Airway injury from transoral endoscopic thyroidectomy vestibular approach

xlomafota13 shared this article with you from Inoreader Airway injury from transoral endoscopic thyroidectomy vestibular approach Via Head & Neck Abstract Background The transoral endoscopic thyroidectomy vestibular approach (TOETVA) is a novel technique that eliminates a cervical scar. This procedure carries unique risks, and data on outcomes are needed as more cases are performed. Methods We describe two cases of airway injury during the TOETVA. A description of the procedure and management of the injuries is outlined. Results In one case, a 3-mm injury in the thyrohyoid membrane was identified. The TOETVA was converted to an open approach due to significant inflammation in the setting of Graves' and the repair was performed while open. In the second case, a fracture occurred from the thyroid notch to Broyle's ligament without avulsion. A primary repair was endoscopically performed. Conclusions Airway injury is a possible complication of both open thyroidectomy and TOETVA. For TOETVA, trauma is most likely to occur in the midline during Hegar dilation and trocar placement through the central incision. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity

xlomafota13 shared this article with you from Inoreader Diversity in Academic Laryngology: An Evaluation of Academic Advancement and Research Productivity Via The Laryngoscope Background Diversity within the medical profession with respect to sex and racial minorities has been shown to have a positive effect on health and healthcare. Characterization of a field is key to evaluating trends and the advancement of diversity in an otolaryngology subspecialty. Study Design Observational study. Methods A comprehensive list of all the academic laryngologists was compiled from the Accreditation Council for Graduate Medical Education accredited otolaryngology residency programs in 2020. The last 20 past presidents of the American Laryngological Association (ALA) and American Broncho-Esophogological Association (ABEA) were analyzed. Academic rank and years in practice were determined from departmental websites, with online search tools used as secondary resources. The h-index was utilized as a measure of research productivity. Regression analysis was performed to analyze these variables. Results There are 184 academic laryngologists in the 124 programs. The majority of the population is Caucasian 76.6% (141/184), followed by Asian 16.3% (30/184), African American 4.34% (8/184), and then Hispanic 1% (2/184). There are 47 full professors with 83% Caucasian, 14.1% Asian, and 2.1% African American and 91.5% male and only 8.5% female. Past ALA presidents were 90% male and for the ABEA 75% male. H-index revealed a statistically significant difference between Caucasian and African American colleagues [P value (<.0005)]. Conclusions Minorities are disproportionately underrepresented in laryngology. Women are less likely to be in leadership roles in laryngology and become full professors. Laryngology lags behind other surgical specialties in the representation of minorities and women. Continued efforts should be made to increase diversity in the field of laryngology, especially in regard to underrepresented minorities. Level of Evidence N/A Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Safety and Predictors of 30‐Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS‐NSQIP data

xlomafota13 shared this article with you from Inoreader Safety and Predictors of 30‐Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS‐NSQIP data Via The Laryngoscope Objectives/Hypothesis To characterize and identify predictors of 30-day adverse events in patients undergoing laryngeal framework surgery (LFS). Study Design This study is a retrospective analysis of the National Surgical Quality Improvement dataset. Methods LFS cases were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2008 to 2018. Demographic variables, patient comorbidities, and perioperative outcomes (any adverse event, 30-day readmission, 30-day reoperation, and unplanned intubation) were extracted. Patient-specific and surgery-specific factors associated with perioperative adverse events were examined using descriptive statistics and univariate logistic regression (LR). Results Of 283 patients who underwent LFS, 225 underwent laryngoplasty medialization, 56 underwent laryngoplasty medialization with arytenoidectomy or arytenoidopexy via an external approach, and 2 underwent local myocutaneous or fasciocutaneous advancement flap along with laryngoplasty. Medical comorbidities were present in 33.6% of patients and 57.9% were American Society of Anesthesiologists (ASA) Class III/IV (57.9%). LFS was performed as same-day surgery in 30.7% of cases. Fourteen patients (4.9%) suffered an adverse condition within 30 days following surgery. In univariate LR, ASA Class III or IV (odds ratio [OR] 4.6, 95% confidence interval [CI] 1.2–30.1) was the only predictor associated with any adverse event. Arytenoid adduction (AA) was associated with increased risk of reoperation within 30 days of the initial surgery (OR 6.4, 95% CI 1.0–49). Conclusions LFS is a generally safe procedure with infrequent perioperative adverse events. In the ACS-NSQIP database, ASA classification of III or IV was associated with a higher risk for any 30-day adverse event and AA was associated with a higher risk for 30-day reoperation. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison of robotic versus laparoscopic distal pancreatectomy: Propensity score matching analysis

