The 'Parachute' technique for the endoscopic repair of high-flow anterior skull-base CSF leaks

xlomafota13 shared this article with you from Inoreader The "Parachute" technique for the endoscopic repair of high-flow anterior skull-base CSF leaks Via leak of cerebrospinal fluid World Neurosurg. 2021 May 8:S1878-8750(21)00689-6. doi: 10.1016/j.wneu.2021.05.006. Online ahead of print. ABSTRACT OBJECTIVE: This study aims to assess the feasibility and reliability of our endoscopic trans-nasal technique for the repair of cribriform and sellar high-flow CSF leaks. METHODS: A comparison between patients suffering from high-flow rhinorrhea and treated through a free grafting endoscopic technique or the "parachute" technique, our nasal packing proposal, was performed. RESULTS: Thirty-three patients were included. The mean age was 52 years (range 36-68). The etiology of the CSF leaks was iatrogenic in 16 cases (48,5%), traumatic in 5 cases (15,2%), spontaneous in 11 cases (33,3%) and related to anterior skull base tumors in one case (3%). The bone defect affected the sphenoidal sinus in 20 cases (60,6%), the cribriform plate of the ethmoid in 10 cases (30,3%), and both the sphenoid and ethmoid in 3 cases (9,1%). T he mean size of bone defects was 8,5 ± 3,9 mm. The median follow-up was 28 (64) months. A CSF leak recurrence occurred in no cases treated with the "parachute" technique and in three cases that underwent conventional endoscopic treatments. The CSF leak recurrences were associated with two iatrogenic and one post-traumatic fistula. All the CSF leak recurrences underwent the parachute technique, not showing second recurrences. CONCLUSION: Our results suggest that the "parachute" technique is simple, safe and effective. We recommend it as an alternative treatment to vascular flaps for the treatment of high-flow and recurrent fistulas. PMID:33974988 | DOI:10.1016/j.wneu.2021.05.006 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Central Retinal Artery Occlusion Due to Subperiosteal Orbital Abscess Caused by Acute Sinusitis in a Child: A Case Report

xlomafota13 shared this article with you from Inoreader Central Retinal Artery Occlusion Due to Subperiosteal Orbital Abscess Caused by Acute Sinusitis in a Child: A Case Report Via ear nose throat Ear Nose Throat J. 2021 May 12:1455613211016731. doi: 10.1177/01455613211016731. Online ahead of print. ABSTRACT Central retinal artery occlusion (CRAO) is an ophthalmic emergency and has poor visual prognosis. It is commonly found in elderly people and very rare in child. We reported an 8-year-old girl who suffered from acute sinusitis, periorbital swelling, and the visual acuity of her right eye was only light perception. She was diagnosed with CRAO, SPOA (subperiosteal or bital abscess), and acute sinusitis. Emergency treatments including surgery, antibiotics, glucocorticoids, intraocular-pressure-lowering drugs, and vasodilators were taken immediately in order to save the eyesight. The visual acuity of the right eye returned to 20/400. Conclusions: Severe intraorbital complications of acute sinusitis can lead to CRAO. Timely drainage, strong antibiotics, and glucocorticoids are the most effective methods for the treatments. PMID:33975449 | DOI:10.1177/01455613211016731 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety of a New Sinus Irrigation Device in Rhinosinusitis: A Pilot Study

xlomafota13 shared this article with you from Inoreader Safety of a New Sinus Irrigation Device in Rhinosinusitis: A Pilot Study Via ear nose throat Ear Nose Throat J. 2021 May 12:1455613211015417. doi: 10.1177/01455613211015417. Online ahead of print. ABSTRACT BACKGROUND: Puncture and lavage of the paranasal sinuses, previously the primary treatment for unresponsive acute bacterial rhinosinusitis before surgery, has been abandoned due to procedural discomfort and advancements in antibiotic efficacy and endoscopic surgery. The rise in antibiotic-resistant bacteria has renewed the interest in minimally invasive sinus lava ge to both avoid aggressive surgical interventions and identify appropriate antibiotic therapy. In this article, we describe the safety and feasibility of a new device in human patients and evaluate its efficacy as a treatment before the traditional sinus surgery in acute rhinosinusitis. METHODS: The device with its seeker-shaped guiding tube and rotating wire can enter the sinus cavity through the natural ostium, pulverize the inspissated mucus, and enable lavage and culture sampling without the need for sinus puncturing. It was tested in 6 patients with chronic sinusitis under general anesthesia during endoscopic sinus surgery and in additional 10 patients with maxillary acute bacterial rhinosinusitis in outpatient settings under local anesthesia. RESULTS: The device enabled rapid, efficient, and atraumatic insertion of the wire into the occluded sinuses. The rotating wire permitted pulverization of the thick mucus, which enabled irrigation without mucosal damage or ad verse events. Overall, 9 of 10 patients with acute bacterial rhinosinusitis demonstrated remarkable improvements and were discharged the following day with no acute symptoms. The visual analog scale score for pain dropped from 8.9 to 0.4. The remaining one patient underwent endoscopic sinus surgery subsequently. None of the patients treated during endoscopic sinus surgery developed any adverse events. PMID:33975441 | DOI:10.1177/01455613211015417 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nasal Septum Hemangioma in a 9-Year-Old Boy

