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1.
Lizhi Wang Lai Wei Weili Lu Ziye Liu Meiyi Wang Zhiqiang Wang 《American journal of otolaryngology》2019,40(2):257-259
Purpose
To introduce a feasible approach for excising a preauricular sinus with abscess in children.Materials and methods
Patients under 14?years old with a preauricular sinus abscess and volunteering for surgery were involved in this study.Results
Neither recurrence nor local deformity was found in these patients with a follow-up of 3 to 72?months.Conclusions
Excising the preauricular sinus with abscess in children is a feasible approach to treatment. 相似文献2.
Introduction
Percutaneous dilatation tracheostomy (PDT) has several advantages over traditional surgical tracheostomy. However, it is still performed using bronchoscopy guidance.Objective
To suggest the safety of unassisted PDT, without bronchoscopy guidance, based on bed–side screening flow chart evaluation.Material and methods
180 consecutive UCI patients referred to tracheostomy were submitted to Avalo's Screening Chart (ASC), in order to decide surgical technique.Results
161 patients were referred to unassisted PDT (un PDT) and 19 to surgical tracheostomy (ST) due to nonfulfillment of ASC steps. 10 patients submitted to unassisted PDT presented early complications, 8 presented mild bleeding and 2 false tracts. None of 6?months follow up patients presented long term complications.Conclusion
The authors suggest unPDT is a safety surgical method in UCI patients who were submitted and approved to an easy anatomical and clinical screening chart (ASC). 相似文献3.
Importance
Repair of full-thickness nasal defects can often be associated with multi-stage operations that can result in significant physical and psychological morbidity for patients. We present a single-stage option for reconstruction of these defects.Objective
Demonstrate the utility of the pedicled levator labii superioris alaeque nasi flap and consistency of its vascular pedicle.Design
Anatomical study using fresh cadavers.Setting
Academic medical center.Main outcome and measures
Evaluation of vascular anatomy of pedicled flap and measurements of distances with relationship to facial anatomic landmarks.Results
With few noted anatomic variations, the vascular pedicle of the pedicled levator labii superioris alaeque nasi flap arises from the superior labial artery and is reliably located within 1?cm lateral and inferior of the nasal sill.Conclusions and relevance
As a robust single-stage option, the pedicled levator labii superioris alaeque nasi flap can serve as a powerful option in the arsenal of the reconstructive surgeon. The technique for harvest is simple with attention to a few anatomic variations as described herein, and excellent results can be obtained with proper application. 相似文献4.
Objective
To evaluate the serum vitamin D level in patients with chronic rhinosinusitis with nasal polyps and its correlation with the disease severity.Setting
Hospital of Zhejiang University.Study design
Retrospective analysis of collected data.Subjects and methods
Patients with chronic rhinosinusitis with or without nasal polyps who underwent endoscopic sinus surgery were recruited. Demographic information including age, gender, body mass index, smoke history, atopic status and asthma was collected. Disease severity was measured by the Lund-Mackay CT score and Sino-Nasal Outcome Test-22 score. Serum 25-hydroxyvitamin D3 was measured by enzyme-linked immunosorbent assay preoperatively.Results
Serum 25-hydroxyvitamin D3 levels were significantly lower in patients with nasal polyps (CRSwNP, 38.2?±?9.1?nmol/L; CRSsNP, 48.94?±?12.1?nmol/L; control, 54.1?±?17.1?nmol/L. p?<?0.001), and the levels were significantly associated with the preoperative Sino-Nasal Outcome Test-22 score (p?=?0.013), but not with the Lund-Mackay score (p?=?0.126). Furthermore, serum 25-hydroxyvitamin D3 levels were associated with the subjective improvement six months postoperatively (p?<?0.001),Conclusion
Serum 25-hydroxyvitamin D3 levels are lower in Chinese CRSwNP patients. These 25-hydroxyvitamin D3 levels are associated with SNOT-22 score. Preoperative 25-hydroxyvitamin D3 level may impact on the symptom improvement after surgery. 相似文献5.
