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Τετάρτη 18 Νοεμβρίου 2020

Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis.

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Intraoperative Applications of Topical Corticosteroid Therapy for Chronic Rhinosinusitis.

Ear Nose Throat J. 2020 Nov 10;:145561320970100

Authors: Lelegren MJ, Bloch RA, Lam KK

Abstract
OBJECTIVES: To provide an overview of recent techniques and technologies for the application of topical corticosteroid therapy immediately following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).
METHODS: A comprehensive search in the PubMed and Google Scholar databases was conducted to identify publications between January 2000 and December 2019 detailing clinical trials that have evaluated the efficacy and safety of intraoperative applications of topical corticosteroids for CRS.
RESULTS: A total of 21 articles, all of which highlight a variety of corticosteroid-infused products, including Propel corticosteroid-eluting stents, NasoPore, Merocel, SinuBand, calcium alginate, and bioresorbable gel-type products, are included for review. Propel stents are the only devices that have achieved level 1A evidence in terms of efficacy and have data to support their safety. The remaining products have shown mixed results in terms of efficacy and safety.
CONCLUSION: A wide range of techniques and technologies have been introduced to enhance the topical delivery of corticosteroids into the neosinuses after ESS for CRS. Regarding efficacy, there is level 1A evidence to support the use of Propel stents. Most of the remaining strategies show some degree of efficacy. Direct comparisons across the different strategies are limited owing to the varied uses of delivery vectors, corticosteroid choices, and doses of corticosteroids. Propel stents and SinuBand have sufficient data to support systemic and ocular safety, whereas the remaining products have limited data to support their safety.

PMID: 33170026 [PubMed - as supplied by publisher]

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A Pilot Study of the Waterless Empirical Taste Test.

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A Pilot Study of the Waterless Empirical Taste Test.

Ear Nose Throat J. 2020 Nov 10;:145561320967337

Authors: Jiang RS, Liu SA, Wang CP, Wu SH, Wang JJ

Abstract
OBJECTIVES: This study was performed to test the clinical applicability of a new taste test-the waterless empirical taste test (WETT).
METHODS: Sixty healthy volunteers and 20 patients with oral cancer were enrolled. They all received the conventional solution-based whole-mouth suprathreshold taste test (WMTT), which contained sucrose, citric acid, sodium chloride, and caffeine solutions for tastants, along with the WETT. The WETT used plastic strips to deliver tastants. The strip was embedded with sucrose, citric acid, sodium chloride, caffeine, or monosodium glutamate taste enhancer in 4 different concentrations. Each strip was tested twice. Thirty of the healthy volunteers received the WETT again to measure a retest reliability. Case-control matching by age and gender was used to compare the scores of WMTT and WETT between 13 healthy volunteers and 13 patients with oral cancer.
RESULTS: The correlation was not high between the WMTT and WETT (r < 0.7) whether in the healthy volunteers or in patients with oral cancer. In terms of retest reliability of the WETT, the mean total score was 24.9 ± 7.3 for the first test and 25.8 ± 8.4 for the second test. The intraclass correlation coefficient was 0.85 (P < .001). When case-control matching was performed, the WMTT scores were not significantly different between 13 healthy volunteers and 13 patients with oral cancer (P = .266), but the WETT scores were significantly lower in patients with oral cancer (P = .017).
CONCLUSION: This study showed that the results of the WETT were not highly correlated with those of the WMTT. However, its retest reliability was high, and its results were significantly different between the healthy volunteers and the patients with oral cancer.

PMID: 33170031 [PubMed - as supplied by publisher]

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Adenoid Cystic Carcinoma of the Larynx: A SEER Database Review.

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Adenoid Cystic Carcinoma of the Larynx: A SEER Database Review.

Ear Nose Throat J. 2020 Nov 10;:145561320970691

Authors: Mur T, Jaleel Z, Agarwal P, Edwards HA

Abstract
BACKGROUND: Adenoid cystic carcinoma (AdCC) of the larynx is an uncommon malignancy of the head and neck with very little literature discussing treatment paradigms and prognostic factors influencing survival.
METHODS: This retrospective cohort study uses data obtained from the Surveillance, Epidemiology and End Result database comprising of patients diagnosed with laryngeal AdCC from 1978 to 2016.
RESULTS: A total of 89 records were analyzed. High histologic grade was a significant negative prognostic factor compared to low histologic grade disease for overall survival (OS; 5-year OS: 35.7% vs 90.5%, P < .005) and disease-specific survival (DSS; 5-year DSS: 38.7% vs 95.2%, P < .005). No differences in OS (5-year OS: 88.9% vs 76.4%, P = .287) or DSS (5-year DSS: 100% vs 79.1%, P = .159) were noted between patients with early versus late American Joint Committee on Cancer (AJCC) stage disease. No differences in DSS was noted in cohorts treated with just definitive surgery versus surgery and adjuvant radiation (5-year DSS: 92.9% vs 74.3%, P = .140) even when stratified for late stage disease (5-year DSS: 100% vs 78.6%, P = .290) or high-grade histology (5-year DSS: 100% vs 83.3%, P = .773).
CONCLUSIONS: Histologic grade may be a more significant prognostic factor than AJCC stage for survival in laryngeal AdCC. Treatment with surgery and radiation may provide no additional survival advantage compared to just definitive surgery in these patients, although further study is warranted.

