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Review Dtsch Arztebl Int
. 2019 Mar 29;116(13):224-234. doi: 10.3238/arztebl.2019.0224.
Otitis Externa
Susanne Wiegand 1, Reinhard Berner, Antonius Schneider, Ellen Lundershausen, Andreas Dietz
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PMID: 31064650 PMCID: PMC6522672 DOI: 10.3238/arztebl.2019.0224
Abstract
Background: Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms.

Methods: This review is based on publications retrieved by a selective search of the pertinent literature.

Results: The treatment of acute otitis media consists of anal- gesia, cleansing of the external auditory canal, and the appli- cation of antiseptic and antimicrobial agents. Local antibiotic and corticosteroid preparations have been found useful, but there have been no large-scale randomized controlled trials of their use. Topical antimicrobial treatments lead to a higher cure rate than placebo, and corticosteroid preparations lessen swelling, erythema, and secretions. Oral antibiotics are indi- cated if the infection has spread beyond the ear canal or in patients with poorly controlled diabetes mellitus or immuno- suppression. Chronic otitis externa is often due to an under- lying skin disease. Malignant otitis externa, a destructive infection of the external auditory canal in which there is also osteomyelitis of the petrous bone, arises mainly in elderly diabetic or immunosuppressed patients and can be life- threatening.

Conclusion: With correct assessment of the different types of otitis externa, rapidly effective targeted treatment can be initi- ated, so that complications will be avoided and fewer cases will progress to chronic disease.

Cited by 1 article3 figures
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J Allergy Clin Immunol
. 2019 Jun;143(6):2190-2201.e9. doi: 10.1016/j.jaci.2018.12.1018. Epub 2019 Jan 22.
Induction of Human Regulatory Innate Lymphoid Cells From Group 2 Innate Lymphoid Cells by Retinoic Acid
Hideaki Morita 1, Terufumi Kubo 2, Beate Rückert 3, Avinash Ravindran 4, Michael B Soyka 5, Arturo Ottavio Rinaldi 3, Kazunari Sugita 2, Marcin Wawrzyniak 2, Paulina Wawrzyniak 2, Kenichiro Motomura 6, Masato Tamari 6, Keisuke Orimo 6, Naoko Okada 6, Ken Arae 7, Kyoko Saito 6, Can Altunbulakli 2, Francesc Castro-Giner 8, Ge Tan 8, Avidan Neumann 3, Katsuko Sudo 9, Liam O'Mahony 10, Kenya Honda 11, Susumu Nakae 12, Hirohisa Saito 6, Jenny Mjösberg 13, Gunnar Nilsson 4, Kenji Matsumoto 6, Mübeccel Akdis 2, Cezmi A Akdis 14
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PMID: 30682454 DOI: 10.1016/j.jaci.2018.12.1018
Abstract
Background: Group 2 innate lymphoid cells (ILC2s) play critical roles in induction and exacerbation of allergic airway inflammation. Thus clarification of the mechanisms that underlie regulation of ILC2 activation has received significant attention. Although innate lymphoid cells are divided into 3 major subsets that mirror helper effector T-cell subsets, counterpart subsets of regulatory T cells have not been well characterized.

Objective: We sought to determine the factors that induce regulatory innate lymphoid cells (ILCregs).

Methods: IL-10+ ILCregs induced from ILC2s by using retinoic acid (RA) were analyzed with RNA-sequencing and flow cytometry. ILCregs were evaluated in human nasal tissue from healthy subjects and patients with chronic rhinosinusitis with nasal polyps and lung tissue from house dust mite- or saline-treated mice.

Results: RA induced IL-10 secretion by human ILC2s but not type 2 cytokines. IL-10+ ILCregs, which were converted from ILC2s by means of RA stimulation, expressed a regulatory T cell-like signature with expression of IL-10, cytotoxic T lymphocyte-associated protein 4, and CD25, with downregulated effector type 2-related markers, such as chemoattractant receptor-homologous molecule on TH2 cells and ST2, and suppressed activation of CD4+ T cells and ILC2s. ILCregs were rarely detected in human nasal tissue from healthy subjects or lung tissue from saline-treated mice, but numbers were increased in nasal tissue from patients with chronic rhinosinusitis with nasal polyps and in lung tissue from house dust mite-treated mice. Enzymes for RA synthesis were upregulated in airway epithelial cells during type 2 inflammation in vivo and by IL-13 in vitro.

Conclusion: We have identified a unique immune regulatory and anti-inflammatory pathway by which RA converts ILC2s to ILCregs. Interactions between airway epithelial cells and ILC2s play an important roles in the generation of ILCregs.

Keywords: Group 2 innate lymphoid cells; IL-33; Regulatory innate lymphoid cells; asthma; chronic rhinosinusitis with nasal polyps; cytotoxic T lymphocyte–associated protein 4; retinoic acid.

Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Cited by 5 articles
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Review Dtsch Arztebl Int
. 2019 Apr 26;116(17):301-310. doi: 10.3238/arztebl.2019.0301.
Hearing Impairment in Old Age
Jan Löhler 1, Mario Cebulla, Wafaa Shehata-Dieler, Stefan Volkenstein, Christiane Völter, Leif Erik Walther
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PMID: 31196393 PMCID: PMC6584833 DOI: 10.3238/arztebl.2019.0301
Abstract
Background: Hearing impairment associated with old age (presbycusis) is becoming more common because the population is aging.

Methods: This review is based on publications retrieved by a selective search in Medline and Google Scholar, including individual studies, meta-analyses, guidelines, Cochrane reviews, and other reviews.

Results: The cardinal symptom of presbycusis is impaired communication due to bilateral hearing impairment. Patients may be unaware of the problem for a long time because of its insidious progression. Evidence suggests that untreated hearing impair- ment in old age can have extensive adverse effects on the patient's mental, physical, and social well-being. Early detection is possible with the aid of simple diagnostic tests or suitable questionnaires. In most cases, bilateral hearing aids are an effective treatment. Surgery is rarely indicated. For patients with uni- or bilateral deafness, a cochlear implant is the treatment of choice. These treatments can improve many patients' quality of life.

Conclusion: The small amount of evidence that is currently available suggests that presbycusis is underdiagnosed and under- treated in Germany. Early detection by physicians of all specialties, followed in each case by a specialized differential diagnostic evaluation, is a desirable goal.

Cited by 1 article4 figures
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Observational Study Heart
. 2019 Oct;105(19):1500-1506. doi: 10.1136/heartjnl-2018-314485. Epub 2019 Apr 8.
Cardiovascular Health and Sleep Disturbances in Two Population-Based Cohort Studies
Nadine Hausler # 1, Quentin Lisan # 2 3 4, Thomas Van Sloten 2 3 5, Jose Haba-Rubio 6, Marie-Cécile Perier 2 3, Frédérique Thomas 7, Nicolas Danchin 2 7 8, Catherine Guibout 2 3, Pierre Boutouyrie 2 9 10, Raphael Heinzer 6, Xavier Jouven 2 3 8, Pedro Marques-Vidal # 1, Jean-Philippe Empana # 2 3
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PMID: 30962189 DOI: 10.1136/heartjnl-2018-314485
Abstract
Objective: We aimed to investigate the association between cardiovascular health (CVH), as defined by the American Heart Association, and several sleep disturbances.

Methods: Two community-based cohorts, the Paris Prospective Study 3 (PPS3, France, n=6441) and the CoLaus study (Switzerland, n=2989) were analysed. CVH includes 7 metrics which all can be classified as poor, intermediate and ideal. Global CVH score was categorised into poor (0-2 ideal metrics), intermediate (3-4 ideal metrics) and ideal (≥5 ideal metrics). Associations between global CVH and self-reported sleep disturbances (proxy of sleep-disordered breathing [SDB], excessive daytime sleepiness, insomnia symptoms and short/long sleep duration) and SDB severity measured by polysomnography (PSG) were investigated. Adjusted OR/relative risk ratio (RRR) and 95% CIs were estimated. Subjects with previous cardiovascular disease were excluded.

Results: Compared with poor CVH, subjects with intermediate and ideal global CVH had lower odds of self-reported SDB in both cohorts (ORs 0.55; 95% CI 0.44 to 0.68 and 0.35; 95% CI 0.22 to 0.53, respectively) and had lower SDB severity measured by PSG (RRR 0.07; 95% CI 0.02 to 0.20) in CoLaus. Subjects with intermediate and ideal global CVH had lower odds of excessive daytime sleepiness in PPS3 (ORs 0.82; 0.72 to 0.95 and 0.80; 0.82 to 1.02, respectively). No consistent associations were found between CVH and sleep duration or insomnia symptoms.

Conclusions: Higher levels of CVH are associated with lower odds of SDB and excessive daytime sleepiness. However, causal interpretation cannot be made and associations might be bidirectional.

Keywords: cardiac risk factors and prevention; epidemiology.

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Conflict of interest statement
Competing interests: None declared.

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5
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1318-1326. doi: 10.1002/alr.22421. Epub 2019 Sep 23.
Infiltration Pattern of Gammadelta T Cells and Its Association With Local Inflammatory Response in the Nasal Mucosa of Patients With Allergic Rhinitis
Qintai Yang 1, Chunwei Li 2, Weihao Wang 1, Rui Zheng 1, Xuekun Huang 1, Huiyi Deng 1, Peng Jin 3, Kaisen Tan 4, Yan Yan 5, Deyun Wang 4
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PMID: 31545872 DOI: 10.1002/alr.22421
Abstract
Background: gammadelta (γδ) T cells play important roles in allergic lower airway inflammation. However, little is known about their infiltration pattern in the nasal mucosa during upper airway inflammation. This study investigated γδ T cell distribution in nasal tissues of allergic rhinitis (AR) patients and the relationship between γδ T cells and other inflammatory cell types.

Methods: A total of 30 patients with septal deviation were examined, including 22 with and 8 without AR. The localization of γδ T cells and other cells (eosinophils, neutrophils, mast cells, macrophages, B cells, cluster of differentiation [CD]4+ T cells, CD8+ T cells, regulatory T cells [Tregs], interferon [IFN]-γ+ cells, interleukin [IL]17+ cells, and IL10+ cells) was evaluated by histological analysis and immunohistochemistry. T helper cell (Th)1/Th2/Th17 and Treg gene expression was analyzed by quantitative polymerase chain reaction (PCR).

Results: γδ T cells were localized in the epithelium or subepithelial region of nasal mucosa, and their infiltration was higher in AR patients relative to control subjects. The number of γδ T cells was associated with the presence of eosinophils, macrophages, mast cells, B cells, CD8+ T cells, Forkhead box (Fox)p3+ Tregs, IL17+ cells, and IL10+ cells but not of neutrophils or IFN-γ+ cells. The messenger RNA (mRNA) level of a γδ T cell subunit was positively correlated with those of Th1 genes (T-bet and IFN-γ), Th2 cytokine (C-C motif chemokine ligand 18), and Treg genes (Foxp3 and IL10).

Conclusion: γδ T cells play multiple roles in mucosal inflammation in AR including immune surveillance and adaptive and innate immune responses.

Keywords: allergic rhinitis; gammadelta T cells; infiltration pattern; local inflammatory response; mucosa inflammation.

© 2019 ARS-AAOA, LLC.

24 references
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6
Multicenter Study Eur J Cancer
. 2019 Sep;118:35-40. doi: 10.1016/j.ejca.2019.05.031. Epub 2019 Jul 9.
Real-world Efficacy and Safety of Lenvatinib: Data From a Compassionate Use in the Treatment of Radioactive Iodine-Refractory Differentiated Thyroid Cancer Patients in Italy
L D Locati 1, A Piovesan 2, C Durante 3, M Bregni 4, M G Castagna 5, S Zovato 6, M Giusti 7, T Ibrahim 8, E Puxeddu 9, G Fedele 10, G Pellegriti 11, G Rinaldi 12, D Giuffrida 13, F Verderame 14, F Bertolini 15, C Bergamini 16, A Nervo 17, G Grani 18, S Rizzati 19, S Morelli 20, I Puliafito 21, R Elisei 22
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PMID: 31299580 DOI: 10.1016/j.ejca.2019.05.031
Abstract
Background: Lenvatinib is a multi-kinase inhibitor approved for patients with radioactive iodine (RAI)-resistant differentiated thyroid cancer (DTC). Before the drug approval from the Italian National Regulatory Agency, a compassionate use programme has been run in Italy. This retrospective study aimed to analyse data from the first series of patients treated with lenvatinib in Italy.

Methods: The primary aim was to assess the response rate (RR) and progression-free survival (PFS). Secondary end-points include overall survival (OS) and toxicity data.

Results: From November 2014 to September 2016, 94 patients were treated in 16 Italian sites. Seventeen percent of patients had one or more comorbidities, hypertension being the most common (60%). Ninety-eight percent of patients were treated by surgery, followed by RAI in 98% of cases. Sixty-four percent of patients received a previous systemic treatment. Lenvatinib was started at 24 mg in 64 subjects. Partial response and stable disease were observed in 36% and in 41% of subjects, respectively; progression was recorded in 14% of patients. Drug-related side-effects were common; the most common were fatigue (13.6%) and hypertension (11.6%). Overall, median PFS and OS were 10.8 months (95% confidence interval [CI], 7.7-12.6) and 23.8 months (95% CI, 19.7-25.0) respectively.

Conclusion: Lenvatinib is active and safe in unselected, RAI-refractory, progressive DTC patients in real-life setting. RR and PFS seem to be less favourable than those observed in the SELECT trial, likely due to a negative selection that included heavily pretreated patients or with poor performance status.

Keywords: Lenvatinib; RAI refractory; Real life; Thyroid cancer.

Copyright © 2019 Elsevier Ltd. All rights reserved.

Cited by 3 articles
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7
FASEB J
. 2019 Dec;33(12):13734-13746. doi: 10.1096/fj.201901543R. Epub 2019 Oct 4.
Localization of Group II and III Metabotropic Glutamate Receptors at Pre- And Postsynaptic Sites of Inner Hair Cell Ribbon Synapses
Lisa Klotz 1, Olaf Wendler 2, Renato Frischknecht 3, Ryuichi Shigemoto 4, Holger Schulze 5, Ralf Enz 1
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PMID: 31585509 DOI: 10.1096/fj.201901543R
Abstract
Glutamate is the major excitatory neurotransmitter in the CNS binding to a variety of glutamate receptors. Metabotropic glutamate receptors (mGluR1 to mGluR8) can act excitatory or inhibitory, depending on associated signal cascades. Expression and localization of inhibitory acting mGluRs at inner hair cells (IHCs) in the cochlea are largely unknown. Here, we analyzed expression of mGluR2, mGluR3, mGluR4, mGluR6, mGluR7, and mGluR8 and investigated their localization with respect to the presynaptic ribbon of IHC synapses. We detected transcripts for mGluR2, mGluR3, and mGluR4 as well as for mGluR7a, mGluR7b, mGluR8a, and mGluR8b splice variants. Using receptor-specific antibodies in cochlear wholemounts, we found expression of mGluR2, mGluR4, and mGluR8b close to presynaptic ribbons. Super resolution and confocal microscopy in combination with 3-dimensional reconstructions indicated a postsynaptic localization of mGluR2 that overlaps with postsynaptic density protein 95 on dendrites of afferent type I spiral ganglion neurons. In contrast, mGluR4 and mGluR8b were expressed at the presynapse close to IHC ribbons. In summary, we localized in detail 3 mGluR types at IHC ribbon synapses, providing a fundament for new therapeutical strategies that could protect the cochlea against noxious stimuli and excitotoxicity.-Klotz, L., Wendler, O., Frischknecht, R., Shigemoto, R., Schulze, H., Enz, R. Localization of group II and III metabotropic glutamate receptors at pre- and postsynaptic sites of inner hair cell ribbon synapses.

Keywords: IHC; cochlea; mGlu receptor; mGluR.

Cited by 1 article
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8
Comparative Study Eur J Cancer
. 2019 Sep;118:112-120. doi: 10.1016/j.ejca.2019.06.019. Epub 2019 Jul 19.
Impact of Cisplatin Dose and Smoking Pack-Years in Human Papillomavirus-Positive Oropharyngeal Squamous Cell Carcinoma Treated With Chemoradiotherapy
Marc Oliva 1, Shao Hui Huang 2, Wei Xu 3, Jie Su 3, Aaron R Hansen 1, Scott V Bratman 2, Jolie Ringash 2, Raymond Jang 1, John Cho 2, Andrew Bayley 2, Andrew J Hope 2, Eric Chen 1, Meredith Giuliani 2, John Waldron 2, Ilan Weinreb 4, Bayardo Perez-Ordonez 4, Douglas Chepeha 5, John Kim 3, Brian O Sullivan 2, Lillian L Siu 1, Anna Spreafico 6
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PMID: 31330486 DOI: 10.1016/j.ejca.2019.06.019
Abstract
Background: To evaluate the impact of cisplatin cumulative dose (CDDP-D) and smoking pack-years (PYs) on cause-specific survival (CSS) and overall survival (OS) in human papillomavirus-positive (HPV+) oropharyngeal carcinoma (OPSCC) using the eighth edition tumour-node-metastasis (TNM) staging classification (TNM8).

Patients and methods: We reviewed patients with HPV+ OPSCC treated with high-dose CDDP and intensity-modulated radiotherapy between 2005 and 2015 at Princess Margaret Cancer Centre. CSS and OS were compared according to CDDP-D <200/=200/>200 mg/m2 stratified by TNM8.

Results: A total of 482 consecutive patients were evaluated (stage I/II/III: N = 189/174/119; CDDP-D <200/=200/>200 mg/m2: N = 112/220/150). Median follow-up duration was 5.1 years (range: 0.6-12.8). Five-year CSS and OS differed by stages I/II/III: 96%/85%/88% (p=0.005) and 93%/84%/78% (p = 0.001), respectively. Five-year CSS by CDDP-D <200/=200/>200 mg/m2 was similar in stage I (98%/95%/95%, p = 0.74) and stage II (88%/84%/84%, p = 0.86) but different in stage III (76%/98%/84%, p = 0.02). Five-year OS by CDDP-D <200/=200/>200 mg/m2 did not differ significantly among stages. In the multivariable analysis, CDDP-D <200 mg/m2 did not influence CSS in the whole cohort versus = 200/>200 mg/m2 (p=0.53/0.79, respectively) but was associated with reduced CSS in stage III subgroup versus =200 mg/m2 (=200 mg/m2 versus < 200 mg/m2 hazard ratio [HR] = 0.08; 95% confidence interval [CI]: 0.01-0.67; p = 0.02). Higher smoking PYs had no effect on CSS (p = 0.34) but reduced OS in the whole cohort (HR = 1.14 [95% CI: 1.02-1.27], p=0.01).

Conclusion: CDDP-D correlated with neither survival nor disease-specific outcomes in this large and homogeneous HPV+ cohort, although reduced CSS was observed in stageIII HPV+ OPSCC receiving CDDP-D <200 mg/m2. Smoking PYs were negatively associated with OS but not with CSS.

Keywords: Chemoradiotherapy; Cisplatin dose; Human papillomavirus; Oropharyngeal squamous cell carcinoma; Outcome; Smoking pack-years.

Copyright © 2019 Elsevier Ltd. All rights reserved.

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9
J Sex Med
. 2019 May;16(5):640-660. doi: 10.1016/j.jsxm.2019.03.001. Epub 2019 Apr 5.
The Female Sexual Function Index (FSFI)-A Systematic Review of Measurement Properties
Koen I Neijenhuijs 1, Nienke Hooghiemstra 1, Karen Holtmaat 1, Neil K Aaronson 2, Mogens Groenvold 3, Bernhard Holzner 4, Caroline B Terwee 5, Pim Cuijpers 6, Irma M Verdonck-de Leeuw 7
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PMID: 30956110 DOI: 10.1016/j.jsxm.2019.03.001
Abstract
Introduction: The Female Sexual Function Index (FSFI) is a patient-reported outcome measure measuring female sexual dysfunction. The FSFI-19 was developed with 6 theoretical subscales in 2000. In 2010, a shortened version became available (FSFI-6).

Aim: To investigate the measurement properties of the FSFI-19 and FSFI-6.

Methods: A systematic search was performed of Embase, Medline, and Web of Science for studies that investigated measurement properties of the FSFI-19 or FSFI-6 up to April 2018. Data were extracted and analyzed according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Evidence was categorized into sufficient, insufficient, inconsistent, or indeterminate, and quality of evidence as very high, high, moderate, or low.

Main outcome measures: The Main Outcome Measure is the evidence of a measurement property, and the quality of evidence based on the COSMIN guidelines.

Results: 83 studies were included. Concerning the FSFI-19, the evidence for internal consistency was sufficient and of moderate quality. The evidence for reliability was sufficient but of low quality. The evidence for criterion validity was sufficient and of high quality. The evidence for structural validity was inconsistent of low quality. The evidence for construct validity was inconsistent of moderate quality. Concerning the FSFI-6, the evidence for criterion validity was sufficient of moderate quality. The evidence for internal consistency was rated as indeterminate. The evidence for reliability was inconsistent of low quality. The evidence for construct validity was inconsistent of very low quality. No information was available on structural validity of the FSFI-6, and measurement error, responsiveness, and cross-cultural validity of both FSFI-6 and FSFI-19.

Clinical implications: Conflicting and lack of evidence for some of the measurement properties of the FSFI-19 and FSFI-6 indicates the importance of further research on the validity of these patient-reported outcome measures. We advise researchers who use the FSFI-19 to perform confirmatory factor analyses and report the factor structure found in their sample. Regardless of these concerns, the FSFI-19 and FSFI-6 have strong criterion validity. Pragmatically, they are good screening tools for the current definition of female sexual dysfunction.

Strength & limitation: A strong point of the review is the use of predefined guidelines. A limitation is the use of a precise rather than a sensitive search filter.

Conclusions: The FSFI requires more research on structural validity (FSFI-19 and FSFI-6), reliability (FSFI-6), construct validity (FSFI-19), measurement error (FSFI-19 and FSFI-6), and responsiveness (FSFI-19 and FSFI-6). Further corroboration of measurement invariance (both across cultures and across subpopulations) in the factor structure of the FSFI-19 is necessary, as well as tests for the unidimensionality of the FSFI-6. Neijenhuijs KI, Hooghiemstra N, Holtmaat K, et al. The Female Sexual Function Index (FSFI)-A Systematic Review of Measurement Properties. J Sex Med 2019;16:640-660.

Keywords: Female Sexual Dysfunction; Female Sexual Function Index; Patient Reported Outcome Measure; Reliability; Validity.

Copyright © 2019 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Cited by 2 articles
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10
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1360-1366. doi: 10.1002/alr.22410. Epub 2019 Aug 12.
Diverse Phenotypes and Endotypes of Fungus Balls Caused by Mixed Bacterial Colonization in Chronic Rhinosinusitis
Dong-Kyu Kim 1, Young Chan Wi 2, Su-Jin Shin 3, Kyung Rae Kim 4, Dae Woo Kim 5, Seok Hyun Cho 4
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PMID: 31403760 DOI: 10.1002/alr.22410
Abstract
Background: The pathogenic roles of fungus and bacteria in chronic rhinosinusitis (CRS) remain unclear. Recently, we described the bacterial ball, which is distinct from the fungus ball, as an unusual phenotype of bacterial infection. In this study, we investigated the clinical, histopathologic, and immunologic characteristics of sinonasal microorganic materials, including fungus ball and bacterial ball.

