Minimally invasive wire-guided balloon catheter puncture for voice prosthesis insertion

Abstract

Background

Tracheoesophageal puncture is an effective and reliable method for voice restoration after total laryngectomy that may be performed as a primary or secondary procedure.

Methods

We describe our technique for secondary tracheoesophageal puncture using a wire-guided balloon catheter in an office setting. A 72-year-old patient with a total laryngectomy performed 2 years ago was selected for wire-guided balloon catheter puncture and voice prosthesis insertion.

Results

Successful tracheoesophageal puncture placement was achieved without complications and the patient tolerated the procedure well. The voice result was satisfactory and immediate.

Conclusion

We conclude that balloon catheter tracheoesophageal puncture can be a simple and safe option for secondary voice prosthesis insertion in total laryngectomy for selected patients. It can be performed in an office setting using only local anesthetic for secondary puncture.

http://ift.tt/2ozz77v

Sinonasal adenoid cystic carcinoma: Treatment outcomes and association with human papillomavirus

Abstract

Background

The purpose of this study was to review long-term outcomes of sinonasal adenoid cystic carcinoma (ACC) and to clarify its association with human papillomavirus (HPV).

Methods

The medical records of 23 patients with sinonasal ACC treated with primary surgical resection between 1998 and 2013 were reviewed. Tissue specimens were available for 17 patients. The p16 testing was performed using immunohistochemistry (IHC), and HPV infection was determined using quantitative polymerase chain reaction (PCR) with primers targeting the E6/E7 region.

Results

Two of the 17 samples showed strong and diffuse p16 staining, whereas the remaining 15 cases showed p16-positivity isolated to the luminal cells. Only one of the p16-positive cases was positive for HPV. The 5-year local failure, disease-free survival (DFS), and overall survival (OS) were 51%, 52%, and 62%, respectively.

Conclusion

Local failures are common with advanced sinonasal ACC, and the association of HPV with true sinonasal ACC is low.

http://ift.tt/2nQytEw

Reviewing the genetic alterations in high-risk cutaneous squamous cell carcinoma: A search for prognostic markers and therapeutic targets

Abstract

Cutaneous squamous cell carcinoma (SCC) is second only in incidence to basal cell carcinoma (BCC), effecting up to 500 000 people in the United States annually. Metastasis to regional lymph nodes occurs in approximately 5% of cases and imparts significant morbidity. Standard treatment in this group involves a combination of surgery and adjuvant radiation. Currently, there are no clinically useful biomarkers of metastatic potential in primary cutaneous SCC and histological predictors can be unreliable. The high level of mutational burden in normal UV-exposed skin has hampered the search for novel drivers of invasive disease, and indeed metastatic potential. This review outlines the clinical problems in high-risk and metastatic cutaneous SCCs, reviews the known genetic events and molecular mechanisms in high-risk primary cutaneous SCC and metastasis, and identifies avenues for further investigation and potential therapy.

http://ift.tt/2ozCZWf

Effectiveness of incorporating cetuximab into docetaxel/cisplatin/fluorouracil induction chemotherapy and chemoradiotherapy for inoperable squamous cell carcinoma of the oral cavity: A phase II study

Abstract

Background

Inoperable oral cavity squamous cell carcinoma (SCC) is a highly invasive disease associated with the extensive destruction of locoregional tissues and a dismal prognosis. Management strategies for these patients are limited.

Methods

This study was a single arm, prospective, open-label phase II trial. A regimen consisting of cetuximab-docetaxel, cisplatin, and fluorouracil (C-TPF) followed by bio-chemoradiotherapy (bio-CRT) with cisplatin and cetuximab was administered to patients who responded to induction chemotherapy. The objective response rate to C-TPF was the primary endpoint.

Results

Forty-three patients were enrolled in this study. The objective response rate of C-TPF was 88.4%; 88.9% (32/36) of the responders completed the full bio-CRT course, and the objective response rate of bio-CRT was 64.7%. The most common grade 3/4 adverse events for induction chemotherapy were leucopenia (32.6%) and febrile neutropenia (14.0%). The 1-year progression-free survival (PFS) and overall survival (OS) rates were 43% and 68%, respectively.

