A Rare Case of Desmoplastic Fibroma. Spontaneous Mandibular Regeneration with 3 Years Follow up – Case Report

xlomafota13 shared this article with you from Inoreader A Rare Case of Desmoplastic Fibroma. Spontaneous Mandibular Regeneration with 3 Years Follow up – Case Report Via Otolaryngology Indian Abstract Desmoplastic fibroma is a benign, rare, but locally aggressive lesion. The intraosseous type rarely presents in the jaws. Desmoplastic fibroma represents the intraosseous counterpart of the soft tissue fibromatoses or desmoid tumor, affects predominantly young people with an affinity for the mandible. The aim of this article is to describe a rare case of spontaneous bone regeneration after resection of intraosseous type of Desmoplastic fibroma. We report a case of intraosseous Desmoplastic fibroma involving right body and ramus of the mandible of a 17 years old, male patient, that underwent surgical procedure by Risdon access to remove all lesion with 1 cm free margins and reconstructed with 2.4 mm plate. After 3 years follow up, spontaneous bone regeneration was found with no signs of recurrence of the lesion. In conclusion, cases of spontaneous bone regeneration after mandibular resection is rare and there are few studies and case report in the literature. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reweighting of Binaural Localization Cues Induced by Lateralization Training

xlomafota13 shared this article with you from Inoreader Reweighting of Binaural Localization Cues Induced by Lateralization Training Via Journal of the Association for Research in Otolaryngology Abstract Normal-hearing listeners adapt to alterations in sound localization cues. This adaptation can result from the establishment of a new spatial map of the altered cues or from a stronger relative weighting of unaltered compared to altered cues. Such reweighting has been shown for monaural vs. binaural cues. However, studies attempting to reweight the two binaural cues, interaural differences in time (ITD) and level (ILD), yielded inconclusive results. This study investigated whether binaural-cue reweighting can be induced by lateralization training in a virtual audio-visual environment. Twenty normal-hearing participants, divided into two groups, completed the experiment consisting of 7 days of lateralization training, preceded and followed by a test measuring the binaural-cue weights. Participants' task was to lateralize 500-ms bandpass-filtered (2–4 kHz) noise bursts containing various combinations of spatially consistent and inconsistent binaural cues. D uring training, additional visual cues reinforced the azimuth corresponding to ITDs in one group and ILDs in the other group and the azimuthal ranges of the binaural cues were manipulated group-specifically. Both groups showed a significant increase of the reinforced-cue weight from pre- to posttest, suggesting that participants reweighted the binaural cues in the expected direction. This reweighting occurred within the first training session. The results are relevant as binaural-cue reweighting likely occurs when normal-hearing listeners adapt to new acoustic environments. Reweighting might also be a factor underlying the low contribution of ITDs to sound localization of cochlear-implant listeners as they typically do not experience reliable ITD cues with clinical devices. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characterization of the mechanical properties of human parietal bones preserved in modified larssen solution, formalin and as fresh frozen

xlomafota13 shared this article with you from Inoreader Characterization of the mechanical properties of human parietal bones preserved in modified larssen solution, formalin and as fresh frozen Via radiol anat Surg Radiol Anat. 2021 May 5. doi: 10.1007/s00276-021-02762-1. Online ahead of print. ABSTRACT PURPOSE: Although the fresh frozen (FF) cadaver is preferred for surgical applications, it is limited due to short usage time, unsuitable for reuse and the risk of infection. Due to its limited use, FF cadavers, which are covered by import in countries with insufficient body donation cause low-cost effectiveness. With the increase of real human tissue specimen necessities for surgi cal training, long-term preservation of the cadavers is crucial due to changes in mechanical properties. Therefore, studies on embalming solutions have increased in recent years. METHODS: We quantify the biomechanical properties of human parietal bones preserved via modified larssen solution (MLS) and compare the results with the specimens preserved as FF and fixed with 10% formalin-based solution (F10). The rectangular samples of 24 parietal bones of male individuals were resected from MLS-embalmed, F10-embalmed and FF cadavers to form three groups each containing eight samples. These specimens were tested longitudinally to identify mechanical properties. RESULTS: The tensile test results showed that there is not a significant difference between the groups in terms of stiffness, elastic modulus, strain at ultimate stress, failure strain and effective plastic strain. However, the yield stress, ultimate stress, yield strain, failure stress and total energy and post-yield properties are significantly lower in F10 than MLS and FF groups. CONCLUSION: It is observed that the mechanical properties of MLS preserved and FF parietal bones have almost similar properties. Thus, it can be concluded that MLS is a suitable fixative solution for bone studies and bone-related surgical anatomy training applications. PMID:33954823 | DOI:10.1007/s00276-021-02762-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Content validity of the tinnitus outcome questionnaire for sound management

