The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers

xlomafota13 shared this article with you from Inoreader The effect of short radiation treatment breaks on chemo‐radiotherapy for oropharyngeal cancers Via Head & Neck Abstract Background Numerous studies and guidelines suggest an outcome detriment from radiation treatment breaks (rTBs) and the need for compensatory dosing in patients with head and neck cancer. Methods In a consecutive cohort of 521 patients with oropharyngeal squamous cell carcinoma (OPSCC), we investigated the impact of rTBs and prolongation of overall treatment time (OTT) on OS, DFS, LRC, and cancer recurrence using competing risk and multivariate analyses. Results Neither OTT prolongation by ≤2 days nor rTBs of ≤3 days were associated with detriments to clinical outcomes. Consecutive breaks of ≥3 days were also not significantly associated with detriment to clinical outcomes. There was significantly increased competing mortality in those with longer breaks. Conclusions In OPSCC patients treated with definitive concurrent chemoradiotherapy, there is no significant association between disease failure and total rTBs of ≤3 consecutive or scattered days. Further investigation is needed for longer breaks. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

xlomafota13 shared this article with you from Inoreader Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma Via leak of cerebrospinal fluid Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print. ABSTRACT Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petrous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surg ically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications. PMID:34587824 | DOI:10.1177/01455613211048966 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma

xlomafota13 shared this article with you from Inoreader Extensive Pneumocephalus Secondary to Petrous Bone Cholesteatoma Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211048966. doi: 10.1177/01455613211048966. Online ahead of print. ABSTRACT Pneumocephalus refers to air inside the cranium; however, otogenic pneumocephalus is rarely reported in the literature. The neurological presentations of pneumocephalus include headache, lethargy, confusion, disorientation, and seizure. Here, we have reported a case of a 42-year-old woman with extensive pneumocephalus and cerebrospinal fluid leak secondary to petr ous bone cholesteatoma. She presented to the emergency department with sudden headache and left ear discharge. Physical examination revealed watery otorrhea through a hole in the tympanic membrane. Radiological studies demonstrated extensive soft tissue in the left middle ear and mastoid extending to the internal auditory canal. Free intracranial air was observed, and bony destruction was seen in the cochlea, vestibule, and semicircular canals. The patient was managed surgically via the transotic approach and fully recovered. Although otogenic pneumocephalus is rarely encountered in clinical practice, early diagnosis and urgent management are important to prevent fatal complications. PMID:34587824 | DOI:10.1177/01455613211048966 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

COVID-19 and anosmia: The story so far

xlomafota13 shared this article with you from Inoreader COVID-19 and anosmia: The story so far Via ear nose throat Ear Nose Throat J. 2021 Sep 29:1455613211048998. doi: 10.1177/01455613211048998. Online ahead of print. ABSTRACT OBJECTIVES: The pandemic has affected over 182 million coronavirus disease 2019 (COVID-19) cases worldwide. Accumulated evidence indicates that anosmia is one of the significant characteristics of COVID-19 with a high prevalence. However, many aspects of COVID-19-induced anosmia are still far from being fully understood. The purpose of this review is to summarize recent developments in COVID-19-induced anosmia to increase awareness of the condition. METHODS: A literature search was carried out using the PubMed, Embase, Web of Science, and Scopus. We reviewed the latest literature on COVID-19-induced anosmia, including mechanisms of pathogenesis, olfactory testing, anosmia as predictive tool, pathological examinations, imaging findings, affected factors, co-existing diseases, treatments, prognosis, hypothesis theories, and future directions. RESULTS: The possible pathogenesis of COVID-19-induced anosmia may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The D614G spike variant may also play a role in the increased number of anosmia patients. Anosmia may also be an essential indicator of COVID-19 spread and an early indicator of the effectiveness of political decisions. The occurrence and develop ment of COVID-19-induced anosmia may be influenced by smoking behaviors and underlying diseases such as type 2 diabetes, gastroesophageal disorders, and rhinitis. Most patients with COVID-19-induced anosmia can fully or partially recover their olfactory function for varying durations. COVID-19-induced anosmia can be treated with various approaches such as glucocorticoids and olfactory training. CONCLUSION: Anosmia is one of the main features of COVID-19 and the underlying disease of the patient may also influence its occurrence and development. The possible pathogenesis of COVID-19-induced anosmia is very complicated, which may involve inflammation of the olfactory clefts and damage to the olfactory epithelium or olfactory central nervous system. PMID:34587819 | DOI:10.1177/01455613211048998 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nonsurgical Risk Factors Associated With Pharyngocutaneous Fistula After Laryngectomy

xlomafota13 shared this article with you from Inoreader Nonsurgical Risk Factors Associated With Pharyngocutaneous Fistula After Laryngectomy Via JAMA Otolaryngology–Head & Neck Surgery Online First This multicenter cohort study of adult patients with laryngeal cancer uses data from a national database to identify nonclinical risks associated with the formation of pharyngocutaneous fistula after total laryngectomy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Unusual Case of Bilateral Chylothorax After Neck Dissection

