- Research articleAbstract only
The utility of narrow band imaging in endoscopic diagnosis of laryngopharyngeal reflux
- Changding He, Jinchao Yu, Fang Huang, Jun Shao
- In Press, Accepted Manuscript, Available online 28 June 2019
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Abstract
Objective
This study assessed the utility of narrow band imaging (NBI) in patients with symptoms of laryngopharyngeal reflux (LPR) and tried to quantitatively evaluate the signs found under the NBI Laryngoscope.
Methods
Patients with and without LPR symptoms completed reflux symptom index (RSI) questionnaires prior to enrolment. The throat was examined by standard white light endoscopy followed by NBI. LPR status was determined using the reflux finding score and the RSI. Laryngoscope images and videos from 70 subjects with LPR and 70 control subjects without LPR were obtained. Features seen only by NBI were compared between the two groups. Then the RGB values of the throat mucosa of the two groups were measured by Photoshop software, and finally statistical analysis was performed.
Results
In total, 140 patients were eligible for final analysis (LPR group mean age = 50.0, 47 males; control group mean age = 44.8, 45 males). A significantly higher proportion of patients with LPR had increased vascularity, green spots, contact ulcers and granulomas. Of these, increased vascularity and green spots can only be found under NBI, and the prevalence rates in the LPR group were found to be 92.8% and 88.6% (P < 0.05), respectively. In the control group, the prevalence rates of increased vascularity and green spots were 21.4% and 7.1%, respectively (P < 0.05). The RGB value of the LPR group was generally higher than that of the control group. The difference is statistically significant (P < 0.05).
Conclusion
LPR presents vascularity and green spots with high specificity and sensitivity under NBI which can play a role in the auxiliary diagnosis of LPR.
- Research articleAbstract only
The effectiveness of cognitive rehabilitation program on auditory perception and verbal intelligibility of deaf children
- Mohammad Ashori, Seyyedeh Somayyeh Jalil-Abkenar
- In Press, Accepted Manuscript, Available online 28 June 2019
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Abstract
Linguistic information and cognitive rehabilitation has more related with auditory perception and verbal intelligibility. The aim of the present study was to assessment of the effectiveness of cognitive rehabilitation program on the auditory perception and verbal intelligibility of deaf children.
This study was a quasi-experimental study with pre-test, post-test and control group design. Participants were 24 deaf children from Ava rehabilitation center of mother child in Isfahan city, Iran. Participants were selected by convenient sampling method. They were randomly divided into experimental and control groups, each group consisted of 12 children. The experimental group participated in the cognitive rehabilitation training program in 10 sessions for 45 min, while control group did not participate this program. The instruments of present research were Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). The data were analyzed using multivariate analysis of covariance (MANCOVA) in 24th version of SPSS.
The results of MANCOVA showed that cognitive rehabilitation program had significant effect on the auditory perception and verbal intelligibility in the experimental group at post intervention stage (P < 0/0001).
There was a positive and significant increase in auditory perception and verbal intelligibility of experimental group. Our findings showed that Cognitive rehabilitation program training led to promote of auditory perception and verbal intelligibility of deaf children.
- Research articleAbstract only
HPV status in patients with nasopharyngeal carcinoma in the United States: A SEER database study
- Michael Wotman, Eun Jeong Oh, Seungjun Ahn, Dennis Kraus, ... Tristan Tham
- In Press, Accepted Manuscript, Available online 26 June 2019
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Abstract
Purpose
To investigate the etiologic and prognostic role of Human Papilloma Virus (HPV) in Nasopharyngeal Carcinoma (NPC).
Materials and methods
Patients diagnosed with NPC were identified with the Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was used to investigate the effect of clinicopathologic predictors on HPV positivity in NPC. Survival analyses were performed with Kaplan-Meier curves and Cox regression models.
Results
180/517 patients (34.8%) with known HPV testing were positive for HPV-associated NPC. East Asians and individuals over 25 were less likely to have HPV-associated NPC, while controlling for AJCC-7 stage and AJCC-7 M stage. According to the survival analysis, cause-specific survival (CSS) did not differ significantly by HPV status throughout the study period, but did differ significantly by HPV ethnicity group.
Conclusions
The clinical implications of HPV in NPC are further elucidated but require more investigation.
