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Objective: To investigate the influence of MSG obesity and maternal periodontal disease on the mandibular bone loss of male offspring in adulthood. Methods: 60 neonatal Wistar females were used and randomly separated into two groups. During the first 5 days of life, half of the female pups received subcutaneous injections in the cervical region of monosodium glutamate (MSG), and the other half-received of hyperosmotic saline solution (CTL). All animals used in the experiments received water and standard feed. At 70 days of life, animals were distributed into four experimental groups: control with no ligature (CTL NL), control with a ligature (CTL WL), MSG with no ligature (MSG NL), and MSG with a ligature (MSG WL). The four groups of females reproduced with control rats (2:1). Offspring (F1) were classified into 4 groups, according to the mothers' treatment. Hemimandibles were collected for histological, morphological, and radiographic analysis and a portion of gingival tissue for analysis by enzyme-linked immunosorbent assay (ELISA) of cytokines IL-6, IL-10, IL-17, and TNF-alpha. Data were assessed using Two-way ANOVA and Tukey's test. Results: There were no changes related to maternal hypothalamic obesity associated with periodontal disease in alveolar bone loss in the male offspring of F1 rats at 120 days. Conclusions: Hypothalamic obesity and maternal periodontal disease did not affect the body and plasma parameters of their male offspring in the first generation, demonstrating that there was no effect of fetal programming on these parameters.

European archives of oto-rhino-laryngology and head & neck 279(8), 4147-4156 (2022). doi:10.1007/s00405-022-07304-y, Published by Springer, Berlin ; Heidelberg

Objective To identify the appropriate treatment in the tonsillar region's infections, a distinction between tonsillitis with or without abscess formation is essential. Ultrasound proved to be a valuable method in identifying abscess formation in the head and neck region. However, no report described the assessment of the tonsil region. This study aims to determine the feasibility of transcervical ultrasound for abscess visualization in the palatal tonsillar region. Methods Retrospective analysis of 354 patients presenting with clinical suspicion of tonsillar abscess to a tertiary referral center and university hospital. All patients received a transcervical ultrasound to establish a primary diagnosis. The existence of an abscess was confirmed by puncture and incision, or final tonsillectomy. If no abscess could be delineated, non-abscessing tonsillitis was supposed, and conservative primary therapy and closed follow-up examinations were performed. Results After the first diagnostic ultrasound examination, in 257 cases (72.59%), the diagnosis of an abscess could be established, but in 97 cases (27.40%), due to missing abscess formation criteria, non-abscessing tonsillitis was documented. Overall, ultrasonography demonstrated an overall accuracy of 78.8% in this selected cohort. The sensitivity, specificity, PPV, and NPV after the first ultrasound examination were calculated with 75.1%, 88.6%, 94.6%, and 57.3%, respectively. Conclusion The presented data confirm that an abscess formation due to tonsillitis can be detected by transcervical ultrasound, enabling prompt, adequate management. As transcervical ultrasound can be conducted fast and is not associated with radiation, it can be regarded as a first-line diagnostic tool in this condition.

Saddle nose deformity (SND) is a pathological entity resulting from loss of dorsal height caused by a substantial decrease in the cartilaginous vault or bony vault, and it can occur after a variety of nasal pathological conditions.

Objective This pilot study aimed to assess the feasibility of intraoperative assessment of safe margins with Confocal Laser Endomicroscopy (CLE) during planned partial or total laryngectomy. Methods Eight patients with confirmed larynx squamous cell carcinoma (SCC) and planned partial or total laryngectomy were included in this study in March 2020. Two head and neck surgeons and one pathologist were asked to classify carcinoma or healthy epithelium in a sample of 94 representative sequences (5.640 images), blinded to the histological results (H&E staining). Results Healthy mucosa areas showed epithelium with cells of uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE optical biopsy of SCC demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 80.1%, 72.3%, 87.9%, 85.7%, and 76.1%, respectively. A distinct transition between healthy appearing tissue and suspicious lesions could also be detected. Conclusion CLE can be easily integrated into the intraoperative setting, generate real-time, in-vivo microscopic images of the larynx for evaluation and demarcation of cancer. If validated in further studies, CLE could eventually contribute to a less radical approach by enabling a more precise evaluation of the cancer margin.

