induced endothelin‐1 in murine lungs, associated with extensive inflammation and airway wall remodelling. Using a selective endothelin‐1 receptor antagonist, we demonstrated for the first time, that endothelin‐1 drives many features of airway wall remodelling and inflammation elicited by A. fumigatus.

Conclusion

Our findings are consistent with the hypothesis that elevated endothelin‐1 levels contribute to subepithelial thickening and highlight this factor as a possible therapeutic target for difficult‐to‐treat fungal‐induced asthma.

This article is protected by copyright. All rights reserved.

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Home‐based cow's milk reintroduction using a milk ladder in children less than 3 years old with IgE‐mediated cow's milk allergy

Abstract

Background

The development of tolerance to cow's milk in allergic children is best determined by supervised baked milk exposure. Widely recommended hospital‐based challenges can potentially delay contact because of resources limitations.

Objective

We sought to determine the efficacy and safety of our low‐dose home‐based reintroduction programme.

Methods

In our allergy service, children with IgE‐mediated cow's milk allergy who met a set criteria (presenting with skin and/or gastrointestinal symptoms only and skin prick test <8mm) are considered for home‐based milk reintroduction (HMR). Early contact is low‐dose ingestion of a commercial baked milk biscuit with slow gradual further exposure followed by increasing milk contact using a milk ladder. We retrospectively reviewed 4‐6 monthly attendance records assessing allergic symptoms, evolving milk tolerance, and compliance. Tolerance was determined using a 7 scale scoring system based on the milk ladder.

Results

The clinic attendance and dietetic contact records of 86 children (49 girls) who underwent HMR were reviewed. HMR was started at a median of 13 months with 49% 8‐12 months, 40% 13‐18 months and 11% 19‐33 months. Allergic symptoms were reported in 81 (43%) of 189 dietetic reviews, 65 (80%) of which were from the milk ladder; no patient experienced anaphylaxis requiring treatment with intramuscular adrenaline. After 4 reviews only 8 patients were not tolerating almost all dairy products, and there was a high rate of completion only with a further 7 patients lost to the programme.

Conclusion and Clinical Relevance

Cow's milk can be successfully and safely reintroduced in a cautious low‐dose exclusively home‐based programme in the appropriate clinical and family setting.

This article is protected by copyright. All rights reserved.

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Novel small molecule decreases cell proliferation, migration, clone formation, and gene expression through ERK inhibition in MCF-7 and MDA-MB-231 breast cancer cell lines

The Ras–Raf–MEK1/2–ERK1/2 pathway is an attractive target for the development of anticancer agents because of the high prevalence of ERK activation in human cancers. However, resistance is often developed despite initial clinical response, most likely because of activation of cross-talk pathways. In Research Genetic Cancer Center (RGCC), we are in the process of synthesizing a novel ERK inhibitor, targeting the final stage of the pathway, thus minimizing cross-talk. We have synthesized an intermediate molecule –RGCC416 – and tested its biological activity. MCF-7 and MDA-MB-231 cells were used. Cell viability was measured by crystal violet and cell proliferation by the methyl tetrazolium assay using various compound concentrations. Cell migration and colony formation were determined to assess the ability of invasion and single cancer cell growth, respectively. Expression of genes linked to MAPK/PI3K pathways was determined by PCR. ERK and phospho-ERK levels were determined in both the cytoplasm and the nucleus by western blot. It was found that although the compound did not affect viability, it significantly decreased cell proliferation, migration, and colony formation in both cell lines. In MDA-MB-231, this is possibly through retaining phospho-ERK to the cytoplasm, where it cannot activate cancer-associated genes. There was no difference in ERK levels in MCF-7 cells. This could be because of the different pathways that these cells utilize for survival. We have synthesized a molecule, which could be a promising ERK inhibitor, leading to possible novel treatment options for breast cancer patients. Correspondence to Ioannis Papasotiriou, MD, Department of R&D, Research Genetic Cancer Centre, 53100 Florina, Greece Tel: +30 238 504 1950; fax: +30 238 504 1931; e-mail: office@rgcc-genlab.com Received September 21, 2018 Accepted January 25, 2019 Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RS9vAt

Endothelin‐1 mediates Aspergillus fumigatus induced airway inflammation and remodelling

Abstract

Background

Asthma is a chronic inflammatory condition of the airways and patients sensitised to airborne fungi such as Aspergillus fumigatus have more severe asthma. Thickening of the bronchial subepithelial layer is a contributing factor to asthma severity for which no current treatment exists. Airway epithelium acts as an initial defence barrier to inhaled spores, orchestrating an inflammatory response and contributing to subepithelial fibrosis.

