Incidence and Prognosis of Brain Metastases in Head and Neck Cancer Patients at Diagnosis

xlomafota13 shared this article with you from Inoreader Incidence and Prognosis of Brain Metastases in Head and Neck Cancer Patients at Diagnosis Via The Laryngoscope Objectives Limited data is available on head and neck cancer (HNC) patients presenting with brain metastases (BM) at initial diagnosis. We sought to evaluate the incidence, management, and treatment outcomes of these patients using the National Cancer Database (NCDB). Methods We identified 465,925 patients diagnosed with HNC between 2010 and 2015 in the NCDB. 14,583 of these patients presented with metastatic disease to any site. 440 of these patients had BM at the time of initial diagnosis. Overall survival was compared using the Kaplan–Meier method. Cox proportional hazard modeling, propensity score matching, and subgroup analyses were performed. Results The median age overall was 62.0 years. Nasopharynx NOS (13.2%) and Parotid Gland (10.9%) were the most common anatomical sites with the highest frequency of BM. The overall median survival time was 7.1 months. Predictors for the presence of BM included distant metastasis to the bone, liver, or lung on univariate analysis, and bone or lung on multivariate analysis. High‐risk Human Papilloma Virus status was associated with a lower chance of BM. No pattern was determined when comparing lymph node level involvement and BM. The median survival for patients receiving radiation therapy and multi‐agent chemotherapy was 8.4 and 11.7 months, respectively. Immunotherapy administered as first course therapy did not influence median survival. Most patients received radiation (62.7%) therapy and chemotherapy (50.2%). Conclusions The data extracted and analyzed from the NCDB should work to aid in the surveillance and management of BM in patients with HNC. Level of Evidence Level 4. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma

xlomafota13 shared this article with you from Inoreader 5-year outcomes of salvage endoscopic nasopharyngectomy for recurrent nasopharyngeal carcinoma Via Journal of Otolaryngology - Head & Neck Surgery Recurrent nasopharyngeal carcinoma (rNPC) can be salvaged with re-irradiation, open nasopharyngectomy, and more recently endoscopic nasopharyngectomy. However, long-term outcomes of endoscopic approaches are l... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Visual biofeedback for paradoxical vocal fold motion (PVFM)

xlomafota13 shared this article with you from Inoreader Visual biofeedback for paradoxical vocal fold motion (PVFM) Via Journal of Otolaryngology - Head & Neck Surgery Paradoxical vocal fold motion (PVFM) is a common condition where the vocal folds inappropriately adduct during inspiration. This results in dyspnea and occasionally significant distress. The condition is thoug... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neurofibromin expression by normal salivary glands

xlomafota13 shared this article with you from Inoreader Neurofibromin expression by normal salivary glands Via Head & Face Medicine Neurofibromin, a protein encoded by the NF1 gene, is mutated in neurofibromatosis 1, one of the most common genetic diseases. Oral manifestations are common and a high prevalence of hyposalivation was recently de... View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intrinsic Laryngeal Muscle Activity During Subvocalization

xlomafota13 shared this article with you from Inoreader Intrinsic Laryngeal Muscle Activity During Subvocalization Via Journal of Voice Subvocalization, the low-grade activity of speech articulator muscles while thinking or reading, may mediate phonological representations of verbal material. However, no literature exists that directly measures whether intrinsic laryngeal muscles (ILMs) are active during subvocalization. The possibility of ILM activation during subvocalization has implications for establishing appropriate baselines when experimental conditions involve linguistic features. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of muscular tone of the tongue using a digital measure spoon in a healthy population: A pilot study