Zusammenfassung Hintergrund Die konfokale Laser-Endomikroskopie (CLE) bietet mit einer bis zu 1000-fachen Vergrößerungsleistung die Möglichkeit, Interzellularräume in vivo zu erkennen. Die CLE hat sich in verschiedensten Fachbereichen bereits etabliert. Dieser Artikel gibt einen Überblick über die aktuelle Studienlage der CLE in der Diagnostik des Plattenepithelkarzinoms des Kopf-Hals-Bereichs. Material und Methoden Systematische Literaturrecherche in folgenden Online-Datenbanken: PubMed, MEDLINE, Thompson Reuters Web of Science, SPIE nach den Suchbegriffen: confocal laser endomicroscopy, CLE, endomicroscopy, head and neck, larynx. Bewertung der wissenschaftlichen Relevanz der Arbeiten nach festgelegten Kriterien. Ergebnisse Es wurden Arbeiten in Bezug auf die klinische Anwendung, die klinische Befunderhebung und die computergestützte Datenauswertung analysiert. Schlussfolgerungen In Zusammenschau der aktuell publizierten Ergebnisse verspricht die CLE ein großes Potenzial, die Diagnostik maligner Schleimhautveränderungen im Bereich des oberen Aerodigestivtrakts zu verbessern.

Confocal laser endomicroscopy (CLE) is an optical imaging technique that allows in vivo microscope-like images of the upper aerodigestive tract's mucosa in 1000-fold magnification. The assessment of morphological tissue characteristics for the correct differentiation between healthy and malignoma suspected mucosa requires strict evaluation criteria. This study aims to validate a score for oral cavity squamous cell carcinoma (OCSCC) diagnostic.We performed CLE and examined a total of twelve patients. All 95 sequences (778 s, 6224 images) originate from the area of the primary tumor 260 s, 2080 images) and unsuspicious mucosa of the oral cavity (518 s, 4144 images). Specimen were taken at corresponding locations and analyzed histologically in HE staining as a reference standard. A total of eight examiners (four experienced and four inexperienced) evaluated the sequences based on a scoring system. The primary endpoints are sensitivity, specificity, and accuracy. Secondary endpoints are inter-rater reliability and receiver operator characteristics.Healthy mucosa showed epithelium with uniform size and shape with distinct cytoplasmic membranes and regular vessel architecture. CLE of malignant cells demonstrated a disorganized arrangement of variable cellular morphology. We calculated an accuracy, sensitivity, specificity, PPV, and NPV of 88.7 %, 90.1 %, 87.4 %, 87.5 %, and 90.0 %, respectively, with inter-rater reliability and κ-value of 0.775, and an area under the curve of 0.935.The results confirm that this scoring system is applicable in the oral cavity mucosa to classify benign and malignant tissue.

Human papillomavirus (HPV)+ and HPV- oropharyngeal squamous cell carcinomas (OPSCC) are separate tumor entities.The aim of this study was to examine if the p16 status influences the need and outcome of a salvage neck dissection (SND) after primary radiochemotherapy (pRCT).Retrospective study of 164 patients (Of the 56 p16+ patients, 17 (30.4%) patients were given an indication for a SND after pRCT with 4 (23.5%) patients showing persistent malignant nodes. Of the 108 p16- patients, 24 (22.2%) patients underwent a SND with 8 (33.3%) patients showing persistent malignant nodes. There was no significant association of the p16 status and neither the indication for SND (p(ChiThere was neither a significant association between the p16 status and the indication for a SND nor for persistent malignant nodal disease after pRCT.

