COVID-19 Pandemic and its Impact on the Management of Head and Neck Cancer in the Spanish Healthcare System

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has represented a major challenge for healthcare systems worldwide, changing the habits of physicians. A reorganization of healthcare activity has been necessary, limiting surgical activity to essential cases (emergencies and oncology), and improving the distribution of health resources. Objective To analyze the impact of the COVID-19 pandemic on head and neck cancer surgery management in Spain. Methods A cross-sectional study, through an anonymous and voluntary online survey distributed to 76 Spanish otorhinolaryngology departments. Results A total of 44 centers completed the survey, 65.9% of which were high-volume. A total of 45.5% of them had to stop high-priority surgery and 54.5% of head and neck surgeons were relocated outside their scope of practice. Surgeons reported not feeling safe during their usual practice, with a decrease to a 25% of airway procedures. A total of 29.5% were "forced" to deviate from the "standard of care" due to the epidemiological situation. Conclusions Approximately half of the departments decreased their activity, not treating their patients on a regular basis, and surgeons were reassigned to other tasks. It seems necessary that the head and neck surgeons balance infection risk with patient care. The consequences of the reported delays and changes in daily practice should be evaluated in the future in order to understand the real impact of the pandemic on the survival of head and neck cancer patients

Relationship between the Superior Attachment of the Uncinate Process and Pneumatization of the Middle Turbinate—A Radiological Study

Objective: the superior attachment of the uncinate process (SAUP) is highly variable. Lateral types of SAUP are associated with frontal rhinosinusitis. SAUP in the middle turbinate is more common when the middle turbinate is aerated. We aim to refine these findings by studying the relationship between the SAUP type and the different subtypes of pneumatization of the middle turbinate. Methods: 200 CT sinonasal scans were analyzed by an otolaryngologist and a radiologist. All CT scans were analyzed to study the type of the middle turbinate concha bullosa and lamellar cell and the type of SAUP. Results: 379 sides were analyzed. The prevalence of the various types of SAUP were: Type I: 43.80%, Type II: 22.16%, Type III: 16.36%, Type IV: 3.69%, Type V: 9.76%, and Type VI: 4.22%. When studying the pneumatization of the middle turbinate and the SAUP types, we only found a statistically significant association between the lateral attachment of the uncinate process and the presence of a lamellar cell (p = 0.029). Conclusion: lateral types of SAUP are more likely in the presence of a lamellar cell. This finding, therefore, renders checking for lateral SAUP types in the presence of a lamellar cell even more relevant than when studying the pre-surgical CT scan. In those cases, it is advisable to perform a careful and complete uncinectomy

Análisis de la marcha y el equilibrio mediante el uso de sensores inerciales: estudio prospectivo, longitudinal, no aleatorio

Introduction: The world population is aging rapidly. A third of those over 65 years of age falls at least once a year, and this prevalence increases by half when they exceed 69 years. Objective: To determine the sensitivity of the use of inertial sensors to determine the gait and rotations of the trunk in a group of healthy individuals. Materials: We use 3 inertial sensors of 9-axis together with the same number of microcontrollers, that sent the information via bluetooth to the computer, the data processing was carried out through an analysis program developed in MATLAB. To analyze the sensitivity of the sensors we use the protocol of Akram et al,5 modified, which consists of 5 activities. Results: In our study 6 volunteers participated, with an average age of 29 years, with an age range 25 to 33 years. The sensors were able to detect multiple variables, including the maximum and minimum elevation of the legs, number of steps, the degree of inclination of the trunk, rotation, speed and cadence. Conclusion: The results obtained are promising and we believe that the use of multiple inertial sensors to assess gait and balance could result in a new tool for the diagnosis and monitoring of people with gait and balance disorder.Antecedentes: la población mundial envejece de manera acelerada. Una tercera parte de los mayores de 65 años se cae por lo menos una vez al año, y esta prevalencia se incrementan a la mitad cuando se superan los 69 años. Objetivo: establecer la sensibilidad del uso de sensores inerciales para determinar la marcha y las rotaciones del tronco en un grupo de individuos sanos. Materiales: utilizamos tres sensores inerciales de nueve ejes, junto a un mismo número de microcontroladores, los cuales enviaron la información vía bluetooth al ordenador, el procesamiento de los datos fue realizado mediante un programa de análisis desarrollado en MATLAB. Para analizar la sensibilidad de los sensores utilizamos el protocolo de Akram et al.,5 modificado, el cual consta de cinco actividades. Resultados: en nuestro estudio participaron seis voluntarios, con una media de edad de 29 años, con un rango de edad de 25 a 33 años. Los sensores fueron capaces de detectar múltiples variables, entre ellas la elevación máxima y mínima de las piernas, número de pasos, el grado de inclinación del tronco, giro, velocidad y cadencia. Conclusión: los resultados hasta ahora obtenidos son prometedores y consideramos que el uso de múltiples sensores inerciales para valorar la marcha y el equilibrio podrían resultar en una nueva herramienta para el diagnóstico y seguimiento de personas con trastorno de la marcha y equilibrio

Loss of Smell and Taste in 2013 European Patients With Mild to Moderate COVID-19

SCOPUS: le.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Validity and reliability of an instrument evaluating the performance of intelligent chatbot: the Artificial Intelligence Performance Instrument (AIPI)

