Is antibiotic prophylaxis expendable in parotid gland surgery? A retrospective analysis of surgical site infection rates

xlomafota13 shared this article with you from Inoreader Is antibiotic prophylaxis expendable in parotid gland surgery? A retrospective analysis of surgical site infection rates Via Clinical Otolaryngology Abstract Objectives To evaluate the rate of surgical site infection (SSI) and associated risk factors after parotid gland surgery including the impact of antibiotic prophylaxis. Design Retrospective single‐center clinical study. Setting Tertiary referral center for head and neck surgery Participants 754 patients who underwent parotid gland surgery at the University Hospital Heidelberg, Germany between 2007 and 2014 were enrolled in this study. Data on patient age, American Society of Anesthesiologists (ASA) classification system, smoking status, diabetes mellitus, operation time, and antibiotic prophylaxis were collected. Additionally, the National Healthcare Safety Network (NHSN) risk index was calculated. Association of these factors with SSI was evaluated in univariate analyses and a multivariate logistic regression model. Main outcome measures Rate of SSI. Results 24 patients (3.2%) had an SSI according to the NHSN definition. In univariate analyses, only smokers (p = 0.048) and male patients (p = 0.01) had a significantly higher rate of SSI. Since the majority of smokers were men (62.3%), the effect of male gender, smoking, together with the NHSN risk index were further investigated as predictors of SSI within a logistic regression model. All three predictors showed a significant effect on SSI. Conclusions Parotid gland surgery has a low rate of SSI. In our cohort, male gender, smoking, and high NHSN risk index scores were significantly associated with SSI, whereas antibiotic prophylaxis had no protective effect. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosis of isolated congenital anosmia using simultaneous functional magnetic resonance imaging and olfactory event‐related potentials: Our experience in six patients

xlomafota13 shared this article with you from Inoreader Diagnosis of isolated congenital anosmia using simultaneous functional magnetic resonance imaging and olfactory event‐related potentials: Our experience in six patients Via Clinical Otolaryngology Abstract ‐ Primary anosmia is usually associated with Kallmann syndrome, which is characterized by hormonal abnormalities such as hypogonadotropic hypogonadism. ‐ On very rare occasions, a primary anosmia presents as olfactory bulb agenesis without this associated syndrome. ‐ In previous studies of such cases, diagnosis is usually based on the absence of an olfactory bulb on structural MRI, rather than on objective functional measures. ‐ Simultaneous functional MRI and olfactory event‐related potential recordings can provide highly objective evidence of olfactory function. ‐ We examined both structural and functional MRI and olfactory event‐related potential data to diagnose primary anosmia with isolated olfactory bulb agenesis, gaining objective evidence of olfactory function. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Phonation Resistance Training Exercises (PhoRTE) With and Without Expiratory Muscle Strength Training (EMST) For Patients With Presbyphonia: A Noninferiority Randomized Clinical Trial

xlomafota13 shared this article with you from Inoreader Phonation Resistance Training Exercises (PhoRTE) With and Without Expiratory Muscle Strength Training (EMST) For Patients With Presbyphonia: A Noninferiority Randomized Clinical Trial Via Journal of Voice Presbyphonia negatively impacts quality of life in patients with age-related voice changes. A proof-of-concept study showed promise for high vocal intensity exercise to treat presbyphonia, which became the basis for a novel intervention for age-related voice changes known as Phonation Resistance Training Exercises (PhoRTE). Expiratory Muscle Strength Training (EMST) has also been proposed as an additional intervention to target and strengthen the aging respiratory system; however, EMST has undergone limited evaluation as an adjunct treatment for elderly patients undergoing voice therapy for presbyphonia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impact of Site, Size and Duration of Tympanic Membrane Perforation on Hearing Loss and Postsurgical Outcome

xlomafota13 shared this article with you from Inoreader Impact of Site, Size and Duration of Tympanic Membrane Perforation on Hearing Loss and Postsurgical Outcome Via Otolaryngology Indian Abstract This paper aims to assess correlation of site, size and duration of tympanic membrane perforation with hearing loss using pure tone audiogram and surgical outcome in terms of above parameters. The present study was conducted on 100 patients in Department of ENT and HNS, SMGS Hospital, Government Medical College Jammu during a time period of November 2018 to October 2019. All the patients with age 15–60 years who presented with tympanic membrane (pars tensa) perforation were included in the study. According to the size of perforation, mean pure tone threshold in group I was 20.87 ± 3.86 dB, in group II was 26.45 ± 6.08 dB and in group III was 32.6 ± 5.56 dB. The difference in hearing threshold between all the three groups was significant statistically. In terms of site, group E had maximum hearing threshold (34.67 ± 4.20 dB), followed by group B (32.71 ± 5.88 dB). Group A had the lowest hearing threshold of 24.99 ± 6.21 dB. The difference between hearing thresholds of group B perforations and group A perforations was statistically significant (p < 0.05). However, the difference between group E and group B was insignificant. This study has shown significant correlation between the size and the site of the perforation to the degree of hearing loss. The bigger the perforation, the greater the hearing loss. The central perforations were associated with more hearing loss than posterior perforations, thus refuting the hypothesis that site and size of a tympanic membrane perforation does not affect the degree of conductive hearing loss. This study did not show any correlation between duration of disease and degree of hearing loss. Surgical and audiometric results obtained in this study can be accepted as satisfactory and as expected by the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Translation and validation of the Voice Handicap Index in Tamil language

