Tube Decompression for Staged Treatment of a Calcifying Odontogenic Cyst

Publication date: Available online 3 February 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): João Luiz Gomes Carneiro Monteiro, José Alcides Almeida de Arruda, Belmiro Cavalcanti do Egito Vasconcelos




http://ift.tt/2nyYyaA

News and Announcements

Publication date: Available online 3 February 2018
Source:Journal of Oral and Maxillofacial Surgery





http://ift.tt/2BRUfvf

USB Dermatoscope as an Oculoscopy tool

http://ift.tt/2nCptSP

Demographics and Outcomes of Stage I-II Merkel Cell Carcinoma Treated with Mohs Micrographic Surgery Compared with Wide Local Excision in the National Cancer Data Base

The optimal surgical approach (wide local excision (WLE) vs. Mohs micrographic surgery (MOHS)) for treating Merkel cell carcinoma (MCC) is yet to be determined.

http://ift.tt/2nCprdF

Use of Sterile Urine Cups as Sharps Containers During Mohs Stages

http://ift.tt/2BTfOLL

Using smooth forceps for assisting incision and drainage of an infected epidermoid cyst

http://ift.tt/2BTspP5

The influence of concomitant medial wall fracture on the results of orbital floor reconstruction

Up to 35% of orbital floor fractures extend to the medial wall. This results in restriction of both abduction and adduction, leading to horizontal diplopia. The greater the defect, the more pronounced the enophthalmos.

http://ift.tt/2E2a5JB

Response to comment: Eustachian tube diameter: Is it associated with chronic otitis media development?

We would like to thank the observer for the interest and comments for our research. We also think that Chronic Otitis Media (COM) is a multifactorial disease and there were many factors involved in the pathogenesis. Upper airway infections, recurrent otitis media, dysfunction of the Eustachian Tube (ET) and nasopharynx, ciliary dysfunction, and allergy are among the investigated probable risk factors [1]. Also Chronic Rhinosinusitis (CRS) and Laryngopharyngeal Reflux (LPR) were proven to be involved in the pathogenesis [2,3].

http://ift.tt/2E2xeHX

International survey and consensus (ICON) on ambulatory surgery in rhinology

Publication date: Available online 3 February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): L. de Gabory, L.J. Sowerby, J.M. DelGaudio, A. Al-Hussaini, C. Hopkins, E. Serrano
ObjectivesDay-case surgery is the gold standard to several surgical procedures in Rhinology. However, few data and guidelines have been published except in the Anglo-Saxon countries and France. The aim of this survey was to propose a list of issues arising during day-case surgery in order to analyze the different constraints encountered around the world.Material and methodIt was a prospective multicenter international email survey. The method was based on the formalized expert consensus methodology. A list of 11 issues was based on literature data and was sent by e-mail to 265 key opinion leaders (KOL) who attended the IFOS congress.ResultsThe response rate was 20% from 27 countries without statistical difference between continents concerning the score on each item. The mean age of KOL was 50±10 years. Their mean length of experience was 21±10 years. Issues in relation with technical resources and experience showed that the last time at which ambulatory surgery in the day is possible was 4:00 PM but responses varied depending the availability of technical resources. Bleeding or hematoma occurred most frequently between the third and fourth postoperative day whatever the surgical procedure. A strong agreement and consensus was obtained concerning the nasal packing, septal contention and their schedule of removal which were not a contraindication of day-case. Also 75% of participants were agreeing with a therapeutic education program to improve the performance of postoperative care and decrease readmission rates. A relative agreement without consensus were obtained for the distance between the day-case unit and home, the role of surgery duration and the impact of anticoagulant and/or antiplatelet drugs in overnight admission and readmission rates.ConclusionPractice varies widely owing to local organization constraints and the availability of a dedicated day-case unit seems to be the main limiting factor.



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International consensus (ICON) on management of otitis media with effusion in children

Publication date: Available online 3 February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): F. Simon, M. Haggard, R.M. Rosenfeld, H. Jia, S. Peer, M.-N. Calmels, V. Couloigner, N. Teissier
Otitis media with effusion (OME) is a common childhood disease defined as the presence of liquid in the middle ear without signs or symptoms of acute ear infection. Children can be impacted mainly with hearing impairment and/or co-occurring recurrent acute otitis media (AOM) thus requiring treatment. Although many meta-analyses and national guidelines have been issued, management remains difficult to standardize, and use of surgical and medical treatments continue to vary. We convened an international consensus conference as part of the 2017 International Federation of Oto-rhino-laryngological Societies Congress, to identify best practices in OME management. Overall, regional differences were minor and consensual management was obtained on several important issues. At initial assessment, although a thorough medical examination is necessary to seek reflux, allergy or nasal obstruction symptoms; an age-appropriate auditory test is the only assessment required in children without abnormal history. Non-surgical treatments poorly address the underlying problem of an age-dependent dysfunctional Eustachian tube; auto-inflation seems to be the only beneficial, low-risk and low-cost non-surgical therapy. There was a clear international recommendation against using steroids, antibiotics, decongestants or antihistamines to treat OME, because of side-effects, cost issues and no convincing evidence of long-term effectiveness. Decisions to insert tympanostomy ventilation tubes should be based on an auditory test but also take into account the child's context and overall hearing difficulties. Tubes significantly improve hearing and reduce the number of recurrent AOM with effusion while in place. Adjuvant adenoidectomy should be considered in children over four years of age, and in those with significant nasal obstruction or infection.



