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1.
Akina Tamaki Berje Shammassian Abhishek Ray Warren R. Selman Kenneth Rodriguez 《American journal of otolaryngology》2017,38(5):645-647
Steroid-releasing sinus stents have emerged as a safe and effective tool in endoscopic sinus surgery. In this case report, we present two patients with recurrent cystic sellar masses. Transsphenoidal approach was used to access the sella. Following resection and drainage of the cystic pathology, a Propel (Menlo Park, CA) stent was placed through the corridor of the resection site to stent the cavity open. This is the first report where a steroid-releasing sinus stent was used in the treatment of a sellar lesion. It supports that this technology is safe and effective for use in skull base surgery. 相似文献
2.
Akina Tamaki Eric Babajanian Brian DAnza Kenneth Rodriguez 《American journal of otolaryngology》2017,38(3):363-366
Vascular tumors of the nasal cavity can represent a variety of pathologies. In this case report, we discuss two patients presenting with a large vascular lesion occupying the nasal cavity. Significant bleeding was encountered during the initial attempts for endoscopic surgical resection. One lesion was successfully excised following preoperative embolization while a second following sphenopalatine artery vascular ligation. In both cases, final pathology showed lobular capillary hemangioma (LCH). We present a literature review and discussion of LCH and other vascular tumors that present in the nasal cavity. In addition, we discuss the utility of pre-resection vascular control of these tumors. 相似文献
3.
Laryngeal sarcoma is a rare and potentially aggressive malignancy. In this case report, we present a 23 year-old-male with four-years of progressive hoarseness who was found to have a large left paraglottic mass. A partial laryngectomy was successful at completely excising the lesion. Final pathology returned as alveolar soft part sarcoma. Alveolar soft part sarcomas of the larynx are extremely rare with only five cases published in the current literature. This article provides a case presentation with literature review of alveolar soft part sarcoma of the head and neck. 相似文献
4.
Sharon Lin Sami Melki Michelle V. Lisgaris Emily N. Ahadizadeh Chad A. Zender 《American journal of otolaryngology》2017,38(4):417-421
Purpose
Surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus (MRSA) is a serious post-operative complication, with head and neck cancer patients at greater risk due to the nature of their disease. Infection with MRSA has been shown to be costly and impart worse outcomes on patients who are affected. This study investigates incidence and risks for MRSA SSIs at a tertiary medical institution.Materials and methods
This study reviewed 577 head and neck procedures from 2008 to 2013. Twenty-one variables (i.e. tumor characteristics, patient demographics, operative course, cultures) were analyzed with SPSS to identify trends. A multivariate analysis controlled for confounders (age, BMI, ASA class, length of stay) was completed.Results
We identified 113 SSIs of 577 procedures, 24 (21.23%) of which were MRSA. Of all analyzed variables, hospital exposure within the preceding year was a significant risk factor for MRSA SSI development (OR 2.665, 95% CI: 1.06–6.69, z statistic 2.086, p = 0.0369). Immunosuppressed patients were more prone to MRSA infections (OR 14.1250, 95%CI: 3.8133–52.3217, p < 0.001), and patients with a history of chemotherapy (OR 3.0268, 95% CI: 1.1750–7.7968, p = 0.0218). Furthermore, MRSA SSI resulted in extended post-operative hospital stays (20.8 ± 4.72 days, p = 0.031).Conclusions
Patients who have a history of chemotherapy, immunosuppression, or recent hospital exposure prior to their surgery are at higher risk of developing MRSA-specific SSI and may benefit from prophylactic antibiotic therapy with appropriate coverage. Additionally, patients who develop MRSA SSIs are likely to have an extended postoperative inpatient stay. 相似文献5.