Methods: In this study, we enrolled 80 CRS patients with sinonasal microorganic materials and 10 control subjects who underwent skull base surgery or endoscopic dacryocystorhinostomy and had no signs or symptoms of nasal inflammation. All specimens were stained with hematoxylin-eosin, Gomori-methenamine-silver, and Gram stain to identify fungal organisms and Gram-positive/negative bacterial colonies. The expression of tumor necrosis factor (TNF)-α; interleukin (IL)-1β; S100A7; S100A8/A9; and short, palate, lung, and nasal epithelial clone 1 (SPLUNC1) were evaluated by enzyme-linked immunosorbent assay using sinus lavage fluid.

Results: We histologically classified sinonasal microorganic materials into the following 4 groups: fungus ball (n = 45); bacterial ball (n = 6); mixed ball (formed by a mixture of fungus and bacteria, n = 27); and double ball (formed by separate fungal and bacterial balls, n = 2). Compared with the fungus ball, the mixed ball was more frequently detected in immunocompromised patients (p < 0.0001). In addition, TNF-α expression was significantly higher in fungus and mixed balls than in control, whereas the mixed ball showed higher expression of IL-1β compared with the fungus ball. Moreover, the expression of S100A7 and S100A8/A9 protein in the mixed ball was significantly decreased when compared with the fungus ball, whereas there was no significant difference in SPLUNC1 expression between fungus and mixed balls.

Conclusion: Our findings suggest that fungal and bacterial interactions are diverse in CRS. Specifically, the mixed ball is prevalent in CRS with an immunocompromised state and it may decrease epithelial barrier function.

Keywords: bacteria; barrier; fungus; immune response; rhinosinusitis.

© 2019 ARS-AAOA, LLC.

Cited by 1 article42 references
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11
Exp Gerontol
. 2019 Apr;118:45-50. doi: 10.1016/j.exger.2019.01.006. Epub 2019 Jan 8.
Age-related Alterations in Swallowing Biomechanics
Heidi Kletzien 1, Miranda J Cullins 2, Nadine P Connor 3
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PMID: 30633957 PMCID: PMC6430567 DOI: 10.1016/j.exger.2019.01.006
Abstract
Background: Aging rodent models allow for the discovery of underlying mechanisms of cranial muscle dysfunction. Methods are needed to allow quantification of complex, multivariate biomechanical movements during swallowing. Videofluoroscopic swallow studies (VSS) are the standard of care in assessment of swallowing disorders in patients and validated quantitative, kinematic, and morphometric analysis methods have been developed. Our purpose was to adapt validated morphometric techniques to the rodent to computationally analyze swallowing dysfunction in the aging rodent.

Methods: VSS, quantitative analyses (bolus area, bolus velocity, mastication rate) and a rodent specific multivariate, morphometric computational analysis of swallowing biomechanics were performed on 20 swallows from 5 young adult and 5 old Fischer 344/Brown Norway rats. Eight anatomical landmarks were used to track the relative change in position of skeletal levers (cranial base, vertebral column, mandible) and soft tissue landmarks (upper esophageal sphincter, base of tongue).

Results: Bolus area significantly increased and mastication rate significantly decreased with age. Aging accounted for 77.1% of the variance in swallow biomechanics, and 18.7% of the variance was associated with swallow phase (oral vs pharyngeal). Post hoc analyses identified age-related alterations in tongue base retraction, mastication, and head posture during the swallow.

Conclusion: Geometric morphometric analysis of rodent swallows suggests that swallow biomechanics are altered with age. When used in combination with biological assays of age-related adaptations in neuromuscular systems, this multivariate analysis may increase our understanding of underlying musculoskeletal dysfunction that contributes to swallowing disorders with aging.

Keywords: Aging; Biomechanics; Dysphagia; Mastication; Swallowing.

Copyright © 2019 Elsevier Inc. All rights reserved.

Cited by 1 article6 figures
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12
Randomized Controlled Trial Int Forum Allergy Rhinol
. 2019 Nov;9(11):1387-1394. doi: 10.1002/alr.22416. Epub 2019 Sep 24.
Free Mucosal Grafts and Anterior Pedicled Flaps to Prevent Ostium Restenosis After Endoscopic Modified Lothrop (Frontal Drillout) Procedure: A Randomized, Controlled Study
Ying-Piao Wang 1 2 3, Ping-Hung Shen 4, Li-Chun Hsieh 1 2 3, Peter-John Wormald 5
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PMID: 31550080 DOI: 10.1002/alr.22416
Abstract
Background: The endoscopic modified Lothrop procedure (EMLP) is used to manage ongoing refractory frontal sinusitis after failed previous endoscopic sinus surgery (ESS), but this approach has a significant restenosis rate. We evaluated the potential benefits of mucosal grafts and pedicled flaps on the opening of the newly formed frontal ostium.

Methods: Fifty patients with refractory frontal sinusitis or mucoceles after ESS were randomized to undergo EMLP, either with (n = 27) or without (n = 23) mucosal grafts and pedicled flap reconstruction of the neo-ostium. The frontal neo-ostium was measured with Lindholm distending forceps, and anteroposterior (A-P) and lateral dimensions were measured intraoperatively, and then again at 6 weeks, 6 months, and 12 months postoperatively. Olfaction outcomes were assessed using the Taiwan Smell Identification Test (TWSIT) and a smell visual analog scale (VAS) score preoperatively and at 6 months postsurgery.

Results: The initial intraoperative mean lateral and A-P dimensions were 23.2 ± 2.7 mm and 14.8 ± 2.3 mm and were significantly decreased at all time-points postoperatively. The mucosal grafts and pedicled flaps had greater lateral and A-P dimensions, and a greater percentage of intraoperative frontal neo-ostium area at all time-points postoperatively (all p < 0.05). At 6 months postoperatively, TWSIT (p = 0.027), but not the smell VAS score (p = 0.063), was significantly improved compared with baseline. TWSIT and smell VAS score changes did not differ between groups (p = 0.92 and p = 0.85, respectively).

Conclusion: The use of mucosal grafts and pedicled flaps reduces stenosis of the frontal neo-ostium postsurgery and should be considered after EMLP.

Keywords: Draf III; chronic rhinosinusitis; frontal sinus; mucosal transplants; restenosis.

© 2019 ARS-AAOA, LLC.

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13
Head Neck
. 2020 Jun;42(6):1303-1304. doi: 10.1002/hed.26212. Epub 2020 Apr 30.
COVID-19: Nasal and Oropharyngeal Swab
Gerardo Petruzzi 1, Armando De Virgilio 2 3, Barbara Pichi 1, Francesco Mazzola 1, Jacopo Zocchi 1, Giuseppe Mercante 2 3, Giuseppe Spriano 2 3, Raul Pellini 1
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PMID: 32352180 PMCID: PMC7267300 DOI: 10.1002/hed.26212
Abstract
Performing a proper nasal and oropharyngeal swab procedure is essential in the screening of COVID-19 infection. The video illustration of nasal and oropharyngeal swab is presented (Video S1). To correctly perform the nasopharyngeal swab, the patient must be seated comfortably with the back of their head against the headrest. The swab is inserted in the nose horizontally, along an imaginary line between the nostril and the ear. Oropharyngeal sampling is easier to perform. The swab is directed toward the rear wall of the oropharynx and it is rotated a few times before removal. After taking the sample, it is necessary to insert both swabs in the same tube, breaking the rod with one swift and controlled movement. Finally, carefully reset the cap. It appears to be extremely important to properly collect nasopharyngeal and oropharyngeal swabs in order to minimize the false negative rate among COVID-19 positive patients.

Keywords: COVID-19; coronavirus; nasopharynx; oropharynx; swab.

© 2020 Wiley Periodicals, Inc.

Conflict of interest statement
The authors declare no potential conflict of interests.

4 references
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14
J Clin Endocrinol Metab
. 2019 Oct 1;104(10):4511-4520. doi: 10.1210/jc.2019-00035.
Poor Glycemic Control Is Associated With Impaired Bone Accrual in the Year Following a Diagnosis of Type 1 Diabetes
David R Weber 1, Rebecca J Gordon 2, Jennifer C Kelley 3, Mary B Leonard 4, Steven M Willi 2, Jacquelyn Hatch-Stein 2, Andrea Kelly 2, Oksana Kosacci 2, Olena Kucheruk 2, Mirna Kaafarani 1, Babette S Zemel 2
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PMID: 31034056 PMCID: PMC6736051 DOI: 10.1210/jc.2019-00035
Abstract
Context: Type 1 diabetes (T1D) is associated with an increased fracture risk across the life course. The effects on bone accrual early in the disease are unknown.

Objective: To characterize changes in bone density and structure over the year following diagnosis of T1D and to identify contributors to impaired bone accrual.

Design: Prospective cohort study.

Setting: Academic children's hospital.

Participants: Thirty-six children, ages 7 to 17 years, enrolled at diagnosis of T1D.

Outcomes: Whole body and regional dual-energy X-ray absorptiometry and tibia peripheral quantitative computed tomography obtained at baseline and 12 months. The primary outcome was bone accrual assessed by bone mineral content (BMC) and areal bone mineral density (aBMD) velocity z score.

Results: Participants had low total body less head (TBLH) BMC (z = -0.46 ± 0.76), femoral neck aBMD (z = -0.57 ± 0.99), and tibia cortical volumetric BMD (z = -0.44 ± 1.11) at diagnosis, compared with reference data, P < 0.05. TBLH BMC velocity in the year following diagnosis was lower in participants with poor (hemoglobin A1c ≥7.5%) vs good (hemoglobin A1c <7.5%) glycemic control at 12 months, z = -0.36 ± 0.84 vs 0.58 ± 0.71, P = 0.003. TBLH BMC velocity was correlated with gains in tibia cortical area (R = 0.71, P = 0.003) and periosteal circumference (R = 0.67, P = 0.007) z scores in participants with good, but not poor control.

Conclusions: Our results suggest that the adverse effects of T1D on BMD develop early in the disease. Bone accrual following diagnosis was impaired in participants with poor glycemic control and appeared to be mediated by diminished bone formation on the periosteal surface.

Copyright © 2019 Endocrine Society.

Cited by 4 articles3 figures
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15
Case Reports Am J Med Genet A
. 2019 Jul;179(7):1196-1204. doi: 10.1002/ajmg.a.61167. Epub 2019 Apr 30.
Sleep-disordered Breathing in Children With Mucolipidosis
Laurence Tabone 1, Catherine Caillaud 2, Alessandro Amaddeo 3 4, Sonia Khirani 3 4 5, Caroline Michot 6, Vincent Couloigner 7, Anais Brassier 8, Valerie Cormier-Daire 6, Geneviève Baujat 6, Brigitte Fauroux 3 4
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PMID: 31038846 DOI: 10.1002/ajmg.a.61167
Abstract
Mucolipidosis (ML) is a rare lysosomal storage disorder with a wide spectrum of disease severity according to the type. Sleep-disordered breathing is recognized as a characteristic feature of ML but objective data are scarce. The aim of the study was to describe sleep data and medical management in children with ML α/β. All patients with ML α/β followed at a national reference center of ML were included. Five patients had ML II, one patient had ML III and one patient had ML II-III. One patient was started on noninvasive ventilation (NIV) to allow extubation after prolonged invasive mechanical ventilation. The six other patients underwent sleep study at a median age of 1.8 years (range 4 months-17.4 years). Obstructive sleep apnea (OSA) was observed in all patients with a median apnea-hypopnea index (AHI) of 36 events/hr (range 5-52) requiring continuous positive airway pressure (CPAP) or NIV. CPAP/NIV resulted in an improvement of nocturnal gas exchange and was continued in all patients with an excellent compliance. Two patients died. Systematic sleep studies are recommended at time of diagnosis in ML. CPAP or NIV are effective treatments of OSA, well tolerated, and may contribute to improve the quality of life of patients and caregivers.

Keywords: mucolipidosis; noninvasive ventilation; obstructive sleep apnea; respiratory polygraphy; sleep-disordered breathing.

© 2019 Wiley Periodicals, Inc.

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16
Randomized Controlled Trial Int Forum Allergy Rhinol
. 2019 Nov;9(11):1257-1262. doi: 10.1002/alr.22420. Epub 2019 Aug 26.
Radiofrequency Ablation of Turbinates After Septoplasty Has No Effect on Allergic Rhinitis Symptoms Other Than Nasal Obstruction
Taegu Kang 1, Chung Man Sung 1, Hyung Chae Yang 1
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PMID: 31449735 DOI: 10.1002/alr.22420
Abstract
Background: In this study we evaluated the effects of inferior turbinate radiofrequency ablation (RFA), performed after septoplasty, on patients with allergic rhinitis (AR) symptoms.

Methods: This was a prospective, randomized, controlled study involving 60 patients with both a deviated nasal septum (DNS) and AR. Those who underwent septoplasty/sham surgery constituted the Septo-Sham group and those who underwent septoplasty/RFA formed the Septo-RFA group. Demographic factors, pre- and postoperative symptom scores for allergic rhinitis (SFARs), and Nasal Obstruction and Septoplasty Effectiveness Scale (NOSE) scores were calculated. We subdivided the total SFAR (tSFAR) scores into scores for nasal obstruction (SFAR-NO) and scores for symptoms other than nasal obstruction (SFAR-SONO); the latter included rhinorrhea, itching, and sneezing.

Results: The baseline characteristics were similar between the groups. The 2 types of surgery improved both the NOSE and SFAR scores. In subgroup analysis according to the type of symptoms, both types of surgery showed improvement in SFAR-NO and SFAR-SONO scores. However, the extent of improvement did not differ between the groups, regardless of the type of symptoms.

Conclusion: For patients with both DNS and AR, both types of surgery afford postoperative symptomatic improvement. Both types of surgery yielded improvement in both nasal obstruction and symptoms other than nasal obstruction. However, performing RFA after septoplasty did not afford further short-term symptomatic improvements. Thus, septoplasty without RFA may be optimal for patients with both DNS and AR.

Keywords: allergic rhinitis; drug resistance; hypertrophy; nasal obstruction; nasal septum; nose diseases; radiofrequency therapy; sneezing; surgery; turbinate hypertrophy.

© 2019 ARS-AAOA, LLC.

20 references
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17
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1352-1359. doi: 10.1002/alr.22442. Epub 2019 Oct 1.
Calmodulin and Protein Kinases A/G Mediate Ciliary Beat Response in the Human Nasal Epithelium
Ba Hung Do 1 2, Thi Nga Nguyen 1, Ryoko Baba 3, Toyoaki Ohbuchi 1, Jun-Ichi Ohkubo 1, Takuro Kitamura 1, Tetsuro Wakasugi 1, Hiroyuki Morimoto 3, Hideaki Suzuki 1
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PMID: 31574592 DOI: 10.1002/alr.22442
Abstract
Background: Mucociliary clearance of the airway epithelium is an essential function for mucosal defense. We recently proposed a hypothetical mechanism of ciliary beat regulation, in which the pannexin-1 (Panx1)-P2X7 unit serves as an oscillator generating a periodic increase in intracellular Ca2+ ([Ca2+ ]i ). In the present study, we examined the localization of Panx1 and P2X7 at the ultrastructural level, and investigated the regulatory pathway subsequent to [Ca2+ ]i increase.

Methods: The inferior turbinate mucosa was collected from patients with chronic hypertrophic rhinitis during endoscopic sinonasal surgery. The mucosa was examined by transmission immunoelectron microscopy for Panx1 and P2X7. Alternatively, the mucosa was cut into thin strips, and ciliary beat frequency (CBF) was measured under a phase-contrast light microscope with a high-speed digital video camera.

Results: In immunoelectron microscopy, immunoreactivities for Panx1 and P2X7 were localized along the plasma membrane of the entire length of the cilia. CBF was significantly increased by stimulation with 100 µM acetylcholine (Ach). The Ach-induced CBF increase was significantly inhibited by calmidazolium (calmodulin antagonist), SQ22536 (adenylate cyclase inhibitor), ODQ (guanylate cyclase inhibitor), KT5720 (protein kinase A inhibitor), and KT5823 (protein kinase G inhibitor). Fluorodinitrobenzene (creatine kinase inhibitor) completely inhibited the ciliary beat in a time- and dose-dependent manner.

Conclusion: These results indicate that Panx1 and P2X7 coexist at the cilia of the human nasal epithelial cells and that the ciliary beat is regulated by calmodulin, adenylate/guanylate cyclases and protein kinases A/G, and crucially depends on creatine kinase.

Keywords: P2X7; calmodulin; ciliary beat; nasal mucosa; pannexin-1; protein kinase A; protein kinase G.

© 2019 ARS-AAOA, LLC.

24 references
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18
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1236-1243. doi: 10.1002/alr.22355. Epub 2019 Jun 25.
Predictive Value of Computed Tomography in the Recurrence of Chronic Rhinosinusitis With Nasal Polyps
Yifan Meng 1, Luo Zhang 1 2 3, Hongfei Lou 1, Chengshuo Wang 1
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PMID: 31237991 DOI: 10.1002/alr.22355
Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a nasal disease with a high tendency for recurrence. The aim of this study was to compare the use of computed tomography (CT) scan with other clinical parameters in predicting the recurrence of CRSwNP.

Methods: A total of 272 consecutive CRSwNP patients undergoing endoscopic functional sinus surgery were recruited. The demographic characteristics and clinical parameters, including CT scores, level of exhaled nitric oxide, and peripheral eosinophilia, were recorded. The degree of infiltration of inflammatory cells in the sinus mucosa was evaluated.

Results: Two hundred thirty of the 272 patients completed the study (118 patients with recurrence and 112 patients with no recurrence). The average follow-up time was 24 months after the first surgery. The 2 groups were not significantly different with respect to age, gender distribution, comorbid allergy, exhaled oral fractional exhaled nitric oxide levels, nasal obstruction/runny nose/headache/facial pain scores, Lund-Mackay score, peripheral eosinophil percentage, and peripheral eosinophil absolute count. The onset of surgical history and asthma, visual analog scores of CRS, anosmia score, ratio of total ethmoid sinus scores for both sides and maxillary sinus score for both sides (E/M ratio), Lund-Kennedy score, tissue eosinophil percentage, and tissue eosinophil absolute count were significantly higher in the recurrence group. The E/M ratio showed high accuracy as a predictor for CRSwNP recurrence. The cut-off point of 2.55 for E/M ratio indicated the highest predictive value of CRSwNP recurrence.

Conclusion: The E/M ratio is a useful predictor for the recurrence of CRSwNP in the Chinese population.

Keywords: chronic rhinosinusitis; computed tomography; diagnosis; nasal polyps; recurrence.

© 2019 ARS-AAOA, LLC.

32 references
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19
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1334-1345. doi: 10.1002/alr.22430. Epub 2019 Sep 23.
Hemokinin-1 Stimulates C-C Motif Chemokine Ligand 24 Production in Macrophages to Enhance Eosinophilic Inflammation in Nasal Polyps
Yi-Ke Deng 1, Jin Ma 1, Zhi-Chao Wang 1, Xiao-Bo Long 1, Cai-Ling Chen 1, Qi-Miao Feng 1, Xin-Hao Zhang 1, Ming Zeng 1, Heng Wang 1, Xiang Lu 1, Zheng Liu 1
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PMID: 31545881 DOI: 10.1002/alr.22430
Abstract
Background: The mechanisms underlying mucosal eosinophilia in chronic rhinosinusitis with nasal polyps (CRSwNP) remain poorly clarified. The nervous system and neuropeptides play an important role in the regulation of immune response. Herein we explore the expression and function of hemokinin-1 (HK-1), a newly identified tachykinin, along with its receptor neurokinin 1 receptor (NK1R) in CRSwNP.

Methods: HK-1, NK1R, and C-C motif chemokine ligand 24 (CCL24) expression in nasal tissues (53 eosinophilic CRSwNP, 32 non-eosinophilic CRSwNP, and 33 controls) was investigated by quantitative reverse transcript polymerase chain reaction (RT-PCR) and immunofluorescence staining. THP-1, a human monocytic leukemia cell line, and eosinophilic polyp tissues were stimulated with HK-1. Cells, tissues, and culture supernatants were subsequently collected for detection of the production of various inflammatory cytokines and chemokines by quantitative RT-PCR and enzyme-linked immunoassay.

Results: HK-1 and NK1R mRNA and protein expression were upregulated in eosinophilic and non-eosinophilic nasal polyps compared with control tissues, with eosinophilic polyps demonstrating a higher upregulation compared with that of non-eosinophilic polyps. Eosinophils constituted the major source of HK-1, whereas macrophages were the predominant cell type exhibiting NK1R in eosinophilic polyps. HK-1 induced CCL24 production from macrophages differentiated from THP-1 cells; this was abolished by an NK1R antagonist. HK-1 also induced CCL24 production from ex vivo-cultured eosinophilic nasal polyps. CCL24 was expressed by macrophages in eosinophilic but not non-eosinophilic polyps. The expression level of HK-1 correlated with CCL24 expression and tissue eosinophilia in eosinophilic nasal polyps.

Conclusion: Eosinophil-derived HK-1 induces CCL24 production from macrophages and therefore exaggerates eosinophilic inflammation in CRSwNP.

Keywords: immunity; mucous membrane; neurokinin 1 receptors; neuropeptide; tachykinins.

© 2019 ARS-AAOA, LLC.

45 references
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20
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1273-1280. doi: 10.1002/alr.22413. Epub 2019 Oct 17.
Tissue Microarray Analysis Reveals That Cofilin Expression Is a Poor Prognostic Factor in Juvenile Nasopharyngeal Angiofibroma
Wanpeng Li 1, Huan Wang 1, Huapeng Yu 1, Jingjing Wang 1, Xiaole Song 1, Zhuofu Liu 1, Juan Liu 1, Li Hu 1, Han Li 1, Dehui Wang 1, Xicai Sun 1
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PMID: 31623023 DOI: 10.1002/alr.22413
Abstract
Background: Juvenile nasopharyngeal angiofibroma (JNA) has a high recurrence rate after surgery. Cofilin overexpression is associated with increased tumor cell metastasis, and progression of various human cancers. However, studies on cofilin expression in JNA are rare. The purpose of this study was to investigate the expression and localization of cofilin in a tissue microarray (TMA) of JNA specimens. In addition, we also analyzed its correlation with clinicopathological features and recurrence.

Methods: Immunohistochemistry was performed to detect cofilin expression in a TMA of samples from 70 JNA patients and 10 control subjects. The association between clinicopathological variables and cofilin immunostaining was analyzed using Pearson's chi-square test. Kaplan-Meier survival analysis was used to calculate the disease-free survival rate, and investigate the effect of cofilin expression on time to recurrence (TTR) in JNA patients. The Cox regression model was used for multivariate survival analysis.

Results: Cofilin was detected in irregular smooth muscle cells, pericytes, less differentiated stromal cells, and plump cells, but not in inactive fibroblasts and mature vascular endothelial cells of JNA specimens. The presence of cofilin in JNA was correlated with tumor stage (p = 0.012) and volume of intraoperative hemorrhage (p < 0.001). JNA patients with high cofilin expression had a higher recurrence rate than those with low cofilin expression (p = 0.012). Cofilin expression and patient's age were significant predictors of TTR, and cofilin was a better predictor for disease recurrence (area under the receiver operating curve [AUROC; 0.711; p = 0.005) than other clinicopathological features.

