Learning Curve of Two Handed Endoscopic Ear Surgery on Sheep Temporal Bone: A Fellow’s Perspective

xlomafota13 shared this article with you from Inoreader Learning Curve of Two Handed Endoscopic Ear Surgery on Sheep Temporal Bone: A Fellow's Perspective Via Otolaryngology Indian Abstract The study puts forth the learning curve of two handed endoscopic middle ear dissection on a sheep temporal bone. It also highlights the usage of sheep temporal bone as an effective simulation technique for two-handed cadaveric temporal bone dissection. 6 sheep temporal bone models were dissected in a period of 15 days. Harvesting of cartilage graft, endoscopic myringotomy and grommet insertion, cartilage butterfly tympanoplasty, ossiculoplasty, stapes surgery and facial nerve decompression, using the Endohold®, were conducted on each bone. There was a remarkable decrease in the time required for subsequent temporal bone dissections, with significant improvement in efficiency, accuracy and neatness of dissection. Practice and experience resulted in upliftment in the level of confidence of the fellow. Striking similarities were noticed between sheep and human temporal bones. Availability of both the hands with a clear endoscopic view made it easier and more c onvenient to perform various procedures. Two handed endoscopic technique provides an excellent approach for ear surgeries. Availability of both the hands for the delicate surgery along with the spectacular endoscopic view contributes to increase in efficiency and surgery outcome. Cadaveric dissection of sheep temporal bones provides a great learning experience for a trainee to practice these delicate and skilful two-handed endoscopic middle ear surgical exercises. Its easy availability and striking similarity of the anatomy makes it a boon for the beginners. It gives ample opportunity to the trainee to explore and learn the complex anatomy, try new skills and develop an expertise in this field. The efficiency and accuracy increases significantly with each dissection, smoothening out the steep learning curve, that is, for such fine and intricate surgical skills. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute Airway Obstruction in a Patient Being Treated With Anticoagulation Therapy

xlomafota13 shared this article with you from Inoreader Acute Airway Obstruction in a Patient Being Treated With Anticoagulation Therapy Via JAMA Otolaryngology–Head & Neck Surgery Online First A 71-year-old man presented to the emergency department with dyspnea, dysph onia, dysphagia, and neck swelling. What is your diagnosis? View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safe and Efficient Performance of Open Tracheostomies in Patients With COVID-19

xlomafota13 shared this article with you from Inoreader Safe and Efficient Performance of Open Tracheostomies in Patients With COVID-19 Via JAMA Otolaryngology–Head & Neck Surgery Online First This case series demonstrates a fenestrated technique of tracheostomy that minimizes aerosolization risks by reducing risk of accidental decannulation and stomal infections while creating a tight seal around the tracheostomy tube. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Systemic Disease After Surgical Treatment for Obstructive Sleep Apnea vs CPAP

xlomafota13 shared this article with you from Inoreader Systemic Disease After Surgical Treatment for Obstructive Sleep Apnea vs CPAP Via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study assesses the association of surgery for patients with obst ructive sleep apnea with outcomes including cardiovascular, endocrine, and neurological sequelae of apnea. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Pepsin Saliva Concentration (Peptest™) Predict the Therapeutic Response of Laryngopharyngeal Reflux Patients?

xlomafota13 shared this article with you from Inoreader Does Pepsin Saliva Concentration (Peptest™) Predict the Therapeutic Response of Laryngopharyngeal Reflux Patients? Via otol rhinol Related Articles Does Pepsin Saliva Concentration (Peptest™) Predict the Therapeutic Response of Laryngopharyngeal Reflux Patients? Ann Otol Rhinol Laryngol. 2021 Jan 19;:3489420986347 Authors: Lechien JR, Bobin F, Dequanter D, Rodriguez A, Le Bon S, Horoi M, Thill MP, Salem C, Muls V, Saussez S Abstract OBJECTIVE: To study the profile and the therapeutic response of patients with laryngopharyngeal reflux (LPR) at the hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring (HEMII-pH) according to the initial pepsin saliva concentration. METHODS: From January 2018 to January 2020, patients with positive LPR diagnosis at the HEMII-pH were consecutively recruited from 3 European Hospitals. Saliva pepsin concentration (Peptest™) was measured during the HEMII-pH testing period and patients were classified into 2 groups: negative versus positive Peptest. The clinical outcomes, that is, gastrointestinal and HEMII-pH findings, reflux symptom score-12 (RSS-12), and 3-month therapeutic response, were compared between groups. RESULTS: A total of 124 patients completed the study. Among them, 30 patients had negative Peptest. Pharyngeal reflux events occurred outside 1-hour post-meal time in 74.0%, after the meals in 20.5% and nighttime in 5.5%. The pepsin saliva level was not significantly associated with the reflux events preceding the sample collection. Patients with positive Peptest had better improvement of RSS-12 digestive and respiratory subscores and oral, pharyngeal, and laryngeal findings compared with patients with negative Peptest. CONCLUSION: Patients with high saliva pepsin concentration had no stronger gastrointestinal, HEMII-pH, or clinical outcomes compared with those with low or undetectable saliva pepsin concentration. PMID: 33467863 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Subjective Evaluation of Balance by the Dizziness Handicap Inventory Does Not Predict Fall Risk in Older Adults Visiting Otolaryngology Clinics.

