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Objectives To analyse the specificity and sensibility of narrow band imaging illumination technology in the early detection of laryngeal cancer in the patients' population without previous diagnosis of laryngeal cancer in a screening setting. Design Unicentre, prospective study. Setting One tertiary medical centre. Participants A total of 158 patients completed all protocol steps. Main outcome measures Sensitivity, specificity, positive and negative predictive values of narrow band imaging (NBI) in detecting precancerous lesions and early laryngeal cancer. Results The blind assessment of NBI patterns concurred in 90% of patients. In identifying laryngeal cancer and its precursor lesions, in-office NBI showed a high sensitivity of 97% (CI, 84.2%-99.9%), specificity of 92.5% (CI, 79.6%-98.4%), PPV of 91.4% (CI, 76.9%-98.2%), NPV of 97.4% (CI, 86.2%-99.9%) and accuracy of 94.5% but intra-operative NBI demonstrated a sensitivity of 97% (CI, 84.2%-99.9%), a slightly higher specificity of 95% (CI, 83.1%-99.4%), PPV of 94.1% (CI, 80.3%-993%), NPV of 97.4% (CI, 86.5%-99.9%) and accuracy of 95.9%. The comparative receiver operating characteristic curves confirmed a slightly higher performance for the intra-operative NBI evaluation without any statistical significance ( P = 0.41). Conclusions Our results confirm the high values of sensitivity and specificity of NBI system in detecting pre-neoplastic laryngeal lesions or early laryngeal cancer in a patients' population selected only by means of risk factors exposure and confirmed the potential role of NBI evaluation as in-office screening tool. [ABSTRACT FROM AUTHOR]

The article discusses the robotic-assisted surgery techniques robotically assisted bivalved palatal transposition flaps (RA-BPTF) and robotically assisted pharyngeal flap (RA-PF) for treating nasopharyngeal stenosis (NPS) and velopharyngeal insufficiency (VPI). It mentions the surgical steps for using RA-BPTF and RA-PF techniques and suggests the safety and efficiency of the methods.

Objectives/hypothesis: To investigate long-term complications of newer reconstructive palate surgery techniques., Study Design: Retrospective case-series analysis., Methods: Retrospective six-country clinical study of OSA patients who had nose and palate surgery., Results: There were 217 patients, mean age = 43.9 ± 12.5 years, mean body mass index = 25.9 ± 4.7, mean preoperative apnea-hypopnea index [AHI] = 30.5 ± 19.1, follow-up 41.3 months. A total of 217 palatal procedures were performed, including 50 expansion sphincter pharyngoplasties (ESP), 34 functional expansion pharyngoplasties (FEP), 40 barbed reposition pharyngoplasties (BRP), 64 modified uvulopalatopharyngoplasties (mUPPP), 11 uvulopalatal flap procedures (UPF), nine suspension pharyngoplasties (SP), eight relocation pharyngoplasties (RP), and one z-pharyngoplasty (ZPP). Complications included were constant and/or felt twice per week; dry throat (7.8%), throat lump feeling (11.5%), throat phlegm (10.1%), throat scar feeling (3.7%), and difficulty swallowing (0.5%). Of the 17 patients who had a dry throat complaint, two were constant (one SP, one RP), 15 were occasional (10 mUPPP, three SP, two BRP). Of the 25 patients with the throat lump feeling, four were constant (three RP, one ZPP), 21 were occasional (10 mUPPP, five SP, five UPF, one BRP). Of the 22 patients with the throat phlegm feeling, four were constant (two SP, two RP), 18 were occasional (10 mUPPP, four BRP, two FEP, two SP). Of the eight patients with throat scar feeling, eight were occasional (four SP, two mUPPP, one FEP, one RP), none were constant. One patient had difficulty swallowing (RP procedure). There was no velopharyngeal incompetence, taste disturbance, nor voice change. Highest symptom complaints were mUPPP, SP, and RP, whereas the lowest symptom complaint was ESP., Conclusions: Newer palatal techniques have shown to have less long-term complications compared to the older ablative techniques., Level of Evidence: 4 Laryngoscope, 130:2281-2284, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: To evaluate a possible regrowth of lingual tonsil lymphatic tissue in patients submitted to lingual tonsil resection with transoral robotic surgery (TORS)., Study Design: Retrospective Study., Methods: Medical records of patients surgically treated by means of TORS to remove excessive lymphatic tissue of the lingual tonsil were retrospectively reviewed. Postoperative endoscopic data after long-term follow-up were analyzed to investigate possible lymphatic tissue regrowth. Preoperative and postoperative lingual tonsil lymphatic tissue were classified according to the standardized Friedman's grading scale ranging from 0 to 4., Results: Sixty-eight patients (41 male and 27 female; mean age = 51.3 years) were considered suitable for the study analysis. Clinical regrowth was observed in six (8.8%) patients: four (5.9%) and two (2.9%) patients with grade 2 and 3 lymphatic hypertrophy, respectively. No correlation between the grade of regrowth, the time interval from surgery, and the volume of lymphatic tissue removed was found., Conclusions: The lymphatic tissue regrowth after TORS resection appears to be very low., Level of Evidence: 4 Laryngoscope, 129:2652-2657, 2019., (© 2018 The American Laryngological, Rhinological and Otological Society, Inc.)

Objectives/hypothesis: To evaluate if upper airway surgery reduces blood pressure in patients with obstructive sleep apnea (OSA)., Study Design: Prospective series., Methods: A prospective series of 112 consecutive OSA patients with hypertension (HTN). All patients were > 18 years old, respiratory disturbance index >5, all levels of apnea-hypopnea index (AHI), with a history of HTN treated with medication for at least 6 months. Surgical procedures included septoplasty, turbinate reduction, palate surgery, and tongue base reduction., Results: There were 92 men and 20 women, with a mean age of 48.6 years, mean body mass index (BMI) was 27.5 (range, 19.7-34.7). Mean follow-up was 16.1 months. The mean preoperative AHI was 32.6 (range, 1.2-104), with the mean lowest oxygen saturation (LSAT) of 79.9% (range, 52%-93%). The mean adjusted preoperative and postoperative systolic blood pressure (SBP) was reduced from 146 ± 15.3 mm Hg to 122 ± 12.5 mm Hg (P < .001), and diastolic blood pressure (DBP) was reduced from 91 ± 10.2 mm Hg to 76 ± 7.8 mm Hg (P < .001). There was a decrease in overall BMI from 27.5 ± 3.6 to 25.5 ± 3.0 (P < .001); however, based on multivariate analysis, the reduction in SBP and DBP was not affected by this BMI reduction. Fifty-eight patients (51.8%) did not require their antihypertensive after surgery. There was poor correlation noted between HTN with AHI, LSAT, and oxygen duration <90%., Conclusions: Upper airway surgery does reduce SBP and DBP in patients with OSA., Level of Evidence: 4. Laryngoscope, 128:523-527, 2018., (© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)