Search

Objectives: In clinical practice, lateral nasal wall collapse during forced inspiration is widely regarded as a sign of nasal obstruction or criterion indicating nasal valve surgery. This study aims to evaluate the relationship between the degree of lateral nasal wall collapse and subjective nasal obstruction. In addition, factors related to lateral nasal wall collapse were also investigated. Methods: In this study, lateral nasal wall collapse is determined by the degree of lateral nasal wall triangle (LNWT) area reduction on frontal view during forced inspiration compared to quiet inspiration. LNWT area ratio of the patient and control groups was compared. The relationship between the lateral nasal wall collapse and clinical factors including symptom scores, nasal valve angles, skin thickness were evaluated. Results: The average LNWT area ratio of the patient (n = 24) and control groups (n = 27) was 0.96 and 0.83 respectively (P =.001). Symptom score (NOSE and VAS) is not related to the degree of lateral nasal wall collapse. Moreover, nasal valve angle and skin thickness were also not related to the degree of lateral nasal wall collapse. In 14 of the 19 patients, the more obstructed side corresponded to the side of narrower nasal valve angle, and 5 were not. Conclusion: Lateral nasal wall collapse is not related to a patients' nasal obstruction. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Thyroid lobectomy is recommended as the primary treatment for low-risk thyroid cancer. However, recurrence and hypothyroidism may develop after lobectomy, necessitating thyroid hormone supplementation. The 2015 American Thyroid Association (ATA) guidelines recommended post-lobectomy thyroid-stimulating hormone (TSH) suppression. This study examined the need for TSH suppression and recurrence after lobectomy for unilateral papillary thyroid carcinoma (PTC). Methods: This study involved 369 patients who underwent thyroid lobectomy and ipsilateral central neck dissection for PTC between 2007 and 2015. Thyroid function tests were performed before and regularly after lobectomy. Binary logistic regression analyses were used to find factors predictive of the post-lobectomy need for TSH suppression that was defined by the 2015 ATA guidelines. Results: Serum TSH concentrations gradually increased after lobectomy: proportions with TSH >2 mIU/L at post-lobectomy 1, 3–6, 12, and 24 months were found in 77.0%, 82.3%, 66.7%, and 59.9%, respectively. After lobectomy, 168 (45.5%) patients received levothyroxine (T4) supplementation. Multivariate logistic regression analyses showed that pre-TSH level >2 mIU/L was the sole independent variable predictive of the need for post-lobectomy TSH suppression (P = 0.003). During the median follow-up of 72 months, recurrence was found in 4 (1.1%) patients who never received T4 supplementation and had post-lobectomy TSH levels >2 mIU/L. Conclusions: Our data show that thyroid lobectomy for unilateral PTC is associated with a low recurrence rate, but a significant risk of hypothyroidism. Preoperative TSH level can predict the need for post-lobectomy TSH suppression compliant with the 2015 ATA guidelines. [ABSTRACT FROM AUTHOR]

Background: Low concentrations of hypochlorous acid (HOCl) have proven antipruritic, anti-inflammatory, and antimicrobial effects without toxicity, although the mechanism has not been fully elucidated. Objective: The aim of this study was to evaluate the effectiveness of HOCl nasal irrigation to reduce allergic rhinitis (AR) symptoms compared with saline nasal irrigation. Methods: This was multicenter, randomized, double-blind, placebo-controlled study. Initially, 139 patients with perennial AR were enrolled; however, 25 did not successfully complete the study. Patients were randomly assigned to the nasal irrigation with low-concentration HOCl (n = 55) or normal saline (n = 59) treatment groups for the 4-week study period. Participants completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) at every visit (baseline, Weeks 2 and 4), and Total Nasal Symptom Score (TNSS) was determined before and after nasal irrigation every morning and evening. Results: We found that RQLQ scores significantly decreased after 4 weeks in the HOCl and placebo groups, but the decrement of the RQLQ score was similar between the 2 groups. Additionally, TNSS improved in both groups between baseline and Week 4, whereas there were no significant differences in the change of TNSS between the 2 groups. The HOCl group did not show any clinical side effects related to nasal irrigation. Conclusion: Allergic symptoms significantly decreased with low-concentration HOCl nasal irrigation, without significant adverse events. However, HOCl showed no additional improvement in symptoms compared with saline nasal irrigation for patients with perennial AR. [ABSTRACT FROM AUTHOR]