xlomafota13 shared this article with you from Inoreader Subjective Evaluation of Balance by the Dizziness Handicap Inventory Does Not Predict Fall Risk in Older Adults Visiting Otolaryngology Clinics. Via otol rhinol Related Articles Subjective Evaluation of Balance by the Dizziness Handicap Inventory Does Not Predict Fall Risk in Older Adults Visiting Otolaryngology Clinics. Ann Otol Rhinol Laryngol. 2021 Jan 19;:3489420987972 Authors: Abe-Fujisawa I, Maeda Y, Takao S, Kariya S, Nishizaki K Abstract OBJECTIVES: Subjective symptoms of dizziness in older adults are affected not only by objective data such as postural balance, but also by complex psychological factors. Published data analyzing how simultaneous evaluations of both objective and subjective assessments of balance can predict fall risk remain lacking. This study examined how fall risk can be predicted based on both objective data for balance and hearing and subjective symptoms of dizziness among older adults visiting otolaryngology clinics. METHODS: Medical charts of 76 patients ≥65 years old with dizziness/vertigo who visited the otolaryngology clinic were reviewed. Objective data were evaluated by postural balance (posturographic data with eyes open and closed, and one-leg standing test), spontaneous nystagmus, and mean hearing levels. Subjective handicap associated with dizziness/vertigo was assessed using the Dizziness Handicap Inventory (DHI). Subjective mental status of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Information on history (cardiovascular diseases) and fall accidents within the preceding year was collected using an in-house interview sheet. RESULTS: Objective data on postural balance did not correlate with subjective symptoms on DHI or HADS (P > .05, Pearson's correlation coefficient). Adjusted logistic regression modeling with the outcome of incident falls revealed that poor postural balance significantly predicted fall risk (P < .05; 4.9 [1.4-16.8] per 10-cm2 increment). Nystagmus tended to be associated with fall risk. In contrast, DHI score did not predict fall risk (P = .43; 1.0 [0.9-1.03]). Receiver operating characteristic analysis proposed a cut-off for postural sway with eyes closed >6.1 cm2 as optimal to predict falls in patients with nystagmus (AUC, 0.74; 95% confidence interval, 0.48-0.997). CONCLUSION: Poor postural balance is associated with increased fall risk after adjusting for subjective symptoms in older adults at otolaryngology clinics. Conversely, the self-perceived dizziness handicap of DHI score is an insufficient tool to evaluate their fall risk. PMID: 33467884 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Laryngeal Squamous Cell Carcinoma: Systematic Review and Pooled Analysis

xlomafota13 shared this article with you from Inoreader Pediatric Laryngeal Squamous Cell Carcinoma: Systematic Review and Pooled Analysis Via Clinical Otolaryngology Abstract Pediatric squamous cell carcinoma (SCC) of the larynx is rare, however recent data seems to support the notion that this pathology is increasing in incidence. Although this has been the case for several decades, treatment algorithms for this patient population remain identical to those of adults View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pattern of Hearing Loss Among Patients Attending ENT Department of a Tertiary Hospital in Nepal: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Pattern of Hearing Loss Among Patients Attending ENT Department of a Tertiary Hospital in Nepal: A Retrospective Study Via Otolaryngology Indian Abstract This study aims to analyze the pattern of hearing loss among patients visiting ENT department in Nepal Police Hospital. Pure tone audiometry results of 1654 patients with a complaint of the hearing loss were analyzed and the results were expressed in number and percentage. Among 1654 patients, 294 patients had normal hearing on both ears. So, a total of 1360 patients had hearing loss. Among 1360 patients, 897 (66%) cases were male and 463 (34%) were female. Most commonly affected age group was 31–40 years followed by 21–30 years age group. Out of 1360 patients, 432 (31.76%) patients had unilateral hearing loss whereas 928 (68.24%) cases had bilateral hearing loss. Sensorineural hearing loss was the most common 1349 (49.60%), followed by conductive 683 (25.11%) and mixed 256 (9.41%) hearing losses respectively. Conductive hearing loss was more common in younger age groups whereas sensorineural hearing loss was more common in older age groups. Mild he aring loss was seen in 1079 ears (39.67%), moderate in 671 (24.67%), severe in 368 (13.52%) and profound in 170 (6.25%). The mean hearing threshold was 42.90 ± 19.26 dB on right ear and 42.60 ± 18.76 dB on left ear with no statistically significant difference (p value −0.68). Hearing loss was more common in male population with younger age group involvement. Sensorineural hearing loss was the most common type. Mild degree of hearing loss and bilateral involvement was most common. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of TIRADS and Bethesda Scoring Systems with Final Histopathology of Thyroid Nodules – An Institutional Experience