Conclusion

C-TPF is an effective and tolerable induction chemotherapy regimen for inoperable oral cavity SCC.

http://ift.tt/2nQAPTM

Ultra–low-dose radiotherapy for definitive management of ocular adnexal B-cell lymphoma

ABSTRACT

Background

The purpose of this study was to report the response to and toxicity of ultra–low-dose radiotherapy (RT) for B-cell ocular adnexal lymphoma (OAL).

Methods

We conducted a retrospective review of patients with indolent B-cell and mantle cell OAL treated with 4 Gy to the orbit(s) in two 2-Gy fractions. Disease response was assessed clinically and/or radiographically at 2 to 4-month intervals after RT. Data collected included rates of overall response, complete response (CR), partial response (PR), and treatment-related toxic effects.

Results

Twenty-two patients (median age, 65 years) had the following histologic subtypes: mucosa-associated lymphoid tissue (MALT; 14 patients; 64%); follicular lymphoma (5 patients; 23%); mantle cell lymphoma (MCL; 2 patients; 9%); and unclassifiable (1 patient, 4%). The overall response rate was 100%; 19 patients (86%) had a CR and 3 patients (14%) had a PR. The only acute toxic effect was grade 1 dry eye syndrome in 1 patient.

Conclusion

Ultra–low-dose RT in patients with OAL is associated with high response rates and minimal toxic effects, and is much shorter in duration and cost. © 2017 Wiley Periodicals, Inc. Head Neck, 2017

http://ift.tt/2ozKoVv

Systematic review of mammary analog secretory carcinoma of salivary glands at 7 years after description

ABSTRACT

Background

Mammary analog secretory carcinoma of the salivary glands (MASC_SG) is a newly introduced malignant tumor of the salivary glands. For decades, it has been confused with acinic cell carcinoma (ACC) of the salivary glands.

Methods

All reported cases of MASC_SG were surveyed from 2010 until January 2017. The collected data was compiled and computationally processed to describe the clinical parameters of MASC_SG. Its epidemiology was also mapped. Moreover, inaccurate data was highlighted.

Results

Clinically implicating, this article tackles simply the several clinical findings of MASC_SG so that our contemporary nosology, at 7 years after description, can be updated. The cytogenetic, histologic, and immunohistochemical details are also defined.

Conclusion

The available data about MASC_SG is sufficient enough to diagnose it with no need to investigate the ETV6-NTRK3 translocation. Although high-grade malignancy and distant metastases were rarely reported, a rapt attention should be paid both to the nature of this tumor and to the indicated close follow-up of such cases, especially when necrosis, increased mitotic activity, and other classic caveats are conspicuous. © 2017 Wiley Periodicals, Inc. Head Neck, 2017

http://ift.tt/2nQElxu

Management of unilateral recurrent laryngeal nerve injury after thyroid surgery: A review

Abstract

Background

Recurrent laryngeal nerve (RLN) damage because of thyroid and parathyroid surgery has been recognized for over a century. Injury rates have been slowly decreasing in this period while effective treatment strategies have been increasing.

Methods

Recent literature was evaluated on the topics of anatomy, pathophysiology, avoidance, and conservative and surgical treatment of RLN injury. Data for this literature review were identified by PubMed and references from relevant articles using the search terms "thyroid," "laryngeal nerve," and "injury." Only articles published in English between 1990 and 2015 were included.

Results

Advances in technique and equipment have made injury less likely. The evidence and role for neuromonitoring is discussed. Treatment strategies may include speech therapy, vocal cord augmentation using injection, laryngeal framework surgery techniques (including laryngoplasty and arytenoid adduction), and reinnervation.

Conclusion

Injury rates in specialist centers are very low. Good to excellent results may be obtained in most cases.

http://ift.tt/2ozCkEa

Intravoxel incoherent motion magnetic resonance imaging in head and neck cancer: A systematic review of the diagnostic and prognostic value

