Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539.

Background: Three- and five-year progression-free survival (PFS) for low-risk meningioma managed with surgery and observation reportedly exceeds 90%. Herewith we summarize outcomes for low-risk meningioma patients enrolled on NRG/RTOG 0539.

Methods: This phase II trial allocated patients to one of three groups per World Health Organization grade, recurrence status, and resection extent.

Orientation of the round window membrane: A normative study of inner ear anatomical orientation using 2D projections of 3D volumes.

Introduction: Orientation of the Round Window Membrane (RWM) is an important metric to establish if utilized as a potential access for targeted delivery of magnetically guided nanomedicines to the inner ear. Orientation with respect to an internal reference frame (such as the planes defined by the semicircular-canals [SCC]) may provide an internally consistent basis if the basis is orthogonal and consistent (from patient to patient).

Materials And Methods: Utilizing a micro computed tomography (CT), 20 temporal bones are scanned for anatomical information.

High-risk Meningioma: Initial Outcomes From NRG Oncology/RTOG 0539.

Background: Phase 2 cooperative group meningioma trial assessing the safety and efficacy of risk-adaptive management strategies. This is the initial analysis of the high-risk cohort.

Methods And Materials: High-risk patients were those with a new or recurrent World Health Organization (WHO) grade III meningioma of any resection extent, recurrent WHO grade II of any resection extent, or new WHO grade II after subtotal resection.

Ultrasonography of Cervical Lymph Nodes.

Ultrasonography is an excellent method for imaging evaluation of cervical lymph nodes. This article provides an image-rich review of the sonographic manifestations of diseases involving the cervical lymph nodes, with an emphasis on the expected anatomic distribution of diseases.

Ultrasound-Guided Fine-Needle Aspiration With Optional Core Needle Biopsy of Head and Neck Lymph Nodes and Masses: Comparison of Diagnostic Performance in Treated Squamous Cell Cancer Versus All Other Lesions.

Objectives: To evaluate the diagnostic performance of ultrasound (US)-guided fine-needle aspiration with optional core needle biopsy of head and neck lymph nodes and masses, with attention to differences between biopsy of treated squamous cell carcinoma (SCC) and biopsy of other lesions.

Methods: Institutional Review Board approval was obtained, and the need for consent was waived for this retrospective study. All 861 US-guided biopsies of head and neck lymph nodes and masses performed between March 1, 2012, and May 16, 2016, were reviewed.

Pediatric Central Nervous System Imaging of Nonaccidental Trauma: Beyond Subdural Hematomas.

Infants and children under 2 years of age are at greatest risk for devastating neurologic complications following nonaccidental trauma. While a subdural hematoma (SDH) is the most common finding and is often enough to raise suspicion for abuse, no single injury is pathognomonic for abusive head trauma (AHT). Rather, the combination of imaging and physical findings and the clinical presentation help confirm the diagnosis of AHT.

Intermediate-risk meningioma: initial outcomes from NRG Oncology RTOG 0539.

OBJECTIVE This is the first clinical outcomes report of NRG Oncology RTOG 0539, detailing the primary endpoint, 3-year progression-free survival (PFS), compared with a predefined historical control for intermediate-risk meningioma, and secondarily evaluating overall survival (OS), local failure, and prospectively scored adverse events (AEs). METHODS NRG Oncology RTOG 0539 was a Phase II clinical trial allocating meningioma patients to 1 of 3 prognostic groups and management strategies according to WHO grade, recurrence status, and resection extent. For the intermediate-risk group (Group 2), eligible patients had either newly diagnosed WHO Grade II meningioma that had been treated with gross-total resection (GTR; Simpson Grades I-III) or recurrent WHO Grade I meningioma with any resection extent.

Fine-needle aspiration with selective use of core needle biopsy of major salivary gland tumors.