PMID: 33170034 [PubMed - as supplied by publisher]

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AHNS endocrine surgery section consensus statement on nasopharyngolaryngoscopy and clinic reopening during COVID‐19: How to get back to optimal safe care

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Abstract

This article provides best practice guidelines regarding nasopharyngolaryngoscopy and OHNS clinic reopening during the COVID‐19 pandemic. The aim is to provide evidence‐based recommendations defining the risks of COVID‐19 in clinic, the importance of pre‐visit screening in addition to testing, along with ways to adhere to CDC guidelines for environmental, source, and engineering controls.

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Electrophysiological and behavioral measures of some speech contrasts in varied attention and noise.

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Electrophysiological and behavioral measures of some speech contrasts in varied attention and noise.

Hear Res. 2019 03 01;373:1-9

Authors: Morris DJ, Tøndering J, Lindgren M

Abstract
This paper investigates the salience of speech contrasts in noise, in relation to how listening attention affects scalp-recorded cortical responses. The contrasts that were examined with consonant-vowel syllables, were place of articulation, vowel length and voice-onset time (VOT) and our analysis focuses on the correspondence between the effect of attention on the electrophysiology and the decrement in behavioral results when noise was added to the stimuli. Normal-hearing subjects (n = 20) performed closed-set syllable identification in no noise, 0, 4 and 8 dB signal-noise ratio (SNR). Identification in noise decreased markedly for place of articulation, moderately for vowel length and marginally for VOT. The same syllables were used in two electrophysiology conditions, where subjects attended to the stimuli, and also while their attention was diverted to a visual discrimination task. Differences in global field power between the attention conditions from each contrast showed that that the effect of attention was negligible for place of articulation. They implied offset encoding of vowel length and were early (starting at 117 ms), and of high amplitude (>3 μV) for VOT. There were significant correlations between the difference in syllable identification in no noise and 0 dB SNR and the electrophysiology results between attention conditions for the VOT contrast. Comparison of the two attention conditions with microstate analysis showed a significant difference in the duration of microstate class D. These results show differential integration of attention and syllable processing according to speech contrast and they suggest that there is correspondence between the salience of a contrast in noise and the effect of attention on the evoked electrical response.

PMID: 30553033 [PubMed - indexed for MEDLINE]

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Inhibitory mechanisms shaping delay-tuned combination-sensitivity in the auditory cortex and thalamus of the mustached bat.

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Inhibitory mechanisms shaping delay-tuned combination-sensitivity in the auditory cortex and thalamus of the mustached bat.

Hear Res. 2019 03 01;373:71-84

Authors: Butman JA, Suga N

Abstract
Delay-tuned auditory neurons of the mustached bat show facilitative responses to a combination of signal elements of a biosonar pulse-echo pair with a specific echo delay. The subcollicular nuclei produce latency-constant phasic on-responding neurons, and the inferior colliculus produces delay-tuned combination-sensitive neurons, designated "FM-FM" neurons. The combination-sensitivity is a facilitated response to the coincidence of the excitatory rebound following glycinergic inhibition to the pulse (1st harmonic) and the short-latency response to the echo (2nd-4th harmonics). The facilitative response of thalamic FM-FM neurons is mediated by glutamate receptors (NMDA and non-NMDA receptors). Different from collicular FM-FM neurons, thalamic ones respond more selectively to pulse-echo pairs than individual signal elements. A number of differences in response properties between collicular and thalamic or cortical FM-FM neurons have been reported. However, differences between t halamic and cortical FM-FM neurons have remained to be studied. Here, we report that GABAergic inhibition controls the duration of burst of spikes of facilitative responses of thalamic FM-FM neurons and sharpens the delay tuning of cortical ones. That is, intra-cortical inhibition sharpens the delay tuning of cortical FM-FM neurons that is potentially broad because of divergent/convergent thalamo-cortical projections. Compared with thalamic neurons, cortical ones tend to show sharper delay tuning, longer response duration, and larger facilitation index. However, those differences are statistically insignificant.

PMID: 30612026 [PubMed - indexed for MEDLINE]

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The onset and post-onset auditory responses of cochlear nucleus neurons are modulated differently by cortical activation.

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The onset and post-onset auditory responses of cochlear nucleus neurons are modulated differently by cortical activation.

