OnlineFirst
Last updated December 16, 2019
1 – 100 of 371
Sort:
Clinic
Open Access
Double Ring in Cochlear Otosclerosis: A Limit to Cochlear Implantation? The Solution Is the Surgical Approach
Daniela Messineo, MD, Massimo Ralli, MD, PhD, Antonio Greco, MD, Arianna Di Stadio, MD, PhD
First Published 16 Dec 2019.https://doi.org/10.1177/0145561319895601
Abstract
Hide Preview
We present a case of a 50-year patient with a severe form of otosclerosis (double ring) that was successfully implanted. We used a bone-anchored hearing implant for restoring the hearing in the right side and a cochlear implant in the left side; both surgeries did not show any complications. For reducing the risk of a secondary bone ossification related to the trauma of cochleostomy for electrode’s insertion, we used a round window approach. The patient recovered a normal auditory threshold and normal speech perception capacity both in silence and noise conditions 1 year after surgery.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes
Andrea Ciorba, PhD, Maria Paola Guidi, MD, Piotr H. Skarżyński, MD, Chiara Bianchini, MD, Monica Rosignoli, MS, Manuela Mazzoli, MD, Stefano Pelucchi, MD, Stavros Hatzopoulos, PhD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319892461
Abstract
Hide Preview
The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment
Jerome R. Lechien, MD, PhD, MSc, Gersende Debie, MD, Virginie Mahillon, MD, Marie-Paule Thill, MD, Alexandra Rodriguez, MD, Mihaela Horoi, MD, Stelianos Kampouridis, MD, Vinciane Muls, MD, Sven Saussez, MD, PhD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319892460
Abstract
Hide Preview
Objectives:
To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure.
Material and Methods:
Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments.
Results:
Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP.
Conclusion:
Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
No-Show Rates in Employed Otolaryngology Practice
Brett T. Comer, MD, Lauren E. Harris, BS, Caitlin E. Fiorillo, MD, Thomas J. Gal, MD, MPH, Allyson Hughes, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893157
Abstract
Hide Preview
Objective:
To report baseline no-show rates in the hospital-employed otolaryngology practice setting and to identify factors that may affect clinic show rates that are targets for potential improvement.
Study Design:
Retrospective chart review.
Methods:
Electronic medical records from October 2012 through July 2014 of a hospital-employed otolaryngology practice were reviewed. Patients were classified by insurance type: commercial, Medicare, Medicaid, and self-pay. Clinic visits were classified as new patient, follow-up, or postoperative. No-show rates were tabulated for each type of clinic visit and compared. Factors to improve no-show rates are discussed.
Results:
There was an overall no-show rate of 8.3% for 5817 scheduled clinic visits. Among visit types, follow-up visits had the highest no-show rates. Among insurance types, Medicaid had the highest no-show rates. New patient Medicaid patients, follow-up Medicaid patients, and follow-up commercial insurance patients had the highest rate of no-shows among visit/insurance type combinations. Persistent reminders are a key factor in improving rate of clinic visit adherence.
Conclusion:
A previously unreported baseline no-show rate was established for hospital-employed otolaryngology clinics. The utilization of repeated, live-person reminders to mitigate the impact of clinic no-show rates needs to be further investigated.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Pediatric Clinic
Open Access
Rare Lingual Congenital Germline Fusion Cyst: Teratoid Variant Recurs as Dermoid Variant in Infant
David Garber, MD, Sophia Chen, BS, John Colavito, MD, Erich Voigt, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893407
Abstract
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Evaluation and Prognostic Significance of Galectin-3 Expression in Oral Squamous Cell Carcinoma
Serdar Tokmak, MD, Deniz Arık, MD, Özgür Pınarbaşlı, MD, Melek Kezban Gürbüz, MD, Mustafa Fuat Açıkalın, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893861
Abstract
Hide Preview
Introduction:
In squamous cell carcinomas of the oral cavity, factors that can predict prognosis are being studied. However, new prognostic factors are needed to provide information on the biological properties of tumors. Galectin-3 is known to be involved in many biological events such as cell adhesion and differentiation, angiogenesis, apoptosis, tumorigenesis, and metastasis. In our study, the prognostic role of galectin-3 expression in squamous cell carcinomas of the oral cavity was investigated.
