Τρίτη 23 Μαρτίου 2021

Symptoms of Depression in Patients with Chemosensory Disorders

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Introduction: Patients with chemosensory dysfunction frequently report symptoms of depression. The current study aims to clarify whether the type (smell dysfunction, taste dysfunction, and mixed smell and taste dysfunction), severity, duration, or cause of dysfunction have differential impacts on the symptoms of depression. Methods: 899 patients with chemosensory disorders and 62 controls were included. Following a structured interview and an otorhinolaryngological examination, subjects underwent olfactory tests (Sniffin' Sticks), gustatory tests (taste sprays) and an assessment of depressive symptoms (Beck Depression Inventory). Information on the cause and duration of disorders was also collected. Results: Patients with combined olfactory/gustatory dysfunction had higher depression scores than patients with smell dysfunction only and controls, and no significant difference was found between the smell dysfunction and controls. Anosmi a patients, but not hyposmia patients, exhibited higher depression scores than controls. Among various causes of chemosensory disorders, patients from the posttraumatic group had higher depression scores than patients with other causes of chemosensory dysfunction (sinonasal, idiopathic, or postinfectious). Multiple linear regression analyses suggested that reduced olfactory function was associated with enhanced depression scores in the olfactory disorders group (B = −0.326, t = −2.294, and p = 0.02) and in all patients with chemosensory disorders (B = −0.374, t = −2.550, p = 0.017). Discussion/Conclusion: Simultaneously decreased input of olfaction and gustation seems to have an additive effect on the exacerbation of emotional dysfunction. Early intervention should be considered for depression symptoms in patients with mixed olfactory/gustatory dysfunction in clinical practice.
ORL
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pT3 N0 Laryngeal Squamous Cell Carcinoma: Oncologic Outcomes and Prognostic Factors of Surgically Treated Patients

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Objectives/Hypothesis

To assess the disease control, survival rates, and prognostic factors of exclusive surgical treatment for patients with pT3 N0 laryngeal squamous cell carcinoma (LSCC).

Study Design

Multicentric retrospective cohort study.

Methods

Multicentric retrospective case series of previously untreated patients with pT3 R0N0 LSCC, who received exclusive surgery between 2011 and 2019. Tumor location; subsite involvement; grading; and lymphatic, vascular, and perineural invasion were reported. Overall survival (OS), disease‐specific survival (DSS), and disease‐free survival (DFS) were measured.

Results

Fifty‐four patients (mean age 67.1; male sex 83.3%; mean follow‐up period 37 months) underwent total laryngectomy (48.1%) or partial laryngectomy (51.9%). Ipsilateral or bilateral neck dissection was performed in 46 (85.2%) cases. Perineural invasion was more frequent in case of supraglottic involvement than glottic involvement (85.7% vs. 14.3%, P = .03). Five (9.3%) patients experienced recurrence (3 local recurrences, 1 nodal recurrence, 1 distant recurrence). Rate of recurrence differed between glottic (0%), supraglottic (80%), and transglottic (20%) tumors (P = .01), with a lower risk yielded by glottic involvement (odds ratio [OR], 0.05, 95% confidence interval [95% CI], 0.01–0.56, P = .01). A higher risk was recorded in case of perineural invasion (OR, 66.0, 95% CI, 1.41–3085.3, P = .03). The OS, DSS, and DFS were 79.6%, 96.3%, and 90.7%, without differences regarding the type of surgery. The DFS was lower in case of supraglottic involve ment when compared to purely glottic LSCC (83.9% vs. 100%, P = 0.02).

Conclusions

Exclusive surgery is a safe option for patients with pT3 R0N0 LSCC. Adjuvant treatments or closer follow‐up monitoring might be considered in case of supraglottic involvement or perineural invasion.

Level of Evidence

4 Laryngoscope, 2021

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Hydroxyapatite bone cement in the reconstruction of defects of the long process of the incus: Personal experience and literature review

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Publication date: Available online 22 March 2021

Source: American Journal of Otolaryngology

Author(s): Konstantinos Mantsopoulos, Vivian Thimsen, Felix Wohlleben, Lava Taha, Matti Sievert, Sarina Katrin Müller, Miguel Goncalves, Heinrich Iro, Joachim Hornung

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Diagnosis and management of pharyngoesophageal stenosis: A comprehensive approach to prophylactic, endoscopic, and reconstructive treatment options

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Publication date: Available online 22 March 2021

Source: American Journal of Otolaryngology

Author(s): Sarah L. Spaulding, Edward Ansari, Monica H. Xing, Mykayla L. Sandler, Quinn F. O'Malley, Rebecca Ho, Hannah Spitzer, Juliana Levy, Cindy Ganz, Azita S. Khorsandi, Neil Mundi, Mark L. Urken

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The tracheotomy of Kaiser Friedrich III in the Year of the Three Kaisers, 1888 : Presentation of the original historical image to the DGHNO-KHC

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HNO. 2021 Mar 22. doi: 10.1007/s00106-021-01026-z. Online ahead of print.

ABSTRACT

The current article describes an image depicting an otorhinolaryngologic surgical intervention being performed on Kaiser Friedrich III. The image was captured by the lithography of an unknown artist and originates from a Cologne printing press. Kaiser Friedrich III was the penultimate German Kaiser and died June 15, 1888, in Potsdam, after ruling for only 99 days (the Year of the Three Kaisers ). Toward the end of his period as Prince Regent and during his time on the throne, Kaiser Friedrich III was tracheostomized and wore a silver cannula. This publication on the Kaiser's disease and the background of the lithography marks the occasion of presentation of this historic image to the German Society of Otorhinolaryngology, Head and Neck Surgery by the author.

PMID:33754200 | DOI:10.1007/s00106-021-01026-z

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Photobiomodulation therapy increases collagen II after tendon experimental injury

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Histol Histopathol. 2021 Mar 23:18330. doi: 10.14670/HH-18-330. Online ahead of print.

ABSTRACT

A tendon is a mechanosensitive tissue that transmits muscle-derived forces to bones. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), has been used in therapeutic approaches in tendon lesions, but uncertainties regarding its mechanisms of action have prevented its widespread use. We investigated the response of PBM therapy in experimental lesions of the Achilles tendon in rats. Thirty adult male Wistar rats weighing 250 to 300 g were surgically submitted to bilateral partial transverse section of the Achilles tendon. The right tendon was treated with PBM, whereas the left tendon served as a control. On the third postoperative day, the rats were divided into three experimental groups consisting of ten rats each, which were treated with PBM (Konf, Aculas - HB 750), 780 nm and 80 mW for 20 seconds, three times/week for 7, 14 and 28 days. The rats were sacrificed at the end of the therapeutic time period. The Sca-1 was examined by immunohistochemistry and histomorphometry, and COLA1, COLA2 and COLA3 gene expression was examined by qRT-PCR. COLA2 gene expression was higher in PBM treated tendons than in the control group. The histomorphometric analysis coincided with increased number of mesenchymal cells, characterized by Sca-1 expression in the lesion region (p<0.001). PBM effectively interferes in tendon tissue repair after injury by stimulating mesenchymal cell proliferation and the synthesis of collagen type II, which is suggested to provide structural support to the interstitial tissues during the healing process of the Achilles tendon. Further studies are needed to confirm the role of PBM in tendon healing.

PMID:33755188 | DOI:10.14670/HH-18-330

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Radioactive Iodine Treatment for Children and Young Adults with Thyroid Cancer in South Korea: A Population-Based Study

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J Clin Endocrinol Metab. 2021 Mar 23:dgab192. doi: 10.1210/clinem/dgab192. Online ahead of print.

ABSTRACT

PURPOSE: This study investigated radioactive iodine treatment (RAIT) patterns and the secondary cancer incidence among child and young adult patients receiving RAIT after thyroidectomy for thyroid cancer.

METHODS: This population-based cohort study used the Health Insurance Review and Assessment database of South Korea to identify a total of 18,617 child and young adult p atients (0-29 years) who underwent thyroidectomy for thyroid cancer between 2008 and 2018. We recorded age at surgery, sex, the interval from surgery to RAIT, the doses of RAI, the number of RAIT sessions, and secondary cancer incidence.

RESULTS: A total of 9,548 (51.3%) child and young adult patients underwent one or more RAIT sessions. The initial dose of RAIT was 4.35±2.19 GBq. The overall RAIT frequency fell from 60.9 to 38.5% and the frequency of high-dose RAIT (>3.7 GBq) from 64.2 to 36.5% during the observational period. A total of 124 cases of secondary cancer developed during 120,474 person-years of follow-up; 43 (0.5%) in the surgery cohort and 81 (0.8%) in the RAIT cohort. The RAIT cohort was thus at an increased risk of secondary cancer (adjusted hazard ratio 1.52 [95%CI 1.03-2.24], P = 0.035).

CONCLUSION: The proportion of child and young adult patients receiving RAIT, and the RAI dose, fell significantly over the observational period. RAIT was associate d with secondary cancers. This is of major concern in the context of child and young adult thyroid cancer survivors.

