Falls Among People With Bilateral Vestibulopathy

xlomafota13 shared this article with you from Inoreader Falls Among People With Bilateral Vestibulopathy Via JAMA Otolaryngology–Head & Neck Surgery Online First This review examines the current knowledge and applied methods on fall incidence, causes, and injuries in bilateral vestibulopathy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma

xlomafota13 shared this article with you from Inoreader Postoperative Radiation Therapy in Oral Cavity Verrucous Carcinoma Via The Laryngoscope Objectives/Hypothesis We investigate the clinicopathologic and treatment factors associated with the use of postoperative radiation therapy (PORT) and its effect on overall survival (OS) for patients with oral cavity verrucous carcinoma (VC). Study Design Retrospective cohort study. Methods A retrospective cohort study of the National Cancer Database (NCDB) from 2006 to 2015 was performed. Multivariable logistic regression was used to identify independent predictive factors associated with the use of PORT. Cox Regression survival and propensity score analyses were used to evaluate the effect of PORT on mortality. Results A total of 356 adult patients with primary oral cavity VC who underwent definitive surgical resection were identified. A total of 10.7% of patients underwent definitive surgical resection followed by PORT. Variables associated with PORT included distance to the hospital per 10 miles (adjusted odds ratio [aOR], 0.81 [95% confidence interval (CI), 0.70–0.95]) and stage III–IV disease (aOR, 12.13 and 23.92, respectively). Multivariable Cox regression survival analysis indicated no evidence of survival benefit in patients undergoing PORT compared to surgery alone (adjusted hazard ratio 1.50 [0.74–3.05], P = .23). Propensity score analysis also showed no OS benefit with the use of PORT (P = .41). Conclusions Variables associated with the use of PORT on multivariable analysis included closer distance to hospital and stage III–IV disease. No clear survival benefit with PORT was identified on either multivariable survival analysis or propensity score analysis. These results suggest that surgery alone with negative margins may be the optimal treatment for patients with oral cavity VC. Level of Evidence 4 Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health

xlomafota13 shared this article with you from Inoreader Characterizing Polarity Sensitivity in Cochlear Implant Recipients: Demographic Effects and Potential Implications for Estimating Neural Health Via Journal of the Association for Research in Otolaryngology Abstract Stimulus polarity can affect both physiological and perceptual measures in cochlear-implant recipients. Large differences between polarities for various outcome measures (e.g., eCAP threshold, amplitude, or slope) theoretically reflect poorer neural health, whereas smaller differences reflect better neural health. Therefore, we expect large polarity effects to be correlated with other measures shown to contribute to poor neural health, such as advanced age or prolonged deafness. Our earlier studies using the electrically evoked compound action potential (eCAP) demonstrated differences in polarity effects between users of Cochlear and Advanced Bionics devices when device-specific clinical pulse designs were used. Since the stimuli differed slightly between devices, the first goal of this study was to determine whether small, clinically relevant differences in pulse phase duration (PD) have a significant impact on eCAP polarity effects to potentially explain the de vice differences observed previously. Polarity effects were quantified as the difference in eCAP thresholds, mean normalized amplitudes, and slope of the amplitude growth function obtained for anodic-first versus cathodic-first biphasic pulses. The results showed that small variations in PD did not explain the observed differences in eCAP polarity effects between devices. Therefore, eCAP polarity sensitivity measures are relatively robust to small differences in pulse parameters. However, it remains unclear what underlies the observed manufacturer differences, which may limit the utility of eCAP polarity sensitivity measures. The second goal was to characterize polarity sensitivity in a large group of CI recipients (65 ears) to relate polarity sensitivity to age and duration of deafness as a proxy for neural health. The same pulse parameters were used for both device groups. The only significant predictors of eCAP polarity effects were age for threshold and amplitude polarity effect s for Cochlear recipients and age and duration of deafness for slope for AB recipients. However, three of these four correlations were in the opposite direction of what was expected. These results suggest that eCAP polarity sensitivity measures likely reflect different mechanisms than the effects that age and duration of deafness induce on the peripheral auditory system. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Systematic Review on the Association Between Clinical Symptoms and CBCT Findings in Symptomatic TMJ Degenerative Joint Disease

