The Zygomatic Implant Perforated (ZIP) flap reconstructive technique for the management of low‐level maxillary malignancy – clinical & patient related outcomes on 35 consecutively treated patients

xlomafota13 shared this article with you from Inoreader The Zygomatic Implant Perforated (ZIP) flap reconstructive technique for the management of low‐level maxillary malignancy – clinical & patient related outcomes on 35 consecutively treated patients Via Head & Neck Abstract Background The zygomatic implant perforated (ZIP) flap technique provides immediate reconstruction and rapid dental rehabilitation for low-level malignant tumors. Methods Patients who underwent ZIP flap reconstruction between December 2015 and February 2021 were followed prospectively. Results Thirty-five consecutively treated patients were studied with 16 undergoing surgery alone and 19 undergoing surgery followed by radiotherapy. The median time to fit the prosthesis was 29 days with all patients requiring adjuvant radiotherapy receiving their fixed dental prosthesis prior to its commencement. Vascularized flap (100%), zygomatic implant (98.4%), and prosthesis (97%) survival were excellent and the ZIP flap protocol was highly rated by patient-related outcome measures especially for the chewing domain. Conclusions The ZIP flap technique provides an excellent means of providing an autogenous oronasal seal and a foundation for immediate cortically anchored fixed dental rehabilitation. Clinical Significance This technique provides rapid and robust rehabilitation for patients presenting with low-level maxillary malignancy despite the use of radiotherapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neoadjuvant immunotherapy prior to surgery for mucosal head and neck squamous cell carcinoma: Systematic review

xlomafota13 shared this article with you from Inoreader Neoadjuvant immunotherapy prior to surgery for mucosal head and neck squamous cell carcinoma: Systematic review Via Head & Neck Abstract Given the recent successes of anti-PD-1 immunotherapy, many clinical trials have sought to assess the safety and efficacy of this treatment modality in the neoadjuvant setting. This systematic review provides a comprehensive summary of findings from neoadjuvant head and neck cancer immunotherapy clinical trials with a focus on PD-1/PD-L1 axis blockade. Pubmed, Embase, Cochrane Library, Web of Science, Google Scholar, and clinicaltrials.gov were systematically searched for all eligible neoadjuvant head and neck cancer immunotherapy clinical trials. Eight clinical trials met the inclusion criteria comprising a total of 260 patients. Study drugs included nivolumab, pembrolizumab, ipilimumab, durvalumab, and tremelimumab. The overall mean objective response rate (ORR) was 45.9 ± 5.7% with a 41.5 ± 5.6% single agent mean ORR. There were no deaths due to immune-related toxicities. Neoadjuvant immunotherapy for mucosal head and neck squamous cell cancer has demonstrated favorable response rates with no unexpected immune-related toxicities in phase I/II clinical trials. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Impingement of the Thyroid Cartilage on the Carotid Causing Clicking Larynx Syndrome and Stroke

xlomafota13 shared this article with you from Inoreader Impingement of the Thyroid Cartilage on the Carotid Causing Clicking Larynx Syndrome and Stroke Via The Laryngoscope We present the case of a patient with a recent history of ischemic stroke who presented with clicking larynx syndrome, a condition in which clicking noises in the larynx can be provoked by movement of the head and neck. Diagnostic imaging revealed unusual development and posterior angulation of the superior horn of the thyroid cartilage that potentially was causing trauma to the left common carotid artery. We deduced that symptomatic impingement of the carotid artery by the thyroid cartilage was not only the cause of the patient's clicking larynx syndrome, but also suspected to be the cause of her prior strokes due to repetitive trauma resulting in thrombus. The patient was managed surgically with thyroplasty and transcervical resection of the left greater cornu of the thyroid cartilage with resolution of her symptoms. Anatomical displacement of the thyroid cartilage can manifest as clicking larynx syndrome as well as cause mechanical injury to the carotid artery, resulting in turbulent flow, possible thrombosis, and stroke. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Identifying Barriers in Access to Care for Head and Neck Cancer Patients: A Field Study in Dakar