xlomafota13 shared this article with you from Inoreader Assessment of muscular tone of the tongue using a digital measure spoon in a healthy population: A pilot study Via Speech therapy by Laura Rodríguez-Alcalá, Juan Martín-Lagos Martínez, Carlos O´Connor-Reina, Guillermo Plaza The study of the muscles of the tongue forms part of a basic evaluation of upper airway function that includes swallowing, speaking and chewing. It is important because the upper airway presents a region of collapse during sleep. Through the action of the dilator muscles, mainly the genioglossus, such collapse can be prevented. In this study, we present a simple tool that can be used to measure the strength of the tongue. This tool may provide an easy way to measure tongue function and allow a simple evaluation of pathologies that affect the tone of the tongue. We have carried out 20 tongue strength measurements using the Tongue Digital Spoon (TDS) in a healthy adult population, using the Iowa Oral Performance Instrument (IOPI) as the gold standard. To validate the procedure, we performed replicate measurements on 20 individuals aged 20–70 years. We found a mean TDS measurement of 115.99 g/cm2 in young subjects, 98.47 g/cm2 in middle-aged subjects and 84.23 g/ cm2 in the elderly. There was a significant difference in the measurements between young and elderly participants. There was also a significant correlation between TDS and IOPI measurements (Pearson correlation coefficient, r = 0.69, P View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary and Secondary Optic Nerve Sheath Meningioma

xlomafota13 shared this article with you from Inoreader Primary and Secondary Optic Nerve Sheath Meningioma Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1723801 Objective This study was aimed to review issues relating to the recognition, radiographic diagnosis, monitoring, and management of primary and secondary optic nerve sheath meningioma (ONSM). Design This study is a review of peer-reviewed literature combined with illustrative case studies. Participants and Methods A literature search was conducted via the PubMed database using pertinent search terms. Selected articles were limited to those written or translated into English. Additional works cited within articles were also included. Individual cases were drawn from the experience of a tertiary academic neuroophthalmic and orbital practice. Tables summarize radiotherapeutic and surgical studies, excluding single case reports and studies focusing on meningioma of intracranial origin. Main Outcome Measurements Review of reported surgical and radiotherapeutic series is the primary measurement. Results The natural history of optic nerve sheath meningiomas is primarily characterized by progressive ipsilateral vision loss. Diagnosis is typically based on radiographic imaging findings, with biopsy remaining indicated in some patients. Management strategies may include observation, radiation, and/or surgical intervention, or a combination of these approaches. The role of surgery, especially with respect to primary ONSM (pONSM), remains controversial. Advancement of radiotherapy techniques has shifted modern treatment paradigms in pONSM toward radiation as primary treatment, as surgical outcomes are inferior in major studies. Although radiation remains the treatment of choice in many cases, selected patients may benefit from surgery, especially in the setting of secondary ONSM (sONSM). Conclusion A wide variety of radiotherapeutic and surgical treatment modalities for ONSM exist. The specific indications for each management strategy continue to be redefined. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Malignant Orbital Tumors

xlomafota13 shared this article with you from Inoreader Primary Malignant Orbital Tumors Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722635 Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the clinical presentation, imaging features, and medical and surgical management of primary orbital malignancies with representative cases will be discussed. Setting Outpatient and inpatient hospital settings. Participants Patients with diagnosed primary orbital malignancies. Main Outcome Measures Descriptive outcomes. Results Advancements in orbital imaging, microsurgical techniques, and multimodal therapy have improved the diagnosis and management of primary orbital malignancies. Special considerations for biopsy or resection are made based on the tumor's location, characteristics, nearby orbital structures, and goals of surgery. Minimally invasive techniques are supplanting traditional approaches to orbital surgery with less morbidity. Conclusions Advances in imaging technologies and surgical techniques have facilitated the diagnosis and management of primary orbital malignancies. Evolution toward less invasive orbital surgery with focus on preservation and restoration of function is underway. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Masses of the Lacrimal Gland: Evaluation and Treatment

xlomafota13 shared this article with you from Inoreader Masses of the Lacrimal Gland: Evaluation and Treatment Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722700 Lacrimal gland lesions account for approximately 9 to 10% of all biopsied orbital masses. Potential causes include nongranulomatous and granulomatous inflammation, autoimmune disease, lymphoproliferative disorders, benign epithelial proliferation, malignant neoplasia, and metastatic disease. Inflammatory lesions and lymphoproliferative disorders are the most common and may be unilateral or bilateral; they may also be localized to the orbit or associated with systemic disease. Both benign and malignant epithelial lacrimal gland masses tend to be unilateral and involve the orbital lobe, but a more rapid onset of symptoms and periorbital pain strongly suggest malignant dis ease. On orbital imaging, both inflammatory and lymphoproliferative lesions conform to the globe and surrounding structures, without changes in adjacent bone, whereas epithelial lacrimal gland masses often show scalloping of the lacrimal gland fossa. Malignant epithelial lacrimal gland tumors can also have radiographic evidence of bony invasion and destruction. Masses of the lacrimal gland may be due to a broad range of pathologies, and a good working knowledge of common clinical characteristics and radiographic imaging findings is essential for diagnosis and treatment. All patients with inflammatory, lymphoproliferative, and epithelial neoplastic lesions involving the lacrimal gland require long-term surveillance for disease recurrence and progression. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany A rticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Morphological Measurement and Anatomical Variations of the Clivus Using Computed Tomography

