New onset of smell and taste loss are common findings also in patients with symptomatic COVID‐19 after complete vaccination

xlomafota13 shared this article with you from Inoreader New onset of smell and taste loss are common findings also in patients with symptomatic COVID‐19 after complete vaccination Via The Laryngoscope Abstract Objective To investigate the clinical profile of patients who developed coronavirus disease 2019 (COVID-19) after full vaccination. Methods Demographic, epidemiological and clinical data were collected through medical records and online patient-reported outcome questionnaire from patients who developed symptomatic SARS-CoV-2 infection, confirmed by nasopharyngeal swab, at least two weeks after completion of vaccination. Results 153 subjects were included. The most frequent symptoms were: asthenia (82.4%), chemosensory dysfunction (63.4%), headache (59.5%), runny nose (58.2%), muscle pain (54.9%), loss of appetite (54.3%) and nasal obstruction (51.6%). Particularly, 62.3% and 53.6% of subjects reported olfactory and gustatory dysfunction, respectively. Symptom severity was mild or moderate in almost all cases. Conclusions Chemosensory dysfunctions have been observed to be a frequent symptom even in subjects who contracted the infection after full vaccination. For this reason, the sudden loss of smell and taste could continue to represent a useful and specific diagnostic marker to raise the suspicion of COVID-19 even in vaccinated subjects. In the future, it will be necessary to establish what the recovery rate is in these patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review

xlomafota13 shared this article with you from Inoreader Diagnostic Accuracy Outcomes of Office‐Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions: A Systematic Review Via Clinical Otolaryngology Abstract Introduction In-office biopsy (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy. Methods A systematic review following the PRISMA guidelines was conducted to assess the diagnostic accuracy of IOBs performed via flexible endoscopy. In addition, an analysis of potentially modifiable factors that may affect diagnostic accuracy was performed. PubMed, EMBASE, The Cochrane Library, Web of Science, CINAHL were used in the literature database search. Results 875 studies were identified, 16 of which were included into the systematic review. 1572 successful biopsies were performed using flexible endoscopy. 1283 cases were accurately diagnosed in the outpatient setting (81.6%). 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOBs was 73%, the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps), additional lighting system or learning curve. Conclusion IOBs are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOBs when benign or pre-malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta‐analysis

xlomafota13 shared this article with you from Inoreader Direct Oral Anticoagulants versus Vitamin K Antagonists in epistaxis patients: a systematic review and meta‐analysis Via Clinical Otolaryngology Abstract Objective Epistaxis is the most common otolaryngological emergency and up to one third of patients in treated on an inpatient basis take oral anticoagulants (OAC). Direct oral anticoagulants (DOAC), an OAC subgroup, have been on the market since 2010 and are being increasingly prescribed due to the cardiologic and hematologic guidelines that favour them over vitamin K antagonists (VKA), the older of the OAC subgroups. The present study aims to investigate which subgroup of epistaxis patients taking OACs has a more favourable outcome. Design/Setting A systematic review and meta-analysis were performed according to the PRISMA 2020 statement using the PubMed and Cochrane Library databases. Continuous data was analysed and standardized mean difference (SMD) was calculated according to Hedges' g. Dichotomous data was analysed and the Mantel-Haenszel method was applied to establish the odds ratio (OR). Heterogeneity was assessed according to the I2 statistics. Main Outcome/Results A total of 8 reports covering 1390 patients were included in the final synthesis. The pooled analysis demonstrated significantly shorter hospital stays in the DOAC group (SMD= -0.22, 95% CI -0.42 to -0.02, P= .03) and a significantly higher rate of posterior bleeding in the VKA group (OR= .39, 95% CI .23 to .68, P= .001). No statistically significant differences with regard to recurrence rates, admission rates, the need for transfusion, or surgical intervention (P= .57, .12, .57 and .38 respectively) were found. Conclusion According to this meta-analysis, epistaxis patients taking DOACs have a more favourable outcome than patients taking VKAs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tongue Edema Secondary to Suspension Laryngoscopy

