Intracranial venous sinus stenting for the treatment of lateral sinus stenoses: An analysis of 200 patients

xlomafota13 shared this article with you from Inoreader Intracranial venous sinus stenting for the treatment of lateral sinus stenoses: An analysis of 200 patients Via leak of cerebrospinal fluid Diagn Interv Imaging. 2021 Jun 11:S2211-5684(21)00138-8. doi: 10.1016/j.diii.2021.05.008. Online ahead of print. ABSTRACT PURPOSE: The purpose of this study was to analyze the long-term efficacy and safety of intracranial venous sinus stenting in a large cohort of patients with any type of presentation of primary lateral venous sinus stenosis (VSS). MATERIALS AND METHODS: A retrospective cohort study was performed including patients treated by venous sinus stenting for symptomatic VSS from 2012 to 2019. Successful primary resolution of symptoms without adjunctive treatment or recurrence, and complications after stenting were analyzed at the last follow-up time point. RESULTS: Two-hundred patients were included. There were 14 men and 186 women with a mean age of 39±14 (SD) years (age range: 13-75 years). Presenting symptoms included venous pulsatile tinnitus in 168 patients (168/200; 84%), idiopathic intracranial hypertension in 1 00 patients (100/200; 50%) and/or spontaneous cerebrospinal fluid leak in 35 patients (35/200; 17%). The overall rate of successful primary resolution of any typical presenting symptoms was 79% (95% CI: 73-85%). This rate ranged from 74% to 93% depending on the symptom with no significant difference between patients with and those without idiopathic intracranial hypertension (P=0.08). Recurrence rate was 10% (95% CI: 6-14%). No death or permanent morbidity were observed during a median follow-up of 2.2 years (Q1, Q3: 1.4, 3.3; range: 1-7.7 years). CONCLUSION: Our study shows that venous sinus stenting has a low morbidity and high success rate at long-term follow-up for the treatment of idiopathic intracranial hypertension, venous pulsatile tinnitus or spontaneous cerebrospinal fluid leak associated with VSS. The excellent safety suggests considering this treatment as first-line treatment when medical management is ineffective or poorly tolerated. PMID:34127434 | DOI:10.1016/j.diii.2021.05.008 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A Study of JCIH (Joint Commission on Infant Hearing) Risk Factors for Hearing Loss in Babies of NICU and Well Baby Nursery at a Tertiary Care Center

xlomafota13 shared this article with you from Inoreader A Study of JCIH (Joint Commission on Infant Hearing) Risk Factors for Hearing Loss in Babies of NICU and Well Baby Nursery at a Tertiary Care Center Via Otolaryngology Indian Abstract Babies in Neonatal Intensive Care Units (NICU) have an additional risk for hearing loss due to various risk factors like, prematurity, low birth weight, mechanical ventilation, hyperbillirubinemia, ototoxic drugs, low APGAR score etc. as compared to the babies from well baby nursery (WBN) who, poses risk factors mostly family history, syndromic deafness. So the present study was aimed know the risk factors responsible for hearing loss in NICU and WBN babies and to assess the incidence of deafness. A total of 800 babies from NICU (n = 402) and WBN (n = 398) underwent hearing screening from a tertiary care center. Hearing screening was done using two staged screening protocol as per JCIH guidelines with Distortion product Evoked Otoacoustic Emissions (DPOAE) and Automated Auditory Brainstem Responses (A-ABR). According to DPOAE test, 311 from NICU and 383 from WBN passed the test and during second screening, 80 out of 91 from NICU and 11 o ut of 13 from WBN passed the DPOAE test. Further BERA was done at the 3rd month of corrected age where 6 out of 11 showed positive responses from NICU and 3 babies from WBN had profound hearing loss. Data analysis revealed that family history of deafness, anemia and hypertension in ANC, TORCH in mother, low Apgar score and hyperbillirubinemia in newborns were a major risk factor for hearing impairment. We conclude that the diagnoses of auditory disorders at early stage due to various risk factors are important since appropriate therapeutic intervention and rehabilitation would help in better development of children. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Neurosurgical anatomy of the floor of the third ventricle and related vascular structures

