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Dhooghe N, Brusselle M, Ureel M, Sinove Y, Vermeersch H, Blondeel P. The effect of various muscle transfer procedures on eye closure and blinking in longstanding facial palsy patients. J Plast Reconstr Aesthet Surg 2024; 89:57-71. [PMID: 38142623 DOI: 10.1016/j.bjps.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/01/2023] [Accepted: 11/21/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Facial palsy causes paralytic lagophthalmos, which remarkably deteriorates a patient's quality of life. In cases where denervation time is over 18-24 months (longstanding facial palsy), a free or pedicled muscle transfer is needed to replace the denervated orbicularis oculi muscle. PURPOSE The purpose of this systematic review is to investigate the effect of various eye sphincter substitution procedures (free or pedicled muscle transfers) in longstanding facial palsy patients on eye closure and blink. METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a systematic review of the Embase, Medline, Web of Science and Cochrane Library databases and Google Scholar. Our literature search yielded 4322 articles. Following a full-text review, 4 retrospective cohort studies and 21 case series were selected for this review. Meta-analyses using R package meta (version 6.5-0) were conducted. MAIN FINDINGS All free and pedicled muscle transfers in this review showed an improvement in the scores and measurements on eye closure and blink. The pedicled temporalis muscle transfer was the procedure most commonly performed as eye reanimation surgery and showed consistent good results. Using the random effects model, the pooled effect of mean difference in lagophthalmos after gentle eye closure post-operatively versus pre-operatively (mm) in patients who received a pedicled (temporalis) muscle transfer was -6.19 (I2 = 85%, 95% CI: -7.89; -4.49) whereas it was -4.11 (I2 = 85%, 95% CI: -7.26; -0.95) for free (gracilis or platysma) muscle transfers. The pooled proportion of patients with complete eye closure after surgery was 0.69 (I2 = 49%, 95% CI: 0.54; 0.82) in patients who received a pedicled (temporalis) muscle transfer and 0.40 (I2 = 74%, 95% CI: 0.13; 0.74) in patients who received a free (platysma) muscle transfer. CONCLUSIONS Unlike smile reanimation, dynamic eye closure and blink restoration are rather neglected topics in facial reanimation. The pedicled temporalis muscle transfer is often recommended as the first treatment of choice for eye reanimation in longstanding facial palsy patients since it is a reliable, straightforward procedure, that does not require complex microsurgery. However, with the advancements in the field of microsurgery, free muscle transfers are promising therapies, which may regenerate voluntary and spontaneous blinking.
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Affiliation(s)
- Nicolas Dhooghe
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Belgium Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Marie Brusselle
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Belgium Corneel Heymanslaan 10, 9000 Ghent, Belgium; Department of Medical Informatics, Erasmus MC Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
| | - Matthias Ureel
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Belgium Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Yves Sinove
- Department of Plastic, Reconstructive and Aesthetic Surgery, General Municipal Hospital Aalst, Merestraat 80, 9300 Aalst, Belgium
| | - Hubert Vermeersch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Belgium Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Phillip Blondeel
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ghent University Hospital, Belgium Corneel Heymanslaan 10, 9000 Ghent, Belgium
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Van Der Kelen L, Ureel M, Bauters W, Vermeersch H, Coopman R. Neurectomy of the Masseteric Nerve Using an Extra-Oral Approach to Treat Masseter Hypertrophy: Case Report and Literature Review. J Oral Maxillofac Surg 2023; 81:1476-1484. [PMID: 37709258 DOI: 10.1016/j.joms.2023.08.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
Masticatory muscle hypertrophy is a benign clinical anomaly which leads to facial asymmetry or a squared face appearance. We report a case of masticatory muscle hypertrophy, particularly on the right side, that was successfully treated by neurectomy of the right masseteric nerve through an extra-oral approach. Clinical examination showed significant aesthetic improvement of the facial symmetry with complete paralysis and atrophy of the right masseter muscle. The impaired postoperative function of the frontal branch of the right facial nerve was fully restored 10 weeks postoperatively. The patient no longer experiences headaches or discomfort with eating or sleeping on her right side.
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Affiliation(s)
- Louise Van Der Kelen
- Co-Assistant, Department of Oral and Maxillofacial Surgery, University Hospital Ghent, Ghent, Belgium
| | - Matthias Ureel
- Resident, Department of Oral and Maxillofacial Surgery, University Hospital Ghent, Ghent, Belgium
| | - Wouter Bauters
- Department Head, Department of Radiology and Imaging, University Hospital Ghent, Ghent, Belgium
| | - Hubert Vermeersch
- Resident, Department of Oral and Maxillofacial Surgery, University Hospital Ghent, Ghent, Belgium; Department Head, Department of Plastic, Reconstructive and Esthetic Surgery, University Hospital Ghent, Ghent, Belgium
| | - Renaat Coopman
- Department Head, Department of Plastic, Reconstructive and Esthetic Surgery, University Hospital Ghent, Ghent, Belgium.
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Poelaert J, Coopman R, Ureel M, Dhooghe N, Genbrugge E, Mwewa T, Blondeel P, Vermeersch H. Visualization of the Facial Nerve with Ultra-high-Frequency Ultrasound. Plast Reconstr Surg Glob Open 2023; 11:e5489. [PMID: 38115834 PMCID: PMC10730079 DOI: 10.1097/gox.0000000000005489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/18/2023] [Indexed: 12/21/2023]
Abstract
Background Profound variations in facial nerve branching, combined with the severe impact of facial palsy on the patient's quality of life, make surgery in this region challenging. Recent advancements in ultrasound (US) technology, including the improved visualization of small structures, have led to a sharp increase in its medical indications in various medical disciplines. We aimed to prove the feasibility of using ultra-high-frequency (UHF) US to visualize the facial nerve and to guide surgeons during surgery on and around the facial nerve. Methods A cadaveric study was performed on one hemi-face with a UHF US imaging system and state-of-the-art transducers. Firstly, a transcutaneous US was performed, and the facial nerve branches of interest (zygomatic, buccal, and marginal mandibular branches) were marked using US-guided color-injections of filler mixed with methylene blue. Skin and subcutaneous fat were then removed to simulate the intraoperative field. Secondly, an "intraoperative" US examination was performed, and the same branches were marked by US-guided color-injections of filler mixed with indocyanine green. Anterograde facial nerve dissection was performed, and the distance between the nerve branches and the injected filler was measured. Results All color-injections (mixed with both methylene blue and indocyanine green) were positioned right next to the nerve branches (<1 mm). The image quality of the US below the skin was observed to be far superior to that of the transcutaneous US. Conclusion UHF US can be used to visualize the facial nerve with high precision both transcutaneously and intraoperatively (after elevation of the skin flap).
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Affiliation(s)
- Jeroen Poelaert
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
| | - Renaat Coopman
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
| | - Matthias Ureel
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
| | - Nicolas Dhooghe
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
| | | | - Tana Mwewa
- Radiology, UZ Brussel, Brussels, Belgium
| | - Phillip Blondeel
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
| | - Hubert Vermeersch
- From the Plastic, Reconstructive and Aesthetic Surgery, UZ Gent, Ghent, Belgium
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Van Doorne L, Vandeweghe S, Matthys C, Vermeersch H, Bronkhorst E, Meijer G, De Bruyn H. Five years clinical outcome of maxillary mini dental implant overdenture treatment: A prospective multicenter clinical cohort study. Clin Implant Dent Relat Res 2023; 25:829-839. [PMID: 37309711 DOI: 10.1111/cid.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 04/27/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The long-term clinical outcome of mini dental implants (MDIs) to support an overdenture is underreported especially in severely atrophic maxillae and when installed flaplessly. PURPOSE The current report is a 5-years follow-up of the previously published 2- and 3-years clinical outcome of MDIs supporting a maxillary overdenture in narrow alveolar ridges. MDI survival, marginal bone level, peri-implant health, technical complications, and oral health related quality of life (OHIP) and respective changes over time are reported. MATERIALS AND METHODS Subjects aged 50 years or older, in need of improvement of maxillary denture retention, were included. The MDIs were 2.4 mm diameter one-piece tapered implants, Class 4 pure Titanium, and lengths 10 or 11.5 mm. Under local anesthesia, 5-6 MDIs were placed in atrophic maxillae with a free-handed flapless approach. One week postoperative the denture was adapted with a retentive soft reliner. The final prosthetic connection was established after 6 months with a metal-reinforced horse-shoe denture. Clinical outcome after 5 years was assessed with probing pocket depts (PPD), bleeding on probing (BoP), and additional cone beam computed tomography (CBCT) MDI bone level measurements were performed. Oral Health-Related Quality of Life (OHRQoL) investigated with OHIP-14 was assessed preoperative, during provisional loading, and after final prosthetic connection up to 5 years. RESULTS Initially, 31 patients (14 females and 17 males) with mean age 62.30 underwent treatment. In the provisional loading interval, 16 patients encountered 32/185 MDIs failures, resulting in a failure of 17.3%; 170 MDIs were functionally loaded in 29 patients. Additionally, 14 implants were lost in three patients, all of whom had had already previous failures. Reimplantation of 17 MDIs were performed during the provisional loading and 2 MDI after functional loading. After 5 years, the absolute implant failure rate was 46/204 (22.5%), corresponding to a cumulative failure rate of 23.2%. Prosthetic failure was observed in four patients due to implant loss and in two patients related to excessive one-piece implant ball attachment wear, making the 5-years prosthetic success 80.0%. The mean PPD and absence/presence of BoP for 149 implants at 5 years was 4.3 and 0.2 mm, respectively. Average mesial-distal-vestibular-palatal bone loss in the interval 2-5 years was 0.08 mm. No statistically significant difference in marginal MDI bone loss between male or female (p = 0.835), smoking and nonsmoking (p = 0.666) was observed. The five-years total measured CBCT interdental bone level (mesial and distal) correlates with the 5-years PPD (Pearson 0.434; p = 0.01). After 5 years, OHRQoL with the treatment procedure was assessed in 27/31 participants. Decreasing mean total OHIP-14 scores with improved OHRQoL, was observed in 27/31 participants, with values of 21.3 at baseline to 15.6 at the time of provisional loading which significantly (p = 0.006) decrease to 7.3 at the final prosthetic connection. The next 3-5 years further decrease was observed with 6.5 and 4.96, respectively. CONCLUSIONS Maxillary MDIs for overdentures are an accessible and acceptable treatment option. Although after 5 years between one fifth and one fourth of the MDIs were lost, prosthetic success remains 80.0% and high OHRQoL could be achieved.