Yasser Mohammad Hassan Mandour Samira Mohammed M.o.Abdel Menem 《American journal of otolaryngology》2019,40(2):168-172
Object
To compare between results of bacterial cellulose graft myringoplasty and fat graft myingoplasty in patients had mild or moderate size safe perforation.Methods
120 patients undergoing myringoplasty due to mild or moderate size perforation were divided into 3 groups: group I: 40 patients undergoing myringoplasty with use of bacterial cellulose graft, group II: 40 patients undergoing myringoplasty with use of fat graft, group III: 40 patients undergoing usual myringoplasty with use of temporalis fascia graft (control group).Results
Healing in 20 patients with small perforation and 17 patients with moderate perforation in Group I, Healing in 15 patients with small perforation and 10 patients with moderate perforation in Group II, Healing in 18 patients with small perforation and 12 patients with moderate perforation in Group III.Conclusion
Bacterial cellulose graft myringoplasty would be a good, simple, rapid and safe surgery that could be done under local anesthesia in outpatient clinic with shorter time of surgery than fat graft myringoplasty and temporalis fascia graft myringoplasty, with better hearing and healing.Summary at glance
120 patients undergoing myringoplasty were divided into 3 groups to compare between results of bacterial cellulose graft myringoplasty, fat graft myringoplasty and temporalis fascia graft myringoplasty. 相似文献6.
Armita Kakavand Hamidi Nasrin Yazdani Kimia Haj Seyedjavadi Nakisa Zarrabi Ahrabi Ardavan Tajdini Keivan Aghazadeh Mahsa M. Amoli 《American journal of otolaryngology》2019,40(2):260-264
Hypothesis
Although the pathogenesis of sudden sensorineural hearing loss (SSNHL) is not clear, however several causes including genetic factors seems to be implicated. We hypothesized that common genetic variants might be involved in SSNHL.Background
SSNHL is known to be an idiopathic disease because the causative factors have not been identified. Several causes including genetic and viral infection besides immune system reaction, neurological disorders, medications, etc. have been previously reported. We examined the association between ApoE and MTHFR gene variants in SSNHL.Methods
This study includes case-control scheme encompassing a total of 177 individuals, include patients inflicted with SSNHL and healthy subjects as control group. Genotyping of MTHFR and ApoE variants was conducted by PCR – RFLP method.Result
Our study showed that MTHFR rs1801133 allele frequency is significantly different between cases and controls. Also genotype distribution of ApoE was significantly different between patients and healthy controls.Conclusions
MTHFR C677T and ApoE gene variant may be associated with sudden sensorineural hearing loss in an Iranian population. 相似文献7.
Anirudh Saraswathula Jennifer Y. Lee Uchechukwu C. Megwalu 《American journal of otolaryngology》2019,40(1):83-88
Objectives
To determine the preferred methods of communicating biopsy results for patients in our comprehensive otolaryngology clinic, and to examine factors associated with preferring remote vs. in-person communication of results.Study design
Cross-sectional study.Setting
Academic comprehensive otolaryngology clinic.Subjects and methods
A survey instrument was administered to 107 consecutive adult otolaryngology patients undergoing head and neck fine needle aspiration biopsy from March 1, 2017 to April 30, 2018 assessing their health literacy using the Brief Health Literacy Score and their preferred method of notification of biopsy results (in-person vs. remote).Results
69% of patients preferred remote notification of their biopsy results (either by telephone or via an online portal). 54% of patients prioritized clear explanation of the results as the most important factor when communicating a malignant result. Adequate health literacy was associated with lower odds of preferring in-person notification (adjusted odds ratio 0.11, 95% CI 0.03 to 0.39). Patients who prioritized clear explanation of the results were more likely to prefer in-person notification (adjusted OR 4.13, 95% CI 1.31 to 14.88).Conclusions
A significant proportion of patients in our comprehensive otolaryngology clinic undergoing fine needle aspiration biopsy preferred remote communication of their biopsy results. Patients most valued clear explanations from the provider and prompt receipt of the result when communicating malignant results. This highlights the need for individualized results communication plans, for patients undergoing biopsy. 相似文献8.