xlomafota13 shared this article with you from Inoreader Neurosurgical anatomy of the floor of the third ventricle and related vascular structures Via radiol anat Surg Radiol Anat. 2021 Jun 14. doi: 10.1007/s00276-021-02785-8. Online ahead of print. ABSTRACT PURPOSE: Anatomical knowledge of the floor of the third ventricle (FTV) is essential in avoiding surgical complications during endoscopic third ventriculostomy. The purpose of this study was to characterize the morphometry of FTV and related arteries, particularly the basilar artery (BA), as well as the factors that influence it. METHODS: Twenty-six formalin-fixed adult brai ns and two hundred adult brain MRIs were studied focusing on FTV and related arteries. Dimensions of interest were measured using image analysis software. Morphometric data obtained were statistically analysed. RESULTS: Distances between FTV, intermammillary sulcus (IMS), infundibulum, BA bifurcation, and posterior communicating arteries (PCoAs) were described on the cadavers and the MRIs. Distance between right and left PCoAs was greater at their anterior extremity (p < 0.001). Right PCoA was longer (p = 0.016). BA was lateralized in 58.4% of cases and its calibre was larger in males (p < 0.001). The distance from BA apex to FTV was inversely correlated with BA diameter (p < 0.001) and age (p = 0.004). Distance from IMS to infundibulum and the distance between both PCoAs were greater in MRI series when compared to cadaver series (p < 0.001). CONCLUSIONS: A quantitative description of the morphometry of the region of the FTV and related vessels was obtained, helping neurosurgeons in planning their surgical approach. The distance from BA apex to FTV was shorter in individuals with larger BA calibre and in older subjects. MRI studies were qualitatively superior to cadaveric studies in evaluating the anatomy of this region. PMID:34128100 | DOI:10.1007/s00276-021-02785-8 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Malignant struma ovarii with late recurrence harbouring high microsatellite instability

xlomafota13 shared this article with you from Inoreader Malignant struma ovarii with late recurrence harbouring high microsatellite instability Via radioactive iodine BMJ Case Rep. 2021 Jun 14;14(6):e242081. doi: 10.1136/bcr-2021-242081. ABSTRACT Struma ovarii (SO) is a rare ovarian teratoma containing abundant mature thyroid tissue. Malignant transformation is even less common and distant metastasis is documented in about 5%-10%. The time from diagnosis of primary SO to metastatic disease varies. As malignant SO is rare, there are no uniform diagnostic criteria or treatment guidelines. Management is usually extrapolated from that of thyroid mal ignancy. We report a patient who relapsed 12 years from the initial diagnosis and metastasised to the lungs 5 years after the first recurrence. Our patient was treated with total thyroidectomy followed by radioactive iodine, and retreated on progression in the lungs. The tumour harboured high microsatellite instability and treatment with programmed cell death protein 1 inhibitor was initiated. This case shows the long latency of SO with the rare phenomenon of metastasis. It also highlights the importance of molecular testing for rare cancers such as this. PMID:34127502 | DOI:10.1136/bcr-2021- 242081 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparing surgical thoroughness and recurrence in thyroid cancer patients across race/ethnicity

xlomafota13 shared this article with you from Inoreader Comparing surgical thoroughness and recurrence in thyroid cancer patients across race/ethnicity Via radioactive iodine Surgery. 2021 Jun 11:S0039-6060(21)00412-8. doi: 10.1016/j.surg.2021.05.001. Online ahead of print. ABSTRACT BACKGROUND: For patients with differentiated thyroid cancer who will receive postoperative radioactive iodine, thyroid remnant uptake can be calculated and may point to the thoroughness of the surgical resection. In the United States, outcome disparities exist among ethnic/racial minorities with differentiated thyroid cancer. Data about surgical thoroughness and recurrence r ates across races/ethnicities do not exist. This study compared the amount of thyroid remnant uptake and cancer recurrence rates across race/ethnicity. METHODS: This was a retrospective analysis of adult patients with differentiated thyroid cancer who had postoperative radioactive iodine in 2017 and 2018 and were followed to 2020. We collected thyroid bed remnant uptake from postoperative radioactive iodine scans and analyzed it as a ratio of percent of uptake to dose of radioactive iodine received to control for varying radioactive iodine doses. Thyroid remnant, uptake to dose of radioactive iodine received, and recurrence were evaluated across race/ethnicity. RESULTS: Of 218 patients: 61% were White, 21% Black, 11% Asian, and 7% Hispanic; 72% were female. Seventy-one percent of patients had their surgery done by a high-volume surgeon, although volume data were not available for all. In White, Black, Asian, and Hispanic patients, median uptake was 0.68%, 0.44%, 1.5%, an d 0.8%, respectively (P = .13). We did not observe differences in median uptake to dose of radioactive iodine received across groups (P = .41). Recurrence rate was 17.0% among White patients, 16.7% among Black patients, 17.6% among Asian patients, and 16.7% among Hispanic patients (P = 1.00). CONCLUSION: We did not observe differences across race/ethnicity in surgical thoroughness or rate of recurrence. These findings suggest that disparities may be mitigated when ethnic/racial minorities have similar access to quality surgical care. PMID:34127303 | DOI:10.1016/j.surg.2021.05.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis

xlomafota13 shared this article with you from Inoreader The Impact of Surgical Posterior Nasal Nerve Cryoablation on Symptoms and Disease-Specific Quality of Life in Patients With Chronic Rhinitis Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211018576. doi: 10.1177/01455613211018576. Online ahead of print. ABSTRACT OBJECTIVE: Preliminary data have demonstrated long-term efficacy of posterior nasal nerve (PNN) cryoablation in reducing rhinitis symptoms for patients with allergic rhinitis (AR) and nonallergic rhinitis (NAR). We sought to evaluate the impact of procedural cryoablation of the PNN on quality of life (QOL) in patients with AR and NAR. METHODS: Adult patients undergoing PNN cryoablation for AR or NAR after appropriate medical therapy were included for analysis. Demographics, medical therapies, baseline rhinitis symptom (total nasal symptom score [TNSS]), and disease-specific QOL (mini-rhinoconjunctivitis quality of life questionnaire [mini-RQLQ]) were recorded. The Wilcoxon signed-rank test was used to test for significant changes in baseline test scores posttreatment. Absolute and relative improvement in outcomes was determined for each participant. Secondary outcomes were assessed with univariate and multivariate analyses. RESULTS: Fourteen patients were enrolled with a mean follow-up of 16.5 weeks. The TNSS and mini-RQLQ scores significantly improved after PNN cryoablation (median δs [interquartile range]: -4 [3] and -1.61 [1.08], respectively; both P = .0002). The minimal clinically important difference for the TNSS and mini-RQLQ was obtained in 92.9% of patients in each category. Relative mean percentage (%) improveme nt after PNN cryoablation in the TNSS and mini-RQLQ was 40.7% and 40.5% (standard deviation = 24.9 and 29.5, respectively), respectively, for all patients. Patients with NAR (n = 10) reported mean improvement of 41.3% (29.1) as measured by the TNSS and 49.6% (25.9) by mini-RQLQ. Patients with AR reported mean percentage improvement in TNSS and mini-RQLQ scores of 39.5% (12.1) and 24.6% (28.5), respectively. Patients who had been prescribed a nasal anticholinergic for management prior to PNN cryoablation had statistically significantly increased improvement in mini-RQLQ scores from pre- to post-procedure (P = .0387). CONCLUSION: Surgical cryoablation of the PNN significantly improves both symptoms and disease-specific QOL in majority of patients with AR and NAR. PMID:34128402 | DOI:10.1177/01455613211018576 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) for Tinnitus: A Retrospective Study Via ear nose throat Ear Nose Throat J. 2021 Jun 15:1455613211016896. doi: 10.1177/01455613211016896. Online ahead of print. ABSTRACT OBJECTIVE: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. METHODS: Between January 2016 and May 2017, 199 tinnitus patients were identifi ed from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. RESULTS: Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient's subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient's subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. CONCLUSIONS: Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patien ts are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week. PMID:34128408 | DOI:10.1177/01455613211016896 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of retromolar canal and its association with mandibular molars: study in CBCT

