Πέμπτη 18 Φεβρουαρίου 2021

Thoracic and lumbar spine pedicle morphology

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Thoracic and lumbar spine pedicle morphology in Japanese patients.

Surg Radiol Anat. 2021 Feb 16;:

Authors: Morita K, Ohashi H, Kawamura D, Tani S, Karagiozov K, Murayama Y

Abstract
PURPOSE: Pedicle morphology is important for intraoperative surgical anatomy and to define pedicle screw design and parameters. However, differences of pedicle size according to ethnicity and gender are not well studied. The purpose of this study is to investigate morphological characteristics of the pedicle in Japanese patients for determining adequate screw size and optimal surgical planning.
METHODS: We investigated thoracic and lumbar pedicle morphology in Japanese patients using computed tomography (CT) measurements and analyzed the standard size of pedicles on upper thoracic to lumbar spine CT images in 227 Japanese patients.
RESULTS: Gender had a larger impact on the shape and size of pedicles than racial differences. In the distribution of pedicle width, we calculated the ratio of values less than 4.5 mm, that in females resulted to be over 30% for the Th3-Th9 segment, and particularly high, above 60% at Th4 and Th5.
CONCLUSION: Our measurement analysis showed that pedicle morphological parameters in Japanese patients showed tendency to be smaller to those found in other studies, and particularly in female patients, they were statistically significantly smaller. Adequate transpedicular instrumentation for Japanese patients will require smaller size pedicle-related devices that will match our anatomical findings to achieve safe device placement. In addition, serving ethnically non-homogenous patient population can require further to spinal morphometric for precise device selection.

PMID: 33591391 [PubMed - as supplied by publisher]

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Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report

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Publication date: Available online 16 February 2021

Source: American Journal of Otolaryngology

Author(s): Alexander N. Goel, Andrey Filimonov, Julie Teruya-Feldstein, Christian Salib, Joseph J. Rousso, Alyssa M. Hackett, Michael A. Rothschild, George B. Wanna

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Management of pedicle ossification following free flap reconstruction: A case report

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Publication date: Available online 17 February 2021

Source: American Journal of Otolaryngology

Author(s): Abigail Katz, Sunder Gidumal, Erica Mayland, Eric Genden

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Horizontal nystagmus is gravity-dependent in patients with vestibular neuritis

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Publication date: Available online 17 February 2021

Source: American Journal of Otolaryngology

Author(s): Hui Wang, Zhuangzhuang Li, Sulin Zhang, Jingchun He, Dongzhen Yu

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Dynamic facial reanimation using active implantable prosthesis: Restoring blink.

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Dynamic facial reanimation using active implantable prosthesis: Restoring blink.

J Plast Reconstr Aesthet Surg. 2021 Jan 27;:

Authors: Hasmat S, Cleary J, Suaning GJ, Lovell NH, Low TH, Clark JR

PMID: 33593711 [PubMed - as supplied by publisher]

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Is the ability of the Eating Assessment Tool (EAT-10) to screen for aspiration in patients with dysphagia depending on the patients' disease?

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Is the ability of the Eating Assessment Tool (EAT-10) to screen for aspiration in patients with dysphagia depending on the patients' disease?

Eur Arch Otorhinolaryngol. 2021 Feb 16;:

Authors: Printza A, Triaridis S

PMID: 33594469 [PubMed - as supplied by publisher]

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Three-dimensional exoscope-assisted laser stapedotomy: a preliminary experience.

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Three-dimensional exoscope-assisted laser stapedotomy: a preliminary experience.

Eur Arch Otorhinolaryngol. 2021 Feb 17;:

Authors: Milanesi U, Pasquariello B, Saibene AM, Felisati G, Atac M, Corbetta D

Abstract
PURPOSE: Stapes surgery, despite the introduction of lasers and endoscopes, still represents a challenging procedure. Recently introduced 3-dimensional exoscopes have known advantages in otological surgery. This study aims to evaluate exoscopes role in stapes surgery, both from a surgical perspective and on the educational profile.
METHODS: Seven consecutive otosclerosis patients underwent single-sided endaural laser stapedotomy with a 4K 3-dimensional exoscope. The surgical setting allowed all operating room personnel 3-dimensional vision. Pre- and postoperative pure tone audiometry and air-bone gaps, and information on the postoperative course and complications were systematically collected. An informal ergonomic evaluation was carried out by the operating room personnel and an informal didactic evaluation was provided by the trainees. A comparable group of microscope-assisted stapedotomy patients undergoing the same procedures and evaluations was chosen as a control group.
RESULTS: Outcomes were solid in all patients, median air-bone gap decreased from 26.5 to 10 dB at the 3-month evaluation (p = 0.01, Wilcoxon's test). No vertigo, tinnitus, or facial palsy was reported. The median operating time was 40 min. The compact design and configuration of the exoscope allowed more practical management of the operating theater. All personnel had the chance for a better understanding of the procedure and trainees felt more confident when asked to identify surgical landmarks and procedure steps. Audiological outcomes, operative times, and complication rates were not different between study and control groups.
CONCLUSION: Though further validation and systematic comparison with microscope- and endoscope-assisted stapedotomy are required, the exoscope proved a safe, practical, and educational tool.

