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ORL; Journal for Oto-rhino-laryngology and its related Specialties

Kitti Jantharapattana, Teerapol Kotamnivates, Siriporn Hirunpat, Roongrueng Jarumanokul
PURPOSE OF STUDY: An association of squamous cell carcinoma antigen (SCC-Ag) level with cancer prognosis has been reported in many studies. Our investigators conducted the first study determining a correlation between the SCC-Ag level and the tumor volume in head and neck cancer. PROCEDURES: The SCC-Ag level of patients were measured from the serum, whilst the tumor volume was calculated by the ellipsoid formula and verified by logistic software on radiology. The correlation between SCC-Ag level and tumor volume was analyzed...
August 9, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Jose Fernando Polanski, Lucas Resende Lucinda, Thomas Linder
Imaging data provided by computed tomography scans of the temporal bone are fundamental for both the diagnosis and treatment of diseases affecting this complex structure. Despite its importance, the expertise required to analyze this exam is seldom properly acquired as it is time-consuming and often neglected among young doctors and even otolaryngologists. Physicians may not even have a look at the scans but rely only on radiology reports. Radiologists, on the other hand, may not describe the individual scans the same way as clinicians...
August 9, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Badr Eldin Mostafa, Lobna El Fiky
BACKGROUND: Congenital cholesteatomas (CC) arise from epithelial remnants around the petrous bone. They enlarge gradually causing progressive destruction and functional damage to the ear and surrounding structures. Because of their insidious course, most patients are misdiagnosed and present late with complications. METHODS: This is a retrospective study of 41 cases diagnosed as CC and followed up for 2 years. All patients underwent full audiological evaluation and a radiological study (CT, MRI)...
July 24, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Vinidh Paleri, Hannah Fox, Stuart Winter
Transoral robotic surgery has shown significant promise in the management of oropharyngeal cancer since its description in 2007. The oncological efficacy of this procedure has been proven in several single-centre studies, multicentre collaborative publications and systematic reviews. The rapid take-up of transoral robotic surgery shows greater acceptance by professionals and is associated with a relatively short learning curve. This overview discusses the rationale and principles underlying the use of transoral robotic surgery in primary and recurrent oropharyngeal cancer and the emerging role for this technique in diagnosing the unknown primary site, and summarizes ongoing research in this field...
July 17, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Srihari Sundararajan, Laurie A Loevner, Suyash Mohan
Trigeminal neuropathy manifests as episodic sharp, shooting pain in the maxillofacial region. Contributory etiologies are myriad, ranging from central pathology affecting its origin in the brainstem to peripheral processes affecting their distal-most insertion sites. We present a case of bilateral hypoplastic Meckel's caves in an adult patient leading to the clinical symptomology of trigeminal neuralgia. To the best of our knowledge, this is the only report of its kind highlighting this anatomic variant.
July 11, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Leonardo Kenji Sakaue Koyama, Leandro Luongo Matos, Marco Aurélio Vamondes Kulcsar, Vergilius José Furtado de Araújo Filho, Claudio Roberto Cernea
INTRODUCTION: Oral squamous cell carcinoma has a high incidence and, although elective neck dissection is recommended, the removed nodes frequently present without metastasis. This surgical approach causes disabilities and increases possible surgical complications. OBJECTIVE: To evaluate the possibility of a watchful waiting approach in oral cancer. METHODS: We compared 78 patients with clinical and pathological node metastases and their counterparts with pathological node metastases but without evident clinical neck disease...
July 4, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Mihir R Patel, Patricia A Hudgins, Jonathan J Beitler, Kelly R Magliocca, Christopher C Griffith, Yuan Liu, Kristen Bougnon, Mark El-Deiry, Nabil F Saba, Ashley H Aiken
BACKGROUND: Radiographic concern for lymphatic extranodal extension (ENE) impacts upfront management decisions for patients with human papilloma virus (HPV) oropharyngeal squamous cell carcinoma (OPSCC). Therefore, we set out to evaluate the accuracy of preoperative contrast-enhanced computed tomography (CECT) to predict major ENE (> 2 mm). METHODS: Twenty-seven consecutive patients with HPV-associated OPSCC who presented at our institutional multidisciplinary tumor board were staged radiographically with positron emission tomography (PET/CT) and CECT, and underwent primary transoral robotic resection and neck dissection...