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Affiliation(s)
- Luc Van Doorne
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Plastic, Oral and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium
| | - Stefan Vandeweghe
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Reconstructive Dentistry, Ghent University Hospital, Ghent, Belgium
| | - Carine Matthys
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Reconstructive and Prosthetic Dentistry, Ghent University Hospital, Ghent, Belgium
| | - Hubert Vermeersch
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Plastic, Oral and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium
| | - Ewald Bronkhorst
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
| | - Gert Meijer
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
| | - Hugo De Bruyn
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
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Cleymaet R, Vermassen T, Coopman R, Vermeersch H, De Keukeleire S, Rottey S. The Therapeutic Landscape of Salivary Gland Malignancies-Where Are We Now? Int J Mol Sci 2022; 23:ijms232314891. [PMID: 36499216 PMCID: PMC9740091 DOI: 10.3390/ijms232314891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/23/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Salivary gland malignancies (SGMs) account for less than 5% of new diagnoses in head and neck tumors. If feasible, surgery is the preferred treatment modality. Nevertheless, some malignancies have a tendency of recurrence, with possible distant metastasis. Alternative treatment strategies, such as primary radiation or chemotherapeutics, often present low response rates. As a result, there is an unmet need for novel therapeutic approaches. Nowadays, target-based therapies (e.g., small inhibitors and immunotherapy) are used by the medical oncologist for possible treatment of advanced SGMs. Based on recent published trials, some novel treatments may provide additional disease control for some patients. However, sample sizes are small, the general findings are unsatisfactory, and a lot of uncertainties remain to be elucidated. Nevertheless, research shows that patients do not benefit from blind administration of systemic treatments and therefore a more personalized approach is highly needed. The aim of this review paper is to summarize the most recent advances in the biological understanding and molecular pathways of salivary gland cancers, the association of these pathways with the current treatments used and their implications for more personalized targeted-based therapies.
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Affiliation(s)
- Robbert Cleymaet
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Tijl Vermassen
- Department Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium
- Department Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
- Correspondence: ; Tel.: +32-9-332-26-92
| | - Renaat Coopman
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
| | - Hubert Vermeersch
- Department of Oromaxillofacial and Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Stijn De Keukeleire
- Department Internal Medicine, University Hospital Brussels, 1090 Brussels, Belgium
| | - Sylvie Rottey
- Department Medical Oncology, University Hospital Ghent, 9000 Ghent, Belgium
- Department Basic and Applied Medical Sciences, Ghent University, 9000 Ghent, Belgium
- Cancer Research Institute Ghent, 9000 Ghent, Belgium
- Drug Research Unit Ghent, University Hospital Ghent, 9000 Ghent, Belgium
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Bettens K, Alighieri C, Bruneel L, D'haeseleer E, Luyten A, Sseremba D, Musasizib D, Ojok I, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Better speech outcomes after very early palatal repair?-A longitudinal case-control study in Ugandan children with cleft palate. J Commun Disord 2022; 96:106198. [PMID: 35217335 DOI: 10.1016/j.jcomdis.2022.106198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/11/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Children born with cleft palate with or without cleft lip (CP±L) tend to use less oral pressure consonants and more glottal sounds in their babbling. The purpose of very early palatal repair (i.e., one-stage palatal closure prior to 6 months of age) is to make the palate functional before the onset of speech acquisition to reduce the anchoring of wrong patterns in the child's developing phonological system. As a result, less compensatory articulation errors are expected to be present. Currently, no detailed longitudinal speech outcomes after very early palatal closure are available. This study aimed to provide longitudinal speech outcomes in Ugandan children with CP±L who received palatal closure prior to the age of 6 months. METHODS Ten children with CP±L were assessed at a mean age of 5 and 10 years old. Speech understandability, speech acceptability, resonance, nasal airflow and articulation were perceptually rated by two experienced speech-language pathologists. Velopharyngeal function was estimated using the velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary (speech) surgery was collected. The outcomes were compared with the longitudinal outcomes of an age- and gender-matched control group of 10 Ugandan children without CP±L. RESULTS Speech understandability and acceptability improved significantly over time in the group with CP±L (all p's ≤ 0.05, all Z's > -2.43). At both test dates, significantly worse judgments were found for the group with CP±L compared to the control group for these variables and variables related to passive speech errors (all p's ≤ 0.05, all Z's > 2.49). A statistically significant difference with the control group was found for the presence of compensatory articulation errors at the age of 5 years but not at the age of 10 years, indicating a catch up by the children with CP±L. CONCLUSION Whether a one-stage palatal closure prior to the age of 6 months is more favorable for speech outcomes compared to one-stage palatal closure at 12 months is still not clear. Speech of the children with CP±L improved over time, but significantly differed from the control group at the age of 5 and 10 years old. Limited access to health care facilities and possible influence of malnutrition on wound healing need to be considered when interpreting the results. Whether palatal closure prior to the age of 6 months is transferable to other countries is subject for further research, including both longitudinal and prospective designs with larger samples.
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Affiliation(s)
- Kim Bettens
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium.
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium
| | - Anke Luyten
- Speech Pathology, Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | - Daniel Sseremba
- Department of Speech-Language Pathology, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Duncan Musasizib
- Department of Speech-Language Pathology, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Isaac Ojok
- Department of Speech-Language Pathology, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Andrew Hodges
- Department of Plastic and Reconstructive Surgery, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - George Galiwango
- Department of Plastic and Reconstructive Surgery, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Hubert Vermeersch
- Department of Head and Skin, Ghent University, Ghent, Belgium; Department of Plastic Surgery, Ghent University Hospital, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), Ghent University, Ghent, Belgium; Department of Speech-Language Therapy and Audiology, University of Pretoria, Pretoria, South-Africa
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Van Slycke S, Van Den Heede K, Magamadov K, Gillardin JP, Vermeersch H, Brusselaers N. Intra-operative vagal neuromonitoring predicts non-recurrent laryngeal nerves: technical notes and review of the recent literature. Acta Chir Belg 2021; 121:248-253. [PMID: 31986987 DOI: 10.1080/00015458.2020.1722931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND During thyroid surgery, extreme caution must be taken not to harm the recurrent laryngeal nerve to avoid vocal cord palsy. A non-recurrent laryngeal nerve (NRLN) is a rare anatomical variation that is extremely vulnerable during thyroid surgery. METHODS Description of two NRLN during thyroid surgery discovered early by using continuous intra-operative vagal nerve neuromonitoring and review of the literature. RESULTS During thyroid surgery, we use continuous intra-operative vagal nerve neuromonitoring starting with checking vagal nerve signals. It is essential to start stimulation in the most proximal portion of the carotid sheath. An absent pre-dissection signal on the right vagal nerve with a positive signal on the left vagal nerve indicates a non-recurrent course of the right laryngeal nerve. Post-operatively computed tomography scan (CT-scan) was performed and showed an associated extra-anatomical course of the subclavian artery also known as an arteria lusoria. CONCLUSION The NRLN is an important surgical challenge because unilateral palsy can lead to permanent hoarseness. This anomaly emphasizes the importance of a thorough surgical dissection and the use of intra-operative vagal nerve neuromonitoring. Our method of continuous intra-operative vagal nerve monitoring makes it possible to predict a non-recurrent laryngeal nerve in an early stage during surgery.
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Affiliation(s)
- S. Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of General Surgery, AZ Damiaan, Ostend, Belgium
| | - K. Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - K. Magamadov
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - J.-P. Gillardin
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - H. Vermeersch
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
| | - N. Brusselaers
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research, Karolinkska Institutet, Karolinska Hospital, Stockholm, Sweden
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Alighieri C, D'haeseleer E, Bettens K, Bonte K, Vermeersch H, Vermeire N, Claeys M, Sseremba D, Galiwango G, Van Lierde K. Sociodemographics and Quality of Life in Dutch-Speaking Adolescents and Adults With and Without a Cleft Lip and/or Palate. Cleft Palate Craniofac J 2021; 59:S65-S73. [PMID: 34142586 DOI: 10.1177/10556656211024513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To investigate the impact of living with a cleft lip and/or cleft palate (CL/P) on sociodemographic variables, quality of life, aesthetics, life satisfaction, and social distress in Dutch-speaking adolescents and adults. DESIGN Cross-sectional study. PARTICIPANTS Thirty Dutch-speaking participants with a CL/P with a mean age of 26.93 years (SD = 11.69) and an age- and gender-matched control group of 30 participants (19 men and 11 women) without a CL/P with a mean age of 26.87 years (SD = 11.73). MAIN OUTCOME MEASURES Self-reported outcomes of sociodemographics, quality of life, aesthetics, life satisfaction, social distress, and impact of cleft on well-being and functioning. RESULTS No significant differences in educational level, employment, monthly net income, marital status, and having children were found between participants with and without a CL/P. In addition, quality of life, overall aesthetics, life satisfaction, and social distress did not differ between the 2 groups. Among participants with CL/P, there were no gender differences in the influence of their CL/P on daily functioning, well-being, social contacts, family life, applying for a job, work, education, or leisure time. CONCLUSION The findings revealed no differences between participants with and without a CL/P with regard to sociodemographics, quality of life, aesthetics, life satisfaction, or social distress. There were no gender differences in the influence of cleft on well-being and functioning. Longitudinal research can help determine possible fluctuations in the impact of living with a CL/P across the life span.
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Affiliation(s)
- Cassandra Alighieri
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Kim Bettens
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Katrien Bonte
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, 26656Ghent University Hospital, Corneel Heymanslaan, Ghent, Belgium
| | - Nele Vermeire
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Merel Claeys
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
| | - Daniel Sseremba
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - George Galiwango
- Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, 26656Ghent University, Corneel Heymanslaan, Ghent, Belgium
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Oscé H, Magamadov K, Van Den Heede K, Brusselaers N, Vermeersch H, Van Slycke S. Intra-operative recovery of preoperative vocal cord paralysis during hemithyroidectomy for benign thyroid disease: case report and review of the literature. Acta Chir Belg 2021; 121:215-218. [PMID: 31580203 DOI: 10.1080/00015458.2019.1675973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Multinodular goiter associated with preoperative vocal cord palsy is usually indicative of invasive thyroid malignancy. However, benign thyroid disease may also lead to vocal cord paralysis. CASE REPORT We present a case of a 63-year old woman with a two-month history of hoarseness, loss of vocal pitch, difficulties with swallowing and shortness of breath. Preoperative flexible fiberoptic laryngoscopy showed a left vocal cord paralysis. Left hemithyroidectomy with isthmectomy under intraoperative neuromonitoring for multinodular goiter was performed. Intra-operatively, both ipsilateral recurrent laryngeal nerve (RLN) and vagal nerve (VN) were identified and preserved. Follow-up laryngoscopy 5 weeks postoperatively showed complete recovery of the left vocal cord movement. DISCUSSION Intuitively, surgeons may assume that preservation of a palsied RLN in patients with preexisting vocal cord paralysis is not meaningful. However, patients with RLN palsy associated with benign thyroid disease can experience full recovery after surgery. CONCLUSION Multinodular goiter associated with preoperative vocal cord paralysis should be managed with extreme caution and use of intra-operative neuromonitoring. The existing probability of intra-operative recovery of a preoperative RLN palsy underlines the importance of preserving the affected RLN during surgery for benign thyroid disease.
