Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation

xlomafota13 shared this article with you from Inoreader Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211065805. doi: 10.1177/00034894211065805. Online ahead of print. ABSTRACT OBJECTIVES: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis. METHODS: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed. RESULTS: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT (P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation (P = .042) in the multivariate analysis. CONCLUSIONS: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis. PMID:34965742 | DOI:10.1177/00034894211065805 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report

xlomafota13 shared this article with you from Inoreader Successful Oral Levothyroxine Desensitization in a Patient with Severe Hypothyroidism Post Radioactive Iodine Therapy: A Case Report Via radioactive iodine J ASEAN Fed Endocr Soc. 2021;36(2):213-215. doi: 10.15605/jafes.036.02.10. Epub 2021 Aug 19. ABSTRACT Levothyroxine remains the standard therapy for patients with hypothyroidism worldwide. Levothyroxine allergy is rarely seen and alternative therapies are less efficacious and scarcely available. The use of liothyronine (LT3) monotherapy is less favoured due to its short half-life and unpredictable pharmacological profile. We report a 59-year-old male with a hypersensitivity reactio n to levothyroxine who was successfully desensitized with oral levothyroxine within a day using a 14-step protocol. PMID:34966208 | PMC:PMC8666481 | DOI:10.15605/jafes.036.02.10 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study

xlomafota13 shared this article with you from Inoreader Effect of dynamic balance during the onset of benign paroxysmal positional vertigo on residual dizziness after successful repositioning: a multicenter prospective cohort study Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1277-1282. doi: 10.3760/cma.j.cn115330-20210912-00607. ABSTRACT Objective: To explore the characteristics of dynamic balance during the onset of benign paroxysmal positional vertigo (BPPV) and its prediction of residual symptoms after successful repositioning. Methods: From January 2018 to August 2019, patients diagnosed with unilateral posterior semicircular canal or horizontal semicircular canal BPPV were consecutively enrolled from five otolaryngology clinics in Shanghai. The dynamic balance function was measured by sensory organization test (SOT) before repositioning maneuver, and the residual symptoms and its duration were followed up from one week to up to three months. Results: A total of 260 patients were recruited. After excluding 17 cases, 243 cases were successfully followed up including 89 males and 154 females, with an average age of (52. 9±13.0) years. There were 175 cases of posterior semicircular BPPV, 61 cases of horizontal semicircular BPPV and 7 cases of canal conversion (from horizontal to posterior semicircular). Among 243 patients, 118 cases reported residual symptoms, with an incidence of 48.6%. The results of SOT showed that 58.0%(141/243) of the patients had abnormal vestibular input and 41.6%(101/243) were categorized as "near falls". With respect to the detailed residual symptoms, 47 cases (39.8%) reported unsteadiness or floating, 35 cases (29.7%) had fogginess/heaviness feeling, 22 cases (18.6%) had transient dizzy while head moving, and 15 cases (12.7%) reported that the symptom was too subtle to describe. Compared with the group without residual symptoms, the group with residual symptoms had more abnormal vestibular input(χ²=67.25, P<0.001) and near falls(χ²=74.78, P<0.001) as identified by SOT test. Cox proportional hazards regression failed to reveal any SOT results having significantly impact on the duration of residual symptoms [abnormal vestibular input (HR= 0.93, 95%CI: 0.48, 1.80), and near falls (HR= 0.90, 95%CI: 0.56, 1.46)]. Kaplan-Meier survival analysis showed that there was no significant difference in the duration of residual symptoms among patients with different SOT manifestations [Log rank (Mantel-Cox) test, P>0.05]. Conclusions: The impaired dynamic balance during the onset of BPPV is characterized by "abnormal vestibular input". The residual symptoms are mainly characterized by unsteadiness or floating feeling. The defect of dynamic balance function is a predictor of the residual symptoms after successful repositioning, but not for the duration of such symptoms. PMID:34963215 | DOI:10.3760/cma.j.cn115330-20210912-00607 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The imaging characteristics and prognosis of patients with cochlear implants whose cochlear nerves are not shown on MRI

