Surgical Management of Cervical Non‐seminomatous Germ Cell Tumor Metastases

xlomafota13 shared this article with you from Inoreader Surgical Management of Cervical Non‐seminomatous Germ Cell Tumor Metastases Via The Laryngoscope Objective/Hypothesis Testicular cancer is the most common malignancy of young males. Limited reports describe perioperative and long‐term outcomes after surgical resection of metastatic, cervical, non‐seminomatous germ cell tumors (NSGCT). The objective of this study was to investigate the effectiveness and safety of cervical lymphadenectomy in the management of metastatic NSGCT. Study Design Retrospective case series. Methods A single institution, retrospective review from 1998 to 2020 of patients with metastatic NSGCT who underwent cervical lymphadenectomy was conducted. Clinicopathological, surgical, and postoperative data were collected and analyzed. Results Sixty‐eight predominantly white (91.0%) male patients with mean age 33.0 ± 11.3 years were included. Most (82.2%) presented with stage III disease at initial diagnosis. All patients had undergone primary platinum‐based chemotherapy 1.0 to 22.7 months prior to selective ND. Surgery mainly involved nodal levels III (67.6%), IV (92.6%) and/or Vb (77.9%) and was frequently performed with concomitant thoracoabdominal NSGCT resections (63.2%). Cervical specimens predominantly revealed mature teratoma (83.8%) as solitary (69.1%) or component of mixed (14.7%) NSGCT. Ten (14.7%) perioperative complications occurred as vocal cord paresis (n = 6) from thoracic surgery and chyle leakage (n = 4). All resolved conservatively except two vocal cord paralyzes that required surgical repair due to tumor involvement of vagus nerve. Six instances of cervical recurrence occurred at median 12.5 (range, 5.8–38.6) months from ND, all re‐demonstrating purely mature teratoma. The two‐year cervical, non‐cervical, and overall recurrence‐free survivals were 83%, 55%, and 55%, respectively. Two‐year disease‐free and overall survivals were both 93%. Conclusions Selective neck dissection is a safe, effective method for managing cervical NSGCT metastases. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Novel Solution of Using Mixed Reality in Bowel and Oral and Maxillofacial Surgical Telepresence: 3D Mean Value Cloning algorithm

xlomafota13 shared this article with you from Inoreader A Novel Solution of Using Mixed Reality in Bowel and Oral and Maxillofacial Surgical Telepresence: 3D Mean Value Cloning algorithm Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background and aim Most of the Mixed Reality models used in the surgical telepresence are suffering from the discrepancies in the boundary area and spatial‐temporal inconsistency due to the illumination variation in the video frames. The aim behind this work is to propose a new solution that helps produce the composite video by merging the augmented video of the surgery site and virtual hand of the remote expertise surgeon. The purpose of the proposed solution is to decrease the processing time and enhance the accuracy of merged video by decreasing the overlay and visualization error and removing occlusion and artefacts. Methodology The proposed system enhanced mean value cloning algorithm that helps to maintain the spatial‐temporal consistency of the final composite video. The enhanced algorithm includes the 3D mean value coordinates and improvised mean value interpolant in the image cloning process, which helps to reduce the sawtooth, smudging and discoloration artefacts around the blending region. Results The accuracy in terms of overlay error of the proposed solution is improved from 1.01mm to 0.80mm whereas the accuracy in terms of visualization error is improved from 98.8% to 99.4%. The processing time is reduced to 0.173 seconds from 0.211 seconds. The processing time and the accuracy of the proposed solution are enhanced as compared to the state of art solution. Conclusion Our solution helps make the object of interest consistent with the light intensity of the target image by adding the space distance that helps maintain the spatial consistency in the final merged video. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neuroprotectin D1 Attenuates Blast Overpressure Induced Reactive Microglial Cells in the Cochlea

