Can Red Blood Cell Distribution Width Predict Laryngectomy Complications or Survival Outcomes?

xlomafota13 shared this article with you from Inoreader Can Red Blood Cell Distribution Width Predict Laryngectomy Complications or Survival Outcomes? Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Oct 29:34894211056117. doi: 10.1177/00034894211056117. Online ahead of print. ABSTRACT OBJECTIVE: Red blood cell distribution width (RDW), a reported biomarker for morbidity and mortality in chronic disease and following certain surgeries, has not been well-studied in head and neck cancer patients. The aim of the study was to examine the association of RDW with postoperative complications and survival among patients who underwent primary or sal vage laryngectomy. METHODS: We analyzed a retrospective case series study of patients diagnosed with squamous cell carcinoma of the larynx treated with total laryngectomy. Survival outcomes were examined using Kaplan-Meier analysis. RESULTS: One hundred seventy-seven patients were included in the final analysis. The most common tumor subsite was the supraglottis (60%). On bivariate analysis, patients with RDW ≥14.5 had higher prevalence of non-surgical, systemic complications, including deep venous thrombosis, pneumonia, cardiovascular events, and difficulty weaning from mechanical ventilation. However, there was no significant difference in laryngectomy-specific post-operative complications, including pharyngocutaneous fistula, wound infection, stoma complications, and chyle leak. RDW was not found to be associated with survival outcomes following laryngectomy. CONCLUSIONS: Among laryngectomy patients, RDW ≥14.5 is associated with higher prevalence of systemic morbidity, but not with specific local surgical complications or decreased survival. PMID:34715735 | DOI:10.1177/00034894211056117 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction

xlomafota13 shared this article with you from Inoreader Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction Via The Laryngoscope Objectives/Hypothesis Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea-hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU) can be employed to guide the surgery and prevent massive bleeding. Study Design Cohort study with historical control. Methods A cohort study to compare the outcomes between OSA patients who received TORS with and without IOU assistance. Results From 2016 to 2019, this study enrolled 80 OSA patients who underwent TORS in BOT: 57 in the IOU(+) and 23 in IOU(−) groups. The TORS with IOU presented with shorter operative time, less blood loss, and greater excised BOT volume. The IOU(+) group had greater improvement in the AHI and subjective questionnaire evaluation. The excised volume of BOT was significantly associated with the change in AHI. Conclusion The IOU could improve outcomes in BOT reduction surgery without raising the risk of surgical complications. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia

xlomafota13 shared this article with you from Inoreader Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia Via The Laryngoscope Objectives/Hypothesis To analyze the role of noninvasive respiratory support (NRS) as an alternative to tracheostomy in the management of severe laryngomalacia. Study Design We conducted a monocentric retrospective study in a tertiary pediatric care center. Methods All children under the age of 3 years with severe laryngomalacia, treated between January 2014 and December 2019, were included. Patient demographics, medical history, nutrition, surgery, NRS, and outcome were reviewed. Predictors for NRS were analyzed. Results One hundred and eighty-eight patients were included. Mean age was 4 ± 5 months and mean weight was 4,925 ± 1,933 g. An endoscopic bilateral supraglottoplasty was performed in 183 (97%) patients and successful in 159 (87%). NRS was initiated in 29 (15%) patients at a mean age of 3 ± 2 months (1–11 months): 15 (52%) patients were treated with NRS after surgical failure, 9 (31%) were treated with NRS initiated prior to surgery because of abnormal overnight gas exchange, and 5 (17%) were treated exclusively with NRS due to comorbidities contraindicating an endoscopic procedure. NRS was successfully performed in all patients with a mean duration of 6 ± 11 months. No patient required a tracheostomy. Univariate analysis identified the following predictors of NRS: neonatal respiratory distress (P = .003), neurological comorbidity (P < .001), associated laryngeal abnormality (P < .001), cardiac surgery (P&n bsp;= .039), surgical endoscopic revision (P = .007), and nutritional support (P < .001). Conclusion NRS is a safe procedure, which may avoid a tracheostomy in severe laryngomalacia, in particular, in case of endoscopic surgery failure, respiratory failure before surgery, and/or severe co-morbidity. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients

xlomafota13 shared this article with you from Inoreader Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients Via The Laryngoscope Objectives/Hypothesis The diffuse sclerosing variant of papillary thyroid carcinoma (DSV) may be more aggressive than conventional well-differentiated non-DSV related papillary thyroid carcinomas (N-PTC). Study Design Retrospective chart review. Methods Retrospective review of clinical outcomes for patients 21 years of age or younger who underwent initial surgery for PTC at a single institution from January 1, 2005 to April 1, 2020. Genomic analysis was performed using targeted next-generation sequencing. Data were analyzed using Fischer's exact test and Kaplan–Meier curve log-rank test. Results Our cohort consisted of 72 patients, nine with DSV and 63 with N-PTC. Age at diagnosis was comparable (15.4 vs. 16.2 years, respectively, P = .46). DSV were more likely to be in the high-risk American Thyroid Academy pediatric risk group (100% vs. 41.3%, P = .004), to present with regional cervical lymph node metastases (100% vs. 60.3%, P = .036), and to present with distant metastases (67% vs. 22%, P = .005). No mortality seen in either group over 27.5 (interquartile range 14.8, 46.00) months average follow-up. Throughout the follow-up period, DSV were more likely to experience progression than N-PTC (hazard ratio = 5.7 [95% confidence interval 1.7–20.0; P = .0056]). In a subset of 19 patients with aggressive disease who had molecular testing as part of clinical care we detected RET fusions in nearly all DSV compared to a minority of N-PTC (83% vs. 15.4%, P =  ;.0095). Conclusions Pediatric patients with DSV have more advanced disease at diagnosis and are more likely to experience progression of disease compared to patients with N-PTC. The prevalence of RET fusions in our cohort recapitulates the frequency of this alteration described in prior studies. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty

xlomafota13 shared this article with you from Inoreader Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty Via The Laryngoscope Objectives/Hypothesis To analyze different variables that influence postrhinoplasty quality of life outcomes to ascertain the determinants of postoperative satisfaction. Study Design Prospective, observational study. Methods This was a prospective, observational study where patients were divided into two groups based on the postoperative Rhinoplasty Outcome Evaluation (ROE) score: high satisfaction group, when postoperative ROE scores were >50, and low satisfaction group, when postoperative ROE scores were ≤50. Patients' general characteristics, Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) score, the Body Dysmorphic Disorder Examination, nasal angles, and measures from the esthetic facial analysis of postoperative photographs were compared between the groups. Results Seventy-eight patients were included: 19 in the low satisfaction group and 58 in the high satisfaction group. The median reduction in the NOSE-p score was −45 (interquartile range [IIQ] −20 to −60) (P < .001) in the high satisfaction group and −10 (IIQ −10 to −30) in the low satisfaction group (P = .053). The high satisfaction group had a significantly higher reduction in NOSE-p scores. There was no significant difference between the groups in terms of the analyzed facial parameters, although a significant difference was found when comparing them with the ones established in the literature as a pattern. Previous rhinoplasty, preoperative crooked nose, and higher NOSE-p scores were significantly associated with lower ROE scores (P < .05) in the robust Poisson regression model. Conclusion Functional results play an important role in satisfaction after rhinoplasty. Neoclassical canons were not fulfilled even in a group of patients with a high postoperative satisfaction evaluation. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy

xlomafota13 shared this article with you from Inoreader Management of first‐line palliative chemotherapy for post‐treatment metastasis after gemcitabine plus cisplatin induction chemotherapy: Gemcitabine plus cisplatin and non‐gemcitabine plus cisplatin chemotherapy Via Head & Neck Abstract Background To evaluate whether patients with post-treatment metastasis are suitable for GP first-line palliative chemotherapy (PCT) after undergoing GP IC. Methods Seven hundred and forty-six patients with post-treatment metastasis after undergoing GP IC were eligible. Survival outcomes were compared. Results Significant differences in survival rates were observed between patients treated with GP and non-GP chemotherapy (2-year progression-free survival [PFS]: 0.7% vs. 9.7%). We investigated survival outcomes of patients treated with GP PCT within 2 years after undergoing GP IC, treated with GP PCT 2 years after undergoing GP IC, and those of non-GP PCT patients (2-year PFS: 0.0%, 2.3%, 9.7%). However, there was no difference in the 2-year PFS between the patients that received GP PCT 2 years after undergoing GP IC and the non-GP PCT treated patients. Conclusions GP is not recommended for patients that have received GP IC within 2 years. Two years after undergoing GP IC, GP can be considered. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Decreased CFTR/PPARγ and increased transglutaminase 2 in nasal polyps

xlomafota13 shared this article with you from Inoreader Decreased CFTR/PPARγ and increased transglutaminase 2 in nasal polyps Via Auris Nasus Larynx Publication date: Available online 30 October 2021 Source: Auris Nasus Larynx Author(s): Thi Nga Nguyen, Hideaki Suzuki, Yasuhiro Yoshida, Jun-ichi Ohkubo, Tetsuro Wakasugi, Takuro Kitamura View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.