Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery.

OBJECTIVE(S): To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS: Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS: Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS: TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians.

INTRODUCTION: Sensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low. METHODS AND MATERIAL: A questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests. RESULTS: One hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group. CONCLUSION: Few Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group.

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians / Prevalencia del uso de protección auditiva y síntomas auditivos subjetivos entre los intérpretes de orquesta de música clásica españoles

Introduction: Sensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low.Methods and materialA questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests.ResultsOne hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group.ConclusionFew Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group. (AU)

Introducción: La hipoacusia neurosensorial motivada por la exposición al ruido es una de las causas más frecuentes de sordera. Los músicos profesionales tienen una exposición ocupacional significativa a los altos niveles de ruido. El uso de protección auditiva entre los músicos podría prevenir sustancialmente el daño auditivo, aunque su tasa de utilización es bastante baja.Métodos y materialUn grupo de intérpretes de orquesta de música clásica españoles completó un cuestionario sobre el uso de dispositivos de protección auditiva, cuidados auditivos, y opiniones subjetivas sobre las dificultades auditivas. Analizamos la frecuencia del uso de dispositivos por instrumento basada en tablas de contingencia analizadas mediante pruebas χ2.ResultadosCiento noventa y cuatro intérpretes de orquesta de música clásica españoles completaron el cuestionario voluntariamente. El porcentaje de músicos que reportaron el uso de protección auditiva en nuestra encuesta fue muy bajo, y variable dependiendo del tipo de instrumento interpretado. Sin embargo, encontramos una alta prevalencia de trastornos auditivos subjetivos dentro de este grupo.ConclusiónPocos músicos españoles utilizan protección auditiva. La formación sobre prevención de hipoacusia en este campo y la mejora de los dispositivos protectores podría incrementar el uso y mejorar la salud auditiva de este colectivo. (AU)

Everything but the squeal: a guide for head and neck surgery training on the live porcine model.

PURPOSE: The porcine model has been demonstrated to be cost-effective for head and neck surgery training. There is no literature describing the porcine head and neck anatomy. The purpose of this study is to provide a porcine surgical guide for training head and neck residents. METHODS: Five head and neck dissections were performed under general anesthesia on the Large White pig model in the animal facilities of the University Hospital Fundación Jiménez. Sessions were photographed, and reference anatomical measurements were taken. RESULTS: The sternum-chin distance (x = 15.80 cm, σ = 0.44), chin-chin distance (x = 11.10 cm, σ = 2.30), prelaryngeal musculature length (x = 10.30 cm, σ = 1.92) and supraomohyoid triangle area (x = 7.07 cm2, σ = 3.91) were among the measurements obtained. The porcine head and neck anatomy was detailed. CONCLUSIONS: Head and neck porcine anatomy was thoroughly described, with emphasis on the similarities with human anatomy. The porcine model is capable of simulating human anatomy for surgery training.

Sialolithiasis: mineralogical composition, crystalline structure, calculus site, and epidemiological features.

The purpose of this paper was to describe the characteristics of salivary calculi and their relationship to epidemiological factors, through a cross-sectional study. We analysed 100 calculi obtained in 2017-2021. Patient data including age, time since onset of symptoms, gland involved, and site of location in the salivary system were studied. The calculi were studied to determine their morphological features using scanning electron microscopy and energy dispersive plain radiographic analysis. Most of the calculi had formed in the submandibular gland (SG) (82%). The mean age of patients at onset was 45.83 years; patients presenting parotid gland (PG) stones were somewhat older (p = 0.031). The mean time since the onset of symptoms was longer in PG calculi (p = 0.038). The most common lithiasis site was the main duct (74%), followed by the hilum (22%). Hilar stones were the largest (p < 0.05) and heaviest (p = 0.028). Octacalcium phosphate (OCP) was the most common crystalline phase (Cp) founded, followed by hydroxyapatite (HA) and whitlockite (WH). Specifically, OCP had a higher presence in PG calculi (p = 0.029) and WH was the most common phase in SG calculi (p = 0.017). The most prevalent site of lithiasis was the main duct, and the largest and heaviest calculi were found in the SG. PG stones were associated with a longer history of symptoms and older age. OCP was the most frequent Cp of the calculi studied, and the main Cp in PG stones. WH was the predominant Cp in SG stones. The Cp of the calculi was not influenced by location, patient age, or time of symptoms.

