Application of the Spider Limb Positioner to Subscapular System Free Flaps

xlomafota13 shared this article with you from Inoreader Application of the Spider Limb Positioner to Subscapular System Free Flaps Via The Laryngoscope Objective To demonstrate the application and surgical time savings of the Spider Limb Positioner for subscapular system free flaps in head and neck reconstructive surgery. Methods Single institution retrospective chart review and analysis of patients between 2011 and 2019 that underwent a subscapular system free flap either with or without use of the Spider Limb Positioner. One hundred five patients in total were reviewed with 53 patients in the Spider group. The surgical times were compared between the two groups. Patient‐specific information regarding average age, laterality of donor site, recipient site, gender, and flap type were reviewed. Results Forty‐one patients in both groups underwent a latissimus free flap. Twelve of 53 in the Spider group and 11/52 in the control group underwent a scapula free flap. The average age in the Spider group at the time of surgery was 64 years. The recipient sites for the Spider groups were reviewed. The free flap was ipsilateral to the defect in 81% of cases. The mean surgical time for the 105 patients without the Spider was 568 minutes versus 486 minutes with a Spider P‐value of .003478. Conclusion Use of the Spider Limb Positioner allows for a simultaneous two‐team approach during free flap elevation of the subscapular system, which eliminates both dependence on an assistant to support the arm and time consuming positioning changes during flap elevation. Level of Evidence 3 Laryngoscope, 131:525–528, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Utility of Transnasal Humidified Rapid Insufflation Ventilatory Exchange for Microlaryngeal Surgery

xlomafota13 shared this article with you from Inoreader Utility of Transnasal Humidified Rapid Insufflation Ventilatory Exchange for Microlaryngeal Surgery Via The Laryngoscope Objective Microlaryngeal surgery typically requires oxygenation and ventilation via either an endotracheal tube (ETT), jet ventilation (JV), or intermittent apnea with an ETT. Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) delivered by high flow nasal cannula has been reported as an alternative technique. This method of apneic oxygenation and ventilation allows for stable, unobstructed visualization of immobile laryngeal structures. We aim to describe the technique and characterize intraoperative parameters related to its safety. Study Design Case Series. Methods The electronic medical record was reviewed for patients who underwent microlaryngoscopy using THRIVE technique. Patient demographics, procedural details, operative parameters, and anesthesia records were reviewed. Descriptive statistics were reported. Results A total of 53 patients underwent microlaryngoscopy using THRIVE as the sole method of ventilation, with 62% female. Median age was 51 years, and median BMI was 25 kg/m2. Most patients were ASA class 2, and most had a Mallampati score of 2. The most common surgical indications were subglottic stenosis, vocal fold lesions, and vocal fold paralysis. Median apnea time was 16 minutes. At the end of case, median end tidal CO2 was 50 mmHg, and median minimum SpO2 was 95. Six cases required supplementation of THRIVE with JV or tracheal intubation for sustained oxygen desaturation. There was an increase in end tidal CO2 of 0.844 mmHg/min of apneic time. Conclusions THRIVE is a safe and effective technique for oxygenation and ventilation in microlaryngeal, non‐laser surgery in appropriately selected patients. To ensure safety, back‐up plans such as jet ventilation and microlaryngeal ETT should be available. Level of Evidence 4 Laryngoscope, 131:587–591, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic Cerebrospinal Venous Insufficiency and Meniere's Disease: Interventional Versus Medical Therapy

xlomafota13 shared this article with you from Inoreader In Reference to Chronic Cerebrospinal Venous Insufficiency and Meniere's Disease: Interventional Versus Medical Therapy Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Fetoscopic Balloon Dilation and Cricotracheal Resection for Laryngeal Atresia in CHAOS

xlomafota13 shared this article with you from Inoreader Fetoscopic Balloon Dilation and Cricotracheal Resection for Laryngeal Atresia in CHAOS Via The Laryngoscope View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of Stage N3 of the Eighth Edition AJCC Staging System for Nasopharyngeal Carcinoma

xlomafota13 shared this article with you from Inoreader Validation of Stage N3 of the Eighth Edition AJCC Staging System for Nasopharyngeal Carcinoma Via The Laryngoscope Objectives To validate stage nodal (N)3 of the 8th edition American Joint Committee on Cancer (AJCC) staging system for nasopharyngeal carcinoma (NPC). Methods This retrospective cohort study extracted NPC patients from the Surveillance, Epidemiology, and End Results database between 2004 and 2016. Pathologically confirmed patients with complete data of level IV, N3a, and N3b lymph node metastasis were investigated. The included patients were divided into level IV, N3a, and N3b groups. Five‐year overall survival (OS) and cancer‐specific survival (CSS) were compared among the three groups. Results A total of 693 patients were included: 285 (41.13%) patients in the level IV group, 124 (17.89%) patients in the N3a group, and 284 (40.98%) patients in the N3b group. The 5‐year OS (57.1%, 55.0%, and 55.2%) and CSS (64.4%, 63.5%, and 64.4%) were not different among the level IV, N3a, and N3b groups. Multivariate regression analysis revealed that N stage was not an independent prognostic factor for OS (hazard ratio [HR] = 1.03, 95% confidence interval [CI]: 0.91–1.17; P = .65) or CSS (HR = 1.03, 95% CI: 0.89–1.19; P = .70). Conclusion Stage N3 of the 8th edition AJCC staging system for NPC is reasonable. Level of Evidence III Laryngoscope, 131:535–540, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eosinophilic Sialodochitis: A Type of Chronic Obstructive Sialadenitis Related to Allergy

