Iatrogenic Cholesteatoma Presenting as Neck Mass

xlomafota13 shared this article with you from Inoreader Iatrogenic Cholesteatoma Presenting as Neck Mass Via The Laryngoscope We present a rare iatrogenic cholesteatoma of the neck in a ten year old male four years after tympanomastoidectomy, an entity that to our knowledge has not been published in the literature for over 30 years. Furthermore, we discuss the diagnostic uncertainty of typical magnetic resonance imaging protocols for pediatric neck lesions and the improved diagnostic specificity of diffusion weighted magnetic resonance imaging. En bloc surgical extirpation was performed. Laryngoscope, 131:E882–E884, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients

xlomafota13 shared this article with you from Inoreader Chloroquine, Hydroxychloroquine and Hearing Loss: A Study in Systemic Lupus Erythematosus Patients Via The Laryngoscope Objectives/Hypothesis Antimalarial drugs (chloroquine and hydroxychloroquine) are widely used for the treatment of systemic lupus erythematosus (SLE). However, these drugs may have side effects such as hearing loss. This study aimed to describe the hearing function in SLE patients using antimalarials. Secondarily, this study aimed to investigate whether SLE causes hearing loss and if there are any serological or clinical aspects of this diseases associated with inner ear damage. Study Design Cross‐sectional study. Methods This study included 84 individuals (43 SLE patients and 41 controls) with audiometry and tympanometry tests. Epidemiological, clinical, serological, and treatment profiles of SLE patients were extracted from the charts. Results SLE patients had more sensorineural hearing loss than controls (23.2% vs. 0; P = .001). Pure‐tone averages in SLE patients using antimalarials and not using antimalarials were similar (8.75 vs. 8.75; P = .63). At 8,000 Hz, antimalarial dug nonusers performed worse than users (10.00 vs. 22.50; P = .03). Tympanometry was normal in all participants. SLE serological and clinical profiles in patients with and without hearing loss were the same (all P = nonsignificant). Conclusions There is a high prevalence of hearing loss in SLE that is not affected by antimalarial drug use. Level of Evidence 3b Laryngoscope, 131:E957–E960, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predicting the Premorbid Shape of a Diseased Mandible

xlomafota13 shared this article with you from Inoreader Predicting the Premorbid Shape of a Diseased Mandible Via The Laryngoscope Objectives/Hypothesis Virtual surgical planning (VSP) for reconstructions of advanced mandibular neoplasms that have distorted the contour of the mandible is challenging, as the premorbid shape of the mandible is unknown. We introduce a novel modeling technique, based on a statistical shape model (SSM), that has learned the shape of a normal mandible from a set of 84 mandibles, such that given a diseased mandible, the model can determine its premorbid shape. Methods Eighty‐four control mandibles were used to generate an SSM. Various mandibular defects were created, and the SSM was applied to predict the shape of the original mandible. The predicted and original shape of the defect were compared for accuracy using volumetric overlap and Hausdorff distance. All mandibular VSP cases in the past 2 years were reviewed to identify those that required virtual preprocessing due to significantly distorted mandibular contours. The SSM was compared to those cases requiring preprocessing and highlighted in one prospective VSP. Results The average volumetric overlap and Hausdorff distance between the defect replacement and the defect are 73.9% ± 13.3% and 4.51 mm ± 2.65 mm, respectively. The SSM is more accurate for smaller defects, and those not including the condyle. Ten out of 40 VSP cases required preprocessing using four different techniques. Qualitatively, the SSM outperformed those preprocessing techniques applied in the retrospective cases. Conclusions The SSM can accurately predict the premorbid shape of a distorted mandible and is superior to current preprocessing techniques. The SSM was successfully applied to a retrospective series and one prospective index case. Level of Evidence 4 Laryngoscope, 131:E781–E786, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing

xlomafota13 shared this article with you from Inoreader Modified Posterior Pedicle Middle Turbinate Flap: An Additional Option for Skull Base Resurfacing Via The Laryngoscope Objectives/Hypothesis Although the Hadad‐Bassagusteguy flap represents the first choice for middle and posterior skull base reconstruction and coverage of exposed bony areas, in some cases it is unavailable. The aim of this study is to describe, as an alternative option in selected cases, a modified posterior pedicle middle turbinate flap (mPPMTF) extended to the lacrimal area. Anatomical features, step‐by‐step harvesting technique, and surgical applications are presented. Study design Anatomic dissection study and case report. Methods Four mPPMTFs were raised in two fresh‐frozen cadaver heads. A study of the vascular supply and measurements of length, width, and area of the flap were performed. The ability of the flap to cover the ventral skull base, particularly the upper clivus area, was tested. A clinical case in which an mPPMTF was used for clivus resurfacing after osteoradionecrosis is reported. Results The vascular supply of the mPPMTF was identified as the middle turbinate branch of the sphenopalatine artery. The flap had a mean length of 6.92 cm, mean maximum width of 1.08 cm, and mean total area of 5.33 cm2. The flap was able to reach the upper clivus, with a clival coverage ratio of 70.66%. In the clinical case, good surgical outcomes were observed, with accelerated re‐epithelization without complications. Conclusions The mPPMTF represents an alternative to the Hadad‐Bassagusteguy flap for posterior cranial fossa and nasopharynx resurfacing. The main drawbacks are its technically demanding and time‐consuming harvesting. Level of Evidence 4 Laryngoscope, 131:E767–E774, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews

xlomafota13 shared this article with you from Inoreader An Evaluation of the Presence of Spin in the Abstracts of Tonsillectomy Systematic Reviews Via The Laryngoscope Objectives/Hypothesis Spin—the practice of adding or omitting information intentionally or unintentionally to make the results of a study more favorable—may influence clinical decision making, especially when present in study abstracts. Here, we quantify and characterize the presence of spin in the abstracts of systematic reviews regarding tonsillectomy. Methods This study is an analysis of systematic review abstracts. Searches were conducted on September 23, 2019 on PubMed and Embase using the advanced search feature to retrieve systematic reviews regarding tonsillectomies. The nine most severe forms of spin were then evaluated. Spin was classified by two investigators in parallel, with each blinded to the classifications of the other. Study characteristics were also recorded in duplicate. Consensus meetings between investigators were held to resolve disagreements. Results In the 85 included systematic reviews, at least one form of spin was present in 44.7% (38/85) of abstracts. Journals with higher impact factors were less likely to contain spin in the abstracts of systematic reviews (point biserial correlation coefficient of −0.30). No statistically significant associations were found between the presence of spin and intervention type (P = .56) or adherence to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (P = .08); however, there was a significant association between spin and funding source (P = .03). Conclusions Spin was common in the abstracts of our sample of tonsillectomy systematic reviews. Researchers, clinicians, and peer reviewers could benefit from learning to recognize spin in medical literature. Further research is needed into the effects of spin on clinical decision making. Level of Evidence NA Laryngoscope, 131:E727–E731, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical Management in Tracheobronchopathia Osteochondroplastica: A Case Study

xlomafota13 shared this article with you from Inoreader Surgical Management in Tracheobronchopathia Osteochondroplastica: A Case Study Via The Laryngoscope Tracheobronchopathia Osteochondroplastica is a benign condition characterized by osseous and cartilaginous submucosal growths of the tracheobronchial tree. This is a case report of an individual that was to undergo elective surgery using general anesthesia with endotracheal tube intubation. However, the anesthesiologist encountered a large osseous mass of the precricoid region and could not be intubated. This case report describes the technique for removal of the obstructing lesion using a Sonopet ultrasonic aspirator. Laryngoscope, 131:E911–E913, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes

xlomafota13 shared this article with you from Inoreader Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes Via The Laryngoscope Objectives/Hypothesis Evaluate the impact and accuracy of clinical laryngeal cancer staging. Study Design Retrospective cohort study. Methods Two hundred sixty‐five consecutive patients with laryngeal squamous cell carcinoma who underwent total laryngectomy from 2001 to 2017 were studied. Clinical versus pathologic tumor (T) and nodal (N) categories were compared. Logistic regression and Cox proportional hazards analyzed the association of stage change with perioperative factors and outcomes. Results Forty‐seven patients (17.7%, accuracy = 0.969 ± 0.010 [standard error]) changed between T1‐2 and T3‐4. Sixty‐four patients (24.1%, accuracy = 0.866 ± 0.020) had inaccurate N category. Salvage patients were less likely to have stage change (downstage: odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.08‐0.50, P < .001; upstage: OR = 0.41, 95% CI: 0.23‐0.74, P = .003), but more likely to have inaccurate nodal category (39.8% vs. 11.7%, P < .001). Patients with stage change tended to have greater odds of positive/close margins (upstage: OR = 1.78, 95% CI: 0.91‐3.5, P = .092) and chemotherapy (downstage: OR = 2.21, 95% CI: 0.80‐6.14, P = .128; upstage: OR = 1.87, 95% CI: 0.85‐4.11, P = .119). Stage change was associated with recurrence (P = .047) with downstaged patients less likely to recur (hazard ratio = 0.26, 95% CI: 0.08‐0.82, P = .021). Stage change was not associated with positron emission tomography scan, subsite, time to surgery, or mortality. Conclusions A third of laryngeal cancer patients were downstaged or upstaged after laryngectomy with 18% and 24% of clinical T and N categories inaccurate, respectively. Stage change was less common for salvage patients and associated with risk of recurrence. Level of Evidence 3 Laryngoscope, 131:559–565, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.