xlomafota13 shared this article with you from Inoreader Content validity of the tinnitus outcome questionnaire for sound management Via Tinnitus by Hye Yoon Seol, Ga-Young Kim, Mini Jo, Soojin Kang, Young Sang Cho, Sung Hwa Hong, Il Joon Moon Standardized instruments are often used to monitor one's progress in tinnitus relief although they were developed to screen and diagnose tinnitus. The need for the development for a tinnitus outcome assessment tool is high in the field of audiology and otolaryngology. The purpose of this study was to develop a tinnitus outcome questionnaire for sound management (listening to sound stimuli for tinnitus relief) and assess its content validity. A total of 32 questions with six domains (Tinnitus characteristics, the impact of tinnitus, tinnitus and hearing issues, handedness, tinnitus management, and sound management outcome) were generated after closely investigating major tinnitus questionnaires used worldwide (i.e. Tinnitus Handicap Inventory and Tinnitus Handicap Questionnaire) as well as literature. Ten healthcare professionals evaluated the appropriateness of the questionnaire items on a five-point Likert scale, where 1 is strongly inappropriate and 5 is strongly appropriate. Con tent relevance was assessed by computing the content validity index with the cut-off value of 0.75. Each response was first weighted as follows: 1 = 0; 2 = 0.25; 3 = 0.5; 4 = 0.75; and 5 = 1.0. The weighted average was then calculated. Items with a content validity index less than 0.75 were discarded and some items were revised according to the experts' feedback. As a result, 31 out of the 32 items had the content validity index higher than 0.75, indicating that the items are appropriate to obtain information about the six domains. Reflecting the experts' feedback, some questions were revised to be more specific. The study provides a baseline structure regarding potential questions to be included in a tinnitus outcome questionnaire for sound management. Development and standardization of such questionnaire would be a pathway to validating tinnitus relief via sound therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sound localization with bilateral bone conduction devices

xlomafota13 shared this article with you from Inoreader Sound localization with bilateral bone conduction devices Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 6. doi: 10.1007/s00405-021-06842-1. Online ahead of print. ABSTRACT PURPOSE: To investigate sound localization in patients bilaterally fitted with bone conduction devices (BCDs). Additionally, clinically applicable methods to improve localization accuracy were explored. METHODS: Fifteen adults with bilaterally fitted percutaneous BCDs were included. At baseline, sound localization, (un)aided pure-tone thresholds, device use, speech, spatial and qualities of hearing scale (SSQ) and York hearing-related quality of life (YHRQL) questionnaire were measured. Settings to optimize sound localizing were added to the BCDs. At 1 month, sound localization was assessed again and localization was practiced with a series of sounds with visual feedback. At 3 months¸ localization performance, device use and questionnaire scores were determined again. RESULTS: At baseline, one patient with congenital hea ring loss demonstrated near excellent localization performance and four other patients (three with congenital hearing loss) localized sounds (quite) accurately. Seven patients with acquired hearing loss were able to lateralize sounds, i.e. identify whether sounds were coming from the left or right side, but could not localize sounds accurately. Three patients (one with congenital hearing loss) could not even lateralize sounds correctly. SSQ scores were significantly higher at 3 months. Localization performance, device use and YHRQL scores were not significantly different between visits. CONCLUSION: In this study, the majority of experienced bilateral BCD users could lateralize sounds and one third was able to localize sounds (quite) accurately. The localization performance was robust and stable over time. Although SSQ scores were increased at the last visit, optimizing device settings and a short practice session did not improve sound localization. PMID:33956208 | DOI:10.1007/s00405-021-06842-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Low skeletal muscle mass predicts frailty in elderly head and neck cancer patients

