Orbital and Midface Reconstruction in a Case of Fibrous Dysplasia

xlomafota13 shared this article with you from Inoreader Orbital and Midface Reconstruction in a Case of Fibrous Dysplasia Via Eplasty Eplasty. 2021 Feb 15;21:ic1. eCollection 2021. NO ABSTRACT PMID:33643517 | PMC:PMC7887300 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis

xlomafota13 shared this article with you from Inoreader Factors Affecting Posterior Glottic Stenosis Surgery Outcomes: Systematic Review and Meta-analysis Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 1:3489421997278. doi: 10.1177/0003489421997278. Online ahead of print. ABSTRACT OBJECTIVES: To investigate surgical adjuncts (stents) and previous surgeries on outcomes from posterior glottic stenosis (PGS). METHODS: PubMED/Medline, CINAHL, EMBASE, and Web of Science were searched for publications on adult patients undergoing surgery for PGS. Decannulation and need for additional surgeries were evaluated as outcomes. Linear mixed-effec ts (with random effects and fixed effects) models were used for multivariate testing. RESULTS: In total, 516 abstracts were reviewed and 26 articles were considered for systematic review. Of these, 19 articles with 140 pooled patient cases were extracted for meta-analysis. On multivariate meta-analysis analysis accounting for study-specific variation and use of open procedures, prior surgeries were associated with additional surgeries (RR = 3.76 [1.39-3.86], P = .038) and the use of a stent was associated with a lower likelihood of decannulation (RR = 0.42 [0.09-0.98], P = .044). CONCLUSION: Minimizing repeat surgery is a predictor for avoiding additional future surgeries and use of a stent was correlated with poor outcomes. These 2 findings may assist providers in patient counseling regarding the need for further surgical interventions. Further, this study is the first to compare the efficacy of surgical approaches for the resolution of PGS, and highlights the importance of avoiding repeat procedures and stents for the management of PGS. PMID:33641352 | DOI:10.1177/0003489421997278 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Computer-Aided Rhinoplasty Using a Novel 'navigated' Nasal Osteotomy Technique: A Pilot Study

xlomafota13 shared this article with you from Inoreader Computer-Aided Rhinoplasty Using a Novel "navigated" Nasal Osteotomy Technique: A Pilot Study Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 1:3489421996846. doi: 10.1177/0003489421996846. Online ahead of print. ABSTRACT OBJECTIVE: To describe the surgical technique of navigation-guided nasal osteotomies and assess feasibility of this technique for treating complex nasal bone deformities in reconstructive rhinoplasty. METHODS: A retrospective chart review was performed in order to identify patients who underwent computer-aided rhinoplasty from August 2014 to February 2017. Inclusion criteria were nasal bone deformities on computed-tomography (CT) that correlated with specific nasal complaints. All patients underwent computer-aided rhinoplasty with navigation-guided nasal osteotomies using a standard navigation system. Osteotomies were performed using real-time visualization on the navigation screen. Additional soft tissue procedures were performed as needed. Medical records were reviewed for presenting symptoms, radiologic and operative findings, and postoperative course. Cosmetic outcomes were subjectively based on patients' standard 6-view photo-documentation from pre- and post-operative timepoints. RESULTS: Twenty-one patients were included in the study; 8 were revision cases and 3 had mild-to-moderate hemifacial microsomia. Fifteen were completely closed procedures. No cases were opened because of inadequate visualization or difficulty accessing bony pathology. Mean (range) follow up was 98.6 (6-559) days. There were no intra-operative comp lications, unplanned admissions or re-admissions, or iatrogenic cosmetic complications (ie, "inverted V" or "saddle nose" deformities). Two patients required revision. One was after suffering nasal trauma within 4 weeks of initial rhinoplasty. The second underwent further correction of a deformity that required a costochondral graft. Both experienced good final results. CONCLUSIONS: Computer-aided rhinoplasty is safe and feasible for treating complex nasal deformities using standard navigation systems. PMID:33641434 | DOI:10.1177/0003489421996846 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of non-invasive diagnostic methods in the diagnosis and screening of oral cancer and precancer