Conclusion: Cofilin is an independent prognostic marker for JNA patients who have undergone surgical treatment and may represent a novel therapeutic target for extensive JNA.

Keywords: JNA; cofilin; disease-free survival; immunohistochemistry; juvenile nasopharyngeal angiofibroma; prognosis; recurrence.

© 2019 ARS-AAOA, LLC.

35 references
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21
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1367-1373. doi: 10.1002/alr.22400. Epub 2019 Aug 12.
Survival Outcomes and Prognostic Factors of Squamous Cell Carcinomas Arising From Sinonasal Inverted Papillomas: A Retrospective Analysis of 120 Patients
Yunxia Li 1, Chengshuo Wang 1 2, Ru Wang 1 2, Shizhi He 1 2, Ling Feng 1 2, Hongzhi Ma 1 2, Meng Lian 1 2, Qian Shi 1 2, Qi Zhong 1 2, Xiaohong Chen 1 2, Jugao Fang 1 2, Luo Zhang 1 2
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PMID: 31403753 DOI: 10.1002/alr.22400
Abstract
Background: This study aimed to analyze the prognostic factors and survival outcomes of squamous cell carcinoma (SCC) originating from sinonasal inverted papillomas (IPs), based on data from a single institution.

Methods: The data from 120 patients treated at the affiliated Beijing Tongren Hospital, Capital Medical University, for SCC originating from sinonasal IPs between 2005 and 2018 were retrospectively reviewed. Data related to demographic features, tumor characteristics, treatment modality, and clinical outcomes were collected. Survival data were investigated using the Kaplan-Meier method, Cox regression analysis, and the nomogram model predictive of survival probabilities.

Results: Among 1034 patients with sinonasal IPs, 120 patients (11.6%) with malignancy were identified. The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 56.0% and 42.3%, respectively. Multivariate analysis showed that synchronous tumors and tumor stage were independent predictive factors for the risk of mortality (hazard ratio [HR], 1.954; 95% confidence interval [CI], 1.022-3.737, p = 0.043; HR, 1.737, 95% CI, 1.095-2.770, p = 0.020, respectively). The surgical margin was another important independent predictor, with patients with negative margins demonstrating a more than 2-fold improved survival compared to those with positive margins (HR, 2.095; 95% CI, 1.031-4.243; p = 0.041).

Conclusion: The main factors affecting the prognosis and outcomes were synchronous tumors, advanced tumor stage, and positive surgical margins. These findings highlight the importance of tumor biology and early detection in patient outcomes. In addition, risk factors should be taken into consideration during treatment planning and subsequent tumor surveillance.

Keywords: inverted papilloma; nasal cavity; neoplasm; prognosis; squamous cell carcinoma.

© 2019 ARS-AAOA, LLC.

28 references
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22
Hum Pathol
. 2019 Dec;94:92-97. doi: 10.1016/j.humpath.2019.08.020. Epub 2019 Sep 5.
ADAM3A Copy Number Gains Occur in a Subset of Conjunctival Squamous Cell Carcinoma and Its High Grade Precursors
M Adelita Vizcaino 1, Abeer Z Tabbarah 2, Laura Asnaghi 3, Azza Maktabi 4, Allen O Eghrari 5, Divya Srikumaran 5, Charles G Eberhart 6, Fausto J Rodriguez 7
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PMID: 31493427 PMCID: PMC6917831 (available on 2020-12-01) DOI: 10.1016/j.humpath.2019.08.020
Abstract
Conjunctival squamous cell carcinoma (cSCC) and its precursors are among the most frequent ocular surface neoplasms worldwide. Copy gain of 8p11.22 and ADAM3A overexpression have been recently identified in invasive cSCC. We sought to study copy number gains using fluorescent in situ hybridization (FISH) in cSCC and the spectrum of precursor lesions. A total of 54 cases conjunctival squamous intraepithelial neoplasia (CIN), carcinoma in situ (CIS), or cSCC were studied using FISH with an ADAM3A (8p11 locus) probe and a chromosome 8 (Chr 8) centromere reference probe. Eighty one percent (44/54) of the cases presented in men and 19% (10/54) in women. The age at presentation ranged from 12 to 94 years (mean 65.5 years). Severe CIN was diagnosed in 45% (24/54) of the cases, followed by CIS in 31% (17/54), moderate CIN in 15% (8/54), invasive cSCC in 7% (4/54), and mild CIN in 2% (1/54). Nine (of 54) (17%) cases harbored ADAM3A or Chr 8 gains, with one of these cases demonstrating high level amplification. All ADAM3A alterations were restricted to high-grade lesions, including 2/17 (12%) cCIS, 1/4 (24%) cSCC, 5/24 (20%) severe CIN and 1/8 (12%) moderate CIN. Monosomy 8 was detected in 2 (4%) cases. No ADAM3A alterations were detected in non-neoplastic controls. Gains of ADAM3A/chromosome 8 occur in a subset of cSCC and its precursors. Alterations were present in high-grade lesions, sparing non-neoplastic conjunctiva and absent in tested controls. Thus, the specificity of this alteration as a biomarker for ocular SCC deserves further study.

Keywords: ADAM3A; Conjunctiva; Conjunctival squamous intraepithelial neoplasia; Ocular surface carcinoma; Squamous cell carcinoma.

Copyright © 2019 Elsevier Inc. All rights reserved.

Conflict of interest statement
Conflicts of interest: None.

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23
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1311-1317. doi: 10.1002/alr.22384. Epub 2019 Jul 12.
HLA-II Genes Are Associated With Outcomes of Specific Immunotherapy for Allergic Rhinitis
Yanming Zhao 1, Yali Zhao 2, Yuan Zhang 1 2 3, Luo Zhang 1 2 3
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PMID: 31299142 DOI: 10.1002/alr.22384
Abstract
Background: Although the precise mechanisms underlying the efficacy of allergen-specific immunotherapy (AIT) are not clear, some evidence suggests that this may be linked to polymorphisms in HLA-II gene. We aimed to investigate the correlation between HLA-II gene polymorphisms and house dust mite (HDM)-specific immunotherapy efficacy, and evaluate specific polymorphisms as potential biomarkers in allergic rhinitis (AR) patients who would benefit most from AIT.

Methods: Fifty-one Han Chinese patients with AR receiving HDM AIT were recruited. Genomic DNA was extracted from venous blood samples and genotyped for HLA-DRB1 and HAL-DQB1 alleles using the polymerase chain reaction sequence-based genotyping method. Nasal and eye symptoms were investigated based on visual analogue scale and rhinoconjunctivitis quality of life.

Results: Allele DRB1*04:06; DRB1*14:05 showed a positive correlation with improvements in nasal blockage, nasal itching, eye itching, and activities. Similarly, DQB1*03:02:01; DQB1*05:03: 01 was positively correlated with improvements in nose blocking, nasal itching, eye itching, behavioral problems, and nasal symptoms scores; and DRB1*03:01; DRB1*04:06 positively correlated with nasal symptoms scores. In contrast, DRB1*07:01:01; DRB1*11:01 was negatively correlated with non-pollen symptoms, behavioral problems, and nasal symptoms.

Conclusion: HLA-DRB1 and HLA-DQB1 gene polymorphism are associated with AIT efficacy in HDM-sensitive Chinese patients with AR, of which DRB1*03:01; DRB1*04:06 and DQB1*03:02:01; DQB1*05:03:01 may be useful biomarkers of AR patient candidacy for effective AIT.

Keywords: HLA-DQB1; HLA-DRB1; allergen-specific immunotherapy; allergic rhinitis; house dust mites; human leukocyte antigen; polymorphism.

© 2019 ARS-AAOA, LLC.

33 references
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24
FASEB J
. 2019 Dec;33(12):13254-13266. doi: 10.1096/fj.201900799RR. Epub 2019 Sep 21.
Mechanical Stretch Promotes Tumoricidal M1 Polarization via the FAK/NF-κB Signaling Pathway
Shengzhou Shan # 1, Bin Fang # 1, Yifan Zhang # 1, Chuandong Wang 2, Jia Zhou 1, Chenguang Niu 3, Ya Gao 1, Danyang Zhao 1, Jiahao He 1, Jing Wang 4, Xiaoling Zhang 2, Qingfeng Li 1
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PMID: 31539281 DOI: 10.1096/fj.201900799RR
Abstract
Macrophages (Mφs) can be used as a part of cell-based cancer immunotherapy. However, they may be hampered by a failure to effectively and stably regulate their polarization state to enhance their tumoricidal effects. In this work, mechanical stretch (MS), as a biology-free modulatory method, was shown to enhance M1 polarization and tumoricidal effects. By using an in vitro Flexcell Tension system, we found that murine Mφ RAW264.7 cells showed higher M1 polarization-related mRNA expression and cytokine release after MS. Further molecular analyses found that focal adhesion kinase and NF-κB activation occurred in the MS-induced M1 polarization. Coculture of MS-preconditioned Mφ with B16F10 skin melanoma cells in vitro showed that the proliferation of B16F10 cells decreased, whereas caspase-3-induced apoptosis increased. Importantly, the injection of MS-preconditioned Mφ into murine skin melanomas in vivo impeded tumor growth; lesions were characterized by increased amounts of M1 Mφ, decreased tumor cell proliferation, and increased tumor cell apoptosis in the tumor microenvironment. Together, our results suggest that MS could be used as a simple preconditioning approach to prepare tumoricidal M1 Mφ for cancer immunotherapy.-Shan, S., Fang, B., Zhang, Y., Wang, C., Zhou, J., Niu, C., Gao, Y., Zhao, D., He, J., Wang, J., Zhang, X., Li, Q. Mechanical stretch promotes tumoricidal M1 polarization via the FAK/NF-κB signaling pathway.

Keywords: cancer; focal adhesion kinase; immunotherapy; macrophage polarization; mechanical force.

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25
Review Cancer Treat Rev
. 2020 Jun;86:102012. doi: 10.1016/j.ctrv.2020.102012. Epub 2020 Mar 19.
Parathyroid Cancer: An Update
Juan P Rodrigo 1, Juan C Hernandez-Prera 2, Gregory W Randolph 3, Mark E Zafereo 4, Dana M Hartl 5, Carl E Silver 6, Carlos Suárez 7, Randall P Owen 8, Carol R Bradford 9, Antti A Mäkitie 10, Ashok R Shaha 11, Justin A Bishop 12, Alessandra Rinaldo 13, Alfio Ferlito 14
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PMID: 32247225 DOI: 10.1016/j.ctrv.2020.102012
Abstract
Parathyroid cancer (PC) is a rare malignant tumor which comprises 0.5-5% of patients with primary hyperparathyroidism (PHPT). Most of these cancers are sporadic, although it may also occur as a feature of various genetic syndromes including hyperparathyroidism-jaw tumor syndrome (HPT-JT) and multiple endocrine neoplasia (MEN) types 1 and 2A. Although PC is characterized by high levels of serum ionized calcium (Ca) and parathyroid hormone (PTH), the challenge to the clinician is to distinguish PC from the far more common entities of parathyroid adenoma (PA) or hyperplasia, as there are no specific clinical, biochemical, or radiological characteristic of PC. Complete surgical resection is the only known curative treatment for PC with the surgical approach during initial surgery strongly influencing the outcome. In order to avoid local recurrence, the lesion must be removed en-bloc with clear margins. PC has high recurrence rates of up to 50% but with favorable long-term survival rates (10-year overall survival of 60-70%) due to its slow-growing nature. Most patients die not from tumor burden directly but from uncontrolled severe hypercalcemia. In this article we have updated the information on PC by reviewing the literature over the past 10 years and summarizing the findings of the largest series published in this period.

Keywords: CDC73 gene; Hypercalcemia; Hyperparathyroidism; Parathyroid cancer; Prognosis; Treatment.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Conflict of interest statement
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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26
Case Reports Int Forum Allergy Rhinol
. 2019 Nov;9(11):1263-1272. doi: 10.1002/alr.22437. Epub 2019 Oct 1.
A Minimally Invasive Endoscopic Transnasal Retropterygoid Approach to the Upper Parapharyngeal Space: Anatomic Studies and Surgical Implications
Juan Liu 1, Xicai Sun 1, Quan Liu 1, Yurong Gu 1, Houyong Li 1, Chunquan Zheng 1, Dehui Wang 1, Juan C Fernandez-Miranda 2, Carl H Snyderman 3, Hongmeng Yu 1
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PMID: 31574593 DOI: 10.1002/alr.22437
Abstract
Background: Surgery remains the mainstay of treatment for lesions in the parapharyngeal space. However, gaining access to the parapharyngeal space is often challenging. In this study we aim to describe a minimally invasive technique of approaching the upper parapharyngeal space through an endoscopic transnasal retropterygoid approach, based on anatomic studies and surgeries.

Methods: Six fresh human cadaver heads were prepared for anatomic study at the Surgical Neuroanatomy Laboratory of the Center for Cranial Base Surgery within the Department of Neurological Surgery at the University of Pittsburgh School of Medicine. Three clinical cases seen in the Department of Otolaryngology, Eye, Ear, Nose, and Throat Hospital, Shanghai Medical College of Fudan University, were used to illustrate the technique and feasibility of this approach and to assess its indications, advantages, and drawbacks.

Results: The medial pterygoid plate is the primary landmark of the endoscopic transnasal retropterygoid approach to the upper parapharyngeal space. Access to the upper parapharyngeal space could be obtained by removing the mucosa on the medial pterygoid plate and the mucosa below the pharyngeal orifice of the Eustachian tube. The 3 patients in our study tolerated the procedure well and had no serious complications after surgery.

Conclusion: The anatomic data and clinical cases in this study confirm that an endoscopic transnasal retropterygoid approach is a feasible and effective surgical treatment for selected tumors in the upper parapharyngeal space.

Keywords: endoscopic surgery; neoplasm; parapharyngeal space; surgical anatomy; transnasal approach.

© 2019 ARS-AAOA, LLC.

20 references
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27
Clin Endocrinol (Oxf)
. 2019 Apr;90(4):617-622. doi: 10.1111/cen.13941. Epub 2019 Feb 21.
Prolongation of Tumour Volume Doubling Time (midDT) Is Associated With Improvement in Disease-Specific Survival in Patients With Rapidly Progressive Radioactive Iodine Refractory Differentiated Thyroid Cancer Selected for Molecular Targeted Therapy
Mona M Sabra 1, Eric Sherman 2, Robert Michael Tuttle 1
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PMID: 30706513 PMCID: PMC6761925 DOI: 10.1111/cen.13941
Abstract
Purpose: To assess molecular targeted therapy (MTT)'s ability to affect tumour volume doubling time (TVDT) and disease-specific survival (DSS) in patients presenting with lung metastasis from radioactive iodine refractory progressive thyroid cancer.

Methods: In this retrospective study, we examined the clinical characteristics, average tumour volume doubling times of lung metastasis and disease-specific survival of patients with lung metastasis from differentiated thyroid cancer who were treated with MTT.

Results: The 5-year DSS from the distant metastasis (DM) diagnosis was 72% with median survival of 8 years (95% CI: 6.6-9.5). The median survival was 2.9 years after MTT start (95% CI: 2.1-3.6). On MTT, lung average tumour volume doubling time (midDT) was prolonged to midDT ≥3 years in 75% of patients with baseline midDT ≤1 year and 100% of patients with midDT 1-3 years. In patients with rapidly progressive thyroid cancer (midDT ≤1 year at baseline), the median survival was 4.5 years in those with MTT-achieved midDT ≥3 years (95% CI: 2.9-6.2), as opposed to 2.3 years (95% CI: 0.3-4.3) and 0.7 years (95% CI: 0.2-1.3) in those with MTT-achieved midDT of 1-3 years and MTT-achieved midDT ≤1 year, respectively (log rank P < 0.001).

Conclusion: Lung midDT is a useful and important clinical marker of disease-specific survival for patients with progressive radioactive iodine refractory (RAIR) metastatic thyroid cancer. In patients with rapidly progressive metastatic RAIR thyroid cancer, molecular targeted therapy prolongs lung tumour volume doubling time and is associated with improved disease-specific survival.

© 2019 John Wiley & Sons Ltd.

Cited by 2 articles3 figures
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28
Comment Otolaryngol Head Neck Surg
. 2020 Jun;162(6):813-815. doi: 10.1177/0194599820921395. Epub 2020 Apr 21.
Flexible Laryngoscopy and COVID-19
Anaïs Rameau 1, VyVy N Young 2, Milan R Amin 3, Lucian Sulica 1
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PMID: 32312166 DOI: 10.1177/0194599820921395
Abstract
Flexible laryngoscopy, the gold-standard evaluation of the larynx and the pharynx, is one of the most commonly performed procedures in otolaryngology. During the coronavirus disease 2019 (COVID-19) pandemic, flexible laryngoscopy represents a risk for patients and an occupational hazard for otolaryngologists and any clinic staff involved with the procedure or endoscope reprocessing. Here we present a set of recommendations on flexible laryngoscopy performance during the pandemic, including patient selection, personal protective equipment, and endoscope disinfection, based on a consensus reached during a virtual webinar on March 24, 2020, attended by approximately 300 participants from the American laryngology community.

Keywords: COVID-19; laryngoscopy; otolaryngology.

Comment on
Covid-19 - Navigating the Uncharted.
Fauci AS, Lane HC, Redfield RR.
N Engl J Med. 2020 Mar 26;382(13):1268-1269. doi: 10.1056/NEJMe2002387. Epub 2020 Feb 28.
PMID: 32109011 Free PMC article. No abstract available.
Cited by 1 article
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29
Kaohsiung J Med Sci
. 2019 Dec;35(12):731-738. doi: 10.1002/kjm2.12109. Epub 2019 Aug 22.
MicroRNA-379 Inhibits Laryngeal Carcinoma Cell Proliferation and Invasion Through Directly Targeting TCF-4
Jin-Long Wei 1, Liang Zhang 1, Zhi-Ming Zhao 1, Yu-Zhu Zhao 1, Qiang Fu 1, Yan Yang 1
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PMID: 31436384 DOI: 10.1002/kjm2.12109
Abstract
The expression pattern, functions, and detailed regulatory mechanisms of miR-379 in laryngeal carcinoma remain unknown. In the present study, we aimed to uncover novel potential miR-379 targets and shed light on its roles in laryngeal carcinoma. The expression level of miR-379 was measured based on the data obtained from the TCGA database and the cell lines. After miR-379 mimic transfection, cell proliferation, invasion and migration assay, and wound-healing assay in HEp-2 cell line were implemented to evaluate the effects of miR-379 on laryngeal carcinoma in vitro. The target genes for miR-379 in silico were predicted and validated using luciferase reporter assay. The miR-379 expression level was reduced in laryngeal carcinoma tissues and cell lines. Moreover, miR-379 overexpression inhibited the cell proliferation, migration, and invasion of laryngeal carcinoma cells. TCF-4 was detected as a direct target of miR-379 in laryngeal carcinoma. Furthermore, restored TCF-4 expression rescued the inhibitory roles of miR-379 overexpression on cell proliferation, migration, and invasion.Our study for the first time demonstrated that miR-379/TCF-4 might involve in the progression of laryngeal carcinoma, and miR-379 appears to serve as a novel tumor suppressor in laryngeal carcinoma.

Keywords: TCF-4; biomarker; invasion; laryngeal carcinoma; miR-379.

© 2019 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia on behalf of Kaohsiung Medical University.

32 references
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30
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1281-1288. doi: 10.1002/alr.22277. Epub 2019 Jan 8.
Formation of Papillary Mucosa Folds and Enhancement of Epithelial Barrier in Odontogenic Sinusitis
Yuan Zhang 1 2 3, Feng Lan 2, Ying Li 2, Chengshuo Wang 1, Luo Zhang 1 2 3
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PMID: 30620087 DOI: 10.1002/alr.22277
Abstract
Background: Odontogenic sinusitis (OS) presents more satisfactory therapeutic effect after endoscopic surgery compared with chronic rhinosinusitis (CRS) of other origin. The aim of the present study was to investigate the clinical characteristics, morphological features, and epithelial barrier function of sinus mucosa of OS and discuss the possible relationship with good prognosis.

Methods: A total of 25 subjects with OS, 7 CRS without nasal polyps (CRSsNP), 10 CRS with nasal polyps (CRSwNP), and 9 control subjects were recruited. The biopsy specimens were stained with hematoxylin and eosin for general observation of cytomorphologic features. Epithelial tight junctions (TJs) protein claudin-4 expression was determined to evaluate the epithelial barrier integrity by using immunofluorescence and Image-Pro Plus software analysis. The representative cytokine profiles regarding T helper 1 (Th1) (interferon [IFN]-γ), Th2 (interleukin [IL]-5), and Th17 (IL-17) were examined by reverse transcription-polymerase chain reaction (RT-PCR).

Results: Extensively small papillary protrusions could be seen in the maxillary sinus mucosa of OS patients under nasal endoscopy, similar to the morphological behavior, which also presented as papillary folds in the surface of the epithelium. The epithelium in OS kept an increased claudin-4 expression compared with that seen in CRSsNP, CRSwNP, and control subjects. The inflammatory pattern analysis demonstrated that OS belonged to the lymphocyte and plasma cell-dominant cellular phenotypes, whereas IL-17 was dominant compared with IFN-γ as well as IL-5.

Conclusion: The odontogenic infections might induce the formation of papillary mucosa folds and enhance the epithelial TJ barrier function. OS exhibited as lymphocyte and plasma cell-dominant cellular phenotypes and Th17 cytokine profiles.

Keywords: Infections; chronic rhinosinusitis; odontogenic sinusitis; papillary fold; tight junction.

© 2019 ARS-AAOA, LLC.

Cited by 2 articles26 references
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31
Eur J Surg Oncol
. 2019 Jun;45(6):1033-1038. doi: 10.1016/j.ejso.2019.01.224. Epub 2019 Feb 5.
Defining Optimum Surgical Margins in Buccoalveolar Squamous Cell Carcinoma
Aseem Mishra 1, Akshat Malik 2, Sourav Datta 3, Manish Mair 4, Munita Bal 5, Deepa Nair 6, Sudhir Nair 7, Pankaj Chaturvedi 8
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PMID: 30777600 DOI: 10.1016/j.ejso.2019.01.224
Abstract
Introduction: Surgical margin is one of the most important prognostic factors in oral cavity squamous cell carcinoma. There have been studies which refute the standard practice of considering 5 mm (mm) margin as free. Therefore we aimed to evaluate the impact of each mm of margin on the local recurrence free survival (LRFS) and to obtain a cut-off value which would impact the survival the most.

Material and methods: This was a retrospective study of 602 treatment naïve patients of buccoalveolar complex cancer. ROC curve was plotted for each millimetre of margin to derive the cut-off margin for maximum LRFS. Multivariate analysis was done for the margin groups to calculate the margin beyond which no significant improvement on LRFS was achieved. Early and advanced tumors were also evaluated separately.

Results: A cut off margin of 5.5 mm was achieved on ROC for early (T1-T2) tumors and 6.5 mm cut off was achieved for advanced (T3-T4) tumors. Based on these cut off different margin groups were made. The cohort was grouped into positive margin, 1-5.5 mm, 5.6-7 mm and > 7 mm. Hazard ratio for patients with 1-5.5 mm and positive margin was 1.886 (95%CI, 1.15 to 3.09) and 5.58 (95%CI, 1.75 to 17.78) respectively. HR for margin 5.5 mm to 7 mm was 1.15 (95% CI, 1.15 to 2.06). There was no statistically significant difference in survival between margin groups of 5.6-7 mm and > 7 mm (p < 0.589) for both early and advanced tumors.