Publication date: May 2017
Source:Oral Oncology, Volume 68
Author(s): Daniel P. Noij, Roland M. Martens, J. Tim Marcus, Remco de Bree, C. René Leemans, Jonas A. Castelijns, Marcus C. de Jong, Pim de Graaf
Intravoxel incoherent motion (IVIM) imaging is increasingly applied in the assessment of head and neck cancer (HNC). Our purpose was to determine the diagnostic and prognostic performance of IVIM in HNC by performing a critical review of the literature. Pubmed and EMBASE were searched until May 2016. Study and patients characteristics, imaging protocol and diagnostic or prognostic outcomes were extracted by 2 independent reviewers. The studied IVIM parameters were diffusion coefficient (D), pseudodiffusion coefficient (D∗), and perfusion fraction (f). We included 10 diagnostic studies, 5 prognostic studies and 2 studies assessing both. Studies were very heterogeneous in terms of applied b-values, imaging protocols, outcome measurements and reference standards; therefore we did not perform a meta-analysis. The most commonly used sequence was "spin-echo planar imaging". A median of 10.5 b-values (range, 3–17) were used. All but three studies included at least 4 b-values below b=200s/mm². By combining IVIM-parameters squamous cell carcinomas, lymphomas, malignant salivary gland tumors, Warthin's tumors and pleomorphic adenomas could be differentiated with a sensitivity of 85–87% and specificity of 80–100%. Low pre-treatment D or f and an increase in D during treatment were associated with a favorable response to treatment. D∗ appeared to be the parameter with the lowest prognostic value. Future research should focus on finding the optimal IVIM protocol, using uniformly accepted study methods and larger patient populations.



http://ift.tt/2orX7gd

Investigating a case of possible field cancerization in oral squamous cell carcinoma by the use of next-generation sequencing

Publication date: May 2017
Source:Oral Oncology, Volume 68
Author(s): Siavosh Tabatabaeifar, Martin J. Larsen, Stine R. Larsen, Torben A. Kruse, Mads Thomassen, Jens A. Sørensen
ObjectivesLocal recurrence and the development of second primary tumors (SPT) are important factors that can influence the survival rate of oral squamous cell carcinoma (OSCC) patients. We investigate the concept of field cancerization which proposes that normal tissue adjacent to the primary tumor harbor pre-neoplastic alterations that can lead to the development of local recurrence and SPTs.Materials and methodsTo examine the concept of field cancerization, we applied whole-exome and targeted ultra-deep sequencing on 5 freshly frozen samples from a stage III OSCC patient from three tumor sites, lymph node metastasis and blood. Lastly, we sequenced one formalin-fixed paraffin-embedded recurrence biopsy that was collected approximately a year and half later located in the same area as before.ResultsSequencing identified 126 somatic mutations. We identified 24 mutations in the recurrence biopsy and 14 mutations are shared by the primary tumor.ConclusionThe low number of shared mutations indicates that either these mutations represent a very early clone in the primary tumor's evolution, or that these mutations represent a pre-neoplastic field, in which the primary tumor and recurrence are derived from. In both instances, the clinical recurrence is of a monoclonal origin which suggests either field cancerization by migration of mutated cells in the adjacent mucosa, or that the recurrence developed out of remaining tumor tissue.



http://ift.tt/2oPmc0H

A Study of Clinicopathological Profile of Patients of Hoarseness of Voice Presenting to Tertiary Care hospital

Abstract

Hoarseness is subjective term used to describe abnormal voice quality which may occur due to many causes because it is just a symptom. Proper knowledge and clinicopathological profile is important to treat the underlying pathology. This prospective study was carried out in 100 patients presented in Department of ENT, Gandhi Medical College, Bhopal from April 2013 to September 2014 with complaint of hoarseness of voice for more than 15 days. Objective of this study is to study incidence, duration and sex predilection for hoarseness of voice. Also to study different etiological and predisposing factors for hoarseness of voice. After taking detailed history of the patient, complete examination of ear, nose and throat has been carried out. Indirect laryngoscopy, direct laryngoscopy, FOFE is done. Any suspicious tissue is sent for histopathological evaluation. X-ray soft tissue neck and if required CT SCAN larynx is done. Out of 100 patients maximum were from 50 to 70 years age group. 89% were males while only 11% were females. Labourers (37%) and farmers (32%) were the major groups affected. Smoking habit found in 60% of patients and tobacco chewing in 33% of patients and both, also having. Most common cause for hoarseness was found out to be laryngeal neoplasms of which supraglottic growth being commonest (37%) in our study. Hoarseness of voice may be present due to various underlying pathologies. So proper diagnosis, through detailed history, clinical examination and investigations is warranted to find out the cause and starting treatment.

http://ift.tt/2orqKOn

Zuckerkandl’s tubercle and its relationship to the recurrent laryngeal nerve: A cadaveric dissection and meta-analysis