Cameron C. Wick Rod P. Rezaee Tammy Wang Andrea M. Garcia-Jarchow Chad A. Zender Michael Gibson Min Yao Pierre Lavertu 《American journal of otolaryngology》2017,38(1):72-76
Hypothesis
Patients with advanced laryngeal cancer sometimes desire organ preservation protocols even if it portends a worse outcome.Background
To assess outcomes of patients with T4 laryngeal cancer treated with chemoradiation therapy.Methods
Case series with chart review at a tertiary university hospital. Twenty-four patients with T4 laryngeal cancer all declined total laryngectomy with adjuvant radiation as the primary treatment modality and alternatively received concurrent chemoradiation therapy. The primary outcome was overall survival. Secondary outcomes were rates of tracheotomy dependence, gastric tube dependence, and need for salvage laryngectomy.Results
All patients had T4 laryngeal disease, 71% had cartilage invasion and 59% had regional metastasis to the neck. Kaplan–Meier analysis determined 2-year and 5-year overall survival to be 64% and 59% respectively. The locoregional recurrence rate was 25%. The distant metastasis rate was 21%. The rate of salvage laryngectomy was 17%, which occurred at a mean of 56.5 months after the original diagnosis. The rate of tracheotomy dependence was 33% while gastric tube dependence was 25%.Conclusion
Advanced T4 laryngeal cancer, particularly with cartilage invasion, remains a surgical disease best treated with total laryngectomy and adjuvant radiation. This data may help guide patients and practitioners considering concurrent chemoradiation therapy for definitive treatment of advanced laryngeal cancer. 相似文献6.
7.
Edward T. Chang Camilo Fernandez-Salvador Jeremy Giambo Blaine Nesbitt Stanley Yung-Chuan Liu Robson Capasso Clete A. Kushida Macario Camacho 《American journal of otolaryngology》2017,38(3):272-278
Objective
Tongue Retaining Devices (TRD) anteriorly displace the tongue with suction forces while patients sleep. TRD provide a non-surgical treatment option for patients with Obstructive Sleep Apnea (OSA). Our objective was to conduct a systematic review of the international literature for TRD outcomes as treatment for OSA.Methods
Three authors independently and systematically searched four databases (including PubMed/MEDLINE) through June 26, 2016. We followed guidelines set within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Results
Sixteen studies with 242 patients met criteria. The overall means ± standard deviations (M ± SD) for apnea-hypopnea index (AHI) decreased from 33.6 ± 21.1/h to 15.8 ± 16.0/h (53% reduction). Seven studies (81 patients) reported lowest oxygen saturation (LSAT), which improved from 79.8 ± 17.5% to 83.9 ± 8.6%. Four studies (93 patients) reported Epworth sleepiness scale (ESS), which decreased from 10.8 ± 4.8 to 8.2 ± 4.5, p < 0.0001. Four studies (31 patients) reported Oxygen Desaturation Index (ODI) which decreased from 29.6 ± 32.1 to 12.9 ± 8.7, a 56.4% reduction.Conclusion
Current international literature demonstrates that tongue retaining devices reduce apnea-hypopnea index by 53%, increase lowest oxygen saturation by 4.1 oxygen saturation points, decrease oxygen desaturation index by 56% and decrease Epworth sleepiness scale scores by 2.8 points. Tongue retaining devices provide a statistically effective alternative treatment option for obstructive sleep apnea. 相似文献8.
Andrea L. Hanick Joseph B. Meleca Steven D. Billings Paul C. Bryson 《American journal of otolaryngology》2019,40(2):331-333
Pyogenic granuloma (PG) may involve gingival mucosa (granuloma gravidarum) in pregnancy but rarely involves the airway. This case report is perhaps the only reported presentation of PG in the larynx causing hemoptysis at a late stage of pregnancy. On laryngoscopic exam, a vascular, right false vocal fold neoplasm was identified with pathological characteristics consistent with PG. Conclusions: Pyogenic granuloma is a relatively common tumor of pregnancy but rarely involves the larynx. In the case of airway involvement during pregnancy, it is best managed in coordination with the high-risk obstetrical team and can be removed safely via standard microsurgical techniques. 相似文献
9.
