Κυριακή 13 Ιουνίου 2021

Clival Mucocele: A Rare Yet not Forgotten Pathology

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Ear Nose Throat J. 2021 Jun 10:1455613211021176. doi: 10.1177/01455613211021176. Online ahead of print.

ABSTRACT

Primary clival mucoceles are a rare clinical entity that usually represents an incidental finding on computed tomography or magnetic resonance imaging scanning. There are only a few reports in the literature of patients who presented with vague symptoms such as headaches, facial paresthesia, and numbness. Clival mucoceles can also be secondary, by extension of a s phenoid mucocele to the clivus. We present a case of primary clival mucocele, aiming to highlight the importance of a multidisciplinary approach.

PMID:34112008 | DOI:10.1177/01455613211021176

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Trace Elements Levels in Serum of Patients with Recurrent Respiratory Papillomatosis

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Abstract

Recurrent respiratory papillomatosis (RRP) is a chronic airway disease characterized by unpredictable recurrences and relapses. Our study aimed to identify the role of trace elements, a proven risk factor for various malignancies, in the development of papilloma and to correlate their serum levels with various disease parameters. 32 RRP patients with 20 age-matched controls were recruited in the study. Analysis of serum trace elements was performed by atomic absorption spectrophotometry in whole blood samples from cases and controls. The serum levels of trace elements were correlated with age of onset, history of previous surgeries, tracheostomy status, Derkay's score, and presence of dysplasia. Among the 32 cases there were 18 males and 14 females with a mean age of 20.85 years (range: 3–60 years). The mean serum levels of Thallium, Zinc, and Gallium were higher among cases compared to their controls whereas the levels of Arsenic, Copper, Cobalt, Selenium, Cadmium, and Lead were higher in control subjects compared to RRP patients. There was a statistically significant correlation of serum level of Cobalt with more than 3 surgeries per year (p = 0.02), Gallium and Thallium with Derkay's score of more than 20 (p = 0.04 and 0.05) and Lead, Arsenic and Gallium with presence tissue dysplasia (p = 0.05, 0.04 and 0.04). Our study had shown a variable association of trace elements in RRP patients. The usefulness of these values need to be completely elucidated and our study calls for future investigations to identify the casual association of various trace elements in the pathogenesis of RRP.

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Is There Any Racial Difference in Term of Anatomical Variations of Nasal and Paranasal Sinus Structures

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Abstract

The aim of our study was to determine the anatomical variations detected on computed tomography radiological imaging of the paranasal sinus between citizens and refugees patient groups and to reveal the differences between the two patient groups. In this study, the data from the files of 38 Turkish Citizens (Group 1), 41 Syrian Refugees (Group 2), a total of 79 patients who were admitted to the ENT Clinic of Adana City Training and Research Hospital due to rhinological complaints between 01.01.2019 and 01.01.2020 and had paranasal sinus tomography, were analyzed retrospectively. Due to the Syrian Civil War that started in 2011, more than 10 million Syrian have left their countries and immigrated to neighboring countries as refugees. The paranasal sinus area has a wide variety of variations. Congenital anomalies and normal anatomical variations in this area are important, although rarely, as they may have pathological consequ ences or may be a source of difficulty during surgery. In the study, 38 of 79 patients were in Group 1 (48.1%) and 41 were in Group 2 (51.9%). Of the patients, 30 were female (38%) and 49 were male (62%). The ages of the patients ranged from 9 to 78 years, with a mean age of 32.52 years. In our study, we could not find a statistically significant difference between Turkish Citizens and Syrian refugees in terms of anatomical variations detected on paranasal radiological imaging. We consider the number of patients in our study as a limitation of our study and we think that it is important to conduct studies with larger populations

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‘Is It Brain Talking to the Ear’: Neuro-otological Evaluation of Tinnitus Using Auditory Brainstem Response Audiometry

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Abstract

Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. The neural abnormalities underlying tinnitus are largely unknown. We evaluated the functional characteristics and the auditory system synchronization using Auditory Brainstem Response (ABR) in normal hearing tinnitus patients. In this observational comparative cross-sectional study, patients with chief complaints of Tinnitus and equal number of age and sex matched controls without hearing loss and tinnitus were enrolled. All patients underwent a full ENT assessment, pure tone audiometry and Brainstem evoked response audiometry (BERA) tests. The study population consisted of 100 patients with tinnitus, 55 controls without tinnitus and 45 controls with tinnitus. Statistical analysis showed significant relation (p < 0.05) between hearing loss and tinnitus between cases and controls with tinnitus, between abs olute latency of wave III amongst cases and controls without tinnitus, Interpeak Latency between wave III and V amongst cases and controls with tinnitus and interpeak latency of wave I and wave III amongst controls without and with tinnitus. Brainstem evoked response audiometry results that we obtained from the patients of tinnitus and controls with and without tinnitus are different from one person to another. This suggests impaired neural firing synchronization and transmission in the central auditory pathway in tinnitus patients. These findings also indicate that the pathology underlying tinnitus is not the same in every individual, with possible brainstem involvement in some cases.

