New ENT Abstracts

Thyroid tumor ratio: Improving the assessment of the impact of size in pediatric thyroid cancer
3d
by
Connie Paik, Beth Osterbauer, Grace Sahyouni, Soyun Park, Gabriel Gomez, Daniel Kwon, Juliana Austin
via
Head & Neck
Abstract
Background
The impact of thyroid nodule size is less useful in children who have smaller thyroid volumes than in adults. We investigate using a novel thyroid tumor ratio measurement in children with thyroid cancer.

Methods
Patient and pathologic characteristics were investigated via Student's t-test in a univariate analysis for any correlation with the log-transformed tumor ratio, followed by a multivariate linear regression.

Results
Of 75 patients with malignancy and tumor ratio information, mean ratio decreased with increasing age (p = 0.04). Out of several clinical factors, patients with lymph node metastases and those treated with postoperative radioactive iodine had significantly higher mean tumor ratios on multivariate analysis (p = 0.04 for both factors).

Conclusions
Our study is the first to describe thyroid tumor volume in pediatric thyroid cancer and shows that increased tumor ratio was associated with indicators of more advanced disease such as lymph node metastases and use of radioactive iodine.

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Efficacy and safety of preoperative embolization in carotid body tumor treatment: A propensity score matching retrospective cohort study
3d
by
Zhaoyu Wu, Peng Qiu, Hongji Pu, Kaichuang Ye, Guang Liu, Weimin Li, Xiaobing Liu, Minyi Yin, Mier Jiang, Jinbao Qin, Xinwu Lu, Zhen Zhao
via
Head & Neck
Abstract
Background
To assess the efficacy and safety of preoperative embolization (PE) in patients with carotid body tumor (CBTs).

Methods
In a single-center retrospective cohort study, 127 patients underwent surgical resection of CBTs from January 2003 to December 2019. One-to-one propensity score matching was conducted between patients with or without PE.

Results
Thirty-two (25.2%) patients received PE. After propensity score matching, no statistically significant differences were found in the baseline characteristics of 28 patients in each group. Compared with NPE group, operative time and estimated blood loss (EBL) were significantly reduced in the PE group. The incidence of stroke, perioperative complications, intraoperative blood transfusion, vascular reconstruction, hospital stay, tumor recurrence, and all-cause mortality were not different between the PE and NPE group.

Conclusions
Preoperative embolization was efficient and safe with a reduction of intraoperative blood loss and operative time during CBT resection.

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Post‐acute health care needs of people with head and neck cancer: Mapping health care services, experiences, and the impact of rurality
3d
by
Jasmine Foley, Clare L. Burns, Elizabeth C. Ward, Rebecca L. Nund, Laurelie R. Wishart, Lizbeth M. Kenny, Maurice Stevens
via
Head & Neck
Abstract
Background
People with head and neck cancer (HNC) have complex health care needs; however, limited evidence exists regarding the nature or patterns of service access and use. This study explored the post-discharge health care needs and experiences of individuals with HNC from metropolitan and rural areas.

Methods
Health care appointments and services accessed by people with HNC were collated for 6-month post-treatment. Data analysis of the whole cohort examined patterns of access while journey mapping integrated participants' experiences of recovery.

Results
The 6-month service access journey was mapped for 11 people. Rural participants attended a significantly greater number of appointments (p = 0.012), higher canceled/missed appointments (p = 0.013), and saw more professionals (p = 0.007). Rural participants reported higher stress and burden due to service access barriers and unmet needs.

Conclusions
Multiple challenges and inequities exist for rural people with HNC. Findings inform opportunities to enhance the post-treatment recovery of people with HNC in rural areas.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Telephone consultation 11855 int 1193,

Ultraviolet light induces HERV expression to activate RIG‐I signaling pathway in keratinocytes

xlomafota13 shared this article with you from Inoreader Ultraviolet light induces HERV expression to activate RIG‐I signaling pathway in keratinocytes Via Experimental Dermatology Abstract Skin inflammation and photosensitivity are common in lupus erythematosus (LE) patients, and Ultraviolet (UV) light is a known trigger of skin and possibly systemic inflammation in systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE) patients. Type I interferons (IFN) are upregulated in LE skin after UV exposure, however, the mechanisms to explain UVB-induced inflammation remain unclear. Here we demonstrated that UVB-irradiation-induced activation of human endogenous retroviruses (HERVs) plays a major role in the immune response. UVB-induced HERV-associated dsRNA transcription and subsequent activation of the innate antiviral RIG-I/MDA5/IRF7 pathway led to downstream transcription of interferon-stimulated genes, which promotes UVB-induced apoptosis and proliferation inhibition in keratinocytes through RIG-I and MDA5 pathways. Our findings indicate that UVB-irradiation induces HERV-dsRNA overexpression, and the dsRNA-sensing innate immunity pathway promotes type I IFN production, which may be a potential mechanism of skin inflammatory response and skin lesion of SLE/DLE. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dynamic changes of vestibular autorotation test in patients with unilateral vestibular dysfunction during rehabilitation