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Erratum to the article “Write your first article, but …” Published in the issue (2017;134(6):371–72), in European Annals of Otorhinolaryngology, Head and Neck diseases. http://ift.tt/2GHZ5yG

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1





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Hypopharyngeal reconstruction using a circular stapler

Publication date: Available online 2 February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): P. Schultz, A. Dupret-Bories, S. Ciftci, L. Fath
Distal anastomosis by tubed free flap is one of the main technical difficulties encountered during hypopharyngeal reconstruction. Although high flap survival probability can be achieved by experienced surgical teams, two complications are commonly observed at the flap-oesophagus junction: fistula and stenosis. Use of a circular stapler reduced the frequency of these complications by ensuring a perfectly circular and resistant suture line. Salivary stent placement is therefore unnecessary, allowing earlier resumption of feeding. The stapling procedure is simple, but a few technical skills are required, as the stapler is not specifically designed for this purpose. We describe the indications, surgical procedure and global results based on our series. We consider the forearm flap to be the gold standard for this reconstruction, but thicker flaps, such as pectoralis major flap, can also be used, but with poorer results in terms of healing and swallowing performance.



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Editorial Board

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1





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Contents

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1





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International consensus (ICON) on basic voice assessment for unilateral vocal fold paralysis

Publication date: Available online 3 February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): A. Mattei, G. Desuter, M. Roux, B.-J. Lee, M.-A. Louges, E. Osipenko, B. Sadoughi, B. Schneider-Stickler, A. Fanous, A. Giovanni
There is a growing need for evaluation tools allowing the quantification of the outcome after voice surgeries. Since the end of the 1990s, multiple unfruitful attempts have been made to reach a consensus, including the Dejonckere protocol for the European Laryngological Society in 2001. This suggested to perform objective and quantifiable measures in the following domains: perception, acoustic, aerodynamic, self-evaluation by the patient and videolaryngostroboscopy. But in a PubMed^® search with the keywords "Voice Assessment" and "Voice Outcome" since 2001 retrieving 452 articles, only 33 of them were using methods taking into account the first four dimensions proposed by Dejonckere. To elaborate a new and simpler protocol, we chose to focus on unilateral vocal fold paralyses (UVFP), which represents a homogeneous disease in terms of physiology. This protocol was elaborated on the basis of a review of the literature and of the database and experience of the IFOS panel members. In summary, our group recommends the use and implementation of the ELS "basic protocol" with some minor modifications. Voice audio recordings are an indispensable prerequisite, and may even have medico-legal implications. We recommend the systematic use of the Voice Handicap Index (VHI). Perceptual analysis must be performed by using Hirano's GRB scale and voice breathiness has to be prioritized. Currently, acoustic analysis remains optional given the lack of data to support clinical usefulness. Aerodynamic studies should include at a minimum an evaluation of the Maximum Phonation Time, calculated in seconds following multiple trials in order to obtain a recording representing the patient's best possible glottis closure.



http://ift.tt/2GJnGTS

Thanks to reviewers

Publication date: February 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases, Volume 135, Issue 1





http://ift.tt/2s2YIvr

A prospective study comparing patients with early and late relapsing pemphigus treated with rituximab

Rituximab (RTX) is an effective therapy for patients with pemphigus. However it does not prevent relapse.

http://ift.tt/2BRLhhC

Efficacy and Safety of Oxymetazoline Cream 1.0% for Treatment of Persistent Facial Erythema Associated With Rosacea: Findings From the 52-Week Open Label REVEAL Trial

Limited treatments are available for persistent erythema of rosacea.

http://ift.tt/2nzoOBH

Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma

Sentinel lymph node biopsy (SLNB) is widely performed for melanoma of certain histologic parameters and offers important prognostic and staging information. Breslow thickness (BT) by itself also provides meaningful prognostic information.

http://ift.tt/2BQkxxP

Editorial Board

Publication date: February 2018
Source:Autoimmunity Reviews, Volume 17, Issue 2





http://ift.tt/2s2JjLw

Interaction between microbiome and host genetics in psoriatic arthritis

Publication date: Available online 3 February 2018
Source:Autoimmunity Reviews
Author(s): Maria Sole Chimenti, Carlo Perricone, Lucia Novelli, Francesco Caso, Luisa Costa, Dimitrios Bogdanos, Paola Conigliaro, Paola Triggianese, Cinzia Ciccacci, Paola Borgiani, Roberto Perricone
Psoriatic arthritis (PsA) is a chronic inflammatory joint disease, seen in combination with psoriasis. Both genetic and environmental factors are responsible for the development of PsA, however little is known about the different weight of these two distinctive components in the pathogenesis of the disease. Genomic variability in PsA is associated with the disease and/or some peculiar clinical phenotypes. Candidate genes involved are crucial in inflammation, immune system, and epithelial permeability. Moreover, the genesis and regulation of inflammation are influenced by the composition of the human intestinal microbiome that is able to modulate both mucosal and systemic immune system. It is possible that pro-inflammatory responses initiated in gut mucosa could contribute to the induction and progression of autoimmune conditions. Given such premises, the aim of this review is to summarize immune-mediated response and specific bacterial changes in the composition of fecal microbiota in PsA patients and to analyze the relationships between bacterial changes, immune system, and host genetic background.