Ultrasound (US) and sialendoscopy (SE) are routinely used in patients presenting with sialolithiasis in the submandibular (SMG) and parotid gland (PG). The objective was to assess the value of the simultaneous application of US and SE in the management of sialolithiasis.Retrospective study.Tertiary referral center for salivary gland diseases.Patients in whom US and SE as single investigation tools were neither conclusive nor useful in the management of sialolithiasis were investigated using both methods simultaneously (simUS + SE).Establishment of the final diagnosis and/or contribution to the planning/performing of treatment in sialolithiasis.74 patients were examined by simUS + SE (58.1 % SMG and 41.9 % PG). In all patients (unclear) hyperechoic reflexes were assessed and/or localized by SE-controlled US navigation. 68.9 % of the patients were investigated for diagnostic or differential-diagnostic reasons including distinguishing extraductal from intraductal calcifications and/or to exclude residual stones after therapy. In 52.7 % simUS + SE was used to plan and/or perform further treatment, in 20.3 % to enable performing a combined approach (all PG) and in 29.7 % to evaluate and plan the most adequate therapy (mainly intraductal vs. extracorporeal shock wave lithotripsy, 68.2 % of these SMG). In two cases SE-controlled and US-guided stone extraction was performed.SimUS + SE is an innovative approach which proved to be very useful in managing sialolithiasis. It added valuable information regarding the establishment of a diagnosis or differential diagnosis, planning and performing the most adequate treatment, intraoperative control of therapy and postoperative follow-up.ZIEL: Ultraschall (US) und Sialendoskopie (SE) werden routinemäßig bei Patienten mit einer Sialolithiasis der Glandula submandibularis (GSM) und Parotis (GP) angewendet. Ziel war es, den Wert der simultanen Anwendung von US und SE (simUS + SE) für die Sicherung der endgültigen Diagnose und/oder ihren Beitrag zur Planung und Durchführung der Therapie der Sialolithiasis zu untersuchen.In einer retrospektiven Studie wurden Patienten, bei welchen US und SE als einzelne Untersuchungsmethoden kein sicheres Ergebnis erbrachten, auf den Mehrwert einer simUS + SE hinsichtlich des weiteren Managements untersucht.Bei 74 Patienten erfolgte eine simUS + SE (58,1 % GSM und 41,9 % GP). Bei allen Patienten wurden (unklare) echoreiche Reflexe mittels Navigation durch US und SE evaluiert und/oder exakt lokalisiert. In 68,9 % der Fälle erfolgte die simUS + SE, um die Diagnose zu sichern bzw. mögliche Differenzialdiagnosen abzuklären. In 52,7 % wurde der simUS + SE benutzt, um die weitere Therapie zu planen und/oder durchzuführen. In 29,7 % aller Fälle half die simUS + SE, die am besten geeignete Therapie (insbesondere intraduktale vs. extrakorporale Schockwellen-Lithotripsie) auszuwählen, in 68,2 % dieser Fälle war die GSM betroffen. In 20,3 % konnte sicherer beurteilt werden, ob eine kombinierte Steinextraktion möglich oder sinnvoll war (alle GP). In 2 Fällen wurde eine US-gesteuerte und SE-kontrollierte Steinextraktion durchgeführt.Die simUS + SE stellt eine innovative Untersuchung dar, welche sich als nützlich für das Management der Sialolithiasis erwiesen hat. Diese war wertvoll für die Sicherung der korrekten Diagnose oder Differenzialdiagnose, Planung und Durchführung der am meisten geeigneten Therapie, darüber hinaus auch bei der intraoperativen Therapiekontrolle und dem postoperativen Follow-up.

Zusammenfassung Hintergrund Die Kupplungsvorrichtung für mikrovaskuläre Anastomosen hat in der freien Gewebetransplantation weite Verbreitung gefunden. Ziel der Arbeit ist der Vergleich der Thromboserate und des Transplantatversagens in Abhängigkeit von der Anastomosentechnik an einem großen Kopf-Hals-Tumorzentrum. Material und Methoden Retrospektive Auswertung von allen Patienten, die im Zeitraum von 2001–2019 eine freie Lappenrekonstruktion erhalten haben. Rekonstruktionstyp, Empfängergefäße, Anzahl an Venenanastomosen, Coupler-Größe und Operationszeit wurden untersucht. Wir verglichen die Raten an Venenthrombosen zwischen handgenähten und gekoppelten Anastomosen sowie die Rate des Transplantatversagens. Ergebnisse Insgesamt wurden 403 freie Lappenrekonstruktionen über einen Zeitraum von 17 Jahren durchgeführt. Die venöse Anastomose wurde bei 113 Lappen in Einzelknopftechnik genäht und in 290 Fällen mittels Coupler durchgeführt. Die Rate der Venenthrombosen, die eine umgehende chirurgische Revision erforderten, betrug in der genähten Gruppe 6,2 % (7/113), verglichen mit 7,6 % in der gekoppelten Gruppe (22/290; p = 0,627). Bei einer allgemeinen Erfolgsrate von 95,0 % (383/403) lag die Rate des Transplantatversagens jeweils bei 3,6 % (4/113) und 5,5 % (16/290; p = 0,421). Die Operationszeit war mit 680 ± 144 Minuten in der handgenähten Gruppe und 688 ± 167 Minuten in der Coupler-Gruppe vergleichbar (p = 0,678). Schlussfolgerungen Bei ähnlichen Erfolgsraten ist der Coupler als wirksame Alternative zur venösen Anastomose in Einzelnahttechnik zu sehen. Aufgrund der allgemein niedrigen Rate an Stielthrombosen in beiden Gruppen können wir den Einfluss der Anastomosentechnik nicht von möglichen Störvariablen trennen.