Eosinophilic Sialodochitis: A Type of Chronic Obstructive Sialadenitis Related to Allergy

xlomafota13 shared this article with you from Inoreader Eosinophilic Sialodochitis: A Type of Chronic Obstructive Sialadenitis Related to Allergy Via The Laryngoscope Objectives To investigate the clinical, laboratory, radiological, histopathological, and immunohistochemical features, and the expression of allergy‐related cytokines in eosinophilic sialodochitis (ES). Methods Thirty‐eight patients diagnosed with chronic obstructive sialadenitis (COS) who had undergone glandular excision or incisional biopsy were enrolled. Seventeen patients with comorbid atopic disease and increased ductal tissue eosinophils comprised the ES group, while 21 patients comprised the COS group. The clinicopathological features and allergy‐related cytokine expression were compared between groups. Results The ES group frequently involved multiple, bilateral major salivary glands, and the number of glands was significantly greater than the COS group (2.8 ± 1.1 vs. 1.2 ± 0.4, P < .001). Serum immunoglobulin (Ig) E was elevated in 91% of patients in ES group (419 ± 357 kU/L) and peripheral blood eosinophil was significantly greater compared with the COS group (7.6% ± 4.6% vs. 2.5% ± 1.4%, P < .001). Histologically, eosinophil infiltration in ES group was observed around the main and interlobular ducts (50 ± 39/high power field [HPF]). Follicular hyperplasia (76%), epithelial mucous metaplasia (82%), and mucus plugs with eosinophils (41%) were observed. IgE‐positive cell count was 20.7 ± 18.3/HPF and tryptase‐positive mast cell count was 23.5 ± 15.1/HPF, which was significantly greater than the respective cell counts in COS group, which mainly infiltrated around the ducts. The levels of interleukin‐4, interleukin‐1 3, and eotaxin in tissue were significantly greater in ES than the COS group. Conclusions The clinicopathological characteristics of ES are significantly different from COS and ES might have an allergy‐related pathogenesis. Level of Evidence 4 Laryngoscope, 131:E800–E806, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of a Parent Proxy Quality‐of‐Life Measure for Young Children With Hearing Loss

xlomafota13 shared this article with you from Inoreader Validation of a Parent Proxy Quality‐of‐Life Measure for Young Children With Hearing Loss Via The Laryngoscope Objectives No hearing‐related quality of life (QL) questionnaire currently exists for children < 7 years. This study aimed to develop and evaluate the construct validity and reliability of a new parent‐proxy Preschool Hearing Environments and Reflection on Quality of Life (HEAR‐QL) questionnaire. Methods Parents of children 2 to 6 years old with any hearing loss (HL) were recruited from multiple sites. To evaluate the new measure's construct validity, participants completed a 70‐item preschool HEAR‐QL and validated questionnaires measuring hearing and communication functioning (Parents' Evaluation of Aural/Oral Performance of Children), generic pediatric QL (Pediatric Quality of Life Inventory Parent Report, PedsQL), family functioning (PedsQL Family Impact Module), and parent well‐being (Patient Reported Outcomes Measurement Information System Adult Global Report). Participants completed the preschool HEAR‐QL 2 weeks later to measure test–retest reliability. Exploratory principal components analysis was used to reduce the number of items and determine the underlying HEAR‐QL factor structure. Analysis of variance examined HEAR‐QL differences by HL. Results Among 205 parents, 144 had children with bilateral HL, 50 had children with unilateral HL, 10 had children with normal hearing (NH), and one child's hearing status was unspecified. The 70‐item questionnaire was reduced to 23 items with five underlying factors: Behavior and Attention, Hearing Environments, New Social Situations, Social Interactions, and Communication. Cronbach's alpha for each factor ranged from 0.80 to 0.91. Test–retest reliability was 0.93. Moderate‐to‐strong correlations (r > .300) were observed between each Preschool HEAR‐QL factor and previously validated measures. Hearing Environments scores differed significantly between children with NH and any HL. Conclusion Preschool HEAR‐QL correlations with other measures supported its construct validity. Discriminant validity testing requires a larger sample of children with NH. Level of Evidence NA Laryngoscope, 131:663–670, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception

xlomafota13 shared this article with you from Inoreader Cochlear Implantation in Candidates With Moderate‐to‐Severe Hearing Loss and Poor Speech Perception Via The Laryngoscope Objectives/Hypothesis To determine the improvement in word recognition score (WRS65) after cochlear implant (CI) surgery in hearing aid (HA) users with preoperative hearing threshold ≤80 dB HL and inadequate speech recognition scores with HA. Secondarily, to identify predictive factors for WRS65 with a CI (WRS65[CI]) 6 months after surgery, derived from the standard German CI preoperative assessment. Study Design Retrospective chart review. Methods Retrospective review of all adult patients who received a Nucleus cochlear implant in the ear, nose, and throat department of the University Hospital of Erlangen between January 2010 and April 2019. The inclusion criteria were a preoperative hearing threshold ≤80 dB HL in the ear to receive the implantation, German as the native language, and at least 6 months postimplantation care at our center. Results The inclusion criteria were met by 128 patients. All but two patients (98.4%) showed a significant improvement, WRS65(CI) versus WRS65 with an (HA) (WRS65[HA]), of at least 15 percentage points (pp). The median improvement was 55 pp with a median WRS65(CI) of 70%. Three preoperative audiometric measures, the maximum word recognition score, age at implantation, and WRS65(HA) were identified as predictive factors for WRS65(CI). For three‐quarters of the CI recipients, the score was not poorer than 12 pp below the predicted WRS65(CI). Conclusions For patients with a hearing loss ≤80 dB HL, cochlear implantation should be considered when speech perception with an HA is insufficient. The prediction model can support counseling in this patient group. Level of Evidence 4 Laryngoscope, 131:E940–E945, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Role of Surgery in Rhabdomyosarcoma of the Head and Neck in Children