Level of evidence
IV.
- Research articleAbstract only
Evaluation of the quality of life in adults with cochlear implants: As good as the healthy adults?
- Elif Tuğba Saraç, Merve Ozbal Batuk, Gonca Sennaroglu
- In Press, Accepted Manuscript, Available online 24 June 2019
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Abstract
Purpose
The aim of this study was to compare the quality of life (QoL) of adult CI users with the QoL of adults in the healthy and normal-hearing population.
Materials and methods
31 patients with CIs were included in the CI group, and 31 normal-hearing subjects were included in the control group. The QoL was evaluated using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) for all subjects.
Results
A comparison of the QoL of the CI group to that of the control group found that the QoL of healthy adults was better than that of the CI users. The results obtained for the subdomains of physical health, psychological health, and social relations showed statistically significant differences between the two groups (p < 0.05). There were no statistically significant differences between the groups in the subdomains of environment and general health (p > 0.05).
Conclusions
The effect of a hearing disability on daily life continues after the CI. As expected, adults with CIs still face challenges in their daily lives due to the hearing impairment.
- Research articleAbstract only
Intratympanic mixture gentamicin and dexamethasone versus dexamethasone for unilateral Meniere's disease
- Kayhan Öztürk, Nurdoğan Ata
- In Press, Corrected Proof, Available online 24 June 2019
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Abstract
Objective
This study aimed to determine the effectiveness of an intratympanic (IT) injection of a mixture of gentamicin and dexamethasone compared with intratympanic dexamethasone (ITD) for controlling vertigo and protecting the hearing level of Meniere's disease patients who have persistent vertigo attacks, despite medical treatment.
Methods
Thirty eight patients with intractable Meniere's disease were included in this study.
Twenty-one patients were treated with IT mixture gentamicin and dexamethasone injection; seventeen patients were treated with ITD. Pre- and post-treatment audiograms were compared with pure-tone averages. Control of vertigo was classified according to the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) vertigo control index.
Results
In the mixture group single IT injection was administered in 18 patients (85.7%), 2 injections were administered in 2 patients (9.5%) and 3 injections were administered in one patient (4.8%). In the ITD group IT injection was performed 3 times (days 1,3,5) at intervals. The mean number of intervals per patient was 3,41 (range 1–6).
Two years after IT treatment there was better control of vertigo in mixture group than in ITD group; 81% of mixture group and 70,6% of the ITD group achieved satisfactory control of vertigo (p = 0,0286). Audiology results of mixture group showed 20 patients (95,24%) with unchanged hearing and 1 patient (4,76%) with only 10-decibel deteriorated hearing. There was no worsening of hearing in the ITD group.
Conclusion
The results of this study showed that an IT injection of a mixture of gentamicin and dexamethasone in intractable Meniere's disease cases is more effective than ITD for vertigo control.
- Research articleAbstract only
Fungus ball of the maxillary sinus: Retrospective study of 48 patients and review of the literature
- Fabio Costa, Enzo Emanuelli, Leonardo Franz, Alessandro Tel, ... Massimo Robiony
- In Press, Corrected Proof, Available online 15 June 2019
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Abstract
Background
Maxillary fungus ball (FB) is the most frequent paranasal localization.
Objective
To review clinical presentation, surgery and results of treatment in our series of patients with maxillary FB. To review the literature concerning treatment of maxillary FB.
Patients and methods
48 patients with a diagnosis of maxillary FB were treated with endoscopic sinus surgery (ESS) alone or in association with external approaches. Before surgery all patients received computed tomography (CT), nasal endoscopy and dental examination. All the patients were followed for 1 year after surgery. Studies concerning surgical treatment of maxillary FB from 2006 were reviewed.
Results
The mean age of patients was 53.6 ± 11.9 years. 20 patients (41.6%) did not present any symptom, 19 patients (39.7%) had nasal symptoms, 3 patients (6.2%) had facial pain, 6 patients (12.5%) had a combination of both. Endoscopic examination was positive in 31 patients (64.6%), 17 patients (35.4%) showed negative findings. Logit regression model demonstrated that clinical symptoms contribute to the prediction of a positive endoscopic examination. 25 patients (52.1%) presented odontogenic factors. Complete clinical and radiological resolution of FB was observed in 46 patients (95.8%).
