Crockettlancaster2216

Periprosthetic leakage represents the most demanding long-term complication in the voice prosthesis rehabilitation. The aim of this article is to discuss the various causes of periprosthetic leakage and to propose a systematic management algorithm.

Retrospective cohort study.

Otolaryngology clinic of the University Polyclinic A. Gemelli-IRCCS Foundation.

The study included 115 patients with voice prosthesis who were treated from December 2014 to December 2019. All patients who experienced periprosthetic leakage were treated with the same step-by-step therapeutic approach until it was successful. Incidence, management, and success rate of every attempt are analyzed and discussed.

Periprosthetic leakage was reported 330 times by 82 patients in 1374 clinic accesses. Radiotherapy, timing of tracheoesophageal puncture, and type of total laryngectomy (primary or salvage) did not influence the incidence of periprosthetic leakage. Salvage total laryngectomy increases the risk of more clinically relevant leakages.

By using a systematic algorithm with a step-by-step standardized approach, periprosthetic leakage management could become a less treacherous issue.

By using a systematic algorithm with a step-by-step standardized approach, periprosthetic leakage management could become a less treacherous issue.Permanent hands-free speech with the use of an automatic speaking valve (ASV) is regarded as the optimal voice rehabilitation after total laryngectomy. Due to fixation problems, regular ASV use in patients with a laryngectomy is limited. We have developed an intratracheal fixation device (ITFD) composed of an intratracheal button augmented by hydrophilic foam around its shaft. This study evaluates the short-term effectiveness and experienced comfort of this ITFD during hands-free speech in 7 participants with a laryngectomy. We found that 4 of 7 participants had secure ASV fixation inside the tracheostoma during hands-free speech for at least 30 minutes with the ITFD. The ITFD's comfort was perceived positively overall. The insertion was perceived as being mildly uncomfortable but not painful. This proof-of-concept study demonstrates the feasibility of the ITFD that might improve stomal attachment of ASVs, and it provides the basis for further development toward a prototype suitable for long-term daily use.

To evaluate long-term disease-specific survival (DSS) and organ preservation (OP) rates in patients affected by Tis-T2 glottic squamous cell carcinoma (SCC) treated by carbon dioxide transoral laser microsurgery (CO

TOLMS).

Single-center retrospective cohort study.

Tertiary academic hospital.

The study included patients treated by CO

TOLMS for Tis-T2 glottic SCC at the Department of Otorhinolaryngology-Head and Neck Surgery of the University of Brescia, Italy, from 1988 to 2018. The malefemale ratio was 11.21, and the mean age was 64 years (range, 31-95). T categories were distributed as follows 124 (10%) Tis, 646 (54%) T1a, 172 (15%) T1b, and 246 (21%) T2.

Ten- and 20-year DSS rates were 97.6% and 96.3%, respectively, and 10- and 20-year OP rates were 94.7% and 93%. During the follow-up, 91% of patients were treated by CO

TOLMS alone, while the remaining needed adjunctive treatments. Assessing the impact of multiple sessions of CO

TOLMS, DSS showed no significant difference in terms of patients treated by 1, 2, or >2 procedures. Conversely, patients treated by >2 sessions of CO

TOLMS showed a significantly worse OP rate.

Our series validates CO

TOLMS as a long-term treatment strategy for early glottic SCC. Salvage CO

TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.

Our series validates CO2 TOLMS as a long-term treatment strategy for early glottic SCC. Salvage CO2 TOLMS provided optimal results in terms of DSS and OP in patients with recurrence after previous transoral surgery.

The purpose of this study was to investigate the clinical features and survival outcomes of patients with middle ear malignancies at a population level.

Retrospective cohort study with data from a national database.

National database of middle ear malignancy.

Records of patients diagnosed with a middle ear malignancy from 1973 to 2016 were extracted from the SEER database (Surveillance, Epidemiology, and End Results). SPSS (version 27; IBM) was used to conduct 5-year survival analysis.

The average survival for all 431 patients was 61.4 months. Five-year disease-specific survival for squamous cell carcinoma (SCCA), adenocarcinoma, other carcinoma, and noncarcinoma subtypes varied significantly at 54.6%, 82.1%, 71.8%, and 82.6%, respectively (

< .0001). There was an improved 5-year survival for patients with adenocarcinoma who received surgery versus those who did not (91.7% vs 65.1%;

= .023, log-rank). Five-year disease-specific survival was significantly better in patients aged <55 years (mean ± SD, 77.8% ± 0.39%) as compared with those >70 years (55.1% ± 5.1%) and those aged 55 to 69 years (60.2% ± 4.9%;

< .01 and

< .001, respectively, log-rank). Patients with SCCA were significantly older than those with adenocarcinoma (

< .0001). Noncarcinoma subtypes were more likely to present with local disease, as opposed to regional or distant disease, when compared with SCCA (

= .0027).

Prognosis and treatment outcomes for primary middle ear malignancies depend on histologic subtype and age at diagnosis. The noncarcinoma and adenocarcinoma subtypes carry the best prognoses. Patients with adenocarcinoma were most likely to benefit from surgery.

Prognosis and treatment outcomes for primary middle ear malignancies depend on histologic subtype and age at diagnosis. The noncarcinoma and adenocarcinoma subtypes carry the best prognoses. Patients with adenocarcinoma were most likely to benefit from surgery.A longstanding debate within philosophy and neuroscience involves the extent to which sensory information is a necessary condition for conceptual knowledge. Much of our understanding of this relationship has been informed by examining the impact of congenital blindness and deafness on language and cognitive development. Relatively little is known about the "lesser" senses of smell and taste. Here we report a neuropsychological case-control study contrasting a young adult male (P01) diagnosed with anosmia (i.e. check details no olfaction) during early childhood relative to an age- and sex-matched control group. A structural MRI of P01's brain revealed profoundly atrophic/aplastic olfactory bulbs, and standardized smell testing confirmed his prior pediatric diagnosis of anosmia. Participants completed three language experiments examining comprehension, production, and subjective experiential ratings of odor salient words (e.g. sewer) and scenarios (e.g. fish market). P01's ratings of odor salience of single words were lower than all control participants, whereas his ratings on five other perceptual and affective dimensions were similar to controls.