Graphical abstract

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Corrigendum to “Oral cancer-derived exosomal NAP1 enhances cytotoxicity of natural killer cells via the IRF-3 pathway” [Oral Oncol. 76 (2018) 34–41]

The authors regret that the affiliation details for Wanjun Chen appeared incorrectly. The correct affiliation should appear as above:

http://ift.tt/2DXfYnf

Systematic review of hearing loss after traumatic brain injury without associated temporal bone fracture

While hearing loss following temporal bone fracture is a well-described phenomenon, few data exist on auditory dysfunction in patients with traumatic brain injury (TBI) without temporal bone fracture. Herein, we aim to systematically review hearing loss after TBI without bony fracture and describe its etiologies.

http://ift.tt/2GKbu5n

Development of swelling following orthognathic surgery at various cooling temperatures by means of hilotherapy─a clinical, prospective, monocentric, single-blinded, randomised study

An alternative cooling method in oral and maxillofacial surgery is post-operative cooling with hilotherapy. It has not yet been clarified how the development of pain and swelling progresses post-operatively at different cooling temperatures. The aim of this study was the post-operative comparison of cooling temperatures of 18°C and 22°C. The parameters of this trial were swelling and the post-operative development of pain levels. In addition, the need for analgesics and patient satisfaction were documented.

http://ift.tt/2s92V0S

Psoriasis and cardiovascular disease risk factors. The HUNT Study, Norway

Abstract

Background

Studies have examined the associations between psoriasis and cardiovascular diseases and their risk factors, but the results are conflicting, especially in the general population.

Objectives

To investigate the association of psoriasis, and in particular psoriasis severity, with objectively measured cardiovascular disease risk factors and cardiovascular morbidity in a large population-based cross-sectional study.

Methods

We linked data on 50 245 persons in the HUNT3 Study, Norway with information from the National Prescription Database to obtain information on use of psoriasis medication. A total of 2 894 persons reported to have psoriasis; 2 643 were classified as mild and 251 as moderate/severe psoriasis. We used linear and logistic regression to estimate adjusted associations with 95% confidence intervals (CIs) between psoriasis and cardiovascular disease risk factors and morbidity.

Results

We observed a positive association between psoriasis and objective measures of body mass index (BMI), waist circumference and high-sensitivity C-reactive protein (hsCRP), but no clear association with blood pressure and blood lipids. People with moderate/severe psoriasis had an odds ratio for being overweight of 1.94 (95% CI 1.42, 2.67), whereas the odds ratio for metabolic syndrome was 1.91 (95% CI 1.47, 2.49). Psoriasis was also positively associated with self-reported diabetes, myocardial infarction and angina pectoris.

Conclusions

In this population-based study we found that psoriasis was positively associated with measures of adiposity, as well as with a clustering of cardiovascular disease risk factors. Overall, these associations were strongest for people with moderate/severe psoriasis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nyGI7A

Hereditary palmoplantar keratodermas. Part II. Syndromic palmoplantar keratodermas. Diagnostic algorithm and principles of therapy

Abstract

Hereditary palmoplantar keratodermas (PPKs) comprise a large and heterogeneous group of disorders characterized by persistent thickening of the epidermis at palmar and plantar surfaces. Clinical and genetic features of isolated and complex PPKs have been reviewed in part I of this 2-part review. Here we focus on clinical and molecular classification of syndromic PPKs which are recognized by additional extracutaneous manifestations, in particular deafness, specific mucosal lesions, cardiomyopathy, inborn errors of metabolism, involvement of internal organs or disorders of sexual development. Other genetic diseases which may show palmoplantar involvement, such as selected subtypes of hereditary epidermolysis bullosa, various hereditary ichthyoses and other keratinization disorders, several ectodermal dysplasias and some multisystem genetic disorders, are also briefly summarized. PPK diagnosis is based on inheritance pattern, age at onset, morphology, distribution and severity of hyperkeratosis, pattern of additional dermatological and systemic manifestations and laboratory findings. Molecular analysis is at present the gold standard to confirm the diagnosis in PPK forms due to mutations in known causative genes. No specific and curative therapy is currently available for PPKs which highly impair patients' quality of life. Topical treatments are symptomatic and offer only temporary relief. Among systemic treatments, retinoids improve disease symptoms in the majority of patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2nyD0KW

Sensitive skin in france: a study on prevalence, relationship with age and skin type and impact on quality of life

Abstract

Background

Many epidemiological studies have been performed, but a potential increase in the prevalence of sensitive skin as well as its relationship with age and skin type and the impact of sensitive skin on quality of life are still debated.

