FEES as a second‐stage diagnostic tool in 117 patients with dysphagia

xlomafota13 shared this article with you from Inoreader FEES as a second‐stage diagnostic tool in 117 patients with dysphagia Via Clinical Otolaryngology Abstract In 1988, Langmore et al. developed fiberoptic endoscopic evaluation of swallowing (FEES) as a safe and reliable tool for the diagnosis and monitoring of dysphagia.1 Currently, FEES represents the gold standard in oropharyngeal dysphagia, although videofluoroscopy may supplement clinical assessment in select cases.2 One or a work pair speech–language therapists (SLTs) most often serve as endoscopists during FEES. In Finland, an ear, nose and throat (ENT) specialist or a phoniatrics specialist as well as an SLT perform FEES either together or alone. Although this work‐pair setting is considered superior vis‐à‐vis safety and precision, a limited amount of research exists on various aspects of the care pathway for patients with dysphagia at a tertiary health care centre. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Objective Evaluation of Biomaterial Effects after Injection Laryngoplasty‐ Introduction of Artificial Intelligence‐Based Ultrasonic Image Analysis

xlomafota13 shared this article with you from Inoreader Objective Evaluation of Biomaterial Effects after Injection Laryngoplasty‐ Introduction of Artificial Intelligence‐Based Ultrasonic Image Analysis Via Clinical Otolaryngology Abstract Objective Hyaluronic acid (HA) can be degraded over time. However, persistence of the effects after injection laryngoplasty (IL) for unilateral vocal fold paralysis (UVFP), longer than expected from HA longevity, has been observed. The purpose of the study was to develop an methodology with clinical utility for objective evaluation of the temporal change in HA volume after IL using artificial intelligence (AI)‐based ultrasonic assessment. Design, setting and participants Imaging phantoms simulating injected HA were built in different volumes for designing the algorithm for machine learning. Subsequently, five adult patients who had undergone IL with HA for UVFP were recruited for clinical evaluation. Main outcome measures Estimated volumes were evaluated for injected HA by the automatic algorithm as well as voice outcomes at 2 weeks, and 2 and 6 months after IL. Results On imaging phantoms, contours on each frame were described well by the algorithm and the volume could be estimated accordingly. The error rates were 0 – 9.2%. Moreover, the resultant contours of the HA area were captured in detail for all participants. The estimated volume decreased to an average of 65.76% remaining at 2 months and to a minimal amount at 6 months while glottal closure remained improved. Conclusion The volume change of the injected HA over time for an individual was estimated non‐invasively by AI‐based ultrasonic image analysis. The prolonged effect after treatment, longer than HA longevity, was demonstrated objectively for the first time. The information is beneficial to achieve optimal cost‐effectiveness of IL and improve the life quality of the patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles

xlomafota13 shared this article with you from Inoreader Comparison of three different types of exercises for selective contractions of supra- and infrahyoid muscles Via swallowing exercises Sci Rep. 2021 Mar 30;11(1):7131. doi: 10.1038/s41598-021-86502-w. ABSTRACT Several exercise methods, such as the Shaker exercise, tongue press exercise, chin tuck against resistance (CTAR) exercise, and submandibular push exercise, have been introduced to strengthen the muscles involved in swallowing. In this study, we compared the effectiveness of the CTAR, submandibular push, and Shaker exercises for the induction of selective supra- and infrahyoid muscle contractions using surfa ce electromyography (EMG). This study is a prospective non-randomized controlled study. Twenty-five healthy subjects and 20 patients experiencing swallowing difficulty were enrolled. During the three different types of exercises, the root mean square (RMS) values of the sternocleidomastoid (SCM), suprahyoid (anterior belly of the digastric and mylohyoid muscles), and infrahyoid (sternothyroid and thyrohyoid muscles) muscles were analyzed using surface EMG. Differences in the activity of swallowing muscles among the three different exercises were analyzed using one-way repeated measured analysis of variance. In terms of both the maximum and mean RMS values of the suprahyoid muscle, the submandibular push exercise showed a larger RMS value than the CTAR and Shaker exercises in healthy subjects (p < 0.05). In terms of both the maximum and mean RMS values of the suprahyoid muscle, the Shaker exercise and submandibular push exercise showed a larger RMS value than the CTAR exercise in patients with swallowing difficulty (p < 0.05). The submandibular push exercise may be effective as a swallowing muscle exercise owing to its superiority in inducing selective contractions of the supra- and infrahyoid muscles. The CTAR and Shaker exercises are also effective in this regard. PMID:33785793 | DOI:10.1038/s41598-021-86502-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Otolaryngology Consult Protocols in the Setting of COVID-19: The University of Pittsburgh Approach

xlomafota13 shared this article with you from Inoreader Otolaryngology Consult Protocols in the Setting of COVID-19: The University of Pittsburgh Approach Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 29:34894211005937. doi: 10.1177/00034894211005937. Online ahead of print. ABSTRACT OBJECTIVE: To analyze trends in otolaryngology consultations and provide algorithms to guide management during the COVID-19 pandemic. METHODS: A retrospective cohort study at a single institution tertiary care hospital. A total of 95 otolaryngology consultations were performed from March 1, 2020 to April 26, 2020 (COVID-era) and 363 were performed from September 1, 2019 to February 29, 2020 (pre-COVID-era) at the UPMC Oakland campus. Data collected included patient demographics, COVID-19 status, reason for consult, location of consult, type of consult, procedures performed, need for surgical intervention, length of hospital stay and recommended follow up. RESULTS: Patient populations in the pre-COVID-era and COVID-era were similar in terms of their distribution of demographics and chief complaints. Craniofacial trauma was the most common reason for consultation in both periods, followed by vocal fold and airway-related consults. We saw a 21.5% decrease in the rate of consults seen per month during the COVID-era compared to the 6 months prior. Review of trends in the consult workflow allowed for development of several algorithms to safely approach otolaryngology consults during the COVID-19 pandemic. CONCLUSIONS: Otolaryngology consultations provide valuable services to inpatients and patients in the emergency departmen t ranging from evaluation of routine symptoms to critical airways. Systematic otolaryngology consult service modifications are required in order to reduce risk of exposure to healthcare providers while providing comprehensive patient care. PMID:33779296 | DOI:10.1177/00034894211005937 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diagnosis of Retrolingual Obstruction during Drug-Induced Sleep Endoscopy versus Polysomnography with Nasopharyngeal Tube in Patients with Obstructive Sleep Apnea