Patrik Pipkorn Parul Sinha Joseph Zenga Evan Graboyes Bruce H. Haughey 《American journal of otolaryngology》2017,38(3):329-332
Purpose
Pharyngocutaneous fistula (PCF) after laryngectomy continues to be a serious complication, especially after radiation. Recruitment of non-radiated tissue into the surgical defect may decrease the risk of fistula. These techniques however have significant morbidity and increases operative time. We hypothesized that using acellular dermal graft to reinforce the pharyngeal closure could decrease the risk of fistula, without the added morbidity of a vascularized flap.Methods
We performed a retrospective chart review of all patients that underwent a laryngectomy between 2005 and 2015 at an acedemic tertiary referral center. Patients who underwent primary pharyngeal closure with Alloderm® reinforcement without any other flap reconstruction were identified. Basic demographics, previous treatment, operative technique and fistula were extracted from the medical records. The primary outcome was PCF rate. The time to closure, margin status and disease recurrence was also evaluated.Results
Among 16 patients with AlloDerm® augmentation, eight had primary laryngectomy and eight had salvage laryngectomy. A total of three in the salvage laryngectomy with prior history of radiation developed PCF. The fistula closed in all three cases with conservative treatment. There was no PCF in the primary laryngectomy group without prior history of radiation.Conclusion
The rate of PCF among the salvage laryngectomy group with previous radiation did not differ from historical data. AlloDerm® can however, provide a simple alternative for repair in radiation patients where flap cannot be performed for pharyngeal reconstruction. In non-radiated patients, AlloDerm® augmentation may have a protective effect on fistula formation. 相似文献10.
H.A. Shah Taha Shipchandler Dominic Vernon Maraya Baumanis David Chan William R. Nunery Hui Bae Harold Lee 《American journal of otolaryngology》2018,39(1):34-36
Purpose
To report a series of patients with extra-ocular movement restriction and diplopia after orbital fracture repair, and determine the effect of timing of repair and the type of implant used.Methods
A chart review was conducted identifying all patients > 18 years of age at our institution between June 2005 and June 2008 who underwent orbital fracture repair, and presented with clinically significant diplopia and extra-ocular movement restriction persisting longer than one month after repair. Data collected included timing of repair, implant used within the orbit, and need for revision.Results
Ten patients were identified with a mean time to primary orbital fracture repair at 9 days (range 1–48). Seven patients underwent revision of their orbital fracture repair with removal of the previously placed implant and replacement with non-porous 0.4 mm Supramid Foil, whereas one patient underwent lateral and inferior rectus recessions without revision of primary fracture repair. Titanium mesh was the intra-orbital implant found in all patients requiring revision of orbital fracture repair. All revisions resulted in resolution of clinically significant diplopia.Conclusions
Clinically significant diplopia and extra-ocular movement restriction is not an uncommon complication after orbital fracture repair. In our series, there was a strong association between these complications and the use of porous titanium mesh implants. Revision of fractures significantly improved diplopia in all but one patient. This suggests that meticulous fracture repair and the use of non-porous implants primarily or secondarily may preclude the need for strabismus surgery after orbital trauma. 相似文献11.
Judd H. Fastenberg Christina H. Fang Nadeem A. Akbar Waleed M. Abuzeid Howard S. Moskowitz 《American journal of otolaryngology》2018,39(5):527-530
Introduction
The development of portable, high resolution video displays such as video glasses allows clinicians the opportunity to offer patients an increased ability to visualize aspects of their physical examination in an ergonomic and cost-effective manner. The objective of this pilot study is to trial the use of video glasses for patients undergoing binocular microscopy as well as to better understand some of the potential benefits of the enhanced display option.Methods
This study was comprised of a single treatment group. Patients seen in the otolaryngology clinic who required binocular microscopy for diagnosis and treatment were recruited. All patients wore video glasses during their otoscopic examination. An additional cohort of patients who required binocular microscopy were also recruited, but did not use the video glasses during their examination. Patients subsequently completed a 10-point Likert scale survey that assessed their comfort, anxiety, and satisfaction with the examination as well as their general understanding of their otologic condition.Results
A total of 29 patients who used the video glasses were recruited, including those with normal examinations, cerumen impaction, or chronic ear disease. Based on the survey results, patients reported a high level of satisfaction and comfort during their exam with video glasses. Patients who used the video glasses did not exhibit any increased anxiety with their examination. Patients reported that video glasses improved their understanding and they expressed a desire to wear the glasses again during repeat exams.Conclusion
This pilot study demonstrates that video glasses may represent a viable alternative display option in the otolaryngology clinic. The results show that the use of video glasses is associated with high patient comfort and satisfaction during binocular microscopy. Further investigation is warranted to determine the potential for this display option in other facets of patient care as well as in expanding patient understanding of disease and anatomy. 相似文献12.
