Κυριακή 27 Ιουνίου 2021

Multicentric Intra/Extracranial Cystic Facial Nerve Schwannoma: Case Report and Review of Literature

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Abstract

To report a case of facial nerve schwannoma which presented a diagnostic and management challenge because of unusual multicentric cystic presentation. A 25-year-old female patient with a history of deep facial pain, parotid gland swelling and normal facial function showed multiple expansive cystic lesions of the temporal bone and parotid gland which turned out to be multicentric cystic facial nerve schwannomas. One should be keep this diagnosis in mind when dealing with a cystic lesions of the temporal bone and parotid gland.

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FACE-Q craniofacial module: Part 2 Psychometric properties of newly developed scales for children and young adults with facial conditions

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J Plast Reconstr Aesthet Surg. 2021 Mar 25:S1748-6815(21)00098-X. doi: 10.1016/j.bjps.2021.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: The FACE-Q Craniofacial Module is a patient-reported outcome measure designed for patients aged 8 to 29 years with conditions associated with a facial difference. In part 1, we describe the psychometric findings for the original CLEFT-Q scales tested in patients with cleft and noncleft facial conditions. The aim of this study was to examine psychometric performance of new FACE-Q Craniofacial Module scales.

METHODS: Data were collected between December 2016 and December 2019 from patients aged 8 to 29 years with conditions associated with a visible or functional facial difference. Rasch measurement theory (RMT) analysis was used to examine psychometric properties of each scale. Scores were transformed from 0 (worst) to 100 (best) for tests of construct validity.

RESULTS: 1495 particip ants were recruited with a broad range of conditions (e.g., birthmarks, facial paralysis, craniosynostosis, craniofacial microsomia, etc.) RMT analysis resulted in the refinement of 7 appearance scales (Birthmark, Cheeks, Chin, Eyes, Forehead, Head Shape, Smile), two function scales (Breathing, Facial), and an Appearance Distress scale. Person separation index and Cronbach alpha values met criteria. Three checklists were also formed (Eye Function, and Eye and Face Adverse Effects). Significantly lower scores on eight of nine scales were reported by participants whose appearance or functional difference was rated as a major rather than minor or no difference. Higher appearance distress correlated with lower appearance scale scores.

CONCLUSION: The FACE-Q Craniofacial Module scales can be used to collect and compare patient reported outcomes data in children and young adults with a facial condition.

PMID:34172403 | DOI:10.1016/j.bjps.2021.03.009

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Lymphography change after liposuction: Possible neo-lymphangiogenesis by surgical trauma

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J Plast Reconstr Aesthet Surg. 2021 Jun 3:S1748-6815(21)00258-8. doi: 10.1016/j.bjps.2021.05.006. Online ahead of print.

NO ABSTRACT

PMID:34172402 | DOI:10.1016/j.bjps.2021.05.006

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New European Medicines Agency approval: Tucatinib in association with trastuzumab and capecitabine for the treatment of HER2-positive metastatic breast cancer previously treated

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Bull Cancer. 2021 Jun 22:S0007-4551(21)00175-2. doi: 10.1016/j.bulcan.2021.04.004. Online ahead of print.

NO ABSTRACT

PMID:34172272 | DOI:10.1016/j.bulcan.2021.04.004

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SEC61G identified as a prognostic biomarker of head and neck squamous cell carcinoma

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Eur Arch Otorhinolaryngol. 2021 Jun 25. doi: 10.1007/s00405-021-06955-7. Online ahead of print.

ABSTRACT

PURPOSE: It is of obvious interest to identify clinical prognosis-related oncogenes in HNSCC (head and neck squamous cell carcinoma).

METHODS: Based on the available datasets within the TCGA (The Cancer Genome Atlas) and the GEO (Gene Expression Omnibus) databases, the potential mechanism of action of the SEC61G (SEC61 translocon subunit gamma) gene in HNSCC tumorigenesis was explored by several bioinformatics approaches.

RESULTS: There was a higher expression level of SEC61G in primary HNSCC tumor tissues than in normal tissues. Moreover, highly expressed SEC61G was statistically associated with the poor survival prognosis of HNSCC patients. When HPV (human papilloma virus) was considered, we also observed a relatively lower proportion of "arm-level gain" and "high amplification" types of CNA (copy-number alteration) in the HNSCC-HPV (+) group than in the HNSCC-HPV (-) group. Additionally, we identified SEC61G CAN-correlated genes, such as CCT6A (chaperonin-containing TCP1 subunit 6A) and HUS1 (HUS1 checkpoint clamp component), and found a correlation between SEC61G copy-number segments and prognosis related to overall and progression-free survival intervals of HNSCC patients. Moreover, the molecular regulation mechanisms of the spliceosome, ribosome, proteasome degradation, cell adhesion, and immune infiltration of B and CD8+ T cells may contribute to the involvement of SEC61G in the pathogenesis of HNSCC.

