Survival analysis of patients with subglottic squamous cell carcinoma based on the SEER database

xlomafota13 shared this article with you from Inoreader Survival analysis of patients with subglottic squamous cell carcinoma based on the SEER database Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 19:S1808-8694(21)00167-1. doi: 10.1016/j.bjorl.2021.09.001. Online ahead of print. ABSTRACT OBJECTIVE: This study aimed to investigate the demographic and clinicopathological characteristics, and survival outcomes of subglottic Squamous Cell Carcinoma (SCC) based on the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: Demographic and clinicopathological information, including age, sex, race, tumor size, histologic grade, clinical/TNM stage, tumor invasion extent, Lymph Node Metastasis (LNM) extent, size of metastatic lymph nodes, LNM ratio and treatment data, of 842 subglottic SCC patients diagnosed between 1996 and 2016 were acquired. Kaplan-Meier survival analyses were performed to assess the effects of clinicopathological characteristics, treatment modalities, surgical procedures, and adjuvant therapies on overall survival and cancer-specific survival. RESULTS: Subgl ottic SCC was more frequent among males aged 60-70 years, with low-grade but locally advanced lesions without local or distant metastases. Age and several primary tumor/LNM related variables were independent risk factors for overall survival and cancer specific survival. Advanced-stage and high-grade disease led to unfavorable prognosis. The most common treatment modality and surgical procedure were surgery plus radiotherapy and total laryngectomy, respectively. Surgery plus radiotherapy provided favorable 5-year survival outcomes, while total laryngectomy had the worst. Surgery plus adjuvant therapy showed better survival outcomes than surgery alone. CONCLUSION: This study confirmed the rarity of subglottic SCC. Patients with subglottic SCCs suffered poor prognosis especially for those with advanced-stage or high-grade lesions. The prognosis of subglottic SCC remained poor over the years, despite recent progress in cancer therapies. Surgery plus adjuvant therapy improved the survival outcome. Although larynx preservation surgery was beneficial for early-stage disease, total laryngectomy was favored for patients with advanced tumors. LEVEL OF EVIDENCE: Level 4. PMID:34716102 | DOI:10.1016/j.bjorl.2021.09.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation between cow's milk protein allergy and otitis media: a systematic review

xlomafota13 shared this article with you from Inoreader Correlation between cow's milk protein allergy and otitis media: a systematic review Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 18:S1808-8694(21)00150-6. doi: 10.1016/j.bjorl.2021.07.005. Online ahead of print. ABSTRACT OBJECTIVES: To review the evidence pertaining to the association between cow's milk protein allergy and recurrent acute otitis media and otitis media with effusion. METHODS: The CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched. RESULTS: Four studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow's milk protein allergy, 10.7% of cow's milk protein allergy in 242 children who underwent ENT procedures, 40% of cow's milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow's milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p < 0.1). CONCLUSION: Considering the characteris tics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow's milk protein allergy and otitis media. PMID:34716104 | DOI:10.1016/j.bjorl.2021.07.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Palatine tonsil metastatic colon adenocarcinoma. Case report

xlomafota13 shared this article with you from Inoreader Palatine tonsil metastatic colon adenocarcinoma. Case report Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 18:S1808-8694(21)00162-2. doi: 10.1016/j.bjorl.2021.07.012. Online ahead of print. NO ABSTRACT PMID:34716109 | DOI:10.1016/j.bjorl.2021.07.012 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cone beam computed tomography with oral contrast for accurate diagnosis and surgical planning of pharyngeal leakage and fistula: a case series