Conclusion: Minimum surgical margins of 5.5 mm in the final histopathology should be aimed for in the bucco-alveolar carcinomas. There was significant improvement in LRFS with increasing margins upto 7 mm. Taking margins beyond 7 mm does not improve LRFS.

Keywords: Buccal mucosa; Local recurrence free survival; Margin; Squamous carcinoma.

Copyright © 2019 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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32
Head Neck
. 2020 Jun;42(6):1280-1281. doi: 10.1002/hed.26167. Epub 2020 Apr 27.
How to Avoid Nosocomial Spread During Tracheostomy for COVID-19 Patients
Hongjun Xiao 1, Yi Zhong 1, Xiaomeng Zhang 1, Fucheng Cai 1, Mark A Varvares 2
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PMID: 32298034 PMCID: PMC7262169 DOI: 10.1002/hed.26167
2 references1 figure
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33
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1297-1303. doi: 10.1002/alr.22389. Epub 2019 Sep 12.
Associations Among Air Pollutants, Grass Pollens, and Daily Number of Grass Pollen Allergen-Positive Patients: A Longitudinal Study From 2012 to 2016
Yuhui Ouyang 1 2, Zhaoyin Yin 3, Ying Li 2, Erzhong Fan 2, Luo Zhang 1 2
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PMID: 31513736 DOI: 10.1002/alr.22389
Abstract
Background: Grass pollen is the most prevalent sensitizing aeroallergen to cause respiratory allergies in northern China. Air pollutants have a substantial effect on respiratory health and some pollens. This study aimed to investigate relationships among airborne grass pollen, air pollutants and allergic diseases, in order to determine their effects on patients with grass pollen allergies in Beijing, China, during the period from 2013 to 2016.

Methods: Data regarding autumnal grass pollens and air pollutants measured in Beijing from 2012 to 2016 were obtained from local governmental agencies. Patient data regarding specific immunoglobulin E (IgE) analyses from 2013 to 2016 were obtained from the Department of Allergy in Beijing Tongren Hospital. Spearman's rank correlation analysis was used to assess associations between the daily number of grass pollen allergen-positive patients and the following parameters: 3 clinically-relevant grass pollen genera (Artemisia, Humulus, and Chenopodium) and inhalable pollutants.

Results: Correlation analysis indicated that the daily number of grass pollen-positive patients was significantly associated with the peak period of grass pollens, as well as pollutants SO2 and NOx. Moreover, concentrations of air pollutants (eg, ozone, oxides of nitrogen [NOx ], and SO2 ) were consistently and significantly associated with concentrations of grass pollens; particulate matter 2.5 µm in diameter was negatively associated with Artemisia and Chenopodium pollens.

Conclusion: Grass pollens exhibited substantial impact on allergic disease morbidity. Air pollutants impacted allergic disease and grass pollen. Thus, public health and clinical approaches to anticipate and reduce allergic disease morbidity from pollen and pollutants are needed.

Keywords: Artemisia; Chenopodium; China; Humulus; Poaceae; immunoglobulin E; ozone; particulate matter; respiratory hypersensitivity; sulfur dioxide.

© 2019 ARS-AAOA, LLC.

23 references
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34
Head Neck
. 2020 Jun;42(6):1278-1279. doi: 10.1002/hed.26163. Epub 2020 Apr 14.
Improving Staff Safety During Tracheostomy in COVID-19 Patients
Maria Vargas 1, Giuseppe Servillo 1
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PMID: 32270574 PMCID: PMC7262035 DOI: 10.1002/hed.26163
Conflict of interest statement
The authors have no conflict of interest.

Cited by 3 articles8 references
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35
Clin Neurophysiol
. 2019 Nov;130(11):2137-2143. doi: 10.1016/j.clinph.2019.08.027. Epub 2019 Sep 17.
Saccular Function Is Associated With Both Angular and Distance Errors on the Triangle Completion Test
E R Anson 1, M R Ehrenburg 2, E X Wei 2, D Bakar 3, E Simonsick 4, Y Agrawal 2
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PMID: 31569041 PMCID: PMC6874399 (available on 2020-11-01) DOI: 10.1016/j.clinph.2019.08.027
Abstract
Objective: The present study was designed to determine whether healthy older adults with age-related vestibular loss have deficits in spatial navigation.

Methods: 154 adults participating in the Baltimore Longitudinal Study of Aging were tested for semicircular canal, saccular, and utricular function and spatial navigation ability using the blindfolded Triangle Completion Test (TCT). Multiple linear regression was used to investigate the relationships between each measure of vestibular function and performance on the TCT (angular error, end point error, and distance walked) while controlling for age and sex.

Results: Individuals with abnormal saccular function made larger angular errors (β = 4.2°, p < 0.05) and larger end point errors (β = 13.6 cm, p < 0.05). Independent of vestibular function, older age was associated with larger angular (β's = 2.2-2.8°, p's < 0.005) and end point errors (β's = 7.5-9.0 cm, p's < 0.005) for each decade increment in age.

Conclusions: Saccular function appears to play a prominent role in accurate spatial navigation during a blindfolded navigation task.

Significance: We hypothesize that gravitational cues detected by the saccule may be integrated into estimation of place as well as heading direction.

Keywords: Aging; Gait; Posture; Spatial orientation; Vestibular function.

Copyright © 2019 International Federation of Clinical Neurophysiology. All rights reserved.

Cited by 1 article
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36
Comment JAMA Netw Open
. 2019 Dec 2;2(12):e1916929. doi: 10.1001/jamanetworkopen.2019.16929.
Acupuncture-A Question of Culture
Matthias Karst 1, Changwei Li 2
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PMID: 31808917 DOI: 10.1001/jamanetworkopen.2019.16929
Comment on
Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer: A Randomized Clinical Trial.
Garcia MK, Meng Z, Rosenthal DI, Shen Y, Chambers M, Yang P, Wei Q, Hu C, Wu C, Bei W, Prinsloo S, Chiang J, Lopez G, Cohen L.
JAMA Netw Open. 2019 Dec 2;2(12):e1916910. doi: 10.1001/jamanetworkopen.2019.16910.
PMID: 31808921 Free PMC article.
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37
Int Forum Allergy Rhinol
. 2019 Nov;9(11):1374-1380. doi: 10.1002/alr.22383. Epub 2019 Aug 23.
Transnasal Endoscopic Resection of Orbital Cavernous Hemangiomas: Our Experience With 23 Cases
Jingying Ma 1, Bing Zhou 1, Huang Qian 1, Zhenxiao Huang 1, Shi Jitong 2
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PMID: 31442008 DOI: 10.1002/alr.22383
Abstract
Background: The aim of this work was to present our single-center experience on orbital cavernous hemangiomas managed using an endonasal endoscopic approach.

Methods: The study design used was one-institutional retrospective review. Twenty-three cases of orbital cavernous hemangioma were analyzed and followed up.

Results: There were 10 males and 13 females, with an average age of 46.1 years, included in our study. Seven cases were extraconal, 16 cases were intraconal, and in 10 of the patients the optic nerve was involved and compressed. Total resection of the tumor was achieved in 16 cases; of the remaining 7 cases, partial tumor resection and orbital decompression were conducted, orbital decompression was conducted in 2 cases, and orbital decompression and optic nerve decompression were conducted in 3 cases. Visual acuity in 9 patients improved significantly, as 16 of the 20 patients with a preoperative visual field defect had a smaller defect after surgery.

Conclusion: This study adds to the literature showing that endoscopic transnasal surgery is likely a reasonable option for patients with the orbital cavernous hemangiomas medial of the optic nerve. With greater experience, skilled surgical technique, and careful operation, better clinical efficacy can be achieved.

Keywords: cavernous hemangioma; endonasal surgery; endoscopic surgery; orbital surgery; orbital tumor.

© 2019 ARS-AAOA, LLC.

12 references
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38
J Infect Dis
. 2019 Jul 19;220(4):589-593. doi: 10.1093/infdis/jiz166.
No Correlation Between Nasopharyngeal Human Bocavirus 1 Genome Load and mRNA Detection or Serology in Adeno-/Tonsillectomy Patients
Lotta E Ivaska 1, Andreas Christensen 2 3, Matti Waris 4, Tuomo Puhakka 1, Tytti Vuorinen 4, Tobias Allander 5, Maria Söderlund-Venermo 6, Tuomas Jartti 7
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PMID: 31001641 DOI: 10.1093/infdis/jiz166
Abstract
Human bocavirus 1 (HBoV1) can persist in nasopharynx and tonsils. Using HBoV1 serology, reverse-transcription polymerase chain reaction (PCR) for detecting messenger RNA (mRNA) and quantitative PCR for HBoV1 genome load count, we studied to what extent the HBoV1 DNA loads in nasopharynx correlate with acute infection markers. Tonsillar tissue, nasopharyngeal aspirate, and serum were obtained from 188 elective adeno-/tonsillectomy patients. Relatively high loads of HBoV1 DNA were detected in the nasopharynx of 14 (7%) primarily asymptomatic subjects with negative mRNA and/or serodiagnostic results. Quantitative HBoV1 DNA PCR may have lower specificity than HBoV1 mRNA detection for diagnosing symptomatic infection.

Keywords: bocavirus; detection; diagnosis; nasopharynx; parvovirus; serology; tonsil.

© The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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39
Randomized Controlled Trial Int Clin Psychopharmacol
. 2020 Jan;35(1):29-35. doi: 10.1097/YIC.0000000000000291.
Effects of Passiflora Incarnata Linnaeus on Polysomnographic Sleep Parameters in Subjects With Insomnia Disorder: A Double-Blind Randomized Placebo-Controlled Study
Jeewon Lee 1, Han-Young Jung 1, Soyoung Irene Lee 1, Ji Ho Choi 2, Shin-Gyeom Kim 1
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PMID: 31714321 DOI: 10.1097/YIC.0000000000000291
Abstract
The purpose of the present double-blind randomized placebo-controlled clinical study was to investigate the effects of Passionflower on polysomnographic sleep parameters in subjects with insomnia disorder. A total number 110 adult participants (mean age = 40.47 ± 11.68, Female = 53.6%) met the inclusion criteria of insomnia disorder according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). After randomization, patients received either the Passionflower extract or the placebo for 2 weeks. Patients underwent an overnight polysomnography and completed sleep diaries, Insomnia Severity Index, and Pittsburgh Sleep Quality Index. Within group comparisons were analyzed with paired t-tests or Wilcoxon's signed rank tests, and between-group comparisons were analyzed with independent t-tests or Mann-Whitney U Tests, as appropriate. Total sleep time (TST) was significantly increased in the Passionflower group compared with placebo (Passionflower vs placebo, 23.05 ± 54.26 vs -0.16 ± 53.12; P = 0.049). Sleep efficiency and wake after sleep onset (WASO) significantly improved after 2 weeks in the Passionflower group but there was no difference compared with the placebo group. The current study demonstrated the positive effects of Passionflower on objective sleep parameters including TST on polysomnography in adults with insomnia disorder. Further study is needed to investigate the clinical efficacy of Passionflower on insomnia.

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40
Can Fam Physician
. 2019 Apr;65(4):243-245.
Ontario Physician Assistants: Decision Time
Natalie F Dies 1, Maureen T Taylor 2
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PMID: 30979752 PMCID: PMC6467679
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41
Review Int Forum Allergy Rhinol
. 2020 Jun 7. doi: 10.1002/alr.22598. Online ahead of print.
Management of Odontogenic Sinusitis: Multidisciplinary Consensus Statement
John R Craig 1, Roderick W Tataryn 2 3, Tara L Aghaloo 4, Alan T Pokorny 5 6, Stacey T Gray 7, Jose L Mattos 8, David M Poetker 9
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PMID: 32506807 DOI: 10.1002/alr.22598
Abstract
Background: Odontogenic sinusitis (ODS) can present a therapeutic dilemma because multiple treatment strategies have been reported. ODS review articles have been published, but they have lacked multidisciplinary collaboration and an evidence-based methodology. The purpose of this article was to perform an evidence-based review of ODS management options, and develop a multidisciplinary consensus statement on ODS management options.

Methods: An evidence-based review of dental and medical literature on ODS management was performed using PubMed, EMBASE, and Cochrane Review Databases up to December 2019. Exclusion criteria included non-English-language articles, case series with fewer than 10 patients, fungal sinusitis, and studies that did not report treatment success rates. Because aggregate levels of evidence for recommendations were no higher than level C, a clinical consensus statement was conducted using a modified Delphi method.

Results: Sixteen articles met inclusion criteria for the evidence-based review on the following ODS management options: dental treatment alone or combined with ESS for various dental pathologies, and endoscopic sinus surgery (ESS) alone for dental implant-related ODS. Strong consensus was achieved for 9 of the 10 clinical statements, the strongest being the use of shared decision-making for selecting management strategies. No consensus was reached for determining the extent of ESS necessary for uncomplicated ODS.

Conclusion: Strong consensus was reached that ODS management should involve shared decision-making between the otolaryngologist, dental provider, and patient, where the benefits and risks of dental treatment and ESS are discussed. Higher-quality studies are necessary to develop evidence-based treatment recommendations for ODS.

Keywords: chronic rhinosinusitis; endodontic therapy; endoscopic sinus surgery; maxillary sinusitis; odontogenic sinusitis; oroantral fistula.

© 2020 ARS-AAOA, LLC.

59 references
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42
Review J Otolaryngol Head Neck Surg
. 2020 Jun 3;49(1):36. doi: 10.1186/s40463-020-00429-2.
Guidance for Otolaryngology Health Care Workers Performing Aerosol Generating Medical Procedures During the COVID-19 Pandemic
Marc J W Lammers 1, Jane Lea 2 3, Brian D Westerberg 1
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PMID: 32493489 PMCID: PMC7269420 DOI: 10.1186/s40463-020-00429-2
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and surgeries are Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers of becoming infected with SARS-CoV-2 while providing clinical care.

Recommendations: During the COVID-19 pandemic all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. For non-AGMPs in all patients, even COVID-19 positive patients Level 1 PPE (surgical mask, gown, gloves and face shield or goggles) is sufficient. If local prevalence is favourable and patients are asymptomatic and test negative for SARS-CoV-2, Level 1 PPE can be used during short duration AGMPs, with limited risk of infected aerosol spread. For AGMPs in patients who test positive for SARS-CoV-2 a minimum of Level 2 PPE, with adequate protection of mucosal surfaces, is recommended (N95/FFP2 respirator, gown, double gloves, goggles or face shield and head cover). For long duration AGMPs that are deemed high-risk in COVID-19 positive patients, Level 3 PPE can provide a higher level of protection and be more comfortable during long duration surgeries if surgical hoods or PAPRs are used. It is recommended that these procedures are performed in negative pressure rooms, if available. It is essential to follow strict donning and doffing protocols to minimize the risk of contamination.

Conclusions: By following strict infection prevention recommendations, the risk of HCWs becoming infected with SARS-CoV-2 while treating patients can be minimized. As the COVID-19 pandemic evolves rapidly, these recommendations should serve as guidance and need to be interpreted based on local factors and availability of healthcare resources.

Keywords: Aerosol; COVID-19; Guideline; PAPR; PPE; Pandemic; Respirator; Review.

Conflict of interest statement
The authors declare that they have no competing interests.

41 references
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43
Review J Allergy Clin Immunol
. 2020 Jun;145(6):1499-1509. doi: 10.1016/j.jaci.2020.04.010.
Epithelial Barriers in Allergy and Asthma
Peter W Hellings 1, Brecht Steelant 2
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PMID: 32507228 PMCID: PMC7270816 DOI: 10.1016/j.jaci.2020.04.010
Abstract
The respiratory epithelium provides a physical, functional, and immunologic barrier to protect the host from the potential harming effects of inhaled environmental particles and to guarantee maintenance of a healthy state of the host. When compromised, activation of immune/inflammatory responses against exogenous allergens, microbial substances, and pollutants might occur, rendering individuals prone to develop chronic inflammation as seen in allergic rhinitis, chronic rhinosinusitis, and asthma. The airway epithelium in asthma and upper airway diseases is dysfunctional due to disturbed tight junction formation. By putting the epithelial barrier to the forefront of the pathophysiology of airway inflammation, different approaches to diagnose and target epithelial barrier defects are currently being developed. Using single-cell transcriptomics, novel epithelial cell types are being unraveled that might play a role in chronicity of respiratory diseases. We here review and discuss the current understandings of epithelial barrier defects in type 2-driven chronic inflammation of the upper and lower airways, the estimated contribution of these novel identified epithelial cells to disease, and the current clinical challenges in relation to diagnosis and treatment of allergic rhinitis, chronic rhinosinusitis, and asthma.

Keywords: Epithelial cell; airway inflammation; epigenetics; tight junction.

Copyright © 2020. Published by Elsevier Inc.

127 references4 figures
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44
Head Neck
. 2020 Jun;42(6):1339-1343. doi: 10.1002/hed.26210. Epub 2020 Apr 28.
Salivary Gland Disease in the Era of COVID-19 Pandemic
Liuba Soldatova 1, Christopher H Rassekh 1, Zubair W Baloch 2, Jalal B Jalaly 2, Neda I Sedora-Roman 3, Laurie L Loevner 3, David M Cognetti 4, Robert L Witt 4 5, Pavel Dulguerov 6
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PMID: 32343454 PMCID: PMC7267671 DOI: 10.1002/hed.26210
Abstract
Coronavirus disease 2019 (COVID-19) pandemic forced significant changes in current approach to outpatient evaluation of common otolaryngology complaints as hospitals around the world are trying to limit the spread of the virus and to preserve health care resources. These changes raise a lot of questions regarding patient triage and treatment decisions in clinical situations when it is unclear if the workup and management can be postponed. In this communication, we present our approach to evaluation and triage of new patients with complaints concerning for salivary gland disease.

Keywords: COVID-19; salivary gland cancer; salivary gland disease; salivary gland imaging; salivary gland neoplasm.

© 2020 Wiley Periodicals, Inc.

17 references1 figure
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45
Editorial Otolaryngol Clin North Am
. 2020 Feb;53(1):xiii-xiv. doi: 10.1016/j.otc.2019.10.001. Epub 2019 Nov 1.
Brain-Nerve-Computer Interfaces in Otolaryngology
Sujana S Chandrasekhar 1
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PMID: 31685240 DOI: 10.1016/j.otc.2019.10.001
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46
Review Eur J Surg Oncol
. 2019 Sep;45(9):1515-1519. doi: 10.1016/j.ejso.2019.05.004. Epub 2019 May 5.
European Society of Surgical Oncology's Strategy for Clinical Research: Paving the Way for a Culture of Research in Cancer Surgery
S Evrard 1, C van de Velde 2, I Noordhoek 2, C Caballero 3, W Ceelen 4, K Polom 5, A Kolacinska 6, W Allum 7, D D'Ugo 8, H Z Malik 9, I T Rubio 10, L Wyld 11, M Leidenius 12, M Rivoire 13, O Zoras 14, W Polkowski 15, G J Poston 16, R A Audisio 17, T Kovacs 18, S González-Moreno 19, on the European Society of Surgical Oncology
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PMID: 31085024 DOI: 10.1016/j.ejso.2019.05.004
Abstract
As part of its mission to promote the best surgical care for cancer patients, the European Society of Surgical Oncology (ESSO) has been developing multiple programmes for clinical research along with its educational portfolio. This position paper describes the different research activities of the Society over the past decade and an action plan for the upcoming five years to lead innovative and high quality surgical oncology research. ESSO proposes to consider pragmatic research methodologies as a complement to randomised clinical trials (RCT), advocates for increased funding and operational support in conducting research and aims to enable young surgeons to be active in research and establish partnerships for translational research activities.

Keywords: Clinical research; Clinical studies; Oncopolicy; Surgical oncology.

Copyright © 2019. Published by Elsevier Ltd.

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47
Comment JAMA Otolaryngol Head Neck Surg
. 2019 Jun 1;145(6):585-586. doi: 10.1001/jamaoto.2019.0839.
Importance of Maintaining Local Otolaryngology Societies
Christopher G Tang 1 2
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PMID: 31046058 DOI: 10.1001/jamaoto.2019.0839
Comment in
Importance of Maintaining Local Otolaryngology Societies-Reply.
Campbell BH.
JAMA Otolaryngol Head Neck Surg. 2019 Jun 1;145(6):585-586. doi: 10.1001/jamaoto.2019.1048.
PMID: 31046068 No abstract available.
Comment on
Whatever Happened to Local Otolaryngology Societies?
Campbell BH.
JAMA Otolaryngol Head Neck Surg. 2019 Feb 1;145(2):107-108. doi: 10.1001/jamaoto.2018.3290.
PMID: 30520937 No abstract available.
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48
Head Neck
. 2020 Jun;42(6):1322-1324. doi: 10.1002/hed.26198. Epub 2020 Apr 27.
Thyroid Surgery During COVID-19 Pandemic: Principles and Philosophies
Ashok R Shaha 1
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PMID: 32338793 PMCID: PMC7267442 DOI: 10.1002/hed.26198
Abstract
No abstract available
Keywords: COVID-19; COVID-19 pandemic; thyroid cancer; thyroid surgery and surveillance.

5 references
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49
Head Neck
. 2020 Jun;42(6):1248-1249. doi: 10.1002/hed.26190. Epub 2020 Apr 24.
What ENT Doctors Should Know About COVID-19 Contagion Risks
Giuseppe Meccariello 1, Oreste Gallo 2
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PMID: 32329539 PMCID: PMC7264546 DOI: 10.1002/hed.26190
6 references
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50
Review Cancer Metastasis Rev
. 2020 Jun 7. doi: 10.1007/s10555-020-09898-3. Online ahead of print.
Expression and Function of Epithelial Cell Adhesion Molecule EpCAM: Where Are We After 40 Years?
Olivier Gires 1 2, Min Pan 3 4, Henrik Schinke 3, Martin Canis 3, Patrick A Baeuerle 5 6
Affiliations expand
PMID: 32507912 DOI: 10.1007/s10555-020-09898-3
Abstract
EpCAM (epithelial cell adhesion molecule) was discovered four decades ago as a tumor antigen on colorectal carcinomas. Owing to its frequent and high expression on carcinomas and their metastases, EpCAM serves as a prognostic marker, a therapeutic target, and an anchor molecule on circulating and disseminated tumor cells (CTCs/DTCs), which are considered the major source for metastatic cancer cells. Today, EpCAM is reckoned as a multi-functional transmembrane protein involved in the regulation of cell adhesion, proliferation, migration, stemness, and epithelial-to-mesenchymal transition (EMT) of carcinoma cells. To fulfill these functions, EpCAM is instrumental in intra- and intercellular signaling as a full-length molecule and following regulated intramembrane proteolysis, generating functionally active extra- and intracellular fragments. Intact EpCAM and its proteolytic fragments interact with claudins, CD44, E-cadherin, epidermal growth factor receptor (EGFR), and intracellular signaling components of the WNT and Ras/Raf pathways, respectively. This plethora of functions contributes to shaping intratumor heterogeneity and partial EMT, which are major determinants of the clinical outcome of carcinoma patients. EpCAM represents a marker for the epithelial status of primary and systemic tumor cells and emerges as a measure for the metastatic capacity of CTCs. Consequentially, EpCAM has reclaimed potential as a prognostic marker and target on primary and systemic tumor cells.