Mark J. Ringstrom Jay Christian Matthew L. Bush Jeffrey E. Levy Bin Huang T.J. Gal 《American journal of otolaryngology》2018,39(5):575-581
Objectives
The objective was to examine the impact of travel distance on stage of presentation and treatment choices in head and neck squamous cell carcinoma in the rural setting.Methods
6029 cases diagnosed from 2002 to 2011 were obtained from the state cancer registry. Travel time was calculated to the nearest academic medical centers, otolaryngologist, and radiation treatment facilities. Multivariate logistic regression was used to examine the association of travel time with stage of presentation as well as the likelihood of appropriate therapy after adjustment for other demographic variables.Results
Patients in the highest quartile for travel distance to academic centers were 33% more likely to present with early stage disease (p?=?0.02), and 42% more likely to receive appropriate surgical therapy for oral cavity cancer. Patients were 70% more likely to receive appropriate surgery if they were farthest from the nearest radiation center (p?=?0.03). Proximity to otolaryngology care was not significant.Conclusion
Increased travel distance to academic medical centers is associated with increased likelihood of proper therapy for surgically treated tumors of the head and neck. Impact on these findings on improvements in access to care is discussed. 相似文献13.
Zachary G. Schwam Rocco Ferrandino Vivian Z. Kaul Maura K. Cosetti George B. Wanna 《American journal of otolaryngology》2019,40(6):102290
PurposeTo determine the risk factors for unanticipated readmission, prolonged index admission, and discharge to a facility after vestibular schwannoma surgery.Materials and methodsRetrospective cohort study of those undergoing surgery for vestibular schwannoma in the Nationwide Readmissions Database (2013–2014). Main outcome measures included readmission rate, length of stay, discharge destination.ResultsThere were 4585 cases identified. The overall unanticipated readmission rate was 8.1%, and 9.1% had a prolonged length of stay (PLOS) of ≥7 days. Mean and median LOS were 4.63 and 4.00 days, respectively, and >90% of patients were discharged after 7 days. Disposition to a facility occurred in 6.7% of cases. Teaching hospitals were protective against unintended readmission (odds ratio [OR] 0.44, p < .001). Major functional loss was associated with PLOS (OR 12.55, p < .001). High volume centers were associated with decreased risk of PLOS (OR 0.46, p < .001) and facility discharge (OR 0.68, p < .001). The most common readmission diagnoses included “other nervous system complications” (n = 128), cerebrospinal fluid leak (n = 71), “other postoperative infection” (n = 61), and meningitis (n = 59).ConclusionsUnanticipated readmission and prolonged LOS following vestibular schwannoma surgery are common, with varied sociodemographic, hospital, and patient factors independently associated with each. Further studies are needed to investigate targeted interventions aimed at minimizing readmission and prolonged LOS using the factors outlined above. 相似文献
14.
O. Laccourreye H. Maisonneuve 《European annals of otorhinolaryngology, head and neck diseases》2019,136(6):475-480
The present review article details developments in medical writing and the ongoing transformation of the scientific medical press. With these twin revolutions, French-language scientific medical journals are at a crossroads: are they going to become vehicles of teaching, of popularization, of liaison between members of medical societies, of general public information contributing to decision-making in the field of public health? Or will they maintain their scientific status? Under certain conditions, a move toward French/English bilingualism could be the solution to maintain and advertise their scientific level, while contributing to the quality of medical teaching in French and to the worldwide influence of the French language. 相似文献
15.
