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Τετάρτη 6 Οκτωβρίου 2021

Effects of Dental Factors on Fungal Sinusitis

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Objectives: This study aimed to investigate the associations between dental treatments and fungal maxillary sinusitis (FMS). Methods: We retrospectively reviewed medical charts between July 2014 and March 2019. In total, 100 cases of FMS were included in this study. We also recruited 200 patients as a control group in the same period. Therefore, each of the FMS, chronic rhinosinusitis (CRS), and normal sinus groups consisted of 100 patients. We recorded all endodontic treatments (EDTs), tooth extractions, dental implantations, and ap ical lesions (ALs). Results: The FMS group had higher incidences of tooth extraction (49% vs. 11%, respectively) and EDT (29% vs. 16%, respectively) compared to the normal sinus group and fewer ALs compared to the CRS group (6% vs. 24%, respectively). There were significant differences between the CRS and normal sinus groups in the extraction rate (53% vs. 11%, respectively) and frequency of ALs (24% vs. 4%, respectively). The dental implantation prevalence rates were similar across all 3 groups. Conclusion: The rates of tooth extraction were significantly higher in the FMS and CRS groups compared to the normal sinus group. In addition, of the 3 conditions, FMS was related to EDT, and CRS was related to ALs.
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Virtual reality versus optokinetic stimulation in visual vertigo rehabilitation

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Eur Arch Otorhinolaryngol. 2021 Oct 5. doi: 10.1007/s00405-021-07091-y. Online ahead of print.

ABSTRACT

BACKGROUND: Visual vertigo (VV) is a condition at which there is worsening or triggering of vestibular symptoms in certain visual environments with large size (full field) repetitive or moving visual patterns as shopping malls.

PURPOSE: This work was designed to study effect of virtual reality and optokinetic stimulation on rehabilitation of VV.

METHOD: A total of 60 subjects divided into 2 groups that were simply randomized by the concealed envelope method: Group I consisted of 30 VV patients underwent vestibular rehabilitation using virtual reality. Group II consisted of 30 VV patients underwent vestibular rehabilitation using optokinetic stimulation.

RESULTS: Significant improvement in performance in the two groups after rehabilitation with no statistically significant difference when comparing both groups.

CONCLUSIONS: A combined intense rehabilitation program including OPK stimulation or VR rehabilitation combined with home-based exercises appeared to be equally effective for management of patients with VV and improving their quality of life.

PMID:34611745 | DOI:10.1007/s00405-021-07091-y

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Parathyroid Gland Autofluorescence Characteristics in Patients With Primary Hyperparathyroidism

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Objective

Near-infrared imaging for intraoperative parathyroid gland (PG) detection has recently commanded significant attention. The PTeye (Medtronic, Minneapolis, MN) is a probe-based system for near-infrared autofluorescent evaluation of PGs. This study was designed to evaluate the capabilities of the PTeye in the setting of surgery for primary hyperparathyroidism.

Study Design

Prospective, Cohort study.

Methods

This single-institution, prospective cohort study included all patients undergoing parathyroidectomy for primary hyperparathyroidism with presumed single gland disease from June 2020 to December 2020. Absolute intensity and intensity ratios, with the thyroid as the control tissue, were obtained for the adenoma, ipsilateral normal PG, and adjacent tissue. The ability of the PTeye to function when not in direct contact with tissue was measured.

Results

Twenty-two patients were included. The median intensity ratio for the in situ adenomas was 4.38 (interquartile range [IQR]: 2.03–5.87), ipsilateral normal PGs 6.17 (IQR: 3.83–7.67), strap muscle 0.47 (IQR: 0.30–0.60), and fat 0.20 (IQR: 0.17–0.47). All normal PGs and 21/22 adenomas demonstrated autofluorescence above the detection threshold. The PTeye functioned at a maximum distance of separation of 10 mm through saline medium and 6 mm through clear solid medium.

Conclusion

This study confirms the PTeye's ability to recognize PGs with a high degree of precision. The device was found to function properly even with the probe not in direct contact with the tissue. Although adenomatous PGs appear to demonstrate altered autofluorescent properties from normal PGs, additional research is required to determine if these differences are clinically useful.

