Single‐port transoral robotic surgery hypopharyngectomy

xlomafota13 shared this article with you from Inoreader Single‐port transoral robotic surgery hypopharyngectomy Via Head & Neck Abstract Transoral robotic surgery (TORS) is an established treatment for many subsites of Head and Neck cancer. With the improved flexibility and access of the single-port (SP) robotic system, tumors within the distal upper aerodigestive tract can now be reached and successfully treated with all the published advantages of transoral endoscopic surgery. Here in we offer the first published surgical technique for SP TORS for resectable hypopharyngeal carcinoma. The video presented demonstrates many important aspects utilizing the enhanced robotic system, including adjustments of the semi-flexible endoscope and use of the third transoral surgical instrumentation. As previously reported, TORS hypopharyngectomy should be considered for resectable tumors to improve upon the deleterious effects of open surgical resection or chemoradiation therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Randomized, Placebo-Controlled Study to Evaluate the Effect of Bio-Enhanced Turmeric Formulation on Radiation-Induced Oral Mucositis

xlomafota13 shared this article with you from Inoreader A Randomized, Placebo-Controlled Study to Evaluate the Effect of Bio-Enhanced Turmeric Formulation on Radiation-Induced Oral Mucositis Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Oral mucositis is the most common toxicity of chemoradiotherapy treatment of head and neck cancers. The present study was performed to evaluate the effect of a researched turmeric formulation on oral mucositis in patients receiving chemoradiotherapy for oral cancer. Methods: This randomized double-blinded placebo-controlled trial included 60 patients with oral cancer who had undergone radical surgery. Patients were equally randomized into 3 arms. Bio- enhanced turmeric formulation (BTF) capsules (low dose [1 g/day] or high dose [1.5 g/day]) or placebo was administered daily for 6 weeks with concurrent chemoradiotherapy. Study endpoints included the impact of the treatment on chemoradiotherapy-induced oral mucositis along with dysphagia, oral pain, dermatitis, and weight loss. Results: The incidence of grade 3 toxicity of oral mucositis, oral pain, dysphagia, and dermatitis was significantly lower in patients who received BTF than placebo. Twenty-five and 20% patients in BTF 1 g/day (p = 0.011) and 1.5 g/day (p = 0.004) arms, respectively, developed grade 3 oral mucositis compared to 65% patients in the placebo arm. Thirty-five and 30% patients in BTF 1 g/day (p = 0.027) and 1.5 g/day (p = 0.011) arms, respectively, developed grade 3 oral pain compared to 70% patients in the placebo arm. Twenty-five and 20% patients in BTF 1 g/day (p = 0.025) and 1.5 g/day (p = 0.010) arms, r espectively, developed grade 3 dysphagia compared to 60% patients in the placebo arm. Ten and 5% patients in BTF 1 g/day (p = 0.114) and 1.5 g/day (p = 0.037) arms. respectively, developed grade 3 dermatitis compared to 30% patients in the placebo arm. Patients under BTF supplementation experienced significantly less weight loss and greater compliance with treatment than placebo. Conclusion: BTF (BCM-95®) can significantly reduce chemoradiotherapy-induced severe oral mucositis, dysphagia, oral pain, and dermatitis in oral cancer patients. Trial Registration: Clinical Trials Registry, India (Registration No. CTRI) (CTRI/2015/12/006413 dated December 4, 2015). ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