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Affiliation(s)
- Hanne Oscé
- Group of Biomedical Sciences, University Hospital Leuven, Leuven, Belgium
| | - Khozh Magamadov
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - Klaas Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - Nele Brusselaers
- Centre for Translational Microbiome Research Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
| | - Sam Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
- Department of Head and Skin, University Hospital Ghent, Ghent, Belgium
- Department of General Surgery, AZ Damiaan, Ostend, Belgium
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10
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Van Slycke S, Van Den Heede K, Magamadov K, Brusselaers N, Vermeersch H. Robotic-assisted parathyroidectomy through lateral cervical approach: first results in Belgium. Acta Chir Belg 2021; 121:178-183. [PMID: 31738661 DOI: 10.1080/00015458.2019.1693155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A parathyroidectomy has been the treatment of choice for primary hyperparathyroidism. Especially the improved imaging techniques have led to minimally invasive techniques. Aim of this study was to evaluate our experience with robot-assisted parathyroidectomy through lateral cervical approach. STUDY DESIGN Prospective clinical cohort. METHODS All consecutive patients who underwent a robotic-assisted parathyroidectomy for primary hyperparathyroidism since 2011 were enrolled in this study. Demographic data, biometrics, imaging data and surgery data were collected. Main outcomes were postoperative hypocalcemia, recurrent laryngeal nerve paralysis and other postoperative complications. RESULTS Twenty-two patients were enrolled. When patients with conversion were excluded (39%) mean operating time was 69 min. In all patients a normal value of serum PTH-levels was achieved 4 h postoperatively. Mean value of serum calcium was 2.92mmol/L preoperative and 2.33mmol/L postoperative. There was no persistent hypocalcemia in any of our patients. 87% was discharged on the first postoperative day. Esthetic results were excellent. CONCLUSIONS Robotic-assisted parathyroidectomy through lateral cervical approach is a safe and feasible procedure in patients with posteriorly localized parathyroid adenomas. Preoperative imaging techniques are crucial to detect the exact location.
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Affiliation(s)
- S. Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
- Department of Head, Neck and Maxillofacial Surgery, University Hospital Ghent, Ghent, Belgium
- Department of General Surgery, AZ Damiaan, Ostend, Belgium
| | - K. Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - K. Magamadov
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Clinic Aalst, Aalst, Belgium
| | - N. Brusselaers
- Department of Head, Neck and Maxillofacial Surgery, University Hospital Ghent, Ghent, Belgium
- Centre for Translational Microbiome Research, Department of Microbiology, Tumour and Cell biology, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
| | - H. Vermeersch
- Department of Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
- Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
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11
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D'haeseleer E, Huvenne W, Vermeersch H, Meerschman I, Imke K, Servayge L, Versavel O, Van Lierde K. Long-term voice quality outcome after thyroidectomy without laryngeal nerve injury: a prospective 10 year follow up study. J Commun Disord 2021; 91:106109. [PMID: 34034037 DOI: 10.1016/j.jcomdis.2021.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/16/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE This study investigates the long-term voice outcome of thyroidectomy up to 10 years after the surgery using a longitudinal prospective study design. METHODS Eighteen participants (6 men and 12 women, mean age: 54 years) who underwent a thyroidectomy between September 2006 and May 2007 were included in this study. A voice assessment protocol consisting of subjective (videolaryngostroboscopic evaluation, auditory- perceptual evaluation, patients' self-report) and objective voice assessments (maximum performance task, acoustic analysis, voice range profile and Dysphonia Severity Index) was used to evaluate the participants' pre- and postoperative voice. Voice measurements were compared before and one week, six weeks, three months and 10 years after the surgery. RESULTS No significant differences over time in auditory-perceptual and objective voice parameters were found, except for shimmer. Only in the first postoperative condition, significantly more patients reported vocal complaints. A progressive amelioration of the vocal folds' movement patterns was observed in the postoperative conditions. CONCLUSION The findings of this small longitudinal prospective study suggest that thyroidectomy without laryngeal nerve injury does not cause a permanent deterioration of the laryngeal aspect or function, vocal fold behavior and the self-perceived, perceptual and objective vocal quality. The increase of the shimmer 10 years post-thyroidectomy may be related to vocal aging.
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Affiliation(s)
- Evelien D'haeseleer
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Otorhinolaryngology, Ghent University Hospital, Belgium.
| | - Wouter Huvenne
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium.
| | - Iris Meerschman
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kissel Imke
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Lena Servayge
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Orphee Versavel
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Kristiane Van Lierde
- Center for Speech and Languages Sciences, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South-Africa.
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12
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Van Slycke S, Simons AS, Van Den Heede K, Van Crombrugge P, Tournoy K, Simons P, Vermeersch H, Brusselaers N. Combined cervicosternotomy and cervicotomy for true retrosternal goiters: a surgical cohort study. Updates Surg 2021; 73:1-10. [PMID: 33779950 PMCID: PMC8397680 DOI: 10.1007/s13304-021-01027-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Abstract
Objective Intrathoracic goiters are a heterogeneous group characterized by limited or extensive substernal extension. Whereas the former can be treated through cervicotomy, the latter sometimes requires a cervicosternotomy. Whether cervicosternotomy leads to more morbidity remains unclear. This study aimed to compare intra- and postoperative morbidity in patients treated by cervicotomy or cervicosternotomy for intrathoracic goiters and standard thyroidectomy. Methods In a prospectively gathered cohort undergoing thyroid surgery (2010–2019) intra- and postoperative morbidity of cervicotomy (N = 80) and cervicosternotomy (N = 15) for intrathoracic goiters was compared to each other and to a ‘standard’ thyroidectomy (N = 1500). Results An intrathoracic extension prior to surgery was found in 95 (6%) of all thyroidectomies. Eighty patients (84%) were operated by cervicotomy and 15 (16%) by cervicosternotomy. The risk of temporary recurrent laryngeal nerve palsy was much higher in the cervicosternotomy group (21%) compared to cervicotomy (4%) and standard thyroidectomy (3%). The risk of temporary hypocalcemia after cervicotomy (28%) was comparable to a standard thyroidectomy (32%) but higher after cervicosternotomy (20%). No cases of permanent hypocalcemia or laryngeal nerve palsy were observed in both groups with substernal extension. The need for surgical reintervention was significantly higher in the cervicotomy group (6%) compared to cervicosternotomy (0%) and standard thyroidectomy (3%). Conclusion In patients undergoing thyroid surgery for an intrathoracic goiter, cervicosternotomy was associated with more temporary laryngeal nerve palsy, but none of the interventions resulted in higher risks of permanent nerve damage, permanent hypocalcemia, or reintervention for bleeding. Reintervention was even more common after cervicotomy compared to cervicosternotomy. Level of evidence IV Supplementary Information The online version contains supplementary material available at 10.1007/s13304-021-01027-1.
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Affiliation(s)
- S Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of General Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium
| | - A-S Simons
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Group of Biomedical Sciences, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - K Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - P Van Crombrugge
- Department of Endocrinology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - K Tournoy
- Department of Pneumology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium.,Department of Internal Medicine and Paediatrics, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - P Simons
- Department of Radiology, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - H Vermeersch
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Plastic and Reconstructive Surgery, Department of Human Structure and Repair, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - N Brusselaers
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Department of Microbiology, Tumour and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Karolinska Hospital, Tomtebodavagen 16, 17165, Stockholm, Sweden. .,Global Health Institute, Antwerp University, Campus Drie Eiken, Gouverneur Kinsbergencentrum, Doornstraat 331, 2610, Wilrijk, Belgium.
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13
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Van Slycke S, Van Den Heede K, Bruggeman N, Vermeersch H, Brusselaers N. Risk factors for postoperative morbidity after thyroid surgery in a PROSPECTIVE cohort of 1500 patients. Int J Surg 2021; 88:105922. [PMID: 33774174 DOI: 10.1016/j.ijsu.2021.105922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/20/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Postoperative hypocalcaemia, recurrent laryngeal nerve palsy and postoperative bleeding are the most frequent postoperative complications after thyroid surgery, and therefore often used as quality indicators of thyroid surgery. We aimed to assess postoperative morbidity in a high-volume endocrine surgery unit, and to detect which factors are associated with higher risks. METHODS Prospective surgical cohort in a high-volume tertiary referral centre for endocrine surgery in xxx. The first 1500 patients operated with hemi or total thyroidectomy during 2010-2019 were included. Postoperative hypocalcaemia, recurrent laryngeal nerve palsy and postoperative bleeding were assessed in relation to pre- and peri-operative characteristics using multivariable logistic regression analyses, expressed as odds ratios and 95% confidence intervals. RESULTS Overall, 1043 patients (69.5%) received a total thyroidectomy and 457 (30.5%) a hemithyroidectomy. Permanent hypocalcaemia occurred in 3.1%, permanent recurrent laryngeal nerve palsy in 1.8% and surgical reintervention for bleeding in 2.6%. Younger age, female sex and cancer were risk factors for permanent hypocalcaemia. No clear risk factors could be identified for permanent nerve palsy. Female sex, high body mass index and heavier thyroids were protective against postoperative bleeding after total thyroidectomy. CONCLUSIONS Surgical experience in endocrine surgery seems beneficial for clinical outcomes and contributes to organizational efficiency. A low complication risk can be obtained by trained high-volume endocrine surgeons, yet the risk is not negligible.
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Affiliation(s)
- Sam Van Slycke
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium; Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Department of General Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium
| | - Klaas Van Den Heede
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium; Department of Endocrine Surgery, Hammersmith, 72 Du Cane Road, W12 0HS, London, UK
| | - Niels Bruggeman
- Department of General and Endocrine Surgery, Onze-Lieve-Vrouw (OLV) Hospital Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Plastic and Reconstructive Surgery, Department of Human Structure and Repair, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Nele Brusselaers
- Department of Head and Skin, University Hospital Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Centre for Translational Microbiome Research Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Karolinska Hospital, Solnavägen 9, 17165, Stockholm, Sweden.
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14
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Bettens K, Bruneel L, Alighieri C, Sseremba D, Musasizib D, Ojok I, Hodges A, Galiwango G, Adriaansen A, D'haeseleer E, Vermeersch H, Van Lierde K. Perceptual Speech Outcomes After Early Primary Palatal Repair in Ugandan Patients With Cleft Palate. Cleft Palate Craniofac J 2020; 58:999-1011. [PMID: 33380217 DOI: 10.1177/1055665620980249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To provide speech outcomes of English-speaking Ugandan patients with a cleft palate with or without cleft lip (CP±L). DESIGN Prospective case-control study. SETTING Referral hospital for patients with cleft lip and palate in Uganda. PARTICIPANTS Twenty-four English-speaking Ugandan children with a CP±L (15 boys, 9 girls, mean 8.4 years) who received palatal closure prior to 6 months of age and an age- and gender-matched control group of Ugandan children without cleft palate. INTERVENTIONS Comparison of speech outcomes of the patient and control group. MAIN OUTCOME MEASURES Perceptual speech outcomes including articulation, resonance, speech understandability and acceptability, and velopharyngeal composite score (VPC-sum). Information regarding speech therapy, fistula rate, and secondary surgery. RESULTS Normal speech understandability was observed in 42% of the patients, and 38% were judged with normal speech acceptability. Only 16% showed compensatory articulation. Acceptable resonance was found in 71%, and 75% of the patients were judged perceptually to present with competent velopharyngeal function based on the VPC-sum. Additional speech intervention was recommended in 25% of the patients. Statistically significant differences for all these variables were still observed with the control children (P < .05). CONCLUSIONS Overall, acceptable speech outcomes were found after early primary palatal closure. Comparable or even better results were found in comparison with international benchmarks, especially regarding the presence of compensatory articulation. Whether this approach is transferable to Western countries is the subject for further research.