Effect of oral antiseptics in reducing SARS-CoV-2 infectivity: evidence from a randomized double-blind clinical trial.

ABSTRACTBackground: In vitro studies have shown that several oral antiseptics have virucidal activity against SARS-CoV-2. Thus, mouthwashes have been proposed as an easy to implement strategy to reduce viral transmission. However, there are no data measuring SARS-CoV-2 viability after mouthwashes in vivo. METHODS: In this randomized double-blind, five-parallel-group, placebo-controlled clinical trial, SARS-CoV-2 salivary viral load (by quantitative PCR) and its infectious capacity (incubating saliva in cell cultures) have been evaluated before and after four different antiseptic mouthwashes and placebo in 54 COVID-19 patients. RESULTS: Contrary to in vitro evidence, salivary viral load was not affected by any of the four tested mouthwashes. Viral culture indicated that cetylpyridinium chloride (CPC) significantly reduced viral infectivity, but only at 1-hour post-mouthwash. CONCLUSION: These results indicate that some of the mouthwashes currently used to reduce viral infectivity are not efficient in vivo and, furthermore, that this effect is not immediate, generating a false sense of security.Trial registration: ClinicalTrials.gov identifier: NCT04707742..

Epidemiologic, radiologic, and sialendoscopic aspects in chronic obstructive sialadenitis.

PURPOSE: Chronic obstructive sialadenitis (COS) is a recurring inflammation of the salivary gland. To date, there are no known predisposing factors for COS. Given the advances seen in radiology and sialendoscopy, we must update our knowledge of COS, analyzing factors that can favor its development. METHODS: We prospectively analyzed 333 patients who underwent sialendoscopy between 2012 and 2021. Epidemiologic, radiologic, and sialendoscopy-related factors were correlated. Suspected diagnosis was established based on the clinical and radiologic data. The final diagnosis was determined on the basis of sialendoscopic findings. RESULTS: The most common etiology of COS was stricture (40.8%). Lack of papilla distensibility (LPD) was also described as an etiology. COS was related to patient gender and age. Submandibular gland involvement was significantly more associated with lithiasis and LPD, while COS of the parotid gland was most frequently caused by stricture. Radioiodine sialadenitis and Sjögren's syndrome were significantly associated with stricture. MR sialography (MR-Si) showed the best overall sensitivity and specificity. CONCLUSION: In our series, stricture was the most common cause of COS. We describe LPD as a frequent cause of COS in this series; ours is the first study to report this finding. There was a significant association between the salivary gland involved, patient sex and age, and the cause of COS. MR-Si showed the greatest diagnostic yield.

Clinical evaluation of antiseptic mouth rinses to reduce salivary load of SARS-CoV-2.

Most public health measures to contain the COVID-19 pandemic are based on preventing the pathogen spread, and the use of oral antiseptics has been proposed as a strategy to reduce transmission risk. The aim of this manuscript is to test the efficacy of mouthwashes to reduce salivary viral load in vivo. This is a multi-centre, blinded, parallel-group, placebo-controlled randomised clinical trial that tests the effect of four mouthwashes (cetylpyridinium chloride, chlorhexidine, povidone-iodine and hydrogen peroxide) in SARS-CoV-2 salivary load measured by qPCR at baseline and 30, 60 and 120 min after the mouthrinse. A fifth group of patients used distilled water mouthrinse as a control. Eighty-four participants were recruited and divided into 12-15 per group. There were no statistically significant changes in salivary viral load after the use of the different mouthwashes. Although oral antiseptics have shown virucidal effects in vitro, our data show that salivary viral load in COVID-19 patients was not affected by the tested treatments. This could reflect that those mouthwashes are not effective in vivo, or that viral particles are not infective but viral RNA is still detected by PCR. Viral infectivity studies after the use of mouthwashes are therefore required. ( https://clinicaltrials.gov/ct2/show/NCT04707742 ; Identifier: NCT04707742).