Juan Li Jianhua Jin Songli Xi Qian Zhu Yuqin Chen Min Huang Chunyan He 《American journal of otolaryngology》2019,40(2):253-256
Background
Although cognitive behavioral therapy (CBT) has been known with a theoretical basis for tinnitus patients, there still were lack of clinical evidence.Objective
To evaluate the clinical efficacy of cognitive behavioral therapy (CBT) for treatment of chronic subjective tinnitus.Methods
One hundred patients with chronic subjective tinnitus patients were randomly divided into control (50 cases) and intervention (50 cases) groups, which received the masking therapy and sound treatment and masking therapy and sound treatment plus CBT. The treatment efficacy was evaluated.Results
The total effective rate in intervention group was significantly higher than control group (P?<?0.01). After treatment, compared with control group, in intervention group the psychotic somatization, interpersonal sensitivity, depression, anxiety, hostility, terror, and phobic anxiety scores in Symptom Checklist-90 and Tinnitus Handicap Inventory score were significantly decreased (P?<?0.05), the serum cortisol level was significantly decreased (P?<?0.05), and the serum interleukin-2 level was significantly increased (P?<?0.05).Conclusion
Based on the elimination the mood disorders and reduce the stress, CBT can significantly relieve the symptoms of chronic subjective tinnitus. 相似文献9.
Herbert Silverstein Joshua Smith Brian Kellermeyer 《American journal of otolaryngology》2019,40(2):247-252
Objective
Hyperacusis is a reduction of normal tolerances for everyday sounds. Although several publications have been produced demonstrating that minimally invasive surgical procedures may improve patient symptoms, the precise etiology of hyperacusis often remains elusive. This study describes 21 patients, 7 of whom stapes hypermobility is believed to be a mechanical genesis of their hyperacusis symptoms.Study design
A prospective, repeated-measure single-arm design was used for this study.Setting
All patients were evaluated and treated at a tertiary level otologic referral center.Subjects and methods
21 patients (Cohort A) with severe hyperacusis underwent oval and round window reinforcement. Seven patients (Cohort B) intraoperatively appeared to have subjective hypermobility of the stapes. Additional reinforcement of the stapes superstructure was performed in these patients.Results
In Cohort A, loudness discomfort level (LDL) values improved on average from 72.7?dB to 81.9?dB. Hyperacusis questionnaire (HQ) scores improved from 30.1 to 14.7. Numeric Rating Scale scores (0?10) decreased from 8.5 to 4.0. In Cohort B, values similarly improved from an average of 72.4?dB to 88.2?dB. HQ scores improved from 35.8 to 18.9. Numeric Rating Scale scores fell from 10.0 to 3.7. Postoperatively there were no complaints of hearing loss. Sixteen out of 21(76%) reported improved quality of life and diminished symptoms of hyperacusis.Conclusion
It is possible that patients suffering from hyperacusis may have a mechanical cause for their symptoms. Further research is necessary to clarify stapes mobility in patients with these symptoms. Excess temporalis tissue reinforcement of the stapes along with round window reinforcement shows promise as a minimally invasive surgical option for patients suffering from hyperacusis. 相似文献10.
Shirley Hu Samuel Helman Peter Filip Jonathan Cabin Patrick Colley 《American journal of otolaryngology》2019,40(1):115-120
Background
Headaches are commonly evaluated in otolaryngology and often represent a diagnostic dilemma. This review addresses rhinogenic headache as well as trigeminal neuralgia and migraine, both of which can masquerade as sinus headache and whose management increasingly involves otolaryngology intervention. Discussion considers diagnostic criteria and novel therapies and derives an algorithm for clinical decision-making.Data sources
OVID MEDLINE, Cochrane Library, and Google Scholar databases.Methods
A literature search was performed to identify relevant articles published in the past 10?years addressing the diagnosis and management of rhinogenic headache, trigeminal neuralgia and/or migraine.Findings
Rhinogenic headache: Identification of the specific cause must be achieved before treatment. No studies have mentioned the effect of certain therapies on the amelioration of headache. New techniques of balloon dilation for sinusitis are controversial, and their use remains contingent on surgeon preference. Removal of mucosal contact points has been shown to benefit quality of life in patients with contact point headache. Trigeminal neuralgia: Microvascular decompression is considered the gold standard for treatment, but percutaneous therapies can be effective for achieving pain control. Migraine: Patients who report amelioration of symptoms after targeted botulinum toxin injection may benefit from definitive decompression or nerve avulsion. Patients with mucosal contact points may have less favorable outcomes with migraine surgery if they are not simultaneously addressed.Conclusions
A comprehensive understanding of the diagnostic workup and therapeutic options available for common headache etiologies is key to the management of a patient presenting with headache attributed to a rhinogenic cause. 相似文献11.
