Recurrent Benign Paroxysmal Positional Vertigo in DFNB16 Patients with Biallelic STRC Gene Deletions

AlexandrosSfakianakis shared this article with you from Inoreader Recurrent Benign Paroxysmal Positional Vertigo in DFNB16 Patients with Biallelic STRC Gene Deletions via Otology & Neurotology - Published Ahead-of-Print Objective Deletions of STRC gene (DFNB16) account for 12% of isolated congenital mild to moderate hearing loss (HL). In mice, the stereocilin protein, encoded by STRC, is present in the vestibular kinocilium embedded in the otoconial membrane of the utricular macula. Despite this, effects on vestibular function have not been widely investigated. The aim of this study was to investigate the prevalence of benign paroxysmal positional vertigo (BPPV) in a cohort of DFNB16 patients. Study Design Observational descriptive epidemiological study. Setting Single-center study, in a tertiary referral center. Patients Older than 5 years, with a genetic diagnosis of HL related to biallelic STRC gene deletions, diagnosed between 2015 and 2021 Intervention Patients or their parents were interviewed to determine whether they had experienced vertigo or episodes of BPPV. Main Outcome Measure Criteria were at least five acute episodes of rotatory vertigo, each lasting less than 1 minute, episodes triggered by changes in specific head position, and an absence of neurological symptoms. Results Sixty-four patients having mild (33%) to moderate (66%) HL were included. Median age was 15 years (range, 6–48 yr). Prevalence of BPPV was 39% (25 of 64). Median age of first onset was 13 years (range, 3–18 yr). Conclusions This study showed recurrent BPPV and early age of onset in patients with biallelic STRC gene deletions. BPPV may be associated with the HL phenotype in patients with STRC gene deletions. It is important to inform patients and families of this potential risk such that appropriate management can be proposed. View on Web

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Impedance Change as an Indicator of Cochlear Implant Failure

AlexandrosSfakianakis shared this article with you from Inoreader Impedance Change as an Indicator of Cochlear Implant Failure via Otology & Neurotology - Published Ahead-of-Print Objective In February 2020, Advanced Bionics initiated a field action notice to remove the MS Ultra (V1) implant from circulation. In this study, we quantify a single site's incidence with device failure and examine the relationship between impedance change and declining speech perception. Study Design Retrospective/cohort study. Setting Tertiary healthcare center. Patients Forty-nine adult patients (52 devices) were implanted between October 2017 and December 2019, with the following exclusion criteria: 15%. Device failures were confirmed through analyses completed by the manufacturer. Results To date, 21% (11/52) of devices have met all three criteria for a confirmed failure with an average decline in speech perception of 27.7 ± 22%. The average length of time for detection of device failure was 21.9 ± 5 months postimplantation. An additional 7 devices (13%) are currently being monitored for failure but have not yet met full criteria. There was no predictive relationship between degree of impedance change and speech perception scores. Electrodes along the entire array (channels 1–16) can be affected. Conclusions Impedance values can be used as a reliable indicator of device malfunction, thus facilitating patient counseling and early intervention. No correlation was identified between impedance changes and speech perception scores. View on Web

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Temporomandibular joint meniscopexy using the juggerknot ®soft anchor system. technical note

AlexandrosSfakianakis shared this article with you from Inoreader Temporomandibular joint meniscopexy using the juggerknot ®soft anchor system. technical note via The British Journal of Oral and Maxillofacial Surgery Anterior disk displacement is one of the most frequent temporomandibular joint (TMJ) disorders. Disc displacement can incite inflammatory changes that cause osteoarthritis and progressive degenerative joint disease1. (Source: The British Journal of Oral and Maxillofacial Surgery) View on Web

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Effects of dimension reduction of hyperspectral images in skin gross pathology

