Current Therapeutic Approaches to Subglottic Stenosis in Patients With GPA: A Systematic Review

xlomafota13 shared this article with you from Inoreader Current Therapeutic Approaches to Subglottic Stenosis in Patients With GPA: A Systematic Review Via ear nose throat Ear Nose Throat J. 2021 Aug 15:1455613211036246. doi: 10.1177/01455613211036246. Online ahead of print. ABSTRACT BACKGROUND: The management of subglottic stenosis (SGS) in granulomatosis patients with polyangiitis (GPA) has no clear guidelines. This systematic review aimed to identify different surgical techniques and evaluate the outcomes of applied procedures. METHODS: An electronic search was performed using 3 major databases, CINAHL, PubMed, and Clinical key, to in clude relevant studies published from the databases from inception through January 2017. All primary studies reporting treatment of SGS in cases with GPA were included. Articles were excluded if not relevant to the research topic or if they were duplicates, review articles, editorials, short comments, unpublished data, conference abstracts, case reports, animal studies, or non-English studies. RESULTS: Thirteen papers were included in our systematic review with a total of 267 cases for the qualitative review Endoscopic approaches showed favorable outcomes with the need to use multiple procedures to achieve remission. The open transcervical approach showed excellent results mainly after failure of other endoscopic techniques. Tracheostomy was necessary for severe respiratory obstruction symptoms. Medical treatment was essential for stabilizing the active disease and therefore may enhance the success rate postoperatively. CONCLUSION: Subglottic stenosis in patients with GP A requires a multidisciplinary approach to provide optimal management regarding disease activity, grade of stenosis, and severity of symptoms. PMID:34392732 | DOI:10.1177/01455613211036246 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tension Pneumocephalus Following Balloon Sinuplasty

xlomafota13 shared this article with you from Inoreader Tension Pneumocephalus Following Balloon Sinuplasty Via ear nose throat Ear Nose Throat J. 2021 Aug 15:1455613211037629. doi: 10.1177/01455613211037629. Online ahead of print. ABSTRACT Balloon sinus dilation (BSD) is a common method of relieving sinus outflow obstruction. With the rising utilization of BSD, increasing numbers of BSD-related complications have also been reported. Here, we report a case of pneumocephalus and cerebrospinal fluid leak following BSD of the frontal sinus. Additionally, a review of the literature regarding BSD complica tions was performed. PMID:34392735 | DOI:10.1177/01455613211037629 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recurrent Respiratory Papillomatosis With Complete Response to Systemic Bevacizumab Therapy

xlomafota13 shared this article with you from Inoreader Recurrent Respiratory Papillomatosis With Complete Response to Systemic Bevacizumab Therapy Via ear nose throat Ear Nose Throat J. 2021 Aug 15:1455613211040578. doi: 10.1177/01455613211040578. Online ahead of print. ABSTRACT Recurrent respiratory papillomatosis is a condition caused by human papilloma virus, usually sub types 6 and 11. Papillomas are benign neoplasms that are most commonly found on the larynx and can be often associated with significant airway involvement. Frequency of episodes varies among patients as do the clinical symptoms. Patients often present with symptoms suc h as hoarseness but there is potential for respiratory compromise and even complete airway obstruction. PMID:34392730 | DOI:10.1177/01455613211040578 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Tension Pneumocephalus Following Balloon Sinuplasty

xlomafota13 shared this article with you from Inoreader Tension Pneumocephalus Following Balloon Sinuplasty Via leak of cerebrospinal fluid Ear Nose Throat J. 2021 Aug 15:1455613211037629. doi: 10.1177/01455613211037629. Online ahead of print. ABSTRACT Balloon sinus dilation (BSD) is a common method of relieving sinus outflow obstruction. With the rising utilization of BSD, increasing numbers of BSD-related complications have also been reported. Here, we report a case of pneumocephalus and cerebrospinal fluid leak following BSD of the frontal sinus. Additionally, a review of the literature regarding BSD complications was performed. PMID:34392735 | DOI:10.1177/01455613211037629 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Post-dural puncture headache following lumbar spinal drain: an atypical presentation with cognitive symptoms

