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1.
Ismail Guler Deniz Baklaci Ihsan Kuzucu Rauf Oguzhan Kum Muge Ozcan 《Auris, nasus, larynx》2019,46(3):319-323
Objective
To investigate the success rates and hearing outcomes of temporalis fascia and tragal cartilage grafts used for type-1 tympanoplasty in the elderly (³65 years)Methods
The medical records of 73 elderly patients who underwent type-1 tympanoplasty at our center between January 2010 and June 2017 were retrospectively reviewed for age, gender, perforation side, presence of contralateral perforation, type and location of perforation, graft material types, preoperative and postoperative hearing levels, and length of follow-up.Results
The graft success rate was 83.5% (61 patients) for the entire group, 76.2% (32 patients) for the fascia group, and 93.5% (29 patients) for the cartilage group. The success rate for the cartilage group was significantly higher than that for the fascia group (P = 0.048). The mean hearing gain was 12.5 ± 7.6 and 8.9 ± 6.1 dB in the fascia and cartilage groups, respectively, and postoperative ABG was 10 dB or better in 29 (69.0%) and 19 (61.3%) patients, respectively. The mean hearing gain was significantly higher in the fascia group than in the cartilage group (P = 0.028), whereas the mean ABG was significantly higher in the cartilage group than in the fascia group (P = 0.009). The functional success rates were similar in both groups (P = 0.490).Conclusion
Tympanoplasty is a safe and effective procedure in elderly patients with a 83.5% of graft success rate. Tragal cartilage may be the first choice of graft material due to its high success rates. The functional outcomes did not show significant differences between the fascia and cartilage groups. 相似文献2.
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3.
Objective
We investigated the medical costs and effects of ofloxacin drops (OFLX), gelatin sponge patches, spontaneous healing, and endoscopic myringoplasty on healing in large tympanic membrane perforations (TMPs).Methods
In total, 100 patients with large traumatic TMPs involving >50% of the eardrum were randomly assigned to OFLX, gelatin sponge, spontaneous healing, or endoscopic myringoplasty treatment groups. Medical costs, closure times, and closure rates were compared among groups at 6?months.Results
The closure rates in the OFLX, gelatin sponge, spontaneous healing, and endoscopic myringoplasty groups were 95.7%, 82.6%, 58.3%, and 91.7%, respectively (P?=?0.05). The mean closure time was 13.73?±?6.14?days in the OFLX group, 15.89?±?4.95?days in the gelatin sponge group, 48.36?±?10.37?days in the spontaneous healing group, and 12?days in the endoscopic myringoplasty group (P?<?0.001). The mean medical costs in US dollars were $15.53?±?3.15, $103.64?±?111.58, $11.17?±?1.33, and $715.90 in the OFLX, gelatin sponge, spontaneous healing, and endoscopic myringoplasty groups, respectively (P?<?0.001).Conclusion
Although the gelatin sponge and myringoplasty treatments significantly shortened the closure time compared with spontaneous healing, the gelatin sponge patch did not significantly improve the closure rate, and the medical cost of myringoplasty was significantly higher than that of the other treatments. In contrast, OFLX significantly shortened closure time and had a higher closure rate than spontaneous healing, and the medical costs were lower than those of the gelatin sponge and myringoplasty procedures. 相似文献4.
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5.
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6.
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7.
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8.
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9.
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10.
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11.
Objective
To compare the effects of epidermal growth factor (EGF) and observation only on human subacute tympanic membrane perforation (TMP).Methods
A total of 44 patients with traumatic TMPs >2?months after trauma were divided into an observation group (n?=?18) and EGF group (n?=?26). Patients in the EGF group underwent direct application of EGF without stripping of the perforation edge. All patients were followed up for at least 6?months. The TMP closure rate, closure time, and hearing gain were evaluated.Results
At 6?months, 25 of 26 (96.2%) perforations achieved complete closure with a mean closure time of 9.1?±?3.9?days (range, 3–14?days) in the EGF group. However, only 11 of 18 (61.1%) perforations achieved complete closure in the observation group, with a mean closure time of 20.6?±?10.7?days (range?=?9–71?days). The patients in the EGF-treated group had significantly improved closure rates (P?=?0.026) and a reduced closure time (P?<?0.01) compared to those in the observation group. The difference in mean hearing improvement between the two groups was not statistically significant (P?=?0.86).Conclusions
Topical application of EGF improved the closure rate and shortened the closure time of human subacute TMPs compared with spontaneous healing, the stripping of the perforation edge was unnecessary. This treatment is simple and convenient and should be recommended pre-myringoplasty. 相似文献12.
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13.
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14.
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15.
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16.
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17.
Rashu Mittal Li-Ang Lee Cheng Hui Lin Li-Jen Hsin Navdeep Bhusri Hsueh-Yu Li 《Auris, nasus, larynx》2019,46(3):384-389
Objective
To elucidate potential role of cephalometric measurements to predict tongue base obstruction as observed on drug Induced Sleep Computed Tomography (DIS-CT).Methods
Study included 35 patients with moderate to severe sleep apnea who underwent DIS-CT & cephalometric examination to assess tongue base obstruction.Results
Statistically significant difference was noted for SNA angle & Mandibular posterior airway space (PAS) among groups with total tongue obstruction versus Non-total tongue obstruction identified on DIS-CT.Conclusion
Lateral cephalogram can be used as a standard screening tool with commonly used skeletal and soft tissue parameters to predict the possibility of tongue collapse/obstruction during sleep in patient with moderate to severe OSAS. 相似文献18.
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19.
Objective
The search for safe and effective tissue fillers has been an ongoing effort for many years. Obtaining biological materials from patients can require additional incisions and brings surgical and cosmetic risks as a major disadvantage. The aim of this experimental study was, therefore, to evaluate the efficacy of folded amniotic membrane as a soft tissue filler and to assess its volume, and to investigate the possible usage of injectable amniotic membrane for augmentation.Methods
Multi-layer amniotic membranes are transplanted to the subcutaneous tunnels created in the rat’s back, and the amniotic membrane transformed into the injection material is inoculated transcutaneously under the rat’s skin. At the end of two months, the amount of volume loss and histopathological changes in the grafts were examined under light microscope.Results
The multi-layer amniotic membrane grafts maintain its volume around 92%. It has been shown that the injectable amniotic membrane maintains its presence in the tissue, can augment it, and can be used as a soft tissue filler. The availability of using amniotic membrane for injection material is shown. No foreign body reaction to the amnion grafts, fibrosis, and necrosis were observed in our study.Conclusion
According to our study results, multi-layer amnion graft and amnion injection seem to be used as camouflage grafts and soft tissue augmentation materials. Although further clinical trials are mandatory before considering the use of amniotic membrane as a tissue filler material in humans, we are hopeful about its long-term safety and efficacy. 相似文献20.
Shirley Hu Samuel Helman Peter Filip Jonathan Cabin Patrick Colley 《American journal of otolaryngology》2019,40(1):115-120