Perigeniculate arachnoid cysts and CSF fistulae of the fallopian canal: Histopathologic correlates of a rare clinical entity

xlomafota13 shared this article with you from Inoreader Perigeniculate arachnoid cysts and CSF fistulae of the fallopian canal: Histopathologic correlates of a rare clinical entity Via leak of cerebrospinal fluid World J Otorhinolaryngol Head Neck Surg. 2021 Jan 24;7(2):71-81. doi: 10.1016/j.wjorl.2020.12.005. eCollection 2021 Apr. ABSTRACT Cerebrospinal fluid (CSF) fistulae originating from the fallopian canal of the facial nerve is hypothesized to arise due to atypical patterns of subarachnoid space extension into the geniculate ganglion or more distal regions along the intratemporal course of the facial nerve, but its pathogenesis remains poorly understood. Although a rare etiology of CSF fistulae of the temporal bone, there are significant clinical ramifications due to the risk of recurrent meningitis, difficulty in identifying the anatomic location of the CSF leak, and technical challenges associated with surgical repair. We present three clinical cases of arachnoid cysts within the geniculate fossa with or without CSF fistulization and provide histopathologic correlates of this rare clinical phenomenon from a human temporal bone collection. The pediatric and adult patients presented suggest differential pathophysiologic mechanisms associated with CSF fistulae. Temporal bone histology reveals atypical patterns of subarachnoid space extension in the fallopian canal that may underlie arachnoid cyst formation and overt CSF leak from the geniculate region. PMID:33997715 | PMC:PMC8103539 | DOI:10.1016/j.wjorl.2020.12.005 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa

xlomafota13 shared this article with you from Inoreader Reducing the risk of cerebrospinal fluid rhinorrhea following translabyrinthine surgery of the posterior fossa Via leak of cerebrospinal fluid World J Otorhinolaryngol Head Neck Surg. 2021 Mar 6;7(2):82-87. doi: 10.1016/j.wjorl.2021.01.003. eCollection 2021 Apr. ABSTRACT OBJECTIVE: To describe the procedure and results of an adapted closure and reconstruction technique for translabyrinthine surgery that focuses on identifying and managing potential pathways for CSF egress to the middle ear and Eustachian tube. METHODS: Retrospective review of a cohort of translabyrinthine acoustic neuroma cases that were reconstructed using this technique. RESULTS: In addition to meticulous packing of potential conduits using soft tissue, hydroxyapatite cement is used to seal opened air cell tracts prior to obliteration of the mastoid defect using adipose tissue. Early results of a small patient cohort using this technique are encouraging and there were no wound infections. There was a single case of CSF rhinorrhea associated with incomplete sealing of opened petrous apex cells, with no recurrence after appropriate implementation of the described protocol during revision surgery. CONCLUSION: Proactive management of potential conduits of CSF egress including opened air cell tracts has a high likelihood of reducing rates of rhinorrhea and need for revision surgery after the translabyrinthine approach to the posterior fossa. PMID:33997716 | PMC:PMC8103534 | DOI:10.1016/j.wjorl.2021.01.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'She's sprung a leak': Significant cerebrospinal fluid leak in an infant post-lumbar puncture

xlomafota13 shared this article with you from Inoreader 'She's sprung a leak': Significant cerebrospinal fluid leak in an infant post-lumbar puncture Via leak of cerebrospinal fluid J Paediatr Child Health. 2021 May 17. doi: 10.1111/jpc.15547. Online ahead of print. NO ABSTRACT PMID:33998724 | DOI:10.1111/jpc.15547 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Lessons Learned from A Case of Functional Total Laryngeal Obstruction Under Anaesthesia by Vocal Cord Polyp Managed by Vortex Approach