CONCLUSIONS: The SEC61G gene was identified for the first time as a prognostic biomarker of HNSCC. The detailed underlying mechanism merits further research.

PMID:34173014 | DOI:10.1007/s00405-021-06955-7

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Audiological results and subjective benefit of an active transcutaneous bone-conduction device in patients with congenital aural atresia

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Eur Arch Otorhinolaryngol. 2021 Jun 26. doi: 10.1007/s00405-021-06938-8. Online ahead of print.

ABSTRACT

PURPOSE: To review functional and subjective benefit after implantation of an active transcutaneous bone conduction device (BCD) in patients with congenital microtia with atresia or stenosis of the external auditory canal.

METHODS: Retrospective chart analysis and questionnaire on the subjective impression of hearing ( Speech, Spatial and Qualities of Hearing Scale (SSQ-B) of patients treated between 2012 and 2015.

RESULTSRESULTS: 18 patients (24 ears) with conductive or mixed hearing loss in unilateral (n = 10) or bilateral (n = 8) atresia were implanted with a BCD. No major complications occurred after implantation. Preoperative unaided air conduction pure tone average at 0.5, 1, 2 and 4 kHz (PTA 4 ) was 69.2 ± 11.7 dB, while postoperative aided PTA 4 was 33.4 ± 6.3 dB, resulting in a mean functional hearing gain of 35.9 +/- 15.6 dB. Preoperatively, the mean monosyllabic word recognition score was 22.9 % ± 22.3 %, which increased to 87.1 % +/- 15.1 % in the aided condition. The Oldenburger Sentence Test at S0N0 revealed a decrease in signal-to-noise-ratio from - 0.58 ± 4.40 dB in the unaided to - 5.67 ± 3.21 dB in the postoperative aided condition for all patients investigated. 15 of 18 patients had a subjective benefit showing a positive SSQ-B score (mean 1.7).

CONCLUSION: The implantation of an active bone conduction device brings along subjective and functional benefit for patients with conductive or combined hearing loss.

PMID:34173875 | DOI:10.1007/s00405-021-06938-8

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The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy

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Dysphagia. 2021 Jun 25. doi: 10.1007/s00455-021-10329-w. Online ahead of print.

ABSTRACT

This study investigated the effect of the structured Neurodevelopmental Therapy Method-Bobath (NDT-B) approach on the feeding and swallowing activity of patients with cerebral palsy (CP) and feeding difficulties. In addition to feeding and oral motor intervention strategies (OMIS), and nutrition-related caregiver training (NRCT), and the NDT-B, which was structured to increase trunk and postura l control, was added to the therapy program. Forty patients with CP, with a mean age of 3.25 ± 0.927 years, were classified using the Gross Motor Function Classification System, Eating and Drinking Ability Classification System, and Mini-Manual Ability Classification System. The patients were randomly assigned into two groups as OMIS + NRCT (n = 20) and OMIS + NRCT + NDT-B (n = 20). The program was applied for 6 weeks, 2 days/week, for 45 min. The patients were evaluated using the Trunk Impairment Scale, Schedule for Oral Motor Assessment, and the Pediatric Quality of Life Inventory before and after 6 weeks. The trunk control of the OMIS + NRCT + NDT-B group was superior to the other group (P = 0.026). Although there was an improvement in the groups according to the subcategories of SOMA, the OMIS + NRCT + NDT-B group was superior in the trainer cup and puree subcategories of SOMA (P = 0.05). A significant correlation was observed between trunk control and oral motor functions in c hildren with CP, and the eating function of children in the OMIS + NRCT + NDT-B group further improved. NDT-B-based neck and trunk stabilization exercises should be added to the treatment programs.Trial Registration NCT04403113.

PMID:34173063 | DOI:10.1007/s00455-021-10329-w

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Supracricoid Partial Laryngectomy With and Without Neoadjuvant Chemotherapy in Glottic Cancer

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Objectives/Hypothesis

To demonstrate that a group of patients who are not considered candidates for organ preservation can achieve organ preservation through neoadjuvant chemotherapy + surgery and to determine if there are differences regarding organ preservation, disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) after comparing such group with another one undergoing standard treatment.

Methods

Patients with laryngeal cancer were retrospectively analyzed and divided into two groups. Group A included patients who were initially treated with supracricoid laryngectomy. Group B included patients with T3N0 glottic squamous cell carcinoma with arytenoid fixation. Patients were offered neoadjuvant chemotherapy. Both groups underwent bilateral selective neck dissection of lymph nodes (II–V) and intentional search of the Delphian lymph nodes.

