Bilateral Orbital Apex Syndrome Related to Sphenoid Fungal Sinusitis

xlomafota13 shared this article with you from Inoreader Bilateral Orbital Apex Syndrome Related to Sphenoid Fungal Sinusitis Via ear nose throat Ear Nose Throat J. 2021 Jul 19:1455613211024768. doi: 10.1177/01455613211024768. Online ahead of print. ABSTRACT Orbital apex syndrome (OAS) is a rare condition that usually occurs due to damage to surrounding inner and surrounding bone tissue. Orbital apex syndrome may result from a variety of conditions that cause damage to the superior orbital fissure and to the optic canal leading to optic nerve (II) dysfunction. We recently experienced a rare case of sphenoidal Asper gillosis, which damaged the adjacent cavernous sinus structures and led to the definite symptom of bilateral OAS in a 77-year-old male. We present this rare case with a brief review of these disease's entities. PMID:34281412 | DOI:10.1177/01455613211024768 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ear wound healing in MRL/MpJ mice is associated with gut microbiome composition and is transferable to non-healer mice via microbiome transplantation

xlomafota13 shared this article with you from Inoreader Ear wound healing in MRL/MpJ mice is associated with gut microbiome composition and is transferable to non-healer mice via microbiome transplantation Via Ear infections by Cassandra Velasco, Christopher Dunn, Cassandra Sturdy, Vladislav Izda, Jake Martin, Alexander Rivas, Jeffrey McNaughton, Matlock A. Jeffries Objective Adult elastic cartilage has limited repair capacity. MRL/MpJ (MRL) mice, by contrast, are capable of spontaneously healing ear punctures. This study was undertaken to characterize microbiome differences between healer and non-healer mice and to evaluate whether this healing phenotype can be transferred via gut microbiome transplantation. Methods We orally transplanted C57BL/6J (B6) mice with MRL/MpJ cecal contents at weaning and as adults (n = 57) and measured ear hole closure 4 weeks after a 2.0mm punch and compared to vehicle-transplanted MRL and B6 (n = 25) and B6-transplanted MRL (n = 20) mice. Sex effects, timing of transplant relative to earpunch, and transgenerational heritability were evaluated. In a subset (n = 58), cecal microbiomes were profiled by 16S sequencing and compared to ear hole closure. Microbial metagenomes were imputed using PICRUSt. Results Transplantation of B6 mice with MRL microbiota, either in weanlings or adults, improved ear ho le closure. B6-vehicle mice healed ear hole punches poorly (0.25±0.03mm, mm ear hole healing 4 weeks after a 2mm ear hole punch [2.0mm—final ear hole size], mean±SEM), whereas MRL-vehicle mice healed well (1.4±0.1mm). MRL-transplanted B6 mice healed roughly three times as well as B6-vehicle mice, and half as well as MRL-vehicle mice (0.74±0.05mm, P = 6.9E-10 vs. B6-vehicle, P = 5.2E-12 vs. MRL-vehicle). Transplantation of MRL mice with B6 cecal material did not reduce MRL healing (B6-transplanted MRL 1.3±0.1 vs. MRL-vehicle 1.4±0.1, p = 0.36). Transplantation prior to ear punch was associated with the greatest ear hole closure. Offspring of transplanted mice healed significantly better than non-transplanted control mice (offspring:0.63±0.03mm, mean±SEM vs. B6-vehicle control:0.25±0.03mm, n = 39 offspring, P = 4.6E-11). Several microbiome clades were correlated with healing, including Firmicutes (R = 0.84, P = 8.0E-7), Lactobacillales (R = 0.65, P = 1.1E-3), and Verrucomicrobia (R = -0.80, P = 9.2E-6). Females of all groups tended to heal better than males (B6-vehicle P = 0.059, MRL-transplanted B6 P = 0.096, offspring of MRL-transplanted B6 P = 0.0038, B6-transplanted MRL P = 1.6E-6, MRL-vehicle P = 0.0031). Many clades characteristic of female mouse cecal microbiota vs. males were the same as clades characteristic of MRL and MRL-transplanted B6 mice vs. B6 controls, including including increases in Clostridia and reductions in Verrucomicrobia in female mice. Conclusion In this study, we found an association between the microbiome and tissue regeneration in MRL mice and demonstrate that this trait can be transferred to non-healer mice via microbiome transplantation. We identified several microbiome clades associated with healing. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Airway Management of the Deformed Trachea Using T-Tube Stents in Patients with Mucopolysaccharidosis Type IVA

