Management of Meningitis Due to Cystic Cochleovestibular Malformation: a Stitch in Time

xlomafota13 shared this article with you from Inoreader Management of Meningitis Due to Cystic Cochleovestibular Malformation: a Stitch in Time Via Otolaryngology Indian Abstract Spontaneous CSF otorrhea alludes to those cases which have no known etiology like traumatic, iatrogenic, neoplastic or infectious. The presentation of the patient depends on the anatomical integrity of the eustachian tube as well as the tympanic membrane. Children with certain congenital inner ear malformations, including incomplete partition deformity, show a higher incidence of spontaneous CSF leaks and the resultant meningitis. Cystic vestibulocochlear deformity accounts for approximately 20% of inner ear malformations. In this case report, we discuss a child who presented with first episode of meningitis and with the help of thorough clinical otorhinolaryngological examination and radiology, was diagnosed with a congenital ear anomaly. With this paper, we stress upon the importance of keeping an open mind regarding the differential diagnosis of any condition, and the value of timely intervention. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sustained Chemosensory Dysfunction during the COVID-19 Pandemic

xlomafota13 shared this article with you from Inoreader Sustained Chemosensory Dysfunction during the COVID-19 Pandemic Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Chemosensory dysfunction (CD) has proven valuable in prediction of COVID-19, as it is a frequent and specific symptom of the disease. The aim of this study was to investigate the duration of CD in patients with sudden subjective olfactory and/or gustatory loss during the SARS-CoV-2 pandemic. The secondary aim was to identify possible prognostic factors for the duration of CD. Methods: An online baseline questionnaire was designed to assess subjective CD. Three rounds of follow-up questionnaires were sent out to any part icipants with persistent CD in 6-week intervals, prospectively assessing subjective chemosensory function and extending the follow-up time of this cohort significantly. Results: In total, 467 participants completed the baseline questionnaire. The most significant improvement and recovery of chemosensory function was observed within the first month after the initial loss. Rates became stagnant after about 2 months, and only little improvement and recovery was seen after 2–4 months. After a mean follow-up of 95.9 days (olfactory dysfunction) and 94.0 days (gustatory dysfunction), 86.7% of participants reported gustatory improvement and 82.6% reported olfactory improvement, while 55.0% reported full gustatory recovery and 43.8% reported full olfactory recovery. Female gender was associated with better improvement of gustatory function. High subjective severity of chemosensory loss was associated with lower rates of olfactory and gustatory recovery as well as improvement of olfactory function. Young age was not associated with a better prognosis. Discussion/Conclusion: Rates of improvement and recovery of chemosensory function decreased after 2–4 months after initial chemosensory loss, possibly indicating that prolonged and perhaps permanent chemosensory loss may be a complication of SARS-CoV-2 infections. High subjective severity of CD may worsen the prognosis for improvement and recovery of chemosensory function. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pediatric Malignant Mandibular Tumors: Personal Experience and Literature Options Discussion

xlomafota13 shared this article with you from Inoreader Pediatric Malignant Mandibular Tumors: Personal Experience and Literature Options Discussion Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Mandibular defects reconstruction could result challenging in childhood, due to facial and mandibular growth patterns. For these reasons, the choice of the most suitable reconstructive option in pediatric patients, affected by mandibular malignancies, still objects of debate. Objective: The aim of our study was to compare our reconstructive schedules to the existing literature in order to give a personal contribute to the present panorama. Method s: We performed, in October 2019, a retrospective evaluation of pediatric patients treated for biopsy-proven mandibular malignancies at our Institute between January 2013 and December 2016. All of them received multimodal therapy in accordance with standard guidelines and their demographic, clinical, treatment, and outcome parameters were collected and analyzed. Results: We observed a shorter duration of surgery, a faster tracheostomy tube and feeding-tube removal, and a minor hospitalization in patients who received grafts transfer compared to those who underwent microsurgical mandibular reconstruction. After a 36-month period of follow-up, osteochondral grafts showed a pattern of growth similar to the mandibular epiphysis (condilylion-gonion linear and vertical ratio ranging to 0.96–1.03 and 1–1.02 at orthopantomogram, respectively). No bone consolidation delays and functional impairment were recorded. Conclusions: Free flaps mandibular reco nstruction in children needs to be better assessed and proximal fibular epiphyseal free flap indication might deserve further studies. Osteochondral grafts find indication for lateral defects, 50–55 mm in maximum length and located in the mandibular ramus, without massive teeth or soft tissue defect. Condyle involvement does not represent an absolute contraindication to rib graft use. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prognostic value and therapeutic implications of nodal involvement in head and neck mucosal melanoma