xlomafota13 shared this article with you from Inoreader Reply to Tongue Edema Secondary to Suspension Laryngoscopy Via Journal of Voice In our article titled "Tongue Edema Secondary to Suspension Laryngoscopy," we presented two patients who underwent prolonged suspension micro laryngoscopy (SML) and developed edema of the tongue that was severe enough that intensive care unit admission with airway monitoring was required.1 At the time of its acceptance for publication in the Journal of Voice on September 23, 2019, the complication of tongue edema following SML had not been reported. We were surprised that this problem had not been described in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reweighting of Binaural Localization Cues in Bilateral Cochlear-Implant Listeners

xlomafota13 shared this article with you from Inoreader Reweighting of Binaural Localization Cues in Bilateral Cochlear-Implant Listeners Via Journal of the Association for Research in Otolaryngology Abstract Normal-hearing (NH) listeners rely on two binaural cues, the interaural time (ITD) and level difference (ILD), for azimuthal sound localization. Cochlear-implant (CI) listeners, however, rely almost entirely on ILDs. One reason is that present-day clinical CI stimulation strategies do not convey salient ITD cues. But even when presenting ITDs under optimal conditions using a research interface, ITD sensitivity is lower in CI compared to NH listeners. Since it has recently been shown that NH listeners change their ITD/ILD weighting when only one of the cues is consistent with visual information, such reweighting might add to CI listeners' low perceptual contribution of ITDs, given their daily exposure to reliable ILDs but unreliable ITDs. Six bilateral CI listeners completed a multi-day lateralization training visually reinforcing ITDs, flanked by a pre- and post-measurement of ITD/ILD weights without visual reinforcement. Using direct electric stimulation, we p resented 100- and 300-pps pulse trains at a single interaurally place-matched electrode pair, conveying ITDs and ILDs in various spatially consistent and inconsistent combinations. The listeners' task was to lateralize the stimuli in a virtual environment. Additionally, ITD and ILD thresholds were measured before and after training. For 100-pps stimuli, the lateralization training increased the contribution of ITDs slightly, but significantly. Thresholds were neither affected by the training nor correlated with weights. For 300-pps stimuli, ITD weights were lower and ITD thresholds larger, but there was no effect of training. On average across test sessions, adding azimuth-dependent ITDs to stimuli containing ILDs increased the extent of lateralization for both 100- and 300-pps stimuli. The results suggest that low-rate ITD cues, robustly encoded with future CI systems, may be better exploitable for sound localization after increasing their perceptual weight via training. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas

xlomafota13 shared this article with you from Inoreader Cochlear nerve continuity preservation during retrosigmoid ablative osteotomy of the internal auditory canal for advanced vestibular schwannomas Via hno HNO. 2021 Nov 23. doi: 10.1007/s00106-021-01116-y. Online ahead of print. ABSTRACT The data of 86 patients with retrosigmoid microsurgical resection of vestibular schwannoma in tumor stage Koos II-IV were evaluated. In more than two thirds of the cases it was shown that the cochlear nerve followed the facial nerve, which is easily identified by electroneurography, in recurrent similar patterns in the region of the internal auditory canal. Starting from the fundus, this facil itated early identification and thus preservation of continuity of the cochlear nerve in the course of the internal auditory canal. This was of particular importance when safe functional preservation could not be guaranteed due to tumor size or formation despite intraoperative derivation of somatosenoric potentials, but when the possibility of subsequent hearing rehabilitation with a cochlear implant should be granted. Preoperative MRI sequences gave an indication of the possible nerve courses in some cases, but intraoperative imaging in the internal auditory canal was superior to MRI. PMID:34812915 | DOI:10.1007/s00 106-021-01116-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Middle Transclival Endoscopic Endonasal Resection of a Ventral Pontine Cavernous Malformation