xlomafota13 shared this article with you from Inoreader Airway Management of the Deformed Trachea Using T-Tube Stents in Patients with Mucopolysaccharidosis Type IVA Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jul 20:34894211032778. doi: 10.1177/00034894211032778. Online ahead of print. ABSTRACT INTRODUCTION: Mucopolysaccharidosis (MPS) type IVA usually results in airway obstruction due to thoracic cage deformity and crowding of intrathoracic structures, causing tracheal compression by the tortuous innominate artery. OBJECTIVES: To offer an alternative and effective method in dealing with the challenged deformity of the airway in patients with M PS type IVA. METHODS: We present 3 patients with MPS type IVA who underwent airway stenting using Montgomery® T-tube stents. Three-dimensional reconstructed computed tomography was essential to design the T-tube and evaluate the anatomical relationship between the innominate artery and the trachea. The Y-shaped Montgomery® Pediatric Safe-T-Tube™ is more suitable for MPS type IVA. Regular follow-ups using fiberoptic bronchoscopy are necessary to evaluate the complications. RESULTS: All 3 patients had good outcomes during the follow-ups until present, despite the complication of granulation formation, which was resolved by revising the limbs of the T-tube. CONCLUSIONS: T-tube stents placed below the vocal cord may restore airway patency and preserve laryngeal function, including respiration, phonation, and swallowing, in patients with MPS type IVA. PMID:34282634 | DOI:10.1177/00034894211032778 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recovery of Vocal Cord Motion Among Pediatric Patients

xlomafota13 shared this article with you from Inoreader Recovery of Vocal Cord Motion Among Pediatric Patients Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jul 20:34894211033366. doi: 10.1177/00034894211033366. Online ahead of print. ABSTRACT OBJECTIVES: Patients with vocal cord paralysis can experience feeding, respiratory, and vocal problems leading to disability and decreased quality of life. Current evidence suggests waiting a period of 12 months for spontaneous recovery before permanent interventions. This study aims to determine the time to recover spontaneously and vocal cord movement in a pediatric population and create a model for evidence-based patient counseling. STUDY DESIGN: Retrospective longitudinal cohort study. METHODS: The report is a single institution longitudinal study on vocal cord paralysis recovery. Patients were categorized based on spontaneous recovery with vocal cord movement or no recovery. Recovery rates were determined using the Kaplan-Meier method. RESULTS: Of 158 cases of vocal cord paralysis over a 4-year period, 36 had spontaneous recovery with symptom improvement and motion return. The average recovery was 8.8 months for those who recovered, and 78% recovered within 9 months. Two groups emerged from the data: an early recovery group with spontaneous recovery before 12 months and a late recovery group after 12 months. Children with dysphonia and paralysis due to cardiac surgery were less likely to recover, and children with aspiration were more likely to recover. Children with gastrointestinal comorbidities were less likely to recover; however, those who did recover were more likely to have recovered after 12 months. Based on our model, there is about a 3% chance of recovery between 9 and 12 months. CONCLUSIONS: Patients should be counseled about earlier interventions. Waiting the conventional 12 months for only a 3% chance of spontaneous recovery without intervention or laryngeal EMG may not be the preferred option for some patients and their families. PMID:34282639 | DOI:10.1177/00034894211033366 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Determining Medical Urgency of Voice Disorders Using Auditory-Perceptual Voice Assessments Performed by Speech-Language Pathologists