A live porcine model for surgical training in tracheostomy, neck dissection, and total laryngectomy.

OBJECTIVES: Head and neck surgery is associated with a steep learning curve, creating a need for effective training methods. Live animal models can be useful in acquiring the required skills and techniques to perform tracheostomy, neck dissection, and laryngectomy. The aim of this study is to assess the feasibility and usefulness of a porcine model to teach tracheostomy, neck dissection, and laryngectomy, describing the similarities between a swine head and neck surgical model and the human cervical area. METHODS: Twelve surgical training sessions were held with the use of a live porcine model maintained under general anaesthesia; a total of 39 procedures were performed. In each session, one otolaryngology resident per year performed a procedure to acquire the targeted competencies for their respective year of training. Each procedure was time recorded and evaluated based on a modified Objective Structured Assessment of Technical Skills. Linear regression was used to analyse the data and express the results as percentages. RESULTS: Training exercises were performed in shorter times over the study period. A 9% reduction in the time spent was observed. There was a global improvement in the evaluation made by OSATS score of 6% in the first period (2018-2019) and 58% in the second period (2019-2020). CONCLUSION: The porcine model was both manageable and helpful in providing training despite slight anatomical differences between human beings and pigs. However, more studies are necessary to guarantee that the competencies acquired with this type of training are transferable to real-life interventions. LEVEL OF EVIDENCE: Level 5.

Incidence and risk factors for radioactive iodine-induced sialadenitis.

BACKGROUND: Radioactive iodine (131I) is one of the treatments of hyperthyroidism and differentiated thyroid carcinoma (DTC). Swelling of salivary glands are one of the possible side effects of this treatment, known as radioactive iodine-induced sialadenitis (RAIS). The prevalence of RAIS varies widely and no specific risk ratio has been established. OBJECTIVES: To determine the incidence of RAIS, analysing the epidemiological data and tumour- and treatment-related factors that may influence the development of the disease. MATERIAL AND METHODS: 197 patients who received radioiodine treatment between 2015 and 2017 were studied (76.6% women). The variables studied were age, gender, weight, height, and body mass index; presence of high blood pressure, dyslipidemia, diabetes, and thyroid diseases; cumulative radioiodine dose, presence of sialadenitis, affected salivary gland, and the time of onset. RESULTS: 14 patients developed sialadenitis (78.6% women), all with DTC. The incidence of sialadenitis was 3.4% overall and 6.3% among DTC patients. Furthermore, we found that higher cumulative radioiodine doses confer a greater risk of developing sialadenitis, with a hazard ratio of 1.009 (p = .001). No association was found between the epidemiologic data studied and sialadenitis. CONCLUSIONS: In this series, a dose-dependent relationship was found between radioiodine treatment and sialadenitis.

Effect of testosterone on oxidative stress and cell damage induced by 3-nitropropionic acid in striatum of ovariectomized rats.

This paper evaluates the effects of testosterone (0.5 mg/kg subcutaneously (s.c.) for 8 days) on oxidative stress and cell damage induced by 3-nitropropionic acid (20 mg/kg intraperitoneally (i.p.) for 4 days) in ovariectomized rats. Gonadectomy triggered oxidative damage and cell loss, evaluated by the detection of caspase-3, whereas 3-nitropropionic acid increased the levels of oxidative stress induced by ovariectomy and prompted cell damage characterized by enhanced levels of lactate dehydrogenase. These changes were blocked by testosterone administration. Our results support the following conclusions: i) ovariectomy triggers oxidative and cell damage via caspase-3 in the striatum; ii) 3-nitropropionic acid exacerbates oxidative stress induced by ovariectomy and leads to cell damage characterized by increased levels of lactate dehydrogenase; iii) testosterone administration decreases oxidative stress and cell damage. Additionally, these data support the hypothesis that testosterone might play an important role in the onset and development of neurodegenerative diseases.