International audienceObjectives: To evaluate the reliability and validity of the Artificial Intelligence Performance Instrument (AIPI). Methods: Medical records of patients consulting in otolaryngology were evaluated by physicians and ChatGPT for differential diagnosis, management, and treatment. The ChatGPT performance was rated twice using AIPI within a 7-day period to assess test–retest reliability. Internal consistency was evaluated using Cronbach’s α. Internal validity was evaluated by comparing the AIPI scores of the clinical cases rated by ChatGPT and 2 blinded practitioners. Convergent validity was measured by comparing the AIPI score with a modified version of the Ottawa Clinical Assessment Tool (OCAT). Interrater reliability was assessed using Kendall’s tau. Results: Forty-five patients completed the evaluations (28 females). The AIPI Cronbach’s alpha analysis suggested an adequate internal consistency (α = 0.754). The test–retest reliability was moderate-to-strong for items and the total score of AIPI (r s = 0.486, p = 0.001). The mean AIPI score of the senior otolaryngologist was significantly higher compared to the score of ChatGPT, supporting adequate internal validity (p = 0.001). Convergent validity reported a moderate and significant correlation between AIPI and modified OCAT (r s = 0.319; p = 0.044). The interrater reliability reported significant positive concordance between both otolaryngologists for the patient feature, diagnostic, additional examination, and treatment subscores as well as for the AIPI total score. Conclusions: AIPI is a valid and reliable instrument in assessing the performance of ChatGPT in ear, nose and throat conditions. Future studies are needed to investigate the usefulness of AIPI in medicine and surgery, and to evaluate the psychometric properties in these fields

Indications, Efficacy, Safety, and Clinical Outcomes of 585 nm Pulsed Dye Laser in Non-Malignant Laryngeal Lesions: A Systematic Review

The objective of this manuscript was to review the indications, efficacy, and safety of a 585 nm pulsed dye laser (PDL) in non-malignant laryngeal lesions. Following the PRISMA statement recommendations, three independent authors searched for articles published in PubMed/MEDLINE, the Cochrane Library, Google Scholar, Scielo, and Web of Science. A bias analysis was performed following NICE guidance tools. From the 506 identified publications, 19 observational studies met the inclusion criteria. The PDL improves vocal quality objectively and subjectively in vascular lesions (p < 0.005) and improves vocal quality in patients with dysplasia/leukoplasia without changing the natural history of the disease compared to other treatments. Reinke’s edema and granulomas require an average of 1.5 PDL sessions for resolution. Treatment of recurrent respiratory papillomatosis requires multiple sessions, with complete remission achieved in 50–70% of patients. Regardless of the lesion, the tolerance of the procedure under local anesthesia is exceptional (84–97%), and the results in terms of regression and vocal quality are promising. The complication rate is minimal, and the procedure does not interfere with other treatment alternatives. There is no consensus on laser settings. The lack of consistent use in evaluating vocal outcomes, whether objective or subjective, prevents the comparability between studies. The 585 nm pulsed dye laser appears to be an effective and safe therapeutic option in patients with non-malignant laryngeal pathology. Future controlled studies are needed to compare the 585 nm pulsed dye laser with other lasers or cold instrument procedures

Non-Squamous Cell Carcinoma of the Larynx: A State-of-the-Art Review

: (1) Background: Non-squamous cell laryngeal carcinoma includes endothelial tumors, such as minor salivary gland tumors, lymphoepithelial tumors, neuroendocrine tumors, soft and hard tissue sarcomas, and malignant melanomas. (2) Methods: A state-of-the-art review using the MEDLINE/PUBMED, Google Scholar, Ovid Medline, Embase, and Scopus electronic databases was performed. (3) Conclusions: In order to optimize overall treatment outcomes, a multidisciplinary, patient-centered approach to the management of non-SCC of the larynx must be adopted universally; a national or international registry on non-SCC laryngeal cancer can be useful to improve understanding about the behavior of this kind of tumor

Artificial Neural Network as a Tool to Predict Facial Nerve Palsy in Parotid Gland Surgery for Benign Tumors

Background: Despite the increasing use of intraoperative facial nerve monitoring during parotid gland surgery or the improvement in the preoperative radiological assessment, facial nerve injury (FNI) continues to be the most feared complication; (2) Methods: patients who underwent parotid gland surgery for benign tumors between June 2010 and June 2019 were included in this study aiming to make a proof of concept about the reliability of an artificial neural networks (AAN) algorithm for prediction of FNI and compared with a multivariate linear regression (MLR); (3) Results: Concerning prediction accuracy and performance, the ANN achieved the highest sensitivity (86.53% vs 46.23%), specificity (95.67% vs 92.59%), PPV (87.28% vs 66.94%), NPV (95.68% vs 83.37%), ROC-AUC (0.960 vs 0.769) and accuracy (93.42 vs 80.42) than MLR; and (4) Conclusions: ANN prediction models can be useful for otolaryngologists-head and neck surgeons-and patients to provide evidence-based predictions about the risk of FNI. As an advantage, the possibility to develop a calculator using clinical, radiological and histological or cytological information can improve our ability to generate patients counselling before surgery