Laryngoscope最新文献_第9页

Reconstruction of the External Auditory Canal for Spontaneous Temporomandibular Joint Herniation. 重建外耳道治疗自发性颞下颌关节疝。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-15 DOI: 10.1002/lary.31843

Shreya Sriram, Kaitlyn Frazier, Desi Schoo, Kofi Boahene, Bryan K Ward, Deepa Galaiya

引用次数: 0

How I do It: Zenker's Per Oral Endoscopic Myotomy with Partial Mucosal Septum Division Modification. 我是怎么做的：Zenker 经口腔内窥镜肌切开术与部分粘膜隔膜分部改良术。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-15 DOI: 10.1002/lary.31840

Shumon I Dhar, Markus Goldschmiedt, Thomas Tielleman

引用次数: 0

Feasibility of Super-thin Anterolateral Thigh Free Flap for Oral and Pharyngeal Reconstruction. 超薄大腿前外侧游离皮瓣用于口腔和咽部重建的可行性。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-15 DOI: 10.1002/lary.31836

Paul Chisolm, John Dowd, Wynne Zheng, Eric Wu, Matthew Pierce, Bruce Davidson, Jessica Maxwell, Michael Reilly, Jonathan Giurintano

{"title":"Feasibility of Super-thin Anterolateral Thigh Free Flap for Oral and Pharyngeal Reconstruction.","authors":"Paul Chisolm, John Dowd, Wynne Zheng, Eric Wu, Matthew Pierce, Bruce Davidson, Jessica Maxwell, Michael Reilly, Jonathan Giurintano","doi":"10.1002/lary.31836","DOIUrl":"https://doi.org/10.1002/lary.31836","url":null,"abstract":"Objectives: To highlight the feasibility of employing super-thin ALT free flaps for reconstruction of complex oral cavity and oropharyngeal defects.Methods: Retrospective chart review.Results: Sixteen super-thin ALT free flaps were performed in 15 patients between 2020 and 2023 for reconstruction of oral cavity defects (seven oral tongue, three floor of mouth, three buccal, two oropharynx, one lower lip). Flap success rate was 100% with only minor complications reported, with no patient requiring return to the operating room within 30 days and no patient requiring radial forearm free flap reconstruction. One patient experienced partial flap failure, one patient experienced superficial necrosis of the distal skin paddle measuring 1 cm, and one patient was converted intraoperatively to a contralateral traditional ALT free flap due to insufficient perforator size. Average operative time was 509 min, average length of hospitalization was nine days, and two patients required gastrostomy placement prior to discharge for dysphagia.Conclusions: Super-thin ALT free flap harvest technique represents a feasible option for oral cavity and oropharyngeal reconstruction in select patients and does not require additional surgical training, invasive testing, or technology. It can be readily adopted by reconstructive surgeons with a simple adaptation in existing ALT harvest technique.Level of evidence: Level 4 Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diffusion-Weighted MRI Over Standard MRI for Differential Diagnosis between Mucopyocele and Mucoceles. 弥散加权核磁共振成像与标准核磁共振成像在黏液囊肿和黏液瘤鉴别诊断中的比较。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-14 DOI: 10.1002/lary.31833

Vanessa Adewole, Fatma Boubaker, Gabriela Hossu, Duc T Nguyen, Alain Blum, Pedro A Gondim Teixeira, Cécile Rumeau, Romain Gillet

{"title":"Diffusion-Weighted MRI Over Standard MRI for Differential Diagnosis between Mucopyocele and Mucoceles.","authors":"Vanessa Adewole, Fatma Boubaker, Gabriela Hossu, Duc T Nguyen, Alain Blum, Pedro A Gondim Teixeira, Cécile Rumeau, Romain Gillet","doi":"10.1002/lary.31833","DOIUrl":"https://doi.org/10.1002/lary.31833","url":null,"abstract":"Objective(s): To determine the accuracy of conventional and diffusion-weighted (DWI) MRI for the differential diagnosis between mucopyocele and mucocele using surgical diagnosis as a reference.Methods: This retrospective study included patients referred to our institution between March 2017 and February 2024 for paranasal sinus MRI to characterize an expansile non-enhanced sinus filling on CT. The T1 and T2 signal intensities were recorded, as well as the presence of restriction diffusion, of the penumbra sign, the double rim sign, and the presence of parietal micro-abscesses. Quantitative apparent diffusion coefficient values were also recorded.Results: The study included 74 patients aged 18 to 88 years (mean age: 60.4 ± 17.7 years). Of these, 43 had a mucopyocele and 31 had a mucocele. The T1 high signal intensity was different amongst groups as an hypersignal was present in 35.5% of mucoceles and only 4.7% of mucopyoceles (p = 0.02). The T2 signal did not differ between the two groups (p = 0.59). The double rim sign and the presence of parietal micro-abscesses demonstrated 96.8% and 100% specificities, respectively, but were predominantly located in the maxillary sinus. The penumbra sign exhibited a sensitivity of 60.5% and a specificity of 67.7%. All mucopyoceles exhibited a diffusion restriction with an apparent diffusion coefficient of less than 0.78 × 10-3 mm2/s.Conclusion: DWI is the most useful MRI tool for the accurate differential diagnosis between mucopyocele and mucocele in non-enhanced sinus fillings.Level of evidence: III (case-control study) Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Systemic Effects and Absorption of Subepithelial Dexamethasone Vocal Fold Injections. 声带褶皱上皮下注射地塞米松的全身效应和吸收。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-14 DOI: 10.1002/lary.31824