Objective

We aimed to analyse the production of profibrogenic factors by airway epithelium in response to A. fumigatus, in order to propose novel anti‐fibrotic strategies for fungal‐induced asthma.

Methods

We assessed the induction of key profibrogenic factors, TGFβ1, TGFβ2, periostin and endothelin‐1, by human airway epithelial cells and in mice exposed to A. fumigatus spores or secreted fungal factors.

Results

A. fumigatus specifically caused production of endothelin‐1 by epithelial cells in vitro but not any of the other profibrogenic factors assessed. A. fumigatus also induced endothelin‐1 in murine lungs, associated with extensive inflammation and airway wall remodelling. Using a selective endothelin‐1 receptor antagonist, we demonstrated for the first time, that endothelin‐1 drives many features of airway wall remodelling and inflammation elicited by A. fumigatus.

Conclusion

Our findings are consistent with the hypothesis that elevated endothelin‐1 levels contribute to subepithelial thickening and highlight this factor as a possible therapeutic target for difficult‐to‐treat fungal‐induced asthma.

This article is protected by copyright. All rights reserved.

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Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study

The aim of this study was to compare the safety of tooth extraction in patients receiving direct oral anticoagulants (DOACs) or warfarin without cessation of their antithrombotic treatment. This prospective observational study included 367 patients undergoing tooth extraction (119 receiving DOACs and 248 receiving warfarin). All extractions in DOAC patients were performed 6 –7h after taking DOACs in consideration of the half-life in blood under continued antithrombotic treatment. To examine the potential postoperative bleeding risk related to the time of extraction and the drug concentration of blood, activated partial thromboplastin time (APTT) in dabigatran and pro thrombin time (PT) in rivaroxaban were measured three times after administration. (Source: International Journal of Oral a...

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Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

Abstract

Background

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of the navigation system for the mandible.

Methods

The TREs were measured in five different experiments, varying only in the number of registration reference markers, which ranged from three to seven. To measure the TREs according to the number of registration reference markers, two experimental navigation devices were used: 1) Cbyon navigation surgery equipment 2) Polaris optical tracker. Both experiments were conducted to obtain the TREs at the anatomical locations of the mandible according to the number of registration markers during the navigation process. Statistical analysis was performed using the SPSS 23.0 software.

Results

At all anatomical locations, errors were 2 mm or less. Further, significant differences in the target errors measured by the Cbyon system were found according to the number of registration markers. Significant differences in the target errors measured by the Polaris optical tracker were found according to the registration markers at the posterior border only. In both groups, the target errors did not decrease as the number of registration markers increased.

Conclusions

This study demonstrates that an increase in the number of registration markers is not associated with a decrease in the TRE, and that a specific number of registration markers could reduce the TREs at each anatomical site. It is important to determine the minimum number of image registration markers at which the smallest TRE would be observed for different surgical sites.

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Atypical variants of posterior canal benign paroxysmal positional vertigo after canalith repositioning: a case report

. (Source: Hearing, Balance and Communication)

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Pulse-wave velocity and benign paroxysmal positional vertigo (BPPV)

. (Source: Hearing, Balance and Communication)

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Deep Neck Space Infection: Study of 52 Cases

Abstract

Deep neck spaces are still common in developing countries like India, even though its less prevalent in developed nations. It can lead to serious complications like jugular vein thrombosis and dissemination of infection if not diagnosed early and intervened. This is a retrospective chart review of 52 patients from 2014 to 2017 in a tertiary care hospital. Only patients with infection deeper to the superficial fascia of neck were included. Submandibular space infection was the most common and precipitating factor being dental infection. Most common comorbid condition was diabetes mellitus. Klebsiella pneumoniae was the most common isolated organism and few patients had mixed culture with anaerobes. Injectable cephalosporin with metronidazole was the most effective antibiotic combination against such infections. Low threshold for early surgical intervention reduce hospital stay and enable quick recovery of patients. Usage of over the counter antibiotics masks the conditions and complicate diagnosis and treatment of this condition.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2SHy3Ak

Safety of tooth extraction in patients receiving direct oral anticoagulant treatment versus warfarin: a prospective observation study

The aim of this study was to compare the safety of tooth extraction in patients receiving direct oral anticoagulants (DOACs) or warfarin without cessation of their antithrombotic treatment. This prospective observational study included 367 patients undergoing tooth extraction (119 receiving DOACs and 248 receiving warfarin). All extractions in DOAC patients were performed 6 –7h after taking DOACs in consideration of the half-life in blood under continued antithrombotic treatment. To examine the potential postoperative bleeding risk related to the time of extraction and the drug concentration of blood, activated partial thromboplastin time (APTT) in dabigatran and pro thrombin time (PT) in rivaroxaban were measured three times after administration. (Source: International Journal of Oral a...