xlomafota13 shared this article with you from Inoreader The imaging characteristics and prognosis of patients with cochlear implants whose cochlear nerves are not shown on MRI Via Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Dec 7;56(12):1283-1291. doi: 10.3760/cma.j.cn115330-20210126-00038. ABSTRACT Objective: To analyze the temporal bone CT and inner ear magnetic resonance imaging characteristics of cochlear implant patients with no cochlear nerve display in the inner auditory canal under MRI. To retrospectively analyze the long-term hearing and speech rehabilitation effects of such patients after cochlear implant. And to analyze the correlation between the results of imaging examinations and the postoperative effects of cochlear implant patients with this type of cochlear nerve deficiency. Methods: A total of 88 children with cochlear nerve deficiency, who underwent cochlear implantation in Shandong Provincial ENT Hospital from May 2014 to October 2018, were enrolled. Patients with cochlear malformations were excluded,only the patients with cochlear nerve deficiency whose cochlear structu re was normal and no cochlear nerve displayed in inner auditory canal under MRI were enrolled. There were 64 patients, including 4 bilaterally implanted, 68 ears in total, with an average age of (2.8±1.7) years (range 1-6 years) at the time of implantation. The implanted product was Cochlear, including 24RECA and 512 models. All patients underwent inner ear magnetic resonance imaging and temporal bone CT scan before operation. Auditory speech function assessments were performed at 12 months, 24 months, and 36 months after surgery, including categories of auditory performance (CAP), speech intelligibility rating (SIR) and hearing aid threshold test. The imaging evaluation content included the width of the cochlear nerve canal of temporal bone CT, the width of the internal auditory canal, the width of the auditory nerve at the cerebellopontine angle of the inner ear MRI, and the ratio of the facial nerve to the width of the auditory nerve at the cerebellopontine angle. The correlatio ns between the results of postoperative hearing aid hearing threshold, CAP, SIR and imaging results were analyzed. Results: Among the 64 cases of cochlear nerve not shown under MRI, 56 ears with CT data showed that the width of the cochlear nerve canal in temporal bone CT was (0.72±0.30) mm (mean±standard deviation, the same below), and the width of the internal auditory canal was (4.07±1.10) mm; 66 ears with MRI data showed that the diameter of the auditory nerve at the cerebellopontine angle of the inner ear MRI was (1.58±0.27) mm, the diameter of the facial nerve was (1.57±0.27) mm, and the ratio of the diameter of the facial nerve to the auditory nerve was (1.02±0.23). The average hearing thresholds at 12, 24, and 36 months after surgery were (46.8±2.5) dB HL, (40.7±0.8) dB HL, and (36.8±1.5) dB HL, respectively. The preoperative and postoperative CAP scores at 12, 24 and 36 months were (1.0±1.0), (3.8±1.4), (4.5±1.4) and (5.1±0.7) points, respectively. The p reoperative and postoperative SIR scores at 12, 24, and 36 months were (1.1±0.3), (1.9±0.9), (2.5±0.9), and (2.9±0.6) points, respectively. The hearing threshold at 24 months after surgery was negatively correlated with the width of the internal auditory canal of temporal bone CT (r=-0.349, P=0.037), and the hearing threshold at 36 months after surgery was positively correlated with the ratio of the diameter of the facial nerve to the auditory nerve at the cerebellopontine angle of the inner ear MRI (r=0.740, P=0.001). Conclusions: Children with cochlear implants whose cochlear nerves are not shown on MRI can benefit from cochlear implantation, and their speech and auditory functions can improve significantly after surgery. The width of the internal auditory canal in the temporal bone CT and the ratio of the diameter of the facial nerve to the auditory nerve at the cerebellopontine angle of the inner ear MRI may be related to the long-term hear ing threshold after surgery. PMID:34963216 | DOI:10.3760/cma.j.cn115330-20210126-00038 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correction of halitosis in chronic inflammatory diseases of the oropharynx in adults