Conclusions
Comparing our sample to the studies reviewed we may concluded that odontogenic factors were frequently reported and should be treated at the same time of maxillary FB. ESS alone or in association with external approaches is an effective treatment for patients with maxillary FB.
- Research articleAbstract only
Microwave ablation: A new technique for the prophylactic management of idiopathic recurrent epistaxis
- Zheng-cai Lou
- In Press, Corrected Proof, Available online 14 June 2019
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Abstract
Objective
The objective of this study was to compare the re-bleeding of idiopathic recurrent epistaxis with no definite bleeding site treated with either prophylactic microwave ablation (MWA) or continuous observation.
Study design
Case series with chart review.
Subjects and methods
61 patients with idiopathic recurrent epistaxis but no definite bleeding sites in the first operation were assigned to prophylactic MWA group (n = 39) and continuous observation group (n = 22). Patients in prophylactic MWA group were given prophylactic MWA at the common bleeding sites. Patients in continuous observation group were only observed in the ward. The bleeding sites, re-bleeding and complications were evaluated during 3 months follow-up period.
Results
Rebleeding was experienced by 7 of the patients (17.9%) who were treated with prophylactic MWA whereas, 13 of the patients (59.1%) who used continuous observation had rebleeding. The rebleeding rate for patients undergoing prophylactic MWA group was lower than that for the observation-only group (p < 0.01). All the ablations were completed for the patients with known bleeding site within 1–2 min. These patients only had the complain of slight postoperative pain, no serious complications (including nasal adhesion, crust, septal perforation, etc.) were found in the follow-up period.
Conclusions
MWA is a simple, convenient, rapid, and definite hemorrhage control method with minimally invasive therapeutic technique. Prophylactic MWA at the common bleeding sites helps to significantly reduce the rate of rebleeding in patients in whom no definite bleeding sites have been identified.
- Research articleAbstract only
Functional outcomes of temporomandibular joint reconstruction with vascularized tissue
- Nikolaus Hjelm, Timothy E. Ortlip, Michael Topf, Adam Luginbuhl, ... Ryan Heffelfinger
- In Press, Corrected Proof, Available online 12 June 2019
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Abstract
Objective
To determine how current temporomandibular joint (TMJ) reconstruction methods affect functional outcomes.
Methods
Retrospective review from January 2006 to July 2017 at a single tertiary care center. All patients who underwent mandibulectomy with subsequent reconstruction with vascularized free tissue were included in the study. Condylar segments were reconstructed with vascularized free tissue flap in conjunction with autologous tissue or allograft in the joint space. Preoperative, 3 month, 1 year, and 2 year postoperative records were assessed for trismus, need for tube feeds, and Functional Oral Intake Scale (FOIS).
Results
Joint space was reconstructed with autologous tissue (n = 10), allograft (n = 15) or both (n = 9). At three months, FOIS scores significantly decreased from 5.4 preoperatively to 4.8 post operatively (P = .024) and need for tube feeds significantly increased from 15.8% preoperatively to 35.1% (P ≤0.027). Trismus significantly decreased from 63.2% to 27% (P = .006). At one-year, there were no significant changes in functional status compared to pre-operative state. Patients who had previous RT had significantly worse FOIS scores preoperatively (p = .002), at three months (p < .001), one year (p < .001), and two years (p = .008). There was no significant difference in postoperative functional status of patients based on the method of TMJ reconstruction.
Conclusion
Reconstruction of the TMJ with vascularized free tissue is a viable option and yields acceptable long-term outcomes. While functional status may improve or worsen in the immediate postoperative period, long term results mirror preoperative function. Preoperative trismus will likely improve.
Level of evidence
Level 3; Retrospective Comparative Study.
- Research articleAbstract only
Management of the neck after definitive chemoradiation in patients with HPV-associated oropharyngeal cancer: An institutional experience
- Michael Wotman, Maged Ghaly, Luke Massaro, Tristan Tham, ... Sewit Teckie
- In Press, Corrected Proof, Available online 12 June 2019
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Abstract
Purpose
To investigate the multidisciplinary management of patients with Human Papilloma Virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) and an incomplete nodal response on restaging PET/CT after definitive chemoradiation (CRT).