CD133+/CD44+ prostate cancer stem cells exhibit embryo-like behavior patterns

xlomafota13 shared this article with you from Inoreader CD133+/CD44+ prostate cancer stem cells exhibit embryo-like behavior patterns Via histochem Acta Histochem. 2021 Jun 19;123(5):151743. doi: 10.1016/j.acthis.2021.151743. Online ahead of print. ABSTRACT Cancer stem cells (CSCs), which act as an important bridge between cancer formation and embryonic development, represent a small population associated with tumor initiation, drug resistance, metastasis and recurrence. CSCs have the ability to form spheroids in three-dimensional culture systems. Tumor spheroids derived from CSCs with symmetric and asymmetric division patterns were found to contain highly heterogeneous cell groups. The biological behavior patterns which some CSCs display serve as an important bridge between cancer formation and embryonic development. The cell population in the DU-145 prostate cancer cell line with surface markers CD133+/CD44+ was isolated by FACS. Prostate spheroids were formed by using agarose-coated plates. The morphological characteristics of the cell population within spheroid structure and the expression of Ki-67 and Caspase-3 were investigated by histochemical methods. In this study, we observed that CD133+/CD44+ prostate CSCs form different spheroid structures as well as normal spheroid structures: i) some spheroid structures formed with a highly transparent zone on the outer part of the spheroid, in addition to the normal spheroidal zones and ii) spheroidal structures obtained from prostate CD1334+/CD44+ CSCs that share the same microenvironment are hollow spheres similar to the blastula-like structure in the embryo. These spheroidal structures exhibiting embryo-like properties indicate that the expression of embryonic factors might be reiterated in CSCs. Further investigation of the formation mechanism of the transparent zone and the hollow sphere will shed light on the embryonic origin of prostate cancer and the design of new therapeutic strategies. PMID:34157581 | DOI:10.1016/j.acthis.2021.151743 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effect of Chronic Kidney Disease on Taste Function: A Case Control Study among Nigerian

xlomafota13 shared this article with you from Inoreader Effect of Chronic Kidney Disease on Taste Function: A Case Control Study among Nigerian Via Otolaryngology Indian Abstract Taste dysfunction has been associated with chronic kidney disease (CKD) especially end stage kidney disease (ESKD) and also implicated as one of the predisposing factors for the prevalent malnutrition, muscle wasting and impaired quality of life among patients with CKD. To assess the taste function and determine the pattern of taste dysfunction in patients with CKD attending the University College Hospital, Ibadan. This was a cross sectional, hospital-based case–control study of adult patients with CKD. The control group were age and sex matched without CKD. Interviewer-assisted questionnaires were administered on all participants to obtain clinical information concerning demographics, clinical data on kidney disease and taste dysfunction. The four basic taste modalities namely; sweet, sour, bitter and salt taste senses of the participants were tested with validated "taste strips". There were 100 patients with CKD and 100 healthy controls, age ranges betwee n 19 and 86 years (mean ± SD = 46.3 ± 13.9 years) and 20 and 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution (p = 0.57). Hypogeusia was found in 27.0% of CKD patients with specific taste modalities dysfunction for salt, sour, sweet and bitter taste of 13.0, 24.0, 13.0 and 17.0%, respectively. The controls only had specific taste modalities dysfunction for salt, sour and bitter taste of 1.0% for each of the taste modalities. The mean total taste scores in the cases and controls were − 9.8 ± 3.2 and 13.4 ± 1.5 (p = 0.001), respectively. The mean taste scores were significantly lower among the cases than controls, salt taste-2.82 ± 1.1 and 3.7 ± 0.7 (p = 0.001), sour taste − 2.2 ± 1.0 and 3.2 ± 0.7 (p = 0.001), sweet taste-, 2.9 ± 1.8 an d 3.8 ± 0.5 (p = 0.001), bitter taste − 1.9 ± 1.2 and 2.8 ± 0.9 (p = 0.001). Taste dysfunction is prevalent among patients with CKD and the affectation involves all taste modalities. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The assessment of fukuda stepping test results in prognosis of benign paroxysmal postural vertigo