xlomafota13 shared this article with you from Inoreader Lessons Learned from A Case of Functional Total Laryngeal Obstruction Under Anaesthesia by Vocal Cord Polyp Managed by Vortex Approach Via Polyps Turk J Anaesthesiol Reanim. 2021 Apr;49(2):175-177. doi: 10.5152/TJAR.2021.64. Epub 2021 Apr 1. ABSTRACT Dynamic airway obstruction is a terrifying situation. Most of the time, the obstruction is intermittent. The situation becomes horrifying and panicky when this intermittent dynamic airway obstruction turns into a total laryngeal obstruction under anaesthesia. Herein, we present a case of a 56-year-old male with vocal cord polyp, who was posted for excision. The difficult airway was anticipated in view of a thick neck. He was also hypertensive and a suggestive case of obstructive sleep apnoea. The patient went to the cannot ventilate, cannot intubate, cannot oxygenate situation because of the polyp taking position between the vocal cords and completely obstructing the central airway gateway. The case was successfully managed by emergency cricothyroidotomy by following the Vortex approach but taught us a few lessons. The case shows us the re levance of clinical findings and the importance of vocal polyp as a cause of inducible laryngeal obstruction and highlights the consequences of intuition and minor lacuna in airway management. PMID:33997850 | PMC:PMC8098741 | DOI:10.5152/TJAR.2021.64 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel Use of Tracheostomy Shield for Emergency Tracheostomy in Covid 19 Era

xlomafota13 shared this article with you from Inoreader Novel Use of Tracheostomy Shield for Emergency Tracheostomy in Covid 19 Era Via Otolaryngology Indian Abstract To evaluate the problems in doing emergency tracheostomy and tracheostomy care of patients with unknown COVID-19 status. Study the usefulness of the specially designed Tracheostomy Shield. A prospective hospital-based study was conducted at a tertiary care center in India treating COVID and Non COVID patients. The study was done from April 2020 to December 2020. A total of 80 tracheostomy were done using Tracheostomy shield. Open tracheostomies were 38 while 42 patients were already intubated (closed circuit). The Tracheostomy shield was also used in 380 tracheostomy tubes changes. Two patients were found COVID positive on RT-PCR after tracheostomy. There was no scope for testing all tube changes with RT-PCR. The use of our indigenously designed Tracheostomy shield has been effective in reducing the aerosol spread and there was no COVID transmission reported. The use of patient Tracheostomy shield is of uttermost importance in reducing the respiratory droplets sp lashing on to the surgeon and assistant while doing awake tracheostomy. It is extremely useful while changing tubes as there are chances of false negatives antigen test which might be miss leading. The use of Tracheostomy shield is very important in the current context of new and fast evolving respiratory infections. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Central Auditory Nervous System Stimulation through the Cochlear Implant Use and Its Behavioral Impacts: A Longitudinal Study of Case Series

xlomafota13 shared this article with you from Inoreader Central Auditory Nervous System Stimulation through the Cochlear Implant Use and Its Behavioral Impacts: A Longitudinal Study of Case Series Via cortical auditory Case Rep Otolaryngol. 2021 Apr 27;2021:8888450. doi: 10.1155/2021/8888450. eCollection 2021. ABSTRACT The purpose of this study was to investigate, over a period of five years, the cortical maturation of the central auditory pathways and its impacts on the auditory and oral language development of children with effective use and without effective use of a Cochlear Implant (CI). A case series study was conducted with seven children who were CI users and seven children with normal hearing, with age- and gender-matched to CI users. The assessment was performed by long-latency auditory evoked potentials and auditory and oral language behavioral protocols. The results pronounced P1 latency decrease in all CI users in the first nine months. Over five years, five children with effective CI use presented decrease or stabilization of P1 latency and a gradual development of auditory and oral language skills, although, for most of the children, the elec trophysiological and behavior results remained poor than their hearing peers' results. Two children who stopped the effective use of CI after the first year of activation had worsened auditory and oral language behavioral skills and presented increased P1 latency. A negative correlation was observed between behavioral measures and the P1 latency, the P1 component being considered an important clinical resource capable of measuring the cortical maturation and the behavioral evolution. PMID:33996165 | PMC:PMC8096579 | DOI:10.1155/2021/8888450 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Skin Acceleration Levels Estimated by a Neck-surface Accelerometer during Phonation Are Affected by The Mechanical Properties of The Anterior Cervical Skin

xlomafota13 shared this article with you from Inoreader Skin Acceleration Levels Estimated by a Neck-surface Accelerometer during Phonation Are Affected by The Mechanical Properties of The Anterior Cervical Skin Via Journal of Voice The aim of the present study was to assess whether skin acceleration levels (SAL) estimated by a neck-surface accelerometer (ACC) are affected by the anterior neck skin condition. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.