Materials and methods
A retrospective chart review was performed of patients diagnosed with node-positive HPV-associated OPSCC from 2012 to 2017, who underwent definitive upfront CRT, and had an incomplete response on post-therapy PET/CT according to NCCN criteria. Post-CRT PET/CT results, management decisions, and clinical outcomes were recorded.
Results
Seventy-four patients with node-positive HPV-associated OPSCC were identified; 20 patients with incomplete neck response on PET/CT according to NCCN criteria were included in the final case series. Median follow-up time was 33 months. Patients were managed as follows: 8 underwent observation and surveillance imaging, 6 underwent ultrasound-guided fine needle aspiration (FNA), and 6 had immediate neck dissection. All the observed patients were disease-free at most recent follow-up. None of the patients who underwent immediate neck dissection had residual neck disease on pathological examination; two patients in this group ultimately developed metastatic disease. Among the 6 who underwent FNA, 1 individual had positive pathology, along with residual primary disease, for which the patient underwent salvage surgery. The 5 remaining individuals had negative FNA results, were subsequently observed, and remained free of disease.
Conclusions
This institutional experience supports the notion of a high threshold for neck dissection in this low-risk population; only 1 of 20 patients with suspicious PET/CT findings had residual disease in the neck. Moreover, these patients should be managed by a multidisciplinary tumor board (MTB) since current algorithms do not universally include HPV status. Finally, the use of restaging PET/CT to guide management of the neck can be improved with changes in terminology and consideration of FDG-avidity at the primary site and on pre-therapy scans.
- Research articleAbstract only
Outcomes in surgically resectable oropharynx cancer treated with transoral robotic surgery versus definitive chemoradiation
- Bhaswanth Dhanireddy, Nicolas P. Burnett, Sreeja Sanampudi, Charles E. Wooten, ... Thomas J. Gal
- In Press, Corrected Proof, Available online 4 June 2019
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Abstract
Purpose
Optimal treatment strategies for the management of oropharyngeal squamous cell carcinoma (OPSCC) remain unclear. The objective of this study is to examine the role of transoral robotic surgery (TORS) on functional and treatment outcomes.
Materials and methods
A retrospective review of patients with OPSCC (tonsil/base of tongue) who underwent TORS with neck dissection± adjuvant therapy between January 2011 to December 2016 were compared to a stage matched cohort of patients treated with primary chemoradiation. Demographic, treatment, and outcome data were collected.
Results
54 patients received primary chemoradiation and 65 patients (surgical group) received TORS ± adjuvant therapy for clinically staged disease meeting study criteria. 25% (N = 17) were treated with surgery alone. The remainder of the surgical group received postoperative radiation (N = 48), half of which received adjuvant chemotherapy (N = 24) in addition to radiation. 63% (N = 41) of the patients did not have risk factors for chemotherapy. No differences in overall or disease free survival were observed with TORS compared to chemoradiation (p = 0.9), although Charlson Comorbidity Index (CCI) was higher in the surgical group (p = 0.01). The strongest predictor of prolonged gastrostomy tube use was not treatment, but rather co-morbidity (p = 0.03), with no significant differences beyond 12 months.
Conclusion
Although no significant survival differences were observed across treatment groups, this was maintained despite increased comorbidity index in the surgical patients. Given the ability to de-escalate and/or eliminate adjuvant therapy, particularly in a less healthy population, TORS would appear to be the viable treatment option it has become.
- Research articleAbstract only
Head and neck involvement with histoplasmosis; the great masquerader
- A. Singh, M. Gauri, P. Gautam, D. Gautam, ... K.K. Handa
- In Press, Corrected Proof, Available online 3 June 2019
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Abstract
Introduction
Head and neck involvement with histoplasmosis usually occurs as a part of the disseminated illness. There are no pathognomic features of the upper aerodigestive tract involvement and the lesion may mimic a host of other conditions. The current report presents our experience with head and neck histoplasmosis in a non-endemic tertiary care center.
Materials and methods
We present a case of disseminated histoplasmosis with oral symptoms and lesions as the chief complaints. A 10 years' retrospective institutional database search was undertaken to identify the patients with histoplasmosis affecting head and neck region treated at our institution. The demographic and treatment details of the patients were reviewed.