Mostafa Alwan, Debra J Phyland, Julian A Smith, Paul M Paddle

{"title":"Systemic Effects and Absorption of Subepithelial Dexamethasone Vocal Fold Injections.","authors":"Mostafa Alwan, Debra J Phyland, Julian A Smith, Paul M Paddle","doi":"10.1002/lary.31824","DOIUrl":"https://doi.org/10.1002/lary.31824","url":null,"abstract":"Objective/hypothesis: To compare the systemic changes following two office-based procedures-subepithelial vocal fold steroid injections (VFSI) and vocal fold augmentation (VFA), and to characterize the magnitude and chronicity of the effects observed.Study design: Prospective, controlled before-after comparative study.Methods: Patients prospectively underwent VFSI with 0.8-2 mg of dexamethasone or VFA. Serum cortisol, white cell count (WCC), and C-reactive protein (CRP) were measured at day 0 (pre-procedure), 1 and 7. Salivary cortisol was measured at baseline and daily for 7 days post-procedure.Results: Fourteen patients underwent VFSI and 36 VFA. At baseline serum cortisol measured 304.6 ± 116.6 nmol/L and fell significantly to 48.1 ± 41.8 nmol/L 1 day following dexamethasone injection (p = 0.001) and recovered by day 7 to 303.7 ± 78.7 nmol/L. Salivary cortisol demonstrated a similar pattern with significant recovery demonstrated by day 3 (p = 0.001). White cell counts were affected by the systemic absorption of exogenous steroid and normalized by day 7. Patients who underwent VFA demonstrated no significant change in their serum or salivary cortisol and no significant change in their WCC. No significant changes in CRP or patient's physiological parameters were observed in either procedure.Conclusion: Our findings demonstrate systemic absorption of dexamethasone following VFSI, with acute hypothalamic-pituitary-adrenal (HPA) axis suppression which normalizes day 3 post-procedurally.Level of evidence: 3 Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic Accuracy of Beta-2 Transferrin Gel Electrophoresis for Detecting Cerebrospinal Fluid Rhinorrhea. β-2转铁蛋白凝胶电泳检测脑脊液鼻出血的诊断准确性。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-14 DOI: 10.1002/lary.31845

Jacob G Eide, William Mason, Hussein Mackie, Bernard Cook, Amrita Ray, Karam Asmaro, Adam Robin, Jack Rock, John R Craig