xlomafota13 shared this article with you from Inoreader Correction of halitosis in chronic inflammatory diseases of the oropharynx in adults Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):41-46. doi: 10.17116/otorino20218606141. ABSTRACT Approximately 25% of the world population suffer from halitosis, making it a significant medico-social issue. It is one of the clinical signs of chronic inflammatory diseases of the oropharynx and is commonly caused by the persistence some bacteria in the oral cavity and in the oropharynx. These in turn facilitate formation of volatile sulphur compounds. OBJECTIVE: To evaluate the effectiveness and safety of the probiotic strain Streptococcus salivarius K12 in the Bactoblis product in exacerbation of chronic inflammatory diseases of the oropharynx. MATERIAL AND METHODS: 45 patients diagnosed with a diagnosis of exacerbation of chronic pharyngitis were studied, gastroesophageal reflux disease was found in 33 patients. After a microbiological testing, all patients were prescribed probiotic strain Streptococcus salivarius K12 in t he amount of 1×109 colony-forming units (CFU) in the form of tablets for resorption as monotherapy for 14 days. The assessment of the therapy was based on physical examination data and on the subjective estimation of the clinical symptoms using a 10-point visual analog scale (VAS) before the start of the treatment and on the 5th and on the 7th day of the therapy. RESULTS: According to the microbiological analysis was revealed the growth of Staphylococcus aureus, Candida albicans, Pseudomonas aeruginosa, Streptococcus agalactiae, Streptococcus viridans which was seen within 103-105 CFU. A significant clinical progress was achieved for all three analyzed signs of diseases (the severity of pain when swallowing, a feeling of perspiration (foreign body) in the pharynx, halitosis), within the statistical significance between the 1st and the 7th day and the 7th and the 14th day of the surveillance. The pain severity was decreased from 5.69±0. 39 points to 2.69±0.34 points on the 7th day and to 0.08±0.05 point on the 14th day from the start of the therapy, itchy throat (foreign body sensation) was relived from 6.88±0.23 points to 3.54±0.29 points on the 7th day and to 0.69±0.12 point on the 14th day of the therapy. In addition, there was a decline in the severity of halitosis from 6.16±0.31 points to 2.47±0.44 points on the 7th day and to 0.68±0.29 point on the 14th day of the therapy. CONCLUSION: Topical application of a drug containing a probiotic Streptococcus salivarius K12, in case of chronic inflammatory diseases of the oropharynx of various etiologies, showed satisfactory effectiveness in the regression of the main symptoms of the exacerbation of the inflammatory process, expressed through pain in the throat when swallowing, halitosis and the foreign body sensation in the oropharynx. PMID:34964328 | DOI:10.17116/otorino20218606141 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Neutrophil extracellular traps in the pathogenesis of chronic rhinosinusitis Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):105-112. doi: 10.17116/otorino202186061105. ABSTRACT The review presents the current understanding of the pathogenesis of chronic rhinosinusitis. The causes of damage to the mucous membrane of the paranasal sinuses are most often the result of a combination of immunological, infectious and anatomical factors. This indicates the need for a multidisciplinary approach to the study of the pathogenesis of this pathology. There is no single universally recognized classification of chronic rhinosinusitis, which takes into account histological and immunological changes in the mucous membrane of the paranasal sinuses. The discovery of the mechanism of completion of the life cycle of neutrophils - the formation of a neutrophil extracellular trap or NETosis, different from necrosis and apoptosis, opened up new prospects in the study of the pathogenesis of inflammatory processes, including rhinosinusitis. Neutroph il extracellular traps reduce the permeability of the epithelial barrier in the mucous membrane of the paranasal sinuses. This determines their possible role in the etiopathogenesis of rhinosinusitis. In recent years, more and more attention has been paid to the feasibility, effectiveness and safety of therapy that affects the immune component of the inflammatory process, including NETosis. The data obtained in the study of extracellular traps can be used in clinical practice. It is neutrophil extracellular traps that can become a potential target in the treatment of patients with chronic rhinosinusitis. PMID:34964339 | DOI:10.17116/otorino202186061105 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case of ear miasis in a 2-month-old child

xlomafota13 shared this article with you from Inoreader A case of ear miasis in a 2-month-old child Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):113-116. doi: 10.17116/otorino202186061113. ABSTRACT A clinical case is presented - a rare observation of ear myasis in a 2-month-old child. PMID:34964340 | DOI:10.17116/otorino202186061113 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal cysts in children

