Evaluation of a non-personalized optopalatographic device for prospective use in functional post-stroke dysphagia therapy

xlomafota13 shared this article with you from Inoreader Evaluation of a non-personalized optopalatographic device for prospective use in functional post-stroke dysphagia therapy Via swallowing exercises IEEE Trans Biomed Eng. 2021 Jul 2;PP. doi: 10.1109/TBME.2021.3094415. Online ahead of print. ABSTRACT OBJECTIVE: Stroke survivors commonly suffer from dysphagia, originating from oro-facial impairments which affect swallowing function. Functional therapy often employs tongue exercises that require the patient to perform short motion sequences. Evaluating the patients performance on those exercises is difficult, because there is no reliable form of visual feedback. METHODS: We propose an optopalatographic device that does not require a personalized dental retainer and is capable of measuring tongue movement trajectories intraorally. The device features nine optical proximity sensors at 100 Hz and is fixated against the hard palate with a specifically developed palatal adhesive. The sensing capabilities of the device were evaluated on a tongue gesture corpus recorded from nine healthy individuals, containing eight different tongue exercises commonly used in functional dysphagia therapy. RESULTS: The measured tongue trajectories contained temporally and spatially resolved information about the tongue movement and location during each exercise. Furthermore, a simple DTW-kNN classifier was able to distinguish the exercises from one another with an average classification accuracy of 97.9 % and 61.4 % (cross-validation and inter-speaker test accuracy, respectively). CONCLUSION: the device can provide real-time feedback for tongue motion and we obta ined promising gesture recognition results with relatively few sensors, even in the absence of a personalized dental retainer. SIGNIFICANCE: Non-personalized optopalatography is readily available and could aid in improving functional dysphagia therapy by providing visual feedback to both the physician and patient. PMID:34214033 | DOI:10.1109/TBME.2021.3094415 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive, objective evaluation of lower extremity lymphedema severity using shear wave elastography: A preliminary study

xlomafota13 shared this article with you from Inoreader Noninvasive, objective evaluation of lower extremity lymphedema severity using shear wave elastography: A preliminary study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00265-5. doi: 10.1016/j.bjps.2021.05.013. Online ahead of print. ABSTRACT BACKGROUND: Increased skin and subcutaneous tissue stiffness in patients with early-stage lymphedema has been reported. The purpose of this study was to examine the use of shear wave elastography (SWE) for evaluating lower extremity lymphedema (LEL). METHODS: For 10 lower extremities of normal controls and 72 limbs of patients with gynecological cancer whose lymphatic function was categorized into six stages based on the range of dermal backflow (DBF) observed in indocyanine green (ICG) lymphography, SWE was performed and shear wave velocity (SWV) of the dermis and three layers of subcutaneous tissue at the thigh and calf were recorded. Twenty-five patients underwent thigh tissue histological and dermal thickness examinations. RESULTS: The strongest correlation between the ICG DBF stage and SWV d uring SWE was observed on the dermal layer of the thigh (p < 0.01, R = 0.67). There was a significant correlation between the dermal thickness of the thigh and the ICG DBF stage (p < 0.01, R = 0.87) and also between the dermal thickness of the thigh and SWV (p < 0.01, R = 0.73). CONCLUSION: Noninvasive, objective evaluation of LEL severity using SWE was well correlated with lymphatic function as determined by ICG lymphography. The DBF changes in the dermis of the thigh best reflected the changes in lymphatic function. Dermal thickness variations may partially account for differences in SWV. PMID:34215544 | DOI:10.1016/j.bjps.2021.05.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap

xlomafota13 shared this article with you from Inoreader Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00273-4. doi: 10.1016/j.bjps.2021.05.021. Online ahead of print. ABSTRACT BACKGROUND/PURPOSE: After total or subtotal maxillectomy, reconstruction using a free rectus abdominis myocutaneous (RAMC) flap is a fundamental and useful option. The purpose of the present study was to clarify the degree of flap volume change and volume distribution change with time after total or subtotal maxillectomy and free RAMC flap reconstruction and to examine the factors affecting the results. METHODS: A total of 20 patients who underwent total or subtotal maxillectomy with free RAMC flap reconstruction were examined, and the flap volume change rate (volume at final evaluation [POD 181-360] / volume at initial evaluation [POD 5-30]) was investigated using the results of imaging tests. Moreover, the flap was divided into four blocks (A-D) in the cranio-caudal direction, and the volume change o f each block was individually analyzed. RESULTS: The overall volume change rate of fat/muscle/total was 0.84 ± 0.21/0.36 ± 0.08/0.67 ± 0.15, at the mean follow-up period of 309±35 days after the operation. The multiple regression analysis revealed that weight loss (for fat), postoperative RT (for fat and muscle), and young age (for muscle) were independently associated with flap volume loss. The results also indicated that the fat volume was stable, whereas the muscle volume decreased to <40% over time, assuming there were no influencing factors. Regarding flap volume distribution change, the fat volume tended to gather toward the central-cranial direction, while the muscle volume gathered toward the cranial direction, and total flap volume gathered toward the central direction. PMID:34215545 | DOI:10.1016/j.bjps.2021.05.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap

xlomafota13 shared this article with you from Inoreader Chronological flap volume and distribution changes after reconstruction of total maxillectomy defect using a rectus abdominis myocutaneous flap Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jun 6:S1748-6815(21)00273-4. doi: 10.1016/j.bjps.2021.05.021. Online ahead of print. ABSTRACT BACKGROUND/PURPOSE: After total or subtotal maxillectomy, reconstruction using a free rectus abdominis myocutaneous (RAMC) flap is a fundamental and useful option. The purpose of the present study was to clarify the degree of flap volume change and volume distribution change with time after total or subtotal maxillectomy and free RAMC flap reconstruction and to examine the factors affecting the results. METHODS: A total of 20 patients who underwent total or subtotal maxillectomy with free RAMC flap reconstruction were examined, and the flap volume change rate (volume at final evaluation [POD 181-360] / volume at initial evaluation [POD 5-30]) was investigated using the results of imaging tests. Moreover, the flap was divided into four blocks (A-D) in the cranio-caudal direction, and the volume change o f each block was individually analyzed. RESULTS: The overall volume change rate of fat/muscle/total was 0.84 ± 0.21/0.36 ± 0.08/0.67 ± 0.15, at the mean follow-up period of 309±35 days after the operation. The multiple regression analysis revealed that weight loss (for fat), postoperative RT (for fat and muscle), and young age (for muscle) were independently associated with flap volume loss. The results also indicated that the fat volume was stable, whereas the muscle volume decreased to <40% over time, assuming there were no influencing factors. Regarding flap volume distribution change, the fat volume tended to gather toward the central-cranial direction, while the muscle volume gathered toward the cranial direction, and total flap volume gathered toward the central direction. PMID:34215545 | DOI:10.1016/j.bjps.2021.05.021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How to deal with an unexpected event that could alter the normal activity of cellular therapy? Recommendations of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC)

xlomafota13 shared this article with you from Inoreader How to deal with an unexpected event that could alter the normal activity of cellular therapy? Recommendations of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) Via Association française pour l'étude du cancer Bull Cancer. 2021 Jun 29:S0007-4551(21)00222-8. doi: 10.1016/j.bulcan.2021.05.002. Online ahead of print. ABSTRACT The SARS-CoV-2 (COVID-19) pandemic has rapidly impacted cell therapy activities across the globe. Not only was this, unexpected event, a threat to patients who had previously received hematopoietic cell transplantation or other cell therapy such as CAR-T cells, but also, it was responsible for a disruption of cell therapy activities due to the danger of the virus and to the lack of solid scientific data on the management of patients and donors. The Francophone Society of Bone Marrow Transplantation and Cellular Therapy (SFGM-TC) devoted a workshop to issue useful recommendations in such an unexpected event in order to harmonize the actions of all the actors involved in cellular therapy programs so that we can collectively face, in the future, the challenges that could threaten our patients. This work is not specifically de dicated to the SARS-CoV-2 outbreak, but the latter has been used as a concrete example of an unexpected event to build up our recommendations. PMID:34215432 | DOI:10.1016/j.bulcan.2021.05.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients

xlomafota13 shared this article with you from Inoreader Complication avoidance protocols in endoscopic pituitary adenoma surgery: a retrospective cohort study in 514 patients Via leak of cerebrospinal fluid Pituitary. 2021 Jul 2. doi: 10.1007/s11102-021-01167-y. Online ahead of print. ABSTRACT PURPOSE: To evaluate the impact of using consistent complication-avoidance protocols in patients undergoing endoscopic pituitary adenoma surgery including techniques for avoiding anosmia, epistaxis, carotid artery injury, hypopituitarism, cerebrospinal fluid leaks and meningitis. METHODS: All patients undergoing endoscopic adenoma resection from 2010 to 2020 were included. Primary outcomes included 90-day complication rates, gland function outcomes, reoperations, readmissions and length of stay. Secondary outcomes were extent of resection, short-term endocrine remission, vision recovery. RESULTS: Of 514 patients, (mean age 51 ± 16 years; 78% macroadenomas, 19% prior surgery) major complications occurred in 18(3.5%) patients, most commonly CSF leak (9, 1.7%) and meningitis (4, 0.8%). In 14 of 18 patients, complications were deemed preventable. Four (0.8%) had complications with permanent sequelae (3 before 2016): one unexplained mortality, one stroke, one oculomotor nerve palsy, one oculoparesis. There were no internal carotid artery injuries, permanent visual worsening or permanent anosmia. New hypopituitarism occurred in 23/485(4.7%). Partial or complete hypopituitarism resolution occurred in 102/193(52.8%) patients. Median LOS was 2 days; 98.3% of patients were discharged home. Comparing 18 patients with major complications versus 496 without, median LOS was 7 versus 2 days, respectively p < 0.001. Readmissions occurred in 6%(31/535), mostly for hyponatremia (18/31). Gross total resection was achieved in 214/312(69%) endocrine-inactive adenomas; biochemical remission was achieved in 148/209(71%) endocrine-active adenomas. Visual field or acuity defects improved in 126/138(91.3%) patients. CONCLUSION: This study suggests that conformance to established protocols for endoscopic pituitary surgery may minimize com plications, re-admissions and LOS while enhancing the likelihood of preserving gland function, although there remains opportunity for further improvements. PMID:34215990 | DOI:10.1007/s11102-021-01167-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Histopathology of Parotid Pleomorphic Adenomas: A “Pleomorphic Approach” to a Demanding Lesion

xlomafota13 shared this article with you from Inoreader Histopathology of Parotid Pleomorphic Adenomas: A "Pleomorphic Approach" to a Demanding Lesion Via The Laryngoscope Objectives/Hypothesis The aim of this study was to identify potential associations between epidemiologic, morphologic, and histopathologic features in pleomorphic adenomas (PAs) of the parotid gland in order to extract information about the natural course and biologic behavior of these lesions on the basis of a single-center series of 845 cases within a period of 15 years. Study Design Retrospective study in a tertiary academic center. Methods For this study, an experienced head and neck pathologist critically re-evaluated the histological slides of the pathological specimens of all patients who underwent a parotidectomy for PA of the parotid gland between 2006 and 2020. Results A total of 845 cases made up our study sample. Our analysis showed a statistically significant association of the histologic subtype with younger age (P = .001) and maximal diameter (P = .044), with the hypocellular type being encountered more often in younger patients and in smaller lesions. The same subtype was significantly associated with an incomplete capsule (P = .001), pseudopodia (P = .006), and satellite nodules (P = .001). An incomplete capsule was associated with the presence of pseudopodia (P = .001) and satellite nodules (P = .001). Conclusion It seems that various histologic subtypes have different capsule-producing properties. Apparently, over the course of time, tumor material builds a finger-like projection still inside the capsule, separates itself from the parenchyma with fibrous tissue still remaining enclosed within the capsule (pseudopodium), slowly penetrates the capsule (incomplete capsule), and leaves the main lesion taking a part of the capsule with it (satellite nodules). Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Aerosol Generation During Laryngology Procedures in the Operating Room