Gülay Açar Aynur Emine Çiçekcibaşı İbrahim Çukurova Kemal Emre Özen Muzaffer Şeker İbrahim Güler 《Revista brasileira de otorrinolaringologia (English ed.)》2019,85(2):136-143
Introduction
The type of endoscopic approach chosen for vidian neurectomy can be specified by evaluating the vidian canal and the surrounding sphenoid sinus structures.Objective
The variations and morphometry of the vidian canal were investigated, focusing on the functional correlations between them which are crucial anatomical landmarks for preoperative planning.Methods
This study was performed using paranasal multidetector computed tomography images that were obtained with a section thickening of 0.625 mm of 250 adults.Results
The distributions of 500 vidian canal variants were categorized as follows; Type 1, within the sphenoid corpus (55.6%); Type 2, partially protruding into the sphenoid sinus (34.8%); Type 3, within the sphenoid sinus (9.6%). The pneumatization of the pterygoid process is mostly seen in vidian canal Type 2 (72.4%) and Type 3 (95.8%) (p < 0.001). The mean distances from the vidian canal to the foramen rotundum and the palatovaginal canal were greater in the vidian canal Type 2 and 3 with the pterygoid process pneumatization (p < 0.001). The prevalence of the intrasphenoid septum between the vidian canal and the vomerine crest and lateral attachment which ending on carotid prominence were much higher in vidian canal Type 3 than other types (p < 0.001). The mean angle between the posterior end of the middle turbinate and the lateral margin of the anterior opening of the vidian canal was measured as 33.05 ± 7.71°.Conclusions
Preoperative radiologic analysis of the vidian canal and the surrounding structures will allow surgeons to choose an appropriate endoscopic approach to ensure predictable postoperative outcomes. 相似文献12.
Alexander L. Luryi Elias M. Michaelides Seilesh Babu Dennis I. Bojrab John F. Kveton Robert S. Hong John Zappia Eric W. Sargent Christopher A. Schutt 《American journal of otolaryngology》2019,40(2):133-136
Objectives
To assess the accuracy of pre-operative diagnosis of masses of the cerebellopontine angle (CPA) when compared to surgical pathology.Design
Retrospective chart review.Participants
Patients who underwent surgery for CPA masses at two tertiary care institutions from 2007 to 2017.Main outcome measures
Percent concordance between pre-operative and surgical pathologic diagnosis; sensitivity, specificity, positive predictive value, and negative predictive value for predicted diagnoses.Results
Concordance between pre-operative diagnosis and surgical pathology was 93.2% in 411 sampled patients. Concordance was 57.9% for masses other than vestibular schwannoma. Prediction of vestibular schwannoma and meningioma had high positive (0.95 and 0.97, respectively) and negative (0.76 and 0.99, respectively) predictive values. Prediction of facial neuroma had sensitivity of 0.13 and positive predictive value of 0.25. Headache (p?=?0.001) and facial weakness (p?=?0.003) were significantly associated with different pathologic profiles. Hearing loss was associated with differences in diagnostic prediction (p?=?0.02) but not with differences in surgical pathology (p?>?0.05).Conclusions
Comparison between pre-operative predicted diagnosis and surgical pathology for cerebellopontine angle masses is presented. Vestibular schwannoma and meningioma were effectively identified while rarer CPA masses including facial neuroma were rarely identified correctly. Clinicians caring for patients with CPA masses should be mindful of diagnostic uncertainty which may lead to changes in treatment plan or prognosis. 相似文献13.
Yasser Mohammad Hassan Mandour Shaimaa Magdy Abo Youssef Hany Hussein Moussa 《American journal of otolaryngology》2019,40(2):187-190
Object
To compare Polysomnography and Pulmonary function tests before and after Septoplasty with Turbinectomy in patients complaining of nasal obstruction and sleep problems due to deviated septum with hypertrophic inferior turbinate.Methods
90 patients underwent Septoplasty with Turbinectomy due to nasal obstruction and sleep problems involved in this study, their sleep quality evaluated by polysomnography before and after the surgery, their pulmonary functions assessed by spirometry before and after the operation.Results
The postoperative pulmonary function values; FVC, FEV1, PEFR and postoperative polysomonographic values; AHI, Snoring index/hour, SpaO2 were higher than the preoperative values, and the results were statistically significant (p-values <0.001).Conclusion
Septoplasty with partial inferior turbinectomy might be a useful operation in the management of nasal obstruction and sleep problems that caused by a deviated nasal septum and hypertrophied inferior turbinate. 相似文献14.