xlomafota13 shared this article with you from Inoreader Laryngeal cysts in children Via Vestnik otorinolaringologii Vestn Otorinolaringol. 2021;86(6):57-61. doi: 10.17116/otorino20218606157. ABSTRACT Laryngeal cysts in children are relatively rare, occupying the 4-5th place in the structure of congenital malformations. The paper presents the combined experience of two Russian pediatric otorhinolaryngological clinics traditionally involved in the rehabilitation of patients with congenital and acquired pathology of the larynx. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of laryngeal cysts in children. MATERIAL AND METHODS: The study included 68 children with laryngeal cysts aged from 3 days to 16 years (on average 39.5±37.0 months, Me=15.5 months). The cyst was localized in the vestibular region of the larynx in 15 (22.1%) patients, in the vocal region - in 15 (22.1%) patients, and in the sub-vocal region - in 38 (55.9%) patients. Data on the presence of a history of tracheal intubation were available in 35 ( 89.7%) children, including 35 (92.1%) of 38 children with a subfold cyst. 11 patients were admitted with a previously applied tracheostomy. RESULTS: The main reasons for going to the clinic were signs of laryngeal stenosis (stridor, signs of obstruction of the upper airways) in 60.3% of patients, dysphonia - in 33.8%, and in 5.9%, the detection of a cyst became an accidental finding. To eliminate the cyst, the method of laser marsupialization was used in 10 patients, coagulatory ablation - in 2 patients, in the remaining 56 patients, decortication was performed with microinstruments, followed by laser treatment of the cyst bed. In the follow-up, children were traced from 6 months to 7 years. We did not observe a recurrence of a cyst in any case. CONCLUSION: Currently, the lining department is the "favorite" localization of the cyst in childhood. Subclavian cysts are more common in preterm infants who need tracheal intubation. A necessary condition for radical elimination is the resection of the cyst walls. PMID:34964331 | DOI:10.17116/otorino20218606157 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels

xlomafota13 shared this article with you from Inoreader The Hypothalamic Paraventricular Nucleus Is the Center of the Hypothalamic–Pituitary–Thyroid Axis for Regulating Thyroid Hormone Levels Via liebertpub1 Thyroid, Ahead of Print. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of the middle turbinate during and after sinus surgery

xlomafota13 shared this article with you from Inoreader Management of the middle turbinate during and after sinus surgery Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Treatment of the middle turbinate (MT) during and after endoscopic sinus surgery (ESS) has been controversial. Historically, there has been concern that resection of the MT may result in smell loss and frontal sinus stenosis. However, these concerns must be balanced by knowledge that a residual diseased MT may result in surgical failure. This review discusses the current evidence on treatment of the MT during and after ESS. Recent findings Several review articles have shown the safety of performing MT resection. Studies have not shown increase rates of frontal sinus stenosis, olfactory loss, or empty nose syndrome. However, the benefit of MT resection is highly debated. There have also been many recent advances and technological developments to assist in management of the postoperative MT. Summary The literature supports the safety of performing MT resection, however, the benefit of resection over preservation is controversial. New technologies and techniques exist that may aid in preventing postoperative MT lateralization. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Emerging concepts in sinonasal tumor research

xlomafota13 shared this article with you from Inoreader Emerging concepts in sinonasal tumor research Via Current Opinion in Otolaryngology & Head and Neck Surgery - Current Issue Purpose of review Sinonasal malignancies are rare and understudied, often diagnosed at late stages, and may behave aggressively. This review explores investigative diagnostic, therapeutic, and scientific advances specific to sinonasal undifferentiated carcinoma (SNUC), intestinal-type adenocarcinoma (ITAC), and olfactory neuroblastoma (ONB). Recent findings A number of studies have recently contributed more robust knowledge of the genetic and molecular landscapes of SNUC, ITAC, and ONB. These analyses have identified SMARCB1 and IDH2 mutations in SNUC, potentially allowing for the tumor's subdivision. Recent studies have also defined a role for induction chemotherapy in SNUC. Somatic mutations for ITAC have been identified and may be potentially targetable with FDA approved therapies. Studies defining the tumor microenvironment for ITAC and ONB have introduced the possibility of immune checkpoint inhibition for these tumor types. Summary Studies reviewed here detail promising results of the most current and novel characterization of SNUC, ITAC, and ONB genetic and molecular landscapes, which have informed ongoing therapeutic discovery. With continued multi-institutional efforts, the field of sinonasal tumor research will achieve higher disease control and improved treatment outcomes for patients afflicted with these rare cancers. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.