Level of Evidence

3 Laryngoscope, 2021

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Loupe Assisted Thyroidectomy: A Tool for Reducing Complications

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Abstract

The objective of this study is to assess if the use of magnification can reduce the incidence of hypocalcemia and vocal cord palsy in thyroid surgery. Data of patients who underwent total thyroidectomy (N = 50) for thyroid malignancy were analyzed retrospectively for 1 year. The patients were divided into two groups based on surgery with and without loupes. Hypocalcemia and Vocal cord palsy was assessed pre as well as post-operatively and the observations were noted. Descriptive statistics were performed to assess the proportion of the respective groups. Inferential statistics to find out the difference between the groups was done using the chi-square test. Significance level was kept at 5%. The incidence of hypocalcemia was 36.9% in the group done without loupes compared to 7.6% with loupes. The event of vocal cord injury though transient was 33% when done without loupes (p < 0.05). Magnification is crucial for the visualization of the n eurovascular anatomy which is depicted in our study. Although the study includes less number of cases, it is evident that the use of loupe magnification can reduce the morbidity associated with thyroid surgery to a great extent. We recommend the use of loupe magnification during surgery whenever possible.

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Efficacy of Sucralfate in Alleviating Post Tonsillectomy Symptoms and Morbidity: A Comparative Randomized Interventional Study

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Abstract

Pain following tonsillectomy still remains the main concern of topic and it occurs along with sever ear pain and trismus until and unless the exposed and inflamed mucosa gets covered with the regenerated mucosa. To study the efficacy of sucralfate in alleviating postoperative pain and morbidity following tonsillectomy. Subjects included in our study were patients which were fulfilling criteria for tonsillectomy and were admitted under the Department of Otorhinolaryngology, SMS Medical College and Hospital, Jaipur from 1st July 2019 to 31st March 2020. 64 patients were evaluated and were randomly allocated into study and control group based on the administration of topical sucralfate. 64 patients who were admitted for tonsillectomy under the Department of Otorhinolaryngology, SMS Medical College and Hospital, Jaipur from 1st July 2019 to 31st March 2020 were included in study. Patients were evaluated and were randomly allocated into study and control group based o n the administration of topical sucralfate. The incidence of throat pain and otalgia showed significant difference among both the group following postoperative day 2 onwards. On postoperative day 2, significant difference in trismus was also found. Effective alleviation of pain not only improves early dietary intake of the patients but also allays fear of apprehensive parents.

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First dorsal metacarpal artery perforator-based propeller flap: functional anatomy and clinical application in soft-tissue defects of the dorsal hand and digits

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Surg Radiol Anat. 2021 Oct 6. doi: 10.1007/s00276-021-02845-z. Online ahead of print.

ABSTRACT

BACKGROUND: Many approaches have been reported to repair soft-tissue defects of the hand using dorsal metacarpal artery flaps. Use of a perforator-based propeller flap from the first intermetacarpal space to the dorsum of the hand has been described. The aim of this study was to confirm the functional anatomy of a first dorsal metacarpal artery (FDMA) perforator flap.

METHODS : Twenty-nine fixed cadaveric hands were dissected to determine the origin, course, and branches of the FDMA. Clinically, five cases of soft tissue defects of the hand underwent reconstructive surgery using an FDMA perforator-based propeller flap.

RESULTS: The FDMA was found in 27 specimens (93%). The ulnar branch of the FDMA always supplied the cutaneous perforator (mean ± SD, 4.3 ± 1.6), and the most distal cutaneous perforating branch was found along the metacarpal long axis within 25 mm of the tip of the metacarpal head with high frequency (28/29, 97%). In the two hands that had aplasia of the FDMA, well-developed perforators arose directly from the radial artery and advanced to the metacarpal head. Seven hands (24%) had perforators arising from the palmar arterial system, penetrating through or passing close by the second metacarpal bone. In clinical application, all the flaps survived completely without major complications.

CONCLUSIONS: The FDMA perforator-based propeller flap is minimally invasive and technically simple. It is expected to be a new option for hand reconstruction.

PMID:34613448 | DOI:10.1007/s00276-021-02845-z

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