A comparative study of functional outcomes following surgical treatment of early tongue cancer

xlomafota13 shared this article with you from Inoreader A comparative study of functional outcomes following surgical treatment of early tongue cancer Via Head & Neck Abstract Background Speech and swallowing are important outcomes following resection in early tongue cancers. Aim This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers. Methods Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery. Results SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH. Conclusion Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparative study of functional outcomes following surgical treatment of early tongue cancer

xlomafota13 shared this article with you from Inoreader A comparative study of functional outcomes following surgical treatment of early tongue cancer Via Head & Neck Abstract Background Speech and swallowing are important outcomes following resection in early tongue cancers. Aim This prospective study was performed to compare speech, swallowing, and tongue mobility between secondary intention healing (SH) and primary closure (PC) in glossectomy for early tongue cancers. Methods Forty T1/T2 tongue cancers underwent wide excision followed by either PC or SH. Operative time, tube feeding, complications, speech, and swallowing were assessed in both groups at 1, 6, 12, and 24 weeks after surgery. Results SH showed better tongue mobility, less errors in continuous speech, and articulation as compared to PC at all-time points. Operative time, bleeding, duration of tube feeding, and pain scores were comparable in both groups. There were no major complications except minor secondary hemorrhage in one patient with SH. Conclusion Following early tongue cancer resection, secondary intention healing can result in better speech and tongue mobility with minimum morbidity. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Risk of surgical site infection in hand trauma, and the impact of the SARS-CoV-2 pandemic: A cohort study

xlomafota13 shared this article with you from Inoreader Risk of surgical site infection in hand trauma, and the impact of the SARS-CoV-2 pandemic: A cohort study Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Jul 2:S1748-6815(21)00351-X. doi: 10.1016/j.bjps.2021.06.016. Online ahead of print. ABSTRACT BACKGROUND: Despite the ubiquity of hand trauma, there remains insufficient published data to reliably inform these patients of surgical site infection (SSI) risk. We describe the risk of SSI in a single-centre cohort of patients with hand trauma, with an analysis of the impact of the coronavirus disease-2019 (COVID-19) pandemic. METHODS: Retrospective data collection of consecutive patients who underwent surgery for hand and wrist trauma in a single plastic surgery centre over two, three-month periods. Demographic, injury and operative details, alongside prophylactic antibiotic use, were recorded. Burn injuries and wounds infected at presentation were excluded. Presence of SSI at 30 days (90 days if a surgical implant was used) was assessed. RESULTS: Overall, 556 patients - 'Pre-COVID-19' (n = 3 10) and 'During COVID-19' (n = 246) - were included. Risk of SSI was 3.6% in the aggregated cohort. Female patients were more likely to develop an SSI, even when adjusted for their greater prevalence of bite aetiologies (adj OR 2.5; 95% CI, 1.00-6.37 and p < 0.05). The absolute risk of SSI in the 'Pre-COVID-19' group was 2.3% and 5.3% in the 'During COVID-19' group. The relative risk of developing an SSI in the 'During COVID-19' group was 2.34 (95% CI, 0.95-5.78 and p = 0.06). Baseline characteristics were equivalent between the two groups. CONCLUSION: The risk of SSI in hand trauma is the same as the nationally estimated risk for all surgeries; 3-5%. Changes in presentation and practice associated with the first wave of the COVID-19 pandemic did not appear to alter the risk of SSI in patients undergoing surgery for hand trauma. PMID:34303636 | DOI:10.1016/j.bjps.2021.06.016 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Associations among Audiometric, Doppler Hydroacoustic, and Subjective Outcomes of Venous Pulsatile Tinnitus