xlomafota13 shared this article with you from Inoreader Diagnosis of Retrolingual Obstruction during Drug-Induced Sleep Endoscopy versus Polysomnography with Nasopharyngeal Tube in Patients with Obstructive Sleep Apnea Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Mar 29:34894211005944. doi: 10.1177/00034894211005944. Online ahead of print. ABSTRACT OBJECTIVE: To compare the retrolingual obstruction during drug-induced sleep endoscopy (DISE) with the retrolingual obstruction during polysomnography with nasopharyngeal tube (NPT-PSG). METHODS: A cross-sectional study of 77 consecutive patients with moderate and severe obstructive sleep apnea (OSA) was conducted. After 15 patients were excluded from t he study for not completing DISE or NPT-PSG successfully, 62 patients were included in this study. Retrolingual sites of obstruction grade 2 determined by DISE according to the VOTE (velum, oropharynx lateral wall, tongue base, and epiglottis) classification were considered as retrolingual obstruction, while apnea-hypopnea index (AHI) ≥ 15 events/hour determined by NPT-PSG was considered as retrolingual obstruction. The extent of agreement between DISE and NPT-PSG findings was evaluated using unweighted Cohen's kappa test. RESULTS: The 62 study participants (11 moderate OSA, 51 severe OSA) had a mean (SD) age of 39.8 (9.9) years, and 58 (94%) were men. No statistically significant differences between included and excluded patients were observed in patient characteristics. The extent of agreement in retrolingual obstruction between DISE and NPT-PSG was 80.6% (Cohen k = 0.612; 95% CI, 0.415-0.807). CONCLUSION: Retrolingual obstruction requiring treatment showed go od agreement between DISE and NPT-PSG, suggesting that NPT-PSG may also be a reliable method to assess the retrolingual obstruction. PMID:33779299 | DOI:10.1177/00034894211005944 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of Conductive Hearing Loss with the Structural Changes in the Organ of Corti

xlomafota13 shared this article with you from Inoreader Association of Conductive Hearing Loss with the Structural Changes in the Organ of Corti Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objective: The aim of the study was to evaluate the association of conductive hearing loss (CHL) with the structural changes in the organ of Corti. Methods: Twenty ears of 10 healthy adult Wistar albino rats were included in the study. The right ears (n = 10) of the animals served as controls (group 1), and no surgical intervention was performed in these ears. A tympanic membrane perforation without annulus removal was performed under operative microscope on the left ears (n = 5) in 5 of 10 animals (group 2). A tympanic membrane perforation with annulus removal was performed under operative microscope on the left ears (n = 5) of the remaining 5 animals (group 3). Auditory brainstem response testing was performed in the animals before the interventions. After 3 months, the animals were sacrificed, their temporal bones were removed, and inner ears were investigated using scanning electron microscopy (SEM). The organ of Corti was evaluated from the cochlear base to apex in the modiolar axis, and the parameters were scored semiquantitatively. Results: In group 1, the pre- and post-intervention hearing thresholds were similar (p #x3e; 0.05). In group 2, a hearing decrease of at least 5 dB was encountered in all test frequencies (p #x3e; 0.05). In group 3, at the frequency range of 2–32 kHz, there was a significant hearing loss after 3 months (p #x3c; 0.01). After 3 months, the hearing thresh olds in group 2 and 3 were higher than group 1 (p #x3c; 0.01). The hearing threshold in group 3 was higher than group 2 (p #x3c; 0.01). On SEM evaluation, the general cell morphology and stereocilia of the outer hair cells were preserved in all segments of the cochlea in group 1 with a mean SEM score of 0.2. There was segmental degeneration in the general cell morphology and outer hair cells in group 2 with a mean SEM score of 2.2. There was widespread degeneration in the general cell morphology and outer hair cells in group 3 with a mean SEM score of 3.2. The SEM scores of group 2 and 3 were significantly higher than group 1 (p #x3c; 0.05). The SEM scores of group 3 were significantly higher than group 2 (p #x3c; 0.05). Conclusion: CHL may be associated with an inner ear damage. The severity of damage appears to be associated with severity and duration of CHL. Early correction of CHL is advocated in order to reverse or prevent progression o f the inner ear damage, which will enhance the success rates of hearing restoration surgeries. Subjective differences and compliance of the hearing aid users may be due to the impact of CHL on inner ear structures. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Langerhans Cell Histiocytosis in Paediatric Zygoma Swelling

xlomafota13 shared this article with you from Inoreader Langerhans Cell Histiocytosis in Paediatric Zygoma Swelling Via Otolaryngology Indian Abstract Langerhans cell histiocytosis (LCH) is a rare neoplasm characterized by accumulation of histiocytes in various tissues. It has a wide clinical spectrum and its presentation may mimic clinical features of common diseases. High level of suspicion is required for early diagnosis. Here is a rare case of a rapidly aggressive LCH which first presented with right zygomatic swelling. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.