Endoscopic ultrasound imaging with high flow mode for endonasal transsphenoidal pituitary surgery

xlomafota13 shared this article with you from Inoreader Endoscopic ultrasound imaging with high flow mode for endonasal transsphenoidal pituitary surgery Via leak of cerebrospinal fluid J Clin Neurosci. 2021 Jul;89:329-335. doi: 10.1016/j.jocn.2021.05.024. Epub 2021 May 21. ABSTRACT Intraoperative ultrasound during transsphenoidal surgery (TSS) for pituitary tumors has been reported. In reports of endonasal ultrasound (US), Doppler US vessel images were informative and effective in endoscopic TSS. We performed endoscopic US imaging with high flow mode, which is a novel technology, to visualize small vessels during endonasal endoscopic TSS. Six patients (five with pituitary adenomas and one with Rathoke's cleft cyst) underwent endoscopic US-assisted TSS. A small endoscopic US probe (Olympus, BF-UC260FW; diameter, 6.9 mm) was inserted transsphenoidally to the sellar floor and into the sella turcica, and endoscopic US monitoring was performed. By rotating the endoscopic US probe, the internal carotid artery, anterior cerebral artery, middle cerebral artery, various small vessels, optic nerve, and residual tumor were clearly vis ualized on the endoscopic US images. Real-time animated vessel images around the tumor could be generated when needed during TSS. The tumors were removed without leakage of cerebrospinal fluid in the six patients, and their visual acuity was restored. Endoscopic US with high flow mode can visualize not only main cerebral arteries but also intracranial small vessels on B-mode US images. Pituitary tumors were clearly recognized and removed safely and precisely by monitoring the cerebral artery and its small branches as landmarks. PMID:34119288 | DOI:10.1016/j.jocn.2021.05.024 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? : Post-operative dysgeusia after EStS

xlomafota13 shared this article with you from Inoreader Taste impairment after endoscopic stapes surgery: Do anatomic variability of chorda tympani and surgical technique matter? : Post-operative dysgeusia after EStS 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 Jul 8. doi: 10.1007/s00405-021-06908-0. Online ahead of print. ABSTRACT PURPOSE: To investigate how the anatomical configuration of the oval window region (OWR) influences the management of the chorda tympani (ChT) and the curetting of adjacent bony structures, in a setting of patients undergoing endoscopic stapes surgery (EStS); to assess the incidence of early and late post-operative dysgeusia and to identify anatomical and surgical factors influencing taste function after EStS. METHODS: Surgical video recordings of 48 patients undergoing EStS for otosclerosis between January 2019 and July 2020 were retrospectively revised, to classify the anatomical variability of selected middle ear structures and the management strategies for the ChT. Clinical records of included patients were reviewed for subjective early and late post-operative taste impairment using a 5-point Likert-scale. RESULTS: Th e most common configuration of the OWR was type III. The extension of the bony curettage resulted inversely proportional to the exposure of the OWR. The long-term rate of preserved post-operative taste function was 85%. Displacement of the ChT was necessary in 43/48 cases (90%), mostly medially (36/48, 75%). CONCLUSION: Bone curetting during EStS does not correlate with post-operative taste impairment. Despite 100% ChT preservation rate, dysgeusia may occur in a minority of patients, with no apparent relationship to anatomical variability or intraoperative management of the ChT. The use of CO2 laser could have a role in increasing the risk of post-operative dysgeusia after EStS. PMID:34236486 | DOI:10.1007/s00405-021-06908-0 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Eosinophils Correlate with Epithelial-Mesenchymal Transition in Chronic Rhinosinusitis with Nasal Polyps

xlomafota13 shared this article with you from Inoreader Eosinophils Correlate with Epithelial-Mesenchymal Transition in Chronic Rhinosinusitis with Nasal Polyps Via O.R.L. Journal for oto-rhino-laryngology and its borderlands Introduction: Chronic inflammation and tissue remodeling always occur together in chronic rhinosinusitis (CRS). Epithelial-mesenchymal transition (EMT) plays a critical role in airway remodeling. Objective: Changes of epithelial cells in sinus mucosa in different subtypes of CRS, especially in eosinophilic chronic rhinosinusitis with nasal polyps, and the role of EMT and eosinophils (EOS) in airway remodeling are still unknown. Methods: We included 85 patients in this study. They were divided into 4 groups: a normal control (NC) group, a chronic rhinosinusitis without nasal polyps (CRSsNP) group, an eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) group, and a noneosinophilic chronic rhinosinusitis with nasal polyps (non-ECRSwNP) group. Clinical data were all collected and analyzed. Standard hematoxylin and eosin staining, immunohistochemical staining, and 2-color immunofluorescence staining were performed. Biomarkers of EMT, epithelial cadherin, and vimentin were labeled. The immunohistochemistry results of each group were counted and statistically analyzed. Results and Conclusion: E-cadherin was downregulated, and vimentin was upregulated in epithelial tissue from the ECRSwNP group, compared with that from the control group and the other groups. The number of vimentin-expressing epithelial cells correlated with sinus CT imaging Lund-Mackay scores (r = 0.560, p #x3c; 0.001). Moreover, expression levels of vimentin in the epithelium were associated with numbers of infiltrating EOS in tissues (r = 0.710, p #x3c; 0.001) and the peripheral blood EOS ratio (r = 0.594, p #x3c; 0.001). EMT occurred in patients with CRSwNP, especially in those with ECRSwNP. Epithelial reprogramming correlates with eosinophil infiltration and disease severity. Eosinophils contributed to impairment of epithelial function and promoted EMT in CRSwNP. ORL View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Osteoradionecrosis of the hyoid presenting as acute airway compromise

