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OBJECTIVE: Treatment management in cases of head and neck squamous cell cancer (HNSCC) that are clinically negative for lymph node metastases (cN0) is still an important topic of discussion. There is increasing interest in sensitive imaging modalities that can detect the risk of occult metastases at levels below 20%. This study aimed to examine the efficacy of integrated positron emission tomography (PET)/magnetic resonance imaging (MRI) in determining neck nodal metastasis status in cN0 patients with HNSCC. PATIENTS AND METHODS: In this retrospective study, 44 patients who underwent neck dissection with the diagnosis of HNSCC between January 2018 and August 2020 were analyzed. Clinical examinations, including ultrasonography, were performed to identify cervical metastases in HNSCC patients with preoperative cN0. A nuclear medicine specialist visually evaluated the MRI, PET, and PET/MRI results. RESULTS: Histopathologically, 86.4% of patients were classified as N0. According to the histopathological results, MRI showed 50% sensitivity, 89.5% specificity, 91.8% negative predictive value (NPV), 42.8% positive predictive value (PPV) and 84% accuracy, while PET showed 83.3% sensitivity, 68.4% specificity, 96.2% NPV, 29.4% PPV and 70.4% accuracy. PET/MRI was more successful in distinguishing pathological N0 and N+ patients (83.3% sensitivity, 92.1% specificity, 97.2% NPV, 62.5% PPV and 90.9% accuracy). CONCLUSIONS: PET/MRI is more sensitive and has a higher NPV compared to MRI alone, while its sensitivity was found to be comparable to that of PET. In addition, with its ability to detect pathological N0 patients, PET/MRI may significantly decrease the number of unnecessary neck dissections. [ABSTRACT FROM AUTHOR]

Purpose: The effect of the inter-implant interval time on language and communication skills has been a subject of research for years in children with bilateral cochlear implants. This study aimed to investigate language and some attention and memory skills in children with bilateral sequential and simultaneous cochlear implants., Method: The study included a total of 40 children aged between 6 and 8 years old, grouping bilateral simultaneous cochlear implanted children, sequential implanted children with 0-2 years interval, sequential implanted children with 2-4 years interval, and normal hearing peers. The language skills of the children were assessed using the Test of Language Development: Primary 4th edition, their selective attention and coping skills with disruptive effect were evaluated using the Stroop test, sustained attention and visual-motor synchronization skills were assessed using the Cancellation Test, and short-term memory skills were evaluated using the Visual Auditory Digit Span Test. The findings were analyzed using nonparametric statistical methods, with a significance level set at 0.05., Results: Children with bilateral simultaneous cochlear implants demonstrated better performance in language skills and the attention-related subtests of the Stroop test (p < 0.05). On the other hand, children with simultaneous and sequential cochlear implants achieved similar scores in the Cancellation and the Visual Auditory Digit Span Test (p > 0.05)., Conclusions: Bilateral simultaneous cochlear implantation in children is beneficial for language, selective attention, and coping with the Stroop effect. However, these children may still lag behind their normal-hearing peers in terms of language, attention, and memory skills., Competing Interests: Declarations. Conflicts of interest: There are no conflicts of interest, financial, or otherwise., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To examine the ocular signs and symptoms in participants of the Sjögren's International Collaborative Clinical Alliance cohort, and to compare them across Sjögren's disease (SjD) status., Methods: Our study population comprised 3380 Sjögren's International Collaborative Clinical Alliance participants who had no missing data relevant to this study. Participants' SjD status was assessed using the updated 2016 American College of Rheumatism/European League Against Rheumatism SjD classification criteria. Participants completed baseline questionnaires of ocular symptoms and underwent ocular examinations. Differences in the ocular signs and symptoms between SjD and non-SjD groups were assessed. We used multivariable linear and linear mixed-effects models to investigate the impact of SjD on Ocular Surface Disease Index-6 and OSS., Results: Among 1532 participants classified as SjD, their Ocular Surface Disease Index-6 did not clinically differ from those classified as non-SjD (adjusted difference, -0.97; 95% confidence interval, -1.52 to -0.41). However, SjD participants exhibited an elevated ocular staining score (adjusted difference, 3.47; 95% confidence interval, 3.36-3.57; P < 0.001) compared with non-SjD participants. In addition, SjD was associated with increased odds of ocular signs, such as reduced tear break-up time, abnormal Schirmer I test, and corneal abnormalities, and was strongly related to more intense corneal and conjunctival staining, as well as additional corneal staining points., Conclusions: SjD is associated with a higher risk of ocular signs and pathology compared with non-SjD, whereas ocular symptoms remain similar. In addition, corneal abnormalities and corneal staining patterns could serve as a potential biomarker in identifying SjD-related dry eye.

Objectives: We investigated the correlation between magnetic resonance imaging (MRI) parameters and tumor pathological depth of invasion (pDOI), between pDOI and radiological DOI (rDOI), between rDOI and duration between biopsy and MRI, and between rDOI and duration between MRI and surgery to determine the efficacy of rDOI in identifying small lesions and other conditions., Study Design: We examined 36 adult patients who had been diagnosed histopathologically with cancer of the tongue and had undergone a glossectomy. Using 1.5 Tesla (T) and 3.0T MRI, we measured rDOI at the deepest infiltration point on 4 MRI sequences. We calculated the correlations between rDOI and the variables examined by Spearman rho analysis and evaluated the diagnostic performance of rDOI by receiver operating characteristic curve analysis., Results: Axial T2-weighted images using 1.5T MRI provided the closest approximation of pDOI. Although the correlation between rDOI and pDOI was significant, rDOI showed poor or acceptable discrimination in identifying small lesions and other conditions. There were no significant correlations between rDOI and the time between biopsy and MRI or between MRI and surgery., Conclusions: The correlation between rDOI and pDOI is significant, but rDOI is ineffective in predicting malignancy and other conditions. Axial T2-weighted images using 1.5T MRI provide the closest approximation of pDOI., Competing Interests: Declaration of interest The authors declare they have no conflicts of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: To calculate the costs to the US healthcare system of transition from single-row (SR) to double-row (DR) rotator cuff repair (RCR) and to calculate the decrease in re-operations for re-tear that DR RCR would need to accomplish in order to render the transition cost-neutral., Methods: Standard accounting methods were used to determine the cost of a single RCR, the annual cost to the US healthcare system of rotator cuff surgery, the cost of a single-revision RCR, and the decrease in revision for re-tear rate necessary to make DR or suture bridge (SB) methods cost-neutral in comparison with SR methods. We varied tear size, operating room cost, time required for implant placement, annual tear size distribution, and repair method., Results: The cost of RCR ranged from $7,572 (SR, <1 cm tear) to $12,979 (DR, >5 cm tear). Complete conversion from SR RCR to a DR technique without an associated decrease in revision surgeries would increase the annual US healthcare cost between $80 million and $262 million per year. To obtain cost neutrality, use of DR or SB methods would need to result in one fewer revision in every 17 primary repairs (for tears <1 cm) to one fewer in every four primary repairs (for tears >5 cm)., Conclusions: Conversion from SR to DR or SB RCR techniques would result in considerable increases in healthcare expenditures. Since the large decreases in revision surgery rates necessary to justify DR or SB repairs purely on a cost basis may not be realistic or even possible, the use of these methods should be supported by evidence of improved structural healing rates and quality-adjusted life years in comparison with SR methods., Level of Evidence: IV.