Materials and Methods:
The study included 60 patients with a diagnosis of squamous cell carcinoma of the oral cavity. The demographic characteristics of the patients were compiled from the patient files. Galectin-3 expression was studied immunohistochemically. Cytoplasmic and nuclear expressions of galectin-3 were evaluated separately. In addition, the total expression score was calculated by multiplying the percentage and intensity scores for each cases. The critical expression score was determined according to the median value of the total scores.
Results:
Among 60 cases, 28 tumors were located on the lip, 21 on the tongue, 4 on the floor of the mouth, 3 on the orobuccal mucosa, 3 on the retromolar trigone, and 1 on the gingivobuccal junction. There was no statistically significant relationship between prognosis and nuclear or cytoplasmic galectin-3 expression. Tumor grade and invasion pattern were found to be associated with the galectin-3 total expression score.
Conclusion:
Although galectin-3 total expression score was correlated with the tumor grade and invasion pattern, it is not associated with overall survival or recurrence rates. However, there is a need for a large series of cases in which methods are standardized in order to clarify the prognostic role of galectin-3 expression in oral squamous cell carcinomas.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Clinical Characteristics of External Auditory Canal Foreign Bodies in Children and Adolescents
Keon-Ho Kim, MD, Jae Ho Chung, MD, PhD, Hayoung Byun, MD, Tao Zheng, MD, Jin-Hyeok Jeong, MD, PhD, Seung Hwan Lee, MD, PhD
First Published 9 Dec 2019.https://doi.org/10.1177/0145561319893164
Abstract
Hide Preview
Objectives:
Foreign bodies (FBs) in external auditory canal (EAC) can occur at any age but are especially common in children and adolescents. The aims of the study were to evaluate the clinical characteristics of EAC FBs in children and adolescents and to discuss their proper management.
Methods:
A retrospective medical chart review was performed on patients who were treated for EAC FBs in a tertiary referral center from January 2007 to December 2017. We investigated the parameters of age, sex, type of FB, sedation method, complications, and removal strategy.
Results:
Of 284 patients, 176 (62.0%) were male. Peak incidences were noted at the ages of 3 to 6 years and 17 to 18 years. The frequently observed FBs were insects, followed by air-gun pellets, cotton balls, marbles, and earrings. Forty-one (14.4%) EAC FBs were removed with the naked eye, while 243 (85.6%) were removed under microscope in the otolaryngology department. Of these patients, 23 (9.5%) were administered sedatives and 1 (4.1%) needed general anesthesia. During or after the removal procedure, 4 (15.5%) patients had complications of EAC abrasion or laceration (42, 14.8%), and tympanic membrane perforation (2, 0.7%).
Conclusions:
External auditory canal FB showed a distinct characteristic of incidence regarding age, related to removal strategies. Characteristics of FB must be considered for safe removal.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical study
Open Access
Total Versus Completion Thyroidectomy: A Multidimensional Evaluation of Long-Term Vocal Alterations
Antonio Minni, Davide Rosati, Carlo Cavaliere, Massimo Ralli, Giulio Sementilli, Andrea Gallo, Stefania Brozzetti, Paolo Ossola, Giuseppe Cavallaro, Marco Bononi
First Published 4 Dec 2019.https://doi.org/10.1177/0145561319886156
Abstract
Hide Preview
Background:
Total thyroidectomy (TT) and completion thyroidectomy (CT) are two common surgical operations that are frequently followed by vocal symptoms despite preservation of the recurrent laryngeal nerve (RLN) and of the external branch of superior laryngeal nerve (EBSLN). The aim of this study was to analyze vocal alterations through endoscopic findings, videolaryngostroboscopy (VLS), acoustic vocal parameters and impact on patients’ quality of life after surgery in the absence of laryngeal nerve injury.
Methods:
We enrolled 198 patients who underwent thyroidectomy by the same surgeon. One hundred twenty-six patients underwent TT (group TT) while 72 underwent CT (group CT). All patients underwent preoperative VLS and Voice Handicap Index (VHI) assessment and postoperative VHI, VLS and Acoustic Voice Analysis with Multidimensional Voice Program Analysis 12 to 18 months after surgery.