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Neck Dissection in Salvage Surgery for Larynx Cancer: National Cancer Database Review

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Ann Otol Rhinol Laryngol. 2021 Jun 10:34894211024062. doi: 10.1177/00034894211024062. Online ahead of print.

ABSTRACT

OBJECTIVE: Salvage laryngeal surgery is the preferred treatment after failure of non-surgical treatment of larynx cancer. This study aims to identify the impact of ND in salvage surgery on survival and factors predictive of nodal metastasis.

METHODS: The National Cancer Database was used to identify patients who received salvage laryngeal surgery. Demog raphics, disease characteristics, and survival were compared between the subgroups of patients stratified according to performance of ND and presence of nodal metastasis.

RESULTS: Sixty-two percent of patients underwent ND. A total of 26% of patients undergoing ND had nodal metastasis. Younger age and lesser time since radiation were associated with nodal metastasis. While undergoing ND did not significantly affect survival, those with nodal metastasis had poorer survival (P = .001).

CONCLUSIONS: Although ND did not show a survival benefit, younger patients and those who have had a shorter time elapsed between the start of radiation and salvage surgery may benefit from the prognostic data provided by ND. Nonetheless, the risks and benefits of elective ND in salvage larynx cancer treatment should be evaluated on an individual case basis as the data do not support a broadly applicable recommendation.

PMID:34111981 | DOI:10.1177/00034894211024062

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Gorham Stout disease of the temporal bone with cerebrospinal fluid leak

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Childs Nerv Syst. 2021 Jun 11. doi: 10.1007/s00381-021-05245-1. Online ahead of print.

ABSTRACT

Gorham Stout disease (GSD) is a rare disease characterized by the proliferation of endothelial lined vessels and replacement of bone by fibrous tissue. The main imaging features are progressive osteolysis and cortical resorption. Temporal bone involvement is rare but presents as a destructive bone lesion that may be misinterpreted as more common lytic processes in the pediatric population, such as infection or Langerhans cell histiocytosis. GSD of the temporal bone is associated with cerebrospinal fluid (CSF) leaks, may present with otorrhea, and can mimic other causes of ear drainage. Here, we report the clinical course, imaging features, and outcomes of a 3-year-old girl with GSD of the temporal bone presenting with CSF leak initially attributed to infection.

PMID:34115176 | DOI:10.1007/s00381-021-05245-1

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Actinomycosis of the nasal cavity

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Braz J Otorhinolaryngol. 2021 May 25:S1808-8694(21)00088-4. doi: 10.1016/j.bjorl.2021.05.003. Online ahead of print.

ABSTRACT

INTRODUCTION: Actinomycosis of the nasal cavity is very rare.

OBJECTIVE: The purpose of this study was to investigate the clinical features, treatment methods, and treatment results of actinomycosis of the nasal cavity in our hospital.

METHODS: We retrospectively enrolled 11 patients with histopathologically identified actinomycosis of the nasal cavity from January 2010 to May 2020.

RESULTS: This study included five males and six females. The most common symptom was purulent nasal discharge (36.4%). Nasal actinomycosis occurred in the maxillary sinus in 5 (45.5%) patients, the ethmoid sinus in two, the hard palate in two, the frontal sinus in one, and the nasal septum in one. After surgery, intravenous administration of antibiotics was performed on average for 7.4 days and oral antibiotics were prescribed for about 120.5 days. The clinical characteristics of the patients with nasal actinomycosis and the duration of antibiotic usage were not significantly different. Trauma was significantly associated with repeated nasal actinomycosis infections (p < 0.05).

CONCLUSION: Actinomycosis of the nasal cavity should be suspected when a patient with chronic sinusitis does not respond to medical therapy and has a history of dental treatment, local surgery or radiation therapy. Nasal can be sufficiently treated with antibiotics and endoscopic surgery.

PMID:34112606 | DOI:10.1016/ j.bjorl.2021.05.003

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Effectiveness of a Blended-Learning Intervention in Teachers’ Vocal Health

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To verify the effectiveness of a blended-learning voice assistance program for elementary school teachers.
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Francis Kiernan (1800-1874) and his unique contribution to liver anatomy

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Surg Radiol Anat. 2021 Jun 11. doi: 10.1007/s00276-021-02779-6. Online ahead of print.