xlomafota13 shared this article with you from Inoreader Osteoradionecrosis of the hyoid presenting as acute airway compromise Via Head & Neck Abstract Background Osteoradionecrosis (ORN) of the mandible is a well-known complication of radiation therapy for head and neck cancer. However, few reports have described hyoid bone ORN and its clinical implications. Methods We describe a retrospective case series of previously irradiated patients who were seen with sudden airway compromise, found to have underlying pathological hyoid fractures secondary to osteoradionecrosis. Results Six patients within postchemoradiation period (3–9 months) for oropharyngeal squamous cell carcinoma were seen with acute-onset dyspnea. Computed topography (CT) imaging was remarkable for severe airway luminal narrowing and pathological hyoid fractures. All six patients required urgent intervention with direct laryngoscopy and tracheostomy. Intraoperatively, five patients were seen with exposed necrotic hyoid bones. Conclusion The hyoid and its associated musculature strongly influence upper airway patency. ORN may compromise its physiological function and leads to acute airway compromise. Hyoid ORN may hold significant and imperative clinical implications in head and neck cancer post-treatment surveillance. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Salivary gland adenocarcinoma metastatic to the pituitary gland

xlomafota13 shared this article with you from Inoreader Salivary gland adenocarcinoma metastatic to the pituitary gland Via American Journal of Otolaryngology Publication date: November–December 2021 Source: American Journal of Otolaryngology, Volume 42, Issue 6 Author(s): Mina Zaky, Rebecca A. Compton, Ipek Alpertunga, Arthur S. Tischler, Jeremiah C. Tracy View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Giant Cutaneous Horn: Is It a Tip of An Iceberg? Two Case Reports and a Review of Literature

xlomafota13 shared this article with you from Inoreader Giant Cutaneous Horn: Is It a Tip of An Iceberg? Two Case Reports and a Review of Literature Via Otolaryngology Indian Abstract Cutaneous horns are uncommon lesions which consist of proliferation of keratotic material resembling that of an animal horn. This lesion most commonly occurs in sun-exposed areas, particularly the face, ear, nose, forearms and dorsum of hands. The purpose of the study was to highlight the atypical presentation of squamous cell carcinoma as a giant cutaneous horn along with the review of literature. Case details were obtained from hospital records and clinical and histopathological findings were noted. Herein we report two cases of giant cutaneous horn associated with an underlying carcinoma presenting at an uncommon site. Both the patients were adults and had a chronic history of a skin lesion over the affected sites. Wide local excision was performed in both cases and histopathological examination confirmed the diagnosis of a cutaneous horn with a well differentiated squamous cell carcinoma at the base of the horn. Cutaneous horns are commonly associated with benign lesions and rarely with malignant conditions. It is imperative to biopsy the base of the horn to rule out any underlying malignancy. Proper surgical excision with adequate margins is the preferred treatment in case of an underlying malignancy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prevalence of Olfactory and Gustatory Dysfunction in Coronavirus Disease (COVID-19): A Cross Sectional Study in Our Tertiary Care Hospital

xlomafota13 shared this article with you from Inoreader Prevalence of Olfactory and Gustatory Dysfunction in Coronavirus Disease (COVID-19): A Cross Sectional Study in Our Tertiary Care Hospital Via Otolaryngology Indian Abstract COVID-19 pandemic is affecting millions of people all across the globe. Along with other clinical features, anosmia and dysgeusia are important symptoms being seen. This study evaluates the prevalence of olfactory and gustatory dysfunction in patients with SARS CoV-2 infection in a tertiary care centre and the severity and duration of altered taste and smell sensation in COVID positive patients. A total number of 167 patients that had tested positive for COVID 19 KLES Dr. Prabhakar Kore hospital in the study period of 3 months were assessed for presence and severity of olfactory and gustatory sensations. The prevalence of alteration of sense in COVID 19 patients in our tertiary care centre was found to be 62.87% and alteration of taste was 58.68%. This study shows that smell and taste loss has a high prevalence in patients of COVID 19 and health care workers should keep high degree of suspicion for COVID 19 when patients present with these symptoms. The earl y identification may help to reduce the risk of spread. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.