Results:
We observed a statistically significant higher rate of EBSLN injury in CT compared to TT. Even in the absence of RLN and EBSLN injury, patients who underwent TT and CT presented slightly worse acoustic vocal parameters and VHI scores compared to healthy controls. Interestingly, some acoustic vocal parameters and VHI scores were significantly worse in group CT compared to group TT.
Conclusions:
The higher rate of EBSLN injury in CT rather than in TT suggests a higher surgical risk in CT. The vocal parameters of loudness and self-perception of voice were significantly worse after CT, suggesting a larger trauma in patients’ vocal outcome in CT if compared to TT, although these alterations were not reported as psychologically limiting daily life of patients. Nevertheless, the existence of multiple factors contributing to vocal alterations after thyroidectomy highlight the importance of a routine comprehensive functional voice analysis before and after surgery.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Systemic Immune Profile in Patients With CRSwNP
Rafaela Veloso-Teles, MD, Rui Cerejeira, MD, PhD, Rosa Roque-Farinha, MD, PhD, Christian von Buchwald, MD, DMSci
First Published 4 Dec 2019.https://doi.org/10.1177/0145561319893163
Abstract
Hide Preview
The immune pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains obscure. Our aim was to compare humoral immunity and white blood cell counts in patients with CRSwNP and controls. A prospective case–control study was carried out in 37 patients with CRSwNP and 34 controls without CRS. Clinical data were gathered through a systematic interview. Computed tomography scan, skin prick test, spirometry, and immunological parameters (leukocyte differential count, immunoglobulin classes, and immunoglobulin [Ig] G subclasses) in serum specimens were obtained. Statistical analysis was performed using SPSS v.23. The prevalence of chronic lower respiratory diseases was greater in the CRSwNP group (P < .001), but atopic disease had no significant difference. A significantly higher eosinophil (P < .001) and basophil relative count (P = .022) and a lower relative neutrophil count (P = .013) were found among CRSwNP group. Patients with CRSwNP had higher IgG1 (P = .022), but lower IgG2 (P = .014) and IgG3 (P = .018) serum levels compared to controls; IgG4, total IgG, IgA, IgM, and IgE serum levels did not differ between groups, as well as the prevalence of immunoglobulin classes or IgG subclasses deficiency. The variation observed in peripheral relative leukocyte count and the systemic IgG1 subclass shift are similar to what is known to happen in nasal polyp tissue. A unique systemic immune profile seems to be present in patients with CRSwNP.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Rare Lingual Congenital Germline Fusion Cyst: Teratoid Variant Recurs as Dermoid Variant in Infant
Show less
David Garber, MD, Sophia Chen, BS, John Colavito, MD, Erich Voigt, MDFirst Published December 15, 2019 Other
https://doi.org/10.1177/0145561319893407
Last updated December 16, 2019
1 – 100 of 371
Sort:
Clinic
Open Access
Double Ring in Cochlear Otosclerosis: A Limit to Cochlear Implantation? The Solution Is the Surgical Approach
Daniela Messineo, MD, Massimo Ralli, MD, PhD, Antonio Greco, MD, Arianna Di Stadio, MD, PhD
First Published 16 Dec 2019.https://doi.org/10.1177/0145561319895601
Abstract
Hide Preview
We present a case of a 50-year patient with a severe form of otosclerosis (double ring) that was successfully implanted. We used a bone-anchored hearing implant for restoring the hearing in the right side and a cochlear implant in the left side; both surgeries did not show any complications. For reducing the risk of a secondary bone ossification related to the trauma of cochleostomy for electrode’s insertion, we used a round window approach. The patient recovered a normal auditory threshold and normal speech perception capacity both in silence and noise conditions 1 year after surgery.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Rehabilitation of Severe to Profound Sensorineural Hearing Loss in Adults: Audiological Outcomes
Andrea Ciorba, PhD, Maria Paola Guidi, MD, Piotr H. Skarżyński, MD, Chiara Bianchini, MD, Monica Rosignoli, MS, Manuela Mazzoli, MD, Stefano Pelucchi, MD, Stavros Hatzopoulos, PhD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319892461
Abstract
Hide Preview