xlomafota13 shared this article with you from Inoreader Identifying Barriers in Access to Care for Head and Neck Cancer Patients: A Field Study in Dakar Via The Laryngoscope Objectives/Hypothesis To identify barriers in access to care for head and neck cancer (H&NC) patients in low- and middle-income countries (LMICs), specifically within Dakar, Senegal, using both quantitative and qualitative data. Study Design Descriptive observational study. Methods Patients with H&NC were selected from two independent university hospitals in Dakar, Senegal. A mixed-methods descriptive study was performed using a specifically tailored questionnaire and a focused ethnographic qualitative approach to identify factors that delay patient presentation, referral, and treatment. Quantitative data were analyzed using descriptive statistics and qualitative using a deductive approach based on a systematic review of the literature. Results Thirty-three patients with a mean age of 57.8 years were included. Presentation delay was 5.7 months, mainly attributed to cost of consultation (39%), waiting time at doctor's office (15%), and distance to healthcare facility (12%). Referral delay greater than 3 months was observed in 60% of participants, secondary to misdiagnosis and lack of appropriate referral. Treatment delay was associated with limited local treatment capacity and securing cost of treatment. Cost of transportation impacted all delays. Conclusions This work used an evidence-based approach to identify barriers in access to care for H&NC patients in sub-Saharan Africa. It suggests the feasibility and transferability of this methodology which combined a quantitative approach based on the literature with a qualitative analysis. Insight provided by this study will be used to guide development of implementation strategies for early detection of H&NC in LMICs. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of the lower lip after broad oncologic resection by Colmenero flap: a reliable option

xlomafota13 shared this article with you from Inoreader Reconstruction of the lower lip after broad oncologic resection by Colmenero flap: a reliable option Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Nov 26. doi: 10.14639/0392-100X-N1458. Online ahead of print. ABSTRACT OBJECTIVE: Reconstruction of the lower lip is complex. The Colmenero flap is an effective albeit rarely described method for the repair of medium- to large-sized defects of the lower lip. METHODS: A retrospective review was carried out using data gathered from patients who had undergone Colmenero flap reconstruction of the lower lip at our centre between 2015 and 202 0. We analysed demographic, histologic and anatomic variables as well as surgical results. This review assessed flap functionality based on proper mouth closure, absence of microstomia and oral competence. RESULTS: Thirteen Colmenero flaps were performed in 9 patients, with the flap being used bilaterally in four cases. All patients had squamous cell carcinoma of the lower lip. The mean length of the reconstructed defect was 4.1 cm (ranging between 3-7.5 cm). None of the flaps exhibited signs of necrosis. Five patients required minor surgical touch up during the second procedure: two for dehiscence, two for oral leakage and one for esthetic improvement. All patients had excellent functional and aesthetic final outcomes. CONCLUSIONS: The Colmenero flap is a good resource for medium- and large-sized lower lip reconstructions due to its reliability, limited complications, and good aesthetic and functional results. PMID:34825668 | DOI:10.14639/0392-100X-N1458 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Introducing a modified algorithm for enhanced operator independency in auditory steady-state responses (ASSRs) testing

xlomafota13 shared this article with you from Inoreader Introducing a modified algorithm for enhanced operator independency in auditory steady-state responses (ASSRs) testing Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Nov 26. doi: 10.14639/0392-100X-N1640. Online ahead of print. NO ABSTRACT PMID:34825670 | DOI:10.14639/0392-100X-N1640 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Leader manipulator with hand rest function for microsurgery

xlomafota13 shared this article with you from Inoreader Leader manipulator with hand rest function for microsurgery Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract: Background Hand rest assists microsurgeons with maintaining a stable hand condition. In manipulating a surgical robot using teleoperation, the external hand rest poses mechanical difficulties such as interferences from manipulators. Methods Herein, we introduced hand rest functionality into a leader manipulator. The hand rest function was realized by switching the impedance value in admittance control for the translation section. With teleoperation, we evaluated the positioning accuracy in the direction of gravity and the manipulating conditions during precise positioning. Results The experiments proved that the position of the hand rest could be arranged at the intended position, and the condition with the hand rest function, applying sufficiently high impedance, and not constraining the hand rest completely provided the best performance. Conclusion Our leader manipulator showed the potentials to improve the quality of robotic microsurgery with the advantage in fine manipulation based on large repositionable working range of the hand rest. 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.