xlomafota13 shared this article with you from Inoreader Neuroprotectin D1 Attenuates Blast Overpressure Induced Reactive Microglial Cells in the Cochlea Via The Laryngoscope Objective/Hypothesis We examined a neuroinflammatory response associated with glial activation in the cochlea exposed to blast overpressure and evaluated the potential therapeutic efficacy of specialized pro‐resolving mediators such as neuroprotectin D1, NPD1; (10R, 17S‐dihydroxy‐4Z, 7Z, 11E, 13E, 15Z, 19Z‐docosahexaenoic acid) in a rodent blast‐induced auditory injury model. Study Design Animal Research. Methods A compressed‐air driven shock tube was used to expose anesthetized adult male Long‐Evan rats to shock waves simulating an open‐field blast exposure. Approximately 30 minutes after blast exposure, rats were treated with NPD1 (100 ng/kg body wt.) or vehicle delivered intravenously via tail vein injection. Rats were then euthanized 48 hours after blast exposure. Unexposed rats were included as controls. Tissue sections containing both middle and inner ear were prepared with hematoxylin–eosin staining to elucidate histopathological changes associated with blast exposure. Cochlear tissues were evaluated for relative expression of ionized calcium‐binding adaptor 1 (Iba1), as an indicator of microglial activation by immunohistochemistry and western blot analyses. Results Our animal model resulted in an acute injury mechanism manifested by damage to the tympanic membrane, hemorrhage, infiltration of inflammatory cells, and increased expression of Iba1 protein. Moreover, therapeutic intervention with NPD1 significantly reduced Iba1 expression in the cochlea, suggesting a reduction of a neuroinflammatory response caused by blast overpressure. Conclusions Blast overpressure resulted in an increased expression of proteins involved in gliosis within the auditory system, which were reduced by NPD1. Treatment of NPD1 suggests an effective strategy to reduce or halt auditory microglial cell activation due to primary blast exposure. Level of Evidence N/A Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Longitudinal Assessment of Frailty and Quality of Life in Patients Undergoing Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Longitudinal Assessment of Frailty and Quality of Life in Patients Undergoing Head and Neck Surgery Via The Laryngoscope Objective To understand changes in frailty and quality of life (QOL) in frail versus non‐frail patients undergoing surgery for head and neck cancer (HNC). Methods Prospective cohort study of patients (median age 67 (50, 88)) with HNC undergoing surgery from December 2011 to April 2014. Fried's Frailty Index, Vulnerable Elders Survey (VES‐13), and comprehensive QOL assessments (EORTC QLQ‐C30 and HN35) were completed at baseline and 3, 6, and 12‐month post‐operative visits. Change in frailty and QOL over time was compared between frailty groups (non‐frail (score 0), pre‐frail (score 1–2), and frail (score 3–5)) using a mixed effects model. Predictors of long‐term elevated frailty (12 months > baseline) were analyzed using logistic regression. Results The study had 108 patients classified as non‐frail (47%), 104 pre‐frail (mean (SD) 1.3 (0.4), 45%), and 17 frail (3.4 (0.6); 7%). Frailty score decreased significantly for frail patients 3 months post‐operatively (2.1 (1.0); P = .002) and remained significantly lower than baseline at 6 and 12 months (2.1 (1.4); P = .0008 and 2.2 (1.5); P = .005, respectively) while frailty score increased for non‐frail patients at 3 months (1.1 (1.0); P < .001) and then decreased. Forty‐eight patients (21%) had long‐term elevated frailty, with baseline frailty and marital status identified as predictors on univariate analysis. The frail population had significantly worse QOL scores at baseline, which persisted 12 months post‐operatively. Conclusions Frail patients demonstrate a decrease in frailty score following surgical treatment of HNC. Frail patients have significantly worse QOL scores on longitudinal assessment and would benefit from supportive services throughout their care. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Disposition Following Pediatric Sistrunk Procedures: A National Database Query