xlomafota13 shared this article with you from Inoreader Cone beam computed tomography with oral contrast for accurate diagnosis and surgical planning of pharyngeal leakage and fistula: a case series Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 13:S1808-8694(21)00153-1. doi: 10.1016/j.bjorl.2021.08.001. Online ahead of print. ABSTRACT OBJECTIVE: Pharyngocutaneous fistula is one of the severe complications related to head and neck surgeries. Detecting the accurate three-dimensional location of both the fistula and leakage is essential for surgical treatment. Videofluoroscopy is usually used for locating these; however, its imaging is two-dimensional. We evaluated pharyngeal leakage and fistulae using Cone Beam Computed Tomography (CBCT), known for its three-dimensional high spatial resolution imaging, taken in a sitting position, with oral contrast (contrast CBCT). METHODS: Pharyngeal leakage and fistulae were evaluated in a total of 31 subjects by sequentially performing videofluoroscopy and contrast CBCT. The detection accuracy of videofluoroscopy and contrast CBCT for leakage and fistula, as well as the ability to determine the extent and depth for surgical planning, were investigated and compared. RESULTS: Videofluoroscopy and contrast CBCT showed suspicious leakage and/or fistula in six and three of the 31 subjects, respectively. Surgical findings revealed the presence of leakage and/or fistula in three of the 31 subjects. The positive predictive values of videofluoroscopy and contrast CBCT were 50% (3/6) and 100% (3/3), respectively. Contrast CBCT provided more precise images, showing the extent and depth of leakage and fistula in three-dimensions. CONCLUSION: The present study's results indicate the usefulness of contrast CBCT in terms of accurate diagnosis of leakage and fistula, due to its three-dimensional imaging being performed with the patient in a sitting position. LEVEL OF EVIDENCE: 4. PMID:34716103 | DOI:10.1016/j.bjorl.2021.08.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The added value of non-contrast 3-Tesla MRI for the pre-operative localization of hyperparathyroidism

xlomafota13 shared this article with you from Inoreader The added value of non-contrast 3-Tesla MRI for the pre-operative localization of hyperparathyroidism Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 17:S1808-8694(21)00160-9. doi: 10.1016/j.bjorl.2021.07.010. Online ahead of print. ABSTRACT OBJECTIVE: We investigated the efficacy of non-contrast 3-Tesla MR imaging added to the combination of sestamibi with99mTc (MIBI) scintigraphy and Ultrasonography (US) for the pre-operative localization of Primary Hyperparathyroidism (PHPT) lesions. METHODS: A total of 34 parathyroid glands, including nine normal glands, were examined with MIBI, US, and non-contrast 3-Tesla MRI. MRI was performed with the acquisition of T1- and T2-weighted images and fat-suppressed T2-weighted images. We calculated the sensitivities of MIBI, US, and the 'additional' MRI, with knowledge of the former two modalities' results. RESULTS: For the diagnosis of PHPT lesions, the sensitivity values of MIBI, US, and additional MRI were 88.0% (22/25), 84.0% (21/25), and 92.0% (23/25), respectively. Normal glands were not visualized with any modality (0/9). One lesion was detected neither with US nor MRI, but only with MIBI, with the limitation that MIBI represented no more than laterality. The two glands not identified in MRI were 4 mm and 6 mm in their size, which are within the range of normal gland's size. Two lesions were not detected with US or MIBI but were visualized with the additional MRI, which indicated that the MRI contributed an 8.0% (2/25) improvement of sensitivity, compared from that of US. Fat-suppressed T2-weighted images were useful in the identification of parathyroid lesions, as these images helped to differentiate between the lesion and the adjacent tissue. CONCLUSION: Additional non-contrast 3-Tesla MRI was a useful adjunctive tool for localization of PHPT, which improved the sensitivity of the pre-operative localization of PHPT lesions. Fat-suppressed T2-weighted images contributed to their identification. LEVEL VI: Evidence from a single descriptive or quali tative study. PMID:34716111 | DOI:10.1016/j.bjorl.2021.07.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of nasal mucociliary clearance by saccharine test in rheumatoid arthritis

xlomafota13 shared this article with you from Inoreader Evaluation of nasal mucociliary clearance by saccharine test in rheumatoid arthritis Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2021 Oct 17:S1808-8694(21)00157-9. doi: 10.1016/j.bjorl.2021.08.005. Online ahead of print. ABSTRACT OBJECTIVE: We aimed to reveal whether there is nasal involvement by examining the Nasal Mucociliary Clearance (NMC) and the relationship between this activity and disease severity in Rheumatoid Arthritis (RA) patients. METHODS: In this prospective study, NMC time, disease activity (Disease Activity Score 28) and blood parameters of RA patients (n = 87) were investigated and compared with the healthy control group (n = 50). In addition, the relationship between DAS 28 and NMC was investigated. RESULTS: The mean NMC of the RA group was 9.51 ± 3.54 min, the mean NMC of the control group was 8.69 ± 2.85 min, and there was no significant difference between the two groups. There was no correlation between NMC and disease duration, and DAS 28. The mean NMC of the RA patients with Anti Cyclic Citrulled Pep tide (Anti-CCP) positive was significantly higher than the negative ones. CONCLUSION: Although there was no significant difference in NMC values between the RA and control group, the NMC of the Anti-CCP positive patients was higher. LEVEL OF EVIDENCE: Level 2. PMID:34716105 | DOI:10.1016/j.bjorl.2021.08.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction

xlomafota13 shared this article with you from Inoreader Quantification of the Impact of Intraoperative Ultrasound in Transoral Robotic Tongue Base Reduction Via The Laryngoscope Objectives/Hypothesis Transoral robotic surgery (TORS) in the base of the tongue (BOT) reduction has been shown to decrease the apnea-hypopnea index (AHI) and improve daytime sleepiness in obstructive sleep apnea (OSA) patients. Intraoperative ultrasound (IOU) can be employed to guide the surgery and prevent massive bleeding. Study Design Cohort study with historical control. Methods A cohort study to compare the outcomes between OSA patients who received TORS with and without IOU assistance. Results From 2016 to 2019, this study enrolled 80 OSA patients who underwent TORS in BOT: 57 in the IOU(+) and 23 in IOU(−) groups. The TORS with IOU presented with shorter operative time, less blood loss, and greater excised BOT volume. The IOU(+) group had greater improvement in the AHI and subjective questionnaire evaluation. The excised volume of BOT was significantly associated with the change in AHI. Conclusion The IOU could improve outcomes in BOT reduction surgery without raising the risk of surgical complications. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Can Red Blood Cell Distribution Width Predict Laryngectomy Complications or Survival Outcomes?

xlomafota13 shared this article with you from Inoreader Can Red Blood Cell Distribution Width Predict Laryngectomy Complications or Survival Outcomes? Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Oct 29:34894211056117. doi: 10.1177/00034894211056117. Online ahead of print. ABSTRACT OBJECTIVE: Red blood cell distribution width (RDW), a reported biomarker for morbidity and mortality in chronic disease and following certain surgeries, has not been well-studied in head and neck cancer patients. The aim of the study was to examine the association of RDW with postoperative complications and survival among patients who underwent primary or sal vage laryngectomy. METHODS: We analyzed a retrospective case series study of patients diagnosed with squamous cell carcinoma of the larynx treated with total laryngectomy. Survival outcomes were examined using Kaplan-Meier analysis. RESULTS: One hundred seventy-seven patients were included in the final analysis. The most common tumor subsite was the supraglottis (60%). On bivariate analysis, patients with RDW ≥14.5 had higher prevalence of non-surgical, systemic complications, including deep venous thrombosis, pneumonia, cardiovascular events, and difficulty weaning from mechanical ventilation. However, there was no significant difference in laryngectomy-specific post-operative complications, including pharyngocutaneous fistula, wound infection, stoma complications, and chyle leak. RDW was not found to be associated with survival outcomes following laryngectomy. CONCLUSIONS: Among laryngectomy patients, RDW ≥14.5 is associated with higher prevalence of systemic morbidity, but not with specific local surgical complications or decreased survival. PMID:34715735 | DOI:10.1177/00034894211056117 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia

xlomafota13 shared this article with you from Inoreader Noninvasive Respiratory Support as an Alternative to Tracheostomy in Severe Laryngomalacia Via The Laryngoscope Objectives/Hypothesis To analyze the role of noninvasive respiratory support (NRS) as an alternative to tracheostomy in the management of severe laryngomalacia. Study Design We conducted a monocentric retrospective study in a tertiary pediatric care center. Methods All children under the age of 3 years with severe laryngomalacia, treated between January 2014 and December 2019, were included. Patient demographics, medical history, nutrition, surgery, NRS, and outcome were reviewed. Predictors for NRS were analyzed. Results One hundred and eighty-eight patients were included. Mean age was 4 ± 5 months and mean weight was 4,925 ± 1,933 g. An endoscopic bilateral supraglottoplasty was performed in 183 (97%) patients and successful in 159 (87%). NRS was initiated in 29 (15%) patients at a mean age of 3 ± 2 months (1–11 months): 15 (52%) patients were treated with NRS after surgical failure, 9 (31%) were treated with NRS initiated prior to surgery because of abnormal overnight gas exchange, and 5 (17%) were treated exclusively with NRS due to comorbidities contraindicating an endoscopic procedure. NRS was successfully performed in all patients with a mean duration of 6 ± 11 months. No patient required a tracheostomy. Univariate analysis identified the following predictors of NRS: neonatal respiratory distress (P = .003), neurological comorbidity (P < .001), associated laryngeal abnormality (P < .001), cardiac surgery (P&n bsp;= .039), surgical endoscopic revision (P = .007), and nutritional support (P < .001). Conclusion NRS is a safe procedure, which may avoid a tracheostomy in severe laryngomalacia, in particular, in case of endoscopic surgery failure, respiratory failure before surgery, and/or severe co-morbidity. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients

xlomafota13 shared this article with you from Inoreader Clinical Outcomes of Diffuse Sclerosing Variant Papillary Thyroid Carcinoma in Pediatric Patients Via The Laryngoscope Objectives/Hypothesis The diffuse sclerosing variant of papillary thyroid carcinoma (DSV) may be more aggressive than conventional well-differentiated non-DSV related papillary thyroid carcinomas (N-PTC). Study Design Retrospective chart review. Methods Retrospective review of clinical outcomes for patients 21 years of age or younger who underwent initial surgery for PTC at a single institution from January 1, 2005 to April 1, 2020. Genomic analysis was performed using targeted next-generation sequencing. Data were analyzed using Fischer's exact test and Kaplan–Meier curve log-rank test. Results Our cohort consisted of 72 patients, nine with DSV and 63 with N-PTC. Age at diagnosis was comparable (15.4 vs. 16.2 years, respectively, P = .46). DSV were more likely to be in the high-risk American Thyroid Academy pediatric risk group (100% vs. 41.3%, P = .004), to present with regional cervical lymph node metastases (100% vs. 60.3%, P = .036), and to present with distant metastases (67% vs. 22%, P = .005). No mortality seen in either group over 27.5 (interquartile range 14.8, 46.00) months average follow-up. Throughout the follow-up period, DSV were more likely to experience progression than N-PTC (hazard ratio = 5.7 [95% confidence interval 1.7–20.0; P = .0056]). In a subset of 19 patients with aggressive disease who had molecular testing as part of clinical care we detected RET fusions in nearly all DSV compared to a minority of N-PTC (83% vs. 15.4%, P =  ;.0095). Conclusions Pediatric patients with DSV have more advanced disease at diagnosis and are more likely to experience progression of disease compared to patients with N-PTC. The prevalence of RET fusions in our cohort recapitulates the frequency of this alteration described in prior studies. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty

xlomafota13 shared this article with you from Inoreader Analysis of Determinants of Postoperative Satisfaction After Rhinoplasty Via The Laryngoscope Objectives/Hypothesis To analyze different variables that influence postrhinoplasty quality of life outcomes to ascertain the determinants of postoperative satisfaction. Study Design Prospective, observational study. Methods This was a prospective, observational study where patients were divided into two groups based on the postoperative Rhinoplasty Outcome Evaluation (ROE) score: high satisfaction group, when postoperative ROE scores were >50, and low satisfaction group, when postoperative ROE scores were ≤50. Patients' general characteristics, Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) score, the Body Dysmorphic Disorder Examination, nasal angles, and measures from the esthetic facial analysis of postoperative photographs were compared between the groups. Results Seventy-eight patients were included: 19 in the low satisfaction group and 58 in the high satisfaction group. The median reduction in the NOSE-p score was −45 (interquartile range [IIQ] −20 to −60) (P < .001) in the high satisfaction group and −10 (IIQ −10 to −30) in the low satisfaction group (P = .053). The high satisfaction group had a significantly higher reduction in NOSE-p scores. There was no significant difference between the groups in terms of the analyzed facial parameters, although a significant difference was found when comparing them with the ones established in the literature as a pattern. Previous rhinoplasty, preoperative crooked nose, and higher NOSE-p scores were significantly associated with lower ROE scores (P < .05) in the robust Poisson regression model. Conclusion Functional results play an important role in satisfaction after rhinoplasty. Neoclassical canons were not fulfilled even in a group of patients with a high postoperative satisfaction evaluation. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.