Background: Frequently, a tilted alar base characterized by a discrepant level of the nostril sill and alar insertion on both sides is encountered in patients seeking rhinoplasty. Herein, we report our surgical technique and outcome of alar lifting technique for correcting tilted alar base. Methods: The medical records of 18 patients with alar base asymmetry who underwent rhinoplasty using the alar lift technique between January 2014 and December 2019 were retrospectively reviewed. The alar lifting procedure included a pointed ellipse-shaped excision of vestibular skin just inside the nostril sill, and sutures using 5-0 monocryl. Surgical outcomes were determined on the frontal view of facial images by comparing pre- and postoperative angles formed by a line drawn parallel to the lowermost part of both pupils and a line connecting the lowermost part of the base of the ala. Results: Of 18 patients, 12 (66.7%) were men, and 6 (33.3%) were women. The mean age was 31.8 years (range 16–55). The alar lifting technique was performed on the left side in 12 cases and on the right side in 6 cases, and concurrent tip plasty was performed in 15 (83.3%) cases. The mean alar tilt angle was 3.9 preoperatively and 2.0 postoperatively. The mean angle change was 1.9°. Sixteen (88.9%) out of 18 patients had decreased alar level discrepancy. No patient had complications. Conclusions: Our alar lifting technique can serve as a useful adjunctive technique in rhinoplasty in patients with a tilted ala. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Purpose: Oral cavity squamous cell carcinoma (OCC) can spread to the neck without apparent lymphadenopathy. Pretreatment detection or prediction of occult metastasis might contribute to proper management of clinically node-negative (cN0) OCC. We examined the role of tumour quantitative 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) measurements for predicting OCC occult metastasis and survival. Methods: This study included 130 cN0 OCC patients who underwent 18F-FDG PET/CT scanning and subsequent curative surgery and neck dissection. Maximum, peak, and mean standardized uptake value (SUVmax, SUVpeak, and SUVmean), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were measured on pretreatment 18F-FDG PET/CT. Binary logistic regression was used to identify factors predicting occult cervical metastasis. Univariate and multivariate Cox proportional hazard regression were used to find factors associated with overall survival (OS). Results: Pathological cervical metastasis (pN +) was found in 29 (22.3%) patients. Age, tumour differentiation, lymphovascular invasion, and T classification were significantly associated with pN + (all P < 0.05). After adjustment for these factors, MTV and TLG independently predicted pN + (P < 0.05). Invasion depth, lymphovascular invasion, T and N classifications, and overall TNM stage were significantly associated with OS. After adjustment for these factors, SUVmax and TLG independently predicted OS (all P < 0.05). Patients with TLG > 9.3 g had a 5.7-fold increased risk of overall mortality. Conclusions: Tumour 18F-FDG PET/CT parameters might predict occult metastasis and survival in cN0 OCC patients. [ABSTRACT FROM AUTHOR]

Objectives: Immediate facial nerve substitution or graft technique has been used for the repair of facial nerve defects occurring as a result of tumour dissection. However, some patients report unsatisfactory outcomes, such as difficulty in maintaining resting or smiling symmetry, due to persistent flaccid facial palsy. Here we evaluated the functional outcomes of transferring the masseteric branch of the trigeminal nerve to the facial nerve adjunct to facial nerve graft. Methods: We reviewed the medical records of seven patients who underwent facial reanimation surgery between 2014 and 2016. The patients were divided into two groups according to the type of facial reanimation surgery: group A, masseteric nerve innervation with interposition graft; group B, interposition graft only. The postoperative resting symmetry and dynamic movement were compared. Results: Facial contraction was first observed in group A at 4 months and in group B at 7.3 months. Most of the patients achieved reliable resting symmetry; however, one patient in group B exhibited unsatisfactory facial weakness on the affected side. Group A patients showed better dynamic movement than group B patients. Eye closure, oral excursion and oral continence were better in group A than in group B patients. Smile symmetry in both groups was similar due to hyperkinetic movement in group A patients and flaccidity in group B patients. Conclusions: Dual innervation of the masseteric branch of the trigeminal nerve improves the dynamic movement of paralysed facial muscles and shortens the recovery period in patients with iatrogenic facial palsy. [ABSTRACT FROM AUTHOR]