xlomafota13 shared this article with you from Inoreader An Unusual Case of Bilateral Chylothorax After Neck Dissection Via JAMA Otolaryngology–Head & Neck Surgery Online First This case report describes a woman in her 30s who underwent to tal thyroidectomy with modified radical neck dissection due to papillary thyroid cancer and was subsequently diagnosed with bilateral chylothorax secondary to cervical thoracic duct injury. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Addressing the safety of hyaluronic acid dermal filler injections during the SARS CoV-2 pandemic worldwide vaccination

xlomafota13 shared this article with you from Inoreader Addressing the safety of hyaluronic acid dermal filler injections during the SARS CoV-2 pandemic worldwide vaccination Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Sep 20:S1748-6815(21)00420-4. doi: 10.1016/j.bjps.2021.08.037. Online ahead of print. NO ABSTRACT PMID:34588152 | DOI:10.1016/j.bjps.2021.08.037 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Receiving Long‐Term Disability or Pursuing a Legal Claim May Prevent Recovery From Chronic Dizziness

xlomafota13 shared this article with you from Inoreader Receiving Long‐Term Disability or Pursuing a Legal Claim May Prevent Recovery From Chronic Dizziness Via The Laryngoscope Objectives/Hypothesis Chronic dizziness (CD) and imbalance have multiple etiologies. CD is strongly linked with psychiatric and psychological comorbidities, thus an interdisciplinary approach, including psychopharmacological interventions, is recommended. Despite the use of this comprehensive treatment approach, the recovery of individuals with CD that pursue long-term disability (LTD) insurance or legal claims (LC) appears hampered. As such, we aimed to compare symptom recovery from CD in an interdisciplinary setting between patients receiving LTD/LC versus those who were not, and to explore the factors that may contribute to changes in symptom severity. Study Design Retrospective cohort study. Methods Dizziness-related diagnoses were extracted from the charts of 195 adults in an outpatient interdisciplinary neurotology clinic in Toronto, Canada. Patients with baseline Dizziness Handicap Inventory (DHI) and Dizziness Catastrophizing Scale (DCS) assessments between August 2012 and July 2018 and a mean follow-up visit within approximately 10 months were included. The study participants were categorized as "LTD/LC+" (n = 92) or "LTD/LC−" (n = 103), referring to either receiving or pursuing LTD/LC or not, respectively. Results There were differences in the mean percentage changes in DHI (t[187] = 3.02, P = .003) and DCS (t[179] = 2.63, P = .009) scores between LTD/LC+ and LTD/LC− patients. LTD/LC+ patients showed 8.0% and 7.6% mean increases in DHI and DCS scores, respectively, whereas LTD/LC− patients showed 21.5% and 25.9% reductions in DHI and DCS scores, respectively, controlling for age, sex, and baseline illness severity. Conclusions Patients receiving or pursuing LTD insurance or a legal claim did not improve from CD and dizziness catastrophizing compared to those who were not. Future studies are required to test these findings prospectively and to determine the factors that may contribute to symptom recovery, including the anxiety-aggravating effects of the LTD/LC process and the deleterious consequences of developing a sick-role while afflicted with a chronic illness. Level of Evidence 3 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Synthesis and Preliminary Evaluation of 131I-Labeled FAPI Tracers for Cancer Theranostics

xlomafota13 shared this article with you from Inoreader Synthesis and Preliminary Evaluation of <sup>131</sup>I-Labeled FAPI Tracers for Cancer Theranostics Via radioactive iodine Mol Pharm. 2021 Sep 30. doi: 10.1021/acs.molpharmaceut.1c00566. Online ahead of print. ABSTRACT As an excellent target for cancer theranostics, fibroblast activation protein (FAP) has become an attractive focus in cancer research. A class of FAP inhibitors (FAPIs) with a N-(4-quinolinoyl)-Gly-(2-cyanopyrrolidine) scaffold were developed, which displayed nanomolar affinity and high selectivity. Compared with 90Y, 177Lu, 225Ac, and 188Re, 211At seems to be more favored as a therapeutic candidate for FAPI tracers which have fast washout and short retention in tumor sites. Thus, the current study reported the synthesis of two FAPI precursors for 211At and 131I labeling and the preliminary evaluation of 131I-labeled FAPI analogues for cancer theranostics. FAPI variants with stannyl precursors were successfully synthesized and labeled with 131I using a radioiododestannylation reaction. Two radioactive tracers were obtained with high radiochemical purity over 99% and good radiochemical yields of 58.2 ± 1.78 and 59.5 ± 4.44% for 131I-FAPI-02 and 131I-FAPI-04, respectively. Both tracers showed high specific binding to U87MG cells in comparison with little binding to MCF-7 cells. Compared to 131I-FAPI-02, 131I-FAPI-04 exhibited higher affinity, more intracellular uptake, and longer retention time in vitro. Biodistributi on studies revealed that both tracers were mainly excreted through the kidneys as well as the hepatobiliary pathway due to their high lipophilicity. In addition, higher accumulation, longer dwell time, and increased tumor-to-organ ratios were achieved by 131I-FAPI-04, which was clearly demonstrated by SPECT/CT imaging. Furthermore, intratumor injection of 131I-FAPI-04 significantly suppressed the tumor growth in U87MG xenograft mice without significant toxicity observed. The above results implied that FAP-targeted alpha endoradiotherapy (specific to 211At) should be used to treat tumors in the near future, considering the chemical similarity between iodine and astatine can ensure the labeling of the latter onto the designed FAPIs. PMID:34591481 | DOI:10.1021/acs.molpharmaceut.1c00566 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Admission of Patients With Obstructive Sleep Apnea Undergoing Ambulatory Surgery in Otolaryngology-Head and Neck Surgery