17 beta-Estradiol may affect vulnerability of striatum in a 3-nitropropionic acid-induced experimental model of Huntington's disease in ovariectomized rats.

The aim of present study was to clarify the role of female sex hormones in the development and course of neurodegenerative disease in an experimental model of Huntington's disease induced by 3-nitropropionic acid (NPA) (30 mg/kg intraperitoneally (i.p.)/day for 4 days) in ovariectomized rat. Gonadectomy prompted oxidative stress and cell death evaluated by the detection of caspase-3, whereas 3-nitropropionic acid enhanced the oxidative stress induced by ovariectomy and it triggered cell damage characterized by increases of LDH levels. These changes were prevented by administration of 17 beta-estradiol. Our findings suggested that: (i) ovariectomy induced oxidative stress and apoptosis in the brain; (ii) 3-nitropropionic acid exacerbated oxidative stress induced by ovariectomy and shifting cell to cell death; and (iii) 17 beta-estradiol administration decreased oxidative stress and cell death induced by ovariectomy and 3-nitropropionic acid. These results revealed that sex ovarian hormones play a important role in onset and development of neurodegenerative diseases, as well as neuroprotective effects of 17 beta-estradiol against the changes induced ovariectomy and ovariectomy plus 3-nitropropionic acid.

Estudios de fuentes hídricas para la adopción de tecnología apropiada al servicio de agua potable en la localidad de Metán, Provincia de Salta

Metodología seguida por el autor para evaluar todos los sistemas hídricos disponibles que pudieran ser aprovechados como fuentes de abastecimiento de agua potable a la ciudad de Metán, Salta

Estudios de fuentes hídricas para la adopción de tecnología apropiada al servicio de agua potable en la localidad de Metán, Provincia de Salta

Metodología seguida por el autor para evaluar todos los sistemas hídricos disponibles que pudieran ser aprovechados como fuentes de abastecimiento de agua potable a la ciudad de Metán, Salta

Estudios de fuentes hídricas para la adopción de tecnología apropiada al servicio de agua potable en la localidad de Metan provincia de Salta

Presenta una metodología para evaluar todos los sistemas hídricos disponibles que pudieran ser aprovechados como fuentes de abastecimiento de agua potable a la ciudad de Metan, en la provincia de Salta. Señala los graves inconvenientes por los que atraviesa la comunidad, en el caso de considerar la provisión de agua como un factor limitante para su propio desarrollo. Al buscar una solución compatible al medio social y económico de la región, concluye que una galería filtrante solucionaría los inconvenientes enunciados

Estudio de fuentes hídricas para la adopción de tecnología apropiada al servicio de agua potable en la localidad de Metán, Pcia. de Salta

El trabajo que se pone a consideración es una metodología seguida por el autor para evaluar todos los sistemas hídricos disponibles que pudieran ser aprovechados como fuentes de abastecimiento de agua potable a la ciudad de Metán, pcia. de Salta. En las evaluaciones efectuadas se pudo apreciar los gravísimos inconvenientes por los que atraviesa la comunidad cuando la provisión de agua potable llega a ser un factor limitante hasta para su propio desarrollo. No obstante la falta de datos estadísticos precisos se puede apreciar que hasta la misma salud de la población se encuentra en deterioro conforme la calidad de las aguas del servicio no sean satisfactorias. Dentro de la búsqueda de encontrar una solución compatible al medio social y economico de la región se ha llegado a la conclusión que una galería filtrante solucionaría todos estos inconvenientes enunciados encontrando de esta manera sistemática la tecnología apropiada a la comunidad estudiada