Objective

To answer these unresolved questions

Methods

An opinion poll was conducted on a representative French 5000-person sample.

Results

Fifty-nine percent of the people declared very sensitive or fairly sensitive skin (together: sensitive skin), and women (66%) declared sensitive skin more frequently than men (51.9%). The results also showed that sensitive skin is more common (more than 60%) in younger people (<35 years old), and there was a decrease in the following age groups. The univariate analysis demonstrated that sensitive skin was more likely to be reported by people with fair skin (OR=1.83) and by people with an atopic predisposition (OR=2.51). The risk of sensitive skin is higher for people with dry skin (OR= 6.18 compared with normal skin), but sensitive skin can occur in other skin types (OR=2.45 for mixed skin and OR=2.16 for greasy skin). Quality of life was clearly altered in patients with sensitive skin, as assessed by SF-12 and DLQI.

Conclusion

This large study demonstrates that sensitive skin can alter quality of life and is more common in young people and in women as well as patients with dry skin or fair skin or an atopic predisposition. It also suggests that there is an increase in the prevalence of sensitive skin.

This article is protected by copyright. All rights reserved.

http://ift.tt/2BSsfro

A Comparative Study of the Efficacy of Fat Plug Myringoplasty and Conventional Myringoplasty in Chronic Suppurative Otitis Media with Small Central Perforation

Abstract

Chronic Otitis Media (COM) is a major cause of acquired hearing impairment especially in developing countries. Persistent perforations occur either due to improper treatment of recurrent otitis media or infected traumatic perforation. Myringoplasty, repair of the Tympanic membrane using autologous temporalis fascia, is the standard procedure for COM. Other graft materials commonly used include tragal perichondrium, tragal cartilage and adipose tissue. This prospective study aims to compare the surgical and audiological outcome of fat plug myringoplasty [FPM] and conventional myringoplasty using temporalis fascia [CM-TF] in COM with small dry central perforation. A total of 60 patients of COM with small dry central perforation, aged 16–60 years, during the study period of October 2013 to August 2015 were divided into two groups of 30 cases each. The first group underwent FPM while the second group underwent CM-TF. The graft uptake and hearing outcome [pre operative and 3 months post operative PTA] were assessed. The surgical outcome of FPM with graft uptake of 86.7% was comparable to CM-TF with a graft uptake of 90%. The mean post operative hearing gain in FPM was 3.43 ± 2.81 dB which correlated well with that of CM-TF with 3.85 ± 3.05 dB. The duration of hospital stay and operative time was significantly lower in FPM group. FPM can be safely performed in cases with dry, small central perforations of the tympanic membrane with outcomes comparable to CM-TF.

http://ift.tt/2EDjYL6

A Comparative Study of the Efficacy of Fat Plug Myringoplasty and Conventional Myringoplasty in Chronic Suppurative Otitis Media with Small Central Perforation

Abstract

Chronic Otitis Media (COM) is a major cause of acquired hearing impairment especially in developing countries. Persistent perforations occur either due to improper treatment of recurrent otitis media or infected traumatic perforation. Myringoplasty, repair of the Tympanic membrane using autologous temporalis fascia, is the standard procedure for COM. Other graft materials commonly used include tragal perichondrium, tragal cartilage and adipose tissue. This prospective study aims to compare the surgical and audiological outcome of fat plug myringoplasty [FPM] and conventional myringoplasty using temporalis fascia [CM-TF] in COM with small dry central perforation. A total of 60 patients of COM with small dry central perforation, aged 16–60 years, during the study period of October 2013 to August 2015 were divided into two groups of 30 cases each. The first group underwent FPM while the second group underwent CM-TF. The graft uptake and hearing outcome [pre operative and 3 months post operative PTA] were assessed. The surgical outcome of FPM with graft uptake of 86.7% was comparable to CM-TF with a graft uptake of 90%. The mean post operative hearing gain in FPM was 3.43 ± 2.81 dB which correlated well with that of CM-TF with 3.85 ± 3.05 dB. The duration of hospital stay and operative time was significantly lower in FPM group. FPM can be safely performed in cases with dry, small central perforations of the tympanic membrane with outcomes comparable to CM-TF.

http://ift.tt/2EDjYL6

Effects of bimaxillary orthognathic surgery on pharyngeal airway and respiratory function at sleep in patients with class III skeletal relationship

The aim of this study was to examine the effects of bimaxillary orthognathic surgery on pharyngeal airway space (PAS) and respiratory function during sleep.

http://ift.tt/2DZz2RM

Is there more to the clinical outcome in posttraumatic reconstruction of the inferior and medial orbital walls than accuracy of implant placement and implant surface contouring? A prospective multicenter study to identify predictors of clinical outcome