xlomafota13 shared this article with you from Inoreader Dynamic changes of vestibular autorotation test in patients with unilateral vestibular dysfunction during rehabilitation Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar 7;57(3):270-275. doi: 10.3760/cma.j.cn115330-20210531-00315. ABSTRACT Objective: To explore the dynamic changes of vestibular autorotation test (VAT) before and after vestibular rehabilitation treatment in patients with unilateral vestibular hypofunction (UVH). Methods: A retrospective study was carried out,48 patients who were diagnosed with UVH and under vestibular rehabilitation in department of otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2019 to January 2021 were enrolled. Among them, there were 21 males and 27 females, with an average age of 46.9 years old, including 25 cases of Meniere's disease, 13 cases of sudden deafness with vertigo and 10 cases of vestibular neuritis. The course of disease ranged from 5 days to 10 years. Demographic characteristics, detailed case data and routine examination were collected for the patients. The horizontal gain/phase, vertical gain/phase, and asymmetry of VAT at different frequencies before and after vestibular rehabilitation were collected. The absolute value of the difference between the measured value of 2.0-5.9 Hz before and after rehabilitation and the standard value were statistically analyzed. Results: Before vestibular rehabilitation, the incidence of abnormal gain was 62.5% (30/48), the incidence of abnormal phase was 56.3% (27/48), and the incidence of asymmetry was 16.7% (8/48). After 4-6 weeks of vestibular rehabilitation, the incidence of gain abnormality was 22.9% (11/48), the incidence of phase abnormality was 31.3% (15/48), and the incidence of asymmetry was 12.5% (6/48).The horizontal gain at frequency of 2.0-3.9 Hz showed statistically significant difference compared with before vestibular rehabilitation (P<0.05), and the horizontal gain at frequency of 4.3-5.9 Hz showed that there was no si gnificant difference (P>0.05); the horizontal phase at 5.9 Hz showed that the difference was statistically significant (P=0.043), and there was no significant difference before and after rehabilitation treatment at 2.0-5.5 Hz (P>0.05); the vertical gain at 4.3 Hz showed the difference was statistically significant (P=0.020), and the remaining frequency showed no significant difference (P>0.05); No frequency of asymmetry and vertical phase showed the difference before and after rehabilitation was statistically significant (P>0.05). Conclusion: VAT can be used to monitor the change trend of multiple frequency bands before and after vestibular rehabilitation in UVH, in order to provide reference for the formulation of personalized rehabilitation strategies. PMID:35325937 | DOI:10.3760/cma.j.cn115330-20210531-00315 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Potential effects of lowering the threshold of statistical significance in the field of chronic rhinosinusitis - A meta-research on published randomized controlled trials over last decade

xlomafota13 shared this article with you from Inoreader Potential effects of lowering the threshold of statistical significance in the field of chronic rhinosinusitis - A meta-research on published randomized controlled trials over last decade Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Dec 4:S1808-8694(21)00196-8. doi: 10.1016/j.bjorl.2021.11.004. Online ahead of print. ABSTRACT OBJECTIVE: To evaluate the impact of change in p-value threshold from 0.05 to 0.005, on published Randomized Controlled Trials (RCTs) over the last ten years in the field of chronic rhinosinusitis. METHODS: A search of the PubMed database from 1st January 2011 to 31st December 2020 was conducted to include all RCTs that used p-value to determine the effects of an intervention. Data extracted included p-values, type of intervention, publishing journal with indexing, registration, funding, and multi- or single center status. The proportion of primary endpoints having p < 0.005 was determined first, followed by those with p > 0.005 but <0.05. Logistic regression analysis was used to determine if any trial characteristic was associated with reporting of significant p-values. RESULTS: In total, 16 8 primary endpoints were identified from 123 RCTs. On analysis, 80 had a p-value <0.05, i.e., statistically significant on conventional parameter. Out of these, 53.75% had a p-value <0.005, which would retain significance under the proposed threshold, and the remaining 46.25% to be reclassified as "suggestive". None of the trial characteristics were contributing to reporting of conventional or proposed p-values on logistic regression analysis. CONCLUSION: Lowering the p-value threshold would render 46.25% of a decade of published RCTs results (in the field of CRS) to be reclassified as merely "suggestive" and not significant. Trial characteristics were not found contributing to reporting of p-value <0.005 or even <0.05. LEVEL OF EVIDENCE: II. PMID:35331655 | DOI:10.1016/j.bjorl.2021.11.004 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Giving Children with Deafness a Cape: Amplifying Diverse Portrayals of Hearing Loss in Media