Publication date: Available online 2 April 2017
Source:Auris Nasus Larynx
Author(s): Brandon Michael Henry, Beatrice Sanna, Jens Vikse, Matthew J. Graves, Alexandru Spulber, Cecylia Witkowski, Iwona M. Tomaszewska, R. Shane Tubbs, Krzysztof A. Tomaszewski
ObjectiveZuckerkandl's tubercle (ZT), when present, is an anatomical landmark by which surrounding structures such as the recurrent laryngeal nerve (RLN) can be identified intraoperatively. This study aimed to investigate the prevalence and anatomical characteristics of Zuckerkandl's tubercle by combining cadaveric dissection with a meta-analysis.MethodsThrough October 2016, an extensive search of PubMed, CNKI, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science was completed. Extracted data, along with the findings from our cadaveric dissections, were pooled into a meta-analysis to assess the prevalence and size of ZT and its relationship to the RLN.ResultsThe pooled prevalence estimate of a ZT was 70.2% in the general population, 65.0% of which were considered Grade 0 tubercles (<1.0cm) and 35.0% Grade 1 (≥1.0cm). The RLN ran posteromedially to the ZT in 82.7% of cases, laterally to it in 8.7%, and on top of it in 8.6% of hemilarynges.ConclusionRLN palsy is a common postoperative complication and cause for litigation following neck surgery. The ZT is a common component of the thyroid gland and with proper knowledge, surgeons can use it to reliably and quickly identify the RLN during operative procedures.



http://ift.tt/2nMjmdx

Could Brugada Syndrome complicate anesthesia?

We read with great interest the article with title "Near miss in a patient with undiagnosed Brugada syndrome: a case report and literature review" [1]. We would like to thank the author for reporting this case, as up to date, safe anesthesia in patients with Brugada Syndrome (BrS) remains controversial. We completely agree that adequate preoperative evaluation is extremely important, especially when history of adverse events during previous anesthesia has been identified. Furthermore, it is not clear in this case which arrhythmia occurred prior to the resuscitation, since a figure is not available for the readers.

http://ift.tt/2oyptly

Patch testing in patients with recurrent vesicular hand eczema

Publication date: Available online 2 April 2017
Source:Allergology International
Author(s): Risa Tamagawa-Mineoka, Naomi Nakamura, Sachiko Ueda, Koji Masuda, Norito Katoh




http://ift.tt/2oNsDkJ

Identifying Potential Child Abuse through Oral Examination

Limited reports of oropharyngeal trauma exist in the literature even though this type of injury is extremely common in pediatric populations. There are no widely agreed upon diagnostic and management tools for such injuries in abuse cases, emphasizing the importance of reporting rare cases of orofacial trauma. This case report of a soft palate laceration demonstrates an instance of initially unrecognized potential child abuse. We aim to clarify understanding of such injuries. Furthermore, the report highlights the need for recognition of oral signs of child abuse in order to promote early detection, reporting, and appropriate management.

http://ift.tt/2nwg0dQ

A three-dimensional planned osteotomy on the zygomatic arch for reduction malarplasty

Publication date: Available online 1 April 2017
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): H.-L. Kim, J.-S. Kwon, Y.-J. Choi, U.-L. Lee
During a reduction malarplasty, precise sectioning of the zygomatic arch according to the plan formulated in the diagnostic stage is very important, because differences in the locations of the osteotomies in the left and right zygomatic arch will result in facial asymmetry, and arch osteotomies that are placed at locations other than those specified during planning elicit unwanted results. A method for the precise planning and sectioning of the zygomatic arch involving the use of computed tomography (CT) and a viewer program is presented herein. Furthermore, a case in which this method was applied during reduction malarplasty via a combined intraoral and external incision is described.



http://ift.tt/2nZfGXP

Scales used to rate adult patients’ psycho-emotional status in tooth extraction procedures a systematic review

Publication date: Available online 1 April 2017
Source:International Journal of Oral and Maxillofacial Surgery
Author(s): I. Astramskaitė, G. Juodžbalys
The aim of this study was to review scales used to assess anxiety, stress, and pain in dental patients undergoing a tooth extraction procedure and to propose a novel psycho-emotional rating scale based on the relevant literature and our own experience. An electronic literature search was conducted of the National Library of Medicine database MEDLINE (Ovid) and EMBASE databases between January 2005 and April 2016. Sequential screening at the title/abstract and full-text levels was performed. The review included all human prospective or retrospective follow-up studies and clinical trials, cohort studies, case–control studies, and case series that demonstrated at least one scale used to measure tooth extraction anxiety, stress, or pain. The search resulted in 32 articles meeting the inclusion criteria. None of the studies were found to be suitable in evaluating patient's stress, pain, and fear at once. Also, no scales were found that included both the doctor's and the patient's rating. In a few studies, vital signs as psycho-emotional status indicators were rated. Guidelines for a suitable questionnaire that could be used for rating the psycho-emotional status of patients undergoing tooth extraction are listed in the present research. Further studies are required for verification and validation of offered scale.