xlomafota13 shared this article with you from Inoreader Nasal Septum Hemangioma in a 9-Year-Old Boy Via ear nose throat Ear Nose Throat J. 2021 May 12:1455613211018128. doi: 10.1177/01455613211018128. Online ahead of print. ABSTRACT Hemangiomas of the head and neck account for about 7% of all benign tumors in children. Τhey are rare in the nasal cavity and especially in the nasal septum. Only 16 cases of intranasal hemangiomas in childhood have been previously described in the literature and 6 of them arising from the nasal septum. We present a rare case of a nasal septum hemangioma (NSH) in a 9-year-old boy who was treated with transnasal endoscopic resection. PMID:33975443 | DOI:10.1177/01455613211018128 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Is preoperative axillary radio-cytology justified after ACOSOG Z001?

xlomafota13 shared this article with you from Inoreader Is preoperative axillary radio-cytology justified after ACOSOG Z001? Via Association française pour l'étude du cancer Bull Cancer. 2021 May 8:S0007-4551(21)00159-4. doi: 10.1016/j.bulcan.2021.02.010. Online ahead of print. ABSTRACT INTRODUCTION: Invasive breast cancer without clinical adenopathy (cN0) is currently explored by the sentinel node (GS) technique, except in the case of positive preoperative radio-cytological screening, where axillary curage (CA) remains systematic from the outset. Since the publication of the ACOSOG-Z0011 trial, abstention from CA is possible in patients presenting less than three metastatic GS. As a result, the value of axillary radio-cytological screening is being questioned as it could potentially lead to axillary surgical over-treatment. The objective of this study was to study clinically N0 patients with positive axillary cytology and to compare it to a group of patients with positive GS. METHOD: One hundred and forty-seven patients with cN0 pN+ breast cancer treated between 2014 and 2016 were selected retrospec tively. Two groups were constituted according to the initial radio-cytological evaluation. A CA was systematically performed. RESULTS: Thirty-one patients with positive axillary cytology (n=31 vs. n=116) had more metastatic lymph nodes (P=0.01) in the AC, larger (P<0.001), less differentiated (P<0.001) tumours, and shorter recurrence-free survival (P=0.0114). It also appeared that 38.7 % of patients with a positive cytology had at most two metastatic nodes and could, according to the results of ACOSOG, benefit from therapeutic de-escalation. CONCLUSION: X-ray cytological screening remains essential in order to select a subgroup of patients with a high lymph node tumour load. Additional studies are necessary in order to be able to offer therapeutic de-escalation to 1/3 of these patients without the risk of under-treatment for the remaining 2/3. PMID:33975722 | DOI:10.1016/j.bulcan.2021.02.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The CQC's recommendations on psychological assessment for cosmetic surgery patients: Will they improve the patient's journey? A review of current practice in the UK based on a survey of 71 plastic surgeons

xlomafota13 shared this article with you from Inoreader The CQC's recommendations on psychological assessment for cosmetic surgery patients: Will they improve the patient's journey? A review of current practice in the UK based on a survey of 71 plastic surgeons Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00200-X. doi: 10.1016/j.bjps.2021.03.097. Online ahead of print. NO ABSTRACT PMID:33975821 | DOI:10.1016/j.bjps.2021.03.097 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stabilization of Recurrent Respiratory Papillomatosis with Pembrolizumab Therapy: A Case Report

xlomafota13 shared this article with you from Inoreader Stabilization of Recurrent Respiratory Papillomatosis with Pembrolizumab Therapy: A Case Report Via Journal of Voice Recurrent respiratory papillomatosis (RRP) is a benign neoplastic disease of the respiratory tract that is caused by human papilloma virus (HPV). The current standard of care is surgical excision with adjuvant treatment as needed. Multiple adjuvant treatments have been used with some success, but long-term control of disease remains difficult. We report on a case of a patient with a long history of RRP who had stabilized true vocal fold disease while on pembrolizumab for concurrent early stage lung squamous cell carcinoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of Sidetone Amplification on Vocal Function During Telecommunication

xlomafota13 shared this article with you from Inoreader Message: Sidetone is a feature that allows you to hear your own voice in the headset as you speak into the microphone. If your ears are covered, you will be prone to speaking louder than necessary; hearing your own voice in the speaker mitigates this. Effects of Sidetone Amplification on Vocal Function During Telecommunication Via Journal of Voice Society has become increasingly dependent on telecommunication, which has been shown to negatively impact vocal function. This study explores the use of sidetone regulation during audio-visual communication as one potential technique to alleviate the effects of telecommunication on the voice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Functional Endoscopic Sinus Surgery on Gustatory Function in Patients With Chronic Rhinosinusitis