Hear Res. 2019 03 01;373:96-102

Authors: Liu X, Zhang O, Qi J, Chen A, Hu K, Yan J

Abstract
Auditory cortex exhibit a capacity of modulating the functions of subcortical auditory nuclei and even inner ear through descending pathways. The cochlear nucleus (CN), which acts as the gateway from the auditory periphery to the central auditory system, is also subjected to corticofugal modulation. Cortical modulation of subcortical nuclei is highly specific to the frequency tunings of cortical and subcortical neurons. It is unclear whether the high frequency-specificity of the cortical modulation of CN frequency tuning is implemented in the CN, in the auditory periphery, or in both. We analyzed the corticofugal effects on the frequency tuning, constructed from both onset (OS) and post-onset (pOS) response components of CN neurons in C57 mice. We found that the focal electrical stimulation of the primary auditory cortex (ESAI) induced remarkable changes in the response magnitude, response latency and the frequency response curves of CN neurons. The changes in the pOS compone nts were highly specific to the difference in BFs between the stimulated AI neurons and recorded CN neurons. The changes in the OS component mostly involved the augmentation of the auditory responses of CN neurons, while exhibiting far poorer frequency-specificity. Considering the large differences in the temporal response patterns and the tuning shapes between the auditory nerve (AN) and the CN, our data suggest that the CN intrinsic neural circuitry plays a critical role in the frequency specificity of corticofugal modulation. Cortical modulation of the inner ear mostly contributes to the augmentation of the AN inputs to the CN, around the BFs of stimulated AI neurons.

PMID: 30640070 [PubMed - indexed for MEDLINE]

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Acute mastoiditis complicated by cerebral venous sinus thrombosis in children

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Publication date: Available online 17 November 2020

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Eleni Vergadi, Stylianos Velegrakis, Maria Raissaki, Maria Bitsori, Alexander Karatzanis, Emmanouil Galanakis

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Is robot assisted‐ retroperitoneal adrenalectomy safe? An investigation of perioperative hypertensive crisis among hypertensive and normotensive patients

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Abstract

Background

/Objective: We examined the incidence of perioperative hypertensive crisis in robot‐assisted retroperitoneal laparoscopic adrenalectomy.

Methods

A consecutive series of 120 patients with adrenal tumors undergoing robot‐assisted retroperitoneal laparoscopic adrenalectomy were included. Patients were divided into two groups: group A (hypertension group, 58 cases, mean age 43.59 years) and group B (normotension group, 62 cases, mean age 48.01 years). General anesthesia was applied using endotracheal intubation and hemodynamic changes were closely monitored.

Results

A total of 9 (7.5%) hypertensive crisis cases were observed. After intravenous infusion of sodium nitroprusside, 7 cases of them were quickly controlled, and 2 cases experienced transient severe hypertension. The incidence of hypertensive crisis was 13.7% and 1.6% in groups A and B, respectively (p< 0.05).

Conclusion

These findings highlight the importance of strengthening the monitoring of anesthesia and taking various measures to effectively control the blood pressure in robot‐assisted retroperitoneal laparoscopic adrenalectomy, especially among hypertensive patients.

This article is protected by copyright. All rights reserved.

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Evaluation of a new spinal surgical robotic system of Kirschner wire placement for lumbar fusion: A multi‐center, randomized controlled clinical study

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Abstract

Background

To introduce a novel robotic system "Orthbot" that has been developed and tested as a surgical assistant for auto‐placement of the K‐wire in lumbar fusion.

Methods

A This is a multi‐center, RCT randomized controlled clinical study contain that includes 56 patients (Robot Group, RG: 27, Free‐hand Group, FG: 29). Following the preoperative planning and intraoperative fluoroscopic images, the "Orthbot" automatically completed registration and K‐wire placement under the supervision of the surgeon. Deviation Distance (DD) and Deviation Angle (DA) were used as important the primary parameters to evaluate the accuracy of the robotic system.

Results

The average DD was 0.95±0.377 mm (RG) and 4.35±2.01 mm (FG), respectively in the RG and FG (P<0.001). The average DA of the K‐wire in the coronal plane and the sagittal plane in X‐Ray was respectively 6.80±7.79° (RG) and 1.27±2.32° (RG) in the RG (P<0.001), and 22.22±16.85°(FG) and 4.57±3.86° (FG) in the FG (P<0.001), which showed a higher accuracy of rate in the robotic‐assisted cases compared to the free‐hand cases.

Conclusions

The novel robotic system could achieve accurate radiological results in K‐wires insertions as indicated by the radiological results.

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Preliminary study on the relationship between pepsin and vocal fold polyp

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Publication date: Available online 18 November 2020

Source: American Journal of Otolaryngology

Author(s): Xiang-Ping Li, Yuan-Feng Dai, Jia-Jie Tan, Chao-Qun Deng, Xiong Liu, Ze-Hong Lv

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