Results
In addition to the index patient, four more patients (two with gingivobuccal and one each with nasal and laryngeal histoplasmosis) were found. Out of the five patients, only one patient was found to have underlying immunosuppression. All of the patients were diagnosed with biopsy showing typical appearance of the intracellular organism. All the patients were satisfactorily treated with systemic antifungal treatment.
Conclusion
Upper aerodigestive tract involvement with histoplasmosis can present as an intriguing clinical puzzle. A high index of suspicion is needed and biopsy is the gold standard for the diagnosis. Intravenous Liposomal Amphotericin B and oral Itraconazole are standard treatment agents of choice and are highly efficacious in achieving cure.
- Review articleAbstract only
Treatment for lymphedema following head and neck cancer therapy: A systematic review
- Albina Tyker, Joel Franco, Sean T. Massa, Shaun C. Desai, Scott G. Walen
- In Press, Corrected Proof, Available online 30 May 2019
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Abstract
Objective
To perform the first systematic review evaluating all established treatment modalities of head and neck lymphedema resulting from head and neck cancer therapy. Since craniofacial lymphedema treatment represents unique challenges not addressed by extremity lymphedema therapies, a systematic review and evaluation of treatment modalities specific to this area is needed to guide clinical management and further research.
Data sources
Four electronic databases were searches from inception to September 2018. These included Scopus (Embase), PubMed (Medline), Clinicaltrials.gov, and Cochrane Databases.
Review methods
A search string was developed, and all databases queried for keywords on three subjects: head and neck cancer, lymphedema, and therapy. Results were uploaded to an EndNote database where relevant items were identified by hand-searching all titles and abstracts. Subsequently results were combined, duplicates removed, and full papers screened according to eligibility criteria.
Results
Of a total 492 search results, twenty-six items met eligibility criteria for this review. These included fourteen cohort studies, seven case reports, two randomized controlled trials, two systematic reviews, and one narrative review totaling 1018 study subjects. The manual lymph drainage group had the largest number of studies and participants, with fewer studies investigating selenium, liposuction, and lymphaticovenular anastomosis.
Conclusion
Evidence for the efficacy of all types of lymphedema therapy is limited by paucity of large randomized controlled trials. While manual lymph drainage is best studied, liposuction and surgical treatments have also been effective in a small number of patients.
- Research articleAbstract only
Morbidity after tonsillectomy in children with autism spectrum disorders
- Jillian N. Printz, Katelin A. Mirkin, Christopher S. Hollenbeak, Michele M. Carr
- In Press, Corrected Proof, Available online 30 May 2019
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Abstract
Objectives
As the incidence of autism spectrum disorder (ASD) increases, otolaryngologists are more likely to encounter patients from this population during tonsillectomy. The purpose of this study was to examine whether outcomes differ between pediatric patients with and without ASD in a national cohort of children undergoing tonsillectomy. Understanding these differences may be used to inform future approaches to improve clinical outcomes and healthcare costs.
Methods
Data for this study were obtained from the Kids Inpatient Database (KID) of the Healthcare Cost Utilization Project. We studied pediatric patients who underwent tonsillectomy during 2003, 2006, 2009, and 2012. Tonsillectomy was identified using ICD-9-CM diagnosis codes 28.2 (tonsillectomy without adenoidectomy) and 28.3 (tonsillectomy with adenoidectomy). ASD was identified using ICD-9-CM diagnosis code 299 (autism). Outcomes including complications, length of hospital stay, and total hospitalization costs. Analyses were performed using multivariable models. Propensity score matching was used to control for covariate imbalance between patients with and without ASD.
Results
In our sample of 27,040 patients, 322 (1.2%) had a diagnosis of ASD. After controlling for potential confounders, multivariable modeling suggested patients with ASD had a shorter LOS of 0.50 days (p < 0.0001), were less likely to experience complications (odds ratio 0.57, p = 0.001), and had lower associated costs of $1308 less (p < 0.0001). Propensity score matching confirmed the findings of the multivariable modeling.
Conclusion
Although ASD alone does not appear to confer additional costs or morbidity, differences between children with and without ASD suggest the need for providers to address patients with ASD uniquely.