PMID: 33594470 [PubMed - as supplied by publisher]

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Prevalence of olfactory and taste dysfunction in COVID-19 patients: a community care facility study.

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Prevalence of olfactory and taste dysfunction in COVID-19 patients: a community care facility study.

Eur Arch Otorhinolaryngol. 2021 Feb 17;:

Authors: Soh SHL, See A, Teo NWY, Tan HK, Palaniappan G, Lim MLA, Kadir HBA, Toh ST

Abstract
PURPOSE: We aim to study the prevalence of olfactory and taste dysfunction (OTD) in subjects residing in a Community Care Facility (CCF), a center unique to Singapore that is dedicated to isolate foreign workers with COVID-19 infection who have mild disease with minimal or no symptoms.
METHODS: This is a cross-sectional study analyzing data prospectively collected from COVID-19-positive subjects who were admitted into a single-center Singapore EXPO CCF from 1st May 2020 to 1st July 2020. The following variables were collected: age, gender, ethnicity, anosmia, ageusia and acute respiratory infection (ARI) symptoms. Symptoms of anosmia and ageusia were self-declared via a mandatory questionnaire administered on admission.
RESULTS: A total of 1983 subjects were included. The overall prevalence of anosmia and ageusia is 3.0% and 2.6%, respectively. 58% of anosmic subjects have co-existent ageusia and 72.6% of anosmic subjects have no concurrent sinonasal symptoms. OTD is less likely to present in subjects who are asymptomatic for ARI, compared to those symptomatic for ARI (anosmia: 2.0% versus 4.4% p = 0.002; ageusia: 1.6% versus 4.2% p < 0.001). There is a difference in the prevalence of OTD between the different ethnic groups (Indian, Chinese, Bangladeshi and Others), with Chinese and Bangladeshi reporting a higher prevalence (p < 0.043) CONCLUSION: The true prevalence of OTD in COVID-19-positive subjects may be low with aggressive screening of all subjects, including those asymptomatic for ARI.

PMID: 33595697 [PubMed - as supplied by publisher]

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Cochleo-facial corridor to the vestibule and fundus of the internal auditory canal through oval window: a minimal invasive and cochlea sparing approach.

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Cochleo-facial corridor to the vestibule and fundus of the internal auditory canal through oval window: a minimal invasive and cochlea sparing approach.

Eur Arch Otorhinolaryngol. 2021 Feb 17;:

Authors: Talas DÜ, Beger O, Vayisoğlu Y, Hamzaoğlu V, Özalp H, Çakır S, Dağtekin A, Bağdatoğlu C

Abstract
PURPOSE: This cadaveric work aimed to test the effectiveness of a modified surgical corridor (ExpTSA: expanded transcanal supracochlear approach) developed for anatomic cochlear preservation in selected vestibular schwannoma patients necessitating to perform cochlear implantation for appropriate cases to achieve the best outcome.
METHODS: The ears of 10 cadavers (at mean age 75.70 ± 13.75 years, range 45-92 years) were dissected from the external auditory canal (EAC) to the internal auditory canal by ExpTSA under the guidance of a microscope and endoscope. All stages of the surgical process were recorded step by step and evaluated morphometrically.
RESULTS: The vestibular base was successfully reached in all ears without damaging the cochlear morphology and facial nerve. The vestibular base was 23.33 ± 2.02 mm away from the entrance (external orifice) and 10.26 ± 1.33 mm from the exit (internal orifice) of EAC. The oval window and vestibular base were measured to be 2.94 ± 1.05 mm and 5.87 ± 1.24 mm deep from the facial nerve, respectively. The normal areas of the oval window, the exit and entrance of EAC were found as 2.90 ± 0.81 mm2, 42.52 ± 13.66 mm2, and 110.73 ± 25.32 mm2, respectively. After ExpTSA procedure, the areas of the oval window (11.04 ± 2.83 mm2), the exit (122.45 ± 20.41 mm2) and entrance (167.49 ± 30.94 mm2) of EAC were expanded approximately 280%, 188%, and 50%, respectively.
CONCLUSION: The ExpTSA may be performed for accessing to the vestibule and fundus of IAC for tumor removal of intravestibular schwannoma patients (with or without fundus involvement) with unserviceable hearing, preserving the cochlear morphology.