xlomafota13 shared this article with you from Inoreader Low skeletal muscle mass predicts frailty in elderly head and neck cancer patients Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 6. doi: 10.1007/s00405-021-06835-0. Online ahead of print. ABSTRACT PURPOSE: Treatment of head and neck cancer (HNC) carries a high risk of adverse outcomes in patients, especially in frail elderly. Therefore, it is important to identify patients in which treatment benefits outweigh the risk of any adverse outcome. Although the comprehensive geriatric assessment (CGA) identifies frailty, it is a time-consuming tool. Instead, measurement of skeletal muscle mass and strength (sarcopenia) may be a promising and time-efficient biomarker for frailty. The aim of this study was to examine the association between sarcopenia and frailty assessment tools, such as the CGA, Fried criteria and the Groningen Frailty Indicator (GFI). METHODS: A retrospective study was performed in elderly patients (≥ 70-years) with HNC. Sarcopenia was defined as the combination of reduced handgrip strength (HGS) and low ske letal muscle mass (SMM), according to the EWGSOP-2 criteria. SMM was measured on routinely available diagnostic imaging and corrected height: skeletal muscle index (SMI). A CGA was performed by a geriatrician. Frailty screening was performed using the GFI and the Fried criteria. RESULTS: In total, 73 patients were included of which 33 were men (45.2%) and 40 women (54.8%). Frail patients diagnosed by CGA were more likely to have low SMI, sarcopenia, more comorbidities and were at high risk for malnutrition (all p < 0.05). In multivariate regression analysis, the only significant predictor for frailty diagnosed by CGA was SMI (OR 0.9, p < 0.01) independent of comorbidity and muscle strength. CONCLUSION: Low SMI and sarcopenia are associated with frailty in elderly HNC patients. Low SMI predicts frailty and is a promising time-efficient and routinely available tool for clinical practice. PMID:33956205 | DOI:10.1007/s00405-021-06835-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of chitosan and platelet-rich plasma on facial nerve regeneration in an animal model

xlomafota13 shared this article with you from Inoreader Effects of chitosan and platelet-rich plasma on facial nerve regeneration in an animal model Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 6. doi: 10.1007/s00405-021-06859-6. Online ahead of print. ABSTRACT PURPOSE: There is still no widely-accepted local agent proven to be effective in nerve regeneration. We aimed to investigate the effects of chitosan gel and platelet-rich plasma MATERIALS AND METHODS: Electrophysiological measurements were performed before and immediately after injury. The injured nerves were covered with spongostan impregnated with the following agents: Group 1 (Control Group): Saline at a dose of 50 µl; Group 2: Chitosan (CHT) at a dose of 50 µl; Group 3: PRP at a dose of 50 ml; and Group 4: a solution of CHT with PRP (1:1). The final measurements were performed after 3 weeks and the injured nerve of each rat was removed. RESULTS: There were statistically-significant differences between the groups regarding the measurements of the after-treatment values of stimulus threshold (p < 0.05). The best improvem ent in electrophysiological measurement and histopathological evaluation was found in Group 4 (CHT-PRP). CONCLUSION: Chitosan gel has a positive effect on nerve healing and applying it along with PRP can enhance the effect of chitosan. PMID:33956207 | DOI:10.1007/s00405-021-06859-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis

xlomafota13 shared this article with you from Inoreader Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 May 6. doi: 10.1007/s00405-021-06763-z. Online ahead of print. ABSTRACT PURPOSE: The prognostic significance of auricular location in cutaneous squamous cell carcinoma (cSCC) is controversial. We aimed to characterize risk factors for, and evaluate the cumulative incidence of, locoregional recurrence in a cohort of patients with primary auricular cSCC. METHODS: The study design was a single-institution retrospective cohort review from 1/2007 to 12/2016. RESULTS: Among 851 potentially eligible individuals, 178 patients with primary auricular cSCC met strict criteria for inclusion. Median follow-up was 32 months, 93% were AJCC 8th edition (AJCC8) stage I and 6% were AJCC8 stage II. Most underwent Mohs micrographic surgery (MMS; 97%) and the remainder underwent wide local excision ± parotidectomy ± neck dissection ± adjuvant therapy (3%). Recurrences occurred in seven patients (4%): six were local and one was regional. The 3-year cumulative incidence of local and regional recurrence for AJCC8 stage I-II tumors were 1% (95% CI 0-5%) and 0%, respectively. Among ten patients upstaged to pT3 disease who underwent MMS alone, none recurred locoregionally. Compared to their respective counterparts, advanced stage, PNI, and LVI associated with a significantly increased risk of locoregional recurrence. CONCLUSIONS: Our findings suggest that auricular location may not be a significant risk factor for cSCC staging systems. In the absence of other risk factors, unimodal therapy appears adequate for patients with primary, stage I-II auricular cSCC. The prognostic significance of pT3 auricular cSCC stage due to depth of invasion alone should be evaluated further. PMID:33956206 | DOI:10.1007/s00405-021-06763-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of patients with bilateral recurrent laryngeal nerve paralysis following esophagectomy

xlomafota13 shared this article with you from Inoreader Management of patients with bilateral recurrent laryngeal nerve paralysis following esophagectomy Via swallowing exercises Thorac Cancer. 2021 May 6. doi: 10.1111/1759-7714.13940. Online ahead of print. ABSTRACT BACKGROUND: Recurrent laryngeal nerve paralysis (RLNP) is a common complication after esophagectomy which can cause severe pulmonary complications. However, bilateral RLNP has been rarely reported in esophagectomy patients. The objective of our study is to investigate the clinical significance of patients who had bilateral RLNP following esophagectomy. METHODS: We retrospectively reviewed patients who underwent esophagectomy at a single center from 1994 to 2018. Among these, patients with bilateral vocal cord paralysis were included in this study. RESULTS: A total of 3217 patients were reviewed and 400 (12.4%) patients had RLNP, including 56 patients with bilateral RLNP identified by laryngoscopic examination. During the postoperative managements, 10 of the 56 patients (17.9%) required tracheostomy. Among them, two died of acute respiratory distress syndrome and the other eight patients were discharged after removing the tracheostomy tube. The median lengths of hospital and intensive care unit stay were 19.5 (range 8-157) and 2 (range 1-46) days, respectively. Forty-six patients (83.6%) were discharged with oral feeding after swallowing therapy including tongue holding maneuver and head tilt exercise. The other five patients (8.9%) were discharged with alternative enteral feeding via jejunostomy, but they were able to achieve oral diet 2-3 months after surgery . CONCLUSION: Bilateral RLNP following esophagectomy was rare, but it required great attention to prevent severe respiratory complications. However, only a few patients required tracheostomy and the majority achieved oral ingestion after intensive rehabilitation. Feeding education and respiratory rehabilitation are critical during the management of patients with bilateral RLNP. PMID:33955175 | DOI:10.1111/1759-7714.13940 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgery with Post-Operative Endoscopy Improves Recurrence Detection in Sinonasal Malignancies