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Affiliation(s)
- Kim Bettens
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
| | - Laura Bruneel
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
| | - Cassandra Alighieri
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
| | - Daniel Sseremba
- Speech-Language Pathologist, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Duncan Musasizib
- Speech-Language Pathologist, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Isaac Ojok
- Speech-Language Pathologist, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Andrew Hodges
- Plastic and Reconstructive Surgeon, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - George Galiwango
- Plastic and Reconstructive Surgeon, Comprehensive Rehabilitation Services in Uganda (CoRSU), Kisubi, Uganda
| | - Anke Adriaansen
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
| | - Evelien D'haeseleer
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Skin, 26656Ghent University, Ghent, Belgium.,Department of Plastic Surgery, 26656Ghent University Hospital, Ghent, Belgium
| | - Kristiane Van Lierde
- Department of Rehabilitation Sciences, Center for Speech and Language Sciences (CESLAS), 26656Ghent University, Ghent, Belgium
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15
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Van Slycke S, Van Den Heede K, Brusselaers N, Vermeersch H. Feasibility of Autofluorescence for Parathyroid Glands During Thyroid Surgery and the Risk of Hypocalcemia: First Results in Belgium and Review of the Literature. Surg Innov 2020; 28:409-418. [PMID: 33372584 DOI: 10.1177/1553350620980263] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Post-operative hypocalcemia remains the most frequent complication after total thyroidectomy. Recently, autofluorescence imaging was introduced to detect parathyroid glands early during dissection. Aim. We aimed to check the feasibility of autofluorescence regarding the number of parathyroid glands visualised and the risk of post-operative hypocalcemia. Methods. In a prospectively gathered cohort of patients undergoing thyroid surgery, we describe the risk of hypocalcemia in relation to the number of parathyroid glands visualised during surgery (and the risk reported in the scientific literature) and the feasibility to obtain an autofluorescence of the parathyroid glands. Results. From 2010 to 2019, 1083 patients were referred for total thyroidectomy in our tertiary referral centre for endocrine surgery, of which, 40 consecutive cases were operated using autofluorescence. Among the autofluorescence group, 14 (35.0%) had all 4 parathyroid glands visualised, compared to 147 (14.1%) in the other patients, without differences in the number of parathyroid glands reimplanted. No permanent hypocalcemia occurred in the autofluorescence group and 17.5% temporary hypoparathyroidism, compared to 3.1% and 31.9% among the other patients, and 4% (95% confidence interval [CI] 3-5%) and 19% (95% CI 15-24%) in the literature. Conclusion. Autofluorescence imaging provides reliable real-time visualisation at any point during thyroid surgery and helps to identify the parathyroid glands before detection with the naked eye. To date, it cannot be used as a standard technique and does not replace meticulous dissection. To become a useful adjunct in peroperative parathyroid management, large multicentre studies need to establish a potential clinical benefit of this novel technique.
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Affiliation(s)
- Sam Van Slycke
- Department of General and Endocrine Surgery, 74840Onze-Lieve-Vrouw (OLV) Hospital Aalst, Aalst, Belgium.,Department of Head and Skin, RinggoldID:60200University Hospital Ghent, Ghent, Belgium.,Department of General Surgery, 81800AZ Damiaan, Gouwelozestraat, Ostend, Belgium
| | - Klaas Van Den Heede
- Department of General and Endocrine Surgery, 74840Onze-Lieve-Vrouw (OLV) Hospital Aalst, Aalst, Belgium.,Department of Endocrine Surgery, 129363Hammersmith Hospital, London, UK
| | - Nele Brusselaers
- Department of Head and Skin, RinggoldID:60200University Hospital Ghent, Ghent, Belgium.,Centre for Translational Microbiome Research Department of Microbiology, Tumour and Cell Biology, 27106Karolinska Institute, Stockholm, Sweden
| | - Hubert Vermeersch
- Department of Head and Skin, RinggoldID:60200University Hospital Ghent, Ghent, Belgium.,Plastic and Reconstructive Surgery, Department of Human Structure and Repair, 60200University Hospital Ghent, Ghent, Belgium
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16
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Huvenne W, De Vriese C, Bogaert J, Vermeersch H. Review of publications on the possible advantages of a direct cheek incision for accessory parotid gland masses. Br J Oral Maxillofac Surg 2020; 58:e248-e253. [PMID: 32847722 DOI: 10.1016/j.bjoms.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
Lesions of the accessory parotid gland (APG) are rare and surgical management is generally under-discussed. The surgical approach should provide complete resection, while minimising complications and aesthetic complaints. The current study reviews recent publications on the surgical management of APG masses, and discusses the advantages, and limitations of, and our experience with, direct cheek incision. Papers on the surgical management of APG masses published in the last 10 years were systematically searched. Information was obtained regarding the surgical approach, type of excision, and postoperative complications. In the included studies, 253 APG masses were selected for analysis, whereof six were treated with the direct cheek incision. Although no local recurrence or postoperative complications were observed after this, the approach was usually not recommended due to a higher reported risk of recurrence and complications in older papers. More recent studies, however, indicate that the direct cheek incision should be considered as a valuable alternative to standard approaches in selected patients.
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Affiliation(s)
- W Huvenne
- Department of Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
| | - C De Vriese
- Faculty of Medicine, University of Ghent, Ghent, Belgium.
| | - J Bogaert
- Faculty of Medicine, University of Ghent, Ghent, Belgium
| | - H Vermeersch
- Department of Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium; Department of Plastic and Reconstructive Surgery, University Hospital Ghent, Ghent, Belgium
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17
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Van Vlaenderen J, Logghe K, Schiettecatte E, Vermeersch H, Huvenne W, De Waele K, Van Beveren H, Van Dorpe J, Creytens D, De Schepper J. A synchronous papillary and follicular thyroid carcinoma presenting as a large toxic nodule in a female adolescent. Int J Pediatr Endocrinol 2020; 2020:14. [PMID: 32699545 PMCID: PMC7372872 DOI: 10.1186/s13633-020-00084-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/18/2020] [Indexed: 11/12/2022]
Abstract
Case presentation We report for the first time a synchronous papillary and follicular thyroid carcinoma in a 12-year-old girl presenting with a large (5 cm diameter) left thyroid nodule, an increased left and right upper pole technetium tracer uptake at scintigraphy and hyperthyroidism. The uptake at the right lobe was explained by the crossing of the left nodule to the right site of the neck at Computed Tomography (CT) scanning. Background Although thyroid nodules are less common in children than in adults, there is more vigilance required in children because of the higher risk of malignancy. According to literature, about 5% of the thyroid nodules in adults are malignant versus 20–26% in children. The characteristics of 9 other pediatric cases with a differentiated thyroid carcinoma presenting with a toxic nodule, which have been reported during the last 20 years, are summarized. A nodular size of more than 3.5 cm and female predominance was a common finding. Conclusions The presence of hyperthyroidism in association with a hyperfunctioning thyroid nodule does not rule out thyroid cancer and warrants careful evaluation, even in the absence of cervical lymph node invasion.
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Affiliation(s)
- Joke Van Vlaenderen
- Department of Pediatric Endocrinology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Karl Logghe
- Department of Pediatrics, AZ Delta, Roeselare, Brugsesteenweg 90, 8800 Roeselare, Belgium
| | - Eva Schiettecatte
- Department of Radiology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Wouter Huvenne
- Department of Head and Neck Surgery, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Kathleen De Waele
- Department of Pediatric Endocrinology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Hanne Van Beveren
- Department of Pathology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - David Creytens
- Department of Pathology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - Jean De Schepper
- Department of Pediatric Endocrinology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium.,Department of Pediatric Endocrinology, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
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18
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Lemmens G, Hendrickx H, Poppe C, Roche N, Peeters P, Vermeersch H, Rogiers X, Van Lierde K, Blondeel P. Psychosocial outcomes 3 years after facial transplantation of a blind patient. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.1410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BackgroundTo date, psychosocial outcomes after facial transplantation are promising although long-term consequences, outcome of blind patients and the impact on family members are less well investigated. The aim of this study was to examine the long-term psychosocial of a blind patient and his partner 2 and 3 years after facial transplantation.MethodsDepressive and anxiety symptoms, hopelessness, coping, resilience, illness cognitions, marital support, dyadic adjustment, family functioning and quality of life of the patient and the partner were assessed before and 2 and 3 years after transplantation. Reliable change index (RCI) was further calculated to evaluate the magnitude of change.ResultsMost psychological, marital and family scores of both the patient and the partner remained within a normative and healthy range at follow-up. Resilience (RCI: 2.5 & 3.4 respectively), affective responsiveness (RCI: −4.1 & −3.2 respectively), physical quality of life (RCI: 8.7 & 7.2 respectively) and helplessness (RCI: −2.2 & −2.9 respectively) of the patient improved at 2 and 3 years follow-up. Further, dyadic cohesion (RCI: 2.4) of the patient improved at 2 years whereas marital depth (RCI: −2.0) of the partner decreased at 3 years.ConclusionsThe results of this study point to positive long-term psychosocial outcomes of a blind patient and his partner after facial transplantation. Further, they may underscore the importance of patient selection, social support and involvement of family members in treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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19
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Willaert R, Shaheen E, Deferm J, Vermeersch H, Jacobs R, Mombaerts I. Three-dimensional characterisation of the globe position in the orbit. Graefes Arch Clin Exp Ophthalmol 2020; 258:1527-1532. [PMID: 32140924 DOI: 10.1007/s00417-020-04631-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/09/2020] [Accepted: 02/14/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE Current methods to analyse the globe position, including Hertel exophthalmometry and computed tomography (CT), are limited to the axial plane and require the lateral orbital rim and cornea as landmarks. This pilot study aimed to design a method to measure the position of the globe in the axial, coronal and sagittal plane and independent from orbital bony and corneal references. METHODS With the aid of three-dimensional CT reconstruction technology, we determined the globe position in the orbit based on the centre of the globe. Method validation was performed using data of consecutive orbital CT scans from the control group and from the patients with Graves' orbitopathy who underwent orbital decompression surgery with removal of the lateral orbital margin. RESULTS The inter- and intra-observer reliability was excellent with a high intraclass correlation coefficient (> 0.99, 95% CI [0.97; 1.00]). In the decompressed orbits, there was a statistically significant globe position shift along the anterior-posterior axis (P = 0.0005, 95% CI [0.63; 3.66]), but not along the medial-lateral and superior-inferior axis. CONCLUSION The 3D CT method can accurately and reliably characterise the globe position shift in the three dimensions without using orbital and corneal anatomical landmarks. The method can be useful to determine the globe shift in proptosis, enophthalmos, hypoglobus and hyperglobus, even in the presence of strabismus and orbital bone defects.