Resit Murat Acikalin Cemal Haci Fazilet Altin Yalcin Alimoglu 《American journal of otolaryngology》2019,40(2):230-232
Background
Tinnitus is a common disease in public. It is not only associated with neuronal, muscular, vascular pathologies, but also with related psychological parameters. In this study, we aimed to investigate the relationship between tinnitus, anxiety and depression in patients undergoing tympanoplasty.Methods
Patients with tinnitus and operated for chronic otitis media were included in our study. Before and after the operation, tinnitus handicap inventory, beck anxiety and depression scales were filled and pre- and postoperative values were compared. In addition, our patients were divided into two groups as tinnitus improve and did not improve and differences between them were investigated.Results
148 patients were included in our study. Of 148 patients, 60 were male and 88 were female. There was no significant difference between the patients with and without tinnitus when the dermografic features, hearing levels and physical examination findings were compared.After the operation, the patients who did not improve tinnitus had higher levels of depression and depression than others (<0.001).Conclusion
As a result of our study, anxiety and depression scales of the patients whose tinnitus did not improve were found to be higher than the patients whose tinnitus improved. 相似文献15.
Ameya Jategaonkar Jaclyn Klimczak Jay Agarwal Arvind Badhey William M. Portnoy Angela Damiano Raymond L. Chai 《American journal of otolaryngology》2019,40(2):143-146
Objective
Syphilis is a sexually transmitted infection with various presentations. Although, oropharyngeal manifestations are known to occur, the purpose of this study is to present the first case series in which the lesions were initially mistaken for human-papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).Methods
A multi-institutional retrospective review.Results
Six cases of oropharyngeal syphilis were initially thought to be secondary to OPSCC due to presentation. Symptoms were vague and exam findings consisted of either a tonsillar or base of tongue mass, or lymphadenopathy. Biopsies were negative for OPSCC. Further workup diagnosed syphilis, with resolution of symptoms and lesions after antibiotic treatment.Conclusions
Head and neck manifestations of syphilis have been reported in the literature. However, this is the first series reporting on oropharyngeal syphilis masquerading as HPV-related OPSCC. Ultimately, otolaryngologists must maintain a high suspicion for syphilis in order to ensure prompt diagnosis and treatment. 相似文献16.
Renhui Chen Qian Cai Faya Liang Peiliang Lin Ling Chen 《American journal of otolaryngology》2019,40(2):233-235
Objective
To confirm the pre-treatment diagnosis of parapharyngeal space malignancy could aid the treatment plan.Methods
For patients with suspected malignant parapharyngeal space tumors following preoperative imaging, oral biopsy was conducted for pathological diagnosis with the use of 22-G biopsy needles.Results
A total of 11 patients were enrolled. There were three previously diagnosed cases of head and neck malignancy, and eight cases were newly diagnosed. The tumor diameters were in the range of 3 to 5.5?cm. Ten cases (90.9%) achieved positive results, of which eight cases (72.7%) obtained positive results with one puncture and two cases obtained positive pathological results with two punctures. One case did not obtain positive results with two punctures; open surgical resection was performed for this patient. There were no complications such as needle track implantation, heavy bleeding or neurological damage symptoms during the puncture process.Conclusions
Oral biopsy is a minimally invasive, safe and effective technique for the diagnosis of parapharyngeal space tumors. It is easy to operate and could facilitate a comprehensive treatment plan for parapharyngeal space malignancies. 相似文献17.