xlomafota13 shared this article with you from Inoreader Aerosol Generation During Laryngology Procedures in the Operating Room Via The Laryngoscope Objective Severe acute respiratory syndrome coronavirus-2 spreads through respiratory fluids. We aim to quantify aerosolized particles during laryngology procedures to understand their potential for transmission of infectious aerosol-based diseases. Study Design Prospective quantification of aerosol generation. Methods Airborne particles (0.3–25 μm in diameter) were measured during live-patient laryngology surgeries using an optical particle counter positioned 60 cm from the oral cavity to the surgeon's left. Measurements taken during the procedures were compared to baseline concentrations recorded immediately before each procedure. Procedures included direct laryngoscopy with general endotracheal anesthesia (GETA), direct laryngoscopy with jet ventilation, and carbon dioxide (CO2) laser use with or without jet ventilation, all utilizing intermittent suction. Results Greater than 99% of measured particles were 0.3 to 1.0 μm in diameter. Compared to baseline, direct laryngoscopy was associated with a significant 6.71% increase in cumulative particles, primarily 0.3 to 1.0 μm particles (P < .0001). 1.0 to 25 μm particles significantly decreased (P < .001). Jet ventilation was not associated with a significant change in cumulative particles; when analyzing differential particle sizes, only 10 to 25 μm particles exhibited a significant increase compared to baseline (+42.40%, P = .002). Significant increases in cumulative particles were recorded during CO2 laser use (+14.70%, P < .0001), specifically in 0.3 to 2.5 μm particles. Overall, there was no difference when comparing CO2 laser use during jet ventilation versus GETA. Conclusions CO2 laser use during laryngology surgery is associated with significant increases in airborne particles. Although direct laryngoscopy with GETA is associated with slight increases in particles, jet ventilation overall does not increase particle aerosolization. Level of Evidence III Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Single Visit Evaluation and Tympanostomy Tube Placement for the Treatment of Acute Otitis Media in Children

xlomafota13 shared this article with you from Inoreader Single Visit Evaluation and Tympanostomy Tube Placement for the Treatment of Acute Otitis Media in Children Via The Laryngoscope Objective To review our experiences with development of a single visit surgery (SVS) program for children with recurrent acute otitis media (AOM) undergoing tympanostomy tube (TT) placement the same day as their otolaryngology surgical consultation. Study Design Retrospective cohort analysis. Methods Retrospective series of patients participating in SVS from inception March 1, 2014 to April 30, 2020 were analyzed, with attention to factors associated with increasing interest and participation in SVS and parent experiences/satisfaction. Results A total of 224 children had TT placed through SVS for AOM management. The average age of patients was 18.1 months (standard deviation 7.8 months), and 130 (58.0%) were male. The median interval between initial contact to schedule SVS, and the SVS date was 15 days (interquartile range 9–23 days). When analyzing year-over-year volumes from inception of SVS, notable increases were seen in 2016 and 2017 after a radio advertisement was played locally. A marked increase in volume was noted after implementation of a Decision Tree Scheduling (DTS) algorithm for children with recurrent AOM. Sixty-six (28.8%) procedures were performed after institution of DTS. A parent survey demonstrated high levels of satisfaction with the SVS experience. Estimations of savings to families in terms of time away from work demonstrated potential for indirect healthcare benefits. Conclusions SVS for TT placement was a successful, alternative model of care for management of children with AOM. Marketing strategies regarding SVS, and the inclusion of SVS pathway in DTS platforms increased rates of interest and choice of this option. Parents of children undergoing TT through SVS were satisfied with the overall experience. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hearing Preservation After Cochlear Reimplantation Using Electrocochleography: A Case Report

xlomafota13 shared this article with you from Inoreader Hearing Preservation After Cochlear Reimplantation Using Electrocochleography: A Case Report Via The Laryngoscope Studies have shown that hearing preservation is possible in the context of reimplantation, but residual hearing could not be predicted or expected in these cases. We describe a case in which a patient with mild to profound sensorineural hearing loss who underwent cochlear implantation with a lateral wall array and had hearing preserved postoperatively. She developed facial nerve stimulation which was unresponsive to reprogramming. Using electrocochleography to measure intracochlear trauma during the insertion process, the patient underwent reimplantation with a perimodiolar electrode and hearing was preserved postoperatively. This case demonstrates the potential to use electrocochleography for hearing preservation during reimplantation. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Complete Remission of Severe Eosinophilic Otitis Media With Dupilumab: A Case Report

xlomafota13 shared this article with you from Inoreader Complete Remission of Severe Eosinophilic Otitis Media With Dupilumab: A Case Report Via The Laryngoscope Eosinophilic otitis media (EOM) is a difficult-to-treat otitis media (OM) characterized by eosinophilic accumulation in the middle ear mucosa and secretion. Associated sensorineural hearing loss can eventually lead to (functional) deafness. EOM is strongly associated with type 2 inflammation driven respiratory disease, i.e. asthma and chronic rhinosinusitis with nasal polyps (CRSwNP), for which biological treatment is available. This case report discusses a patient suffering from EOM with severe mixed hearing loss, nearing functional deafness. Dupilumab treatment resulted in complete and enduring remission of the EOM, enabling adequate hearing rehabilitation. Concurrent control of the comorbid asthma and CRSwNP was obtained. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.