xlomafota13 shared this article with you from Inoreader Role of Surgery in Rhabdomyosarcoma of the Head and Neck in Children Via The Laryngoscope Objectives Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. The goal of this research is to analyze the role of surgery in the management of pediatric parameningeal (PM) and non‐PM head and neck RMS (HNRMS). Study Design Retrospective review. Methods Retrospective chart review of patients <20 years of age treated for HNRMS between 1970 and 2015. Clinical presentation, tumor characteristics, treatment, recurrence, follow‐up, and outcome data were collected. Results Of 97 patients with HNRMS, 56% were male. Overall median (IQR: interquartile range) age at diagnosis was 5.8 (3.3–9.8) years. Sixty‐five patients (67%) had PM tumors. Of 75 patients with histologic subtype identified, 51 (53%) had embryonal and 20 (21%) alveolar RMS. Almost all patients received chemotherapy (99%) and radiotherapy (95%). Forty‐four patients (45%) underwent surgery. Surgery was more likely to be conducted in patients with lesions of a non‐PM site. Median follow‐up time was 3.4 years (IQR: 1.1–10.8). In 5 years of follow‐up, 20% (17 of 85) died and 29% (20 of 70) had recurrence. The estimated 5‐year survival rate was 72% (95% CI, 57.8, 81.5%). Surgery was associated with a reduced risk of mortality after accounting for TNM stage 4 and tumor site (adjusted HR 0.24; 95% CI, 0.07, 0.79; P = .02). The association between surgery and risk of mortality was similar in PM and non‐PM tumors. Conclusion A multimodal protocol for treatment including chemotherapy, surgery, and radiotherapy is the mainstay for management of children with HNRMS. While surgery is more commonly used to treat non‐PM HNRMS, patients who are able to undergo surgery have significantly higher 5‐year survival. Level of Evidence 4 Laryngoscope, 131:E984–E992, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporal Bone Plasmacytoma Presenting With a Mobile Third Window

xlomafota13 shared this article with you from Inoreader A Window Into the Whole Story: Temporal Bone Plasmacytoma Presenting With a Mobile Third Window Via The Laryngoscope A 63‐year‐old man presented with imbalance when coughing due to a respiratory tract infection. He had a history of multiple myeloma with a plasmacytoma of the left temporal bone. Examination revealed a positive leftward head impulse test, no spontaneous nystagmus, left‐beating positional nystagmus, and left‐beating Valsalva‐induced nystagmus. Videonystagmography, audiology, and comprehensive vestibular function tests revealed a subtotal left peripheral audio‐vestibular loss. Temporal bone computed tomography showed an unchanged bony erosion of the left labyrinth from 2 years prior. Vertigo subsided after treatment of the respiratory tract infection. Although no tumor progression was evident, coughing had triggered a preexisting third mobile window to declare itself. Laryngoscope, 131:E966–E969, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Incudo‐Malleolar Arthrodesis: A New Surgical Treatment for Incudo‐Malleolar Subluxation

xlomafota13 shared this article with you from Inoreader Endoscopic Incudo‐Malleolar Arthrodesis: A New Surgical Treatment for Incudo‐Malleolar Subluxation Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes in N3 Head and Neck Squamous Cell Carcinoma and Role of Upfront Neck Dissection

xlomafota13 shared this article with you from Inoreader Outcomes in N3 Head and Neck Squamous Cell Carcinoma and Role of Upfront Neck Dissection Via The Laryngoscope Objectives We investigated the prognostic factor of N3 head and neck squamous cell carcinoma (HNSCC), including the role of upfront neck dissection (UFND) before radiotherapy (RT). Methods We retrospectively reviewed the charts of consecutive N3 HNSCC patients treated with curative intent RT. Results In the study, 323 N3 HNSCC patients were included. Of those, 125 patients (39%) had UFND. Median follow‐up was 3.9 years (0–14.8 years). Overall survival (OS) at 5 years was 31.2%, and progression‐free survival (PFS) was 26%. In the multivariate analysis, OS was improved in PS 0, T1‐2 tumors, patients receiving concurrent chemotherapy, never or former smokers, and UFND. UFND was strongly associated with increased OS (45.7% vs. 21.2%, P < .001), and PFS (P < .001). Regardless of neck node size, UFND improved survival (P = .001 for ≤ 7 cm and P = .004 for > 7 cm). Conclusion UFND could improve treatment outcomes in N3 HNSCC, especially for non‐oropharyngeal cancer, regardless of neck node size. Level of Evidence 2B Laryngoscope, 131:E844–E850, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.