xlomafota13 shared this article with you from Inoreader Post-dural puncture headache following lumbar spinal drain: an atypical presentation with cognitive symptoms Via leak of cerebrospinal fluid Anaesth Rep. 2021 Jul 23;9(2):e12127. doi: 10.1002/anr3.12127. eCollection 2021 Jul-Dec. ABSTRACT Post-dural puncture headache is a consequence of cerebrospinal fluid loss, leading to reduced intracranial pressure. Its classical symptoms include a frontal-occipital headache which is worse on standing, neck stiffness, nausea, hearing loss and photophobia. In this report, we describe an atypical presentation of post-dural puncture headache in a 72-year-old woman following an endovascular repair of an aortic aneurysm, before which a lumbar spinal drain was placed to reduce the risk of spinal cord ischemia. Following drain removal, the patient developed hypoactive delirium, challenges with both depth perception and fine motor skills and a mild headache. An epidural blood patch was performed, which resulted in the complete resolution of her symptoms. This case highlights an atypical presentation of post-dural puncture headache in an older patient, in whom the major symptoms were cognitive. Cerebrospinal fluid leakage should be considered as a cause of postoperative delirium in patients who have undergone neuraxial anaesthesia. PMID:34396133 | PMC:PMC8340929 | DOI:10.1002/anr3.12127 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Survival and prognosis of lung large cell neuroendocrine carcinoma

xlomafota13 shared this article with you from Inoreader Survival and prognosis of lung large cell neuroendocrine carcinoma Via Association française pour l'étude du cancer Bull Cancer. 2021 Aug 12:S0007-4551(21)00208-3. doi: 10.1016/j.bulcan.2021.04.010. Online ahead of print. ABSTRACT INTRODUCTION: Only a few large-scale studies have focused on large cell neuroendocrine carcinoma, a rare type of pulmonary malignancy, and uniform diagnostic criteria and standardized treatments are lacking. This study aimed to assess the treatment outcomes and factors influencing patients' prognosis with large cell neuroendocrine carcinoma. METHODS: The data of 55 patients with pathologically confirmed large cell neuroendocrine carcinoma, treated at our hospital from January 2013 to January 2018, were collected. Relationships between clinical characteristics, diagnoses, treatment outcomes, and prognoses were retrospectively analyzed. RESULTS: Patients were followed for a median of 18.5 (0.5-41.0) months. Thirty-four patients died before the final follow-up, resulting in a median overall survival of 17.9 (0.5-3 6.0) months, with 1-, 2-, and 3-year survival rates of 69.1%, 23.6%, and 1.8%, respectively. Single-factor analysis identified gender (P=0.036), smoking history (P=0.008), obstructive atelectasis (P=0.032), regional lymph node metastasis (P=0.020), and treatment selection (P=0.000) as factors influencing overall survival. Multifactor analysis identified treatment selection as an independent survival prognostic factor. Particularly, significant differences were observed between the combination therapies (surgery+chemotherapy, surgery+radiotherapy, surgery+radiotherapy+chemotherapy, and concurrent chemoradiotherapy) and single-therapy approaches (chemotherapy or radiotherapy alone; P<0.001), but not among the combination therapies (P=0.216). DISCUSSION: Male patients with large cell neuroendocrine carcinoma with a history of smoking, obstructive atelectasis, and regional lymph node metastasis have a particularly poor prognosis. Our observation of the treatment approach as an independent survival prognostic factor suggests that combination therapies may yield survival benefits to patients. PMID:34392973 | DOI:10.1016/j.bulcan.2021.04.010 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Patterns of Regional Recurrence and Salvage Treatment in Patients With Oral Cancer

xlomafota13 shared this article with you from Inoreader Patterns of Regional Recurrence and Salvage Treatment in Patients With Oral Cancer Via The Laryngoscope Objectives Regional failure after primary treatment for oral squamous cell carcinoma (OSCC) carries a dismal outcome. Our goal was to investigate the recurrence patterns and salvage treatment in patients with OSCC and regional failure. Study design Retrospective chart review of all patients treated for OSCC in a university-affiliated tertiary care center during 2000-2018. Methods Data collected from patients' medical charts included demographics, clinical and pathological features, staging, treatment modalities and outcomes. Patients with insufficient data or a follow-up of less than 2 years were excluded. Results Out of 266 surgically treated patients, 55 developed regional recurrence and were included in the study cohort. Forty patients received surgical salvage treatment followed by adjuvant chemo-radiotherapy (CRT). Disease specific survival and overall survival were significantly higher in surgically treated patients compared to patients who received non-surgical treatment (46.7% vs. 0%, log-rank P value < .001 and 35.3% vs. 0%, log-rank P value = .001, respectively) and in patients who recurred regionally more than 10 months following initial treatment (40.8% vs 10.7%, log-rank P value = .065). Patients with early recurrence were older (73.6 vs. 61.3 years) and had a deeper invasion of the primary tumor (10.1 vs. 7 mm). Conclusions Salvage neck dissection is feasible in most cases, providing the best outcomes in patients with OSCC who fail regionally. Close follow-up during the first year after initial treatment is paramount as early recurrence carries a dismal prognosis. Specifically, elderly patients and patients with deeper primary tumor invasion should be closely monitored during the first post-operative year. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.