{"title":"Diagnostic Accuracy of Beta-2 Transferrin Gel Electrophoresis for Detecting Cerebrospinal Fluid Rhinorrhea.","authors":"Jacob G Eide, William Mason, Hussein Mackie, Bernard Cook, Amrita Ray, Karam Asmaro, Adam Robin, Jack Rock, John R Craig","doi":"10.1002/lary.31845","DOIUrl":"https://doi.org/10.1002/lary.31845","url":null,"abstract":"Objective: Unilateral thin clear rhinorrhea (UTCR) may represent a variety of pathologies including cerebrospinal fluid (CSF) rhinorrhea. Beta-2 transferrin (B2Tf) gel electrophoresis (GE) has become the preferred testing modality due to reportedly high sensitivity (87%-100%) and specificity (71%-100%). However, there have been relatively few studies assessing its diagnostic accuracy. The purpose of this single-institution study was to determine the accuracy of B2Tf GE in detecting CSF rhinorrhea.Methods: A single-center retrospective review was conducted from 2016 and 2024 for all patients who presented with UTCR and underwent B2Tf GE. Institutional review board approval was obtained. The gold standard for diagnostic confirmation of true and false positives (TP, FP) as well as false negatives (FN) was endoscopic exploration. The gold standard for true negative (TN) was response to medical therapy.Results: A total of 105 patients underwent 149 B2Tf GE tests. 40 (38.1%) patients were diagnosed with CSF rhinorrhea. Of the 149 B2-Tf GE tests, there were 51 TPs, 72 TNs, 20 FPs, and 6 FNs yielding 89.5% sensitivity, 78.3% specificity, 71.8% positive predictive value, and 92.3% negative predictive value, respectively. Of the false results the most common causes for error were purulent sinusitis (n = 6, 23.1%), possible mucous contamination from nose-blowing during collection (n = 3, 11.5%), patient collection error (n = 3, 11.5%), and blood contamination (n = 1, 3.8%).Conclusion: Although these single-institutional data demonstrate test accuracy within ranges previously reported in the literature, they also demonstrate diagnostic limitations. Future studies should explore reasons for erroneous B2Tf GE results and how these may change clinical decision-making.Level of evidence: IV Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of Abnormal MRI Findings in Patients with Asymmetrical Sensorineural Hearing Loss. 非对称性感音神经性听力损失患者核磁共振成像异常结果的预测因素。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-12 DOI: 10.1002/lary.31841

Pattarawadee Prayuenyong, Pittayapon Pitathawatchai, Yuvatiya Plodpai, Viraporn Atchariyasathian, Wandee Khaimook, Rassamee Chotipanvithayakul, Virat Kirtsreesakul

{"title":"Predictors of Abnormal MRI Findings in Patients with Asymmetrical Sensorineural Hearing Loss.","authors":"Pattarawadee Prayuenyong, Pittayapon Pitathawatchai, Yuvatiya Plodpai, Viraporn Atchariyasathian, Wandee Khaimook, Rassamee Chotipanvithayakul, Virat Kirtsreesakul","doi":"10.1002/lary.31841","DOIUrl":"https://doi.org/10.1002/lary.31841","url":null,"abstract":"Objective: This study aimed to determine the predictive factors of abnormal MRI findings in patients with asymmetrical sensorineural hearing loss (ASNHL).Study design: A retrospective review of medical records.Setting: A tertiary care hospital.Methods: Patients with asymmetries of ≥10 dB in at least 1 frequency, who underwent an MRI study of the temporal bone or brain during 2019-2021, were included. Age, sex, clinical symptoms, past medical history, and audiometric parameters, including pure tone thresholds, speech reception thresholds, and speech discrimination scores, were retrieved from the electronic database. The MRI findings reported by radiologists were reviewed and extracted.Results: Of 390 patients, 50 (12.8%) patients had relevant abnormal MRI findings that could explain ASNHL. The most prevalent abnormal MRI finding was an internal acoustic canal (IAC) or cerebellopontine angle (CPA) tumor (n = 38; 76.0%), with other notable abnormalities including labyrinthitis, stroke, mucocele, and epidermoid. Multiple logistic regression analysis highlighted that hearing asymmetry of 15 dB at 1000 Hz (OR = 4.8; 95% CI 2.2-10.5) was a significant variable. The proposed predictor demonstrated 84% sensitivity and 48% specificity in detecting abnormal MRI findings.Conclusion: A hearing asymmetry of 15 dB at 1000 Hz was an important clinical predictor of abnormal MRI findings in patients with ASNHL. This finding has the potential to serve as a referral guide for further MRI investigations.Level of evidence: Level 3 Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Soleus Muscle Necrosis Following Harvest of Fibula Free Flap: A Case Report and Retrospective Contrast CT Analysis. 收割腓骨游离皮瓣后的腓肠肌坏死：病例报告和回顾性对比 CT 分析

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-12 DOI: 10.1002/lary.31842

Takashi Nuri, Akinori Asaka, Sooyeon Lee, Yuki Otsuki, Koichi Ueda

引用次数: 0

Preliminary Normative Reference Values of Validated FEES Scales in Healthy Young Adults. 经验证的健康年轻人 FEES 量表的初步标准参考值。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-10 DOI: 10.1002/lary.31814

Cara Donohue, Kayla Croft, Steven A Maristela, Maureen Folsom, Katherine A Hutcheson, Emily K Plowman