Results

Thirty-four patients were assigned to group A of surgery alone, and 16 patients were included in group B of induction chemotherapy. No statistical differences were found regarding sex, tumor localization, histological diagnosis, TNM staging, recurrence, or organ preservation. DFS, OS, and CSS at 60 months were the same in both groups. No statistical differences were found when comparing induction versus noninduction groups according to the T-stage in DFS, OS, and CSS.

Conclusions

Neoadjuvant chemotherapy allows to perform conservative surgery in patients with poor functional prognosis or who are not good candidates for organ preservation at first. We could perform safe surgery, and there was no more recurrence. Hence DFS is not modified (i.e., there was no more recurrence); consequently, OS and CSS are not affected. Neoadjuvant chemotherapy plus supracricoid partial laryngectomy-cricohyoidoepiglottopexy is an oncologically safe procedure that preserves basic functions such as breathing, phonation, and swallowing.

Level of Evidence

3 Laryngoscope, 2021

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The impact of COVID‐19 on elective otolaryngology surgery in a rural hospital in the United Kingdom

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Abstract

A return to normal surgical practice following the first wave of the COVID-19 pandemic was expected to be limited by extra precautions put in place to mitigate the risks posed by the Sars-Cov2 virus to patients and theatre staff. Rates of COVID-19 infection within the local authority area remained well below national levels from August 2020-February 2021 despite a surge in cases during the second wave. Despite low levels of COVID-19 infection there was a 16.2% reduction in the number of operating lists and a 31.2% reduction in the number of surgical procedures performed. There was a significant increase in the number of cancellations (p=0.011) year on year. The results suggest that the ability of Otolaryngological departments to clear the backlog of cases caused by the postponement of non-urgent surgery during 2020 will be limited as long as the extra precautions remain.

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The role of sepsis screening, SIRS and qSOFA in Head and Neck Infections: An Audit of 104 Patients

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Abstract

Sepsis is associated with high morbidity and mortality and is a known complication of infections of the head and neck. Screening for sepsis should be conducted on admission in order to identify patients at risk and provide early intervention. Compliance with sepsis screening was poor on an ENT ward in a district general hospital, however this can be improved further by education and visual reminders such as poster or a clerking proforma. The most common head and neck infections admitted to a district general hospital were tonsillitis, peritonsillar cellulitis and peritonsillar abscesses. The incidence of sepsis as a complication of head and neck infections is very rare if using the qSOFA criteria. Using SIRS criteria may result in overidentification of sepsis and may lead to excessive and inappropriate clinical management in patients who could otherwise be managed less aggressively.

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Increased incidence of unilateral sudden sensorineural hearing loss in patients with hematological malignancies requiring hematopoietic stem cell transplantation

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Abstract

Haematopoietic stem cell transplantation (HSCT) may dramatically alter the immunity of a recipient Transient immunodeficiency that occurs before and after HSCT could be associated with the development of sudden sensorineural hearing loss (SSNHL), which is presumed to be often due to viral aetiology We found an incidence of SSNHL of 29.4 per 10,000 person-years in patients receiving HSCT, 12-fold higher than reported for background population incidence Development of SSNHL tended to cluster early after diagnosis of haematological malignancies, rather than around date of treatment with HSCT Increased risk of unilateral SSNHL in patients with haematological malignancy may relate to underlying disease rather than treatment

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Prognosis and Outcomes in Early Stage Glottic Carcinoma Involving the Anterior Commissure Treated with Laser CO2 Surgery: A Retrospective Observational Analysis

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Abstract

The anterior commissure (AC) is the area where the vocal cords attach to the thyroid cartilage through Broyles' ligament. Many authors argue that involvement of the anterior commissure in early stage glottic carcinoma (I, II) constitutes a risk factor for local recurrence. The objective of this study is to evaluate whether anterior commissure involvement in early stage glottis cancer is an independent risk factor for recurrence and mortality. The study included all those patients diagnosed with glottis carcinoma in stages I and II of the AJCC treated by transoral laser surgery at the Hospital San Pedro (Logroño, Spain) between 2005 and 2015. Patients were divided into two groups according to the presence (AC1) or absence (AC0) of involvement of the commissure. Of 29 patients treated, 44.8% were AC1. Patients with anterior commissure involvement had more local recurrence (p = 0.2701); higher mortality rate (p = 0.2256); lower disease-f ree survival (p = 0.0881) and a lower overall survival (p = 0.0331). The 5-year survival rate was 24.5% lower in patients with invasion of the anterior commissure. The involvement of the anterior commissure is an independent risk factor that should be considered in the prognosis of laryngeal cancer.

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