xlomafota13 shared this article with you from Inoreader Prognostic value and therapeutic implications of nodal involvement in head and neck mucosal melanoma Via Head & Neck Abstract Background The prognostic significance of nodal involvement is not well established in head and neck mucosal melanoma (HNMM). Methods A retrospective, monocentric study was performed on 96 patients with HNMM treated between 2000 and 2017. Results At diagnosis, seventeen patients (17.8%) were cN1, with a higher risk for HNMM arising from the oral cavity (p = 0.01). cN status had no prognostic value in patients with nonmetastatic resectable HNMM. No occult nodal metastasis was observed in the cN0 patients after a nodal dissection (ND). The nodal recurrence rate was similar in the cN1 and the cN0 patients. No isolated nodal recurrences were noted. Among the patients who underwent a ND, no benefit of this procedure was noted. Conclusions cN1 status is not a prognostic factor in patients with resectable HNMM. Elective ND should not be systematically performed in cN0 HNMM. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A novel application of superior thyroid artery perforator flaps for medium‐sized intraoral reconstructions: A retrospective analysis of 12 cases

xlomafota13 shared this article with you from Inoreader A novel application of superior thyroid artery perforator flaps for medium‐sized intraoral reconstructions: A retrospective analysis of 12 cases Via Head & Neck Abstract Background To describe the indications, technique, and preliminary experience in the application of the superior thyroid artery perforator flap (STAPF) for the reconstruction of various medium‐sized intraoral defects. Methods From September 2018 to September 2019, 12 consecutive cases of oral squamous cell carcinoma underwent reconstruction with a STAPF. Clinical details were collected, and postoperative function was analyzed. Results The venous drainage of the STAPF is variable with drainage into the internal jugular vein in six cases, into both the internal and external jugular veins in four cases, and into the external jugular vein in two cases. Ten cases were harvested as pedicled flaps, while two cases required a venous anastomosis due to inadequate length of the venous pedicle. Ten flaps survived completely, whereas two flaps had partial necrosis that ultimately resolved with secondary healing. Conclusions STAPF is a reliable method for the reconstruction of medium‐sized intraoral defects. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An improved predictive model for postoperative pulmonary complications after free flap reconstructions in the head and neck

xlomafota13 shared this article with you from Inoreader An improved predictive model for postoperative pulmonary complications after free flap reconstructions in the head and neck Via Head & Neck Abstract Background Commonly used predictive models for postoperative pulmonary complications (PPCs) do not perform when applied to head and neck cases. A head and neck‐specific risk prediction tool is needed. Methods Data on 794 free flap head and neck surgery cases at a single center were abstracted from the electronic medical record. Each case was reviewed for the development of PPCs. A predictive model was developed and was then compared to existing predictive models for PPCs. Results The least absolute shrinkage and selection operator procedure identified age, alcohol use, history of congestive heart failure, preoperative packed cell volume, preoperative oxygen saturation, and preoperative metabolic equivalents as predictors of PPCs in the head and neck population. The model demonstrated an area under the receiving operating characteristic curve of 0.75 (0.69–0.80) with moderately good calibration. Comparisons to the performance of existing models demonstrate superior performance. Conclusions The model for the development of PPCs developed in this article displays superior performance to existing models. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A dynamic prognostic nomogram to predict the benefit from surgical treatment modality for patients with laryngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader A dynamic prognostic nomogram to predict the benefit from surgical treatment modality for patients with laryngeal squamous cell carcinoma Via Head & Neck Abstract Background Although nonsurgical treatment strategy is increasingly adopted in patients with locoregionally advanced laryngeal squamous cell carcinoma (LSCC), survival disparities were reported between surgical treatment modality and organ preservation protocols, highlighting the great importance for accurate patients' selection. Method This secondary analysis used data from the Surveillance, Epidemiology, and End Results database between 2010 and 2015 with follow‐up data up to 2018. We developed and validated a dynamic prognostic nomogram for overall survival (OS) in 4237 patients with LSCC and subgroup of 2087 patients with locoregionally advanced laryngeal squamous cell carcinoma (LALSCC). Based on the total risk score derived from the dynamic nomogram, two well‐matched risk groups (i.e., low‐ and high‐risk) were created via X‐tile software and 1‐to‐1 propensity score matching (PSM); surgical treatment modality was compared with nonsurgical one in each risk group. Results A more accurate and convenient dynamic prognostic nomogram based on age, marital status, T category, N category, M category, tumor size, and tumor differentiation was developed and validated, of which the predictive performance was superior to that of TNM staging system. For high‐risk LALSCC selected by the dynamic nomogram, after 1‐to‐1 PSM, significantly improved OS was observed in patients with receiving surgical treatment compared to those receipt of nonsurgical management (restricted mean survival time at 36‐month: 26.6 vs 22.7, p < 0.001; restricted mean survival time at 60‐month: 36.7 vs 31.0, p = 0.003). Conclusion We establish and validate a more accurate and convenient dynamic prognostic nomogram for patients with LSCC, which may predict the benefit from surgical treatment modality for patients with high‐risk LALSCC. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Trunkoplasty after massive weight loss - a case series with a one-stage body contouring procedure for the NHS patient