xlomafota13 shared this article with you from Inoreader Middle Transclival Endoscopic Endonasal Resection of a Ventral Pontine Cavernous Malformation Via leak of cerebrospinal fluid World Neurosurg. 2021 Nov 3;158:34-35. doi: 10.1016/j.wneu.2021.10.142. Online ahead of print. ABSTRACT The surgical management of lesions within or around the brainstem is usually associated with significant morbidity. Even though several safe entry zones have been described for brainstem lesions, especially cavernous malformations (CMs), their resection remains a challenge due to the convergence of highly functional nerve tracts and nuclei in this rather small structure. Moreover, the ventral location of some of these lesions usually calls for complex surgical approaches involving extensive bone drilling and significant manipulation of neurovascular structures. The expanded endoscopic endonasal approach has been subject to considerable advancements, widening the range of lesions accessible through this route. In this operative video, we describe the surgical nuances of an endoscopic endonasal transclival resection of a ventral pontine CM (F igures 1 and 2). A pedicled nasoseptal flap was harvested for reconstruction, gaining access to the sphenoid rostrum, which was resected. The sellar floor was removed to expose the middle third of the clivus, which was drilled out until posterior fossa dura mater was identified. A centered dural incision was performed to expose the ventral pons and basilar artery. Using image guidance, a limited pial incision over the most superficial aspect of the lesion allowed a prompt drainage of the hematoma and resection of the CM. The surgical cavity was directly inspected through the endoscope, confirming a complete resection. Reconstruction was carried out in a multilayered fashion. The patient presented a postoperative cerebrospinal fluid leak, which resolved with a lumbar drain. Neurologic status remained unchanged after surgery, with the patient displaying a favorable clinical outcome (Video 1). PMID:34740828 | DOI:10.1016/j.wneu.2021.10.142 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Intervention to Treat Pharyngolaryngeal Stenosis Caused by Behcet's Disease

xlomafota13 shared this article with you from Inoreader Surgical Intervention to Treat Pharyngolaryngeal Stenosis Caused by Behcet's Disease Via ear nose throat Ear Nose Throat J. 2021 Nov 24:1455613211053427. doi: 10.1177/01455613211053427. Online ahead of print. ABSTRACT We aimed to summarize the surgical treatment for pharyngolaryngeal stenosis and discuss prognosis in patients with Behcet's disease. Six cases of pharyngolaryngeal stenosis caused by Behcet's disease were analyzed retrospectively. All underwent surgical treatment for pharyngolaryngeal stenosis after systematic medical treatment. The follow-up time for the 6 patien ts was between 1 and 12 years. Four of the 6 patients underwent adhesiolysis as their first procedure. Two of these 4 experienced recurrence of stenosis within 6 months and underwent flap repair as their second procedure. The remaining two patients underwent flap reconstruction as their first procedure and maintained good swallowing function. Three of the 6 patients underwent preoperative tracheotomy because of dyspnea. Tracheal decannulation was successful in all patients. None of the patients experienced recurrence after their final surgical procedure and all recovered to a near-normal condition. Pharyngolaryngeal stenosis caused by Behcet's disease is a rare but severe complication; surgical intervention should be considered in patients with dysphagia after systematic medical treatment. PMID:34814770 | DOI:10.1177/01455613211053427 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ultrasonography vs Computed Tomography for Papillary Thyroid Cancer Cervical Lymph Node Metastasis

xlomafota13 shared this article with you from Inoreader Ultrasonography vs Computed Tomography for Papillary Thyroid Cancer Cervical Lymph Node Metastasis Via JAMA Otolaryngology–Head & Neck Surgery Online First This systematic review and meta-analysis compares ultrasonogra phy and computed tomography in the preoperative evaluation of papillary thyroid cancer for cervical lymph node metastasis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trends in Diagnosis of NIFTP and Total Thyroidectomies for Papillary Thyroid Neoplasms