Reconstruction of orbital wall fractures is demanding and has improved dramatically with the implementation of new technologies. True-to-original accuracy of reconstruction has been deemed essential for good clinical outcome, and reasons for unfavorable clinical outcome have been researched extensively. However, no detailed analysis on the influence of plate position and surface contour on clinical outcome has yet been published.

http://ift.tt/2EEEVF6

Preclinical Randomized Controlled Trial of Bilateral Discectomy versus Bilateral Discopexy in Black Merino Sheep Temporomandibular Joint: TEMPOJIMS – phase 1- Histologic, Imaging and Body Weight results

The role of temporomandibular joint (TMJ) surgery is not well defined due to a lack of quality randomized controlled clinical trials, comparing different TMJ surgical treatments with medical and placebo interventions. The temporomandibular joint interposal study (TEMPOJIMS) is a rigorous preclinical trial divided in 2 phases. In phase 1 the authors investigated the role of the TMJ disc and in phase 2 the authors evaluated 3 different interposal materials. The present work of TEMPOJIMS - phase 1, aims to evaluate histopathologic and imaging impact of bilateral discectomy or discopexy in Black Merino sheep TMJ, using a high-quality trial following the ARRIVE guidelines.

http://ift.tt/2DYR86H

Endoscopic Stapes Surgery

The management of stapes fixation using transcanal endoscopic ear surgery is a viable alternative approach. The advantages of transcanal endoscopic ear surgery are improved visualization and illumination of the stapes and oval window regardless of the size and geometry of the external auditory canal. Footplate work and prosthesis placement pose significant but surmountable challenges using transcanal endoscopic ear surgery secondary to the lack of depth perception. Several recent studies demonstrate the efficacy and safety of transcanal endoscopic ear surgery.

http://ift.tt/2DXdxFv

Letter to the editor: “Considerations in computer-aided design for inlay cranioplasty: technical note”

http://ift.tt/2ECboff

Preoperative laboratory data are associated with complications and surgical site infection in composite head and neck surgical resections

1) Describe normal/abnormal preoperative laboratory testing incidence in head and neck (H&N) composite resections and 2) determine complication, surgical site infection (SSI), and transfusion predictors by laboratory test.

http://ift.tt/2DXXEPc

The treatment of vocal process granuloma

We reviewed with great interest the paper entitled "Comparison of the effects of esomeprazole plus mosapride citrate and botulinum toxin A on vocal process granuloma" by Lei et al. [1]. This is an excellent study. The authors compared the effects on vocal process granulomas (VPGs) of proton pump inhibitors (PPI) together with prokinetic agents and injections of botulinum toxin A. It was concluded that combined PPI and prokinetic drugs played a significant role in VPG treatment after surgery. However, the study design is unusual and the inclusion criteria vague.

http://ift.tt/2nGtRzs

Lifetime Air Pollution Exposure and Asthma in a Pediatric Birth Cohort

Publication date: Available online 2 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): M.B. Rice, S.L. Rifas-Shiman, A.A. Litonjua, M.W. Gillman, N. Liebman, I. Kloog, H. Luttmann-Gibson, B.A. Coull, J. Schwartz, P. Koutrakis, E. Oken, M.A. Mittleman, D.R. Gold




http://ift.tt/2GLppZ1

Autophagic dysfunction in Papillon Lefèvre syndrome is restored by recombinant Cathepsin C treatment

Publication date: Available online 2 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Pedro Bullón, Beatriz Castejón-Vega, Lourdes Román-Malo, María Paz Jimenez-Guerrero, David Cotán, Tamara Y. Forbes-Hernandez, Alfonso Varela-López, Antonio Pérez-Pulido, Francesca Giampieri, José L. Quiles, Maurizio Battino, José A. Sánchez-Alcázar, Mario D. Cordero
BackgroundCathepsin C (CatC) is a lysosomal enzyme involved in the activation of serine proteases from immune and inflammatory cells. Several mutations with loss of function in the Cathepsin C (CatC) gene have been shown to be the genetic mark of Papillon-Lefèvre syndrome (PLS), a rare autosomal recessive disease characterized by severe early-onset periodontitis, palmoplantar hyperkeratosis and increased susceptibility to infections. Deficiencies or dysfunction in other cathepsin family proteins such as B or D have been associated with autophagic and lysosomal disorders.ObjectivesHere, we characterized the basis for autophagic dysfunction in PLS by analyzing skin fibroblasts derived from patients with several mutations in the CatC gene and reduced enzymatic activity.MethodsSkin fibroblasts were isolated from PLS patients assessed by genetic analysis. Authophagy flux dysfunction was evaluated by examining the accumulation of p62/SQSTM1 and a bafilomycin assay. Ultrastructural analysis further confirmed an abnormal accumulation of autophagic vesicles in mutant cells. A recombinant recombinant CatC (rCatC) protein was produced by a baculovirus system in insect cell cultures.ResultsPLS mutant fibroblasts showed alterations in the oxidative/antioxidative status, reduced oxygen consumption and a marked autophagic dysfunction associated with autophagosome accumulation. These alterations were accompanied by lysosomal permeabilization, CatB release and NLRP3-inflammasome activation. Treatment of mutant fibroblasts with rCatC improved cell growth, autophagic flux and partially restored lysosomal permeabilization.ConclusionsOur data provide a novel molecular mechanism underlying PLS. Impaired autophagy caused by insufficient lysosomal function may represent a new therapeutic target for PLS.