PMID:33755732 | DOI:10.1210/clinem/dgab192

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Juckt es nur oder läuft es auch? – Der ungewöhnliche Fall einer Perichondritis der Ohrmuschel

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Laryngorhinootologie
DOI: 10.1055/a-1418-9458



Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Gracilis and semitendinosus moment arm decreased by fascial tissue release after hamstring harvesting surgery: a key parameter to understand the peak torque obtained to a shallow angle of the knee

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Surg Radiol Anat. 2021 Mar 23. doi: 10.1007/s00276-021-02738-1. Online ahead of print.

ABSTRACT

PURPOSE: Semitendinosus and gracilis muscles whose tendons are used in surgical reconstruction of the anterior cruciate ligament maintain their contractile ability, but the peak torque angle of hamstring muscles shifted to a shallow angle postoperatively. The goal was to quantify the influence of the myofascial structures on instantaneous moment arms of knee muscles to attempt exp laining the above-mentioned post-surgical observations.

METHODS: Hamstring harvesting procedures were performed by a senior orthopaedic surgeon on seven lower limbs from fresh-frozen specimens. Femoro-tibial kinematics and tendons excursion were simultaneously recorded at each step of the surgery.

RESULTS: No significant difference was demonstrated for instantaneous moment arm of gracilis during anterior cruciate ligament surgery (84% of the maximum intact values; P ≥ 0.05). The first significant semitendinosus moment arm decrease was observed after tendon harvesting (61% of the maximum intact values; p ≤ 0.005). After hamstring harvesting, the maximum and minimum moment arm (both gracilis and semi tendinosus) shifted to a shallow angle and 90°, respectively.

CONCLUSION: Moment arm modifications by paratenons and the loose connective tissue release are essential to understand the peak torque obtained to a shallow angle.

LEVEL OF EVIDENCE: Basic science s tudy, biomechanics.

PMID:33755756 | DOI:10.1007/s00276-021-02738-1

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An image-guided (CT) assessment of a new asymmetric balloon for the treatment of epistaxis

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Eur Arch Otorhinolaryngol. 2021 Mar 23. doi: 10.1007/s00405-021-06758-w. Online ahead of print.

ABSTRACT

PURPOSE: The main objective was to perform an image-guided (CT) assessment of the efficacy of the CAVI-T™ balloon to compress the sphenopalatine artery (SPA) on cadaver heads, for the management of epistaxis. The secondary objectives were to analyse the deployment and stability of this balloon according to the volume injected into the nasal cavity, to optimise its use.

METHODS: A descriptive anatomical study was performed. The catheterization of the SPA was performed on four fresh-frozen heads with a SPA approach through the maxillary sinus, leaving the nasal cavity unscathed. Computed Tomography images were acquired without and with the balloon, inflated by injections of progressive volumes of diluted iodine, for optimal contrast with the surrounding tissues. We evaluated the positioning of the balloon according to two pred etermined markers on the device.

RESULTS: Out of 68 image-guided acquisitions, the CAVI-T™ balloon compressed the SPA in 88% of cases. The other nasal cavity structures were compressed in 86% to 100% of the cases, depending on the positioning of the CAVI-T™ balloon, therefore allowing a complete obstruction of the nasal cavity. The device remained stable upon inflation and did not obstruct the nasopharynx.

CONCLUSION: The CAVI-T™ balloon provided effective compression of the SPA and the different structures of the nasal cavity.

PMID:33755780 | DOI:10.1007/s00405-021-06758 -w

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Clinical Assessment and Lesion-Specific Management of Orbital Vascular Malformations

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J Neurol Surg B Skull Base 2021; 82: 116-128
DOI: 10.1055/s-0040-1722702

The systematic classification of vascular disease as proposed and refined by the International Society for the Study of Vascular Anomalies (ISSVA) divides vascular pathology first into tumors and malformations. Malformations are described as simple and complex, where simple malformations contain a single vascular system and complex malformations comprised of multiple vascular systems. Arteriovenous malformations are considered in terms of inflow characteristics which are primarily responsible for the key management challenges. Management utilizing endovascular embolization and/or surgical resection is often employed; however, recurrence can occur, part icularly in diffuse cases. There may be an increasing role for systemic antiangiogenic therapy in such cases. Lymphaticovenous malformations are divided into the principle components on the lymphatic and venous sides for clarity of discussion. Lymphatic malformations are described morphologically as macrocystic and microcystic, and physiologically in terms of the processes responsible for growth. In both cases, surgical options are challenging and local therapeutics intended to close large luminal spaces in the case of macrocystic and to slow biological signaling for growth in microcystic. Venous malformations are described physiologically in terms of flow and distensibility, as volume plays a critical role in the limited space of the orbital cavity. Combined embolic-surgical approaches can be effective for management. More complicated, combined lesions can be managed by dividing the lesion into principal components and treating each appropriately.
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Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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