xlomafota13 shared this article with you from Inoreader Efficacy of non-invasive diagnostic methods in the diagnosis and screening of oral cancer and precancer Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00017-3. doi: 10.1016/j.bjorl.2020.12.019. Online ahead of print. ABSTRACT INTRODUCTION: Traditional meta-analyses on the diagnostic accuracy of oral lesions have been conducted, but they were inherently limited to direct pairwise comparisons between a single method and a single alternative, while multiple diagnostic options and the ranking thereof were methodologically not possible. OBJECTIVE: To evaluate the diagnostic values of various methods in patients with oral potential malignant disease by performing a network meta-analysis. METHODS: Two authors independently searched the databases (MEDLINE, SCOPUS, the Cochrane Register of Controlled Trials, and Google scholar) up to June 2020 for studies comparing the diagnostic accuracy of various tools (autofluorescence, chemiluminescence, cytology, narrow band imaging, and toluidine blue) with visual examination or other tools . The outcomes of interest for this analysis were sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Both a standard pairwise meta-analysis and network meta-analysis were conducted. RESULTS: Treatment networks consisting of six interventions were defined for the network meta-analysis. The results of traditional meta-analysis showed that, among six methods, narrow band imaging showed higher sensitivity, specificity, negative predictive value, positive predictive value, and accuracy compared to visual examination. The results of network meta-analysis showed that autofluorescence, chemiluminescence, and narrow band imaging had higher sensitivity compared with visual examination, and that chemiluminescence and narrow band imaging had higher negative predictive value compared with visual examination. However, autofluorescence and chemiluminescence had lower specificity compared with visual examination. There were no significant differences in positive predictive value and accuracy among the six interventions. CONCLUSION: This study demonstrated that narrow banding imaging has superiority in terms of sensitivity and negative predictive value compared with the other five tested agents. PMID:33642212 | DOI:10.1016/j.bjorl.2020.12.019 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sandwich graft technique outcomes in medium and large size nasal septal perforations

xlomafota13 shared this article with you from Inoreader Sandwich graft technique outcomes in medium and large size nasal septal perforations Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00016-1. doi: 10.1016/j.bjorl.2020.12.018. Online ahead of print. ABSTRACT INTRODUCTION: Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used. OBJECTIVE: The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results. METHODS: We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2 cm, Group B: ≥ 2 cm). RESULT S: We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659). CONCLUSION: This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques. PMID:33642213 | DOI:10.1016/j.bjorl.2020.12.018 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss

xlomafota13 shared this article with you from Inoreader The relationship between thiol-disulfide balance and idiopathic sudden sensorineural hearing loss Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00012-4. doi: 10.1016/j.bjorl.2021.01.004. Online ahead of print. ABSTRACT INTRODUCTION: Impaired cochlear perfusion is a major etiological factor in idiopathic sudden sensorineural hearing loss. Oxidative stress has been shown to be a risk factor for oxidative damage. OBJECTIVES: We investigated the role of oxidative stress in idiopathic sudden sensorineural hearing loss by comparing serum levels of oxidant and antioxidant molecules including thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin and myeloperoxidase in patients who did and did not recover after treatment. METHODS: The amount of dynamic disulfide was calculated by determining half of the difference between the total thiols and native thiols. After the determination of native, total thiol, and disulfide amounts, the disulfide/total thiol perce nt ratio, native thiol/total thiol ratio and disulfide/native thiol percent ratio were calculated and then compared between the two groups. Additionally, clinical relationship between audiological recovery and native thiol, disulfide, disulfide/native thiol percent ratio, and disulfide/total thiol percent ratio levels was investigated. Blood samples were also analyzed for the assessment of thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, arylesterase, ceruloplasmin, and myeloperoxidase levels. RESULTS: A significant difference was found between the two groups with regard to total oxidant status disulfide, disulfide/native thiol percent ratio, disulfide/total thiol percent ratio, and native thiol/total thiol ratio levels (p = 0.001, p = 0.001, p = 0.001, p = 0.003, p = 0.001, p = 0.002, respectively). However, no significant difference was found between the two groups with regard to thiol/disulfide homeostasis paraoxonase, stimulated thiol/disulfide homeostasis paraoxonase, ceruloplasmin, and myeloperoxidase levels (p > 0.05 for all). CONCLUSION: The results supported the common hypothesis that vascular pathologies are the primary cause of idiopathic sudden sensorineural hearing loss and that other etiological factors ultimately result in vascular pathologies. The oxidant-antioxidant and thiol-disulfide balances were impaired in the idiopathic sudden sensorineural hearing loss group. PMID:33642215 | DOI:10.1016/j.bjorl.2021.01.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pedunculated pleomorphic adenoma of uvula - a rare presentation