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

Errors according to the number of registered markers used in navigation-assisted surgery of the mandible

Abstract

Background

The aim of this study was to evaluate the accuracy of navigation according to the number of markers in terms of target registration errors (TREs) at each anatomical location during the registration process of the navigation system for the mandible.

Methods

The TREs were measured in five different experiments, varying only in the number of registration reference markers, which ranged from three to seven. To measure the TREs according to the number of registration reference markers, two experimental navigation devices were used: 1) Cbyon navigation surgery equipment 2) Polaris optical tracker. Both experiments were conducted to obtain the TREs at the anatomical locations of the mandible according to the number of registration markers during the navigation process. Statistical analysis was performed using the SPSS 23.0 software.

Results

At all anatomical locations, errors were 2 mm or less. Further, significant differences in the target errors measured by the Cbyon system were found according to the number of registration markers. Significant differences in the target errors measured by the Polaris optical tracker were found according to the registration markers at the posterior border only. In both groups, the target errors did not decrease as the number of registration markers increased.

Conclusions

This study demonstrates that an increase in the number of registration markers is not associated with a decrease in the TRE, and that a specific number of registration markers could reduce the TREs at each anatomical site. It is important to determine the minimum number of image registration markers at which the smallest TRE would be observed for different surgical sites.

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

Atypical variants of posterior canal benign paroxysmal positional vertigo after canalith repositioning: a case report

. (Source: Hearing, Balance and Communication)

MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2I0G2ob

Pulse-wave velocity and benign paroxysmal positional vertigo (BPPV)

. (Source: Hearing, Balance and Communication)

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

Deep Neck Space Infection: Study of 52 Cases

AbstractDeep neck spaces are still common in developing countries like India, even though its less prevalent in developed nations. It can lead to serious complications like jugular vein thrombosis and dissemination of infection if not diagnosed early and intervened. This is a retrospective chart review of 52 patients from 2014 to 2017 in a tertiary care hospital. Only patients with infection deeper to the superficial fascia of neck were included. Submandibular space infection was the most common and precipitating factor being dental infection. Most common comorbid condition was diabetes mellitus. Klebsiella pneumoniae was the most common isolated organism and few patients had mixed culture with anaerobes. Injectable cephalosporin with metronidazole was the most effective antibiotic combina...

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

Expectations and Experience of Children with Unilateral Cochlear Implantation: A Parental Perspective

AbstractTo find out parental expectations regarding outcomes of unilateral cochlear implantation prior to surgery and experience received by them after cochlear implantation and 1  year of regular auditory verbal therapy, with respect to the communication abilities, social skills and participation. Total of 200 parents of hearing impaired children participated in the study. A closed ended questionnaire containing 13 questions were used to collect the data. The participants w ere instructed to complete all the questions provided based on their expectations and experiences. The descriptive statistics were used to determine the frequency and percentage. Among 200 parents, almost all (95%) of the parents expected to have improvement in all the subscale of communication abil ities, social skil...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2td949L

Deep Neck Space Infection: Study of 52 Cases

AbstractDeep neck spaces are still common in developing countries like India, even though its less prevalent in developed nations. It can lead to serious complications like jugular vein thrombosis and dissemination of infection if not diagnosed early and intervened. This is a retrospective chart review of 52 patients from 2014 to 2017 in a tertiary care hospital. Only patients with infection deeper to the superficial fascia of neck were included. Submandibular space infection was the most common and precipitating factor being dental infection. Most common comorbid condition was diabetes mellitus. Klebsiella pneumoniae was the most common isolated organism and few patients had mixed culture with anaerobes. Injectable cephalosporin with metronidazole was the most effective antibiotic combina...

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

Expectations and Experience of Children with Unilateral Cochlear Implantation: A Parental Perspective

AbstractTo find out parental expectations regarding outcomes of unilateral cochlear implantation prior to surgery and experience received by them after cochlear implantation and 1  year of regular auditory verbal therapy, with respect to the communication abilities, social skills and participation. Total of 200 parents of hearing impaired children participated in the study. A closed ended questionnaire containing 13 questions were used to collect the data. The participants w ere instructed to complete all the questions provided based on their expectations and experiences. The descriptive statistics were used to determine the frequency and percentage. Among 200 parents, almost all (95%) of the parents expected to have improvement in all the subscale of communication abil ities, social skil...

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2td949L