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Affiliation(s)
- Robin Willaert
- Department of Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium. .,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
| | - Eman Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Julie Deferm
- Department of Oral and Maxillofacial Surgery, Radboud University Hospital, Nijmegen, The Netherlands
| | - Hubert Vermeersch
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Ghent, Belgium
| | - Reinhilde Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Ilse Mombaerts
- Department of Ophthalmology, University Hospitals Leuven, Leuven, Belgium
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20
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Schümmer L, Ninclaus V, Callebert I, Lantsoght H, Geldhof K, Vermeersch H, De Schryver I. Mantle cell lymphoma: how not to be misled. Acta Ophthalmol 2019. [DOI: 10.1111/j.1755-3768.2019.5152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Laura Schümmer
- Department of Ophthalmology Ghent University Hospital Ghent Belgium
| | | | - Ineke Callebert
- Department of Ophthalmology Jan Yperman Hospital Ieper Belgium
| | - Helena Lantsoght
- Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
| | - Kurt Geldhof
- Department of Oncology Jan Yperman Hospital Ieper Belgium
| | | | - Ilse De Schryver
- Department of Ophthalmology Ghent University Hospital Ghent Belgium
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21
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Cardon E, Van Rompaey V, Jacquemin L, Mertens G, Vermeersch H, Joossen I, Beyers J, Vanderveken OM, Van de Heyning P, Topsakal V, Gilles A. Sequential dual-site High-Definition transcranial Direct Current Stimulation (HD-tDCS) treatment in chronic subjective tinnitus: study protocol of a double-blind, randomized, placebo-controlled trial. Trials 2019; 20:471. [PMID: 31370873 PMCID: PMC6676604 DOI: 10.1186/s13063-019-3594-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic tinnitus is a highly prevalent symptom, with many patients reporting considerable effects of tinnitus on quality of life. No clear evidence-based treatment options are currently available. While counseling-based methods are valuable in some cases, they are not sufficiently effective for all tinnitus patients. Neuromodulation techniques such as high-definition transcranial direct current stimulation (HD-tDCS) are proposed to have positive effects on tinnitus severity but, to date, these effects have not been proven conclusively. The proposed trial will investigate the hypothesis that chronic tinnitus patients receiving HD-tDCS will report a positive effect on the impact of tinnitus on daily life, as compared to patients receiving sham stimulation. Methods This study proposes a randomized, double-blind, placebo-controlled trial with parallel group design. A total of 100 chronic tinnitus patients will be randomly allocated to an experimental group or a sham group, with allocation stratified according to gender and tinnitus severity. Patient and researcher will be blinded to the patient’s allocation. Patients will undergo six sessions of sequential dual-site HD-tDCS of the left temporal area and the right dorsolateral prefrontal cortex. Evaluations will take place at baseline, immediately following treatment, and at three and six months after the start of the therapy. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Secondary outcome measures include audiological measurements, cortical auditory evoked potentials, the Repeatable Battery for the Assessment of Neuropsychological Status adjusted for hearing-impaired individuals (RBANS-H), and supplementary questionnaires probing tinnitus severity and additional symptoms. By use of a linear regression model, the effects of HD-tDCS compared to sham stimulation will be assessed. Discussion The objective of this study is to evaluate whether HD-tDCS can reduce the impact of tinnitus on daily life in chronic tinnitus patients. To date, published trials on the effects of HD-tDCS on tinnitus suffer from a lack of standardization and few randomized controlled trials exist. The proposed study will be the first adequately powered trial to investigate the effects of sequential dual-site HD-tDCS on tinnitus severity. Trial registration ClinicalTrials.gov, NCT03754127. Registered on 22 November 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3594-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Cardon
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.
| | - V Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - L Jacquemin
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - G Mertens
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - H Vermeersch
- Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - I Joossen
- Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - J Beyers
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - O M Vanderveken
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - P Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - V Topsakal
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - A Gilles
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Department of Education, Health & Social Work, University College Ghent, Ghent, Belgium
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22
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Vermeir P, Degroote S, Van Tiggelen H, Vandijck D, Peleman R, Verhaeghe R, Mariman A, Vermeersch H, Vogelaers D. Patient perspectives on electronic health record accessibility and patient participation: a questionnaire survey. Acta Clin Belg 2018; 73:292-297. [PMID: 29431035 DOI: 10.1080/17843286.2018.1436233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives To explore patient perceptions on personal comfort with participation in their own care process and on support of this patient participation through electronic health record (EHR) accessibility. Methods Explorative quantitative questionnaire study in ambulatory patients visiting the departments of General Internal Medicine or Head, Neck and Maxillo-Facial Surgery of a Belgian tertiary referral center. Results Patients were recruited by convenience sampling of 438 out of the total of 1270 patients visiting either one of these departments within a time period of two weeks. Overall response rate was 97.3% (n = 426; 45.3% male; mean age 42.5 ± 15.4 years). Most patients (89.7%) indicated a desire to make healthcare decisions in partnership with their physician. They were in need of transparent and comprehensible health information. The EHR was perceived as a suitable and effective means to inform patients about their health and to increase involvement in care and treatment (77.6%). Furthermore, access to the EHR was perceived to result in a more effective communication transfer between physician and patient (65.5%), increased patient compliance (64.3%), and satisfaction (57.4%). Conclusion Patients indicate a desire for proactive participation in their individual care process. They felt that medical record accessibility could support decision-making and assist in managing and coordinating individual and personalized care choices.
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Affiliation(s)
- Peter Vermeir
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sophie Degroote
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
| | - Hanne Van Tiggelen
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dominique Vandijck
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
- Department of Business Economics, Hasselt University, Diepenbeek, Belgium
| | - Renaat Peleman
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Rik Verhaeghe
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Public Health, Ghent University, Ghent, Belgium
| | - An Mariman
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hubert Vermeersch
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Head, Neck and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium
| | - Dirk Vogelaers
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Internal Medicine, Ghent University, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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23
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Deroo L, Vermeersch H, Willaert R, De Keyzer F, Vanneuville B, De Schryver I. Orbital lymphoma presenting as a recurrence of posterior scleritis after treatment with adalimumab. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0t078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L. Deroo
- Faculty of Medicine and Health Sciences; Ghent University; Gent Belgium
| | - H. Vermeersch
- Head- Neck and Maxillo-Facial Surgery; Ghent University Hospital; Ghent Belgium
| | - R. Willaert
- Head- Neck and Maxillo-Facial Surgery; Ghent University Hospital; Ghent Belgium
| | - F. De Keyzer
- Rheumatology; Ghent University Hospital; Ghent Belgium
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24
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Bruneel L, Luyten A, Bettens K, D'haeseleer E, Dhondt C, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Delayed primary palatal closure in resource-poor countries: Speech results in Ugandan older children and young adults with cleft (lip and) palate. J Commun Disord 2017; 69:1-14. [PMID: 28675808 DOI: 10.1016/j.jcomdis.2017.06.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 06/09/2017] [Accepted: 06/13/2017] [Indexed: 06/07/2023]
Abstract
AIMS Unrepaired clefts still regularly occur in resource-poor countries as a result of limited health-care access. The purpose of the present study was to report resonance, airflow and articulation characteristics following delayed (≥8years) primary palatal closure. METHODS Fifteen Ugandan participants with cleft (lip and) palate (CP±L) were included as well as 15 age- and gender-matched Ugandan subjects without clefts. Palatal closure was performed at a mean age of 15;10 years using the Sommerlad technique. Speech evaluations were carried out on a single occasion postoperatively (mean age: 18;10 years). Resonance and nasal airflow were perceptually evaluated and detailed phonetic and phonological assessments were carried out. Additionally, nasalance values were determined. RESULTS Nasal emission occurred postoperatively in only 27% (4/15) of the patients, whereas resonance disorders and articulation errors were prevalent in 87% (13/15) of the patient group. Compared with the control group, a significantly higher prevalence of hypernasality and significantly higher nasalance values for all oral and oronasal speech samples were obtained in the CP±L group. Moreover, significantly smaller consonant inventories and significantly more phonetic and phonological disorders were observed. CONCLUSIONS Delayed palatal repair (≥8years) seems to be insufficient to eliminate nasal airflow errors, resonance abnormalities, and articulation disorders. In order to prevent patients' late presentation at specialized centers, the availability of high quality surgical cleft palate treatment should increase as well as people's awareness of the possibility and importance of early surgical intervention. Moreover, speech therapy following delayed palatal closure would be beneficial. Furthermore, a standardized and validated protocol for speech assessment in future studies is advocated.
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Affiliation(s)
- Laura Bruneel
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - Anke Luyten
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - Kim Bettens
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - Evelien D'haeseleer
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - Cleo Dhondt
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - Andrew Hodges
- Comprehensive Rehabilitation Services in Uganda (CoRSU), P.O. Box 46, Kisubi, Uganda.
| | - George Galiwango
- Comprehensive Rehabilitation Services in Uganda (CoRSU), P.O. Box 46, Kisubi, Uganda.
| | - Hubert Vermeersch
- Ghent University, Department of Head and Neck Surgery, De Pintelaan 185 2P2, 9000 Gent, Belgium.
| | - Kristiane Van Lierde
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium; University of Pretoria, Faculty of Humanities, Department of Speech-Language Pathology and Audiology, Lynnwood Road Hillcrest, Pretoria, South Africa.
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25
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De Letter M, Vanhoutte S, Aerts A, Santens P, Vermeersch H, Roche N, Stillaert F, Blondeel P, Van Lierde K. Facial nerve regeneration after facial allotransplantation: A longitudinal clinical and electromyographic follow-up of lip movements during speech. J Plast Reconstr Aesthet Surg 2017; 70:729-733. [PMID: 28351610 DOI: 10.1016/j.bjps.2017.02.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 12/07/2016] [Accepted: 02/27/2017] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Facial allotransplantation constitutes a reconstructive option after extensive damage to facial structures. Functional recovery has been reported but remains an issue. CASE REPORT - METHODS A patient underwent facial allotransplantation after a ballistic injury with extensive facial tissue damage. Speech motor function was sequentially assessed clinically, along with repeated electromyography of lip movements during a follow-up of 3 years. RESULTS Facial nerve recovery could be demonstrated within the first month, followed by a gradual increase in electromyographic amplitude and decrease in reaction times. These were accompanied by gradual improvement of clinical assessments. CONCLUSIONS Axonal recovery starts early after transplantation. Electromyographic testing is sensitive in demonstrating this early recovery, which ultimately results in clinical improvements.