xlomafota13 shared this article with you from Inoreader Associations among Audiometric, Doppler Hydroacoustic, and Subjective Outcomes of Venous Pulsatile Tinnitus Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Objective: Venous pulsatile tinnitus (PT) has received increasing attention recently. As analyses of psychophysical and neuropsychological dimensions of venous PT are lacking, this study aimed to quantitatively and qualitatively investigate the correlation among audiometric, hydroacoustic, and subjective outcomes in patients with PT. Methods: Fifty-five venous PT patients, with or without sigmoid sinus wall anomalies (SSWAs), were subdivided into SSWAs (n = 30) and non-SSWAs (n = 25) groups. Audiometric and hemodynamic evaluations were assessed. Questionnaires including the Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale (HADS), and Athens Insomnia Scale (AIS) were deployed to evaluate the psychological impacts of PT. Results: Among 55 subjects, PT frequency-related pure-tone audiometry (PTA) was significantly different between ipsilesional non-PT frequency-related PTA (p #x3c; 0.01), ipsilateral jugular vein compression PTA (p #x3c; 0.01), and contralesional ear PTA (p #x3c; 0.01). In contrast with the pulsatility index and flow velocity, bilateral EOET and flow volume were significantly different (p #x3c; 0.01). Of the 3 questionnaire types, there was a strong correlation between HADS anxiety and AIS scores (r = 0.658, p #x3c; 0.01). The duration of PT was not correlated with subjective outcomes, and there was no statistical significance foun d among audiometric, hemodynamic, and subjective outcomes between SSWAs and non-SSWAs groups. Conclusions: (1) The duration of PT was irrelevant to the increase of PTA. (2) Venous PT is the perception of vascular flow sound, in which hydroacoustic characteristics can be highly independent. (3) Anxiety, depression, and sleep disorders commonly prevail among PT patients. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique

xlomafota13 shared this article with you from Inoreader Intraoral Hirudotherapy for Venous Congestion following Free Flap Head and Neck Reconstruction: Novel Intraoral Technique Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Intraoral hirudotherapy is traditionally used for venous congestion following head and neck free flap reconstruction. Many institutions and healthcare teams have been reluctant to use intraoral leech therapy due to risks such as migration into the airway, increased infection from intraoral manipulation, and patient discomfort. Several protocols recommend blocking the path to the oropharynx via gauze or leaving a tracheotomy in place to protect the airway. This report pre­sents a novel technique f or intraoral hirudotherapy that is safe and simple for treatment of free flap venous congestion. The base of a clear cup or a plastic lid is utilized, and the leech is attached onto the inside of the lid with 2 sutures near each end. Several cups with leeches attached are made at a time to reduce delay and difficulty of application by less experienced clinical staff. The leech is then applied onto the compromised flap and then simply removed once it has unlatched from the flap. This method allows the leech to be applied with ease by multiple members of the healthcare team, decreases the need for intraoral manipulation, and reduces the risk of migration into the aerodigestive tract. Future prospective studies are warranted to assess the efficacy of this technique. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Ninety‐day mortality after radiotherapy for head and neck cancer: A population‐based comparison between rural and urban patients

xlomafota13 shared this article with you from Inoreader Ninety‐day mortality after radiotherapy for head and neck cancer: A population‐based comparison between rural and urban patients Via Head & Neck Abstract Background This study assesses whether 90-day mortality differs between patients living in rural and urban areas, as lower access to supportive care services in rural areas could result in higher mortality. Methods All patients with head and neck cancer (HNC) treated between 1998 and 2014 with radiotherapy in British Columbia were included. Patients were divided into rurality areas according to the Modified Statistics Canada (mSC) definition, which classifies a population <30 000 as rural and ≥30 000 as urban. Results Five thousand five hundred and fifty-four patients were included in this study, of which 68% lived in urban centers. The 90-day mortality for rural versus urban patients were 3.0% and 3.9% (p = 0.09), respectively. Univariate and multivariate analyses showed no association with 90-day mortality and rurality. Conclusion After controlling for potentially confounding factors, we did not find a significant association between 90-day mortality and rurality in patients who were treated with radiotherapy for HNC in British Columbia. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival impact of angiotensin‐converting enzyme inhibitors and angiotensin II receptor antagonists in head and neck cancer

xlomafota13 shared this article with you from Inoreader Survival impact of angiotensin‐converting enzyme inhibitors and angiotensin II receptor antagonists in head and neck cancer Via Head & Neck Abstract Background Preclinical evidence suggests a link between the renin-angiotensin system and oncogenesis. We aimed to explore the impact of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in head and neck cancer (HNC). Methods Over 5000 patients were identified from the Surveillance, Epidemiology, and End Results-Medicare linked dataset and categorized according to ACEi and ARB and diagnoses of chronic kidney disease (CKD) or hypertension (HTN). Overall survival (OS) and cancer-specific survival (CSS) were compared using Cox multivariable regression (MVA), expressed as hazard ratios (HR) with 95% confidence intervals (95%CI). Results No significant MVA associations for OS or CSS were found for ACEi. Compared to patients with CKD/HTN taking ARB, those with CKD/HTN not taking ARB experienced worse OS (HR 1.28, 95%CI 1.09–1.51, p = 0.003) and CSS (HR 1.23, 95%CI 1.00–1.50, p = 0.050). Conclusions ARB usage is associated with improved OS and CSS among HNC patients with CKD or HTN. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.