xlomafota13 shared this article with you from Inoreader Eosinophilic Sialodochitis: A Type of Chronic Obstructive Sialadenitis Related to Allergy Via The Laryngoscope Objectives To investigate the clinical, laboratory, radiological, histopathological, and immunohistochemical features, and the expression of allergy‐related cytokines in eosinophilic sialodochitis (ES). Methods Thirty‐eight patients diagnosed with chronic obstructive sialadenitis (COS) who had undergone glandular excision or incisional biopsy were enrolled. Seventeen patients with comorbid atopic disease and increased ductal tissue eosinophils comprised the ES group, while 21 patients comprised the COS group. The clinicopathological features and allergy‐related cytokine expression were compared between groups. Results The ES group frequently involved multiple, bilateral major salivary glands, and the number of glands was significantly greater than the COS group (2.8 ± 1.1 vs. 1.2 ± 0.4, P < .001). Serum immunoglobulin (Ig) E was elevated in 91% of patients in ES group (419 ± 357 kU/L) and peripheral blood eosinophil was significantly greater compared with the COS group (7.6% ± 4.6% vs. 2.5% ± 1.4%, P < .001). Histologically, eosinophil infiltration in ES group was observed around the main and interlobular ducts (50 ± 39/high power field [HPF]). Follicular hyperplasia (76%), epithelial mucous metaplasia (82%), and mucus plugs with eosinophils (41%) were observed. IgE‐positive cell count was 20.7 ± 18.3/HPF and tryptase‐positive mast cell count was 23.5 ± 15.1/HPF, which was significantly greater than the respective cell counts in COS group, which mainly infiltrated around the ducts. The levels of interleukin‐4, interleukin‐1 3, and eotaxin in tissue were significantly greater in ES than the COS group. Conclusions The clinicopathological characteristics of ES are significantly different from COS and ES might have an allergy‐related pathogenesis. Level of Evidence 4 Laryngoscope, 131:E800–E806, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Validation of a Parent Proxy Quality‐of‐Life Measure for Young Children With Hearing Loss

xlomafota13 shared this article with you from Inoreader Validation of a Parent Proxy Quality‐of‐Life Measure for Young Children With Hearing Loss Via The Laryngoscope Objectives No hearing‐related quality of life (QL) questionnaire currently exists for children < 7 years. This study aimed to develop and evaluate the construct validity and reliability of a new parent‐proxy Preschool Hearing Environments and Reflection on Quality of Life (HEAR‐QL) questionnaire. Methods Parents of children 2 to 6 years old with any hearing loss (HL) were recruited from multiple sites. To evaluate the new measure's construct validity, participants completed a 70‐item preschool HEAR‐QL and validated questionnaires measuring hearing and communication functioning (Parents' Evaluation of Aural/Oral Performance of Children), generic pediatric QL (Pediatric Quality of Life Inventory Parent Report, PedsQL), family functioning (PedsQL Family Impact Module), and parent well‐being (Patient Reported Outcomes Measurement Information System Adult Global Report). Participants completed the preschool HEAR‐QL 2 weeks later to measure test–retest reliability. Exploratory principal components analysis was used to reduce the number of items and determine the underlying HEAR‐QL factor structure. Analysis of variance examined HEAR‐QL differences by HL. Results Among 205 parents, 144 had children with bilateral HL, 50 had children with unilateral HL, 10 had children with normal hearing (NH), and one child's hearing status was unspecified. The 70‐item questionnaire was reduced to 23 items with five underlying factors: Behavior and Attention, Hearing Environments, New Social Situations, Social Interactions, and Communication. Cronbach's alpha for each factor ranged from 0.80 to 0.91. Test–retest reliability was 0.93. Moderate‐to‐strong correlations (r > .300) were observed between each Preschool HEAR‐QL factor and previously validated measures. Hearing Environments scores differed significantly between children with NH and any HL. Conclusion Preschool HEAR‐QL correlations with other measures supported its construct validity. Discriminant validity testing requires a larger sample of children with NH. Level of Evidence NA Laryngoscope, 131:663–670, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.