- Review articleAbstract only
What is the evidence for cannabis use in otolaryngology?: A narrative review
- William L. Valentino, Brian J. McKinnon
- In Press, Corrected Proof, Available online 30 May 2019
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Abstract
Objectives
Review of the English literature for all studies involving cannabis and Otolaryngology.
Methods
PubMed was searched using a combination of the terms cannabis, marijuana, otolaryngology, hearing, tinnitus, vestibular, rhinology, sinusitis, laryngology, voice, airway, head and neck, head and neck cancer, facial trauma, spasm, pediatric otolaryngology, sleep medicine, obstructive sleep apnea, and other variations. Literature included in the review provided substantive research on cannabis in Otolaryngology.
Results
Seventy-nine unique publications were found in the literature. The majority were published in the last decade and pertain to the subspecialty of Head and Neck; specifically, its association with incident cancers. A small number of studies exist that suggest cannabis may be a useful therapy for Otolaryngological patients suffering from blepharospasm, the effects of radiation, and the psychological sequelae of receiving a cancer diagnosis.
Conclusion
Further research is required to determine the potential therapeutic roles and adverse effects of cannabis on conditions related to Otolaryngology. This study serves the Otolaryngological researcher with the most current, comprehensive literature review for the exploration into possible projects to undertake.
- Research articleAbstract only
New wand coblation turbinator vs coblation radiofrequency
- Yuce Islamoglu, Gulın Gokcen Kesici, Kadır Sınası Bulut, Ebubekır Alper Ozer, ... Mehmet Ali Babademez
- In Press, Corrected Proof, Available online 21 May 2019
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Abstract
Introduction
İnferior turbinate hypertrophy is a common reason of nasal obstruction. One of the most preferred surgical metod is radiofrequency tecnique. Coblation submucosal reduction turbinator (SCT);new surgical device; started to use recently. Since the method is new, very few study has been done yet. We compare coblation radiofrequency (CR) with SCT.
Material and methods
Patients with only inferior turbinate hypertrophy but no other diseases included in study. Paranasal CT was made to all patient to rule out turbinate bone hypertrophy. Group 1 32 patient; performed CR. Group 2 25 patients performed SCT. To all patients preoperative and 3 weeks later post operative mucosiliary activity test was performed. Nasal flow was measured with nasal flow meter preoperatively and 3 weeks post operatively. VAS and NOSE was measured. Results compared between two groups. SCT performed under general; CR performed under local anesthesia.
Results
There was significant nasal flow changes in CR group. (p < 0.001) There was no difference in pre-and-post operatively saccharin test results in CR group. (p = 0.385) There was slightly nasal flow gain in SCT group but this was not statistically significant. (p < 0.192) Also there was no statistically significant changes in pre-and-post operatively saccharin test results in SCT group. (p = 0.167) There was no difference between two groups in terms of post operative nasal flow values and mucociliary activity. (respectively p = 0.562, p = 0.355). (Table 2). Both two tecnique has significant increase in VAS and NOSE scores. (p < 0.001).
Conclusions
According to our study two tecnique is suitable and safe for nasal mucociliary activity. Tecniques has positive effect on nasal flow, VAS and NOSE scores.
- Research articleNo access
Post-operative treatment patterns after functional endoscopic sinus surgery: A survey of the American Rhinologic Society
- Samuel N. Helman, Benjamin M. Laitman, Mingyang Gray, Brian Deutsch, ... Anthony Del Signore
- In Press, Corrected Proof, Available online 21 May 2019
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- Research articleAbstract only
Comparison of the effects of the temperature of intratympanic dexamethasone injections on vertigo
- Nurdoğan Ata, Kayhan Öztürk, Bahri Gezgin
- In Press, Corrected Proof, Available online 20 May 2019
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Abstract
Objective
This study aimed to compare if vertigo improved in patients when the dexamethasone used in the intratympanic (IT) injection was applied at body temperature or at room temperature.
Methods
The study included 54 patients who had undergone intratympanic treatment due to sudden hearing loss and tinnitus. The IT injection was administered to all patients, 2 times with 1-day intervals. Two different IT injection techniques were used for each patient: injecting dexamethasone at room temperature and injecting it at body temperature. Patients were asked to report the vertigo they felt immediately, and at 15 min after the injection using the visual analogue scale (VAS) and the four-point categorical rating scale (CRS-4).