xlomafota13 shared this article with you from Inoreader Giving Children with Deafness a Cape: Amplifying Diverse Portrayals of Hearing Loss in Media Via ear nose throat Ear Nose Throat J. 2022 Mar 24:1455613221087941. doi: 10.1177/01455613221087941. Online ahead of print. NO ABSTRACT PMID:35331032 | DOI:10.1177/01455613221087941 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Columellar strut grafts versus septal extension grafts during rhinoplasty for airway function, patient satisfaction and tip support

xlomafota13 shared this article with you from Inoreader Columellar strut grafts versus septal extension grafts during rhinoplasty for airway function, patient satisfaction and tip support Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2022 Feb 24:S1748-6815(22)00095-X. doi: 10.1016/j.bjps.2022.02.017. Online ahead of print. ABSTRACT IMPORTANCE: Different techniques exist to provide tip support in rhinoplasty. There is little evidence to provide a consensus on the most effective choice. OBJECTIVE: Evaluating columellar strut graft (CSG) and septal extension grafts (SEG) for their influence on airway function, patient satisfaction and tip support. DESIGN, SETTINGS AND PARTICIPANTS: A retrospective cohort study was undertaken on 165 adult patients who underwent open rhinoplasty with either a CSG or SEG, from February 2012 to August 2019 in a single tertiary facial-plastic practice in Sydney, Australia. Operations were for both cosmetic and functional indications, and both primary and revision cases were assessed. Airway testing and patient-reported outcomes (PROMs) were performed preoperatively and at least 6 months following the procedure. Photographic tip analysis was taken from approximately 4 and 12-month postoperative photographs. MAIN OUTCOMES AND MEASURES: Nasal peak inspiratory flow (NPIF) and total nasal airway resistance (NAR) were the primary airway functional outcomes. The primary PROMs analysed were a visual analogue scale (VAS) for nasal obstruction and 13-point Likert scale for global cosmesis, the Nose Outcome Symptom Evaluation (NOSE), and the nasal obstruction score. Tip support was determined by the nasolabial angle (NLA) and Simon's ratio as assessed by Rhinobase developed by Apaydin et al. on lateral Frankfort plane photographs. Data normalised as an improvement over preoperative baseline, accounting for individual variability. RESULTS: A total of 165 patients was assessed (35.2 ± 12.9 yrs, 72% female), 100 (61%) of which received SEG. There were similar nasal airway assessments between CSG and SEG groups, with ΔNPIF (20.0 ± 42.1 L/min v 19.9 ± 44.9 L/min, p = 0.983) and Δ "obstructed" NAR (-1.13 ± 1.90 v -1.02 ± 4.33 Pa/cm3/s, p = 0.849). Amongst PROMs, a greater cosmetic outcome was seen in the SEG group (7.20 ± 2.97 v 5.69 ± 3.45, p < 0.01) with all other assessments similar between CSG and SEG techniques. Photographic analysis of tip projection showed reduced NLA distortion in the SEG. CONCLUSION AND RELEVANCE: While greater patient-perceived cosmesis was seen in patients with a SEG, there were similar airflow and patient-reported nasal function between groups. Photographic analysis of tip projection showed SEG patients additionally benefited from less NLA distortion and greater tip maintenance. PMID:35337759 | DOI:10.1016/j.bjps.2022.02.017 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The application of polyethylene glycol‐coated collagen patches in nasal surgery

xlomafota13 shared this article with you from Inoreader The application of polyethylene glycol‐coated collagen patches in nasal surgery Via Clinical Otolaryngology Abstract Nasal packing is a significant factor of postoperative morbidity that affects quality of recovery following nasal surgery. The polyethylene glycol-coated (PEG) collagen patch (Hemopatch®) is a synthetic hemostatic agent with a dual mechanism of action, but whether it can be applied in nasal surgery remains unexplored. The postoperative symptoms of thick nasal discharge, loss of smell, headache, postnasal discharge, ear fullness and lack of good night's sleep in patients with Hemopatch are minimal after surgery. The total nasal resistance at postoperative day 1 (0.224 Pa/cm3) is lower than the preoperative total nasal resistance (0.412 Pa/cm3), indicating that the nasal air flow increases after surgery in patients using Hemopatch at postoperative day 1. This is the first report to demonstrate that Hemopatch is an alternative nasal packing to reduce the postoperative morbidity after nasal surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.