PMID: 33595698 [PubMed - as supplied by publisher]

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Endoscopic video-assisted transoral (EVAT) surgery of the oropharynx: clinical, oncological and functional outcomes.

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Endoscopic video-assisted transoral (EVAT) surgery of the oropharynx: clinical, oncological and functional outcomes.

Eur Arch Otorhinolaryngol. 2021 Feb 17;:

Authors: Jackson R, Ross E, Jose J

Abstract
PURPOSE: Transoral surgery for suspected or proven oropharyngeal malignancies has increased significantly with the practice of transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). An accepted alternative technique is endoscopic video-assisted transoral (EVAT) surgery. Our aim is to review the clinical, oncological and functional outcomes of this technique at our institution.
METHODS: 56 consecutive patients undergoing EVAT surgery as part of their cancer work up or treatment were reviewed, focusing on clinical, oncological, and functional outcomes.
RESULTS: Patients had primary oropharyngeal cancer or carcinoma of unknown primary (CUP) staged between T0-T3 and N0-N3. EVAT surgery identified a primary in 47.1% of CUP with p16 positive disease. Major haemorrhage occurred in 1.8%, with eight post-operative complications. 8.9% of patients developed locoregional recurrence. Mean MD Anderson Dysphagia Inventory score was 76.4 following EVAT surgery, 68.8 after EVAT surgery + radiotherapy and 67.1 after EVAT surgery + chemoradiotherapy CONCLUSION: Early clinical, oncological and functional outcomes following EVAT surgery are comparable to TLM and TORS.
LEVEL OF EVIDENCE: 4 (case series).

PMID: 33595699 [PubMed - as supplied by publisher]

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The palato-oropharyngeal musculo-aponeurotic system (POMAS): this must be the place-an integrated new vision of the palatal and oropharyngeal surgical anatomy.

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The palato-oropharyngeal musculo-aponeurotic system (POMAS): this must be the place-an integrated new vision of the palatal and oropharyngeal surgical anatomy.

Eur Arch Otorhinolaryngol. 2021 Feb 17;:

Authors: Mantovani M, Rinaldi V, Moffa A, Casale M, Pignataro L

PMID: 33595700 [PubMed - as supplied by publisher]

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[Perioperative medical prophylaxis of venous thromboembolic events in head and neck surgery : A retrospective study and recommendations].

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Via hno

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[Perioperative medical prophylaxis of venous thromboembolic events in head and neck surgery : A retrospective study and recommendations].

HNO. 2021 Feb 16;:

Authors: Höing B, Hussain T, Kanaan O, Stuck BA, Mattheis S, Lang S, Hansen S

Abstract
BACKGROUND: In the authors' department, a newly implemented clinical algorithm for application of perioperative thrombosis prophylaxis in head and neck surgery recommends restrictive handling of anticoagulants. This retrospective study aims to evaluate the algorithm by comparing incidences of venous thromboembolic events (VTE) and surgical revisions due to postoperative hemorrhage.
MATERIALS AND METHODS: Perioperative incidences of deep vein thrombosis and pulmonary embolism as well as surgical revisions due to postoperative hemorrhage after head and neck surgery were determined based on all patients operated in the department over a period of 36 months. The incidences before (group I) and after (group II) implementation of the restrictive algorithm were compared.
RESULTS: A total of 9276 patients were included. The incidences of VTE (0.12%) and surgical revisions due to postoperative hemorrhage (1.4%) were low. Incidences of VTE were non-significantly higher in group II (0.16%) than in group I (0.08%; p > 0.45, chi-square-test). Case analysis revealed that this difference was not due to implementation of the restrictive algorithm. The incidence of surgical revision due to postoperative hemorrhage was identical in the two groups (1.4%).
CONCLUSION: After restricting the indication for thrombosis prophylaxis, the incidence of VTE or surgical revision due to postoperative hemorrhage did not change significantly. The provided clinical algorithm represents a low-risk and low-cost strategy of perioperative risk stratification.

PMID: 33594495 [PubMed - as supplied by publisher]

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