Results
The level of vertigo immediately after injection was lower when the dexamethasone was injected at body temperature rather that at room temperature for both the VAS and CRS-4 (p < 0.05). However, no statistical differences in the VAS and CRS-4 self-report values between the two methods were found 15 min after the injection (p > 0.05).
Conclusion
Vertigo due to IT decreases within minutes. When the IT drugs are administered at body temperature, temporal vertigo due to injection is lower than when they are administered at room temperature.
- Research articleAbstract only
Craniofacial injuries related to motorized scooter use: A rising epidemic
- Amishav Y. Bresler, Curtis Hanba, Peter Svider, Michael A. Carron, ... Boris Paskhover
- In Press, Corrected Proof, Available online 20 May 2019
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Abstract
Objectives
Over the last decade, there has been increased interest in utilizing motorized scooters for transportation. The limited regulation of this modernized vehicle raises numerous safety concerns. This analysis examines a national database to describe the yearly incidence of craniofacial injuries and patterns of injury related to motorized scooter use.
Methods
The Consumer Product Safety Commission's National Electronic Injury Surveillance system was queried for craniofacial injuries associated with motorized scooter use. Patient demographics, injury type, anatomic location, injury pattern, and helmet status were extracted for analysis.
Results
From 2008 to 2017, there were 990 recorded events for craniofacial injuries secondary to motorized scooters extrapolating to an estimated 32,001 emergency department (ED) visits. The annual incidence was noted to triple over that 10-year period. The majority of patients were male (62.1%) and the common age groups at presentation were young children 6–12 years old (33.3%), adolescents 13–18 years old (16.1%) and young adults 19–40 years old (18.0%). The most common injury pattern was a closed head injury (36.1%) followed by lacerations (20.5%). Facial fractures were only present in 5.2% of cases. In cases in which helmet use was recorded, 66% of the patients were not helmeted.
Conclusion
The incidence of motorized scooter related craniofacial trauma is rising, resulting in thousands of ED visits annually. Many patients are experiencing morbid traumatic injuries and may not be wearing appropriate protective equipment. This study highlights the importance of public awareness and policy to improve safety and primarily prevent craniofacial trauma.
- Research articleAbstract only
Buteyko breathing technique for obstructive Eustachian tube dysfunction: Preliminary results from a randomized controlled trial
- Haicang Zeng, Xiaoxin Chen, Yaodong Xu, Yiqing Zheng, Hao Xiong
- In Press, Corrected Proof, Available online 17 May 2019
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Abstract
Purpose
To assess the effectiveness of Buteyko breathing technique in patients with obstructive Eustachian tube dysfunction (ETD).
Materials and methods
Fifty-one patients (77 ears) aged between 21 and 62 years were randomized to Buteyko breathing in conjunction with medical management (nasal steroid) group or medical management alone group. The Eustachian Tube Dysfunction Questionnaire (ETDQ-7) symptom scores, tympanogram, positive Valsalva maneuver were evaluated at baseline, 6-week and 12-week follow-up.
Results
Normalization of ETDQ-7 symptom scores at 6-week follow-up was observed in 30.0% (12/40) of the Buteyko breathing group versus 16.2% (6/37) of the controls (P > 0.05). At 12-week follow-up, the ratio rose to 50.0% (20/40) in the Buteyko breathing group and 24.3% (9/37) in the controls (P < 0.05). Tympanogram normalization at 12-week follow-up was observed in 53.6% (15/28) of the Buteyko breathing group versus 26.9% (7/26) of the controls (P < 0.05). The Buteyko breathing group showed slight improvement in positive Valsalva maneuver at 6- and 12-week follow-up (P > 0.05).
Conclusions
Our study shows that Buteyko breathing technique might be an effective adjunctive intervention in treatment of obstructive ETD, especially for those patients who are refractory to medical treatment and cannot afford Eustachian tube balloon dilation surgery.
- CorrespondenceNo access
Commentary on Surgical management of patients with Eagle syndrome
- Zhengcai- Lou
- In Press, Corrected Proof, Available online 17 May 2019
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