http://ift.tt/2nwt4zL

Prophylactic embolisation of the internal maxillary artery in patients with ankylosis of the temporomandibular joint

Publication date: Available online 31 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): R.H. Hossameldin, J.P. McCain, G. Dabus
The aim of the present study was to assess the efficacy of using prophylactic embolisation of the internal maxillary artery to minimise the risk of bleeding during gap arthroplasty.We studied a prospective series of 14 patients with ankylosis of the temporomandibular joint (TMJ) between January 2011 and February 2016, who were under the care of one surgeon.They were all treated by embolisation of the internal maxillary artery 24hours before gap arthroplasty. The main outcome variable was estimated blood loss, and others included the need to extend the gap arthroplasty, and the risk of reankylosis. We studied nine women and five men, mean (SD) age 51 (18) years, seven with unilateral and seven with bilateral ankylosis. Their mean (SD) estimated blood loss was 136 (77) ml, which we considered to be minimal. Patients were followed-up at six-monthly intervals, during which time there was no reankylosis or limitation of mouth opening. No patient lost more than 250ml blood in total.Prophylactic embolisation of the internal maxillary artery seems to be beneficial and safe in the management of selected cases of ankylosis of the TMJ.



http://ift.tt/2opsiZx

Training Groups

Publication date: April 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 3





http://ift.tt/2oNepAr

Editorial Board

Publication date: April 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 3





http://ift.tt/2oppPhQ

How far reaching is our research? An analysis of the journals in which oral and maxillofacial surgery research is cited

Publication date: Available online 31 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): A. Tahim, S. Hilmi, S. Holmes
In this study we investigate the five most cited articles in the British Journal of Oral and Maxillofacial Surgery (BJOMS). Articles cited were usually published in other OMFS journals (40%) or dentistry journals (32%). The mean (SD) SCImago Journal and Country Rank, (SJR) (an interface to access the bibliometric database of journals) for cited papers was 0.64 (SD=0.56). Nearly one third of citations were of research in OMFS and dentistry, suggesting its relevance to the wider academic community.



http://ift.tt/2oMXCxg

Has the primary care oral surgery service reduced the activity in secondary care oral and maxillofacial units?

Publication date: Available online 28 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): G.A. Chiu
To find out if the devolution of some dentoalveolar services into primary care in 2007 was having an effect on the workload of oral and maxillofacial units, I reviewed the workload of two units in 2011-13.



http://ift.tt/2oprzr7

Reanimation surgery in patients with acquired bilateral facial palsy

Publication date: April 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 3
Author(s): D.P. Butler, K.S. Johal, D.H. Harrison, A.O. Grobbelaar
Acquired bilateral facial palsy is rare and causes difficulty with speech and eating, but dynamic reanimation of the face can reduce the effect of these problems. Of 712 patients who had these procedures during our study period, two had an acquired bilateral facial paralysis. In both, reanimation was completed in a single operation using a free-functional transfer of the latissimus dorsi muscle that was coapted to the masseteric branch of the trigeminal nerve. Both patients achieved excellent non-spontaneous excursion and an improvement in function. Careful evaluation of the available donor nerves including thorough examination and electromyographic testing should always be completed before operation.



http://ift.tt/2oMUbab

Congenital lipoma of the hard palate: case report

Publication date: Available online 31 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Y. Ohyama, N. Uzawa, M. Yamashiro, S. Yamaguchi




http://ift.tt/2oMPi0z

Compliance of referral and hospital documentation with National Institute of Health and Care Excellence guidelines for the extraction of third molars: a comparative analysis of two NHS Trusts