xlomafota13 shared this article with you from Inoreader Translation and validation of the Voice Handicap Index in Tamil language Via Otolaryngology Indian Abstract Voice Handicap Index (VHI) is the most commonly used tool to assess the quality of life in voice disordered patients. A validated Tamil language version of VHI is not developed yet. Hence, this study was undertaken to translate and validate the Voice Handicap Index in Tamil language, which can potentially benefit Tamil speaking patients with voice disorders. This was a translation and tool validation study done at a tertiary care teaching hospital using an analytical, follow up design according to WHO guidelines. Dysphonic (Group A) and Normal (Group B) respondents were purposively invited to fill a self administered VHI-Tamil questionnaire. The content validity, response process validity, internal consistency and clinical validity of the questionnaire was calculated using appropriate statistical analysis methods using SPSS version 24.0 software. Out of 117 respondents, 61 respondents were dysphonic (Group A) and 56 respondents were normal (Group B). Overall inde x for content validation was over 0.84, and response process validation was 1.00 in all domains. Overall internal consistency was excellent, with Cronbach's alpha of 0.993. Excellent test–retest reliability was identified using the Spearman rank correlation coefficient (r = 0.96; p-value < 0.001). For clinical validity, a statistically significant difference between the dysphonic and the normal groups, for the overall VHI-Tamil scores and each of the three domain scores was noted. VHI-Tamil was found to be reliable and valid for assessing the quality of life in patients with voice disorders. It can be recommended for future use among Tamil speaking population. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hormonal influence on hearing

xlomafota13 shared this article with you from Inoreader Hormonal influence on hearing Via hno HNO. 2021 Mar 16. doi: 10.1007/s00106-021-01019-y. Online ahead of print. ABSTRACT BACKGROUND: Hearing loss leads to impairments in communication, social interactions, and cognitive functions. This renders early treatment particularly important. A causal therapy is not yet available. Human and animal studies have shown that certain hormones can have a positive effect on hearing. OBJECTIVE: This review provides an overview of the effects of various hormones on hearing a nd describes the potential benefit for future therapeutic approaches. MATERIALS AND METHODS: A systematic literature review of reviews dealing with the effects of various hormones on hearing in humans and animals published in PubMed between 2015 and 2020 was conducted. RESULTS: Hormones may mediate antiapoptotic effects on structure-relevant cells of the cochlea and auditory pathway, and may influence hair cell functionality or the electrolyte balance of the endo- and perilymph. Current research focuses on glucocorticoids; the mineral corticoid aldosterone; the sex hormones estrogen, progesterone, and testosterone; the growth hormones GH (growth hormone) and IGF‑1 (insulin-like growth factor 1); thyroid hormones; and insulin. Study results are still inconsistent at this time, but various hormones appear to represent a possible future treatment option for acute hearing loss. Long-term hormone treatment, which would be necessary particularly in the case of age-related he aring loss, does not currently represent a sensible course of action due to the side effect profile of the systemic treatment/lack of practicable topical application options. CONCLUSION: The mode of action of hormones is complex. Whether they can be used in the future for individualized treatment of patients with acute hearing impairment requires further investigation. PMID:33725160 | DOI:10.1007/s00106-021-01019-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

2021 European Thyroid Association Guideline on Thyroid Disorders prior to and during Assisted Reproduction

xlomafota13 shared this article with you from Inoreader 2021 European Thyroid Association Guideline on Thyroid Disorders prior to and during Assisted Reproduction Via radioactive iodine Eur Thyroid J. 2021 Feb;9(6):281-295. doi: 10.1159/000512790. Epub 2021 Jan 21. ABSTRACT Severe thyroid dysfunction may lead to menstrual disorders and subfertility. Fertility problems may persist even after restoring normal thyroid function, and then an assisted reproductive technology (ART) may be a solution. Prior to an ART treatment, ovarian stimulation is performed, leading to high oestradiol levels, which may lead to hypothyroidism in women with thyroid autoimmunity (TAI), ne cessitating levothyroxine (LT4) supplements before pregnancy. Moreover, women with the polycystic ovarian syndrome and idiopathic subfertility have a higher prevalence of TAI. Women with hypothyroidism treated with LT4 prior to ART should have a serum TSH level <2.5 mIU/L. Subfertile women with hyperthyroidism planning an ART procedure should be informed of the increased risk of maternal and foetal complications, and euthyroidism should be restored and maintained for several months prior to an ART treatment. Fertilisation rates and embryo quality may be impaired in women with TSH >4.0 mIU/L and improved with LT4 therapy. In meta-analyses that mainly included women with TSH levels >4.0 mIU/L, LT4 treatment increased live birth rates, but that was not the case in 2 recent interventional studies in euthyroid women with TAI. The importance of the increased use of intracytoplasmic sperm injection as a type of ART on pregnancy outcomes in women with TAI deserves more investigatio n. For all of the above reasons, women of subfertile couples should be screened routinely for the presence of thyroid disorders. PMID:33718252 | PMC:PMC7923920 | DOI:10.1159/000512790 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.