{"title":"Preliminary Normative Reference Values of Validated FEES Scales in Healthy Young Adults.","authors":"Cara Donohue, Kayla Croft, Steven A Maristela, Maureen Folsom, Katherine A Hutcheson, Emily K Plowman","doi":"10.1002/lary.31814","DOIUrl":"10.1002/lary.31814","url":null,"abstract":"Objectives: Limited normative reference data are available for validated outcomes of flexible endoscopic evaluation of swallowing (FEES). We aimed to examine healthy swallowing via FEES in community-dwelling healthy adults to derive a preliminary reference dataset of normative validated FEES outcomes to guide clinical interpretation and diagnostic decision-making.Methods: Adults with no history of dysphagia-related disease underwent simultaneous videofluoroscopy and FEES imaging using a standardized 11-item bolus protocol. Trained raters performed duplicate, independent, blinded ratings of the New Zealand Secretion Scale (NZSS), Penetration-Aspiration Scale (PAS), and Dynamic Imaging Grade of Swallowing Toxicity-FEES (DIGEST-FEES) validated scales. Descriptive statistics were performed at the bolus (PAS) and participant level (NZSS, DIGEST-FEES).Results: 361 swallows from 33 community-dwelling adults (36.6 ± 14.7 years old) were analyzed. In rank order, distribution profiles were: (1) NZSS: 95% normal (NZSS = 0), 5% abnormal (NZSS = 4); (2) Worst PAS: 73% safe (PAS 1-2, n = 24), 21% penetration above the true vocal folds (PAS 3, n = 7), 6% deep penetration to the true vocal folds (PAS = 5, n = 2); (3) DIGEST-FEES Safety Grades: 91% Grade 0 (normal, n = 30), 9% Grade 1 (mild impairment, n = 3); (4) DIGEST-FEES Efficiency Grades: 73% Grade 0 (normal, n = 24), 24% Grade 1 (mild impairment, n = 8), 3% Grade 2 (moderate impairment, n = 1).Conclusion: This preliminary healthy FEES dataset highlights variation in swallowing safety and efficiency and suggests careful interpretation of FEES outcomes to avoid over-pathologizing impairment. Future studies are warranted to obtain additional normative data in diverse populations to further understand normal variation in FEES outcomes to guide clinically meaningful diagnostic cut-points.Level of evidence: Level 3 Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outcomes after Functional Nasal Surgery in Patients with Versus without Rhinitis Medicamentosa. 药物性鼻炎与非药物性鼻炎患者鼻腔功能性手术后的疗效。

IF 2.2 3区医学

Laryngoscope Pub Date : 2024-10-10 DOI: 10.1002/lary.31839

Anthony P Di Ponio, Mohammad-Nadim Samad, Richard Pellizzari, Hussein Mackie, Robert H Deeb, John R Craig

{"title":"Outcomes after Functional Nasal Surgery in Patients with Versus without Rhinitis Medicamentosa.","authors":"Anthony P Di Ponio, Mohammad-Nadim Samad, Richard Pellizzari, Hussein Mackie, Robert H Deeb, John R Craig","doi":"10.1002/lary.31839","DOIUrl":"https://doi.org/10.1002/lary.31839","url":null,"abstract":"Objective: Topical nasal decongestants (TNDs) are used to reduce nasal soft tissue edema and obstruction. However, after frequent TND use, patients can develop rhinitis medicamentosa (RM) with rebound nasal edema and obstruction. Management of RM has centered largely on TND cessation ± intranasal corticosteroids. The purpose of this study was to compare nasal obstruction outcomes following nasal obstruction surgery in patients with versus without RM.Methods: A retrospective case-control study was conducted with adult patients who underwent bilateral inferior turbinate reduction (ITR) with or without septoplasty and nasal valve repair. Patients with versus without RM were assessed. RM was defined as at least daily TND use for ≥4 weeks. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores, and long-term TND cessation rates were collected. NOSE score changes were compared between patients with versus without RM.Results: Of the 36 RM patients, mean age was 52.0 years, and 63.9% were male. Of 116 non-RM patients, mean age was 41.6 years, and 46.6% were male. Postoperative NOSE scores were collected at a mean 972.1 days postoperatively for RM patients, and 565.0 days for non-RM patients. Mean NOSE score reductions were - 9.8 for RM and - 8.6 for non-RM patients, both of which were significant (p < 0.0001). NOSE score reductions were not significantly between the two groups (p = 0.2438). Long-term TND cessation was maintained in 86.1% of RM patients.Conclusion: Patients with and without RM achieved similar long-term significant NOSE score reductions following nasal obstruction surgery, and 86.1% of RM patients maintained long-term TND cessation.Level of evidence: Level 3 evidence Laryngoscope, 2024.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0