xlomafota13 shared this article with you from Inoreader Effect of Functional Endoscopic Sinus Surgery on Gustatory Function in Patients With Chronic Rhinosinusitis Via ear nose throat Ear Nose Throat J. 2021 May 12:1455613211015754. doi: 10.1177/01455613211015754. Online ahead of print. ABSTRACT OBJECTIVES: In this study, we investigated the effect of functional endoscopic sinus surgery (FESS) on gustatory function in patients with chronic rhinosinusitis (CRS). METHODS: Forty-three patients with CRS who underwent FESS were included in this study. Prior to FESS and 3 months after surgery, the severity of rhinosinusitis was assessed using the Taiwanes e version of the 22-item SNOT (SNOT-22), endoscopic examination, and acoustic rhinometry. The olfactory function was evaluated using the phenylethyl alcohol odor detection threshold test and the traditional Chinese version of the University of Pennsylvania Smell Identification Test, and the gustatory function was evaluated using the whole mouth suprathreshold taste test (WMTT) and the taste quad test (TQT). Subgroup analyses were performed based on CRS phenotypes and endotypes. RESULTS: The SNOT-22 significantly improved 3 months after FESS for all patients with CRS. The endoscopic score and olfactory function significantly improved in patients with eosinophilic CRS and in patients with nasal polyps (CRSwNP). The WMTT sweet and bitter scores were significantly lower after FESS in CRSwNP, but the TQT sweet score was significantly higher in patients without nasal polyps. In addition, patients with noneosinophilic CRS had significantly decreased WMTT and salty scores 3 months aft er FESS. CONCLUSION: Our results showed that the effect of FESS on gustatory function of patients with CRS was different with the different testing procedures, the association with nasal polyps, and the underlying inflammatory patterns. PMID:33977765 | DOI:10.1177/01455613211015754 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laryngeal framework surgery

xlomafota13 shared this article with you from Inoreader Laryngeal framework surgery Via hno HNO. 2021 May 12. doi: 10.1007/s00106-021-01054-9. Online ahead of print. ABSTRACT Laryngeal framework surgery is an umbrella term for all phonosurgical procedures by which the cartilaginous structure of the larynx and thereby the position and tension of the vocal folds are changed. The aim is to improve the voice. By far the best known and most frequently performed operation is thyroplasty type 1 according to Isshiki, also known as medialization thyroplasty, which is indica ted for treatment of glottic insufficiency. Although the first medialization thyroplasty was successfully performed by Payr in Germany in 1915, more than 100 years later, it is still not widely used in Germany. PMID:33978776 | DOI:10.1007/s00106-021-01054-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopic Endonasal Resection of Rathke Cleft Cyst with Xanthogranulomatous Change: Two-Dimensional Operative Video

xlomafota13 shared this article with you from Inoreader Endoscopic Endonasal Resection of Rathke Cleft Cyst with Xanthogranulomatous Change: Two-Dimensional Operative Video Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1727128 Objective Sellar xanthogranulomas (XGAs) are a rare pathological subtype of hypophysitis reflecting a degenerative process of Rathke's cleft cyst with predilection in young adults. While the histological features have been described, there is limited discussion on the technical expectations in surgical management. We present the clinical, radiographic, and surgical features of the third literature-reported XGA in the pediatric population. Setting The patient was a 17-year-old boy who first identified by ophthalmologically confirmed peripheral vision loss. Subsequent endocrine workup identified delayed-onset puberty and hypopituitarism. Magnetic resonance imaging (MRI) showed a nonenhancing 2.6-cm T1 and T2 sellar-based hyperintense mass with suprasellar extension and mass effect on the optic chiasm. A small T1 hypointense encased nodule was also seen (Fig. 1). Consent for resection was obtained. Results Intraoperatively the tumor was firm and adherent, requiring piecemeal removal. Radiofrequency ablation enabled ergonomic debulking and minimize thermal injury (Fig. 2).1 We used initial settings of 25 W, equivalent to 55 W. A cystic component with motor oil–like fluid was encountered and decompressed. The tumor was notably very adherent to the optic nerve and infiltrated the stalk, requiring its truncation. Closure was achieved by fat graft dead space plugging, fascia lata underlay, Medpor gasket seal, and nasoseptal flap. Conclusion Pathology confirmed dense fibrous tissue with features of chronic inflammation, cholesterol clefts, hemosiderin pigment, multinucleate giant cells, and foamy macrophages. Additional cyst wall sampling identified squamous and ciliated epithelial lining, collectively consistent with Rathke's cleft cyst and xanthogranulomatous reaction. These lesions can undergo surgical cure with resection, most commonly by transsphenoidal approach.The link to the video can be found at: https://youtu.be/S2n5iQ3aFgc. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  | &nbs p;Abstract  |  open access Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.