xlomafota13 shared this article with you from Inoreader A Systematic Review on the Association Between Clinical Symptoms and CBCT Findings in Symptomatic TMJ Degenerative Joint Disease Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Nov-Dec;35(4):332-345. doi: 10.11607/ofph.2953. ABSTRACT AIMS: To evaluate the association between clinical signs/symptoms and bone changes on CBCT images in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). METHODS: An electronic literature search of the MEDLINE, PubMed, EMBASE, Scopus, and Web of Science databases, as well as Google Scholar for gray literature, was conducted to identify relevant art icles on February 26, 2021. Risk of bias was evaluated using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Recommendation, Assessment, Development, and Evaluation) system instrument was applied to assess the level of evidence across studies. RESULTS: Nine papers assessing clinical signs/symptoms and CBCT findings were included. TMJ pain (arthralgia) and TMJ noises carried the strongest associations with various CBCT findings, each of which were supported by four studies with significant associations. Only one study found significant associations between masticatory myalgia (muscle pain) and CBCT findings. Range of motion carried no significant associations with CBCT findings in the included studies. Based on the GRADEpro system, the certainty of evidence is low for said associations. CONCLUSION: The results suggest that TMD patients with TMJ arthralgia and joint noises may benefit from CBCT imaging. There would be less benefit in TMD patients exhibi ting primarily myalgia or limited range of motion, and therefore these patients should not be prescribed routine CBCT radiographs unless indicated by other clinical findings. The heterogeneity of reporting in the included studies suggests that embracing universal clinical (DC/TMD) and radiographic diagnostic criteria for TMJ-DJD would benefit both research and clinical outcomes. PMID:34990502 | DOI:10.11607/ofph.2953 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Importance of the Graded Chronic Pain Scale as a Biopsychosocial Screening Instrument in TMD Pain Patient Subtyping

xlomafota13 shared this article with you from Inoreader Importance of the Graded Chronic Pain Scale as a Biopsychosocial Screening Instrument in TMD Pain Patient Subtyping Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Fall;35(4):303-316. doi: 10.11607/ofph.2983. ABSTRACT AIMS: To compare the suitability of Graded Chronic Pain Scale (GCPS) pain intensity and interference assessments (GCPS version 1.0 vs 2.0) for the biopsychosocial screening and subtyping of Finnish tertiary care referral patients with TMD pain. METHODS: Altogether, 197 TMD pain patients participated in this study. All patients received Axis II specialist-level psychosocial questionn aires from the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD-FIN) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD-FIN), as well as questionnaires for the assessment of additional pain-related, biopsychosocial, and treatment-related variables. Clinical examinations were performed according to the DC/TMD Axis I protocol. The patients were categorized into TMD subtypes 1, 2, and 3 (GCPS I and II-low; II-high; and III and IV, respectively) based on their biopsychosocial profiles according to GCPS versions 1.0 and 2.0. RESULTS: The distribution of TMD pain patients into TMD subtypes was similar according to the GCPS 1.0 compared to the GCPS 2.0. Over 50% of the patients were moderately (TMD subtype 2) or severely (TMD subtype 3) compromised. Patients in subtype 3 experienced biopsychosocial symptoms and reported previous health care visits significantly more often than patients in subtypes 1 and 2. Patients in subtype 2 reported intermediate biopsychosocial burden compared to subtypes 1 and 3. CONCLUSION: TMD pain patients differ in their biopsychosocial profiles, and, similarly to the GCPS 1.0, the GCPS 2.0 is a suitable instrument for categorizing TMD tertiary care pain patients into three biopsychosocially relevant TMD subtypes. The GCPS 2.0 can be regarded as a suitable initial screening tool for adjunct personalized or comprehensive multidisciplinary assessment. PMID:34990499 | DOI:10.11607/ofph.2983 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Refractory Orofacial Pain: Is It the Patient or the Pain?

xlomafota13 shared this article with you from Inoreader Refractory Orofacial Pain: Is It the Patient or the Pain? Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Nov-Dec;35(4):317-325. doi: 10.11607/ofph.3009. ABSTRACT AIMS: To highlight and discuss the term "refractory" when used to describe pain conditions and its application to orofacial pain, as well as to highlight the factors that must be considered in a refractory patient. METHODS: A scoping review of recent publications (2010 to 2021) applying the term "refractory" to orofacial pain was conducted, and this paper presents their limitatio ns and definitions. RESULTS: The term "refractory" is often used to describe pain instead of "persistent" or "nonresponsive." There are clear definitions in the use of refractory for migraine, cluster headaches, and other nonheadache disorders. Currently, the term is applied to pain conditions in order to alter the patient pathway of treatment, sometimes to escalate a patient from one care sector to another and sometimes to escalate treatment to more costly surgical interventional techniques. CONCLUSION: There is a need for a clear definition for use of the term "refractory" in orofacial pain conditions, excluding migraine and cluster headaches. In addition, there is a requirement for a consensus on the implications of the use of refractory when assessing and managing patients. PMID:34990500 | DOI:10.11607/ofph.3009 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporomandibular Disorders Core Curriculum for Predoctoral Dental Education: Recommendations from the American Academy of Orofacial Pain

xlomafota13 shared this article with you from Inoreader Temporomandibular Disorders Core Curriculum for Predoctoral Dental Education: Recommendations from the American Academy of Orofacial Pain Via pubmed: "j oral facial pain ... J Oral Facial Pain Headache. 2021 Fall;35(4):271-277. doi: 10.11607/ofph.3073. NO ABSTRACT PMID:34990495 | DOI:10.11607/ ofph.3073 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.