July 3, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Tom Vauterin, George Garas, Asit Arora
Obstructive sleep apnoea-hypopnoea (OSAH) syndrome constitutes a major health care problem. Surgical modalities for the treatment of OSAH are regaining momentum in view of the increasing prevalence of OSAH and the low compliance rates associated with continuous positive airway pressure. There are several investigations to complement clinical examination in accurately determining the level of airway collapse to ensure correct patient selection and a targeted surgical approach. The most commonly employed include drug-induced sleep endoscopy and imaging with the tongue base and epiglottis often revealed as the major sites of airway narrowing during sleep...
June 22, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Philip Pratt, Asit Arora
Transoral robotic surgery (TORS) is being used increasingly as an alternative to conventional open procedures, as its minimally invasive approach results in significant benefits for the patient. This includes faster recovery times and better functional outcomes, less postoperative pain and morbidity associated with open access, shorter operative times, and a reduction in the risk of infection. However, the confined working spaces and sensory deficit, due to a lack of haptic sensation, and proximity to critical vasculature and other vitally important anatomical structures bestow significant challenges on the surgeon...
June 22, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
George Garas, Asit Arora
The first application of robotic technology in surgery was described in 1985 when a robot was used to define the trajectory for a stereotactic brain biopsy. Following its successful application in a variety of surgical operations, the da Vinci® robot, the most widely used surgical robot at present, made its clinical debut in otorhinolaryngology and head and neck surgery in 2005 when the first transoral robotic surgery (TORS) resections of base of tongue neoplasms were reported. Subsequently, the indications for TORS rapidly expanded, and they now include tumours of the oropharynx, hypopharynx, parapharyngeal space, and supraglottic larynx, as well as obstructive sleep apnoea (OSA)...
June 20, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Nils Kristian Prenzler, Lennart Gruber, Thomas Lenarz, Hannes Maier, Burkard Schwab
OBJECTIVE: To evaluate possible increases in bone conduction (BC) hearing thresholds in patients undergoing subtotal petrosectomy (SP) with fat obliteration and blind sac closure of the outer ear canal and subsequent round window vibroplasty. PATIENTS AND INTERVENTIONS: Between 1997 and 2013, 43 patients (45 ears) with combined hearing loss and recurrent chronic otitis or status post formation of a radical cavity underwent SP around 6 months prior to implantation of a Vibrant SoundbridgeTM...
June 14, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Joseph White, Arun Sharma
PURPOSE OF THE STUDY: (1) To develop a multifaceted didactic and hands-on curriculum to prepare otolaryngology residents to perform transoral robotic surgery (TORS) and safely transition to the operating room. (2) To assess the effectiveness of the TORS curriculum. PROCEDURES: Learning objectives were developed and a curriculum was formulated utilizing five unique modalities: focused didactic reading, online training modules, backpack console simulations, videos of TORS cases, and hands-on cadaveric dissections with the robotic surgical system in a simulated operating room...
May 30, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Patrick Aidan, Asit Arora, Balazs Lorincz, Neil Tolley, George Garas
Robotic transaxillary thyroidectomy, pioneered in South Korea, is firmly established throughout the Far East but remains controversial in Western practice. This relates to important population differences (anthropometry and culture) compounded by the smaller mean size of thyroid nodules operated on in South Korea due to a national thyroid cancer screening programme. There is now level 2 evidence (including from Western World centres) to support the safety, feasibility, and equivalence of the robotic approach to its open counterpart in terms of recurrent laryngeal nerve injury, hypoparathyroidism, haemorrhage, and oncological outcomes for differentiated thyroid cancer...