AlexandrosSfakianakis shared this article with you from Inoreader Effects of dimension reduction of hyperspectral images in skin gross pathology via Wiley: Skin Research and Technology: Table of Contents Abstract Background Hyperspectral imaging (HSI) is an emerging modality for the gross pathology of the skin. Spectral signatures of HSI could discriminate malignant from benign tissue. Because of inherent redundancies in HSI and in order to facilitate the use of deep-learning models, dimension reduction is a common preprocessing step. The effects of dimension reduction choice, training scope, and number of retained dimensions have not been evaluated on skin HSI for segmentation tasks. Materials and methods An in-house dataset of HSI signatures from pigmented skin lesions was prepared and labeled with histology. Eleven different dimension reduction methods were used as preprocessing for tumor margin detection with support vector machines. Cluster-wise principal component analysis (ClusterPCA), a new variant of PCA, was proposed. The scope of application for dimension reduction was also investigated. Results The components produced by ClusterPCA show good agreement with the expected optical properties of skin chromophores. Random forest importance performed best during classification. However, all methods suffered from low sensitivity and generalization. Conclusion Investigation of more complex reduction and segmentation schemes with emphasis on the nature of HSI and optical properties of the skin is necessary. Insights on dimension reduction for skin tissue could facilitate the development of HSI-based systems for cancer margin detection at gross level. View on Web

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Growth Rates of Pulmonary Carcinoid Tumors and Hamartomas

AlexandrosSfakianakis shared this article with you from Inoreader Growth Rates of Pulmonary Carcinoid Tumors and Hamartomas via Journal of Computer Assisted Tomography - Published Ahead-of-Print Background Pulmonary nodule growth is often measured by volume doubling time (VDT), which may guide management. Most malignant nodules have a VDT of 20 to 400 days, with longer VDTs typically observed in indolent nodules. We assessed the utility of VDT in differentiating pulmonary carcinoids and hamartomas. Methods A review was performed from January 2012 to October 2021 to identify patients with pathologic diagnoses and at least 2 chest computed tomography scans obtained 6 or more months apart. Visualization software was used to segment nodules and calculate diameter and volume. Volume doubling time was calculated for scans with 1-mm slices. For the remainder, estimated nodule volume doubling time (eVDT) was calculated using nodule diameter. Volume doubling times/eVDTs were placed into growth categories: less than 400 days; 400–600 days; and more than 600 days. Results Sixty nodules were identified, 35 carcinoids and 25 hamartomas. Carcinoids were larger than hamartomas (median diameter, 13.5 vs 11.5 mm; P = 0.05). For carcinoid tumors, median VDT (n = 15) was 1485 days, and median eVDT (n = 32) was 1309 days; for hamartomas, median VDT (n = 8) was 2040 days and median eVDT (n = 25) was 2253 days. Carcinoid tumor eVDT was significantly shorter than hamartomas (P = 0.03). By growth category, 1 of 25 hamartomas and 5 of 35 carcinoids had eVDT less than 400 days and 24 of 25 hamartomas and 27 of 35 carcinoids had eVDT more than 600 days. Of 4 carcinoid tumors with metastases, 2 had eVDT less than 400 days and 2 had eVDT more than 600 days. Conclusions Growth rate was not a reliable differentiator of pulmonary hamartomas and carcinoids. Slow growing carcinoids can metastasize. Radiologists should be cautious when discontinuing computed tomography follow-up based on growth rates alone. View on Web

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Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches

AlexandrosSfakianakis shared this article with you from Inoreader Differentiating Peripherally Located Pulmonary Noncalcified Hamartoma From Carcinoid Using CT Radiomics Approaches via Journal of Computer Assisted Tomography - Published Ahead-of-Print Objective This article aimed to differentiate noncalcified hamartoma from pulmonary carcinoid preoperatively using computed tomography (CT) radiomics approaches. Materials and Methods The unenhanced CT (UECT) and contrast-enhanced CT (CECT) data of noncalcified hamartoma (n = 73) and pulmonary carcinoid (n = 54; typical/atypical carcinoid = 13/41) were retrospectively analyzed. The patients were randomly divided into the training and validation sets. A total of 396 radiomics features were extracted from UECT and CECT, respectively. The features were selected by using the minimum redundancy maximum relevance and the least absolute shrinkage and selection operator to construct a radiomics model. Clinical factors and radiomics features were integrated to build a nomogram model. The performance of clinical factors, radiomics, and nomogram models on the differential diagnosis between noncalcified hamartoma and carcinoid were investigated. Diagnostic performance of radiologists was also explored. Result In regard to distinguishing noncalcified hamartoma from carcinoid, the areas under the receiver operating characteristic curves of the clinical, radiomics, and nomogram models were 0.88, 0.94, and 0.96 in the training set UECT, and were 0.85, 0.92, and 0.96 in the training set CECT, respectively. The areas under the curve of the 3 models were 0.89, 0.96, and 0.96 in the validation set UECT, and were 0.79, 0.90, and 0.94 in the validation set CECT, respectively. The nomogram model exhibited good calibration and was clinically useful by decision curve analysis. Nomogram did not show significant improvement compared with radiomics, neither for UECT nor for CECT. Diagnostic performance of radiologists was lower than both radiomics and nomogram model. Conclusions Radiomics approaches may be useful in distinguishing peripheral pulmonary noncalcified hamartoma from carcinoid. Radiomics features extracted from CECT provided no significant benefit when compared with UECT. View on Web