The aim of this article is to describe the audiological patterns of 71 adult patients presenting severe to profound sensorineural hearing loss, who were rehabilitated by cochlear implants (CIs) and hearing aids. This is a retrospective study in a university setting, where the clinical records of 71 adult patients were reviewed and processed. Speech intelligibility was evaluated at one aided ear (CI) or at both aided ears (double CI or a combination of CI and hearing aid [HA]). Patients with a bilateral CI or with a bimodal hearing setup (CI and HA) performed better than those with a single CI; data from the phonetic matrices test showed that there was a statistically significant difference among patients aided by a single CI versus binaural setup (double CI or CI + HA). In particular, patients aided by a bilateral CI, or by a CI and HA, showed an improvement in the functional results of the speech tests, compared to patients using a single CI. Binaural hearing (either with a bilateral CI or bimodal) allows an improvement in the functional results at the speech tests, compared to the use of a CI only.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
A 10-Year Follow-Up of a Randomized Prospective Study of 2 Treatments for Chronic Rhinosinusitis Without Nasal Polyps and Investigation of the Impact of Gastroeosophageal Reflux Disease in the Resistance to Treatment
Jerome R. Lechien, MD, PhD, MSc, Gersende Debie, MD, Virginie Mahillon, MD, Marie-Paule Thill, MD, Alexandra Rodriguez, MD, Mihaela Horoi, MD, Stelianos Kampouridis, MD, Vinciane Muls, MD, Sven Saussez, MD, PhD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319892460
Abstract
Hide Preview
Objectives:
To compare the 2 long-term medical strategies in chronic rhinosinusitis without nasal polyps (CRSnNP) and to identify the role of gastroesophageal reflux disease (GERD) and Helicobacter pylori as factors of treatment failure.
Material and Methods:
Fifty-seven patients with CRSnNP were randomized into 2 therapeutic groups. The first group was treated with 4 weeks of amoxicillin/clavulanate and a short course of oral steroids. The second group received 8 weeks of clarithromycin. Sinonasal Outcome Test-20 (SNOT-20) and Lund and Mackay scores were assessed at baseline and after treatment, and GERD Health-Related Quality of Life (GERD-HRQL) questionnaire was evaluated in all patients. Patients with a GERD-HRQL score >8 received esogastroscopy and H pylori detection. Patients were followed during a 10-year period for clinical course and GERD evolution. The 10-year evolution of patients was described in terms of recurrence, medical, and surgical treatments.
Results:
Thirty-seven patients completed the study; SNOT-20 and Lund and Mackay scores similarly improved in both groups. Amoxicillin/clavulanate group had significantly more adverse reactions than the clarithromycin group (P = .03). After the therapeutic course, 35% (amoxicillin/clavulanate) and 41% (clarithromycin) of patients needed functional endoscopic sinus surgery (FESS). During the long-term follow-up, 54% (amoxicillin/clavulanate) and 40% (clarithromycin) of patients had late CRSnNP recurrence; FESS was performed in less than 15% of cases of recurrence. Gastroesophageal reflux disease complaint’s severity was associated with late recurrence of CRSnNP.
Conclusion:
Amoxicillin/clavulanate and clarithromycin would be competitive treatments for CRSnNP. Gastroesophageal reflux disease seems to be a negative factor for treatment response and recurrence.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
No-Show Rates in Employed Otolaryngology Practice
Brett T. Comer, MD, Lauren E. Harris, BS, Caitlin E. Fiorillo, MD, Thomas J. Gal, MD, MPH, Allyson Hughes, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893157
Abstract
Hide Preview
Objective:
To report baseline no-show rates in the hospital-employed otolaryngology practice setting and to identify factors that may affect clinic show rates that are targets for potential improvement.
Study Design:
Retrospective chart review.
Methods:
Electronic medical records from October 2012 through July 2014 of a hospital-employed otolaryngology practice were reviewed. Patients were classified by insurance type: commercial, Medicare, Medicaid, and self-pay. Clinic visits were classified as new patient, follow-up, or postoperative. No-show rates were tabulated for each type of clinic visit and compared. Factors to improve no-show rates are discussed.
Results:
There was an overall no-show rate of 8.3% for 5817 scheduled clinic visits. Among visit types, follow-up visits had the highest no-show rates. Among insurance types, Medicaid had the highest no-show rates. New patient Medicaid patients, follow-up Medicaid patients, and follow-up commercial insurance patients had the highest rate of no-shows among visit/insurance type combinations. Persistent reminders are a key factor in improving rate of clinic visit adherence.