xlomafota13 shared this article with you from Inoreader Correlation of TIRADS and Bethesda Scoring Systems with Final Histopathology of Thyroid Nodules – An Institutional Experience Via Otolaryngology Indian Abstract Fine needle aspiration cytology (FNAC) reduces the number of unnecessary thyroid surgeries for patients with benign nodules and appropriately triages patients with thyroid cancer to appropriate treatment. This was a observational study done on cases presenting with clinical suspicion of thyroid malignancy which underwent ultrasonography followed by FNAC of thyroid nodule. Ultrasonographic characterization of nodules was based on Thyroid Imaging Reporting and Data System (TIRADS) and cytology reporting was based on Bethesda system. All recruited patients underwent thyroidectomy. Pre-operative cytology and ultrasonography features were compared with final histopathology report. In our study, Bethesda system of cytology reporting for thyroid nodules had a better sensitivity, specificity and diagnostic accuracy than TIRADS system of ultrasound reporting. Bethesda system in FNAC had a larger area under the ROC curve (0.91) as compared to ultrasound TIRADS (0.70). Mali gnancy rate of TIRADS 5 nodules was 97.1% with significant p value (0.022). 100% of Bethesda VI lesions were malignant according to final histopathology report. Ultrasound TIRADS could pre-operatively predict malignancy in 63.6% of indeterminate thyroid nodules which were malignant according to post-operative histopathology. The overall concordance of ultrasound TIRADS, Bethesda system and histopathology was 69.8%. Higher TIRADS and Bethesda scoring among thyroid nodules was associated with increased risk of malignancy. US TIRADS is a good predictor of malignancy in indeterminate thyroid nodules. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Distribution of sole Pacinian corpuscles: a histological study using near-term human feet.

xlomafota13 shared this article with you from Inoreader Distribution of sole Pacinian corpuscles: a histological study using near-term human feet. Via radiol anat Related Articles Distribution of sole Pacinian corpuscles: a histological study using near-term human feet. Surg Radiol Anat. 2021 Jan 20;: Authors: Sugai N, Cho KH, Murakami G, Abe H, Uchiyama E, Kura H Abstract INTRODUCTION: Fast-adapting afferent input from the sole Pacinian corpuscles (PCs) is essential for walking. However, the distribution of PCs in the plantar subcutaneous tissue remains unknown. MATERIALS AND METHODS: Using histological sections tangential to the plantar skin of eight near-term fetuses, we counted 528-900 PCs per sole. RESULTS: Almost half of the sole PCs existed at the level of the proximal phalanx, especially on the superficial side of the long flexor tendons and flexor digitorum brevis. Conversely, the distribution was less evident on the posterior side of the foot. The medial margin of the sole contained fewer PCs than the lateral margin, possibly due to the transverse arch. In contrast to a cluster formation in the anterior foot, posterior PCs were almost always solitary, with a distance greater than 0.5 mm to the nearest PC. DISCUSSION AND CONCLUSION: Because a receptive field of PCs is larger than that of the other receptors, fewer solitary PCs might cover the posterior sole. In infants, the amount of anterior sole PCs seemed to determine the initial walking pattern using the anterior foot without heel contact. Anterior PCs concentrated along flexor tendons might play a transient role as tendon organs during the initial learning of walking. During a lesson in infants, mechanical stress from the tendon and muscle was likely to degrade the PCs. In the near term, the sole PCs seemed not to be a mini-version of the adult morphology but suggested an infant-specific function. PMID: 33471166 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series

xlomafota13 shared this article with you from Inoreader Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722668 Background Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification. Design Present study is a single-institution retrospective cohort. Methods A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient. Results Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery. Conclusion In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract&nbs p; |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.