NO ABSTRACT

PMID:34115178 | DOI:10.1007/s00276-021-02779-6

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Epidermal growth factor as a potential prognostic and predictive biomarker of response to platinum-based chemotherapy

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by Margot Geens, Sofie Stappers, Heleen Konings, Benedicte Y. De Winter, Pol Specenier, Jan P. Van Meerbeeck, Gert A. Verpooten, Steven Abrams, Annelies Janssens, Marc Peeters, Paul Van de Heyning, Olivier M. Vanderveken, Kristien J. Ledeganck

In this study, we investigated serum epidermal growth factor (EGF) in an oncological population of head- and neck and pulmonary neoplasms and whether serum EGF could serve as a prognostic marker of survival and as a predictive marker for treatment response to platinum-based chemotherapy. A total of 59 oncological patients and a control group of age- and sex-matched healthy volunteers were included in this study. Pre-treatment serum EGF from both groups was determined. Patient's and tumour characteristics and mortality were recorded during a 5-year follow up period. Baseline serum EGF significantly differed between the oncological patients and the healthy volunteers (p
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REM-related obstructive sleep apnea and vertigo: A retrospective case-control study

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Via Tinnitus

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by Po-Yueh Chen, Tzu-Ying Chen, Pin-Zhir Chao, Wen-Te Liu, Chyi-Huey Bai, Sheng-Teng Tsao, Yi-Chih Lin

Background

In recent population-based case-control studies, sleep apnea was significantly associated with a higher incidence (hazard ratio, 1.71) of vertigo and the risk of tinnitus was found to increase 1.36 times in patients with sleep apnea. The possibility that obstructive sleep apnea (OSA) might affect neurotological consequences was not noticed, until studies using polysomnography (PSG) for these patients.

Objectives

The purpose of this study was to investigate the relationship between vertigo and OSA.

Methods

The collected data among patients from May 1st, 2018 to October 31th, 2018 at Shuang Ho Hospital. Eligibility criteria included an age older than 20 years, a diagnosis of obstructive sleep apnea. The diagnosis of OSA was defined as an oxygen desaturation index of at least 5, was established with the use of polysomnographic examination at hospital. Patients were excluded from the study if they had head injury, brain tumour, headache history and hearing los s. Patients who had vertigo were labeled as Vertigo group. In the other hand, patients who had no dizziness were labeled as control group. 58 patients were in the Vertigo group, and 113 were in the control group.

Results

After PSG examination, 58 patients who had vertigo, were diagnosed OSA (29 males, average age = 57.07 years old, BMI = 26.64, RDI = 24.69, ESS = 8.65), and 24 patients of them (41.3%) were REM-related OSA. Meanwhile, in the control group, 113 patients had OSA (92male, average age = 49.66 years old, BMI = 26.06, RDI = 35.19, ESS = 11.43), and 18 patients of them (15.9%) were REM-related OSA (Table 1). Therefore, patient who had vertigo, would have higher proportion of REM OSA (P Conclusions

The vertigo patients have a higher rate of REM-related OSA, and the acceptance rate to CPAP use is low. Further research is needed to explore novel therapeutic approaches, or combination of currently available non-CPAP therapies, in patients with REM OSA.

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Clinical Validation of the Champagne Algorithm for Evoked Response Source Localization in Magnetoencephalography

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Brain Topogr. 2021 Jun 11. doi: 10.1007/s10548-021-00850-4. Online ahead of print.

ABSTRACT

Magnetoencephalography (MEG) is a robust method for non-invasive functional brain mapping of sensory cortices due to its exceptional spatial and temporal resolution. The clinical standard for MEG source localization of functional landmarks from sensory evoked responses is the equivalent current dipole (ECD) localization algorithm, known to be sensitive to initialization, noise, and manual choice of the number of dipoles. Recently many automated and robust algorithms have been developed, including the Champagne algorithm, an empirical Bayesian algorithm, with powerful abilities for MEG source reconstruction and time course estimation (Wipf et al. 2010; Owen et al. 2012). Here, we evaluate automated Champagne performance in a clinical population of tumor patients where there was minimal failure in localizing sensory evoked responses using the clinical st andard, ECD localization algorithm. MEG data of auditory evoked potentials and somatosensory evoked potentials from 21 brain tumor patients were analyzed using Champagne, and these results were compared with equivalent current dipole (ECD) fit. Across both somatosensory and auditory evoked field localization, we found there was a strong agreement between Champagne and ECD localizations in all cases. Given resolution of 8mm voxel size, peak source localizations from Champagne were below 10mm of ECD peak source localization. The Champagne algorithm provides a robust and automated alternative to manual ECD fits for clinical localization of sensory evoked potentials and can contribute to improved clinical MEG data processing workflows.

PMID:34114168 | DOI:10.1007/s10548-021-00850-4

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