xlomafota13 shared this article with you from Inoreader Admission of Patients With Obstructive Sleep Apnea Undergoing Ambulatory Surgery in Otolaryngology-Head and Neck Surgery Via otol rhinol Ann Otol Rhinol Laryngol. 2021 Sep 30:34894211048783. doi: 10.1177/00034894211048783. Online ahead of print. ABSTRACT OBJECTIVES: Within Otolaryngology-Head and Neck Surgery (OHNS), obstructive sleep apnea (OSA) patients are frequently encountered. To implement policies and screening measures for admission of OSA patients undergoing ambulatory surgery, actual rates of admission must first be determined. We aimed to evaluate rates and reasons for admission of OSA patients aft er ambulatory OHNS surgery. METHODS: Retrospective chart review was undertaken of all OSA patients undergoing elective day-surgery OHNS procedures at a tertiary center from January 1, 2018 to December 31, 2019. The primary outcome measure was percentage of OSA patients admitted to hospital after ambulatory OHNS surgery. Secondary outcome measures included reasons for admission. American Society of Anesthesiologists (ASA) score, perioperative complications, and patient demographics were captured. RESULTS: There were 118 OSA patients, out of 1942 cases performed during the review period. Thirty-eight were excluded as the procedures were not considered ambulatory. The remaining 80 OSA patients were included for analysis, with an average age of 51.7, SD 13.8, and 30 (38%) females. The admission rate was 47.5% (38/80 patients). Admitted patients were older (P = .0061), and had higher ASA (P = .039). Indication for surgery or type of surgery did not differ among admitted and non-admitted patients. The majority of patients, 97% (37/38 patients), were admitted for post-operative monitoring. CONCLUSION: More than half of OSA patients did not require admission to hospital after ambulatory OHNS surgery, unaffected by indications for surgery or type of surgery. Higher ASA score and older age were found in admitted as compared to non-admitted patients. PMID:34590890 | DOI:10.1177/00034894211048783 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

An Endoscopic Endonasal Nasopharyngectomy with Posterolateral Extension

xlomafota13 shared this article with you from Inoreader An Endoscopic Endonasal Nasopharyngectomy with Posterolateral Extension Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1735557 Background Invasion depth influences the choice for extirpation of nasopharyngeal malignancies. This study aims to validate the feasibility of endoscopic endonasal resection of lesions with a posterolateral invasion. As a secondary goal, the study intends to propose a classification system of endoscopic endonasal nasopharyngectomy determined by the depth of posterolateral invasion. Methods Eight cadaveric specimens (16 sides) underwent progressive nasopharyngectomy using an endoscopic endonasal approach. Resection of the torus tubarius, Eustachian tube (ET), medial pterygoid plate and muscle, lateral nasal wall, and lateral pterygoid plate and muscle were sequentially performed to expose the fossa of Rosenmüller, petroclival region, parapharyngeal space (PPS), and jugular foramen, respectively. Results Technical feasibility of endonasal nasopharyngectomy toward a posterolateral direction was validated in all 16 sides. Nasopharyngectomy was classified into four types as follows: (1) type 1: resection restricted to the posterior or superior nasopharynx; (2) type 2: resection includes the torus tubarius which is suitable for lesions extended into the petroclival region; (3) type 3: resection includes the distal cartilaginous ET, medial pterygoid plate, and muscle, often required for lesions extending laterally into the PPS; And (4) type 4: resection includes the lateral nasal wall, pterygoid plates and muscles, and all the cartilaginous ET. This extensive resection is required for lesions involving the carotid artery or extending to the jugular foramen region. Conclusion Selected lesions with posterolateral invasion into the PPS or jugular foramen is amenable to a resection via expanded endonasal approach. Classification of nasopharyngectomy based on tumor depth of posterolateral invasion helps to plan a surgical approach. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.