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Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach?

AlexandrosSfakianakis shared this article with you from Inoreader Imaging Gallbladder Lesions: What Can Positron Emission Tomography/Computed Tomography Add to the Conventional Imaging Approach? via Journal of Computer Assisted Tomography - Published Ahead-of-Print Objective Incidental gallbladder lesions are common in imaging studies, although it is not always easy to discriminate benign lesions from gallbladder cancer with conventional imaging procedures. The present study aims to assess the capacity of positron emission tomography/computed tomography (PET/CT) with 2-[18F]FDG to distinguish between benign and malignant pathology of the gallbladder, compared with conventional imaging techniques (contrast-enhanced CT or magnetic resonance imaging). Methods Positron emission tomography/CT and conventional imaging studies of 53 patients with gallbladder lesions were evaluated and visually classified as benign, malignant, or inconclusive. Agreement between PET/CT and conventional imaging was determined, and imaging findings were correlated with histology or follow-up. Positron emission tomography/CT images were also analyzed semiquantitatively (SUVmax and maximum tumor-to-liver ratio [TLRmax]). The presence of adenopathies and distant metastases was assessed and compared between both imaging procedures. Results According to histology or follow-up, 33 patients (62%) had a malignant process and 20 (38%) had benign lesions. Positron emission tomography/CT and conventional imaging showed a moderate agreement (κ = 0.59). Conventional imaging classified more studies as inconclusive compared with PET/CT (17.0% and 7.5%, respectively), although both procedures showed a similar accuracy. Malignant lesions had significantly higher SUVmax and, especially, TLRmax (0.89 and 2.38 [P = 0.00028] for benign and malignant lesions, respectively). Positron emission tomography/CT identified more pathologic adenopathies and distant metastases, and patients with regional or distant spread had higher SUVmax and TLRmax in the gallbladder. Conclusions Positron emission tomography/CT is accurate to distinguish between benign and malignant pathology of the gallbladder, with a similar performance to conventional imaging procedures but with less inconclusive results. Malignant lesions present higher SUVmax and TLRmax values. View on Web

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Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis

AlexandrosSfakianakis shared this article with you from Inoreader Safety of different surgical modalities for recurrent respiratory papillomatosis resection: A systematic review and meta‐analysis via Wiley: Clinical Otolaryngology: Table of Contents Abstract Background Currently, the most common surgical modalities used for recurrent respiratory papillomatosis (RRP) resection are microdebrider, carbon dioxide (CO2) laser and potassium-titanyl-phosphate (KTP) laser. However, complication rates vary among different surgical modalities and have been controversial in different studies. Objective of Review This study systematically reviews the available studies which reported intra-operative and post-operative complications, aiming to compare the safety of microdebrider, CO2 laser and KTP laser. Type of Review Meta-analysis. Search Strategy Seven electronic databases (PubMed/MEDLINE, EMBASE[Ovid], Scopus, Cochrane Library and Web of Science) were searched from inception through 28 April 2022. Randomised controlled, prospective or retrospective observational studies that recorded the complications of three different surgical modalities for RRP resection were included in the meta-analysis. Evaluation Method Outcomes of interest were intra-operative and post-operative complications, and complication rate was calculated to evaluate the safety of surgical methods. Results Twenty different studies were included in quantitative synthesis. Only one study compared outcomes of those three kinds of treatment modalities simultaneously, two studies compared microdebrider and CO2 laser, and the remaining studies focussed on only one of three treatments. The weighted average complication rate for microdebrider was 0.03 (95% confidence interval [CI] 0.00–0.21), n = 6, for CO2 laser treatment was 0.16 (95% CI 0.09–0.25), n = 14 and for KTP laser treatment was 0.04 (95% CI 0.00–0.14), n = 4. Conclusion The limited evidence demonstrated that CO2 lasers in the surgical treatment of RRP may lead to more surgical complications, and microdebrider and KTP lasers may be safer. However, the heterogeneous data limit any strong comparison of outcomes of different treatment of laryngeal papillomas. Future randomised controlled trials that directly compare the safety of different surgical modalities are needed. View on Web