Conclusion:
A previously unreported baseline no-show rate was established for hospital-employed otolaryngology clinics. The utilization of repeated, live-person reminders to mitigate the impact of clinic no-show rates needs to be further investigated.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Pediatric Clinic
Open Access
Rare Lingual Congenital Germline Fusion Cyst: Teratoid Variant Recurs as Dermoid Variant in Infant
David Garber, MD, Sophia Chen, BS, John Colavito, MD, Erich Voigt, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893407
Abstract
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Evaluation and Prognostic Significance of Galectin-3 Expression in Oral Squamous Cell Carcinoma
Serdar Tokmak, MD, Deniz Arık, MD, Özgür Pınarbaşlı, MD, Melek Kezban Gürbüz, MD, Mustafa Fuat Açıkalın, MD
First Published 15 Dec 2019.https://doi.org/10.1177/0145561319893861
Abstract
Hide Preview
Introduction:
In squamous cell carcinomas of the oral cavity, factors that can predict prognosis are being studied. However, new prognostic factors are needed to provide information on the biological properties of tumors. Galectin-3 is known to be involved in many biological events such as cell adhesion and differentiation, angiogenesis, apoptosis, tumorigenesis, and metastasis. In our study, the prognostic role of galectin-3 expression in squamous cell carcinomas of the oral cavity was investigated.
Materials and Methods:
The study included 60 patients with a diagnosis of squamous cell carcinoma of the oral cavity. The demographic characteristics of the patients were compiled from the patient files. Galectin-3 expression was studied immunohistochemically. Cytoplasmic and nuclear expressions of galectin-3 were evaluated separately. In addition, the total expression score was calculated by multiplying the percentage and intensity scores for each cases. The critical expression score was determined according to the median value of the total scores.
Results:
Among 60 cases, 28 tumors were located on the lip, 21 on the tongue, 4 on the floor of the mouth, 3 on the orobuccal mucosa, 3 on the retromolar trigone, and 1 on the gingivobuccal junction. There was no statistically significant relationship between prognosis and nuclear or cytoplasmic galectin-3 expression. Tumor grade and invasion pattern were found to be associated with the galectin-3 total expression score.
Conclusion:
Although galectin-3 total expression score was correlated with the tumor grade and invasion pattern, it is not associated with overall survival or recurrence rates. However, there is a need for a large series of cases in which methods are standardized in order to clarify the prognostic role of galectin-3 expression in oral squamous cell carcinomas.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Clinical Characteristics of External Auditory Canal Foreign Bodies in Children and Adolescents
Keon-Ho Kim, MD, Jae Ho Chung, MD, PhD, Hayoung Byun, MD, Tao Zheng, MD, Jin-Hyeok Jeong, MD, PhD, Seung Hwan Lee, MD, PhD
First Published 9 Dec 2019.https://doi.org/10.1177/0145561319893164
Abstract
Hide Preview
Objectives:
Foreign bodies (FBs) in external auditory canal (EAC) can occur at any age but are especially common in children and adolescents. The aims of the study were to evaluate the clinical characteristics of EAC FBs in children and adolescents and to discuss their proper management.
Methods:
A retrospective medical chart review was performed on patients who were treated for EAC FBs in a tertiary referral center from January 2007 to December 2017. We investigated the parameters of age, sex, type of FB, sedation method, complications, and removal strategy.
Results:
Of 284 patients, 176 (62.0%) were male. Peak incidences were noted at the ages of 3 to 6 years and 17 to 18 years. The frequently observed FBs were insects, followed by air-gun pellets, cotton balls, marbles, and earrings. Forty-one (14.4%) EAC FBs were removed with the naked eye, while 243 (85.6%) were removed under microscope in the otolaryngology department. Of these patients, 23 (9.5%) were administered sedatives and 1 (4.1%) needed general anesthesia. During or after the removal procedure, 4 (15.5%) patients had complications of EAC abrasion or laceration (42, 14.8%), and tympanic membrane perforation (2, 0.7%).