xlomafota13 shared this article with you from Inoreader The assessment of fukuda stepping test results in prognosis of benign paroxysmal postural vertigo Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Jun 1:S1808-8694(21)00090-2. doi: 10.1016/j.bjorl.2021.05.005. Online ahead of print. ABSTRACT INTRODUCTION: Benign paroxysmal postural vertigo originating from the peripheral vestibular system is characterized by brief vertigo spells triggered by the sudden head motion. Usually, vestibular dysfunction in benign paroxysmal postural vertigo is unilateral. Fukuda stepping test which is helpful in the diagnosis of unilateral vestibular dysfunction, may also be valuable in the prediction of prognosis of benign paroxysmal postural vertigo. OBJECTIVE: The purpose of this study is to evaluate the relevance of Fukuda stepping test results with resistant and/or recurrent benign paroxysmal postural vertigo cases. METHODS: We evaluated 62 patients with unilateral, idiopathic benign paroxysmal postural vertigo of posterior and/or lateral canals. The Fukuda stepping test was performed prior to the Dix-Hallp ike and head-roll tests. Two groups were created according to the Fukuda stepping test results. In Group 1 Fukuda stepping test results were positive with a deviation angle >45°, while in Group 2 the results were negative with no apparent deviation. Two groups were compared by the number of canalith repositioning manuevers performed and the frequency of recurrences. RESULTS: We found Fukuda stepping test to be invaluable in the diagnosis of benign paroxysmal postural vertigo since the ratio of Fukuda stepping test positivity and negativity were similar in benign paroxysmal postural vertigo patients. However, the need for multiple canalith repositioning manuevers was significantly higher in Group 1 (p = 0.0103). In addition, the recurrence frequency was found significantly lower in the Group 2 (p = 0.0441). CONCLUSION: Although the sensitivity of Fukuda stepping test in detecting mild/moderate unilateral vestibular dysfunction is poor, it may be valuable in prediction of the prognosis of benign paroxysmal postural vertigo. We suggest that positive Fukuda stepping test results in benign paroxysmal postural vertigo patients indicate poor prognosis, the need for multipl canalith repositioning manuevers and the higher possibility of recurrences. PMID:34158254 | DOI:10.1016/j.bjorl.2021.05.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Botulinum toxin type a intralesional monotherapy for treating human hypertrophic scar in a dose-dependent manner: In an animal model

xlomafota13 shared this article with you from Inoreader Botulinum toxin type a intralesional monotherapy for treating human hypertrophic scar in a dose-dependent manner: In an animal model Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 24:S1748-6815(21)00153-4. doi: 10.1016/j.bjps.2021.03.062. Online ahead of print. ABSTRACT BACKGROUND: The effect of Botulinum toxin type A (BTX-A) in treating or preventing a hypertrophic scar (HS) had been reported in clinical studies. However, the dose-effect relationship remains unclear. OBJECTIVE: To study the dose-effect relationship of BTX-A intralesional monotherapy treating human HS. METHODS: Six HS tissues were collected from six patients. Each tissue was segmented into 24 specimens and split into four groups: negative control (group A), 0.5U BTX-A (group B), 1U BTX-A (group C), and 2U BTX-A (group D). Six nude mice, each was prepared by implanting four specimens (one from each group) into the back for a total of 24 specimens. The process mentioned above were repeated six times. A re-entry operation was performed to obtain the specimens after 8 weeks. The weight of HS, the e xpression of decorin and TGF-β1, the proliferation, and migration ability of hypertrophic scar fibroblasts (HSFBs) were compared among groups. RESULTS: The weight of HS, the expression of decorin and TGF-β1, the proliferation, and migration ability of HSFBs showed significant differences in groups C and D as compared to group A; there has been no statistical significance in group B. CONCLUSION: BTX-A showed significant therapeutic efficacy when compared with the negative control group in a dose-dependent manner. BTX-A can reduce the weight of HS, upregulate the expression of decorin, downregulate the expression of TGF-β1, and inhibit HSFBs proliferation and migration ability. This study indicates that BTX-A intralesional monotherapy treating HS should reach a threshold dose to achieve an effective treatment, and a high dose of BTX-A is more effective than a low dose. PMID:34158272 | DOI:10.1016/j.bjps.2021.03.062 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of mandibular defects involving the central segment with fibula osteoseptocutaneous free flap following ameloblastoma resection: Patient-reported outcomes