Publication date: Available online 31 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): D.G. Gray, J.L. Franklin, M.K. Nicholls, K.A. Eaton, A.W. Barrett
To find out whether documentation for the extraction of wisdom teeth complies with National Institute of Health and Care Excellence (NICE) guidelines, we reviewed the referral letters and hospital notes of patients treated at the maxillofacial unit of two NHS Trusts (A: 314 records and B: 280) over 12 months (1 September 2012 to 31 August 2013). Compliance was assessed as unsatisfactory ("indication for extraction not mentioned", "incorrect indication", "indication unclear") or satisfactory ("correct indication implied", "correct indication explicit"). The grade of the clinician who examined the patient was also recorded. A total of 194/314 (62%) referral letters in Trust A and 126/280 (45%) in Trust B were unsatisfactory (p<0.001). Hospital notes were unsatisfactory in 168/323 (52%) and 87/297 (29%) of cases, respectively (p<0.001). In Trust A, middle grades saw 23% (75/323) of the patients, as compared with 53% (157/297) in Trust B. In both, junior staff produced the highest percentage of satisfactory documentation, but in Trust A they were also responsible for most of the unsatisfactory examples. However, senior house officers saw 60% (195/323) of the patients in Trust A, and only 28% (83/297) in Trust B. Consultants were responsible for significantly more unsatisfactory documentation (p<0.001). One referral letter (0.2%) and seven hospital records (1%) explicitly and accurately complied with the guidelines. We conclude that compliance of documentation with the current NICE guidelines is poor and inconsistent.



http://ift.tt/2opsiJ1

Squamous cell carcinoma of the pinna: which histological features could be used to predict prognosis?

Publication date: Available online 29 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): E. Mayo, S. Sharma, J. Horne, H.M. Yuen, A. Lee, A. Gulati
Squamous cell carcinoma (SCC) that originates in the pinna is thought to have a high risk of metastases (up to 16%) compared with under 5% for cutaneous SCC at any other site, and histological features of the primary tumour may provide evidence for further surveillance or treatment. To identify any association between histological features and the risk of metastases we made an electronic search of the histopathological records at the University Hospital Southampton NHS Foundation Trust for all patients who presented with auricular SCC from 2007-2012. Inclusion criteria included origin in the pinna, complete two-year follow up, and no history of immunosuppressive treatment. We looked for histopathological features that were thought to be relevant to metastases. We studied specimens from 192 patients, four of whom developed metastases (2%), each with involved lymph nodes. Perineural invasion and local recurrence were significantly associated with increased risk of metastases (p<0.001 and p=0.006). The overall metastatic rate was much lower than those reported in other studies, and factors other than histological features alone may explain the results. We suggest that although some histological features were significantly associated, they do not predict a high enough risk of metastatic disease to provide evidence for further surveillance or elective lymphadenopathy.



http://ift.tt/2oN6m6x

Rotational autotransplantation of mandibular alveolar ridge

Publication date: April 2017
Source:British Journal of Oral and Maxillofacial Surgery, Volume 55, Issue 3
Author(s): İ. Damlar, A. Altan, O. F Arpağ




http://ift.tt/2ophYAO

Corrigendum to

Publication date: Available online 27 March 2017
Source:British Journal of Oral and Maxillofacial Surgery
Author(s): Diogo J.B. Menezes, Jamil Awad Shibli, Sergio Alexandre Gehrke, Andréa M. Beder, Wilson R. Sendyk




http://ift.tt/2oMYIcy

The effects of postnatal phthalate exposure on the development of auditory temporal processing in rats

Publication date: June 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 97
Author(s): Bong Jik Kim, Jungyoon Kim, Vanhnansy Keoboutdy, Ho-Jang Kwon, Seung-ha Oh, Jae Yun Jung, Il Yong Park, Ki Chung Paik
ObjectiveThe central auditory pathway is known to continue its development during the postnatal critical periods and is shaped by experience and sensory inputs. Phthalate, a known neurotoxic material, has been reported to be associated with attention deficits in children, impacting many infant neurobehaviors. The objective of this study was to investigate the potential effects of neonatal phthalate exposure on the development of auditory temporal processing.MethodsNeonatal Sprague-Dawley rats were randomly assigned into two groups: The phthalate group (n = 6), and the control group (n = 6). Phthalate was given once per day from postnatal day 8 (P8) to P28. Upon completion, at P28, the Auditory Brainstem Response (ABR) and Gap Prepulse Inhibition of Acoustic Startle response (GPIAS) at each gap duration (2, 5, 10, 20, 50 and 80 ms) were measured, and gap detection threshold (GDT) was calculated. These outcomes were compared between the two groups.ResultsHearing thresholds by ABR showed no significant differences at all frequencies between the two groups. Regarding GPIAS, no significant difference was observed, except at a gap duration of 20 ms (p = 0.037). The mean GDT of the phthalate group (44.0 ms) was higher than that of the control group (20.0 ms), but without statistical significance (p = 0.065). Moreover, the phthalate group tended to demonstrate more of a scattered distribution in the GDT group than the in the control group.ConclusionNeonatal phthalate exposure may disrupt the development of auditory temporal processing in rats.