Keywords: Carcinoma; EpCAM; Epithelial-to-mesenchymal transition; Liquid biopsy; Metastasis; Regulated intramembrane proteolysis.

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51
Editorial Facial Plast Surg Clin North Am
. 2020 Feb;28(1):xi. doi: 10.1016/j.fsc.2019.10.001.
Update on Facial Skin Rejuvenation Technology
J Regan Thomas 1
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PMID: 31779947 DOI: 10.1016/j.fsc.2019.10.001
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52
Review J Plast Reconstr Aesthet Surg
. 2020 May 6;S1748-6815(20)30161-3. doi: 10.1016/j.bjps.2020.03.030. Online ahead of print.
A Closer Look at the Paralyzed Face; A Narrative Review of the Neurobiological Basis for Functional and Aesthetic Appreciation Between Patients With a Left and a Right Peripheral Facial Palsy
Thomas E Tieman 1, Scott R Chaiet 2, Robin Luijmes 3, Elijah Sanches 4, Frank W de Jongh 5, Koen J A O Ingels 1, Carien H G Beurskens 6, Stan J Monstrey 7, Ietske Siemann 8, Corrie E Erasmus 9, Godelieve W J A Verhage-Damen 1, Dirk Kunst 1, Sjaak Pouwels 10
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PMID: 32507705 DOI: 10.1016/j.bjps.2020.03.030
Abstract
Background: The facial nerve or n. facialis (NVII) is the seventh cranial nerve and it is responsible for the innervation of the mimic muscles, the gustatory organ, and the secretomotor function to the salivary, lacrimal, nasal and palatine glands. Clinical presentation of Facial Palsy (FP) is characterized by unilateral facial asymmetry and may present with a change in taste, decreased saliva production, and dysarthria. A facial palsy has a notable effect on the facial appreciation by both the patient and the environment and also affects quality of life and emotional processing. There appear to be differences in the appreciation of people with a left and right facial palsy.

Purpose of this review: The purpose of the review is to give an overview of the anatomy of the facial nerve, neuro-anatomy of face processing, and hemispheric specialization and lateralization. Further,an overview is given of the clinical studies that translated the neuro-anatomical and neurobiological basis of these concepts into clinical studies. What this review adds: This review emphasizes the neurobiological evidence of differences in face processing between the left and right cerebral hemisphere, wherein it seems that the right hemisphere is superior in emotional processing. Several theories are proposed; 1) a familiarity hypothesis and 2) a left-right hemispheric specialization hypothesis. In clinical studies, promising evidence might indicate that, in patients with FP, there is indeed a difference in how left and right FP are perceived. This might give differences in decreased quality of life and finally in occurrence of depression. Further research must aim to substantiate these findings and determine the need for altering the standard therapeutic advice given to patients.

Keywords: hemispheric specialisation; neurobiology, cosmetic appreciation; peripheral facial palsy; socials aesthetics.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Conflict of interest statement
Conflict of Interest None

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53
Comment JAMA Otolaryngol Head Neck Surg
. 2019 Jul 1;145(7):690. doi: 10.1001/jamaoto.2019.0917.
Chronic Rhinosinusitis and Increased Risk of Depression and Anxiety-Reply
Jong-Yeup Kim 1 2, Dong-Kyu Kim 3 4
Affiliations expand
PMID: 31120496 DOI: 10.1001/jamaoto.2019.0917
Comment on
Association of Chronic Rhinosinusitis With Depression and Anxiety in a Nationwide Insurance Population.
Kim JY, Ko I, Kim MS, Yu MS, Cho BJ, Kim DK.
JAMA Otolaryngol Head Neck Surg. 2019 Apr 1;145(4):313-319. doi: 10.1001/jamaoto.2018.4103.
PMID: 30730537 Free PMC article. Clinical Trial.
Chronic Rhinosinusitis and Increased Risk of Depression and Anxiety: The Role of Impaired Sleep Quality.
Ghadami MR.
JAMA Otolaryngol Head Neck Surg. 2019 Jul 1;145(7):689-690. doi: 10.1001/jamaoto.2019.0916.
PMID: 31120483 No abstract available.
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54
Review Eur Arch Otorhinolaryngol
. 2020 Jun 6;1-7. doi: 10.1007/s00405-020-06112-6. Online ahead of print.
Long-term Intubation and High Rate of Tracheostomy in COVID-19 Patients Might Determine an Unprecedented Increase of Airway Stenoses: A Call to Action From the European Laryngological Society
Cesare Piazza 1 2, Marta Filauro 3 4 5, Frederik G Dikkers 6, S A Reza Nouraei 7, Kishore Sandu 8, Christian Sittel 9, Milan R Amin 10, Guillermo Campos 11, Hans E Eckel 12, Giorgio Peretti 13 14
Affiliations expand
PMID: 32506145 PMCID: PMC7275663 DOI: 10.1007/s00405-020-06112-6
Abstract
Introduction: The novel Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, may need intensive care unit (ICU) admission in up to 12% of all positive cases for massive interstitial pneumonia, with possible long-term endotracheal intubation for mechanical ventilation and subsequent tracheostomy. The most common airway-related complications of such ICU maneuvers are laryngotracheal granulomas, webs, stenosis, malacia and, less commonly, tracheal necrosis with tracheo-esophageal or tracheo-arterial fistulae.

Materials and methods: This paper gathers the opinions of experts of the Laryngotracheal Stenosis Committee of the European Laryngological Society, with the aim of alerting the medical community about the possible rise in number of COVID-19-related laryngotracheal stenosis (LTS), and the aspiration of paving the way to a more rationale concentration of these cases within referral specialist airway centers.

Results: A range of prevention strategies, diagnostic work-up, and therapeutic approaches are reported and framed within the COVID-19 pandemic context.

Conclusions: One of the most important roles of otolaryngologists when encountering airway-related signs and symptoms in patients with previous ICU hospitalization for COVID-19 is to maintain a high level of suspicion for LTS development, and share it with colleagues and other health care professionals. Such a condition requires specific expertise and should be comprehensively managed in tertiary referral centers.

Keywords: Airway team; COVID-19; European laryngological society; Intubation injuries; Laryngotracheal stenosis; Prevention; Tracheostomy.

Conflict of interest statement
The authors declare that they have no conflict of interest.

37 references1 figure
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55
Editorial Otolaryngol Clin North Am
. 2020 Jun 2;S0030-6665(20)30070-0. doi: 10.1016/j.otc.2020.04.006. Online ahead of print.
Preface
Jennifer A Villwock 1
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PMID: 32507321 DOI: 10.1016/j.otc.2020.04.006
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56
Ann Otol Rhinol Laryngol
. 2020 Jun 8;3489420933650. doi: 10.1177/0003489420933650. Online ahead of print.
Cardiothoracic Patients With Unilateral Vocal Fold Paralysis: Pneumonia Rates Following Injection Laryngoplasty
Jason H Barnes 1, Diana M Orbelo 1, Michael F Armstrong 1, Semirra L Bayan 1, Christine M Lohse 2, Dale C Ekbom 1
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PMID: 32506947 DOI: 10.1177/0003489420933650
Abstract
Objective: Recurrent laryngeal nerve injury is a potential complication of cardiothoracic surgery and cause of unilateral vocal fold paralysis (UVFP). Injection laryngoplasty (IL) is an intervention offered to patients with UVFP to alleviate symptoms including dysphagia, dysphonia and weak cough. There is no definitive evidence that IL prevents pneumonia. In this study, we compare rates of pneumonia in patients with UVFP secondary to cardiothoracic surgery who did or did not undergo IL.

Methods: A retrospective chart review identified patients diagnosed with UVFP by an otolaryngologist using flexible laryngoscopy following cardiothoracic surgery from January 1, 2008 to December 31, 2017. Each subject was grouped by IL status and assessed for subsequent pneumonia within 6 months of their diagnosis of UVFP. The association of IL with pneumonia was evaluated using Cox proportional hazards regression.

Results: Of 92 patients who met inclusion criteria, 35 (38%) underwent IL and 57 (62%) did not. Twenty patients developed pneumonia, four who had undergone IL and 16 who had not; 12 patients developed aspiration pneumonia including two having undergone IL and 10 who had not. Those who had IL were less likely to develop total pneumonia compared to those who had not (HR = 0.33, P = .045). The protective effect of IL was not as clearly sustained when measuring for aspiration pneumonia, specifically (HR = 0.34; P = .10).

Discussion: Injection laryngoplasty may reduce the risk of pneumonia in patients with UVFP secondary to cardiothoracic surgery; however, further research is needed to quantify the potential protective nature of IL in this patient population.

Level of evidence: 3 (A retrospective cohort study).

Keywords: Cymetra; aspiration; cardiothoracic surgery; injection laryngoplasty.

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57
Eur Arch Otorhinolaryngol
. 2020 Jun 6. doi: 10.1007/s00405-020-06074-9. Online ahead of print.
Clinical Characteristics of Herpes Zoster Laryngitis
Jong-Min Park 1, Seong Eun Kim 2, Hyung Chae Yang 3
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PMID: 32506144 DOI: 10.1007/s00405-020-06074-9
Abstract
Introduction: Herpes zoster laryngitis (HZL) is a recently recognized rare disease, easily mistaken for common viral laryngopharyngitis. There are only a few case reports in the English literature. No study has evaluated the clinical characteristics of HZL. In this study, we analyzed the clinical characteristics of HZL and compared them to those of Ramsay Hunt syndrome (RHS).

Materials and methods: Seventy-three patients who were initially diagnosed with HZL or RHS were enrolled in this study. Their medical records, including laryngoscopic findings, were analyzed retrospectively. The demographic factors, cranial nerve involvement, and recovery rate of both groups were evaluated.

Results: Sixty patients in the non-HZL group and 13 patients in the HZL group were analyzed. Five more patients in the non-HZL group were newly identified with HZL during the retrospective chart review. The mean age of the patients in the HZL group was higher than that of the non-HZL group (p = 0.016). The prevalence of hypertension was higher in the HZL group (p = 0.012). Patients with multiple cranial nerve involvement were more common in the HZL group (p < 0.001). In addition, the prognosis of facial weakness (p = 0.002) and multisensory dizziness (p = 0.006) was poor in HZL group.

Conclusion: This study showed that a considerable proportion of HZL cases were misdiagnosed or overlooked if not suspected. Considering the poor prognosis of HZL patients with facial paralysis and dizziness, HZL should be diagnosed earlier and treated properly.

Keywords: Diagnostic error; Herpes zoster oticus; Herpes zoster virus; Laryngitis; Ramsay hunt syndrome.

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58
Comment JAMA Otolaryngol Head Neck Surg
. 2019 Jul 1;145(7):624-625. doi: 10.1001/jamaoto.2019.0896.
Pediatric Thyroid Cancer-Are My Kids at Increased Risk?
Jeffrey C Rastatter 1 2, Ken Kazahaya 3 4, Gregory W Randolph 5 6
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PMID: 31120481 DOI: 10.1001/jamaoto.2019.0896
Comment on
Pediatric Thyroid Cancer Incidence and Mortality Trends in the United States, 1973-2013.
Qian ZJ, Jin MC, Meister KD, Megwalu UC.
JAMA Otolaryngol Head Neck Surg. 2019 Jul 1;145(7):617-623. doi: 10.1001/jamaoto.2019.0898.
PMID: 31120475 Free PMC article.
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59
Cochlear Implants Int
. 2019;20(Suppl 1):2-5.
Executive Functioning and Language Development in Children With Cochlear Implants
William G Kronenberger 1 2
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PMID: 31920459 PMCID: PMC6952116
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60
Laryngoscope
. 2020 Jun 8. doi: 10.1002/lary.28739. Online ahead of print.
Validation of an Objective Assessment Tool for Tonsillectomy in Otolaryngology Resident Training
Luke Jakubowski 1, Brittany A Leader 2, Stacey L Ishman 2 3 4, Robert Chun 5, Sergey S Tarima 6, Sanjay Parikh 7, Margaret Skinner 8, Marc Thorne 9, Robert Weatherly 10, Gregory Wiet 11, David J Brown 9
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PMID: 32510606 DOI: 10.1002/lary.28739
Abstract
Objective: Create and validate an objective structured assessment of technical skills (OSATS) for otolaryngology residents learning how to perform a tonsillectomy.

Study design: Multicenter prospective longitudinal validation study.

Methods: A multi-institutional study at six tertiary academic otolaryngology residency programs from July 2009 to May 2012. Using the modified Delphi technique, a panel of pediatric otolaryngologists created a tonsillectomy task-based checklist (TBC) for a tonsil OSATS using a 5-point Likert-type scale. Residents were assessed by pediatric otolaryngology staff at the time of surgery with the TBC and a global rating scale. Procedure time, patient age, number of previously performed tonsillectomies, and surgical technique were also collected.

Results: One hundred sixty-seven tonsil OSATS were completed for 38 residents, and competency was recorded for 99 (59.2%). Residents scored as competent had performed significantly more previous tonsillectomies than those deemed noncompetent, 44.4 ± 35.6 and 13.5 ± 11.6, respectively (P < .001). The mean overall score on the tonsil TBC was 4.0 ± 0.8 and 2.6 ± 1.0 for competent and noncompetent, respectively (P < .001). Higher number of tonsillectomies performed and mean tonsil TBC score significantly increased the likelihood of competency (P < .001). Each additional tonsillectomy performed increased the likelihood of achieving competency by 6.3% (P = .006, 95% confidence interval (CI): 1.330-1.110), and each 1.0 point increase in mean tonsil TBC score increased the likelihood of competency by a factor of 2.71 (P = .006, 95% CI:1.330-5.513). There is a 95% likelihood of competency at 48 tonsillectomies or a tonsil TBC score of 4.91.

Conclusion: The tonsil OSATS is a valid and feasible instrument to assess resident competency with tonsillectomy and provides timely objective feedback.

Level of evidence: 4. Laryngoscope, 2020.

Keywords: Xxx.

© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

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61
Case Reports Anaesthesist
. 2019 Apr;68(Suppl 2):99-102. doi: 10.1007/s00101-019-0549-3.
[56-year-old Male on Panendoscopy With ENT Tumor and Radiotherapy : Preparation for the Medical Specialist Examination: Part 5]
[Article in German]
H Ilper 1
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PMID: 30989302 DOI: 10.1007/s00101-019-0549-3
7 references
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62
Laryngoscope
. 2020 Jun 8. doi: 10.1002/lary.28756. Online ahead of print.
Saliva Pepsin Concentration of Laryngopharyngeal Reflux Patients Is Influenced by Meals Consumed Before the Samples
Jerome R Lechien 1 2 3 4, Francois Bobin 1 5, Vinciane Muls 1 6, Mihaela Horoi 4, Marie-Paule Thill 4, Didier Dequanter 1 4, Camille Finck 1 7, Alexandra Rodriguez # 1 4, Sven Saussez # 1 2 4
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PMID: 32510588 DOI: 10.1002/lary.28756
Abstract
Objectives/hypothesis: To assess the impact of diet on the saliva pepsin concentration of patients with laryngopharyngeal reflux (LPR).

Study design: Non-controlled Prospective Study.

Methods: Patients with positive LPR regarding hypopharyngeal-esophageal impedance-pH monitoring (HEMII-pH) were enrolled from three European Hospitals. Patients collected three saliva samples, respectively, in the morning (fasting), and 1 to 2 hour after lunch and dinner. Patients carefully detailed foods and beverages consumed during meals and before the pepsin samples. The 3-month treatment was based on the association of diet, proton pump inhibitors, alginate, or magaldrate regarding the HEMII-pH characteristics. Reflux Symptom Score (RSS) and Reflux Sign Assessment (RSA) were used for assessing the pre- to posttreatment clinical evolution. The Refluxogenic Diet Score and the Refluxogenic Score of a Dish (RESDI) were used to assess the refluxogenic potential of foods and beverages. The relationship between saliva pepsin concentration, HEMII-pH, RESDI, RSS, and RSA was investigated through multiple linear regression.

Results: Forty-two patients were included. The saliva pepsin concentration of the 24-hour period of testing was significantly associated with foods and beverages consumed during the testing period and the evening dinner (rs = 0.973, P < .001). RSS and RSA significantly improved throughout treatment. The level of saliva pepsin in the morning was a negative predictive factor of the therapeutic response regarding RSA and RSS (P < .036).

Conclusions: Foods and beverages may significantly impact the saliva pepsin concentration of patients with LPR. Patients with high-level saliva pepsin in the morning had lower therapeutic response compared with those with low-level saliva pepsin.

Level of evidence: 4 Laryngoscope, 2020.

Keywords: Reflux; beverages; diet; foods; laryngitis; laryngopharyngeal; pepsin; saliva.

© 2020 The American Laryngological, Rhinological and Otological Society, Inc.

20 references
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63
Facial Plast Surg
. 2020 Jun 8. doi: 10.1055/s-0040-1712474. Online ahead of print.
Pain After External and Endonasal Septorhinoplasty-A Propensity Score Matching Analysis
Magdalena Gostian 1, Johannes Loeser 1, Ludwig Heindl 2, Antoniu Oreste Gostian 3
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PMID: 32512602 DOI: 10.1055/s-0040-1712474
Abstract
Guidelines for pain management following septorhinoplasty are lacking, leading to a wide range of therapy regimes even including opioid medication. Thus, the presented study strived to investigate and compare postoperative pain intensities after external and endonasal septorhinoplasty and evaluate whether pain perception is potentially related to patient satisfaction with the aesthetic result. In addition, the effectiveness of an escalating pain treatment protocol was evaluated sparing the necessity of opioid medication. This retrospective study performed at a tertiary referral medical center includes two well-balanced groups of 54 patients each created by propensity score matching out of a total of 161 patients following external or endonasal functional septorhinoplasty performed by a single surgeon between October 1, 2011 and March 31, 2017. Pain intensity was assessed using the visual analogue scale (0-10) on the first three postoperative days (PODs) alongside with the evaluation of the analgesic score. Patients' self-reported outcome was measured with the Utrecht questionnaire, preoperatively, and 3 and 12 months, postoperatively. Postoperative mean pain sensations were similarly high following the external and endonasal approach (F (2;190) = 2.166, p = 0.118) followed by a linear decrease over the first three PODs (F (2;190) = 16.84, p < 0.001). Pain sensations were not related to the duration of surgery, gender, patients' age, revision surgery, and the preoperative and postoperative assessment of the nasal appearance. The consumption of metamizole (F (1,76;172,15) = 2.83, p = 0.065) and ibuprofen (F (2;196) = 1.037, p = 0.356) were similarly high regardless of the surgical approach. Accordingly, both the endonasal and the external approaches led to comparable postoperative pain intensities and analgesic scores. Pain was treated effectively using a standardized escalating pain treatment protocol sparing the administration of opioids. Pain was not related to patient satisfaction with the nasal appearance pre- and postsurgery.

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Conflict of interest statement
The authors have stated explicitly that there is no conflict of interest in connection with this article.

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64
Comment JAMA Otolaryngol Head Neck Surg
. 2019 Jun 1;145(6):548-549. doi: 10.1001/jamaoto.2019.0785.
Inclusion of Neck Level IV in Treatment of Patients With Clinically Node-Negative Oral Cavity Cancer
Arun Sharma 1
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PMID: 31070695 DOI: 10.1001/jamaoto.2019.0785
Comment on
Assessment of the Rate of Skip Metastasis to Neck Level IV in Patients With Clinically Node-Negative Neck Oral Cavity Squamous Cell Carcinoma: A Systematic Review and Meta-analysis.
Warshavsky A, Rosen R, Nard-Carmel N, Abu-Ghanem S, Oestreicher-Kedem Y, Abergel A, Fliss DM, Horowitz G.
JAMA Otolaryngol Head Neck Surg. 2019 Jun 1;145(6):542-548. doi: 10.1001/jamaoto.2019.0784.
PMID: 31070693 Free PMC article.
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65
Auris Nasus Larynx
. 2020 Jun 4;S0385-8146(20)30116-4. doi: 10.1016/j.anl.2020.04.011. Online ahead of print.
Wideband Acoustic Immitance - Absorbance Measurements in Ears After Stapes Surgery
Elżbieta Niemczyk 1, Magdalena Lachowska 2, Emanuel Tataj 3, Katarzyna Kurczak 4, Kazimierz Niemczyk 1
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PMID: 32505608 DOI: 10.1016/j.anl.2020.04.011
Abstract
Objectives: The study aimed to thoroughly assess absorbance in ears after stapes surgery (stapedotomy/stapedectomy) and how stapes surgery affects wideband acoustic immittance (WAI) metrics.

Methods: Eighty-three otosclerotic ears were analyzed pre- and postoperatively. The analysis comprised: air-bone gap (ABG) and WAI which included absorbance measurements, resonance frequency assessment, low frequency tympanometry and metrics derived from these measures.

Results: Absorbance after stapes surgery changed considerably compared to otosclerotic ears before surgery and also differed from normal ears. Absorbance after stapes surgery revealed two significantly different plot types: single-low-frequency-peak absorbance and two-peaks absorbance. Stapes surgery reduced resonance frequency in majority of operated ears and increased static compliance in low frequency tympanometry. Static compliance difference was directly proportional to ABG improvement at low frequencies. Postoperative ABG at 250 Hz and 500 Hz was most commonly correlated with postoperative WAI parameters. ABG improvement at 3000 Hz and 4000 Hz was directly proportional to absorbance difference at ~3000 Hz and 4000 Hz. It influenced the width of the postoperative absorbance by shifting both sides of the plot (negative values shift the points of the plot toward lower frequencies) with the correlation being more pronounced in postoperative two-peaks absorbance type ears.

Conclusions: Absorbance by itself is not sufficient for assessment of changes to middle function following stapes surgery, and should be complemented with other measures. WAI measurements including absorbance, resonance frequency assessment, low frequency tympanometry, and metrics derived from these measures combined with air-bone gap provide insight into mechano-acoustic changes in the middle-ear system as a result of stapes surgery.

Keywords: Absorbance; Air-bone gap; Hearing loss; Stapedectomy; Stapes surgery; Wideband tympanometry.

Copyright © 2020. Published by Elsevier B.V.