http://ift.tt/2s25odj

Genomic analysis to assess disease progression and recurrence in patients with oral squamous cell carcinoma: – a preliminary study

We studied the progression from dysplasia to invasive carcinoma and subsequent second primaries or locoregional recurrences in 11 patients with recurrent squamous cell carcinoma (SCC). Between one and six samples were sequenced/patient. DNA samples were prepared, and libraries multiplexed to between 40 and 80 samples/lane of an Illumina HiSeq 3000 and sequenced with 2×100bp paired end sequencing. Copy number data were generated by CNAnorm (Bioconductor package). Samples of recurrent SCC showed unique patterns of descent when compared with earlier samples from the primary tumour, and three main patterns emerged.

http://ift.tt/2GGHlUB

Assessment of the anterior loop of the inferior alveolar nerve using reformatted computed tomography: a retrospective study

The anterior loop of the inferior alveolar nerve (IAN) is an important landmark in the anterior mandible that must be considered during the placement of dental implants. We measured the length and prevalence of loops of the IAN in 188 consecutive, dentate patients using reformatted computed tomography (CT). A total of 158/188 (84%) had at least one anterior loop; 111/188 (59%) had bilateral loops. The mean (SD) length of the loops in the third quadrant was 1.4 (0.7)mm; 95% CI 1.3 to 1.6; (range 0.3 – 4.0mm).

http://ift.tt/2s37IR7

Management of self-inflicted gunshot wounds to the face: retrospective review from a single tertiary care trauma centre

There are limited published data about the surgical management of self-inflicted facial gunshot wounds. The aim of this retrospective study was to review our management of subjects who initially survive such a wound and were admitted to a tertiary care trauma centre between 2002 and 2012. Only subjects with definitive evidence of a self-inflicted facial gunshot wound and who were admitted alive were included. Data collected included personal and clinical details, characteristics of the gunshot wound, and medical and surgical management.

http://ift.tt/2GLJZse

Outcomes of treatment for intracapsular fractures of the mandibular condyle: recommendation for a new classification

We know of no universally accepted classification for intracapsular condylar fractures. We propose here a new classification based on the concept of a "disc-condyle" unit, and validate the classification based on outcomes of treatment. From 1 January 2010 - 31 December 2014, 55 patients with unilateral intracapsular condylar fractures were classified into three types: type A has no reduction in mandibular height or displacement of the disc (n=7); type B has displacement of the disc with no reduction in mandibular height (n=17); and type C has reduced mandibular height with or without displacement of the disc (n=31).

http://ift.tt/2s3tyEp

Tuberculosis: the great imitator in the head and neck - our experience of 24 cases in 22 years

This retrospective study covered over two decades, during which an individual head and neck surgeon treated 24 patients with cervicofacial lymphadenitis that was related to both Mycobacterium tuberculosis complex (n=17, made up of M tuberculosis (n=16) and M bovis (n=1)), and non-tuberculous mycobacteria. The seven cases of non-tuberculous mycobacteria were caused by M avium complex (n=3), M malmoense (n=3), and M kansaii (n=1). By using a tailored management approach, at times selective combined surgical and antimycobacterial treatment, he achieved a success rate of 23/24 cases, with only one recurrence and no major complications.

http://ift.tt/2GISnsk

Quality of life after reconstruction with a free forearm flap in patients who have survived oral cancer for more than five years

To our knowledge, no study has specifically evaluated the quality of life (QoL) after reconstruction with a radial forearm free flap (RFFF) in long-term (more than five years) survivors of oral cancer. We therefore analysed the records of 27 disease-free patients who had survived for more than five years, and who had had their tumours resected and immediate reconstruction with a RFFF between 2001 and 2011 (Table 1).

http://ift.tt/2saU7rl

One versus two venous anastomoses in microsurgical head and neck reconstruction: a cumulative meta-analysis

Venous compromise is still the most common cause of free flap failure. The use of two venous anastomoses has been advocated to reduce venous compromise. However, the effectiveness of this approach remains controversial. A systematic review and cumulative meta-analysis was performed to assess the effect of one versus two venous anastomoses on venous compromise and free flap failure in head and neck microsurgical reconstruction. A total of 27 articles reporting 7389 flaps were included in this study.

http://ift.tt/2s3LNJF

Transoral robotic surgery of parapharyngeal space tumours: a series of four cases

Tumours arising from the parapharyngeal space (PPS) represent less than 1% of all head and neck tumours. Salivary gland tumours account for 40–50% of PPS lesions and are located in the pre-styloid parapharyngeal space. Pleomorphic adenomas represent 80–90% of salivary tumours in the PPS. Recently, transoral robotic surgery (TORS) has become common in head and neck surgery as a minimally invasive procedure. Four cases of benign PPS tumour treated with TORS are presented here. Preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging, and the results were used to plan the correct surgical approach.

