Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults

xlomafota13 shared this article with you from Inoreader Understanding Public Perceptions Regarding Cochlear Implant Surgery in Adults Via leak of cerebrospinal fluid Otol Neurotol. 2022 Mar 1;43(3):e331-e336. doi: 10.1097/MAO.0000000000003439. ABSTRACT BACKGROUND AND OBJECTIVE: Approximately 6% of adults eligible for cochlear implantation (CI) undergo surgery. This study aims to understand how general perceptions about CI contribute to barriers causing this low utilization rate. METHODS: Participants completed an online survey regarding their perceptions about cochlear implantation. They were asked to rank CIQOL-10 Global priorities and corresponding risk tolerance for minor complications (changes in taste, vertigo) and major complications (infections requiring hospitalization, meningitis, reimplantation, facial paralysis, and cerebrospinal fluid [CSF] leak). RESULTS: A total of 615 responses (female 55%, mean age 39 years [range 20-78]) were included. Respondents identified issues with insurance (46%) and fear of undergoing surgery (21%) as barriers preventing eligible adults from receiving C I. Regarding surgical risk, respondents significantly underestimated rates of minor complications (p < 0.0001) and almost all major complications (all p < 0.0001) while overestimating rates of serious infections and need for reimplantation (both p < 0.005). The ability to hear strangers in noisy environments was identified as the highest priority for CI (26%). Individuals who knew someone with a cochlear implantation were willing to tolerate higher rates of all minor and major complications (all p < 0.05). Healthcare workers were similarly willing to tolerate significantly higher rates of meningitis, facial paralysis, and CSF leak to achieve their highest priority (all p < 0.05). CONCLUSIONS: Respondents identify insurance coverage and fear of surgery as primary reasons for low utilization of adult CI in the United States. However, healthcare workers or those who knew someone with a cochlear implantation indicated significantly higher rates of risk tolerance to achieve their highest quality of life priorities, indicating the potential that the benefits of cochlear implantation are underappreciated in the general population. PMID:35147605 | DOI:10.1097/MAO.0000000000003439 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Two‐Incision Approach for Hypoglossal Nerve Stimulator Placement: A Single Institution Assessment

xlomafota13 shared this article with you from Inoreader Two‐Incision Approach for Hypoglossal Nerve Stimulator Placement: A Single Institution Assessment Via The Laryngoscope Objective(s) Upper airway stimulator (UAS) placement is a treatment for obstructive sleep apnea (OSA) with few complications and low morbidity. UAS placement has traditionally been performed using a three-incision approach, however, it has been implanted using a two-incision approach. This approach could significantly decrease operation time without a difference in postoperative complications, demonstrating its safety and feasibility for UAS placement. The objective was to assess operative time and complication rate in the two-incision approach for UAS placement compared to the three-incision approach. Study Design Retrospectively reviewed. Methods Patients who underwent UAS placement using the two- or three-incision approach at a single academic institution from November 2014 to June 2021 were retrospectively reviewed. The two-incision approach did not include the incision at the mid-axillary line. Main outcome measures included operation time and complication rates. Results Three-hundred forty-eight patients underwent UAS placement. The three-incision approach demonstrated an average operation time of 143.3 minutes whereas the two-incision approach averaged 129.4 minutes (P < .001). There was no significant difference in rate of postoperative complications between the two- and three-incision cohorts including pneumothorax (0% vs. 0.4%, P > .99), patient-reported discomfort (5.6% vs. 6.5%, P > .99), activity restriction (0% vs. 1.4%, P > .50), and incisional pain (0.0% vs. 1.0%, P > .99). No patients experienced incision site bleeding or infection. The two-incision approach was associated with decreased rate of revision surgery (0.0% vs. 5.4%, P = .048). Conclusion The UAS two-incision approach proved to have a significantly shorter operative time without an increase in complications as compared to the three-incision approach. This approach is a safe and feasible option. Level of Evidence III Laryngoscope, 2022 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of postradiation late hemorrhage following treatment for HPV‐positive oropharyngeal squamous cell carcinoma

xlomafota13 shared this article with you from Inoreader Management of postradiation late hemorrhage following treatment for HPV‐positive oropharyngeal squamous cell carcinoma Via Head & Neck Abstract Background Acute oropharyngeal hemorrhage is a serious complication for patients with oropharyngeal squamous cell carcinoma (OPSCC), particularly in patients with a history of radiation therapy (RT). Methods Retrospective case series from at a tertiary care center for treated patients with HPV-positive OPSCC presenting with oropharyngeal hemorrhage. Results Median time from completion of chemoradiation to first hemorrhagic event was 186 days (range 66–1466 days). Seven patients (58%) required intervention to secure their airway. All patients were evaluated for endovascular intervention, six (50%) were embolized. Eight patients (67%) had a second hemorrhagic event; median time to second bleed was 22 days (range 3–90 days). Conclusions Acute oropharyngeal hemorrhage is a sequelae following treatment for HPV-positive OPSCC. The majority of bleeds occurred within a year of completion of treatment. While more research is needed to determine optimal treatment paradigms, endovascular intervention should be considered, even if noninvasive imaging does not demonstrate active bleeding. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