Conclusions:
External auditory canal FB showed a distinct characteristic of incidence regarding age, related to removal strategies. Characteristics of FB must be considered for safe removal.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical study
Open Access
Total Versus Completion Thyroidectomy: A Multidimensional Evaluation of Long-Term Vocal Alterations
Antonio Minni, Davide Rosati, Carlo Cavaliere, Massimo Ralli, Giulio Sementilli, Andrea Gallo, Stefania Brozzetti, Paolo Ossola, Giuseppe Cavallaro, Marco Bononi
First Published 4 Dec 2019.https://doi.org/10.1177/0145561319886156
Abstract
Hide Preview
Background:
Total thyroidectomy (TT) and completion thyroidectomy (CT) are two common surgical operations that are frequently followed by vocal symptoms despite preservation of the recurrent laryngeal nerve (RLN) and of the external branch of superior laryngeal nerve (EBSLN). The aim of this study was to analyze vocal alterations through endoscopic findings, videolaryngostroboscopy (VLS), acoustic vocal parameters and impact on patients’ quality of life after surgery in the absence of laryngeal nerve injury.
Methods:
We enrolled 198 patients who underwent thyroidectomy by the same surgeon. One hundred twenty-six patients underwent TT (group TT) while 72 underwent CT (group CT). All patients underwent preoperative VLS and Voice Handicap Index (VHI) assessment and postoperative VHI, VLS and Acoustic Voice Analysis with Multidimensional Voice Program Analysis 12 to 18 months after surgery.
Results:
We observed a statistically significant higher rate of EBSLN injury in CT compared to TT. Even in the absence of RLN and EBSLN injury, patients who underwent TT and CT presented slightly worse acoustic vocal parameters and VHI scores compared to healthy controls. Interestingly, some acoustic vocal parameters and VHI scores were significantly worse in group CT compared to group TT.
Conclusions:
The higher rate of EBSLN injury in CT rather than in TT suggests a higher surgical risk in CT. The vocal parameters of loudness and self-perception of voice were significantly worse after CT, suggesting a larger trauma in patients’ vocal outcome in CT if compared to TT, although these alterations were not reported as psychologically limiting daily life of patients. Nevertheless, the existence of multiple factors contributing to vocal alterations after thyroidectomy highlight the importance of a routine comprehensive functional voice analysis before and after surgery.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Clinical Study
Open Access
Systemic Immune Profile in Patients With CRSwNP
Rafaela Veloso-Teles, MD, Rui Cerejeira, MD, PhD, Rosa Roque-Farinha, MD, PhD, Christian von Buchwald, MD, DMSci
First Published 4 Dec 2019.https://doi.org/10.1177/0145561319893163
Abstract
Hide Preview
The immune pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains obscure. Our aim was to compare humoral immunity and white blood cell counts in patients with CRSwNP and controls. A prospective case–control study was carried out in 37 patients with CRSwNP and 34 controls without CRS. Clinical data were gathered through a systematic interview. Computed tomography scan, skin prick test, spirometry, and immunological parameters (leukocyte differential count, immunoglobulin classes, and immunoglobulin [Ig] G subclasses) in serum specimens were obtained. Statistical analysis was performed using SPSS v.23. The prevalence of chronic lower respiratory diseases was greater in the CRSwNP group (P < .001), but atopic disease had no significant difference. A significantly higher eosinophil (P < .001) and basophil relative count (P = .022) and a lower relative neutrophil count (P = .013) were found among CRSwNP group. Patients with CRSwNP had higher IgG1 (P = .022), but lower IgG2 (P = .014) and IgG3 (P = .018) serum levels compared to controls; IgG4, total IgG, IgA, IgM, and IgE serum levels did not differ between groups, as well as the prevalence of immunoglobulin classes or IgG subclasses deficiency. The variation observed in peripheral relative leukocyte count and the systemic IgG1 subclass shift are similar to what is known to happen in nasal polyp tissue. A unique systemic immune profile seems to be present in patients with CRSwNP.
Full Text
PDF Download
|
Permissions
Creative Commons Attribution, Non Commercial 4.0 License
Rare Lingual Congenital Germline Fusion Cyst: Teratoid Variant Recurs as Dermoid Variant in Infant
Show less
David Garber, MD, Sophia Chen, BS, John Colavito, MD, Erich Voigt, MDFirst Published December 15, 2019 Other
https://doi.org/10.1177/0145561319893407
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου