Κυριακή 11 Ιουλίου 2021

Three-dimensional morphologic classifications and analysis of canal isthmuses in permanent molars

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Surg Radiol Anat. 2021 Jul 10. doi: 10.1007/s00276-021-02796-5. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the three-dimensional morphology of isthmuses in molars according to their boundary characteristics using micro-computed tomography (micro-CT).

METHODS: Micro-CT reconstructed images of 248 molars were evaluated. Isthmuses were classified into four types based on the boundary characteristics: isthmus with roof, isthmus with floor, band-shaped isthmus, and isthmus without boundary. The tooth and root with isthmuses, the number and location of the isthmuses in the root, and the canal configurations were recorded. The maximum of the major diameter of all canal cross-sections in one isthmus (dmax), the minor diameter of the canal in same cross-section (dmin), the distance between the dmax cross-section and apex (Dm-a), isthmus length (Li), and distance from the isthmus ending cross-section to apex (De-a) were measured and analysed with a significance threshold set to 5%.

RESULTS: Isthmuses were present in 75.4% specimens. The four types of isthmuses were found in various molars and roots. Their distribution in different root locations and canal configurations was significantly different. The dmax, dmin, Li, and De-a were analysed according to different molars and different isthmus types; their respective median values were 2.508 mm, 0.07 mm, 3.09 mm, and 3.96 mm.

CONCLUSION: The three-dimensional classification of isthmuses according to the boundary characteristics provides a comprehensive picture of the isthmus in molars. Their corresponding distributions in different molars, location in roots, and canal configurations will be helpful in predicting the type of isthmus based on the tooth position and canal configurations.

PMID:34245350 | DOI:10.1007/s00276-021-02796-5

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A comprehensive morphometric analysis of crista galli for sex determination with a novel morphological classification on computed tomography images

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Surg Radiol Anat. 2021 Jul 10. doi: 10.1007/s00276-021-02799-2. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to examine the morphometry of the crista galli (CG) on paranasal sinus computed tomography (PNCT) images to develop a new approach of morphological classification with objective radiological criteria and to investigate the relationship of morphometric and morphological characteristics with gender.

METHODS: The height, width, and length of the CG wer e measured on the PNCT images of 533 subjects (266 males, 267 females). Based on the dimensions and the presence of the cavitary component of the CG, the CG was classified into three morphological types. The success of CG dimensions and new morphological classification of CG in the determination of gender was evaluated with ROC and Paired Logistic Regression analyses.

RESULTS: The morphometric cutoff values of the height, width, and length of the CG for the estimation of gender were determined as 15.15, 3.45, and 13.25 mm, respectively. CG length (accuracy 83.7%) showed more successful classification rate on gender determination as compared to height (accuracy: 81.4%), and width (accuracy 81.2%) of the CG. The presence of ossified type CG accurately identified the male sex at a rate of 88.7%, and teardrop type CG determined female sex at a rate of 82.9%. Tubular type CG identified male sex correctly at the rate of 65.8%.

CONCLUSION: The height, length, and width measurem ents of CG on PNCT images and the new morphological types recommended in this study can be used in the determination of gender with high accuracy rates.

PMID:34245351 | DOI:10.1007/s00276-021-02799-2

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Acoustic Voice Analysis of Normal and Pathological Voices in Indian Population Using Praat Software

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Abstract

Acoustic voice analysis is still a valuable technique which enables voice clinicians to compare voices to differentiate them into normal and abnormal. The present study was undertaken to standardize acoustic voice parameters in normal healthy adult individuals and gender comparison among them and also acoustic voice analysis of pathological voices and it's comparison with normal healthy voices. Voice samples of vowels /a/, /i/ and /u/ of 80 normal healthy adults (males = 40, females = 40) of control group and 40 patients with dysphonic voice of case group collected and acoustic voice parameters were extracted by using Praat software. There were statistically significant higher values of fundamental frequency (F0) in females, while jitter local (%), shimmer local (%) and harmonic to noise ratio (HNR) had no gender differences in normal healthy voices. Pathological voices of case group subjects with laryngeal pathologies had statistically significant high er values of jitter local (%), shimmer local (%) and lower values of HNR as compare to normal healthy voices of control group. Objective voice analysis by using Praat software is convenient, reliable and cost effective method. This study establishes normative acoustic voice parameters in normal healthy adults. There are no gender differences in adult healthy voices except fundamental frequency (F0), which is higher in females. Patients who are with dysphonic voices due to laryngeal pathologies had altered values of acoustic parameters compared to normophonic adults and clinicians can precisely differentiate pathological voices from normophonics.