Conflict of interest statement
Declaration of Competing Interest The authors declare that there is no conflict of interest including any financial interest or financial support related to this manuscript to be disclosed. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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66
This article is a preprint
Preprints have not been peer reviewed.
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medRxiv
. 2020 May 19;2020.05.10.20096073. doi: 10.1101/2020.05.10.20096073. Preprint
A Collaborative Online AI Engine for CT-based COVID-19 Diagnosis
Yongchao Xu 1 2, Liya Ma 1, Fan Yang 3, Yanyan Chen 4, Ke Ma 2, Jiehua Yang 2, Xian Yang 2, Yaobing Chen 5, Chang Shu 2, Ziwei Fan 2, Jiefeng Gan 2, Xinyu Zou 2, Renhao Huang 2, Changzheng Zhang 6, Xiaowu Liu 6, Dandan Tu 6, Chuou Xu 1, Wenqing Zhang 2, Dehua Yang 7, Ming-Wei Wang 7, Xi Wang 8, Xiaoliang Xie 8, Hongxiang Leng 9, Nagaraj Holalkere 10, Neil J Halin 10, Ihab Roushdy Kamel 11, Jia Wu 12, Xuehua Peng 13, Xiang Wang 14, Jianbo Shao 13, Pattanasak Mongkolwat 15, Jianjun Zhang 16 17, Daniel L Rubin 18, Guoping Wang 5, Chuangsheng Zheng 3, Zhen Li 1, Xiang Bai 2, Tian Xia 2 5
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PMID: 32511484 PMCID: PMC7273252 DOI: 10.1101/2020.05.10.20096073
Abstract
Artificial intelligence can potentially provide a substantial role in streamlining chest computed tomography (CT) diagnosis of COVID-19 patients. However, several critical hurdles have impeded the development of robust AI model, which include deficiency, isolation, and heterogeneity of CT data generated from diverse institutions. These bring about lack of generalization of AI model and therefore prevent it from applications in clinical practices. To overcome this, we proposed a federated learning-based Unified CT-COVID AI Diagnostic Initiative (UCADI, http://www.ai-ct-covid.team/), a decentralized architecture where the AI model is distributed to and executed at each host institution with the data sources or client ends for training and inferencing without sharing individual patient data. Specifically, we firstly developed an initial AI CT model based on data collected from three Tongji hospitals in Wuhan. After model evaluation, we found that the initial model can identify COVID from Tongji CT test data at near radiologist-level (97.5% sensitivity) but performed worse when it was tested on COVID cases from Wuhan Union Hospital (72% sensitivity), indicating a lack of model generalization. Next, we used the publicly available UCADI framework to build a federated model which integrated COVID CT cases from the Tongji hospitals and Wuhan Union hospital (WU) without transferring the WU data. The federated model not only performed similarly on Tongji test data but improved the detection sensitivity (98%) on WU test cases. The UCADI framework will allow participants worldwide to use and contribute to the model, to deliver a real-world, globally built and validated clinic CT-COVID AI tool. This effort directly supports the United Nations Sustainable Development Goals' number 3, Good Health and Well-Being, and allows sharing and transferring of knowledge to fight this devastating disease around the world.

Conflict of interest statement
Competing interests The authors declare no competing interests.

12 references4 figures
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67
J Cancer Surviv
. 2020 Jun 6. doi: 10.1007/s11764-020-00897-5. Online ahead of print.
Looking Under the Hood of "The Cadillac of Cancers:" Radioactive Iodine-Related Craniofacial Side Effects Among Patients With Thyroid Cancer
Samantha A Diamond-Rossi 1 2, Jacqueline Jonklaas 1, Roxanne E Jensen 3, Charlene Kuo 4, Selma Stearns 5, Giuseppe Esposito 6, Bruce J Davidson 7, George Luta 8, Gary Bloom 9, Kristi D Graves 10
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PMID: 32506220 DOI: 10.1007/s11764-020-00897-5
Abstract
Purpose: Despite having a generally favorable prognosis, differentiated thyroid cancer is known to have a significant, long-term impact on the quality of life of survivors. We wished to investigate short- and long-term effects among thyroid cancer survivors following radioactive iodine therapy.

Methods: We conducted eight focus groups (N = 47) to understand patients' experiences of short- and long-term effects after radioactive iodine treatment and the impact these treatment-related side effects had on patients' quality of life. We elicited responses regarding experiences with side effects following radioactive iodine treatment, particularly salivary, lacrimal, and nasal symptoms. We transcribed audiotapes and conducted qualitative analyses to identify codes and themes.

Results: We identified eight broad themes from the qualitative analyses. Themes reflecting physical symptoms included dry mouth, salivary gland dysfunction, altered taste, eye symptoms such as tearing or dryness, and epistaxis. Psychosocial themes included lack of knowledge and preparation for treatment, regret of treatment, and distress that thyroid cancer is labeled as a "good cancer."

Conclusions: Thyroid cancer survivors reported a wide range of radioactive iodine treatment-related effects and psychosocial concerns that appear to reduce quality of life. The psychosocial concerns reported by participants underscore the significant unmet information and support needs prior to and following RAI treatment among individuals diagnosed with thyroid cancer.

Implications for cancer survivors: Future research is needed to help both patients and physicians understand the effect of radioactive iodine on quality of life, and to better assess the benefits versus the risks of radioactive iodine therapy.

Keywords: Benefit/risk; Lacrimal; Quality of life; Radioiodine; Salivary; Symptoms; Thyroid cancer.

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68
Case Reports J Neurol
. 2019 Nov;266(11):2875-2877. doi: 10.1007/s00415-019-09504-9. Epub 2019 Aug 13.
Aperiodic Alternating Nystagmus in Isolated Vestibular Nucleus Infarction
Chang-Hee Kim 1, Kwang-Dong Choi 2
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PMID: 31410550 DOI: 10.1007/s00415-019-09504-9
14 references
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69
Panminerva Med
. 2020 Jun 4. doi: 10.23736/S0031-0808.20.03976-2. Online ahead of print.
MiR-181a Reduces Radiosensitivity of Non-Small Cell Lung Cancer via Inhibiting PTEN
Ping Hu 1, Lulian Zhou 2, Chuanli Wang 1, Guangju Cao 1, Ying Chang 3
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PMID: 32506887 DOI: 10.23736/S0031-0808.20.03976-2
Abstract
Background: To explore the effect of micro ribonucleic acid (miR)-181a on the radiosensitivity of non-small cell lung cancer (NSCLC) and its potential mechanism of action.

Methods: The differentially expressed miRNAs were screened in lung cancer tissues of radiotherapy-resistant and non-radiotherapy-resistant NSCLC patients, and verified via reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Next, the effects of different miRNA expressions on patients' survival time were discussed, and target genes of miR-181a were predicted. The effect of miR-181a expression on radiosensitivity was determined using cell counting kit-8 (CCK-8) assay and flow cytometry. The direct target of miR-181a was verified via luciferase reporter assay. Phosphatase and tensin homolog deleted on chromosome ten (PTEN) was overexpressed using lentiviruses, and then whether miR-181a reduces radiosensitivity via targeting PTEN was detected via CCK-8 assay and flow cytometry. Finally, Western blotting was performed to detect the protein expression of PTEN.

Results: The screening results of microarray expression profile assay revealed that 15 miRNAs had significant differences in lung cancer tissues of radiotherapy-resistant NSCLC patients compared with those in non-radiotherapy-resistant NSCLC patients. The results of RT-qPCR showed that hsa-miR-181a, hsa-miR-199b, hsa-miR-489 and hsa-miR-589 were significantly up-regulated in the lung cancer tissues of radiotherapy-resistant NSCLC patients compared with those in non-radiotherapy-resistant NSCLC patients. In addition, it was found that the survival time of NSCLC patients was obviously prolonged in hsa-miR-181a low-expression group and hsa-miR-589 high-expression group, but hsa-miR-489 and hsa-miR-199b had no significant influence on the survival time of NSCLC patients. According to KEGG enrichment analysis, the target genes of miR-181a were evidently enriched in the phosphatidylinositol 3-hydroxy kinase (PI3K)/protein kinase B (AKT) signaling pathway, NSCLC signaling pathway and other cancer signaling pathways. Under the radiation dose of 2, 4, 6 and 8 Gy, the survival rate of A549 cells rose in miR-181a mimic group, but declined in miR-181a inhibitor group. Moreover, compared with that in model group, the radiotherapy-induced apoptosis was markedly inhibited in miR-181a mimic group, but markedly promoted in miR-181a inhibitor group. It was also observed that the response of cells to radiotherapy-induced apoptosis was remarkably weakened in miR-181a mimic + PTEN overexpression group compared with that in miR-181a mimic group. Finally, miR-181a mimic group had a significantly lower protein expression of PTEN and significantly higher protein expressions of CXC chemokine receptor 4 (CXCR4), phosphorylated signal transducer and activator of transcription 3 (p-STAT3), p-AKT1 and p-mammalian target of rapamycin (mTOR) than model group, while miR-181a inhibitor group had the opposite protein expressions. The protein expressions of CXCR4, p-STAT3, p-AKT1 and p-mTOR were obviously lower in miR-181a mimic + PTEN overexpression group than those in miR-181a mimic group.

Conclusions: MiR-181a reduces the radiosensitivity of NSCLC via inhibiting PTEN expression.

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70
Int Forum Allergy Rhinol
. 2020 Jun 7. doi: 10.1002/alr.22566. Online ahead of print.
Staphylococcus Aureus Biofilm Exoproteins Are Cytotoxic to Human Nasal Epithelial Barrier in Chronic Rhinosinusitis
Beula Subashini Panchatcharam 1, Clare M Cooksley 1, Mahnaz Ramezanpour 1, Rajan Sundaresan Vediappan 1, Ahmed Bassiouni 1, Peter J Wormald 1, Alkis J Psaltis 1, Sarah Vreugde 1
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PMID: 32506835 DOI: 10.1002/alr.22566
Abstract
Background: Chronic rhinosinusitis patients (CRS) suffer from chronic inflammation of the sinus mucosa associated with chronic relapsing infections. Mucosal biofilms, associated with Staphylococcus aureus, have been implicated as a cause. We compared the effect of exoproteins secreted from clinical isolates of S aureus from CRS patients in planktonic and biofilm form on the nasal epithelial barrier.

Methods: Clinical S aureus isolates from 39 CRS patients were grown in planktonic and biofilm forms and their exoproteins concentrated. These were applied to primary human nasal epithelial cells grown at the air-liquid interface. Transepithelial electrical resistance, permeability of flourescein isothiocyanate-dextrans, and cytotoxicity were measured. Structure and expression of tight junctions zona occludens-1, and claudin-1 proteins were assessed by electron microscopy and immunofluorescence. The Wilcoxon signed rank test was used for statistical analyses.

Results: S aureus biofilm exoproteins showed dose- and time-dependent reduction of transepithelial electrical resistance, increased cell toxicity, and increased permeability (p < 0.001) compared with equal concentrations of planktonic cultures. Discontinuity in zona occludens-1 and claudin-1 immunofluorescence was confirmed as disrupted tight junctions on electron microscopy.

Conclusion: S aureus biofilm exoproteins disrupt the mucosal barrier structure in a time- and dose-dependent manner and are toxic. Damage to the mucosal barrier by S aureus biofilm exoproteins may play a major role in CRS etiopathogenesis.

Keywords: Staphylococcus aureus exoproteins; biofilm; chronic rhinosinusitis; claudin-1; mucosal barrier; tight junction; transepithelial electrical resistance; zona occludens-1.

© 2020 ARS-AAOA, LLC.

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71
Int Forum Allergy Rhinol
. 2020 Jun 7. doi: 10.1002/alr.22605. Online ahead of print.
Surgeon Cost Feedback Through a Surgical Receipt Program Reduces Cost in Sinonasal Surgery
Amarbir S Gill 1, Renuka K Reddy 1, Andrea G Kulinich 1, Joanna Kim 1, Machelle D Wilson 2, Jonathan Liang 3, E Bradley Strong 1, Toby O Steele 1 4
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PMID: 32506719 DOI: 10.1002/alr.22605
Abstract
Background: Operating room (OR) costs are a large portion of healthcare expenses. This study evaluates the impact of a surgeon-targeted surgical receipt cost feedback system on OR supply costs in sinonasal surgery and individual components contributing to procedural cost.

Methods: Itemized weekly surgical receipts detailing individual case supply costs were analyzed before and after the implementation of a non-incentivized surgeon cost feedback system between January 2017 and June 2019. Supply cost data collected 15 months prior to intervention was compared to cost data 15 months after implementation of the weekly automated receipt dissemination to surgeons. Chi square test was used for categorical data and the Wilcoxon test was used to compare change in cost. Univariate and mediation analyses were performed to assess variables impacting cost.

Results: Of 502 sinonasal procedures analyzed, 239 were before and 264 after cost feedback implementation. There were no significant differences in age/gender, or indication for surgery. The median OR supply cost decreased from $1229.64 to $1097.22 (p = 0.02) after receipt implementation. There were effects of procedure type (p = 0.02), circulating nurse specialization (p < 0.001), steroid eluting stent (p = 0.002), and sinus drill (p < 0.001) on cost. Mediation analysis confirmed full mediation by decreasing use of steroid-eluting stents.

Conclusion: Surgeon cost feedback in the form of individualized OR surgical receipts is an effective model to reduce supply cost per case in sinonasal surgery.

Keywords: FESS; allergic rhinitis; chronic rhinosinusitis; endoscopy; evidence-based medicine; health care economics; statistics.

© 2020 ARS-AAOA, LLC.

10 references
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72
Int Forum Allergy Rhinol
. 2020 Jun 7. doi: 10.1002/alr.22603. Online ahead of print.
Chronic Rhinosinusitis: Assessment of Changes in Nociceptive Neurons
Stijn Bogaert 1 2, Koen Van Crombruggen 1, Gabriele Holtappels 1, Natalie De Ruyck 1, Nicole Suchonos 2, Jonas Jae-Hyun Park 3, Claus Bachert 1 4
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PMID: 32506798 DOI: 10.1002/alr.22603
Abstract
Background: Pain is a major symptom of chronic rhinosinusitis (CRS). It is mainly associated with CRS without nasal polyps (CRSsNP) and has a major impact in the decision to move on to surgery. Patients with CRS with nasal polyps (CRSwNP) are characterized by trigeminal hypoesthesia and suffer from less pain. The aim of this study was to investigate whether CRS induces alterations in the peripheral nociceptive neurons, mainly focusing on quantitative changes.

Methods: Sinus mucosa and inferior turbinate (IT) samples were obtained from patients with CRS, and IT tissue of healthy patients served as controls. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was performed for neuronal markers including CNTNAP2, FAM19A1, GFRA2, NEFH, NTRK1, PLXNC1, RET, SCN10A, SCN11A, TRPV1, and PGP 9.5; enzyme-linked immunosorbent assay (ELISA) was performed for KCNK18, SCN10A, MRGPRD, and MAP2. For PGP 9.5, immunohistochemistry was additionally used to analyze tissue slides.

Results: We included 35 patients with CRSsNP, 47 patients with CRSwNP, and 18 control patients. No differences in expression of the neuronal markers were observed between CRSsNP, CRSwNP, and controls. SCN10A was the only marker exclusively expressed on nociceptive neurons in sinus tissue. No histological difference in nerve fibers was observed between sinus mucosa of both phenotypes.

Conclusion: Our results indicate that the nociceptive nerve density in CRSwNP is not lower than in CRSsNP, as was assumed previously. The nociceptive neurons in sinonasal mucosa cannot be classified into subtypes due to the lack of specificity of the respective marker genes. Our findings question the generally accepted claim that nasal polyp tissue does not contain any nerves.

Keywords: chronic rhinosinusitis; nociceptive neurons; olfaction; rhinosinusitis; sinus anatomy.

© 2020 ARS-AAOA, LLC.

30 references
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73
Carbohydr Polym
. 2020 Aug 1;241:116254. doi: 10.1016/j.carbpol.2020.116254. Epub 2020 Apr 28.
Preparation and Antibiofilm Studies of Curcumin Loaded Chitosan Nanoparticles Against Polymicrobial Biofilms of Candida Albicans and Staphylococcus Aureus
Su Ma 1, Doris Moser 2, Feng Han 3, Matthias Leonhard 4, Berit Schneider-Stickler 4, Yulong Tan 5
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PMID: 32507182 DOI: 10.1016/j.carbpol.2020.116254
Abstract
Polymicrobial biofilms related infections are an important clinical problem with classical antibiotics being not sufficient in therapy. Here, curcumin (Cur) was loaded on positively charged chitosan nanoparticles (CSNP). The antibiofilm activities against mono- and polymicrobial biofilms of Candida albicans and Staphylococcus aureus were evaluated. The average diameter of CSNP-Cur was 134.37 ± 1.99 nm and its surface charge was +18.10 ± 0.82 mV. Cur released from NPs was slower at pH 7.4 than at pH 5.4. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) were used to observe biofilm architecture and live/dead organisms within biofilm on medical silicone surface. CSNP-Cur exhibited excellent antibiofilm activity against planktonic bacteria or fungi, mono- and polymicrobial biofilm formations and preformed biofilms. SEM and CLSM showed that CSNP-Cur was able to reduce biofilm thickness as well as kill microbial cells embedded in biofilm on silicone surfaces.

Keywords: Antibiofilm; Biofilm; Curcumin; Nanoparticle; Polymicrobial.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Conflict of interest statement
Declaration of Competing Interest The authors claim no conflict of interest.

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74
PLoS Biol
. 2020 Jun 8;18(6):e3000644. doi: 10.1371/journal.pbio.3000644. Online ahead of print.
Human MAIT Cell Cytolytic Effector Proteins Synergize to Overcome Carbapenem Resistance in Escherichia Coli
Caroline Boulouis 1, Wan Rong Sia 2, Muhammad Yaaseen Gulam 2, Jocelyn Qi Min Teo 3, Yi Tian Png 4, Thanh Kha Phan 5, Jeffrey Y W Mak 6 7, David P Fairlie 6 7, Ivan K H Poon 6, Tse Hsien Koh 8, Peter Bergman 9, Chwee Ming Lim 4 10, Lin-Fa Wang 2, Andrea Lay Hoon Kwa 2 3, Johan K Sandberg 1, Edwin Leeansyah 1 2 11
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PMID: 32511236 DOI: 10.1371/journal.pbio.3000644
Abstract
Mucosa-associated invariant T (MAIT) cells are abundant antimicrobial T cells in humans and recognize antigens derived from the microbial riboflavin biosynthetic pathway presented by the MHC-Ib-related protein (MR1). However, the mechanisms responsible for MAIT cell antimicrobial activity are not fully understood, and the efficacy of these mechanisms against antibiotic resistant bacteria has not been explored. Here, we show that MAIT cells mediate MR1-restricted antimicrobial activity against Escherichia coli clinical strains in a manner dependent on the activity of cytolytic proteins but independent of production of pro-inflammatory cytokines or induction of apoptosis in infected cells. The combined action of the pore-forming antimicrobial protein granulysin and the serine protease granzyme B released in response to T cell receptor (TCR)-mediated recognition of MR1-presented antigen is essential to mediate control against both cell-associated and free-living, extracellular forms of E. coli. Furthermore, MAIT cell-mediated bacterial control extends to multidrug-resistant E. coli primary clinical isolates additionally resistant to carbapenems, a class of last resort antibiotics. Notably, high levels of granulysin and granzyme B in the MAIT cell secretomes directly damage bacterial cells by increasing their permeability, rendering initially resistant E. coli susceptible to the bactericidal activity of carbapenems. These findings define the role of cytolytic effector proteins in MAIT cell-mediated antimicrobial activity and indicate that granulysin and granzyme B synergize to restore carbapenem bactericidal activity and overcome carbapenem resistance in E. coli.

Conflict of interest statement
I have read the journal’s policy and the authors of this manuscript have the following competing interests: David P Fairle is an inventor on a patent application (PCT/AU2013/000742, WO2014005194), and Jeffrey YW Mak and David P Fairlie are inventors on another patent application (PCT/AU2015/050148, WO2015149130) involving MR1 ligands for MR1-restricted MAIT cells owned by University of Queensland, Monash University and University of Melbourne. The other authors declare no competing interests.

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75
J Oral Pathol Med
. 2020 Jun 7. doi: 10.1111/jop.13051. Online ahead of print.
Sarcomatoid Variant of Squamous Carcinoma in Recurrent and Second Primary Tumors of the Oral Cavity
Arjun Singh 1, Florida Sharin 1, Hitesh Singhavi 1, Akshay Patil 2, Sudhir Nair 1, Pankaj Chaturvedi 1
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PMID: 32506553 DOI: 10.1111/jop.13051
Abstract
Background: Sarcomatoid variant of oral squamous cell carcinoma (OSCC) are aggressive tumors that frequently recur and metastasize. Our aim was to determine the survival outcomes and factors that predict its incidence in recurrent and second primary tumors (SPT).

Methods: We retrospectively analyzed the records of SPT and recurrent OSCC cases with sarcomatoid differentiation. The overall survival (OS) and disease free survival (DFS) was determined by the Kaplan-Meier method. Logistic regression was used to identify the factors associated with SPT and recurrent sarcomatoid OSCC. Recursive partitioning was performed to classify the sample based on the clinicopathological factors of the index tumor.

Results: 82 patients were included in the study with a median survival, calculated from the date of diagnosis of recurrence or SPT, of 6 months (recurrence-2 months, SPT-8 months). The 3-year OS for the recurrence group was 19.9% and for SPT group was 29%. Perineural invasion in the index tumor was significantly associated with sarcomatoid differentiation in the recurrent tumor. At one end of the spectrum of the recursive partitioning were the SPTs that had small index tumor sizes and DOI/thickness less than 14.5cm (lowest risk) and at the other end were recurrent diseases that had index tumors of advanced T stage (highest risk).

Conclusion: Sarcomatoid variant in the recurrent/SPT OSCC infers a poor prognosis. Recurrent disease that had an index tumor with advanced T stage carries the worst outcomes. Perineural invasion in the index tumor can help predict the presence of sarcomatoid carcinoma in the recurrent or SPT.

Keywords: recurrent; sarcomatoid carcinoma; second primary tumor; squamous cell carcinoma.

This article is protected by copyright. All rights reserved.

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76
Am J Otolaryngol
. 2020 Jun 1;41(5):102574. doi: 10.1016/j.amjoto.2020.102574. Online ahead of print.
Rapid Implementation of COVID-19 Tracheostomy Simulation Training to Increase Surgeon Safety and Confidence
Phillip S LoSavio 1, Michael Eggerstedt 2, Bobby A Tajudeen 1, Peter Papagiannopoulos 1, Peter C Revenaugh 1, Pete S Batra 1, Inna Husain 1
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PMID: 32505992 DOI: 10.1016/j.amjoto.2020.102574
Abstract
Objective: To determine if rapid implementation of simulation training for anticipated COVID-19 tracheostomy procedures can increase physician confidence regarding procedure competency and use of enhanced personal protective equipment (PPE).

Methods: A brief simulation training exercise was designed in conjunction with the development of a COVID-19 Tracheostomy Protocol. The simulation training focused primarily on provider safety, pre and post-surgical steps and the proper use of enhanced PPE. Simulation training was performed in the simulation lab at the institution over 2 days. Pre and post self-evaluations were measured using standardized clinical competency questionnaires on a 5-point Likert Scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent."

Results: Physicians self-reported a significant increase in knowledge and competency immediately after completing the training exercise. Resident physicians increased from a mean score of 3.00 to 4.67, p-value 0.0041, mean increase 1.67 (CI 95% 0.81 to 2.52). Attending physicians increased from a mean score of 2.89 to 4.67, p-value 0.0002, mean increase 1.78 (CI 95% 1.14 to 2.42). Overall, all participants increased from a mean score of 3.06 to 4.71, p-value 0.0001, mean increase 1.65 (CI 95% 1.24 to 2.05).

Discussion: Implementation of this simulation training at our institution resulted in a significant increase in physician confidence regarding the safe performance of tracheostomy surgery in COVID-19 patients.

Implications for practice: Adoption of standardized COVID-19 tracheostomy simulation training at centers treating COVID-19 patients may result in improved physician safety and enhanced confidence in anticipation of performing these procedures in real-life scenarios.