xlomafota13 shared this article with you from Inoreader Determining Medical Urgency of Voice Disorders Using Auditory-Perceptual Voice Assessments Performed by Speech-Language Pathologists Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jul 20:34894211032779. doi: 10.1177/00034894211032779. Online ahead of print. ABSTRACT OBJECTIVE: This study examined whether speech-language pathologist auditory-perceptual voice assessments can predict the medical urgency of voice disorders. METHODS: Twenty speech-language pathologists (SLPs) evaluated 25 voice samples recorded during initial voice evaluations. Voice samples represented a range of dysphonia severity (mild-severe) balanc ed across patient diagnoses. Diagnoses included: benign lesions, laryngeal cancer, non-organic voice disorders, laryngeal edema (associated with LPR), and laryngeal paralysis or paresis. Laryngeal cancer and severe unilateral laryngeal paralysis were considered urgent disorders. While blinded to patient information, SLPs rated severity of voice quality, predicted patient diagnosis, and determined whether the patient should be seen urgently by a laryngologist. SLPs were then given basic medical history information and rated medical urgency of voice disorder a second time. RESULTS: On average, SLPs correctly identified 65% of urgent voices and 87% of nonurgent voices when blinded to patient information. Accuracy improved significantly to 86% for urgent voices with medical history information (P < .001) and decreased to 77% for nonurgent voices. Accuracy was better when severity of voice quality was severe for urgent voices and mild for nonurgent voices (P < . 001). SLPs indicated that patient smoking history and severity of dysphonia were most influential in their decision making. Diagnostic accuracy of auditory-perceptual assessments was poor. CONCLUSIONS: SLPs identified 86% of medically urgent voice disorders when auditory perceptual assessments were combined with medical history information. Further work is needed to determine what medical history information is most crucial to rating accuracy and what speech tasks might best separate urgent and nonurgent patients. PMID:34282649 | DOI:10.1177/00034894211032779 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Determining Medical Urgency of Voice Disorders Using Auditory-Perceptual Voice Assessments Performed by Speech-Language Pathologists

xlomafota13 shared this article with you from Inoreader Determining Medical Urgency of Voice Disorders Using Auditory-Perceptual Voice Assessments Performed by Speech-Language Pathologists Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jul 20:34894211032779. doi: 10.1177/00034894211032779. Online ahead of print. ABSTRACT OBJECTIVE: This study examined whether speech-language pathologist auditory-perceptual voice assessments can predict the medical urgency of voice disorders. METHODS: Twenty speech-language pathologists (SLPs) evaluated 25 voice samples recorded during initial voice evaluations. Voice samples represented a range of dysphonia severity (mild-severe) balanc ed across patient diagnoses. Diagnoses included: benign lesions, laryngeal cancer, non-organic voice disorders, laryngeal edema (associated with LPR), and laryngeal paralysis or paresis. Laryngeal cancer and severe unilateral laryngeal paralysis were considered urgent disorders. While blinded to patient information, SLPs rated severity of voice quality, predicted patient diagnosis, and determined whether the patient should be seen urgently by a laryngologist. SLPs were then given basic medical history information and rated medical urgency of voice disorder a second time. RESULTS: On average, SLPs correctly identified 65% of urgent voices and 87% of nonurgent voices when blinded to patient information. Accuracy improved significantly to 86% for urgent voices with medical history information (P < .001) and decreased to 77% for nonurgent voices. Accuracy was better when severity of voice quality was severe for urgent voices and mild for nonurgent voices (P < . 001). SLPs indicated that patient smoking history and severity of dysphonia were most influential in their decision making. Diagnostic accuracy of auditory-perceptual assessments was poor. CONCLUSIONS: SLPs identified 86% of medically urgent voice disorders when auditory perceptual assessments were combined with medical history information. Further work is needed to determine what medical history information is most crucial to rating accuracy and what speech tasks might best separate urgent and nonurgent patients. PMID:34282649 | DOI:10.1177/00034894211032779 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Blood Loss and Transfusion Risk in Robotic‐Assisted Knee Arthroplasty: A Retrospective Analysis

xlomafota13 shared this article with you from Inoreader Blood Loss and Transfusion Risk in Robotic‐Assisted Knee Arthroplasty: A Retrospective Analysis Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract: Background The purpose of this study was to compare total blood loss and the risk of receiving a blood transfusion in robotic-assisted total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) against conventional jig-based techniques Methods Robotic TKA (n=50) and UKA (n=50) patients were matched to contemporary controls for TKA (n=50) and UKA (n=50) and retrospectively analysed Results Robotic TKA patients experienced 23.7% less blood loss compared to conventional TKA patients (911.0ml vs 1193.7ml, p<0.01), and were associated with an 83% relative risk reduction of receiving a transfusion (2% of patients vs 12%, p=0.02). Robotic UKA patients did not demonstrate less blood loss compared to corresponding controls (821.7ml vs 854.7ml, p=0.69). Both UKA groups received no transfusions Conclusions Robotic surgical systems in TKA reduces blood loss and lowers the risk of requiring a blood transfusion. In UKA, robotic-assisted arthroplasty did not reduce blood loss compared to conventional arthroplasty. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neurosurgical Performance between Experts and Trainees: Evidence from Drilling Task