May 22, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Asit Arora, George Garas, Neil Tolley
Robotic parathyroidectomy represents a novel surgical approach in the treatment of primary hyperparathyroidism when the parathyroid adenoma has been pre-operatively localised. It represents the "fourth generation" in the evolution of parathyroid surgery following a process of surgical evolution from cervicotomy and 4-gland exploration to a variety of minimally invasive, open and endoscopic, targeted approaches. The existing evidence (levels 2-3) supports it as a feasible and safe technique with equivalent results to targeted open parathyroidectomy for primary hyperparathyroidism in carefully selected patients...
May 22, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Filippo Montevecchi, Alberto Caranti, Giovanni Cammaroto, Lisa Buci, Bruno Brevi, Claudio Vicini
Clinical presentations of pyriform sinus fistulas vary, and this sometimes leads to a delay in diagnosis and treatment. Recently, we experienced a case of recurrent cervical abscesses occurring after thyroidectomy in an adult affected by a bifidus pyriform sinus fistula. The diagnostic dilemma was related to the timing of events, with a single episode of acute suppurative thyroiditis having occurred 16 years before the onset of the more recent clinical scenario. An endoscopic approach allowed effective management of this clinical case...
May 16, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Qingsong Liu, Guodong Feng, Yingying Shang, Suju Wang, Zhiqiang Gao
Subtotal petrosectomy may be performed for refractory chronic middle ear diseases, such as massive cholesteatoma or recurrent otitis media. It involves permanent obliteration of the operative cavity, thus precluding the chance to restore conductive hearing via traditional inertial ossicular prostheses. The Vibrant Soundbridge (VSB) is an alternative option for hearing rehabilitation. Vibrant energy is delivered into the inner ear via a floating mass transducer (FMT), which can be coupled with any part of the middle ear acoustic transmission structure...
April 26, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Xiao-Feng Qiao, Xin Li, Dong Wang, Tong-Li Li
OBJECTIVE: This study aims to investigate the correlation between thresholds of preoperative multiple auditory steady-state response (ASSR) and electrically evoked auditory brainstem response (EABR) and the behavioral threshold. METHODS: A total of 72 patients were elected to receive a multichannel cochlear implant. According to the residual hearing determined in a preoperative test using high-, moderate-, and low-frequency ASSR, these patients were divided into the following 2 groups: residual hearing and hearing loss...
2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Tomoaki Nakada, Shu Kikuta, Harushi Mori, Yuya Shimizu, Hironobu Nishijima, Kenji Kondo, Tatsuya Yamasoba
OBJECTIVES: On computed tomography (CT), sinonasal schwannoma displays as a soft-tissue mass without any distinctive features. Our aim was to define the radiological criteria for distinguishing schwannoma from other sinonasal benign tumours. METHODS: We retrospectively identified consecutive patients who were pathologically diagnosed with benign sinonasal tumours between 2007 and 2016. CT attenuation values were compared between benign tumours and the brainstem...
2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Andrew T Tkaczuk, Rodney J Taylor, Jeffrey S Wolf
BACKGROUND: Tracheoesophageal puncture (TEP) for post-laryngectomy speech rehabilitation can be performed at the time of laryngectomy (primary) or at a subsequent time (secondary). Traditionally, the secondary procedure is performed using a rigid esophagoscope. Diseases like esophageal stricture, limited neck extension, and soft-tissue fibrosis can make this procedure technically challenging or impossible. We developed a novel device to perform a secondary tracheoesophageal puncture using a flexible esophagoscope...
2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Kenji Kondo, Shintaro Baba, Sayaka Suzuki, Hironobu Nishijima, Shu Kikuta, Tatsuya Yamasoba
BACKGROUND/AIMS: This study aimed to examine variations in the location of the infraorbital nerve relative to postoperative maxillary cysts to assess the potential risk of nerve injury during endonasal marsupialization. METHODS: Coronal computed tomography images of 130 patients (162 sides) with postoperative maxillary cysts who visited our clinic between 2003 and 2014 were reviewed from the viewpoint of the anatomical relationship between the infraorbital nerves and cysts...
2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
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