xlomafota13 shared this article with you from Inoreader Surgery with Post-Operative Endoscopy Improves Recurrence Detection in Sinonasal Malignancies Via otol rhinol Ann Otol Rhinol Laryngol. 2021 May 6:34894211011449. doi: 10.1177/00034894211011449. Online ahead of print. ABSTRACT OBJECTIVE: The mainstay of treatment in sinonasal malignancy (SNM) is surgery, and when combined with chemoradiation therapy, often leads to the best overall prognosis. Nasal endoscopy is essential for post-treatment surveillance along with physical exam and radiologic evaluation. The ability to directly visualize the sinus cavities after surgery may also impro ve early detection of tumor recurrence and is another reason to potentially advocate for surgery in these patients. METHODS: A retrospective chart review of medical records of patients with pathologically proven SNM was conducted from 2005 to 2019. RESULTS: The nasal cavity and maxillary sinus were the most common primary tumor sub-sites. The most common pathology was squamous cell carcinoma (42%). The median time to recurrence was 9.8 months. Recurrence was initially detected endoscopically in 34.3% patients, by imaging in 62.7% patients, and by physical exam in 3.0% patients. 67 (29%) total recurrences were detected on follow-up, of which 46 (68.7%) were local. Twenty-three of the local recurrences were identified via nasal endoscopy. Thirteen recurrences were identified via endoscopic surveillance within the surgically patent paranasal sinuses while 13 were identified within the nasal cavity; 5 patients had multiple sites of recurrence. CONCLUSION: Local recurre nce of SNM is the most common site for recurrent disease and nasal endoscopy identified half of these cases. 50% of these recurrences were within the paranasal sinuses and would not have been easily identified if the sinuses were not open for inspection. Thus, open sinus cavities aid in the detection of tumor recurrence and is another advantage of surgery in the management of SNM. PMID:33955268 | DOI:10.1177/00034894211011449 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Innervation of digital joints: an anatomical overview

xlomafota13 shared this article with you from Inoreader Innervation of digital joints: an anatomical overview Via radiol anat Surg Radiol Anat. 2021 May 6. doi: 10.1007/s00276-021-02754-1. Online ahead of print. ABSTRACT INTRODUCTION: The innervation of the digital joints as well as the anatomical relationships of the articular branches is present in this anatomical work to determine the technical feasibility of a selective and efficient denervation of the digital joints. MATERIALS AND METHODS: A study of 40 distal interphalangeal (DIP), 40 proximal interphalangeal (PIP), 50 metacarpophalange al (MCP), 10 interphalangeal (IP) of the thumb, and 10 trapezo-metacarpophalangeal (TMC) joints was performed on ten hands. Under magnification and a proper surgical approach, we collected the course, the source origin, the number of articular nerve branches, and their caliber. RESULTS: In total, 118 nerve branches arising from the proper palmar digital nerves were found on 10 DIP of each dissected long finger (n = 40). A total of 226 nerve branches were found on 10 PIPs of each long finger (n = 40), of which 204 branches (90.3%) had a palmar origin. Dorsal innervation was found for the ring and little finger, originating from the dorso-ulnar digital nerve. 212 branches were found on 10 MCP of long fingers (n = 40), including 87 branches of palmar origin (41.1%), 107 branches of dorsal origin (50.4%), and 18 branches of the motor branch of the ulnar nerve (8.5%). 42 articular branches directed to the TMC joint (n = 10) were found. 13 branches (31%) originated from the anterior sensory branch of the radial nerve, 13 branches (31%) originated from the lateral cutaneous nerve of the forearm, 5 branches (12%) originated from the palmar cutaneous branch of the median nerve, and 11 (26%) branches originated from the thenar branch of the median nerve. The involvement of the sensory anterior branch of the radial nerve was always present for the innervation of each TMC. DISCUSSION AND CONCLUSION: Our research shows that finger joints receive their primary innervation from small branches of the digital nerves with the exception of the MCP joint and the TMC joint. To obtain an efficient and a selective digital denervation for articular pain relief, it is necessary to plan the best surgical approach and it is crucial to recognize the articular nervous branch localization and source. PMID:33956202 | DOI:10.1007/s00276-021-02754-1 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.