xlomafota13 shared this article with you from Inoreader Neurosurgical Performance between Experts and Trainees: Evidence from Drilling Task Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Lumbar laminectomy is a common neurosurgery that requires precise manipulation of power drills. We examined the fine movement controls of novice neurosurgeons in drilling tasks and compared its accuracy to expert surgeons' performance. Methods Four expert and three novice neurosurgeons performed a lumbar laminectomy on a 3D printed spine model. Scene video and surgeons' eye movements were recorded. Independent sample T-Tests were conducted on the number of jump, total fixation durations, pre-jump fixation durations, post-jump fixation durations, and jump distances over novice and expert surgeons. Results No statistically significant differences were recorded in terms of total fixations and pre-jump fixation durations. However, novices had more jumping events, greater jump distances, and longer post-jump fixation durations when compared to expert neurosurgeons. Conclusion Differences in movement accuracy and eye measures were found between expert and novice neurosurgeons during a simulated microscopic lumbar laminectomy. A more comprehensive understanding of surgeon's fine movement control mechanism and eye-hand coordination in microsurgery is essential for us before building an enhanced training protocol for surgical residents in neurosurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neurosurgical Performance between Experts and Trainees: Evidence from Drilling Task

xlomafota13 shared this article with you from Inoreader Neurosurgical Performance between Experts and Trainees: Evidence from Drilling Task Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background Lumbar laminectomy is a common neurosurgery that requires precise manipulation of power drills. We examined the fine movement controls of novice neurosurgeons in drilling tasks and compared its accuracy to expert surgeons' performance. Methods Four expert and three novice neurosurgeons performed a lumbar laminectomy on a 3D printed spine model. Scene video and surgeons' eye movements were recorded. Independent sample T-Tests were conducted on the number of jump, total fixation durations, pre-jump fixation durations, post-jump fixation durations, and jump distances over novice and expert surgeons. Results No statistically significant differences were recorded in terms of total fixations and pre-jump fixation durations. However, novices had more jumping events, greater jump distances, and longer post-jump fixation durations when compared to expert neurosurgeons. Conclusion Differences in movement accuracy and eye measures were found between expert and novice neurosurgeons during a simulated microscopic lumbar laminectomy. A more comprehensive understanding of surgeon's fine movement control mechanism and eye-hand coordination in microsurgery is essential for us before building an enhanced training protocol for surgical residents in neurosurgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Migraine and Its Comorbidities

xlomafota13 shared this article with you from Inoreader Vestibular Migraine and Its Comorbidities Via Otolaryngologic Clinics of North America Vestibular migraine (VM) is one of the most common neurologic causes of vertigo. Symptoms and International Classification of Headache Disorders criteria are used to diagnose VM because no objective tests, imaging or audiologic, have been shown to reliably diagnose this condition. Central auditory, peripheral, and central vestibular pathway involvement has been associated with VM. Although the interaction between migraine and other vestibular disorders can be a challenging scenario for diagnosis and treatment, there are data to show that vestibular rehabilitation and a variety of pharmacologic agents improve reported symptoms and vertigo frequency. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Acute Vestibular Syndrome and ER Presentations of Dizziness

xlomafota13 shared this article with you from Inoreader Acute Vestibular Syndrome and ER Presentations of Dizziness Via Otolaryngologic Clinics of North America Acute vestibular syndrome (AVS) describes sudden onset, severe, continuous dizziness that persists for more than 24 hours. Its wide differential presents a diagnostic challenge. Vestibular neuritis is the most common cause, but stroke, trauma, medication effects, infectious, and inflammatory causes all present similarly. The TiTrATE model (Timing, Triggers, And Targeted Exam) is systematic way to evaluate these patients, and the HINTS Plus exam (Head Impulse, Nystagmus, Test of Skew, plus hearing loss) is critical in differentiating central and peripheral causes. The importance of recognizing risk factors for stroke and the role of imaging is also discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.