Michael Chang Alanna Coughran Yu-Jin Lee Jeremy Collins Davud Sirjani 《American journal of otolaryngology》2019,40(2):152-155
Objective
To report the patient selection, surgical technique, and outcomes of parotidectomy using local anesthesia under monitored anesthesia care (MAC).Methods
A retrospective chart review was performed for patients undergoing parotidectomy under local anesthesia at an academic head and neck surgery center.Results
Six patients deemed high risk for general anesthesia (GA) due to medical comorbidities or with a strong preference to avoid GA underwent parotidectomy using local anesthesia and MAC. Parotidectomy was performed for several indications, including benign tumors, malignant tumors, and chronic sialadenitis. Mean age of patients was 78.0?±?7.9?years, and all had an American Society of Anesthesia score?≥?2 and Charlson comorbidity index ≥4. Mean operative time was 102.8?±?38.3?min, comparable to that of parotidectomy under general anesthesia. No major complications occurred. Minor complications included three cases of temporary postoperative facial nerve weakness limited to 1–2 lower division branches. At most recent follow up (10 to 48?months), all patients were medically stable and disease free.Conclusion
In carefully selected patients, parotidectomy under local anesthesia is a viable treatment alternative that can be offered to patients. Successful outcomes require preoperative counseling, meticulous technique, and close collaboration with anesthesia colleagues. 相似文献18.
Purpose
The goal of this study was to describe the incidence of and our long-term results in the management of spontaneous temporal bone CSF leak and to determine if there is any association with an increase in body mass index (BMI).Methods
This was an Institutional Review Board (IRB) approved retrospective review of 58 patients who underwent repair of spontaneous temporal bone CSF leaks by a single surgeon at a tertiary care academic medical center between 1988 and 2017. Patients with CSF leaks due to trauma, iatrogenic injury, or chronic infection were excluded. Surgical approaches included middle cranial fossa, transmastoid, or a combination of both. Cases were divided into three decades. Patient demographics, clinical features, audiologic results, imaging studies, operative findings, complications, and long-term results were reviewed with a specific emphasis on the potential correlation with BMI.Results
The average BMI was 32. There was a statistically significant increase in BMI between the two most recent decades (p?=?0.044). The middle cranial fossa was the most commonly utilized approach. Multiple tegmen defects were often noted on imaging and intraoperatively.Conclusion
There is an increase in the incidence of spontaneous CSF leaks possibly associated with an increase in BMI in the United States over the last 30?years. 相似文献19.
Kuang-Hsuan Shen Yu-Hsuan Wang Ting-Wei Hsu Li-Chun Hsieh Fang-Ju Sun Ying-Piao Wang 《American journal of otolaryngology》2019,40(1):22-29
Purpose
The efficacy of postoperative oral corticosteroids on surgical outcomes in chronic rhinosinusitis with nasal polyps (CRSwNP) patients following endoscopic sinus surgery (ESS) remains controversial. This study evaluated the potential benefits of postoperative oral corticosteroids on surgical outcomes in CRSwNP patients and investigated the differential effects on eosinophilic CRSwNP (ECRSwNP) and noneosinophilic CRSwNP (NECRSwNP).Materials and methods
Patients with bilateral CRSwNP who underwent ESS were enrolled and randomized to receive either oral prednisolone (30?mg/day) or placebo for 2?weeks after surgery. Visual analog scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22) scores were chosen as the subjective outcomes, evaluated at preoperative baseline and 1, 3, and 6?months postoperatively. Lund-Kennedy Endoscopic Scores (LKESs) were used as the objective outcome, evaluated at preoperative baseline and at 2?weeks and 2, 3, and 6?months postoperatively.Results
In total, 100 patients with bilateral CRSwNP were enrolled, of whom only 82 completed the 6-month follow-up. The subjective outcomes showed no significant difference at each follow-up points. Of the objective outcomes, the corticosteroid group reporting a trend of improvement in LKESs at 6?months postoperatively (p?=?0.05). After stratification by tissue eosinophils, only patients with NECRSwNP (<10 eosinophils/HPF) demonstrated a significant improvement in LKESs at 3?months postoperatively (p?=?0.03).Conclusions
Postoperative oral corticosteroids did not provide additional improvements in VAS and SNOT-22 scores; nevertheless, a trend of LKES improvement was noted at 6?months postoperatively. After stratification by tissue eosinophils, this effect was significant only among NECRSwNP patients at 3?months follow-up. 相似文献20.
H. Tovi H. Ovadia R. Eliashar M.A. de Jong M. Gross 《European annals of otorhinolaryngology, head and neck diseases》2019,136(2):99-101