xlomafota13 shared this article with you from Inoreader Morphological Measurement and Anatomical Variations of the Clivus Using Computed Tomography Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722712 Objectives The aim of this study was to evaluate the clivus morphology, including fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CC), on computed tomography (CT) images. Design This is a retrospective study. Setting Faculty of Dentistry, Department of Dentomaxillofacial Radiology. Participants The CT images of 500 patients (253 males; 247 females) were evaluated. Main Outcome Measures The prevalence of FNM, CBM, and CPC; the length, width, and depth of FNM; and CBM types were recorded. Also, a morphological analysis of the clivus (length of the clivus, angle between the clivus and the posterior margin of the foramen magnum, angle between the clivus and the dens axis, and anteroposterior diameter of the foramen magnum) was performed. Results FNM was identified in 5.4%, CBM in 4%, and CC in 0.8% of the study group. Type 5 CBM was not found. Type 6 was the most common CBM type. There was no significant correlation between the age and gender of patients with FNM. There were significant differences between the clivus length, the angle between the clivus and the dens axis, the anteroposterior diameter of the foramen magnum, and gender. Also, there was a significant difference between the angle between the clivus and the foramen magnum and age. Conclusions The anatomical variations of the clivus are rare and important for the oral and maxillofacial radiologist to make the differential diagnosis. These anatomical variations should not be confused with pathologic formations. The morphological measurements and anatomical variations of the clivus can be evaluated in detail on CT images. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abs tract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Effect of Prescription Isodose Variation on Tumor Control and Toxicities in Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma: Propensity Score-Matched Case–Control Study

xlomafota13 shared this article with you from Inoreader The Effect of Prescription Isodose Variation on Tumor Control and Toxicities in Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma: Propensity Score-Matched Case–Control Study Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1718908 Objective Vestibular schwannoma (VS) treated with Gamma Knife stereotactic radiosurgery (SRS) was typically performed at 50% isodose line (IDL50); however, the impact of IDL variation on outcomes is poorly understood. This study aimed to compare tumor control (TC) and toxicities between treatment at 40% (IDL40) and 50% (IDL50). Methods and Materials Sporadic/unilateral VS patients treated with SRS dose 12 to 14 Gy and prescription isodose volume ≤10cm3 were included. Propensity score matching was applied to IDL40 cohort to generate an IDL50 companion cohort, adjusting for age and prescription isodose volume. After exclusion of patients with follow-up <24 months, there were 30 and 28 patients in IDL40 and IDL50 cohorts, respectively. Results Median follow-up time was 96 months (24–225 months). Actuarial and radiographic TC rates were 91.8% and clinical TC was 96.2% both at 5 and 10 years. TC was higher in IDL40 cohort but not significant (96.4 vs. 86.7%; p = 0.243). Hearing preservation (HP) rates were 71.9 and 39.2% at 5- and 10-year intervals, with significantly higher rates of HP noted in IDL40 cohort (83.3 vs. 57.1% at 5-year interval; 62.5 vs. 11.4% at 10-year interval; p = 0.017). Permanent facial neuropathy occurred in two patients, both from the IDL50 cohort (3.5%). Rates of post-SRS steroid treatment or shunt placement for hydrocephalus were slightly higher in IDL50 patients (6.9 vs. 17.9%; p = 0.208 and 3.3 vs. 7.1%; p = 0.532). Conclusion For treatment of VS with SRS, dose prescription at IDL40 or IDL50 provides excellent long-term TC and toxicity profiles. IDL40 may be associated with improved long-term HP. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.