Evaluación electrofisiológica del procesamiento auditivo

xlomafota13 shared this article with you from Inoreader Evaluación electrofisiológica del procesamiento auditivo Via Otorrinolaringología y cirugía de cabeza y cuello Resumen En la actualidad existen distintas herramientas para la evaluación del procesamiento auditivo y sus alteraciones. Además de las pruebas conductuales y de las mediciones electroacústicas, se ha establecido que la batería mínima de evaluación del procesamiento auditivo debe incluir exámenes electrofisiológicos que permitan dar cuenta del estado funcional de las estructuras anatómicas a nivel de tronco cerebral, la corteza auditiva y del sistema nervioso auditivo central en general. Las pruebas electrofisiológicas más descritas en la literatura corresponden a las respuestas auditivas complejas de tronco cerebral, potenciales evocados auditivos de latencia media, potenciales evocados auditivos de latencia tardía, y los potenciales auditivos asociados a eventos como el potencial de disparidad y el P300. A pesar de que diversos organismos internacionales como la American Speech-Language-Hearing Association y la American Academy of Audiology han recomendado su util ización en el proceso diagnóstico del trastorno del procesamiento auditivo y han mencionado su utilidad en la diferenciación de cuadros asociados, no existe evidencia concluyente en relación con sus aplicaciones clínicas. Esto último ha llevado a organizaciones como la British Society of Audiology a poner en duda su verdadera utilidad en estos casos. Abstract Currently, there are different tools for the assessment of auditory processing and its disorders. In addition to behavioral tests and electroacoustic measurements, it has been established that the minimum battery for auditory processing assessment must include electrophysiological examinations that allow to verify the functional state of anatomical structures at the brainstem, the auditory cortex and, broadly, the central auditory nervous system. In literature, the most described electrophysiological tests correspond to complex auditory brainstem responses, auditory middle latency evoked responses, auditory late latenc y evoked responses and event related evoked potentials, such as mismatch negativity and P300. Although several international organizations such as the American Speech-Language-Hearing Association and the American Academy of Audiology have recommended its use in the diagnostic process of auditory processing disorder and have mentioned its usefulness in the differentiation of associated conditions, there is no conclusive evidence in relation to its clinical applications. The latter has led organizations such as the British Society of Audiology to question its true usefulness in these cases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dural Tears During Lumbar Spinal Endoscopy: Surgeon Skill, Training, Incidence, Risk Factors, and Management

xlomafota13 shared this article with you from Inoreader Dural Tears During Lumbar Spinal Endoscopy: Surgeon Skill, Training, Incidence, Risk Factors, and Management Via leak of cerebrospinal fluid Int J Spine Surg. 2021 Apr;15(2):280-294. doi: 10.14444/8038. Epub 2021 Apr 1. ABSTRACT BACKGROUND: Incidental dural tears during lumbar endoscopy can be challenging to manage. There is limited literature on their appropriate management, risk factors, and the clinical consequences of this typically uncommon complication. MATERIALS AND METHODS: To improve the statistical power of studying durotomy with lumbar endoscopy, we performed a retrospective survey study among endoscopic spine surgeons by email and chat groups on social media networks, including WhatsApp and WeChat. Descriptive and correlative statistics were done on the surgeons' recorded responses to multiple-choice questions. Surgeons were asked about their clinical experience with spinal endoscopy, training background, the types of lumbar endoscopic decompression they perform by approach, the decompression instruments they use, and incidental durotomy incidence with routine lu mbar endoscopy. RESULTS: There were 689 dural tears in 64 470 lumbar endoscopies, resulting in an incidental durotomy incidence of 1.07%. Seventy percent of the durotomies were reported by 20.4% of the surgeons. Eliminating these 19 outlier surgeons yielded an adjusted durotomy rate of 0.32. Endoscopic stenosis decompression (54.8%; P < .0001), rather than endoscopic discectomy (44.1%; 41/93), was significantly more associated with durotomy. Medium-sized dural tears (1-10 mm) were the most common (52.2%; 48/93). Small pinhole durotomies (less than 1 mm) were the second most common type (46.7%; 43/93). Rootlet herniations were seen by 46.2% (43/93) of responding surgeons. The posterior dural sac injury during the interlaminar approach (57%; 53/93) occurred more frequently than traversing nerve-root injuries (31.2%) or anterior dural sac (23.7%; 22/93). Exiting nerve-root injuries (10.8%;10/93) were less common. Over half of surgeons did not attempt any repair or closu re (52.2%; 47/90). Forty percent (36/90) used sealants. Only 7.8% (7/90) of surgeons attempted an endoscopic repair or sutures (11.1%; 10/90). DuralSeal was the most commonly used brand of commercially available sealant used (42.7%; 35/82). However, other sealants such as Tisseal (15.9%; 13/82), Evicel (2.4%2/82), and additional no-brand sealants (38; 32/82) were also used. Nearly half of the patients (48.3%; 43/89) were treated with 24-48 hours of bed rest. The majority of participating surgeons (64%; 57/89) reported that the long-term outcome was unaffected. Only 18% of surgeons reported having seen the development of a postoperative cerebrospinal fluid (CSF)-fistula (18%;16/89). However, the absolute incidence of CSF fistula was only 0.025% (16/64 470). Severe radiculopathy with dysesthesia; sensory loss; and motor weakness in association with an incidental durotomy were reported by 12.4% (11/89), 3.4% (3/89), and 2.2% (2/89) of surgeons, respectively. CONCLUSIONS: The inci dence of dural tears with lumbar endoscopy is about 1%. The incidence of durotomy is higher with the use of power drills and the interlaminar approach. Stenosis decompression that typically requires the more aggressive use of these power instruments has a slightly higher incidence of dural tears than does endoscopic decompression for a herniated disc. Most dural tears are small and can be successfully managed with mechanical compression with Gelfoam and sealants. Two-thirds of patients with incidental dural tears had an entirely uneventful postoperative course. The remaining one-third of patients may develop a persistent CSF leak, radiculopathy with dysesthesia, sensory loss, or motor function loss. Patients should be educated preoperatively and reassured. LEVEL OF EVIDENCE: 3. PMID:33900986 | DOI:10.14444/8038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Study on Otorhinolaryngological Presentations in Covid 19 Patients in a Tertiary Health Care Center