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Automated detection of glottic laryngeal carcinoma in laryngoscopic images from a multicentre database using a convolutional neural network

AlexandrosSfakianakis shared this article with you from Inoreader Automated detection of glottic laryngeal carcinoma in laryngoscopic images from a multicentre database using a convolutional neural network via Wiley: Clinical Otolaryngology: Table of Contents Abstract Objective Little is known about the efficacy of using artificial intelligence (AI) to identify laryngeal carcinoma from images of vocal lesions taken in different hospitals with multiple laryngoscope systems. This multicentre study aimed to establish an AI system and provide a reliable auxiliary tool to screen for laryngeal carcinoma. Study design Multicentre case–control study. Setting Six tertiary care centres. Participants Laryngoscopy images were collected from 2179 patients with vocal fold lesions. Outcome measures An automatic detection system of laryngeal carcinoma was established and used to distinguish malignant and benign vocal lesions in 2179 laryngoscopy images acquired from 6 hospitals with 5 types of laryngoscopy systems. Pathological examination was the gold standard for identifying malignant and benign vocal lesions. Results Out of 89 cases in the malignant group, the classifier was able to correctly identify laryngeal carcinoma in 66 patients (74.16%, sensitivity). Out of 640 cases in the benign group, the classifier was able to accurately assess the laryngeal lesion in 503 cases (78.59%, specificity). Furthermore, the region-based convolutional neural network (R-CNN) classifier achieved an overall accuracy of 78.05%, with a 95.63% negative predictive value and a 32.51% positive predictive value for the testing data set. Conclusion This automatic diagnostic system has the potential to assist clinical laryngeal carcinoma diagnosis which may improve and standardise the diagnostic capacity of laryngologists using different laryngoscopes. View on Web

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Spontaneous recovery rate of idiopathic sudden sensorineural hearing loss: A systematic review and meta‐analysis

AlexandrosSfakianakis shared this article with you from Inoreader Spontaneous recovery rate of idiopathic sudden sensorineural hearing loss: A systematic review and meta‐analysis via Wiley: Clinical Otolaryngology: Table of Contents Abstract Purpose Steroids comprise the mainstay of treatment for idiopathic sudden sensorineural hearing loss (ISSNHL). Since steroidal treatment was integrated to clinical practice guidelines, newly published no-treatment or placebo arms in clinical trials are scarce. To evaluate the effectiveness of steroidal treatment ± hyperbaric oxygen therapy, the data should be compared to spontaneous recovery. The aim of this paper is to find the most accurate spontaneous recovery rate, in the light of which, other treatment modalities should be judged. Materials and Methods Eligible studies published until July 2021 were identified through systematic searches of 'PubMed', 'Web of Science' and 'Google Scholar'. Retrospective studies and randomised/non-randomised control trials involving only adult participants (≥18 years) with ISSNHL, and placebo/no treatment were included. Only articles that used the American Academy of Otolaryngology–Head and Neck Surgery's diagnostic criteria for ISSNHL were included. Results 942 records initially identified, 166 duplicates and 753 articles were excluded based on article subject, title, and abstract. The full texts of 13 articles were reviewed. Seven studies were included for qualitative synthesis, five papers included in quantitative synthesis. 180 ears were included in pooled statistics. The pooled spontaneous recovery was 60.28% (95% confidence interval [CI] = 38.88%–79.94%) with a heterogeneity of 86.0% (95% CI = 69.4%–93.6%). Conclusions Spontaneous recovery of ISSNHL should not be over-looked, as it may be close to 60%. This may have both clinical and research implications. View on Web

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