xlomafota13 shared this article with you from Inoreader Reconstruction of mandibular defects involving the central segment with fibula osteoseptocutaneous free flap following ameloblastoma resection: Patient-reported outcomes Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Apr 18:S1748-6815(21)00194-7. doi: 10.1016/j.bjps.2021.03.090. Online ahead of print. ABSTRACT OBJECTIVES: Mandibular defects involving the central segment are challenging. This study analyzes the impact of defect extent and reconstruction method on quality of life (QOL) and obstructive sleep apnea (OSA). MATERIALS AND METHODS: Twenty-nine ameloblastoma patients received segmental mandibulectomy involving the C-segment and immediate fibula free flap reconstruction were recruited. Defects: (C: 2, LC: 11, LCL: 19). Mean defect length: 8.79 cm (± 2.34). Inset: Low-single-barrel (n: 19), with secondary distraction osteogenesis (n: 8/19), high-single-barrel (n: 7), double barrel (n: 3). Patients were surveyed using University of Washington Quality of Life (UW-QOL) and Berlin risk of postoperative sleep apnea questionnaires. RESULTS: Flap failure: None. Mean follow-up: 109.6 ± 92.8 months. UW-QOL: Physical function 91.83 (± 14.92); social function 90.17 (± 17.19). No statistical difference between C, LC, and LCL was found, but C group which received low-single-barrel had the lowest score in appearance and chewing domains. In health-related QOL (HR-QOL) compared with 1 month before cancer, 69% reported best results. "Appearance" was the most important issue for the past 7 days, followed by "Chewing," prevailing in LC and C groups that predominately reconstructed by low-single-barrel. Berlin score: 7 patients (4 LCL, 3 LC≥8 cm) were at high risk for postoperative OSA. CONCLUSION: "Like-with-like" reconstruction with immediate endosteal dental implants yields the best results. Inset of fibula bone could affect outcomes, favoring double-barrel or single-high-barrel inset. Appearance and chewing remain the main concerns, largely, in those with low-single-barrel inset and no dental restoration. After long/extensive LCL and LC mandibulectomies, postoperative OS A warrants further investigation, and modification of resection/reconstruction techniques. PMID:34158274 | DOI:10.1016/j.bjps.2021.03.090 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence, Patterns and Variations of Anterior Loop of Inferior Alveolar Nerve—A CBCT Based Retrospective Study

xlomafota13 shared this article with you from Inoreader Prevalence, Patterns and Variations of Anterior Loop of Inferior Alveolar Nerve—A CBCT Based Retrospective Study Via Otolaryngology Indian Abstract The fragment of inferior alveolar nerve (IAN) existing anterior to the mental foramen (MF), before dividing the canal, is known as the "Anterior Loop of the IAN". The presence of anterior loop (AL) is important when placing the implant in inter foraminal area of the mandible or during any other surgical procedure. It is imperative to precisely determine the position and dimensions of these anatomical variations on a cone-beam CT (CBCT) scan. To estimate the prevalence and pattern of anterior loop of IAN and establish any corelation between dimension of the MF with length and angulation of the AL of the IAN. Total 178 CBCT samples were collected fulfilling the inclusion criteria from a private diagnostic centre in Bhubaneswar, Odisha. The greatest diameter of the mental foramen was measured along with anterior loop length and angulation in the panoramic section of the CBCT scan. The angulation formed and the length was corelated with the greatest diameter o f the mental foramen and analysed. Our study reveals that the AL was more frequently seen among males, predominantly on the left side of the mandible. The relationship between length of the anterior loop and diameter of the mental foramen demonstrated a mild negative corelation. There was no possible corelation present between angle formed by anterior loop with inferior alveolar canal and diameter of mental foramen. A small positive corelation was established between length of anterior loop and angle formed by the anterior loop with inferior alveolar canal. CBCT scans should be recommended for pre-surgical evaluation of anatomical variations in the mandibular region. Also, a safe margin of 3–4 mm anterior to mental foramen should be maintained while working in the premolar area. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Dysphagia Severity and Outcomes Following Iatrogenic High Vagal Nerve Injury