xlomafota13 shared this article with you from Inoreader A Study on Otorhinolaryngological Presentations in Covid 19 Patients in a Tertiary Health Care Center Via Otolaryngology Indian Abstract Corona virus also known as 2019 novel corona virus, a single stranded positive sense RNA virus is the causative agent of COVID 19 disease. It mainly spreads via the respiratory route by means of aerosols. The objectives of our study were. To know the prevalence of ENT presentations in COVID 19 patients and to know the relationship between the symptoms and category of the disease as well as to know the relation between the blood group and recovery from the disease. The first 500 patients who were tested positive for COVID 19 and getting treated in our hospital were included in the study after taking written informed consent from the patients who were willing to participate in the study. A detailed history was taken from all the patients and more stress was given on the ENT symptoms with respect to its onset, duration and time taken for the relief of symptoms. The ENT symptoms were compared with the category of the disease as well as the blood group of the patients . Statistical analysis was done using Chi square test and Statistical Package for Social Sciences [SPSS] for Windows Version 22.0 Released 2013. Armonk, NY: IBM Corp., was used to perform statistical analyses. In our study 310 (62.0%) were males and 190 (38.0%) patients were females (38%), of age group ranging from 2 years to 87 years. In our study 367 (73.3%) patients were symptomatic and the rest 133 (26.6%) were asymptomatic. There were 335 (67.0%) patients in category A, 140 (28.0%) in category B and 25 (5.0%) in category C. The most common ENT presentation was headache and its prevelance was more in category C and it was of statistical significance. On comparing the blood group and the ENT symptoms occurrence of sore throat was of statistical significance and its prevelance was more among the O blood group patients. In terms of recovery from the disease the patients with blood group O had good recovery rate. Covid 19 pandemic is still an on going problem and newer strains of th e virus are arising as well hence. In our study we found out that isolated ENT symptoms such as aguesia and anosmia were the only presentation of the disease. Thus they can be considered as early marker of the disease and it will be helpful in early detection and isolation of the patient as well as prevention of further spread of the disease. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ileocecal Valve and Cecum Adenocarcinoma Metastatic to the Larynx

xlomafota13 shared this article with you from Inoreader Ileocecal Valve and Cecum Adenocarcinoma Metastatic to the Larynx Via ear nose throat Ear Nose Throat J. 2021 Apr 26:1455613211013072. doi: 10.1177/01455613211013072. Online ahead of print. NO ABSTRACT PMID:33900883 | DOI:10.1177/01455613211013072 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trust in physicians among patients with head and neck cancer before and after treatment

xlomafota13 shared this article with you from Inoreader Trust in physicians among patients with head and neck cancer before and after treatment Via Head & Neck Abstract Background Little is known about physician trust in patients with head and neck cancer. This study's aim is to evaluate trust pre‐ and post‐treatment. Methods A study was conducted of 50 patients with head and neck cancer at a tertiary referral center. Surveys administered before and after treatment included several validated survey tools including the Trust in Oncologist Scale Short Form. Results There was an increase in overall trust scores (p < 0.001). Female patients (p = 0.034) and those who received chemotherapy (p = 0.001) were less trusting post‐treatment. Patients with more comorbidities (p = 0.045) and progression of disease (p = 0.029) had higher final trust than those without. Patients with high initial distress scores showed a decrease in trust (p = 0.023). Conclusions Patients with head and neck cancer trust their surgeon more after completion of treatment, with specific characteristics having a variable impact on trust scores. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Transoral robotic surgery versus nonrobotic resection of oropharyngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Transoral robotic surgery versus nonrobotic resection of oropharyngeal squamous cell carcinoma Via Head & Neck Abstract The aim of this study is to evaluate the impact of transoral robotic surgery (TORS) compared to nonrobotic surgery (NRS) on overall survival in oropharyngeal squamous cell carcinoma (OPSCC). We performed a retrospective study of patients with HPV+ and HPV− OPSCC undergoing TORS or NRS with neck dissection using the National Cancer Database from the years 2010–2016. Among patients with OPSCC in our cohort, 3167 (58.1%) patients underwent NRS and 2288 (41.9%) underwent TORS. TORS patients demonstrated better overall survival than NRS patients (HPV+ patients: aHR 0.74, p = 0.02; HPV− patients: aHR 0.58, p < 0.01). Subsite analysis showed TORS was correlated with improved survival in base of tongue (BoT) primaries for both HPV+ (aHR 0.46, p = 0.01) and HPV− (aHR 0.42, p = 0.01) OPSCC. Compared to NRS, TORS is associated with improved overall survival for HPV+ and HPV− OPSCC, as well as greater overall survival for BoT primaries. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bilateral Puffy Orbits in a toddler: Therapeutic Challenges

xlomafota13 shared this article with you from Inoreader Bilateral Puffy Orbits in a toddler: Therapeutic Challenges Via Otolaryngology Indian Abstract We report a rare case of bilateral paediatric sinus related orbital infection (SROI) in a toddler who initially presented with unilateral lid oedema, worsening bilaterally in spite of parenteral antibiotics requiring multiple surgical interventions. Challenges in management of life threatening intracranial sequelae of SROIs including visual loss are discussed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.