Keywords: Airway; COVID-19; PPE; PSQI; Safety; Simulation; Tracheostomy.

Copyright © 2020 Elsevier Inc. All rights reserved.

Conflict of interest statement
Declaration of competing interest None.

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77
Diagn Cytopathol
. 2020 Jun 7. doi: 10.1002/dc.24515. Online ahead of print.
The Milan System for Reporting Salivary Gland Cytopathology: Single Center Experience With Cell Blocks
Marie Behaeghe 1, Vincent Vander Poorten 2, Robert Hermans 3, Constantinus Politis 4, Birgit Weynand 1, Esther Hauben 1
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PMID: 32506684 DOI: 10.1002/dc.24515
Abstract
Background: Salivary gland fine needle aspiration (FNA) has a well-established role in the evaluation of salivary gland lesions. The Milan system for reporting salivary gland cytopathology (MSRSGC) was developed in 2018 to accomplish a standardized reporting across institutions. This classification is predominantly based on the use of direct smears. This single center study aims to evaluate and further validate the MSRSGC based on the sole use of cell blocks and carry out a risk assessment based on follow up histopathology.

Methods: A total of 359 FNA specimens from 343 patients processed as cell blocks between 2012 and 2018 were retrieved, with histologic follow-up available in 235 cases. The cytological diagnosis were reclassified according to the MSRSGC categories: non-diagnostic, non-neoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SFM), and malignant. The use of ancillary immunohistochemistry or molecular testing was recorded. The risk of malignancy (ROM) was calculated for each diagnostic category.

Results: Overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 92.9%, 75.9%, 97.9%, 91.7%, and 95%, respectively. The ROM for the non-diagnostic, non-neoplastic, AUS benign neoplasms, SUMP, SFM and malignant categories were 13.8%, 14.2%, 30%, 6.3%, 20.8%, 60%, and 100%, respectively.

Conclusion: This large single center retrospective series further validates the MSRSGC. The proposed diagnostic classification is reproducible with use of cell blocks. Discrepancies in number of cases per category and ROM are based on cross-institution variabilities, pre-FNA diagnostics (imaging) and ancillary tests.

Keywords: MSRSGC; Milan system; cell blocks; cytopathology; salivary gland.

© 2020 Wiley Periodicals, LLC.

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78
Am J Audiol
. 2020 Jun 8;1-10. doi: 10.1044/2020_AJA-19-00098. Online ahead of print.
Characteristics and Help-Seeking Behavior of People Failing a Smart Device Self-Test for Hearing
Danielle Schönborn 1, Faheema Mahomed Asmail 1, Karina C De Sousa 1, Ariane Laplante-Lévesque 2 3, David R Moore 4 5 6, Cas Smits 7, De Wet Swanepoel 1 8
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PMID: 32510970 DOI: 10.1044/2020_AJA-19-00098
Abstract
Purpose This study investigated user characteristics, help-seeking behavior, and follow-up actions of people who failed an app-based digits-in-noise hearing screening test, considering their stage of change. Method Test and user characteristics of 3,092 listeners who failed the test were retrospectively analyzed. A posttest survey determining follow-up (verb) actions was sent to listeners who failed the test (n = 1,007), of which 59 responded. Results The majority of listeners were in the precontemplation stage (75.5%). Age and stage of change were significant (p < .05) predictors of the digits-in-noise speech recognition threshold (DIN SRT). Listeners in the precontemplation stage were significantly younger than in other stages (p < .05). Posttest survey response rate was low (5.9%). Of those, most (82.4%) did not think they had a hearing loss. Only 13.6% followed up with an audiologist. Conclusion Older people presented with poorer DIN SRTs and were typically in a more advanced stage of change. The majority of those who did not follow up after failing the screening test did not believe they had a hearing loss. A combination of factors, including poor DIN SRT, older age, and a more advanced stage of change inclined participants to follow up with audiological care.

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79
Neoplasia
. 2020 May 13;22(8):294-310. doi: 10.1016/j.neo.2020.04.005. Online ahead of print.
An in Vivo Functional Genomics Screen of Nuclear Receptors and Their Co-Regulators Identifies FOXA1 as an Essential Gene in Lung Tumorigenesis
Suzie K Hight 1, Allison Mootz 2, Rahul K Kollipara 3, Elizabeth McMillan 4, Paul Yenerall 5, Yoichi Otaki 6, Long-Shan Li 2, Kimberley Avila 2, Michael Peyton 2, Jaime Rodriguez-Canales 7, Barbara Mino 7, Pamela Villalobos 7, Luc Girard 2, Patrick Dospoy 8, Jill Larsen 9, Michael A White 4, John V Heymach 10, Ignacio I Wistuba 7, Ralf Kittler 3, John D Minna 11
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PMID: 32512502 DOI: 10.1016/j.neo.2020.04.005
Abstract
Using a mini-library of 1062 lentiviral shRNAs targeting 40 nuclear hormone receptors and 70 of their co-regulators, we searched for potential therapeutic targets that would be important during in vivo tumor growth using a parallel in vitro and in vivo shRNA screening strategy in the non-small cell lung cancer (NSCLC) line NCI-H1819. We identified 21 genes essential for in vitro growth, and nine genes specifically required for tumor survival in vivo, but not in vitro: NCOR2, FOXA1, HDAC1, RXRA, RORB, RARB, MTA2, ETV4, and NR1H2. We focused on FOXA1, since it lies within the most frequently amplified genomic region in lung adenocarcinomas. We found that 14q-amplification in NSCLC cell lines was a biomarker for FOXA1 dependency for both in vivo xenograft growth and colony formation, but not mass culture growth in vitro. FOXA1 knockdown identified genes involved in electron transport among the most differentially regulated, indicating FOXA1 loss may lead to a decrease in cellular respiration. In support of this, FOXA1 amplification was correlated with increased sensitivity to the complex I inhibitor phenformin. Integrative ChipSeq analyses reveal that FOXA1 functions in this genetic context may be at least partially independent of NKX2-1. Our findings are consistent with a neomorphic function for amplified FOXA1, driving an oncogenic transcriptional program. These data provide new insight into the functional consequences of FOXA1 amplification in lung adenocarcinomas, and identify new transcriptional networks for exploration of therapeutic vulnerabilities in this patient population.

Keywords: FOXA1; NKX2-1; Non-small cell lung cancer; Pooled shRNA screens; Xenograft.

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

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80
Editorial Otolaryngol Clin North Am
. 2020 Feb;53(1):xv-xvi. doi: 10.1016/j.otc.2019.09.015. Epub 2019 Oct 21.
The Impact and Evolution of Cranial Nerve Stimulators in Otolaryngology
James G Naples 1, Michael J Ruckenstein 2
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PMID: 31648822 DOI: 10.1016/j.otc.2019.09.015
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81
Head Neck
. 2020 Jun;42(6):1250-1251. doi: 10.1002/hed.26194. Epub 2020 Apr 24.
Who Should Perform the Rhinopharyngeal Swab in COVID-19 Positive Patients?
Armando De Virgilio 1 2, Raul Pellini 3, Giuseppe Mercante 1 2, Fabio Ferreli 1 2, Gerardo Petruzzi 3, Giuseppe Spriano 1 2
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PMID: 32329138 PMCID: PMC7264563 DOI: 10.1002/hed.26194
Abstract
No abstract available
Keywords: COVID-19; oropharynx; otorhinolaryngologists; swab: rhinopharynx.

8 references
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82
J Med Imaging (Bellingham)
. 2020 May;7(3):031504. doi: 10.1117/1.JMI.7.3.031504. Epub 2020 Jun 3.
Preoperative Prediction of Angular Insertion Depth of Lateral Wall Cochlear Implant Electrode Arrays
Mohammad M R Khan 1, Robert F Labadie 2, Jack H Noble 1
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PMID: 32509912 PMCID: PMC7269369 (available on 2021-06-03) DOI: 10.1117/1.JMI.7.3.031504
Abstract
Purpose: Cochlear implants (CIs) use an array of electrodes surgically threaded into the cochlea to restore hearing sensation. Techniques for predicting the insertion depth of the array into the cochlea could guide surgeons toward more optimal placement of the array to reduce trauma and preserve the residual hearing. In addition to the electrode array geometry, the base insertion depth (BID) and the cochlear size could impact the overall array insertion depth. Approach: We investigated using these measurements to develop a linear regression model that can make preoperative or intraoperative predictions of the insertion depth of lateral wall CI electrodes. Computed tomography (CT) images of 86 CI recipients were analyzed. Using previously developed automated algorithms, the relative electrode position inside the cochlea was measured from the CT images. Results: A linear regression model is proposed for insertion depth prediction based on cochlea size, array geometry, and BID. The model is able to accurately predict angular insertion depths with a standard deviation of 41 deg and absolute deviation error of 32 deg. Conclusions: Surgeons may use this model for patient-customized selection of electrode array and/or to plan a BID for a given array that minimizes the likelihood of causing trauma to regions of the cochlea where residual hearing exists.

Keywords: angular insertion depth; cochlear implant; image-guided cochlear implantation; lateral wall electrode arrays; straight electrode arrays.

© 2020 Society of Photo-Optical Instrumentation Engineers (SPIE).

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83
Lung Cancer
. 2020 May 28;146:42-49. doi: 10.1016/j.lungcan.2020.05.011. Online ahead of print.
Durvalumab vs Placebo Consolidation Therapy After Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer: An Updated PACIFIC Trial-Based Cost-Effectiveness Analysis
Jiaqi Han 1, Kun Tian 2, Jiangping Yang 1, Youling Gong 3
Affiliations expand
PMID: 32512272 DOI: 10.1016/j.lungcan.2020.05.011
Abstract
Introduction: Recently updated three-year survival data from the PACIFIC trial showed that durvalumab consolidation therapy improved OS rates versus placebo for patients with unresectable stage III non-small cell lung cancer (NSCLC) after chemoradiotherapy. Considering the impact of the high cost of durvalumab, its cost-effectiveness should be updated to see if its cost-effectiveness has changed from the US payers' perspective.

Methods: A comprehensive Markov model was used to evaluate mean lifetime costs and effectiveness of first-line durvalumab consolidation therapy versus placebo for patients with unresectable stage III NSCLC imputing updated survival and quality-of-life data from the PACIFIC trial. The main endpoints include total costs, life years (LYs), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). One-way, two-way, and probabilistic sensitivity analyses were conducted to access the uncertainty in the variables. We also considered durvalumab cost-effectiveness in the subgroups.

Results: Durvalumab consolidation therapy resulted in additional 1.34 LYs and 1.01 QALYs, resulting in an ICER of $138,920 per QALY versus the placebo treatment. One-way sensitivity analysis revealed that the utility values of two treatments, body weight, and unit cost of durvalumab have the greatest influence on the result. Subgroup analyses demonstrated that durvalumab was more cost effective for patients with non-squamous-cell lung cancer, followed by 25% or greater PD-L1 expression. Probabilistic sensitivity analysis showed that the probability of durvalumab being cost-effective versus the placebo is 62.6% at a willingness-to-pay (WTP) of $150,000 per QALY CONCLUSION: Our analyses demonstrated that receiving durvalumab consolidation therapy was more cost-effective than placebo at a WTP threshold of $150,000. These results can be of use to US practitioners in the application of durvalumab and for durvalumab prescription and reimbursement policies.

Keywords: Cost-effectiveness; Durvalumab; Non-small-cell lung cancer; Quality-adjusted life-year.

Copyright © 2020 Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of Competing Interest We wish to confirm that there are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome. We confirm that the manuscript has been read and approved by all named authors and that there are no other persons who satisfied the criteria for authorship but are not listed. We further confirm that the order of authors listed in the manuscript has been approved by all of us.

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84
Int J Otolaryngol
. 2020 May 17;2020:1891250. doi: 10.1155/2020/1891250. eCollection 2020.
Management of Complex Facial Injuries: Cutting Traumas by Angle Grinders
Holger Sudhoff 1, Jan Schulte Am Esch 2, Nazli Ay 1, Ingo Todt 1
Affiliations expand
PMID: 32508925 PMCID: PMC7251467 DOI: 10.1155/2020/1891250
Abstract
The use of angle grinders can lead to complex facial injuries. The most frequent sites affected are within the head and face region. Anatomical boundaries or structures are not respected by the high-speed disc of angle grinders, and thus, injuries can be mutilating, permanently disabling, or even lethal. Functional and aesthetical satisfying results can be reached through debridement, excision of wound edges, and meticulous layered functional closure after appropriate reconstruction of additional facial bony defects. The management and short-term outcome of a complex facial cutting trauma by an angle grinder are presented and discussed.

Copyright © 2020 Holger Sudhoff et al.

Conflict of interest statement
The authors have no conflicts of interest to declare.

5 references11 figures
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85
J Am Med Dir Assoc
. 2020 Jun 2;S1525-8610(20)30329-7. doi: 10.1016/j.jamda.2020.04.011. Online ahead of print.
The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan
Ying Hsin Hsu 1, Ming Yueh Chou 2, Hsiu-Min Chen 3, Wei-Cheng Cheng 4, Che Sheng Chu 5, Yu-Chun Wang 6, Chiao-Lin Hsu 7, Chih-Kuang Liang 8, Ching-Chih Lee 9, Yu Te Lin 10
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PMID: 32507531 DOI: 10.1016/j.jamda.2020.04.011
Abstract
Objectives: We evaluated the trend of end-of-life healthcare utilization and life-sustaining interventions for older adults with dementia 3 to 4 years after the change in hospice policy.

Design: Population-based retrospective cohort study.

Setting and participants: We used the National Health Insurance Research database of enrolled patients ≥65 years of age diagnosed with dementia who died in 2010-2013 (n = 2062).

Methods: Aggressive treatments, including healthcare utilization and life-sustaining interventions, were recorded within 6 months of death. Aggressive healthcare utilization included ≥1 emergency department visits, ≥1 hospitalizations, >14 days of hospitalization, intensive care unit admission, and death in an acute care hospital. Life-sustaining interventions were enteral tube, artificial nutrition, blood transfusion, hemodialysis, invasive ventilation, and cardiopulmonary resuscitation.

Results: Compared with 2010‒2012, 2013 rates significantly decreased for all measures (P < .001). Composite scores of healthcare utilization and life-sustaining treatments in 2013 were significantly lower than for 2010‒2012, after controlling for confounding variables (both P < .001).

Conclusions and implications: Older patients with dementia had a trend of reduced healthcare utilization and fewer life-sustaining treatments near the end of life from 2010 to 2013 after a policy change.

Keywords: Dementia; end of life; healthcare utilizations; life-sustaining interventions.

Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

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86
Review Am J Otolaryngol
. 2020 Jun 1;41(5):102570. doi: 10.1016/j.amjoto.2020.102570. Online ahead of print.
Preferential Use of Total Intravenous Anesthesia in Ambulatory Otolaryngology Surgery During the COVID-19 Pandemic
Matthew Stewart 1, Adam Thaler 2, Patrick Hunt 2, Leonard Estephan 3, Maurits Boon 3, Colin Huntley 3
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PMID: 32505994 PMCID: PMC7263220 DOI: 10.1016/j.amjoto.2020.102570
Abstract
The novel coronavirus (SARS-CoV-2 or COVID-19) pandemic has impacted nearly every aspect of otolaryngologic practice. The transition from office-based evaluation to telemedicine and the number of postponed elective surgical cases is unprecedented. There is a significant need to resume elective surgical care for these patients at the appropriate time. As practices begin to move towards resuming elective and same day ambulatory surgery, safety of both the patient and healthcare team is of paramount importance. Usage of total intravenous anesthesia (propofol and remifentanil) over volatile gas anesthesia (e.g., sevoflurane) may increase the number of patients able to safely receive care by reducing potential spread of the virus through reduction in coughing and significantly decreasing the time spent in the recovery room.

Keywords: COVID-19; Coronavirus; Otolaryngology; Outpatient surgery; Same day surgery.

Copyright © 2020 Elsevier Inc. All rights reserved.

Conflict of interest statement
Declaration of competing interest None.

10 references
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87
Ann Otol Rhinol Laryngol
. 2020 Jun 6;3489420931562. doi: 10.1177/0003489420931562. Online ahead of print.
Nasal Bone Fractures: Differences Amongst Sub-Specialty Consultants
Jason E Cohn 1, Sammy Othman 2, Michael Toscano 3, Tom Shokri 4, Jason D Bloom 5 6, Seth Zwillenberg 7
Affiliations expand
PMID: 32506930 DOI: 10.1177/0003489420931562
Abstract
Background: Nasal fractures constitute the largest proportion of facial trauma each year, however, there is no consensus management. In this study, we investingated the role of the consultant and the functional and aesthetic outcomes of procedures performed to address nasal bone fractures.

Methods: A retrospective chart review of patients who sustained nasal bone fractures was conducted from 8/1/14 through 1/23/18. Categorical variables were analyzed using chi-squared testing and Fisher's exact test, where appropriate, while continuous variables were compared using Mann-Whitney U testing.

Results: During the study period, 136 patients met inclusion criteria for full analysis. The mean age of this cohort was 47.6 ± 20.2 years with the majority identifying as African-American (53.7%) and male (67.2%). Otolaryngologists were significantly more likely to assess pre-operative nasal obstruction (100%) compared to plastic surgeons (24.1%) (P < .001). Otolaryngology elected operative management (53.3%) at a significantly higher rate than plastic surgery (24.1%) (P = .005). Additionally, otolaryngology was significantly more likely to manage patients in an outpatient setting (91.2%), whereas plastic surgery more commonly performed inpatient management (57.1%) (P = .006). Plastic surgery averaged a significantly shorter amount of time from presentation to operative management (7.3 ± 10.7 days) compared to otolaryngology (20 ± 27.7) (P = .019). Consulting service was not associated with a need for revision surgery.

Conclusions: Consultants across subspecialties differ in the management of nasal bone trauma. A more standardized approach is warranted by all individuals involved in the care of maxillofacial trauma patients.

Keywords: Facial Plastic and Reconstructive Surgery; Facial trauma; Miscellaneous; Nose; Reconstruction; nasal fracture.

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88
Review Allergy
. 2020 Jun 8. doi: 10.1111/all.14422. Online ahead of print.
ARIA Digital Anamorphosis: Digital Transformation of Health and Care in Airway Diseases From Research to Practice
Jean Bousquet 1 2, Josep M Anto 3 4 5 6, Claus Bachert 7, Tari Haahtela 8, Torsten Zuberbier 9, Wienczyslawa Czarlewski 10, Anna Bedbrook 1, Sinthia Bosnic-Anticevich 11, G Walter Canonica 12, Victoria Cardona 13, ElisioCosta 14, Alvaro A Cruz 15, Marina Erhola 16, Wytske J Fokkens 17, Joao A Fonseca 18, Maddalena Illario 19, Juan CarlosIvancevich 20, Marek Jutel 21, Ludger Klimek 22, PiotrKuna 23, Violeta Kvedariene 24, Ltt Le 25, Desiree Larenas-Linnemann 26, Daniel Laune 27, Olga M Lourenço 28, Eric Melén 29, Joaquim Mullol 30, Marek Niedoszytko 31, Mikaëla Odemyr 32, Yoshitaka Okamoto 33, Nikos G Papadopoulos 34 35, Vincenzo Patella 36, Oliver Pfaar 37, Nhân Pham-Thi 38, Christine Rolland 39, Boleslaw Samolinski 40, Aziz Sheikh 41, Mikhail Sofiev 42, Charlotte SuppliUlrik 43, Ana Todo-Bom 44, Peter V Tomazic 45, Sanna Toppila-Salmi 8, Ioanna Tsiligianni 46, Arunas Valiulis 47, Erkka Valovirta 48, Maria-Teresa Ventura 49, Samantha Walker 50, Sian Williams 51, Arzu Yorgancioglu 52, Ioana Agache 53, Cezmi A Akdis 54, Rute Almeida 18, Ignacio J Ansotegui 55, Isabella Annesi-Maesano 56, Sylvie Arnavielhe 27, Xavier Basagaña 3 4 5 6, Eric Bateman 57, Annabelle Bédard 3 4 5 6, Martin Bedolla-Barajas 58, Sven Becker 59, Kazi S Bennoor 60, Samuel Benveniste 61 62, Karl C Bergmann 9, Michael Bewick 63, Slawomir Bialek 64, Nils Billo 65, Carsten Bindslev-Jensen 66, Leif Bjermer 67, Hubert Blain 68 69, Matteo Bonini 70, Philippe Bonniaud 71, Isabelle Bosse 72, Jacques Bouchard 73, Louis P Boulet 74, Rodolphe Bourret 75, Koen Boussery 76, Fluvio Braido 77, Vitalis Briedis 78, Andrew Briggs 79, Christopher E Brightling 80, JanBrozek 81, Guy Brusselle 82, Luisa Brussino 83, Roland Buhl 84, Roland Buonaiuto 85, Moises A Calderon 86, Paolo Camargos 87, Thierry Camuzat 88, Luis Caraballo 89, Ana Maria Carriazo 90, Warner Carr 91, Christine Cartier 92, Thomas Casale 93, Lorenzo Cecchi 94, Alfonso M Cepeda Sarabia 95, Niels Chavannes 96, Ekaterine Chkhartishvili 97, Derek K Chu 81, Cemal Cingi 98, Jaime Correia de Sousa 99, David J Costa 100, Anne Lise Courbis 101, Adnan Custovic 102, Biljana Cvetkosvki 11, Gennaro D'Amato 103, Jane da Silva 104, Carina Dantas 105, Dejan Dokic 106, Yves Dauvilliers 107, Giulia De Feo 108, Govert De Vries 109, Philippe Devillier 110, Stefania Di Capua 111, Gerard Dray 101, Ruta Dubakiene 112, Stephen R Durham 113, Marc Dykewicz 114, Motohiro Ebisawa 115, Mina Gaga 116, Yehia El-Gamal 117, Enrico Heffler 12, Regina Emuzyte 118, John Farrell 119, Jean-Luc Fauquert 120, Alessandro Fiocchi 121, Antje Fink-Wagner 122, Jean-François Fontaine 123, José M Fuentes Perez 124, Bilun Gemicioğlu 125, Amiran Gamkrelidze 126, Judith Garcia-Aymerich 3, Philippe Gevaert 7, Maximiliano Gomez 127, Sandra González Diaz 128, Maia Gotua 129, Nick A Guldemond 130, Maria-Antonieta Guzmán 131, Jawad Hajjam 132, Yunuen R Huerta Villalobos 133, Marc Humbert 134, Guido Iaccarino 135, Despo Ierodiakonou 136, TomohisaIinuma 33, Ewa Jassem 137, Guy Joos 82, Ki-Suck Jung 138, Igor Kaidashev 139, Omer Kalayci 140, Przemyslaw Kardas 141, Thomas Keil 142, Musa Khaitov 143, Nikolai Khaltaev 144, Jorg Kleine-Tebbe 145, Rostislav Kouznetsov 42, Marek L Kowalski 146, Vicky Kritikos 11, Inger Kull 147, Stefania La Grutta 148, Lisa Leonardini 149, Henrik Ljungberg 150, Philip Lieberman 151, Brian Lipworth 152, Karin C Lodrup Carlsen 153, Catarina Lopes-Pereira 154, Claudia C Loureiro 155, Renaud Louis 156, Alpana Mair 157, Bassam Mahboub 158, Michaël Makris 159, Joao Malva 160, Patrick Manning 161, Gailen D Marshall 162, Mohamed R Masjedi 163, Jorge F Maspero 164, Pedro Carreiro-Martins 165, Mika Makela 8, Eve Mathieu-Dupas 27, Marcus Maurer 9, Esteban De Manuel Keenoy 166, Elisabete Melo-Gomes 167, Eli O Meltzer 168, Enrica Menditto 169, Jacques Mercier 170, Yann Micheli 27, Neven Miculinic 171, Florin Mihaltan 172, Branislava Milenkovic 173, DimitiriosI Mitsias 35, Giuliana Moda 174, Maria-Dolores Mogica-Martinez 175, Yousser Mohammad 176, Steve Montefort 177, Ricardo Monti 83, Mario Morais-Almeida 178, Ralph Mösges 179, Lars Münter 180, Antonella Muraro 181, Ruth Murray 182, Robert Naclerio 183, Luigi Napoli 184, Leila Namazova-Baranova 185, Hugo Neffen 186, Kristoff Nekam 187, Angelo Neou 188, Björn Nordlund 150, Ettore Novellino 189, Dieudonné Nyembue 190, Robin O'Hehir 191, Ken Ohta 35, Kimi Okubo 192, Gabrielle L Onorato 1, Solange Ouedraogo 193, Julia Palamarchuk 42, Isabella Pali-Schöll 194, Peter Panzner 195, Hae-Sim Park 196, Gianni Passalacqua 197, Jean-Louis Pépin 198, Ema Paulino 199, Jim Phillips 200, Robert Picard 201, Hilary Pinnock 41, Davor Plavec 202, Todor A Popov 203, Fabienne Portejoie 1, David Price 204, Emmanuel P Prokopakis 205, Fotis Psarros 206, Benoit Pugin 207, Francesca Puggioni 12, Pablo Quinones-Delgado 208, Filip Raciborski 40, Rojin Rajabian-Söderlund 209, Frederico S Regateiro 44, Sietze Reitsma 17, Daniele Rivero-Yeverino 210, Graham Roberts 211, Nicolas Roche 212, Erendira Rodriguez-Zagal 210, Christine Rolland 39, Regina E Roller-Wirnsberger 213, Nelson Rosario 214, Antonino Romano 215, Menahem Rottem 216, Dermot Ryan 217, Johanna Salimäki 218, Mario M Sanchez-Borges 219, Joaquin Sastre 220, Glenis K Scadding 221, Sophie Scheire 76, Peter Schmid-Grendelmeier 222, Holger J Schünemann 81, FaradibaSarquis Serpa 223, Mohamed Shamji 224, Juan-Carlos Sisul 225, Mikhail Sofiev 42, Dirceu Solé 226, David Somekh 227, Talant Sooronbaev 228, Milan Sova 229, François Spertini 230, Otto Spranger 122, Cristiana Stellato 108, Rafael Stelmach 231, Michel Thibaudon 232, Teresa To 233, MondherToumi 234, Omar Usmani 235, AntonioA Valero 236, Rudolph Valenta 237 238, Marylin Valentin-Rostan 239, Rianne van der Kleij 240, Michiel Van Eerd 109, Olivier Vandenplas 241, Tuula Vasankari 242, Antonio Vaz Carneiro 243, Giorgio Vezzani 244, Frédéric Viart 92, Giovanni Viegi 245, Dana Wallace 246, Martin Wagenmann 247, De Yun Wang 248, Susan Waserman 249, Magnus Wickman 250, Dennis M Williams 251, Gary Wong 252, Piotr Wroczynski 253, Panayiotis K Yiallouros 254, Osman M Yusuf 255, Heather J Zar 256, Stéphane Zeng 257, Mario E Zernotti 258, Luo Zhang 259, Nan Shan Zhong 260, Mihaela Zidarn 261
Affiliations expand
PMID: 32512619 DOI: 10.1111/all.14422
Abstract
Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis.It strengthens the ARIA change management strategy in the prevention and managementof airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.