xlomafota13 shared this article with you from Inoreader A comparison of robotic versus laparoscopic distal pancreatectomy: Propensity score matching analysis Via The International Journal of Medical Robotics and Computer Assisted Surgery Abstract Background The aim of this study was to assess the perioperative and pathologic outcomes of robotic distal pancreatectomy compared with a laparoscopic approach. Methods A total of 121 robotic distal pancreatectomies and 992 laparoscopic distal pancreatectomies were retrospectively evaluated, comparing the demographic, perioperative and pathologic outcomes. After 1:2 propensity score matching with 11 demographic variables, the factors were analyzed again. Results Following propensity score matching, 104 robotic distal pancreatectomy patients were compared with 208 laparoscopic distal pancreatectomy patients. The operation time and proportion of spleen preservation were not different between the groups. The rates of open conversion were lower, whereas the hospital costs were higher in the robotic group. Other perioperative outcomes and pathologic factors did not differ between the groups. Conclusions Although robotic distal pancreatectomy is more expensive, this operation is feasible, with a higher probability of proceeding with the planned operation and with low open conversion rate. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lip angioedema after indirect contact with a sea anemone

xlomafota13 shared this article with you from Inoreader Lip angioedema after indirect contact with a sea anemone Via ear nose throat Ear Nose Throat J. 2021 Nov 3:1455613211055704. doi: 10.1177/01455613211055704. Online ahead of print. ABSTRACT Sea anemones are marine animals that can produce toxins causing severe angioedema. Swimmers and divers should be aware of sea anemone species that can cause local and systemic toxic reactions and avoid indirect or direct skin contact. High index of suspicion, full laboratory workup, and treatment with steroids and antibiotics are imperative for an uneventful recove ry. PMID:34732103 | DOI:10.1177/01455613211055704 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance

xlomafota13 shared this article with you from Inoreader Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance Via JAMA Otolaryngology–Head & Neck Surgery Online First This qualitative study surveys otolaryngologists and radiation oncologists regarding their opinions on deintensification of surveillance in patients with diagnosed head and neck cancer. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The 5‐HT1A receptor agonist, 8‐OH‐DPAT, Attenuates Long‐Lasting Pain in Imiquimod‐Induced Psoriasis in Mice.

xlomafota13 shared this article with you from Inoreader The 5‐HT1A receptor agonist, 8‐OH‐DPAT, Attenuates Long‐Lasting Pain in Imiquimod‐Induced Psoriasis in Mice. Via Experimental Dermatology ABSTRACT Psoriasis pain is a common symptom underestimated and rarely evaluated in psoriasis clinical trials. This work aimed to investigate if the development of secondary chronic allodynia and hyperalgesia in the imiquimod (IMQ)-induced psoriasis mice model could be modulated by anti-inflammatory agents and compound 48/80 (C48/80) and to determine whether the activation of 5-HT1A receptor modulates these nociceptive behaviors. C57BL/6 male mice were treated with 5% IMQ for 7 days. The paw withdrawal responses to von Frey filaments (10 and 250 mN) were used to assess the allodynia and hyperalgesia. Nociceptive behaviors were also evaluated using ketorolac 15 mg/kg s.c; adalimumab 10 mg/kg s.c., and C48/80 10 mg/kg i.p. Then, the serum serotonin and the impact of 8-OH-DPAT (1 mg/kg s.c), a 5-HT1A receptor agonist, on long-lasting pain were examined. Mice receiving IMQ showed enhanced nociception, which decreased with all tested compounds. The serum serotonin in the IM Q-group showed a significant decrease (947.042 ng/ml) regarding the control group (1143.68 ng/ml). The pre-treatment with 8-OH-DPAT alleviated pain-related behaviors. These results suggest that the long-lasting pain resulting from psoriasis inflammation is also associated with the serotonergic system. The 5-HT1A receptor should be further explored as a potential therapeutic target for psoriasis pain modulation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Engineering Functional Skin Constructs: A Quantitative Comparison of Three‐Dimensional Bioprinting with Traditional Methods

xlomafota13 shared this article with you from Inoreader Engineering Functional Skin Constructs: A Quantitative Comparison of Three‐Dimensional Bioprinting with Traditional Methods Via Experimental Dermatology Abstract Tissue engineering has been successful in reproducing human skin equivalents while incorporating new approaches such as three-dimensional (3D) bioprinting. The latter method offers a plethora of advantages including increased production scale, ability to incorporate multiple cell types, and printing on demand. However, the quality of printed skin equivalents compared to those developed manually has never been assessed. To leverage the benefits of this method, it is imperative that 3D printed skin should be structurally and functionally similar to real human skin. Here, we developed four bilayered human skin epidermal-dermal equivalents: non-printed dermis and epidermis (NN), printed dermis and epidermis (PP), printed epidermis and non-printed dermis (PN), and non-printed epidermis and printed dermis (NP). The effects of printing induced shear stress [0.025 kPa (epidermis); 0.049 kPa (dermis)] were characterized both at the cellular and at the tissue level. At cellular level, no st atistically significant differences in keratinocyte colony forming efficiency (CFE) (p=0.1641), was observed. In the case of fibroblasts, no significant differences in the cell alignment index (p<0.1717), and their ability to contract collagen gel (p=0.851) were detected. At the tissue levels, all the four skin equivalents were characterized using histological and immunohistochemical analysis with no significant differences found in either epidermal basal cell count, thickness of viable epidermis, and relative intensity of filaggrin and claudin-1. Our results demonstrated that 3D printing can achieve the same high-quality skin constructs as have been developed traditionally, thus opening new avenues for numerous high-throughput industrial and clinical applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal

xlomafota13 shared this article with you from Inoreader The importance of the patient's perspective in function-sparing parotid surgery for benign neoplasms: clinical reappraisal Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):410-418. doi: 10.14639/0392-100X-N1463. ABSTRACT OBJECTIVE: Function-sparing surgery is the cornerstone for the treatment of benign parotid neoplasms. We assessed the incidences and determinants of the main postoperative complications, reappraising their influence on the patient's quality of life (QoL). METHODS: Patients who underwent parotid surgery for benign neoplasms were reviewed (2016-2019). Parotidectomy Outcome Invento ry-8 (POI-8) and condition-specific questionnaires were used to investigate the patient's perspective. RESULTS: We enrolled 211 patients. Preservation of the posterior branch of the great auricular nerve (GAN) seemed to reduce early dysfunction (87% vs 96%, p = 0.053), but not the late one. Deep lobe dissection and resection of more than one parotid segment favoured first bite syndrome (FBS) and Frey's syndrome (FS), respectively (16% vs 3%, p = 0.003; 37% vs 15%, p = 0.003). Neither GAN impairment, FBS, nor FS influenced patient QoL. Facial weakness affected 19 patients (9%), being more likely after total parotidectomy (23% vs 7%, p = 0.034). According to POI-8, QoL was mainly jeopardised by fear of revision surgery, especially in females (p = 0.005) and those experiencing early complications (p = 0.004). CONCLUSIONS: Reappraisal of the patient's perspective after functional parotid surg ery is fundamental to tailor preoperative counselling. PMID:34734576 | DOI:10.14639/0392-100X-N1463 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye

xlomafota13 shared this article with you from Inoreader Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):443-449. doi: 10.14639/0392-100X-N1344. ABSTRACT OBJECTIVE: To evaluate the olfactory function in primary Sjögren's syndrome (pSS) patients and investigate its correlation with dry eye parameters. METHODS: Thirty-eight pSS patients (49.47 ± 10.06 years) and 20 healthy volunteers (47.40 ± 8.92 years) were enrolled in the study. All participants underwent ENT and eye examinations including a modified Connecticut Chemosensory Clinical Research Center (CCCRC) test, tear break-up time (TBUT), ocular surface staining (OSS) and Schirmer test. The parameters were compared between the two groups using Student-t test, and Pearson test was used to evaluate the correlations. RESULTS: Mean Schirmer and TBUT values were 2.39 ± 1.48 mm/5 min and 3.66 ± 1.5 sec in pSS and 18.30 ± 6.16 mm/5 min and 14.60 ± 3.64 sec in healthy subjects (p < 0.001, both). There was a significant decrease in mean odour threshold, odour identification, CCCRC and VAS scores in the pSS group (p < 0.001). Dry eye parameters showed moderate correlations with CCCRC parameters (r = 0.4-0.6, p < 0.001) and olfaction VAS score (r = 0.4-0.75, p < 0.05). CONCLUSIONS: There is a mild clinical impairment in smell sense in patients with pSS which seems to be correlated with dry eye parameters. Therefore, smell complaints should be queried in pSS patients suffering from severe dry eye. PMID:34734580 | DOI:10.14639/0392-100X-N1344 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute

xlomafota13 shared this article with you from Inoreader VITOM-3D-assisted retroauricular neck surgery (RANS-3D): preliminary experience at Candiolo Cancer Institute Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2021 Oct;41(5):419-431. doi: 10.14639/0392-100X-N1293. ABSTRACT OBJECTIVE: The recent introduction of 3D exoscopic surgery has engendered interesting technical improvements in head and neck surgery. The main goal of this study was to describe the application of 3D exoscopic technology on a wide range of pathologies of the neck, benign and malignant, through a minimally invasive retroauricular approach. METHODS: In the period January-December , 2019, 40 consecutive patients underwent neck surgery with a retroauricular approach, enhanced by using a 3D exoscope at the Head and Neck Oncological Unit of Candiolo Cancer Institute. RESULTS: Data regarding time to drain removal, length of hospitalisation, degree of pain experienced, need for opioid drugs during hospitalisation and after discharge, and intra-operative and post-operative complications were collected. All patients were followed for a minimum of 90 days with possible complications evaluated at each post-operative visit. Post-operative outcomes were evaluated at 3 months after surgery. CONCLUSIONS: The current study indicates that VITOM-3D-assisted retroauricular neck surgery (RANS-3D) may be an interesting approach for neck surgery. The hybrid execution of neck dissection under direct and exoscopic vision represents a valid alternative to video-assisted endoscopic- and robot-assisted techniques. PMID:34734577 | DOI:10.14639/0392-100X-N1293 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.