xlomafota13 shared this article with you from Inoreader Dysphagia Severity and Outcomes Following Iatrogenic High Vagal Nerve Injury Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jun 22:34894211026991. doi: 10.1177/00034894211026991. Online ahead of print. ABSTRACT OBJECTIVE: To examine severity of dysphagia and outcomes following iatrogenic high vagal nerve injury. METHODS: Retrospective chart review of all patients with iatrogenic high vagal nerve injury that were seen at a tertiary referral center from 2012 to 2020. RESULTS: Of 1304 patients who met criteria for initial screening, 18 met all inclusion cri teria. All 18 required intervention to address postoperative dysphagia. Eleven required enteral feeding tubes with 7 eventually able to advance to exclusively per oral diets. Fourteen underwent vocal fold injection and 6 underwent laryngeal framework surgery. Sixteen pursued swallowing therapy with speech language pathology. Patients lost a mean of 8.6 kg of weight in the 6 months following the injury. Swallowing function on the Functional Outcome Swallowing Scale (FOSS) and Functional Oral Intake Scale (FOIS) was 4.4 and 2.4 respectively immediately following the injury and improved to 1.9 and 5.3 at the last follow-up. No patients had complete return of normal swallowing function at last follow up. CONCLUSION: Iatrogenic high vagal injury causes significant lasting dysphagia which improves with intervention but does not completely resolve. Interventions such as vocal fold injection, medialization laryngoplasty, cricopharyngeal myotomy, or swallowing therapy may be required t o reestablish safe swallowing in these patients. PMID:34157900 | DOI:10.1177/00034894211026991 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Medical School Geography and Ranking Influence Residency Match in Otolaryngology?

xlomafota13 shared this article with you from Inoreader Does Medical School Geography and Ranking Influence Residency Match in Otolaryngology? Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Jun 22:34894211026482. doi: 10.1177/00034894211026482. Online ahead of print. ABSTRACT OBJECTIVE: To elucidate the associations between geographic locations, rankings, and size/funding of medical schools and residency programs among the current otolaryngology residents. METHODS: This retrospective cross-sectional study queried otolaryngology residency program websites for relevant publicly accessible information. Location was categorized as Midwest, Northeast, South, and West. Ranking was according to Doximity (residency) and US News and World Report (medical school). Medical school and residency programs were labeled large if they had >704 students or >15 residents, respectively. RESULTS: A total of 1413 residents from 98 (89%) otolaryngology residency programs were included. Residents attending their home medical schools (18%) were equally distributed among regions (P = .845). Residents who attended medical schools in the same US regions (54%) were more likely from top-25 (P = .001) or private (P < .001) medical schools. Southern residents were most likely (64%) and Western residents were least likely (39%) from regional medical schools (P < .001), while residents from Midwest and Northeast had similar rates (54%-55%). The percentage of Midwest residents coming from regional medical schools has decreased from the 2013 to 2014 residency cycle (P = .037). Completi ng undergraduate school, medical school, and residency in the same region (38%) was also highest in the South (45%) and lowest in the West (25%) (P < .001). Residents at top-ranked residency programs were more likely from top-ranked (P < .001), large (P = .025), and private (P = .018) medical schools. CONCLUSION: There exist significant associations between otolaryngology residents' medical school location, ranking, size, and funding source and their residency destination. More than half of the current otolaryngology residents attended medical school in the same geographic region, and about one-fifth have attended medical school and residency at the same institution. Future studies are warranted to evaluate how these results change as the match process evolves in the future. LEVEL OF EVIDENCE: N/A. PMID:34157902 | DOI:10.1177/00034894211026482 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

What is the Evidence for Clinical Use of Advanced Technology in Unicompartmental Knee Arthroplasty?

xlomafota13 shared this article with you from Inoreader What is the Evidence for Clinical Use of Advanced Technology in Unicompartmental Knee Arthroplasty? Via The International Journal of Medical Robotics and Computer Assisted Surgery Background With an aim of improving prosthesis survivorship of unicompartmental knee arthroplasty (UKA), use of computer-assisted technologies (CATs) such as robotics, has been on the rise to reduce intraoperative errors in surgical technique. In light of recent influx of CATs in the UKA, a review of these innovations will help providers to understand their clinical utility. Method A systematic literature search was performed following PRISMA guidelines. Results Among 19 studies comparing robotic UKA (rUKA) with conventional UKA, only 32% were randomized control trials, 47% reported minimum mean follow-up of 2 years, and 21% evaluated prosthesis survival. Similar results were obtained for navigation-assisted UKA and UKA performed with patient-specific instrumentation. Conclusion While CATs seem to reduce the surgical errors in UKA, the evidence on the efficacy of any of the studied CATs to improve survivorship remains limited and there are issues related to cost-effectiveness, learning curve, and increase in operating time. 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.