Transcervical styloidectomy for Eagle syndrome

xlomafota13 shared this article with you from Inoreader Transcervical styloidectomy for Eagle syndrome Via Head & Neck Abstract We demonstrate a safe and effective surgical technique for the operative management of Eagle syndrome, also known as stylohyoid syndrome, via transcervical styloidectomy. Fifteen patients who presented to our institution for surgical management of Eagle syndrome were included. A detailed video shows the operative techniques used to perform styloidectomy via a transcervical approach. The procedure was well tolerated without complications, and all patients were discharged on postoperative day one. Thirteen patients (87%) endorsed significant improvement or complete resolution of their presenting complaint(s), most commonly throat and neck pain/discomfort (53%), otalgia (47%), and/or tinnitus (40%). The transcervical approach for styloidectomy provides an alternative for operative access that overcomes the limitations associated with the transoral approach. It enables better exposure of the operative field, a more efficient procedure, and, in the senior author's experience, results i n decreased postoperative pain, trismus, and length of hospital stay. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery

xlomafota13 shared this article with you from Inoreader Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery Via The Laryngoscope Objectives Investigate outcomes following oral cavity and oropharyngeal salvage surgery. Methods Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed. Results One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03–0.78) and negative margins (HR = 0.36, 95% CI: 0.14–0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14–6.19) and higher stage (III vs. I–II, HR = 3.94, 95% CI: 1.22–12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09–13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy. Conclusions After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted. Level of Evidence 3 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Case report of unusual insertion of the fibularis brevis muscle

xlomafota13 shared this article with you from Inoreader Case report of unusual insertion of the fibularis brevis muscle Via radiol anat Surg Radiol Anat. 2022 Feb 22. doi: 10.1007/s00276-022-02894-y. Online ahead of print. ABSTRACT The fibularis brevis and fibularis longus muscles belong to the lateral compartment of the leg. The fibularis brevis is morphologically variable, especially in the number of tendons and place of insertion. Its type of insertion is correlated with the presence of a fibularis digiti quinti, which is also anatomically variable. We present a case study based on dissection of a seventy -three-year-old female cadaver with an unusual insertion of the fibularis brevis muscle. The tendon had three bands inserting into the fifth metatarsal bone. There was a coexisting fibularis digiti quinti, which was fused with the fibularis tertius muscle. Awareness of such anatomical variation could be useful during reconstructive surgery and planning rehabilitation protocols. PMID:35192041 | DOI:10.1007/s00276-022-02894-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical outcomes of a cohort of 271 patients with lung metastases from differentiated thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Clinical outcomes of a cohort of 271 patients with lung metastases from differentiated thyroid carcinoma Via radioactive iodine Clin Endocrinol (Oxf). 2022 Feb 22. doi: 10.1111/cen.14700. Online ahead of print. ABSTRACT CONTEXT: Lung is the most common site of distant metastases from differentiated thyroid carcinoma (DTC). OBJECTIVE: To investigate the outcomes of a cohort of patients with DTC and lung metastases (LM). METHODS: A retrospective analysis of a cohort of 271 patients with LM was performed. RESULTS: The female-to-male ratio was 1:1 and the median follow-up time was 5.9 (1.1-38. 4) years. Papillary thyroid carcinoma (PTC) was the most frequent type (83.4%), mainly the classic variant, followed by follicular thyroid carcinoma (FTC, 10.3%) and Hürthle cell carcinoma (HTC, 6.3%). The prevalence of PTC, FTC and HCC was different between the micronodular and macronodular LM groups [87.4%, 6.3% and 6.3 % vs 74.6%, 19.0% and 6.3%, respectively (p=0.013)]. Only 5.0% of the patients had LM diagnosed after a period of remission. LM were submitted to radioactive iodine treatment (RAIT) in 84.5% (52.8% showed 131iodine avid metastases). Complete remission was only achieved in 12.2%. Micronodular disease and age <55 years at LM diagnosis were associated with a better prognosis (p<0.05). We found no difference in survival between patients with LM treated or not with RAIT. However, in patients submitted to RAIT, there was a tendency for longer survival in the group of patients with 131I avid lesions. CONCLUSION: The classic variant of PTC was the most frequen t histology found in LM of DTC. LM are rarely diagnosed in the follow-up when complete remission is achieved after surgery and 131I. Younger age at LM diagnosis and a micronodular pattern are associated with a better prognosis. This article is protected by copyright. All rights reserved. PMID:35192239 | DOI:10.1111/cen.14700 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype

xlomafota13 shared this article with you from Inoreader Introduction and expression of PIK3CAE545K in a papillary thyroid cancer BRAFV600E cell line leads to a dedifferentiated aggressive phenotype Via Journal of Otolaryngology - Head & Neck Surgery Anaplastic thyroid cancer (ATC) is a rare, aggressive form of undifferentiated thyroid cancer, which exhibits rapid progression and is almost universally fatal. At least a subset of ATC is thought to arise fro... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Selumetinib Plus Adjuvant Radioactive Iodine in Patients With High-Risk Differentiated Thyroid Cancer: A Phase III, Randomized, Placebo-Controlled Trial (ASTRA)

xlomafota13 shared this article with you from Inoreader Selumetinib Plus Adjuvant Radioactive Iodine in Patients With High-Risk Differentiated Thyroid Cancer: A Phase III, Randomized, Placebo-Controlled Trial (ASTRA) Via radioactive iodine J Clin Oncol. 2022 Feb 22:JCO2100714. doi: 10.1200/JCO.21.00714. Online ahead of print. ABSTRACT PURPOSE: Selumetinib can increase radioactive iodine (RAI) avidity in RAI-refractory tumors. We investigated whether selumetinib plus adjuvant RAI improves complete remission (CR) rates in patients with differentiated thyroid cancer (DTC) at high risk of primary treatment failure versus RAI alone. METHODS: ASTRA (NCT01843062) is an international, phase III, randomized, placebo-con trolled, double-blind trial. Patients with DTC at high risk of primary treatment failure (primary tumor > 4 cm; gross extrathyroidal extension outside the thyroid gland [T4 disease]; or N1a/N1b disease with ≥ 1 metastatic lymph node(s) ≥ 1 cm or ≥ 5 lymph nodes [any size]) were randomly assigned 2:1 to selumetinib 75 mg orally twice daily or placebo for approximately 5 weeks (no stratification). On treatment days 29-31, recombinant human thyroid-stimulating hormone (0.9 mg)-stimulated RAI (131I; 100 mCi/3.7 GBq) was administered, followed by 5 days of selumetinib/placebo. The primary end point (CR rate 18 months after RAI) was assessed in the intention-to-treat population. RESULTS: Four hundred patients were enrolled (August 27, 2013-March 23, 2016) and 233 randomly assigned (selumetinib, n = 155 [67%]; placebo, n = 78 [33%]). No statistically significant difference in CR rate 18 months after RAI was observed (selumetinib n = 62 [40%]; placebo n = 30 [38%]; odds ratio 1.07 [95% CI, 0.61 to 1.87]; P = .8205). Treatment-related grade ≥ 3 adverse events were reported in 25/154 patients (16%) with selumetinib and none with placebo. The most common adverse event with selumetinib was dermatitis acneiform (n = 11 [7%]). No treatment-related deaths were reported. CONCLUSION: Postoperative pathologic risk stratification identified patients with DTC at high risk of primary treatment failure, although the addition of selumetinib to adjuvant RAI failed to improve the CR rate for these patients. Future strategies should focus on tumor genotype-tailored drug selection and maintaining drug dosing to optimize RAI efficacy. PMID:35192411 | DOI:10.1200/JCO.21.00714 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cochlear Fluid Spaces and Structures of the Gerbil High-Frequency Region Measured Using Optical Coherence Tomography (OCT)

xlomafota13 shared this article with you from Inoreader Cochlear Fluid Spaces and Structures of the Gerbil High-Frequency Region Measured Using Optical Coherence Tomography (OCT) Via Journal of the Association for Research in Otolaryngology Abstract Since it has been difficult to directly observe the morphology of the living cochlea, our ability to infer the mechanical functioning of the living ear has been limited. Nearly all our knowledge about cochlear morphology comes from postmortem tissue that was fixed and processed using procedures that possibly distort the structures and fluid spaces of the organ of Corti. In this study, optical coherence tomography was employed to obtain volumetric images of the high-frequency hook region of the gerbil cochlea, as viewed through the round window, with far better resolution capability than had been possible before. The anatomical structures and fluid spaces of the organ of Corti were segmented and quantified in vivo and over a 90-min postmortem period. We find that the arcuate-zone and pectinate-zone widths change very little postmortem. The volume of the scala tympani between the round-window membrane and basilar membrane and the volume of the inner spiral sulcus d ecrease in the first 60-min postmortem. While textbook drawings of the mammalian organ of Corti and cortilymph prominently depict the tunnel of Corti, the outer tunnel is typically missing. This is likely because textbook drawings are typically made from images obtained by histological methods. Here, we show that the outer tunnel is nearly twice as big as the tunnel of Corti or the space of Nuel. This larger outer tunnel fluid space could have a substantial, little-appreciated effect on cochlear micromechanics. We speculate that the outer tunnel forms a resonant structure that may affect reticular-lamina motion. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.