Purpose: Subclinical lymph node (LN) metastasis is associated with poor survival outcome in oral cavity squamous cell carcinoma (OCC), which alleges elective neck LN dissection. Preoperative detection of metastatic LNs may improve prognosis and proper management of OCC. We examined the clinical usefulness of fluorine 18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) for the detection of occult neck LN metastasis in OCC patients in comparison with conventional CT/magnetic resonance (MR) imaging. Methods: A total of 178 OCC patients with negative neck palpation findings were assessed prospectively with 18F-FDG PET/CT and CT/MR imaging. Histopathological analyses of neck dissection samples served as reference. Diagnostic values of 18F-FDG PET/CT versus CT/MR imaging were compared with the McNemar test and logistic regression with generalized estimating equations. Results: Forty-two patients (23.6%) had metastasis in 44 sides and 58 levels of the neck. The sensitivity for detection of occult metastasis was higher for 18F-FDG PET/CT than that for CT/MR imaging on a per-patient (69.1% vs 35.7%), per-side (70.5% vs 36.4%), and per-level (62.1% vs 29.3%) basis (all P ≤ 0.001). However, the specificity for metastatic detection was higher for CT/MR imaging than that for 18F-FDG PET/CT (all P < 0.005). 18F-FDG PET/CT improved detection of occult metastasis up to 33.4% in these patients compared to CT/MR imaging. Conclusions: 18F-FDG PET/CT can better detect occult neck metastasis than CT/MR imaging, which may potentially impact the clinical management of OCC patients. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the characteristics of idiopathic unilateral vocal fold paralysis (IUVFP) in elderly versus younger patients, including the diagnostic yield of computed tomography (CT) scans for identifying the structural causes of IUVFP. Methods: We retrospectively analyzed medical records of the patients initially diagnosed with IUVFP in a single referral tertiary hospital. We compared patients’ baseline characteristics, initial symptoms, laryngoscopic findings, and prevalence of structural causes on CT scans with respect to age (younger, <65 years vs older, ⩾65 years). Results: One hundred forty-two patients were enrolled (90 younger, 52 older). Evident structural causes were more frequently found on CT in older patients than younger patients (40.4% vs 22.2%, P = .034). Among truly idiopathic cases (70 younger, 31 older), recovered vocal fold mobility was identified in 48.6% younger and 41.9% older patients (P = .666). There was no statistically significant difference in the characteristics between unrecovered and recovered subjects of the older patients with true IUVFP (all P > .05). Conclusions: The CT scans provided significantly higher diagnostic yields in older patients than younger patients. The degrees of symptoms and complications and likelihood of natural recovery did not significantly differ between younger and older patients with IUVFP. [ABSTRACT FROM AUTHOR]

Numerous studies have demonstrated adaptive behavioral responses of males and females to changes in operational sex ratio (the ratio of potentially receptive males to receptive females; OSR), and theory often assumes that animals have perfect instantaneous knowledge about the OSR. However, the role of sensory mechanisms in monitoring the local sex ratio by animals and whether animals can perceive local sex ratio in a manner consistent with model assumptions have not been well addressed. Here, we show that mating water striders Gerris gracilicornis respond to local sex ratio even when visual and physical contact with other individuals were experimentally prohibited. Our study shows that insects are able to estimate local population's sex ratio and adjust their behavior based on nonvisual cues perceived at a distance or released to the habitat. Hence, the frequent theoretical assumption that individuals have knowledge about their local sex ratio regardless of their direct behavioral interactions may be an acceptable approximation of reality. [ABSTRACT FROM AUTHOR]