Keywords: ARIA; CARAT; MASK; asthma; digital transformation of health and care; rhinitis.

This article is protected by copyright. All rights reserved.

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89
Case Reports J Oral Maxillofac Pathol
. Jan-Apr 2020;24(1):168-171. doi: 10.4103/jomfp.JOMFP_346_19. Epub 2020 May 8.
Bisphosphonate-related Spindle Cell Carcinoma and Osteonecrosis
Nazanin Mahdavi 1, Kheirandish Yasaman 2, A Garajei 3 4, Naeimeh Nikfarjam Nouri 5
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PMID: 32508468 PMCID: PMC7269287 DOI: 10.4103/jomfp.JOMFP_346_19
Abstract
A 48-year-old female with a complaint of persistent pain referred to the Imam Khomeini (Tehran, Iran) in 2018. Based on the radiographic findings, radiolucent lesion found in the right mandible and she had alendronate administration approximately for 10 years. Since the past 6 months, the lesion detected in the right mandible. According to the computed tomography scan, a large lytic destructive lesion with a soft-tissue component was seen at the right mandibular ramus. Microscopic examinations revealed the proliferation of anaplastic spindle-shaped cells arranged in interlacing bundles and whorled patterns. Nuclear polymorphism, scattered cells with hyperchromatic nuclei and increased mitotic activity were notable. Immunohistochemistry findings for tissue section composed of spindle cell proliferation revealed Ki67 (20% positive in hotspots), scattered positive right side incisional biopsy was done. The observation revealed hyperplastic and disorganized squamous epithelial lesion, suggestive of spindle squamous cell carcinoma and osteonecrosis in this patient.

Keywords: Bisphosphonate; osteonecrosis; spindle cell carcinoma; women.

Copyright: © 2020 Journal of Oral and Maxillofacial Pathology.

Conflict of interest statement
There are no conflicts of interest.

19 references2 figures
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90
Auris Nasus Larynx
. 2020 Jun 3;S0385-8146(20)30120-6. doi: 10.1016/j.anl.2020.05.004. Online ahead of print.
Resection of a Desmoid-Type Fibromatosis With a CTNNB1 p.S45P Mutation Using a Cervico-Thoracic Approach: A Case Report and Literature Review
Ryosuke Sato 1, Nobuyuki Bandoh 2, Takashi Goto 3, Akihiro Uemura 3, Nobuyuki Inoue 4, Yuki Otomo 4, Hiroshi Nakano 5, Tomomi Yamaguchi 5, Yasutaka Kato 5, Hiroshi Nishihara 6, Hidehiro Takei 7, Yasuaki Harabuchi 8
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PMID: 32505607 DOI: 10.1016/j.anl.2020.05.004
Abstract
Desmoid-type fibromatosis (DF) is a rare, locally infiltrative, and fibroblastic proliferative disease. DF usually arises from abdominal fascial tissue, but in rare cases, it can occur in extra-abdominal areas. A 73-year-old Japanese male complained of a painless, left anterior neck mass of 3-month duration. Computed tomography revealed the mass measured 9 × 7 × 6 cm and extended to the anterior mediastinum, with invasion of the left clavicle. En bloc resection of the tumor with the left sternoclavicular joint and the medial portion of the left clavicle was performed by cervico-thoracic approach with L-shaped partial sternotomy. Histopathologic examination showed fascicular growth of spindle-shaped cells separated by abundant collagen. Immunohistologic examination revealed nuclear staining of β-catenin and cytoplasmic staining of vimentin. Genetic analysis of 160 cancer-related genes by next-generation sequencing (NGS) demonstrated only a missense mutation in the CTNNB1 gene (c.133T>C, p.S45P). DF extending from the neck to the anterior mediastinum is rare. We report the complete resection of a large-sized DF with the clavicular invasion. A low-frequency CTNNB1 mutation of DF was identified. Genetic analysis with NGS was beneficial for the diagnosis.

Keywords: CTNNB1; Cervico-thoracic approach; Clavicle; Desmoid-type fibromatosis; L-shaped partial sternotomy; Next-generation sequencing.

Copyright © 2020. Published by Elsevier B.V.

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91
Br J Oral Maxillofac Surg
. 2020 Jun 4;S0266-4356(20)30240-0. doi: 10.1016/j.bjoms.2020.05.019. Online ahead of print.
Lessons Learnt From the First Dual-Specialty Conference in Oral and Maxillofacial Surgery Led by Medical Students
J Yiu 1, A Tahim 2
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PMID: 32507645 DOI: 10.1016/j.bjoms.2020.05.019
Abstract
There remains limited formal teaching and placements in oral and maxillofacial surgery (OMFS) in medical schools. OMFS incorporates surgical techniques and attends to conditions that overlap with specialties such as plastic, and ear, nose, and throat (ENT) surgery. With an aim to introduce medical undergraduates to OMFS and promote links to clinical OMFS departments, we hereby report the successful organisation and impact of a locally-arranged, undergraduate, dual-specialty conference.

Keywords: dual-specialty; medical student organisers; medicine-first; oral and maxillofacial surgery; surgical education; undergraduate conference.

Copyright © 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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92
Eur Arch Otorhinolaryngol
. 2020 Jun 6. doi: 10.1007/s00405-020-06095-4. Online ahead of print.
Round Window Accessibility During Cochlear Implantation
Konrad Stuermer 1, Tanja Winter 1, Lisa Nachtsheim 2, Jens Peter Klussmann 1, Jan Christoffer Luers 1
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PMID: 32506146 DOI: 10.1007/s00405-020-06095-4
Abstract
Objective: To assess data regarding round window (RW) visibility and surgical approaches in cochlear implant cases, and to describe and analyze surgical steps relevant for the RW approach in cochlear implantation.

Study design: Prospective clinical study.

Methods: A questionnaire was completed by surgeons after each of altogether 110 cochlear implantations. Round window membrane (RWM) visibility was graded according to the St Thomas Hospital (STH) classification.

Results: Performing different surgical steps during the preparation of the RW niche, the RWM could be fully exposed (STH Type I) in 87%. A RW approach could be used for electrode insertion in 89% of the adult and 78% of the pediatric cases. The distribution of RW types differed significantly between adults and children. Drilling of the superior bony lip was the surgical step most frequently needed in adult as well as pediatric cases to obtain optimal RW exposure.

Conclusion: In children, optimized surgical exposure of the RW niche resulted in only 52% full RWM visibility; whereas in adults, this could be achieved in 87%. The facial nerve (FN) had to be exposed at the level of the posterior tympanotomy in more than 70% of pediatric cases with full RWM visibility; while in adult cases with 100% visibility, such specific exposure was necessary in only 33%. Thus, surgical preparation of the RW niche seems to be more demanding in children than in adults.

Keywords: Cochlea implant; Cochleostomy; Posterior tympanotomy; Round window; Round window visibility.

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93
Head Neck
. 2020 Jun 8. doi: 10.1002/hed.26320. Online ahead of print.
Changing Paradigms in Sinus and Skull Base Surgery as the COVID-19 Pandemic Evolves: Preliminary Experience From a Single Italian Tertiary Care Center
Apostolos Karligkiotis 1, Alberto D Arosio 2, Paolo Battaglia 2 3, Giorgio Sileo 2, Camilla Czaczkes 2, Luca Volpi 1, Mario Turri-Zanoni 2 3, Paolo Castelnuovo 2 3
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PMID: 32510716 DOI: 10.1002/hed.26320
Abstract
Background: Italy was the first European country suffering from COVID-19. Health care resources were redirected to manage the pandemic. We present our initial experience with the management of urgent and nondeferrable surgeries for sinus and skull base diseases during the COVID-19 pandemic.

Methods: A retrospective review of patients treated in a single referral center during the first 2 months of the pandemic was performed. A comparison between the last 2-month period and the same period of the previous year was carried out.

Results: Twenty-four patients fulfilled the inclusion criteria. A reduction of surgical activity was observed (-60.7%). A statistically significant difference in pathologies treated was found (P = .016), with malignancies being the most frequent indication for surgery (45.8%).

Conclusions: Although we feel optimistic for the future, we do not feel it is already time to restart elective surgeries. Our experience may serve for other centers who are facing the same challenges.

Keywords: COVID-19; SARS-Cov-2; endoscopy; skull base; surgery.

© 2020 Wiley Periodicals, Inc.

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94
Head Neck
. 2020 Jun 8. doi: 10.1002/hed.26312. Online ahead of print.
Cost-effectiveness of Fiberoptic Laryngoscopy Prior to Total Thyroidectomy for Low-Risk Thyroid Cancer Patients
Evan Walgama 1, Gregory W Randolph 2 3, Carol Lewis 4, Neil Tolley 5, Wendy Sacks 6, Yufei Chen 7, Allen S Ho 1
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PMID: 32510729 DOI: 10.1002/hed.26312
Abstract
Background: Flexible fiberoptic laryngoscopy is performed prior to thyroid surgery to evaluate the function of the recurrent laryngeal nerve. We assess the cost-effectiveness of preoperative laryngoscopy prior to total thyroidectomy for a low-risk thyroid cancer patient without dysphonia.

Methods: A decision tree analysis was performed from a third-party payer perspective. We assessed the cost-effectiveness of fiberoptic laryngoscopy prior to total thyroidectomy for T2N0M0 papillary thyroid carcinoma, such that an ipsilateral vocal fold paralysis alters the surgical plan to hemi-thyroidectomy, when permissible, to avoid the risk of bilateral vocal fold paralysis.

Results: Performing preoperative laryngoscopy to assess vocal fold function has an incremental cost-effectiveness ratio (ICER) of 45 193 USD/QALY compared to no laryngoscopy. At a willingness-to-pay of 100 K/QALY, the intervention is cost-effective if the incidence of vocal fold paralysis is at least 0.57%, or when the permissible rate of hemithyroidectomy in cases of incidental paralysis is at least 41%. Probabilistic sensitivity analysis shows that laryngoscopy is cost-effective in 90.9% of cases.

Conclusions: Fiberoptic laryngoscopy is a cost-effective prior to total thyroidectomy in asymptomatic, low-risk thyroid cancer patients.

Keywords: cost-effectiveness; economic evaluation; laryngoscopy; thyroid cancer; vocal fold paralysis.

© 2020 Wiley Periodicals, Inc.

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95
Head Neck
. 2020 Jun 8. doi: 10.1002/hed.26156. Online ahead of print.
Reply to Letter to the Editor Regarding "Treatment Modality and Outcomes in Larynx Cancer Patients: A Sex-Based Evaluation"
Alexandra E Kejner 1, Hong Li 2, Eva Y Li 3, J Zachary Porterfield 4
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PMID: 32511828 DOI: 10.1002/hed.26156
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96
This article is a preprint
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bioRxiv
. 2020 May 9;2020.05.08.084996. doi: 10.1101/2020.05.08.084996. Preprint
Elevated ACE2 Expression in the Olfactory Neuroepithelium: Implications for Anosmia and Upper Respiratory SARS-CoV-2 Entry and Replication
Mengfei Chen 1, Wenjuan Shen 1, Nicholas R Rowan 1, Heather Kulaga 1, Alexander Hillel 1, Murugappan Ramanathan Jr 1, Andrew P Lane 1
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PMID: 32511390 PMCID: PMC7263519 DOI: 10.1101/2020.05.08.084996
Abstract
The site of SARS-CoV-2 entry and replication critically impacts strategies for COVID-19 diagnosis, transmission mitigation, and treatment. We determined the cellular location of the SARS-CoV-2 target receptor protein, ACE2, in the human upper airway, finding striking enrichment (200-700 folds) in the olfactory neuroepithelium relative to nasal respiratory or tracheal epithelial cells. This cellular tropism of SARS-CoV-2 may underlie its high transmissibility and association with olfactory dysfunction, while suggesting a viral reservoir potentially amenable to intranasal therapy.

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97
Editorial Otolaryngol Clin North Am
. 2020 Jun 3;S0030-6665(20)30069-4. doi: 10.1016/j.otc.2020.04.005. Online ahead of print.
Spreading Our Wings: Leadership and Personal Growth in Otolaryngology
Sujana S Chandrasekhar 1
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PMID: 32505490 DOI: 10.1016/j.otc.2020.04.005
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98
Editorial Genet Test Mol Biomarkers
. 2020 Jun;24(6):319-320. doi: 10.1089/gtmb.2020.0117.
LncRNAs H19 and MEG3 as Universal Indicators of Metabolic Derangements?
Garth D Ehrlich 1 2 3 4 5 6 7
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PMID: 32511063 DOI: 10.1089/gtmb.2020.0117
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99
Head Neck
. 2020 Jun 8. doi: 10.1002/hed.26157. Online ahead of print.
Treatment Modality and Outcomes in Larynx Cancer Patients
Guan-Jiang Huang 1, Zhi-Heng Huang 1
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PMID: 32511816 DOI: 10.1002/hed.26157
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100
J Formos Med Assoc
. 2020 Jun 5;S0929-6646(20)30210-2. doi: 10.1016/j.jfma.2020.05.020. Online ahead of print.
Dynamic Tongue Base Thickness Measured by Drug-Induced Sleep Ultrasonography in Patients With Obstructive Sleep Apnea
Yun-Chen Huang 1, Yen-Bin Hsu 2, Ming-Ying Lan 2, Mei-Chen Yang 3, Ming-Chang Kao 4, Tung-Tsun Huang 1, Ming-Chin Lan 5
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PMID: 32507352 DOI: 10.1016/j.jfma.2020.05.020
Abstract
Background/purpose: The aim of this study was to determine the value of drug-induced sleep ultrasonography (DISU) for evaluating tongue base thickness (TBT) from the awake state to drug-induced sleep, to further understand the impact of dynamic changes in TBT in obstructive sleep apnoea (OSA) patients.

Methods: From May 2017 to May 2018, thirty patients with OSA were prospectively recruited. Sleep was induced with propofol via use of a target-controlled infusion (TCI) system. The depth of sedation was monitored by the bispectral (BIS) index with BIS levels ranging from 50 to 70. The dynamic change in the tongue base from the awake state to drug-induced sleep was recorded. The correlation between TBT in the awake state and in drug-induced sleep with OSA severity was analysed.

Results: The mean TBT in drug-induced sleep was significantly greater than that in the awake state (66.2 ± 4.8 mm vs 61.6 ± 4.6 mm, P < 0.001). TBT in drug-induced sleep was more correlated with AHI compared to TBT in the awake state (r = 0.50 vs r = 0.40). This study showed that TBT in drug-induced sleep had the largest AUC (Area Under the Curve) in the ROC (Receiver Operating Characteristics) analysis (0.875), providing a cut-off point of 63.20 mm with 95% sensitivity for diagnosis of moderate versus severe OSA.

Conclusion: Our findings validate the use of DISU in objectively assessing the tongue base collapse in OSA patients. It provides a convenient and non-invasive way to evaluate the upper airway changes in OSA patients in the future.

Keywords: Drug-induced sleep ultrasonography; Dynamic tongue base thickness; Obstructive sleep apnoea.

Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of Competing Interest The authors have no conflicts of interest relevant to this article.

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101
Case Reports J Int Adv Otol
. 2020 Jun 8. doi: 10.5152/iao.2020.3766. Online ahead of print.
Successful Use of a Cochlear Implant in a Patient With Bony Cochlear Nerve Canal Atresia
Emel Tahir 1, Betül Çiçek Çınar 2, Hilal Burcu Özkan 2, Mehmet Yaralı 2, Bilgehan Böke 3, Levent Sennaroğlu 3
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PMID: 32510457 DOI: 10.5152/iao.2020.3766
Abstract
The anatomical cause of congenital sensorineural hearing loss can be atresia of the bony cochlear nerve canal (BCNC). It has been reported that the cochlear nerve (CN) can be either hypoplastic or aplastic when the BCNC width is <1.5 mm radioanatomically. It is difficult to estimate the auditory-verbal abilities after cochlear implantation (CI) in patients with a hypoplastic CN. In such cases, it is also challenging to decide on the best treatment modality: CI or auditory brainstem implantation. In this case report, we present a 4-year-old male patient with BCNC atresia and the successful use of a cochlear implant; we also discussed the importance of audiological evaluation. A detailed radiological evaluation must be performed in every case following electrophysiological studies prior to CI. To accurately diagnose the pathology and select the surgical side, both computed tomography and magnetic resonance imaging scans should be used as complementary imaging methods in all CI candidates.

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102
Ear Nose Throat J
. 2020 Jun 8;145561320931951. doi: 10.1177/0145561320931951. Online ahead of print.
Primary Nasopharyngeal Tuberculosis: A Case Report Focused on Nasopharyngoscopic Features and CT Findings
Hyun Jin Min 1, Kyung Soo Kim 1
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PMID: 32511010 DOI: 10.1177/0145561320931951
Abstract
Primary nasopharyngeal tuberculosis, defined as an isolated tuberculosis infection of the nasopharynx without systemic or pulmonary disease, is rare, even in areas endemic for tuberculosis. It is challenging for ENT specialists to diagnose primary nasopharyngeal tuberculosis at an early stage. In this report, we describe a new case of primary nasopharyngeal tuberculosis, focusing on its nasopharyngoscopic features and radiological findings that can help the understanding and aid in accurate diagnosis of this unusual disease entity. Our experience suggests that although primary nasopharyngeal tuberculosis is a relatively rare disease, it must be included in the differential diagnosis of various nasopharyngeal lesions, particularly in patients with unusual nasopharyngoscopic and computed tomography findings.

Keywords: computed tomography; nasopharyngoscopy; nasopharynx; tuberculosis.

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103
Case Reports Int J Pediatr Otorhinolaryngol
. 2020 May 19;135:110124. doi: 10.1016/j.ijporl.2020.110124. Online ahead of print.
Congenital Nasal Piriform Aperture Atresia: A Case Report and Novel Finding
Camila Angulo 1, Asitha D L Jayawardena 2, Paul A Caruso 3, Daniel Ramos 4, José A Bonilla 4, Evelyn Zablah 5, Christopher J Hartnick 6
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PMID: 32512323 DOI: 10.1016/j.ijporl.2020.110124
Abstract
Congenital nasal piriform aperture stenosis and choanal atresia are types of nasal obstructions that can be life threatening to infants if left untreated. While there has been numerous reports on both of them there has not been a single reported case of congenital nasal piriform aperture atresia. Here, we present the first case of piriform aperture atresia that includes the diagnostic and clinical approach.

Keywords: Choanal stenosis; Congenital nasal piriform aperture atresia; Congenital nasal piriform aperture stenosis.

Copyright © 2020 Elsevier B.V. All rights reserved.

Conflict of interest statement
Declaration of competing interest The authors have no conflicts of interest or financial disclosure.

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104
Comment Front Neural Circuits
. 2020 May 19;14:28. doi: 10.3389/fncir.2020.00028. eCollection 2020.
Commentary: Preservation of a Remote Fear Memory Requires New Myelin Formation
Yini Li 1 2, Haibo Shi 1 2
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PMID: 32508599 PMCID: PMC7248388 DOI: 10.3389/fncir.2020.00028
Abstract
No abstract available
Keywords: experience; memory; myelination; oligodendrogenesis; reconsolidation.

Comment on
Preservation of a remote fear memory requires new myelin formation.
Pan S, Mayoral SR, Choi HS, Chan JR, Kheirbek MA.
Nat Neurosci. 2020 Apr;23(4):487-499. doi: 10.1038/s41593-019-0582-1. Epub 2020 Feb 10.
PMID: 32042175 Free PMC article.
19 references
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