Objectives: Preferential use of fine-needle aspiration (FNA) versus core needle biopsy (CNB) for distinguishing benign from malignant major salivary gland tumors is highly debated. The main disadvantage of FNA is lower sensitivity, whereas arguments against CNB include use of a larger bore needle and greater risk of complications. The aim of this study is to evaluate our experience performing ultrasound-guided (UG) FNA with selective use of CNB based on preliminary cytopathology, and to determine whether our preoperative diagnostic approach is more sensitive and specific than FNA alone-and at least as sensitive and specific as CNB alone.

The New Interventional Radiology Pathways: Options for Implementation.

The new interventional radiology (IR) pathways have generated much discussion with articles and editorials pointing out perceived advantages and disadvantages compared to the current pathways. To briefly review, under the new system, there are three pathways to enter IR: the integrated (INT) IR residency, the independent (IND) IR residency, and the early specialization in interventional radiology (ESIR) program. The pathways have been designed to provide maximum flexibility to programs for implementation and to radiology residents for planning their subspecialty training.

Ultrasound-Guided Transcutaneous Needle Biopsy of the Base of the Tongue and Floor of the Mouth From a Submental Approach.

Limited data exist regarding the feasibility of ultrasound-guided transcutaneous biopsy of the base of the tongue and floor of the mouth. This retrospective study reviewed 8 cases with lesions in the base of the tongue or floor of the mouth that were biopsied by fine-needle aspiration. Core biopsy was also needed in 1 case.

Feasibility and implementation of a literature information management system for human papillomavirus in head and neck cancers with imaging.

This work examines the feasibility and implementation of information service-orientated architecture (ISOA) on an emergent literature domain of human papillomavirus, head and neck cancer, and imaging. From this work, we examine the impact of cancer informatics and generate a full set of summarizing clinical pearls. Additionally, we describe how such an ISOA creates potential benefits in informatics education, enhancing utility for creating enduring digital content in this clinical domain.

Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis.

Osmotic demyelination syndrome (ODS) refers to central pontine myelinolysis and extrapontine myelinolysis. These disorders are characterized by insults to regions of the brain with anatomical features predisposing white matter tracts to myelin injury in the setting of osmotic disturbances and their attempted correction. Occurring independently or in combination, central pontine myelinolysis and extrapontine myelinolysis share a characteristic timing of onset, but distinct clinical features.

Microglia and a functional type I IFN pathway are required to counter HSV-1-driven brain lateral ventricle enlargement and encephalitis.

HSV-1 is the leading cause of sporadic viral encephalitis, with mortality rates approaching 30% despite treatment with the antiviral drug of choice, acyclovir. Permanent neurologic deficits are common in patients that survive, but the mechanism leading to this pathology is poorly understood, impeding clinical advancements in treatment to reduce CNS morbidity. Using magnetic resonance imaging and type I IFN receptor-deficient mouse chimeras, we demonstrate HSV-1 gains access to the murine brain stem and subsequently brain ependymal cells, leading to enlargement of the cerebral lateral ventricle and infection of the brain parenchyma.

Biofilms in chronic suppurative otitis media and cholesteatoma: scanning electron microscopy findings.

Background: Biofilms play a role in the pathogenesis of a variety of otorhinolaryngologic diseases, including otitis media and cholesteatoma. Despite this, relatively few studies have undertaken to demonstrate the presence of biofilms tissues from patients with chronic otitis media or infected cholesteatoma.

Objective/hypothesis: Our objective is to detect evidence of biofilms human chronic ear infections with scanning electron microscopy (SEM).

Have you wondered about your colleague's surgical skills?

Surgical skills are important for surgical competence. Surgical skills may be assessed during residency but are not routinely evaluated in practicing surgeons. The current literature is reviewed to evaluate models for objectively assessing surgical skills.

Prevention of head injuries in children bicyclists: a proposal.

Bicycle-related head injury is a significant source of morbidity in children. Upon review of contemporary approaches for reducing such injuries, summarized herein, the authors conclude that a school-based promotion of proper helmet usage represents a reasonable compromise between expediency and probability of success. This proposal contains an outline for a pilot program to be implemented in an elementary school setting.