xlomafota13 shared this article with you from Inoreader Postoperative Disposition Following Pediatric Sistrunk Procedures: A National Database Query Via The Laryngoscope Objective/Hypothesis Variability exists in the postoperative disposition of children following Sistrunk procedures. Management options include discharge home versus overnight observation, with the latter allowing monitoring for immediate postoperative complications, presumably reducing the need for subsequent readmission. This study investigates the association between overnight observation and ambulatory management of children undergoing Sistrunk procedures and relevant postoperative complication and revisit rates to clarify best practice for these patients. Methods This was a retrospective database review using the Pediatric Health Information System database from 2007 to 2016. Results The cited dataset identified 6,434 qualifying patients, categorized into ambulatory versus overnight observation cohorts. The overall 30‐day revisit rate was 4.9%; the revisit rate with overnight observation (6.1%) was higher than for ambulatory patients (3.8%, adjusted odds ratio (OR) 1.60; 95% confidence interval (CI): 1.21, 2.12). Revisit rates were significantly higher in patients 2 years of age or younger compared to older patients (6.7% vs. 4.3%). The rates of return to the operating room for the observation versus ambulatory groups were 1.8% and 0.5%, respectively. Cervical fluid collection and neck swelling were among the most common revisit indications in both groups, with a mean time to presentation of 9 days. Conclusions This study demonstrates that ambulatory management following a Sistrunk procedure is not associated with increased rates of common postoperative complications, readmission, or need for secondary surgical intervention. A Sistrunk procedure may be safely performed on an ambulatory basis in select cases. Level of Evidence IV Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Platelet-Rich Plasma for Vocal Fold Scar: A Preliminary Report of Concept

xlomafota13 shared this article with you from Inoreader Platelet-Rich Plasma for Vocal Fold Scar: A Preliminary Report of Concept Via Journal of Voice Vocal fold atrophy and scar can lead to loss of normal superficial lamina propria, negatively affecting the vibratory function of the vocal fold. These changes can lead to dysphonia, vocal fatigue, decreased volume, and altered pitch. Treatment options for these conditions are limited. Platelet-rich plasma (PRP) consists of platelets, growth factors, and cytokines derived from the patient's own blood and is believed to activate tissue regeneration. The purpose of this study was to review the technical aspects of collecting PRP and injecting it into the vocal fold injection – based on our initial experience with this procedure. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epitheliale Speicheldrüsentumoren – monozentrische retrospektive Erhebung für den Süden Sachsen-Anhalts

xlomafota13 shared this article with you from Inoreader Epitheliale Speicheldrüsentumoren – monozentrische retrospektive Erhebung für den Süden Sachsen-Anhalts Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1337-3126 Zielsetzung Es war das Ziel dieser Untersuchung, Daten zu epithelialen Speicheldrüsentumoren im Rahmen einer umfassenden monozentrischen und retrospektiven Analyse zu erheben. Material und Methoden Analysiert wurden Patienten mit einer epithelialen Speicheldrüsenneoplasie, welche zwischen 1993 und 2017 entweder die Klinik für Mund-, Kiefer- und Gesichtschirurgie (MKG) des Universitätsklinikums Halle (UKH) aufsuchten oder/und am Institut für Pathologie (IPA) des UKH diese Diagnose erhielten oder/und deren Diagnose zwischen 2000 und 2017 dem Statistischen Landesamt Sachsen-Anhalt gemeldet wurde. Folgende Parameter wurden erhoben: demografische Daten, Tumorlokalisation, Tumorentität, Klinik, Therapieverfahren und Verlauf. Die Daten wurden in einer Datenbank im Format SPSS 21.5 erfasst und statistisch analysiert. Ergebnisse Im Beobachtungszeitraum wurden unter Verwendung der Datenbanken der MKG sowie des IPA des UKH 382 Patienten mit einer epithelialen Speicheldrüsenneoplasie registriert. Die häufigste Tumorlokalisation entfiel auf die Gl. parotis mit 71 % (n = 271), während 15 % der Tumoren in den kleinen Speicheldrüsen auftraten (n = 57). Der Anteil benigner Speicheldrüsentumoren betrug 80 % (n = 307). Im genannten Zeitraum waren in Sachsen-Anhalt 5586 Patienten mit epithelialen Speicheldrüsentumoren gemeldet worden. Schlussfolgerung Unserer Kenntnis nach ist dies die erste epidemiologische Analyse zur Evaluation von Häufigkeit, Dignität und Therapie von epithelialen Speicheldrüsenneoplasien in Sachsen-Anhalt. Das pleomorphe Adenom mit der Vorzugslokalisation Ohrspeicheldrüse ist in unserer Analyse die häufigste Entität. Unter den malignen Pathologien dominiert das adenoid-zystische Karzinom, welches in der Regel von den kleinen Speicheldrüsen seinen Ausgang nimmt. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.