xlomafota13 shared this article with you from Inoreader Prevalence of retromolar canal and its association with mandibular molars: study in CBCT Via radiol anat Surg Radiol Anat. 2021 Jun 15. doi: 10.1007/s00276-021-02787-6. Online ahead of print. ABSTRACT OBJECTIVE: Investigate the presence and characteristics of the retromolar canal and association with mandibular molars using cone-beam computed tomography (CBCT). STUDY DESIGN: CBCT images of 200 consecutive patients were analyzed using the Anatomage Invivo 5® software. Retromolar canal present evaluated the type of trajectory, buccal or lingual location, uni or bilateral, origin and final diameters. Pearson's Chi square test was used to verify the association between the retromolar canal and the presence of the third molar (p ≤ 0.05). RESULTS: The prevalence of the retromolar canal was 24.5%. The oblique trajectory was the most common (33.3% on the right side and 50% on the left side). Buccal location was the most frequent (right side 50% and left side 70%). The unilateral canal was the most frequent (77.6%). As for the caliber, the diameters vary from 1.12 to 2.37 mm. Regarding the association between the retromolar canal and the third molar, there was no statistically significant difference (right side p = 0.60 and left side p = 0.90). CONCLUSION: The retromolar canal is not a rare anatomical variation showing a prevalence of 24.5%. Surgical procedures should consider the presence of the retromolar canal to avoid excessive bleeding, considering its significant caliber. PMID:34129064 | DOI:10.1007/s00276-021-02787-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus

xlomafota13 shared this article with you from Inoreader Assessment of the necessity of frontal sinostomy in cases of frontal sinusitis associated with fungus ball of the maxillary sinus Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jun 15. doi: 10.1007/s00405-021-06933-z. Online ahead of print. ABSTRACT PURPOSE: This study was conducted to evaluate outcomes in patients presenting with fungus ball of the maxillary sinus (MSFB) and frontal sinusitis who were treated via middle meatal antrostomy alone. METHODS: This was a randomized, controlled study with a parallel group design. Patients with MSFB and frontal sinusitis were randomly assigned to the maxillary middle meatal antrostomy (MMMA) or control (MMMA + frontal sinusotomy) groups. Patient demographics, complaints, imaging findings were analyzed, and surgical outcomes were evaluated using the Lund-Kennedy endoscopic score (LKES) and the 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaire. RESULTS: In total, 40 patients were separated into two groups, with similar symptoms including nasal obstruction, mucopurulent rhinorrhea, maxillary or frontal pain, blood staine d nasal discharge, nasal cacosmia and orbital pain being observed in both groups. Total LKES and SNOT-22 scores were significantly improved in both groups at 6 months post-treatment, with no significant differences in these scores between groups within a mean 6.8-month follow-up. CONCLUSION: These results suggest that frontal sinusotomy is not required to resolve frontal sinusitis associated with MSFB. As such frontal sinusitis appears to be a reactive process caused by fungal ball obstruction, it regresses spontaneously following fungus ball removal, drainage of the maxillary sinus, and middle meatal antrostomy. PMID:34129085 | DOI:10.1007/s00405-021-06933-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation

xlomafota13 shared this article with you from Inoreader Comparison of cervical and ocular vestibular-evoked myogenic potential responses between tone burst versus chirp stimulation Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2021 Jun 15. doi: 10.1007/s00405-021-06936-w. Online ahead of print. ABSTRACT PURPOSE: To compare the effectiveness of chirp and tone burst stimuli in oVEMP and cVEMP testing for healthy adults METHODS: This study was conducted in 56 healthy volunteers (112 ears). Ocular and cervical VEMP (oVEMP, cVEMP) tests were performed for each participant using tone burst and chirp stimuli. VEMP response rates, latency of each peak (p1-n1, n1-p1), peak to peak amplitude (p1-n1 amplitude and n1-p1 amplitude), and rectified amplitudes were measured and compared between these two different stimuli. RESULTS: VEMP response rates with chirp stimuli are higher than the tone burst stimuli for both cVEMP and oVEMP tests (The difference was statistically significant for oVEMP, p = 0.001). Chirp stimuli have higher p1n1 amplitude and rectified amplitude and shorter p1and n1 latency then tone burst stimuli for cVEMP (p = 0.01 5, p = 0.007, p < 0.001, p < 0.001, respectively). Chirp stimuli also have higher n1p1 amplitude and shorter n1and p1 latency then tone burst stimuli for oVEMP (p = 0.006, p < 0.001, p < 0.001, respectively). CONCLUSION: The present findings show that the chirp stimulus triggers earlier VEMP responses with higher amplitudes than the tone burst stimulus during cVEMP and oVEMP testing. VEMP response rate with chirp stimulus is also higher than the tone burst. Therefore chirp stimulus can be used in VEMP testing as effectively as, if not more than, tone burst stimulus in clinical practice. PMID:34129084 | DOI:10.1007/s00405-021-06936-w View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.