xlomafota13 shared this article with you from Inoreader Trends in Diagnosis of NIFTP and Total Thyroidectomies for Papillary Thyroid Neoplasms Via JAMA Otolaryngology–Head & Neck Surgery Online First This cohort study determines adoption rates of 2 recent strate gies developed to limit overtreatment of low-risk thyroid cancers: a new classification, noninvasive follicular thyroid neoplasm with papillarylike nuclear features, and hemithyroidectomy for selected papillary thyroid carcinomas up to 4 cm in size. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sudden Sensorineural Hearing Loss and COVID-19 Vaccination

xlomafota13 shared this article with you from Inoreader Sudden Sensorineural Hearing Loss and COVID-19 Vaccination Via JAMA Otolaryngology–Head & Neck Surgery Online First To the Editor Recent attention has centered on whether COVID-19 vaccines are associated with Bell Palsy or sudden sensorineural hearing loss (SSNHL). Formeister and colleagues address the latter, using Centers for Disease Control and Prevention (CDC) Vaccine Adverse Event Reporting System (VAERS) data to compare the incidence of SSNHL in individuals receiving a COVID-19 vaccine to historical baseline rates. Their study reports a lower estimated incidence of SSNHL in vaccinated individuals compared with historical norms. As the authors acknow ledge, the finding should be interpreted with care. The VAERS is an early warning system for detecting adverse events, and reports may be incomplete, inaccurate, coincidental, or unverifiable. Extrapolated epidemiological analyses are susceptible to bias, underreporting, or spurious associations. Many cases go unreported (particularly if mild and self-limited), and duplicate reporting may occur. As an example of potential distortions, long before the pandemic, VAERS reporting increased during pending litigation for vaccine injury. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perfluorooctane sulfonate induces heart toxicity involving cardiac apoptosis and inflammation in rats

xlomafota13 shared this article with you from Inoreader Perfluorooctane sulfonate induces heart toxicity involving cardiac apoptosis and inflammation in rats Via Experimental and therapeutic medicine Exp Ther Med. 2022 Jan;23(1):14. doi: 10.3892/etm.2021.10936. Epub 2021 Oct 28. ABSTRACT Perfluorooctane sulfonate (PFOS) is a persistent pollutant that exerts toxicity and induces cardiogenesis in humans and animals. Yet, the effect of PFOS exposure on cardiac toxicity in adult rats has, to our knowledge, not been reported and the mechanism still remains unknown. The present study aimed to investigate the toxicity of PFOS on rat hearts and any associated mechanisms. Rats were exposed to 0 (control), 1 and 10 mg/kg PFOS every other day for 14 days. Body weight and heart weight were recorded. The serum levels of lactic dehydrogenase (LDH), creatine kinase (CK), creatine kinase-isoenzyme-MB (CK-MB) and cardiac troponin-T (cTn-T) in heart tissues were measured using biochemical assays. TUNEL staining and western blotting were applied to analyze levels of apoptosis in rat hearts. Pathological assessment and immunohistochemistry analysis of heart tissues were used to evaluate the levels of PFOS-induced cardiotoxicity and inflammatory infiltration. PFOS exposure at the dosage of 10 mg/kg significantly increased the percentage of heart to body weight; however, it did not alter the body weight. At 10 mg/kg, PFOS significantly increased expression levels of myocardial injury markers, such as cTn-T, LDH, CK and CK-MB, while 1 mg/kg PFOS upregulated the expression level of cTn-T in rats. Notably, cardiac fibrosis and myocardiac hypertrophy appeared in the 10 mg/kg PFOS group. In addition, TUNEL-positive cells were significantly increased by exposure to 10 mg/kg PFOS in rat heart tissues. The protein expressions profiles of p53 and Bax were also significantly upregulated in the 10 mg/kg PFOS group. Inflammatory infiltration, detected by anaylzing expression levels of IL-1β and TNF-α, was significantly raised by 10 mg/kg PFOS exposure. In conclusion, these results demonstrated that 10 mg/kg PFOS-induced cardiac toxicity in rats, which was associated with an increase in apoptosis and the expression of proinflammatory cytokines. PMID:34815766 | PMC:PMC8593915 | DOI:10.3892/etm.2021.10936 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.