STAMP2 suppresses autophagy in prostate cancer cells by modulating the integrated stress response pathway

xlomafota13 shared this article with you from Inoreader STAMP2 suppresses autophagy in prostate cancer cells by modulating the integrated stress response pathway Via American Journal of Cancer Research Am J Cancer Res. 2022 Jan 15;12(1):327-336. eCollection 2022. ABSTRACT Six Transmembrane Protein of Prostate 2 (STAMP2) is critical for prostate cancer (PCa) growth. We previously showed that STAMP2 regulates the expression of stress induced transcription factor ATF4, which is implicated in starvation-induced autophagy. We therefore investigated whether STAMP2 is involved in the regulation of autophagy in PCa cells. Here we show that STAMP2 suppresses autophagy in PCa cells through modulation of the integrated stress response axis. We also find that STAMP2 regulates mitochondrial respiration. These findings suggest that STAMP2 has significant metabolic effects through mitochondrial function and autophagy, both of which support PCa growth. PMID:35141021 | PMC:PMC8822275 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Overcoming Vaccine Hesitancy Around Bell Palsy in Otolaryngology–Head and Neck Surgery—Reply

xlomafota13 shared this article with you from Inoreader Overcoming Vaccine Hesitancy Around Bell Palsy in Otolaryngology–Head and Neck Surgery—Reply Via JAMA Otolaryngology–Head & Neck Surgery Current Issue In Reply We thank the authors of the Letter to the Editor for stimulating further discussion. Tamaki et al explored the relationship between COVID-19 and the COVID-19 vaccine on Bell palsy (BP). Patients were counted as having Bell palsy if they received a diagnosis of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) code G51.0. Granular patient-level data may be lacking in an analysis of this magnitude, and it was not possible to differentiate persistent or recurrent BP. Likewise, it is difficult to accurately quality check the accuracy of coding without the benefit of reviewing clinical data. We plan to expand on our work with further analysis. We agree that research using large databases may be at risk for misclassification. However, such databases can be an effective resource i n studying rare pathologies, especially in specific populations such as those who have had COVID-19 or received the COVID-19 vaccination. Our propensity score matched analysis suggests that rates of BP are higher in patients who are positive for COVID-19 and this incidence exceeds the reported incidence of BP with the COVID-19 vaccine. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cover Image

xlomafota13 shared this article with you from Inoreader Cover Image Via Head & Neck The cover image is based on the Education A novel method to reconstruct right recurrent laryngeal nerve by transforming into nonrecurrent laryngeal nerve: The end-to-free vagal laryngeal branch end anastomosis by Yu-Long Wang et al., https://doi.org/10.1002/hed.26942. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long-term outcome of patients treated with antithyroid drugs, radioactive iodine or surgery for persistent or relapsed Graves' disease

xlomafota13 shared this article with you from Inoreader Long-term outcome of patients treated with antithyroid drugs, radioactive iodine or surgery for persistent or relapsed Graves' disease Via radioactive iodine Br J Surg. 2022 Feb 7:znab474. doi: 10.1093/bjs/znab474. Online ahead of print. ABSTRACT BACKGROUND: The aim of this study was to compare long-term mortality, morbidity, and cumulative healthcare costs between antithyroid drugs, radioactive iodine, and surgical treatment for patients with persistent or relapsed Graves' disease. METHODS: Data on patients with persistent or relapsed Graves' disease between 2006 and 2018 were retrieved from the Hong Kong Hospital Authority. Haza rd ratios (HRs) estimated by Cox proportional hazards regression models were used to compare the risks of all-cause mortality, cardiovascular disease, atrial fibrillation, psychological disease, Graves' ophthalmopathy, and cancer across treatment groups. The 10-year healthcare cost and change in co-morbidity status were also estimated. RESULTS: Over a median follow-up of 79 months (22 636 person-years), a total of 3443 patients (antithyroid drug 2294, radioactive iodine 755, surgery 394) were analysed. Compared with antithyroid drug treatment, surgery was associated with significantly lower risks of all-cause mortality (HR 0.40, 95 per cent c.i. 0.36 to 0.45), cardiovascular disease (HR 0.54, 0.48 to 0.60), atrial fibrillation (HR 0.11, 0.09 to 0.14), psychological disease (HR 0.85, 0.79 to 0.92), Graves' ophthalmopathy (HR 0.09, 0.08 to 0.10), and cancer (HR 0.56, 0.50 to 0.63). Patients who underwent surgery also had a lower risk of all outcome events than those in the radio active iodine group. The 10-year direct cumulative healthcare cost was €14 754 for surgery compared with €17 390 for antithyroid drugs, and €17 918 for the radioactive iodine group. CONCLUSION: Patients who underwent surgery for persistent or relapsed Graves' disease had lower risks of all-cause mortality and analysed morbidities. The 10-year cumulative healthcare cost in the surgery group was lowest among the three treatment alternatives. PMID:35136950 | DOI:10.1093/bjs/znab474 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.