http://ift.tt/2GKNzTm

Comparison of xerostomia incidence after three-dimensional conformal radiation therapy and contralateral superficial lobe parotid-sparing intensity-modulated radiotherapy for oropharyngeal and hypopharyngeal cancer

In the treatment of head–neck cancer, parotid-sparing intensity-modulated radiotherapy (IMRT) could reduce the incidence of xerostomia. When the parotid glands cannot be sufficiently spared because of the widespread tumor, contralateral superficial lobe parotid-sparing (CSLPS)-IMRT could be used to reduce marginal recurrence, however the success of this approach remains to be determined. The primary purpose of this study was to compare the incidence of xerostomia between three-dimensional conformal radiotherapy (3D-CRT) and CSLPS-IMRT for oropharyngeal and hypopharyngeal cancer.

http://ift.tt/2nAzPCA

Endoscopic cartilage versus temporalis fascia grafting for anterior quadrant tympanic perforations — A prospective study in a tertiary care hospital

Management of anterior perforations of tympanic membrane is a surgical challenge. The objective of this study is to analyse and compare the results of composite cartilage perichondrium island (CCPI) graft and temporalis fascia graft by endoscopic technique in anterior quadrant perforations.

http://ift.tt/2BVcpfO

Vespa crabro immunotherapy versus Vespula-venom immunotherapy in Vespa crabro allergy: a comparison study in field re-stings

In ascertained allergic sensitization to Vespa crabro (VC) venom, the European guidelines still consider venom immunotherapy (VIT) with Vespula (VE) venom sufficient to achieve an adequate protection against VC. ...

http://ift.tt/2BV8W0M

Race and ethnicity have significant influence on fractional exhaled nitric oxide

Race and ethnicity have been shown to influence fractional exhaled nitric oxide (FeNO). There is a need to investigate cutoff points for different races and ethnicities to improve clinical application.

http://ift.tt/2GKARnE

Significant association of increased PD-L1 and PD-1 expression with nodal metastasis and a poor prognosis in oral squamous cell carcinoma

Programmed cell death ligand 1 (PD-L1) and its receptor PD-1 are immune checkpoint molecules that attenuate the immune response. Blockade of PD-L1 enhances the immune response in a variety of tumours and thus serves as an effective anti-cancer treatment. However, the biological and prognostic roles of PD-L1/PD-1 signalling in oral squamous cell carcinoma (OSCC) remain to be elucidated. The purpose of this study was to examine the correlation of PD-L1/PD-1 signalling with the prognosis of OSCC patients to assess its potential therapeutic relevance.

http://ift.tt/2BRyvzC

Evaluation of stress by finite element analysis of the midface and skull base at the time of midpalatal osteotomy in models with or without pterygomaxillary dysjunction

Surgically-assisted rapid maxillary expansion (SARME) is commonly used to treat skeletally mature patients with transverse discrepancies. Some osteotomies are made in areas that resist expansion, but there is no clear consensus about the sequence in which the osteotomies are made. Some clinicians do the pterygomaxillary osteotomy last, while others do it before the midpalatal osteotomy. We used the finite element method to measure the stresses on the midface, cranial base and pterygoid plates at the time of midpalatal osteotomy in two models, one with and one without pterygomaxillary dysjunction (PMD).

http://ift.tt/2FH2mxd

The influence of management of tooth wear on oral health-related quality of life

Abstract

Objective

The purpose of this study was to identify the level of oral health-related quality of life and orofacial appearance in patients with moderate to severe tooth wear. Patients with and without a request for restorative treatment were included.

Methods

One hundred twenty-four patients (98 men, 26 women, mean age: 40.5 ± 8.8 years) with moderate to severe tooth wear were included. Patients without a request for help received a non-restorative treatment of counseling and monitoring. Patients with a request for restorative treatment were treated with a full rehabilitation using composite resin restorations. Oral Health Impact Profile (OHIP-NL) and Orofacial Esthetic Scale (OES-NL) questionnaires were filled in at baseline and after 1 year.

Results

Counseling and monitoring group: baseline OHIP-NL score was 0.4 ± 0.3, baseline summary score of OES-NL was 48 ± 7.0, and baseline impression score was 7.1 ± 1.2. Scores had not changed significantly after 1 year (p = 1.00 after Bonferroni correction).Restoration group: baseline OHIP-NL score was 0.8 ± 0.6, baseline summary score of OES-NL was 38 ± 10, and baseline impression score was 5.9 ± 1.5. Scores had improved significantly after 1 year (p < 0.001 after Bonferroni correction).

Conclusions

Counseling and monitoring did not result in a significant deterioration and restorative treatment resulted in a significant improvement of oral health-related quality of life (OHRQoL) and orofacial appearance in this patient group.