xlomafota13 shared this article with you from Inoreader Trunkoplasty after massive weight loss - a case series with a one-stage body contouring procedure for the NHS patient Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 10:S1748-6815(21)00087-5. doi: 10.1016/j.bjps.2021.02.008. Online ahead of print. ABSTRACT Body contouring post massive weight loss (MWL) is a considerable task and is often a functional rather than esthetic operation. Clinicians are often encouraged to solve multiple issues in a single setting that can be difficult in the MWL patient. A simple abdominoplasty often does not provide a satisfactory outcome in such patients and may result in disharmony of the esthetic unit of the trunk. Trunkoplasty is a technique that combines a fleur-de-lis abdominoplasty and reverse abdominoplasty. This is a one-stage operation to address the extra skin of the whole trunk esthetic unit. The average operation time was 4 h with a 3-surgeon team. No blood transfusions were required. There were 3 out of 15 patients with wound-related problems and no incidence of postoperative hematomas. There were no returns to theat ers. Seromas formed were not symptomatic and no interventions were required. The average inpatient stay was 6.9 days and a return to work after 4 weeks. It can improve abdominal contour, define the waist, and improve mons ptosis in one stage without any change in position. This procedure has some specific advantages (accommodates preexisting abdominal scars), but also has shortcomings as compared to "standard" circumferential body contouring. PMID:33785269 | DOI:10.1016/j.bjps.2021.02.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative morphological changes over time of vascularized scapular bone used for mandibular reconstruction: A retrospective cohort study

xlomafota13 shared this article with you from Inoreader Postoperative morphological changes over time of vascularized scapular bone used for mandibular reconstruction: A retrospective cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Mar 10:S1748-6815(21)00085-1. doi: 10.1016/j.bjps.2021.02.009. Online ahead of print. ABSTRACT BACKGROUND: Currently, sequential morphological changes of vascularized scapular bone for mandibular reconstruction have remained unreported. METHODS: We retrospectively analyzed 18 patients with defects on the lateral segment of the mandible who underwent postoperative computed tomography (CT) scanning at 1, 6, 12, and 24 months postoperatively. Using the cross-sectional coronal CT images during each assessment, we measured the height and thickness of the grafted scapular bone at points 10 and 30 mm away from the mesial segment and evaluated their differences over time. Then, the relationship between the morphological changes of the grafted scapular bone and the distance from the mesial bone segment, the number of occlusal supports on the contralateral side of the mandible, and the correlation of sex and age were evaluated. RESULTS: The height of the grafted scapular bone decreased by approximately 11% and its thickness increased by 14% within 24 months postoperatively. The bone thickness increase was greater at point 30 mm from the mesial bone segment. Patients with two occlusal contacts (premolar and molar) on the contralateral side had a significantly higher rate of bone thickness increase. Furthermore, the graft morphology was not associated with age or sex. CONCLUSION: A vascularized scapular bone thickens over time, which depends on the distance from the mesial bone segment and the occlusal contact regions on the contralateral side of the mandible. PMID:33785268 | DOI:10.1016/j.bjps.2021.02.009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sarcoidosis Causing Complete Nasal Obstruction

xlomafota13 shared this article with you from Inoreader Sarcoidosis Causing Complete Nasal Obstruction Via ear nose throat Ear Nose Throat J. 2021 Mar 31:1455613211003837. doi: 10.1177/01455613211003837. Online ahead of print. ABSTRACT Our case demonstrates the rare presentation of sinonasal sarcoidosis causing severe nasal obstruction. While the patient had a remote history of pulmonary sarcoidosis, she was in remission and had no prior history of sinonasal involvement. Sarcoidosis should be considered in a patient with nasal obstruction especially when there is a history of systemic sarcoid dis ease. PMID:33784855 | DOI:10.1177/01455613211003837 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Rare Clinical Report of Intramuscular Hemangioma of the Middle Scalene Muscle

xlomafota13 shared this article with you from Inoreader A Rare Clinical Report of Intramuscular Hemangioma of the Middle Scalene Muscle Via ear nose throat Ear Nose Throat J. 2021 Mar 31:1455613211003834. doi: 10.1177/01455613211003834. Online ahead of print. ABSTRACT Intramuscular hemangioma (IMH) is an uncommon benign vascular lesion, which develops in skeletal muscles and it accounts for <1% of all hemangiomas. The accurate diagnosis is often difficult because the clinical and radiological findings are not specific. The gold standard treatment of IMH is surgical resection. We present a rare clinical report of IMH of the m iddle scalene muscle that was treated successfully with preoparative embolization and surgical excision. PMID:33784878 | DOI:10.1177/01455613211003834 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Delayed Tracheal Perforation Following Total Thyroidectomy

xlomafota13 shared this article with you from Inoreader Delayed Tracheal Perforation Following Total Thyroidectomy Via The Laryngoscope Abstract Delayed tracheal rupture following total thyroidectomy (TT) is rare and represents a potential airway emergency. A 34‐year‐old female with Felty Syndrome underwent TT for Hashimoto's thyroiditis. On post‐operative day 10, she presented with subcutaneous emphysema and an anterolateral tracheal perforation on CT scan. Urgent operative exploration revealed transmural tracheal necrosis and a 5 mm perforation. This was oversewn with non‐absorbable suture and a strap muscle flap rotated over the defect to promote healing. Repeat direct laryngoscopy at 72 hours revealed healing tissue. Tracheal necrosis and perforation following TT constitutes a potential airway emergency and should be promptly explored and repaired. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.