http://ift.tt/2nvMZ1Q

Effects of music intervention on anxiety and pain reduction in ambulatory maxillofacial and otorhinolaryngology surgery: a descriptive survey of 27 cases

Abstract

Purpose

The aim of this study is to determine patients' opinion regarding listening to music before an ambulatory maxillofacial surgery and effects on anxiety and pain reduction.

Methods

This study was conducted on outpatients having a maxillofacial surgery between December 2015 and April 2016 at Poissy/Saint-Germain-en-Laye hospital (France). Patients listened with headphones to an easy-listening music in the operation theater before the first ambulation. A questionnaire including a visual analog scale (VAS) for pain and anxiety was given to participants. The primary endpoint was to determine patients' opinion regarding listening to music before surgery. Secondary endpoints were to determine VAS pain mean, VAS anxiety mean before surgery, VAS anxiety mean after surgery, and if patients wanted to listen to their own playlist. We decided to compare VAS anxiety and pain mean between patients who accepted to listen to music (ALM) and who refused to listen to music (RLM).

Results

Nineteen patients ALM and 8 patients RLM to music. 78.9% of patients considered that listening to music before surgery decreased their anxiety. In patients who ALM, the mean (standard deviation, SD) of VAS pain after surgery was 3.42 (1.95), the mean (SD) of VAS anxiety before surgery was 3.1 (2.3), and the mean (SD) of VAS anxiety was 1.21 (0.85). There was a statistically significantly difference of the VAS anxiety mean (SD) before surgery between patients who ALM 3.10 (2.30) and who RLM 6.12 (1.88) (p = 0.005). There was a statistically significantly difference of the VAS anxiety mean (SD) after surgery between patients who ALM 1.21 (0.85) and who RLM 2.62 (1.30) (p = 0.009). Fifty percent of the patients wanted to choose their own music.

Conclusion

Music seems to reduce anxiety before maxillofacial surgery. An interventional randomized study is needed to demonstrate the positive impact of music on anxiety before maxillofacial surgery.

http://ift.tt/2nrEDaD

Discussing HPV with oropharyngeal cancer patients: A cross-sectional survey of attitudes in health professionals

Publication date: May 2017
Source:Oral Oncology, Volume 68
Author(s): Rachael H. Dodd, Alice S. Forster, Jo Waller, Laura A.V. Marlow
BackgroundHuman papillomavirus (HPV) is now known to cause a significant proportion of head and neck cancers (HNC). Qualitative research has shown that some health professionals find it difficult to discuss HPV with patients due to its sexually transmitted nature, and have concerns about their own knowledge of the virus. We used a survey to quantify attitudes towards discussing HPV among HNC health professionals.MethodsWe carried out a cross-sectional survey of HNC health professionals (n=260) in the UK and Ireland, assessing participants' knowledge of HPV, their experiences of and attitudes towards discussing HPV with patients, and their willingness to discuss HPV with their patients in the future.ResultsOverall, health professionals had good knowledge of HPV (mean score: 9.97 out of 12). Oncologists had significantly greater knowledge than specialist nurses, speech and language therapists and 'other' health professionals. Most were willing to discuss HPV with patients (mean=4.3 out of 5). Willingness to discuss HPV in the future was associated with higher HPV knowledge (r=0.35, p<0.001), fewer negative and more positive attitudes towards discussing HPV (r=−0.23 and r=0.20 respectively, both p<0.001), fewer personal barriers (r=−0.49, p<0.001) and greater confidence (r=0.58, p<0.001).ConclusionKnowledge, experiences and attitudes to discussing HPV varied across HNC health professionals. Addressing gaps in health professionals' HPV knowledge and improving their confidence in discussing HPV with patients may increase their willingness to have such conversations. This may help minimise the negative psychosocial consequences of an HPV diagnosis in this patient group.



http://ift.tt/2n0CxTT