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Affiliation(s)
- Miet De Letter
- Department of Speech, Language and Hearing Sciences, Ghent University, Belgium; Department of Neurology, Ghent University Hospital, Belgium.
| | | | - Annelies Aerts
- Department of Neurology, Ghent University Hospital, Belgium
| | | | - Hubert Vermeersch
- Department of Head and Neck Surgery, Ghent University Hospital, Belgium
| | - Nathalie Roche
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Belgium
| | - Filip Stillaert
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Belgium
| | - Philip Blondeel
- Department of Plastic and Reconstructive Surgery, Ghent University Hospital, Belgium
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26
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Van Slycke S, Gillardin JP, Van Den Heede K, Minguet J, Vermeersch H, Brusselaers N. Comparison of the harmonic focus and the thunderbeat for open thyroidectomy. Langenbecks Arch Surg 2016; 401:851-9. [DOI: 10.1007/s00423-016-1448-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 05/11/2016] [Indexed: 02/04/2023]
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Luyten A, Bettens K, D'haeseleer E, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Short-term effect of short, intensive speech therapy on articulation and resonance in Ugandan patients with cleft (lip and) palate. J Commun Disord 2016; 61:71-82. [PMID: 27060419 DOI: 10.1016/j.jcomdis.2016.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 11/24/2015] [Accepted: 03/26/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The purpose of the current study was to assess the short-term effectiveness of short and intensive speech therapy provided to patients with cleft (lip and) palate (C(L)P) in terms of articulation and resonance. METHODS Five Ugandan patients (age: 7.3-19.6 years) with non-syndromic C(L)P received six hours of individualized speech therapy in three to four days. Speech therapy focused on correct phonetic placement and contrasts between oral and nasal airflow and resonance. Speech evaluations performed before and immediately after speech therapy, including perceptual and instrumental assessment techniques, were compared. RESULTS Post-therapy, improvement of speech was noted for most of the patients, although to varying degrees. Clinically relevant progress of objective nasalance values and/or articulation was obtained in four patients. Overall, two patients showed normal speech intelligibility, while three patients required additional speech therapy. CONCLUSION These preliminary short-term results demonstrate that short and intensive speech therapy can be effective for patients with C(L)P in countries with limited access to speech-language therapy. However, further research is needed on the long-term effectiveness and the advantages of applying this treatment protocol in countries with good access to speech therapy. LEARNING OUTCOMES The reader will be able to (1) list the challenges in resource poor-countries to achieve access to speech-language therapy services, (2) describe when the application of speech therapy is appropriate in patients with C(L)P, (3) describe the speech therapy that can be applied to reduce compensatory articulation and resonance disorders in patients with C(L)P, and (4) list the (possible) advantages of short, intensive speech therapy for both resource-poor and developed countries.
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Affiliation(s)
- A Luyten
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - K Bettens
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - E D'haeseleer
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
| | - A Hodges
- Comprehensive Rehabilitation Services in Uganda (CoRSU), P.O. Box 46, Kisubi, Uganda.
| | - G Galiwango
- Comprehensive Rehabilitation Services in Uganda (CoRSU), P.O. Box 46, Kisubi, Uganda.
| | - H Vermeersch
- Ghent University, Department of Head and Neck Surgery, De Pintelaan 185 2P2, 9000 Gent, Belgium.
| | - K Van Lierde
- Ghent University, Department of Speech, Language, and Hearing Sciences, De Pintelaan 185 2P1, 9000 Gent, Belgium.
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28
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De Roo N, Van Doorne L, Troch A, Vermeersch H, Brusselaers N. Quantifying the Impact of Surgical Treatment on Temporo-Mandibular Joint Ankylosis: a Systematic Review and Meta-analysis. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Bonte K, Huvenne W, De Loof M, Deron P, Viaene A, Duprez F, Vermeersch H. Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration. Dysphagia 2015; 30:695-701. [DOI: 10.1007/s00455-015-9646-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 07/31/2015] [Indexed: 11/28/2022]
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30
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Van Lierde KM, De Letter M, Vermeersch H, Roche N, Stillaert F, Lemmens G, Peeters P, Rogiers X, Blondeel P, Corthals P. Longitudinal progress of overall intelligibility, voice, resonance, articulation and oromyofunctional behavior during the first 21 months after Belgian facial transplantation. J Commun Disord 2015; 53:42-56. [PMID: 25576345 DOI: 10.1016/j.jcomdis.2014.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 08/13/2014] [Accepted: 09/13/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE The purpose of this study is to document the longitudinal progress of speech intelligibility, speech acceptability, voice, resonance, articulation and oromyofunctional behavior in a male facial transplant patient 8 days, 15 days, 5 months, 12 months and, finally, 21 months after surgery. METHOD Identical objective (Dysphonia Severity Index, nasometry, acoustic analysis) and subjective (consensus perceptual evaluation, Dutch speech intelligibility test; flexible videolaryngostroboscopy/naso-endoscopy) assessment techniques and questionnaires (speech and voice handicap index, oral health impact profile, facial disability index) were used during each of the five postsurgical assessments. RESULTS The pattern of results shows a longitudinal progress of speech intelligibility and acceptability and of the interactive processes underpinning overall speech intelligibility. Vocal quality is normal and resonance is characterized by hypernasality. The phonetic inventory is complete but four phonetic disorders remain. Outcomes pertaining to articulation (formant analysis) show evident progress over time. Lip functions are improving but still decreased. CONCLUSIONS Transplantation of the face in this patient has largely restored speech. To what extent resonance, articulation, and lip functions can be enhanced by the permanent use of a palatal obturator, by specialized facial and lip movement exercises in combination with motor-oriented speech therapy, is subject for further research. Learning outcomes Facial transplantation: Readers will be able to (1) describe the relationship between facial transplantation and the impact on speech and oromyofunctional behavior, (2) identify variables that influence the outcome after facial transplantation, (3) define an assessment protocol after facial transplantation, (4) define facial transplantation.
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Affiliation(s)
- Kristiane M Van Lierde
- Department of Speech, Language and Hearing sciences, University Gent, De Pintelaan 185, 9000 Gent, Belgium.
| | - Miet De Letter
- Department of Speech, Language and Hearing sciences, University Gent, De Pintelaan 185, 9000 Gent, Belgium
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Nathalie Roche
- Department of Plastic and Reconstructive Surgery, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Filip Stillaert
- Department of Plastic and Reconstructive Surgery, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Gilbert Lemmens
- Department of Psychiatry and Medical Psychology, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Patrick Peeters
- Department of Nephrology, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Xavier Rogiers
- Department of Transplant Surgery, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Phillip Blondeel
- Department of Plastic and Reconstructive Surgery, University Hospital, De Pintelaan 185, 9000 Gent, Belgium
| | - Paul Corthals
- Department of Speech, Language and Hearing sciences, University Gent, De Pintelaan 185, 9000 Gent, Belgium
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Van Lierde KM, Bettens K, Luyten A, Plettinck J, Bonte K, Vermeersch H, Roche N. Oral strength in subjects with a unilateral cleft lip and palate. Int J Pediatr Otorhinolaryngol 2014; 78:1306-10. [PMID: 24882455 DOI: 10.1016/j.ijporl.2014.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/09/2014] [Accepted: 05/13/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE Facial appearance and speech outcome may affect psychosocial functioning in girls and boys. Several studies reported dissatisfaction with facial appearance and more specifically the lip and mouth profile in children with cleft lip and palate (CLP). The purpose of this controlled study was to measure the tongue and lip strength and endurance in boys and girls with CLP. METHODS Twenty-five subjects (mean age: 10.6 years) with a unilateral CLP and a gender- and age- matched control group were selected. All subjects with an unilateral CLP consulted the same craniofacial team and had undergone an identical surgical procedure. Surgical procedure of the lip was performed using a modified Millard technique without primary nose correction at an average age of 5.5 months. The Iowa Oral Performance instrument was used to measure lip and tongue strength and tongue endurance. RESULTS The results of the Iowa Oral Performance measurement showed no significant differences between the subjects with an unilateral cleft lip and palate and the age and gender matched control group without a cleft lip and palate. CONCLUSION There is no significant differences regarding oral strength more specifically the lip and tongue strength and endurance between subjects with and without an unilateral cleft lip and palate. ENT specialists and speech pathologists must be aware of this aspect of the normal lip and tongue functions.
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Affiliation(s)
| | - Kim Bettens
- Department of Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Anke Luyten
- Department of Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Janne Plettinck
- Department of Speech, Language and Hearing Sciences, Ghent University, Belgium
| | - Katrien Bonte
- Department of Head and Neck Surgery, Ghent University Hospital, Belgium
| | - Hubert Vermeersch
- Department of Head and Neck Surgery, Ghent University Hospital, Belgium
| | - Nathalie Roche
- Department of Plastic Surgery, Ghent University Hospital, Belgium
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Luyten A, Bettens K, D'haeseleer E, De Ley S, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Impact of Early Synchronous Lip and Palatal Repair on Speech. Folia Phoniatr Logop 2014; 65:303-11. [DOI: 10.1159/000362501] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Van Slycke S, Stockman A, Dionigi G, Carette R, Gillardin, JP, Brusselaers N, Vermeersch H. Harlequin syndrome after thyroidectomy for compressive retrosternal goiter. Case report and review of the literature. Acta Chir Belg 2014; 114:212-4. [PMID: 25102714 DOI: 10.1080/00015458.2014.11681012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 74-year-old woman with known euthyroid multinodular retrosternal goiter necessitated an urgent intubation at home, due to acute respiratory distress evoked by tracheal compression. Extubation after a few days failed, and she underwent an urgent total thyroidectomy. During postoperative extubation the patient developed suddenly unilateral facial flushing and sweating at the left side, without ptosis of the left levator palpebrae superioris. These symptoms persisted during the next 24 hours. The skin at the right side of the face remained uninvolved. In the early postoperative period this appearance recurred at moments of emotions, exercise or heat. Beside this, the patient had a normal recovery. Six weeks later this reaction couldn't be provoked anymore. 'Harlequin' syndrome (unilateral facial flushing and sweating) is caused by a lesion of the controlateral sympathetic chain at the levels T2 and T3. It is unknown if the sweating and vasodilation at the "healthy" side is normal or if it is a reaction of hyperactivity.