Clinical significance

In patients with moderate to severe tooth wear, without functional and esthetical problems, counseling and monitoring may be an appropriate treatment option. Restorative treatment in patients with a need for treatment results in an improved OHRQoL. OHIP and OES questionnaires may be used to monitor changes in clinically relevant symptoms.

http://ift.tt/2BQCDQy

Surgical indications or inclusion/exclusion criteria of explorative tympanotomy on sudden sensorineural hearing

We read with great interest the work described in the article entitled, "The role of explorative tympanotomy (EXT) in patients with sudden sensorineural hearing loss with and without perilymphatic fistula," by Prenzler et al. [1]. Sudden sensorineural hearing loss (SSNHL) is a medical emergency frequently seen in patients presenting in the otology clinic. With increasing productivity at work, increased psychological pressure of modern life, and frequent use of headphones, SSNHL has become increasingly common in recent years.

http://ift.tt/2BRiJEV

A New Technique for Transcutaneous Fixation of the Costal Cartilage Block Utilized in Reconstructed Ear Elevation for Microtia

With the aim of implementing good projection of the three-dimensional frame (auriculo-cephalic angle) and maintaining projection, a significant issue during the stage of auricular elevation for avoiding the potential for dislodging the cartilage blocks remains. Herein we present an innovative and technically simple method of transcutaneous fixation of the costal cartilage block during the stage of auricular elevation.

http://ift.tt/2nEdK5n

Squamous cell carcinoma of the maxilla: Analysis of clinicopathological predictors for disease recurrence and metastatic behavior

Publication date: Available online 2 February 2018
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Julius Moratin, Andreas Fuchs, Carolin Zeidler, Urs DA. Müller-Richter, Roman C. Brands, Stefan Hartmann, Alexander C. Kübler, Christian Linz




http://ift.tt/2s7NsOw

Facelifts: Improving The Long-Term Outcomes of Lower Face and Neck Rejuvenation Surgery: The Lower Face and Neck Rejuvenation Combined Method

Determining which facelift procedures yield the most long-term rejuvenating effects and stability over time is an important question in cosmetic surgery: does radical and invasive surgery produce the most long-lasting results? The experience of our team suggests that using a combination of various techniques (liposuction, lipectomy, myotomies, suspensions, tissular induction techniques) appears to be essential to achieve satisfactory, lasting results. In this paper, we describe the lower facelift and neck rejuvenation combined method.

http://ift.tt/2BSlOo2

EGFR amplification and expression in oral squamous cell carcinoma in young adults

The aim of this study was to investigate epidermal growth factor receptor (EGFR) gene alterations in two groups of patients with oral squamous cell carcinoma (OSCC) (a test group of subjects aged ≤40 years and a control group of subjects aged ≥50 years) and to associate the results with EGFR immunostaining, clinicopathological features, and the prognosis. Sixty cases of OSCC were selected (test group, n=21; control group, n=39). The tissue microarray technique was applied to ensure the uniformity of results.

http://ift.tt/2BRFNTO

Structured review of the patient-reported outcome instruments used in clinical trials in head and neck surgery

The number of clinical trials that relate to patients with cancer of the head and neck is growing. Patient-reported outcomes, which are rarely the primary outcome, are now an important component, and in this structured review to identify and report the characteristics of the questionnaires that have been used in these trials, we summarise the findings reported. We searched several online databases using the key terms: head and neck oncology, head and neck surgery, reconstruction, clinical trials patient-reported outcomes, questionnaires, quality of life (QoL), validated instruments, and patients' satisfaction.

http://ift.tt/2DXn53c

Immediate provisionalization in the esthetic zone: 1-year interim results from a prospective single-cohort multicenter study evaluating 3.0-mm-diameter tapered implants

Abstract

Objectives

The aim of this interim analysis of a 5-year prospective multicenter study is to evaluate clinical and radiological performance of immediately provisionalized 3.0-mm-diameter tapered implants.

Materials and methods

Patients needing implant rehabilitation of maxillary lateral incisors or mandibular lateral and central incisors were treated with 3.0-mm-diameter implants placed in extraction or healed sites and immediately provisionalized. Clinical and radiographic examinations were performed at implant insertion, 6 months thereafter, and are ongoing. Marginal bone levels and changes, complications, the papilla, plaque, and bleeding indices, and the pink esthetic score (PES) were evaluated at each follow-up visit.

Results

Of 112 enrolled patients, 77 patients (91 implants) met the inclusion criteria. Seventy-one patients with 82 implants completed the 1-year follow-up. Three implants failed yielding a CSR of 96.7%. All failures occurred within the first 3 months after implant insertion. Marginal bone level changes from insertion to 6 months was − 0.57 ± 1.30 mm (n = 75) and from insertion to 12 months − 0.25 ± 1.38 mm (n = 72). Fifteen non-serious complications were recorded. Papilla index score and PES improved at the 1-year follow-up. Plaque formation and bleeding-on-probing showed no statistically significant differences between the 6-month and the 1-year visit.

Conclusions

This 1-year analysis demonstrated high survival, stable bone levels, and healthy soft tissue with 3.0-mm-diameter implants.

Clinical implications

Narrow diameter implants are a safe and predictable treatment option in patients with limited bone volume and/or limited interdental space and eligible for immediate loading protocols.

http://ift.tt/2s8a1CO