xlomafota13 shared this article with you from Inoreader Pedunculated pleomorphic adenoma of uvula - a rare presentation Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00009-4. doi: 10.1016/j.bjorl.2020.12.013. Online ahead of print. NO ABSTRACT PMID:33642217 | DOI:10.1016/j.bjorl.2020.12.013 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of applying head-shaking maneuver before Epley maneuver in BPPV

xlomafota13 shared this article with you from Inoreader Effect of applying head-shaking maneuver before Epley maneuver in BPPV Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00013-6. doi: 10.1016/j.bjorl.2020.12.015. Online ahead of print. ABSTRACT INTRODUCTION: The Epley maneuver is applied in the treatment of benign paroxysmal positional vertigo, the BPPV. However, dizziness and balance problems do not improve immediately after the treatment. OBJECTIVE: In this study, the effectiveness of the head-shaking maneuver before the Epley maneuver was investigated in the treatment of BPPV. METHODS: Between March 2020 and August 2020, ninety-six patients with posterior semicircular canal BPPV were analyzed prospectively. The patients were divided into two groups: patients who underwent the Epley maneuver only in the treatment (Group 1) and patients who underwent the Epley maneuver after the head-shaking maneuver (Group 2). The results of the Berg balance scale and dizziness handicap index were evaluated before the treatment and at the first week after the treatment. RESULTS: The improvement in functional, emotional, and physical dizziness handicap index and Berg balance scale values after the treatment was found to be statistically significant in both groups. It was determined that the change in functional and physical dizziness handicap index and Berg balance scale values of the patients in Group 2 was statistically higher than those in Group 1. Although, the change in emotional dizziness handicap index values in Group 2 was higher than those in Group 1, no statistical significance was found between the groups. CONCLUSION: As a result of our hypothesis, we think that in the treatment of posterior semicircular canal BPPV, the otoliths adhered to the canal can be mobilized by the head-shaking maneuver, and this will contribute to the increase of the effectiveness of the Epley maneuver. PMID:33642216 | DOI:10.1016/j.bjorl.2020.12.015 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis

xlomafota13 shared this article with you from Inoreader Does the video head impulse test replace caloric testing in the assessment of patients with chronic dizziness? A systematic review and meta-analysis Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Feb 13:S1808-8694(21)00008-2. doi: 10.1016/j.bjorl.2021.01.002. Online ahead of print. ABSTRACT INTRODUCTION: Caloric testing is the most frequently used test to assess peripheral vestibular function since the beginning of the 20th century. However, the video head impulse test, vHIT, has gained prominence in the field of neurotology, as it is a faster examination, easier to perform and less uncomfortable for the patient. OBJECTIVE: To compare, through systematic review and meta-analysis, the proportion of altered cases between vHIT tests and caloric testing in patients with chronic dizziness, in addition to assessing the sensitivity and specificity of vHIT, with caloric testing as the gold standard. METHODS: The literature search was carried out in the PubMed, Scopus, BVS-Bireme, Web of Science, Embase, Cochrane and ProQuest indexed databases, with no restrictions regarding the publication peri od. All articles that contained the results of the two tests were included in the evaluation of patients with dizziness. Two researchers independently conducted data selection and extraction from the studies, strictly following the inclusion and exclusion criteria defined in the research protocol. In case of disagreement during the selection, a discussion was carried out with a third evaluator. RESULTS: Eleven of the 1293 initial articles met the eligibility criteria and were analyzed. 2670 patients were evaluated, of which 1112 (41.6%) were males and 1558 (58.4%) females, with a mean age of 51.6 years. The proportion of altered results in the vHIT was 21% (95%CI 9% -33%), and 55% in the caloric testing (95%CI 43% -67%). CONCLUSION: The vHIT does not substitute for caloric testing. The tests are complementary in assessing the patient with dizziness, as they describe the tonotopy of the ampullary crest at different frequency ranges of stimulation. In chronic cases, the vH IT has a low sensitivity and high diagnostic specificity in comparison to caloric testing. PMID:33642214 | DOI:10.1016/j.bjorl.2021.01.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vestibular Impairments on Objective Diagnostic Tests in HIV+ Women and Control Men and Women

xlomafota13 shared this article with you from Inoreader Vestibular Impairments on Objective Diagnostic Tests in HIV+ Women and Control Men and Women Via The Laryngoscope Objective To describe the value of two vestibular test batteries across ages in healthy men and women for detecting vestibular disorders and to compare the occurrence of vestibular disorders in the healthy adult population and women with human immunodeficiency virus (HIV) disease. Study Design Two groups were tested on the battery of objective diagnostic tests of the vestibular system. Setting Two tertiary care centers. Subjects Healthy controls (284 women and 105 men) and women (63) with HIV/AIDS (HIV+) who are being followed up in a longitudinal study of HIV. They were tested on objective diagnostic tests of the vestibular system. Results In all age decades, healthy controls had evidence of vestibular impairment, significantly more in older adults. HIV+ subjects, all females, did not differ from healthy control females. Conclusion These data suggest that at all ages, people do have decreased vestibular function, even young, asymptomatic, and apparently healthy adults. HIV disease, itself, does not cause an increased prevalence of peripheral vestibular disorders when HIV is controlled on antiretroviral medication. Level of Evidence 2 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frailty as a Predictor of Postoperative Complications Following Skull Base Surgery

xlomafota13 shared this article with you from Inoreader Frailty as a Predictor of Postoperative Complications Following Skull Base Surgery Via The Laryngoscope Objective/Hypothesis Frailty has emerged as a powerful risk stratification tool across surgical specialties; however, an analysis of the impact of frailty on outcomes following skull base surgery has not been published. The aim of this study was to assess the validity of the 5‐factor modified frailty index (mFI‐5) as a predictor of perioperative morbidity and mortality in patients undergoing skull base surgery. Methods A mFI‐5 score was calculated for patients undergoing skull base surgeries using the National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2018. Multivariate logistic regression analysis was used to evaluate the association of increasing frailty with complications in the 30‐day postoperative period, with a subanalysis by operative location. Results A total of 17,912 patients who underwent skull base procedures were identified, with 45.5% of patients having a frailty score of one or greater; 44.9% were male and the mean age was 52.0 (±16.1 SD) years. Multivariable regression analysis revealed frailty to be an independent predictor of overall complications (odds ratio [OR]: 1.325, P < .001), life‐threatening complications (OR: 1.428, P < .001), and mortality (OR: 1.453, P < .001). Higher frailty also correlated with increased length of stay. When procedures were stratified by operative location, frailty correlated significantly with overall complications for middle, posterior, and multiple‐fossae operations but not the anterior fossa. Conclusions Frailty demonstrates a significant and stepwise association with life‐threatening postoperative morbidity, mortality, and length of stay following skull base surgeries. mFI‐5 is an objective and easily calculable measure of preoperative risk, which may facilitate perioperative planning and counseling regarding outcomes prior to surgery. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.