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Affiliation(s)
- S. Van Slycke
- Department of General and Endocrine Surgery OLV Clinic Aalst Belgium
- Department of Head and Neck Surgery University Hospital Ghent Belgium
| | - A. Stockman
- Department of General and Endocrine Surgery OLV Clinic Aalst Belgium
| | - G. Dionigi
- Department of Endocrine Surgery-University of Insubria (Varese-Como) Italy
| | - R. Carette
- Department of Anesthesia and Intensive Care OLV Clinic Aalst Belgium
| | - J.-P. Gillardin,
- Department of General and Endocrine Surgery OLV Clinic Aalst Belgium
| | - N. Brusselaers
- Department of Internal Medicine and Infectious Diseases University Hospital Ghent Belgium
| | - H. Vermeersch
- Department of General and Endocrine Surgery OLV Clinic Aalst Belgium
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Van Lierde KM, Roche N, De Letter M, Corthals P, Stillaert F, Vermeersch H, Blondeel P. Speech characteristics one year after first Belgian facial transplantation. Laryngoscope 2014; 124:2021-7. [DOI: 10.1002/lary.24585] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 12/19/2013] [Accepted: 12/31/2013] [Indexed: 11/06/2022]
Affiliation(s)
| | - Nathalie Roche
- Department of Plastic Surgery; University Hospital Ghent; Ghent Belgium
| | - Miet De Letter
- Department of Speech; Language and Hearing Sciences; University Ghent; Ghent Belgium
| | - Paul Corthals
- Department of Speech; Language and Hearing Sciences; University Ghent; Ghent Belgium
| | - Filip Stillaert
- Department of Plastic Surgery; University Hospital Ghent; Ghent Belgium
| | - Hubert Vermeersch
- Department of Head and Neck Surgery; University Hospital Ghent; Ghent Belgium
| | - Philippe Blondeel
- Department of Plastic Surgery; University Hospital Ghent; Ghent Belgium
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Luyten A, D'haeseleer E, Budolfsen D, Hodges A, Galiwango G, Vermeersch H, Van Lierde K. Parental satisfaction in Ugandan children with cleft lip and palate following synchronous lip and palatal repair. J Commun Disord 2013; 46:321-329. [PMID: 23528930 DOI: 10.1016/j.jcomdis.2013.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 02/18/2013] [Accepted: 03/01/2013] [Indexed: 06/02/2023]
Abstract
UNLABELLED The purpose of the present case control study was to assess parental satisfaction with speech and facial appearance in Ugandan children with complete unilateral or bilateral cleft lip and palate (CLP), who underwent a synchronous lip and palatal closure. The results are compared with an age- and gender-matched control group. The experimental group consisted of the parents or guardians of 44 Ugandan patients (21 males, 23 females) with complete unilateral or bilateral CLP (mean age: 3;1 years). The control group included the foster mothers of 44 orphan children matched by age and gender (mean age: 3;7 years). A survey based on the Cleft Evaluation Profile was used to assess the perceived satisfaction for individual features related to cleft care. Overall high levels of satisfaction were observed in the experimental group for all features (range: 56-100%). No significant differences could be established regarding age, gender, age of lip and palatal closure, cleft type or maternal vs. paternal judgments. In participants who were dissatisfied with the appearance of the lip, the time period between the cleft closure and the survey was significantly larger compared with satisfied participants. Furthermore, significantly lower levels of satisfaction were observed in the cleft group for speech and the appearance of the teeth and the nose compared with the control group. Satisfaction with speech and facial appearance in Ugandan children with cleft lip and/or palate is important since normal esthetics and speech predominantly determine the children's social acceptance in the Ugandan society. LEARNING OUTCOMES As a result of reading this manuscript, the reader will be able to explain the attitudes of parents toward the surgical repair of their children's cleft lip and palate. As a result of reading this manuscript, the reader will be able to identify differences in parental attitudes toward synchronous lip and palate repair.
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Affiliation(s)
- Anke Luyten
- Ghent University, Department of Otorhinolarygnology, Logopaedic and Audiologic Sciences, De Pintelaan 185, 2P1, 9000 Gent, Belgium.
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Lambrecht P, Vandeplas G, Van Slycke S, Smet PF, Brusselaers N, Vermeersch H. Phototoxic reaction after parathyroid surgery: case report and review of the literature. Acta Clin Belg 2013; 67:438-41. [PMID: 23340151 DOI: 10.2143/acb.67.6.2062710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND A woman of 41 years old underwent surgery for primary hyperparathyroidism. She developed a long-lasting sharply demarcated erythematous skin reaction, appearing one hour after parathyroid surgery. This erythematous reaction felt like sunburn and was limited to the light exposed skin of the operation field, leading to the diagnosis of a phototoxic reaction. Since this phototoxic reaction occurred just after changing the operation lamp from a halogen type to a Light-Emitting Diode (LED) type, we suspected that the type of operation lamp could be a part of the cause of this phototoxic reaction. This is because our department has never before diagnosed phototoxic reactions (with a halogen type of operation lamp) during methylene blue (MB) assisted parathyroid surgery. METHODS To investigate the cause of this phototoxic reaction, we performed an analysis of the adverse effects of all administered peroperative drugs and an evaluation of altered operation conditions. RESULTS MB, used as a peroperative surgical marker of the parathyroid glands, was the most likely causal agent of this phototoxic reaction. Emission spectrum analysis of the operation light shows that the new LED operation lamp gives a high intensity of blue light. This may have resulted in activation of MB leading to a phototoxic reaction. CONCLUSIONS To our knowledge, this is the first described phototoxic reaction in adults due to MB used as peroperative marker. Although rare, this potential side effect should be considered when using high doses of MB in combination with high intensity of blue light.
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Affiliation(s)
- P Lambrecht
- Faculty of Medicine and Healt Sciences, Ghent University Hospital, Belgium
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Van Slycke S, Gillardin JP, Brusselaers N, Vermeersch H. Initial experience with S-shaped electrode for continuous vagal nerve stimulation in thyroid surgery. Langenbecks Arch Surg 2013; 398:717-22. [DOI: 10.1007/s00423-013-1068-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 02/18/2013] [Indexed: 10/27/2022]
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Luyten A, Dhaeseleer E, Hodges A, Galiwango G, Budolfsen T, Vermeersch H, Van Lierde K. Normative Nasalance Data in Ugandan English-Speaking Children. Folia Phoniatr Logop 2012; 64:131-6. [DOI: 10.1159/000338235] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Deron P, Vermeersch H, Mees G, Vangestel C, Pauwels P, Van de Wiele C. Expression and prognostic value of glucose transporters and hexokinases in tonsil and mobile tongue squamous cell carcinoma. Histol Histopathol 2011; 26:1165-72. [PMID: 21751148 DOI: 10.14670/hh-26.1165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to assess the expression pattern and prognostic value of the high affinity glucose transporters GLUT-1, 3, 4, 8 and 9, SGLT-1 and of hexokinases (HK) I, II and III in squamous cell carcinoma of the tonsil and mobile tongue (TTSCC) by means of immunohistochemistry. Seventy-one consecutive patients suffering from TTSCC were included. The intensity and amount of positive tumour cells in the immunoreaction (histology score (H-score)) for GLUT-1, 3, 4, 8 and 9 as well as for HK-I, II and III were assessed independently by two experienced observers, blinded to the clinical results. H-scores as well as clinical variables were related to patient outcome. Median follow-up time was 49 months (range 1-123 months). Mean H-scores for GLUT expression in decreasing order of magnitude were respectively 10.99 for GLUT-1 (sd 3.9), 5.7 for GLUT-8 (sd 4.0), 5.4 for GLUT-3 (sd 3.7), 1.0 for GLUT-4 (sd 2.0), 1.1 (sd 1.3) for SGLT-1, and 0.4 for GLUT-9 (sd 0.6); GLUT-1 > GLUT-8 = GLUT-3 > GLUT-4 = GLUT-9 = SGLT-1 (with > meaning significantly (p<0.05 on ANOVA + posthoc Bonferroni correction) higher than and =, meaning not significantly different from). Mean H-scores for hexokinase expression were respectively 5.8 for HK-I (sd 3.5), 4.6 for HK-II (sd 3.0) and 2.0 for HK-III (sd 2.0); HK-I > HK-II > HK-III. Finally high H-scores for GLUT-4 were favourably related to disease-free and overall survival on multivariate analysis. To conclude, TTSCC expresses a wide variety of glucose transporter systems and hexokinase enzymes with the "housekeeping" GLUT-1 and HK-I being the most intensely expressed. GLUT-4 over-expression appears to confer a favourable prognosis in squamous cell carcinoma of the tonsil and mobile tongue. Additional studies confirming this finding in larger cohorts of patients are mandatory.
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Affiliation(s)
- Philippe Deron
- Department of Head and Neck Surgery, University Hospital Ghent, Gent, Belgium.
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Van Lierde K, Galiwango G, Hodges A, Bettens K, Luyten A, Vermeersch H. Impact of tongue reduction on overall speech intelligibility, articulation and oromyofunctional behavior in 4 children with Beckwith-Wiedemann syndrome. Folia Phoniatr Logop 2011; 64:55-63. [PMID: 22095257 DOI: 10.1159/000329569] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to determine the impact of partial glossectomy (using the keyhole technique) on speech intelligibility, articulation, resonance and oromyofunctional behavior. PATIENTS AND METHODS A partial glossectomy was performed in 4 children with Beckwith- Wiedemann syndrome between the ages of 0.5 and 3.1 years. An ENT assessment, a phonetic inventory, a phonemic and phonological analysis and a consensus perceptual evaluation of speech intelligibility, resonance and oromyofunctional behavior were performed. RESULTS It was not possible in this study to separate the effects of the surgery from the typical developmental progress of speech sound mastery. Improved speech intelligibility, a more complete phonetic inventory, an increase in phonological skills, normal resonance and increased motor-oriented oral behavior were found in the postsurgical condition. The presence of phonetic distortions, lip incompetence and interdental tongue position were still present in the postsurgical condition. CONCLUSION Speech therapy should be focused on correct phonetic placement and a motor-oriented approach to increase lip competence, and on functional tongue exercises and tongue lifting during the production of alveolars. Detailed analyses in a larger number of subjects with and without Beckwith-Wiedemann syndrome may help further illustrate the long-term impact of partial glossectomy.
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Affiliation(s)
- K Van Lierde
- Department of ENT, Head and Neck Surgery and Logopaedics, University Hospital Gent, Gent , Belgium.
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Deron P, Mertens K, Goethals I, Rottey S, Duprez F, De Neve W, Vermeersch H, Van de Wiele C. Metabolic tumour volume. Prognostic value in locally advanced squamous cell carcinoma of the head and neck. Nuklearmedizin 2011; 50:141-6. [PMID: 21594304 DOI: 10.3413/nukmed-0367-10-11] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 03/01/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE Evaluate the predictive and prognostic value of semi-quantitative FDG-PET variables derived from pretreatment FDG-PET images in patients suffering from locally advanced squamous cell carcinoma of the head and neck (SCCHN), treated by means of concomitant radiochemotherapy. PATIENTS, METHODS 40 patients with newly diagnosed SCCHN that were treated with concomitant radiochemotherapy underwent FDG-PET/CT for treatment planning; 18 patients had neck dissection prior to their baseline scan and to receiving radiochemotherapy. FDG-PET images were used to calculate metabolic tumour volumes using region growing and a threshold of 50% (MTV50) of primary lesions and involved lymph nodes as well as the mean and maximum standard uptake value (SUVmean and SUVmax) of the primary tumours. RESULTS Neither SUVmean nor SUVmax values of the primary tumour were significantly different between responders and non-responders whereas MTV50 values of the primary tumour proved significantly higher in non-responders. SUVmean, SUVmax and MTV50 of the primary tumour were not predictive for overall or disease free survival. Contrariwise, dichotomized summed MTV50 values (cut-off≥31 cm3) of the primary tumour and involved lymph nodes in patients that didn't have neck dissection prior to radiochemotherapy were predictive for disease free and overall survival in both univariate and multivariate analysis (p≤0.05). CONCLUSION Summed MTV50 values of both the primary tumour and involved lymph nodes provided independent prognostic information on disease free and overall survival.
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Affiliation(s)
- P Deron
- Ghent University Hospital, Department of Head and Neck Surgery, Gent, Belgium.