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Sentinel lymph node biopsy versus elective neck dissection in squamous cell carcinoma of the oral cavity with a clinically N0 neck: A systematic review and meta‐analysis of prospective studies

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Abstract

Sentinel lymph node biopsy (SLNB) is an emerging strategy for managing early-stage oral squamous cell carcinoma (SCC) with a clinically N0 (cN0) neck. However, the role of SLNB in this scenario is debatable. Herein, relevant literature was systematically reviewed, and a meta-analysis was performed to evaluate the potential dividends of SLNB compared to elective neck dissection (END) for these patients. The meta-analysis, including six prospective studies, showed comparable results of the two management strategies in terms of regional recurrence (risk ratio [RR] = 0.99; 95% confidence interval [CI], 0.58–1.70), 5-year disease-free survival (RR = 0.99; 95% CI, 0.87–1.11), and 5-year overall survival (RR = 1.01; 95% CI, 0.90–1.13). Fewer adverse events occurred in the SLNB arm than in the END arm (RR = 0.12; 95% CI, 0.02–0.70). Overall, SLNB results in as favorable an oncologic prognosis for patients with cN0 oral SCC as END, while sign ificantly lessening side effects and unnecessary surgeries.

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Pretherapeutic Predictive Factors for Histological High‐Grade Parotid Gland Carcinoma

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Objective

The histological grade of parotid gland carcinoma (PGC) is an important prognostic factor; however, the diagnosis prior to treatment has been challenging to make. This study aimed to investigate whether the pretreatment clinical findings, including hematological inflammatory, nutritional, and immune markers, could predict the histological grade of PGC.

Study Design

Retrospective study.

Methods

We retrospectively enrolled 111 patients with PGC and evaluated the correlation between histological grade and pretreatment clinical findings such as age, sex, tumor staging, facial nerve paralysis, pain or tenderness, adhesion to the surrounding tissues or tumor immobility, and hematological markers.

Results

Sixty patients (54%) were diagnosed with histological high-grade PGC. Univariate analysis revealed that age, T classification, N classification, TNM stage, facial nerve paralysis, adhesion/immobility, C-reactive protein (CRP), and CRP-to-albumin ratio (CAR) were significant predictors of PGC histological grade. On multivariate analysis, high T classification (T3, 4), high N classification (≥1), and elevated CRP (≥0.22 mg/dL) were independent predictors of high-grade PGC.

Conclusions

Pretreatment T classification, N classification, and CRP are significant predictors of the histological grading of PGC. Our results are useful for treatment planning and obtaining appropriate informed consent from the patients before treatment.

Level of Evidence

4 Laryngoscope, 2021

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Auditory Event Related Potentials in children with autism spectrum disorder

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Int J Pediatr Otorhinolaryngol. 2021 Jun 30;148:110826. doi: 10.1016/j.ijporl.2021.110826. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze auditory cortical processing in high functioning ASD individuals.

METHODS: Thirty individuals were included in the study (15 with Autism Spectrum Disorder and 15 with typical development), and their Auditory Event Related Potentials evaluation, elicited with tone burst and speech stimuli, were analyzed.

RESULTS: There were no significant differences between individuals with high-functioning Autism Spectrum Disorder without intellectual disability and those with typical development in the auditory Event-related Potentials elicited with tone bursts or speech stimuli.

CONCLUSIONS: The results of Auditory Event Related Potentials did not show any change at the cortical level in individuals with Autism Spectrum Disorder.

PMID:34246067 | DOI:10.1016/j.ijporl.2021.110826

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Diagnostic Usefulness of Flexible Fibroscopy Biopsy in Suspected Lesions of the Otolaryngological Area

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Abstract

The efficiency in the management of patients with suspected malignant lesions represents the main objective of the oncology of head and neck. Flexible nasopahyngolaryngoscopy with working channel allows to quickly and safely assess and obtain histological samples of this type of lesion. Our objective is to describe the usefulness of this technique in lesions suggestive of malignancy in terms of efficiency, sensitivity and specificity. A retrospective study was carried out over a period of time from December 2014 to December 2019, including patients biopsied with flexible fibroscopy of lesions of debut suspected of malignancy. Here we assess the location of the lesion, the histological results, the diagnostic time and the epidemiological variables. 104 patients were included in the study. More than half of the lesions, 55.2% (57), were located in the larynx; 57.7% (60) resulted positive for malignancy in the flexible fiberscope biopsy; 19.2% (20) were taken to the operating room to get biopsied under general anesthesia resulting in 7.4% (14) positive for malignancy, which shows a sensitivity of the test of 81%. In our sample, a diagnostic time of 15 days was obtained. Considering our results, the few complications and the revised literature, flexible fiberscope biopsy with working channel is an efficient procedure for the management of oncological patients of head and neck.

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