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Van Lierde KM, Luyten A, Mortier G, Tijskens A, Bettens K, Vermeersch H. Overall intelligibility, articulation, resonance, voice and language in a child with Nager syndrome. Int J Pediatr Otorhinolaryngol 2011; 75:270-6. [PMID: 21145116 DOI: 10.1016/j.ijporl.2010.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 11/08/2010] [Accepted: 11/13/2010] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The purpose of this study was to provide a description of the language and speech (intelligibility, voice, resonance, articulation) in a 7-year-old Dutch speaking boy with Nager syndrome. To reveal these features comparison was made with an age and gender related child with a similar palatal or hearing problem. METHODS Language was tested with an age appropriate language test namely the Dutch version of the Clinical Evaluation of Language Fundamentals. Regarding articulation a phonetic inventory, phonetic analysis and phonological process analysis was performed. A nominal scale with four categories was used to judge the overall speech intelligibility. A voice and resonance assessment included a videolaryngostroboscopy, a perceptual evaluation, acoustic analysis and nasometry. RESULTS The most striking communication problems in this child were expressive and receptive language delay, moderately impaired speech intelligibility, the presence of phonetic and phonological disorders, resonance disorders and a high-pitched voice. The explanation for this pattern of communication is not completely straightforward. The language and the phonological impairment, only present in the child with the Nager syndrome, are not part of a more general developmental delay. The resonance disorders can be related to the cleft palate, but were not present in the child with the isolated cleft palate. One might assume that the cul-de-sac resonance and the much decreased mandibular movement and the restricted tongue lifting are caused by the restricted jaw mobility and micrognathia. To what extent the suggested mandibular distraction osteogenesis in early childhood allows increased mandibular movement and better speech outcome with increased oral resonance is subject for further research. CONCLUSION According to the results of this study the speech and language management must be focused on receptive and expressive language skills and linguistic conceptualization, correct phonetic placement and the modification of hypernasality and nasal emission.
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Affiliation(s)
- Kristiane M Van Lierde
- Department of Otorhinolaryngology and Speech Language Pathology, University Gent, Belgium.
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Roodenburg JLN, de Jong RJB, Reintsema H, van Laer CG, Langendijk JA, Vermeersch H, Vermorken JB. Hoofd-halstumoren. ONCOLOGIE 2011. [DOI: 10.1007/978-90-313-8476-1_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Deron P, Vangestel C, Goethals I, De Potter A, Peeters M, Vermeersch H, Van de Wiele C. FDG uptake in primary squamous cell carcinoma of the head and neck. The relationship between overexpression of glucose transporters and hexokinases, tumour proliferation and apoptosis. Nuklearmedizin 2010; 50:15-21. [PMID: 21052609 DOI: 10.3413/nukmed-0324-10-06] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 10/19/2010] [Indexed: 01/12/2023]
Abstract
AIM This study aimed at assessing the relationship between over-expression of glucose transporters and hexokinases, tumour proliferation and apoptosis corrected for cellularity and partial volume corrected (pvc) FDG SUV values in primary squamous cell carcinoma of the head and neck (pSCCHN). PATIENTS, METHODS In 27 consecutive patients suffering from pSCCHN, FDG SUVmax and mean pvc values of the primary tumour were derived from a pre-surgical routine staging FDG PET/CT examination. GLUT-1, GLUT-3, HK-1, HK-3 expression, tumour proliferation (Ki-67 staining) and the number of apoptotic cells (cleaved caspase-3 staining), corrected for tumour cellularity, were subsequently assessed on the corresponding post-surgically obtained biopsies and tumour specimens. FDG SUVmax and mean pvc values of pSCCHN were correlated with the corresponding histological findings. RESULTS FDG SUV max and mean pvc values correlated significantly: with GLUT-1 scores r = 0.408 (p = 0.04) and r = 0.439 (p = 0.03) as well as with the number of apoptotic cells r = 0.529 (p = 0.008) and r = 0.484 (p = 0.017). The number of apoptotic cells also correlated to GLUT-3 scores: r = 0.62 (p = 0.001) and GLUT-1 scores r = 0.528 (p = 0.008). CONCLUSION FDG SUV pvc proved significantly related to GLUT-1 expression by tumour cells and to the absolute number of apoptotic cells. The latter finding warrants further exploration and confirmation by additional studies.
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Affiliation(s)
- P Deron
- Department of Head and Neck Surgery, Ghent University Hospital, De Pintelaan 185, 9000-B Gent, Belgium.
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François P, Hamoir G, Sonveaux E, Vermeersch H, Ma Y. On the Phosphorylation of Deoxyribonucleosides and the Protection of Deoxyguanosine. ACTA ACUST UNITED AC 2010. [DOI: 10.1002/bscb.19850941109] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Van Lierde K, Luyten A, Van Borsel J, Baudonck N, Debusschere T, Vermeersch H, Bonte K. Speech intelligibility of children with unilateral cleft lip and palate (Dutch cleft) following a one-stage Wardill–Kilner palatoplasty, as judged by their parents. Int J Oral Maxillofac Surg 2010; 39:641-6. [DOI: 10.1016/j.ijom.2010.02.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2008] [Revised: 07/03/2009] [Accepted: 02/01/2010] [Indexed: 11/16/2022]
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Van Lierde KM, Mortier G, Huysman E, Vermeersch H. Long-term impact of tongue reduction on speech intelligibility, articulation and oromyofunctional behaviour in a child with Beckwith-Wiedemann syndrome. Int J Pediatr Otorhinolaryngol 2010; 74:309-18. [PMID: 20079942 DOI: 10.1016/j.ijporl.2009.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 12/11/2009] [Indexed: 11/27/2022]
Abstract
The purpose of the present case study was to determine the long-term impact of partial glossectomy (using the keyhole technique) on overall speech intelligibility and articulation in a Dutch-speaking child with Beckwith-Wiedemann syndrome (BWS). Furthermore the present study is meant as a contribution to the further delineation of the phonation, resonance, articulation and language characteristics and oral behaviour in a child with BWS. Detailed information on the speech and language characteristics of children with BWS may lead to better guidance of pediatric management programs. The child's speech was assessed 9 years after partial glossectomy with regard to ENT characteristics, overall intelligibility (perceptual consensus evaluation), articulation (phonetic and phonological errors), voice (videostroboscopy, vocal quality), resonance (perceptual, nasometric assessment), language (expressive and receptive) and oral behaviour. A class III malocclusion, an anterior open bite, diastema, overangulation of lower incisors and an enlarged but normal symmetric shaped tongue were present. The overall speech intelligibility improved from severely impaired (presurgical) to slightly impaired (5 months post-glossectomy) to normal (9 years postoperative). Comparative phonetic inventory showed a remarkable improvement of articulation. Nine years post-glossectomy three types of distortions seemed to predominate: a rhotacism and sigmatism and the substitution of the alveolar /z/. Oral behaviour, vocal characteristics and resonance were normal, but problems with expressive syntactic abilities were present. The long-term impact of partial glossectomy, using the keyhole technique (preserving the vascularity and the nervous input of the remaining intrinsic tongue muscles), on speech intelligibility, articulation, and oral behaviour in this Dutch-speaking child with congenital macroglossia can be regarded as successful. It is not clear how these expressive syntactical problems demonstrated in this child can be explained. Certainly they are not part of a more general developmental delay, hearing problems or cognitive malfunctioning. To what extent the presence of expressive syntactical problems is a possible aspect of the phenotypic spectrum of children with BWS is subject for further research. Multiple variables, both known and unknown can affect the long-term outcome after partial glossectomy in a child with BWS. The timing and type of the surgical technique, hearing and cognitive functioning are known variables in this study. But variables such as children's motivation, the contribution of the motor-oriented speech therapy, the parental articulation input and stimulation and other family, school and community factors are unknown and are all factors which can influence speech outcome after partial glossectomy. Detailed analyses in a greater number of subjects with BWS may help further illustrate the long-term impact of partial glossectomy.
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Affiliation(s)
- K M Van Lierde
- Department of Otorhinolaryngology, Head and Neck Surgery and Speech Language Pathology, University Hospital, 2P1 De Pintelaan 185, 9000 Gent, Belgium.
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Claeys S, Van Zele T, Vermeersch H. Why do we prefer the external approach? B-ENT 2010; 6 Suppl 15:35-39. [PMID: 21305922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Open structure rhinoplasty (OSR) is an old technique that has gained in popularity amongst plastic surgeons and otolaryngologists over the past twenty years. Opponents of the external approach cite potential problems such as unnecessary scaring, reduction of tip support, extended operative time and excessive post-operative tip swelling. However, even relatively inexperienced rhinoplastic surgeons embrace this approach, especially in cases with more complex tip deformities and skeletal abnormalities. Concerns about scarring and post-operative tissue reaction due to the more "aggressive" external approach make it necessary to consider the indications for the open approach carefully. Various incisions have been described for open rhinoplasty to reduce scarring, such as the Z, V, reverse V, and W incisions. There should be a strong emphasis on post-operative care in open approach rhinoplasty since open structure rhinoplasty is generally considered to be a more traumatic technique than the endonasal approach. Careful incision and dissection of the skin flap in the right surgical plane and proper suturing are essential to avoid short- and long-term complications. In conclusion, the external approach is preferable in selected cases where extended exposure (asymmetry cases, for example), per-operative assessment (revision cases), grafting and suturing are required. It allows the surgeon to work bimanually during reconstruction and the better per-operative evaluation reduces the revision rate.
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Affiliation(s)
- S Claeys
- Ear, Nose and Throat Department, Ghent University Hospital, Belgium.
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Van Lierde K, D'haeseleer E, Wuyts FL, Baudonck N, Bernaert L, Vermeersch H. Impact of thyroidectomy without laryngeal nerve injury on vocal quality characteristics: An objective multiparameter approach. Laryngoscope 2009; 120:338-45. [DOI: 10.1002/lary.20762] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cicone F, Loose D, Deron P, Vermeersch H, Signore A, Van de Vyvere F, Scopinaro F, Van de Wiele C. Prognostic value of FDG uptake by the bone marrow in squamous cell carcinoma of the head and neck. Nucl Med Commun 2008; 29:431-5. [PMID: 18391726 DOI: 10.1097/mnm.0b013e3282f5d2ce] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The appearance of natural suppressor cells and circulating endothelial progenitor cells in tumour tissue has been associated with myelopoetic stimulation by growth factors that may increase fluorodeoxyglucose (FDG) uptake by the bone marrow and high FDG uptake by bone marrow in patients suffering from human malignancies is a not uncommon finding. METHODS This study looked at the relationship between bone marrow FDG uptake, biochemical (Hb level, RBC count, WBC count and platelet count), clinical and radiological findings and outcome in a series of 35 patients suffering from squamous cell carcinoma of the head and neck (SCCHN), consecutively referred for FDG PET as part of their routine staging procedure. RESULTS AND CONCLUSION In SCCHN, mean FDG standardized uptake values (SUVs) of the primary tumour correlate significantly with blood WBC count (r=0.44; P=0.011, Bonferroni corrected P=0.04) and mean FDG SUVs of bone marrow are significantly correlated to the maximum FDG SUVs of the primary tumour (r=0.523; P=0.002). Finally, FDG uptake by the bone marrow is related to disease-free and overall survival. These findings warrant confirmation in a larger patient series.
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Affiliation(s)
- Francesco Cicone
- Department of Nuclear Medicine, 2nd Faculty of Medicine, University La Sapienza, Rome, Italy
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