Richard Chan Woo Park Amishav Y. Bresler Amy P. Bansal Soly Baredes 《American journal of otolaryngology》2018,39(5):522-526
Background
Resident duty hour restrictions can limit the frequency of resident flap checks at smaller institutions with “home” call. Institutions are compensating with adjuvant nursing flap checks as well as incorporating technology; however, this management remains controversial.Methods
A prospective cohort of 122 free flaps for reconstruction of the head and neck by a single surgeon. Demographic information, operative details, postoperative care, and flap outcomes were recorded.Results
Over 42?months, 122 free flaps were performed on 115 patients. The overall flap success rate was 96%. The flap success rate at 72?h was 98% and 96% at the time of discharge with reexploration rates of 11.6%. The intraoperative and postoperative salvage rates were 71% and 64.3% respectively.Conclusion
Limited resident flap checks combined hourly nurse flap checks and an implantable Doppler is an effective monitoring protocol for academic programs in the setting of residency duty hour restrictions. 相似文献16.
Hisami Fujio Naoki Otsuki Yuto Horichi Shungaku Yanagisawa Mari Nishio Masanori Teshima Hirotaka Shinomiya Kazunobu Hashikawa Ken-ichi Nibu 《Auris, nasus, larynx》2019,46(6):902-906
Cardiac metastasis from head and neck cancers are very rare. Metastases to heart are mostly diagnosed at autopsy, and seldom found while patients are alive. Patients with cardiac metastasis do not present with specific symptoms in the early stages, and diagnosis is often delayed until the disease has advanced significantly. Here, we report a 66-year-old lady who was diagnosed with cardiac metastasis 10 months after surgical resection of oral cancer. She died one month following the discovery of cardiac metastasis. Cardiac metastasis should be considered when unexplained and progressive decline of general health is observed, even in the absence of abnormalities on the electrocardiogram. Early diagnosis may be made by analyzing the chronological changes in the cardiac accumulation of fluorodeoxyglucose during positron emission tomography–computed tomography scan. 相似文献
17.
Seiichiro Makihara Shin Kariya Mai Noujima-Harada Nobuya Ohara Tomoyuki Naito Junya Matsumoto Yohei Noda Mitsuhiro Okano Tadashi Yoshino Kazunori Nishizaki 《Auris, nasus, larynx》2019,46(6):927-933
As has been well recognized, methotrexate (MTX) leads to a state of immunosuppression and can provide a basis for the development of lymphoproliferative disorders (LPDs). MTX-associated LPDs can affect nodal sites as well as extranodal sites, though the manifestation of an LPD in the form of multiple pulmonary nodules is rare. Here, we report two cases of MTX-associated LPD with multiple bilateral pulmonary nodules, which was a finding suggestive of lung cancer, and bilateral cervical lymphadenopathy. After withdrawal of MTX, the multiple bilateral pulmonary nodules and bilateral cervical lymphadenopathy disappeared without chemotherapy in both cases. From these results, patients with pulmonary nodules and cervical lymphadenopathy should be examined for head and neck malignant tumors. Also, physicians should carefully check the administration of MTX. In patients with an MTX-associated LPD, we need to make an early diagnosis and consider discontinuing the administration of MTX as soon as possible. 相似文献
18.
Seiichiro Makihara Shin Kariya Tomoyuki Naito Kensuke Uraguchi Junya Matsumoto Yohei Noda Mitsuhiro Okano Kazunori Nishizaki 《Auris, nasus, larynx》2019,46(5):748-753
ObjectiveThe treatment of all forms of sinonasal inverted papilloma (IP) is a complete, wide, local resection. The main surgical purpose is to remove all diseased mucosa and mucoperiosteum, together with a cuff of normal-looking mucosa at the attachment site, followed by drilling and/or coagulation. Our aim is to present our experiences in endoscopic surgical management of IP by using attachment-oriented excision.MethodsWe present 20 cases of sinonasal IP. The data collected includes the histopathological diagnosis, staging, extension of the tumor, tumor attachment site, approach to surgery, serum squamous cell carcinoma antigen (SCCA) level, and recurrences.ResultsAll patients underwent endoscopic surgery. A Caldwell-Luc operation was required in addition to the endoscopic surgery in one case. There was one case of recurrence (5%). After the additional operation, there was no recurrence. The tumor attachment sites vary, and the case of recurrence had a wide attachment site at the primary surgery. No major intra- or post-operative complications were observed.ConclusionThe present study shows that attachment-oriented excision for IP is useful for complete resection of IP. Surgeons should choose the surgical approach according to the location of the tumor attachment site rather than the Krouse staging system. 相似文献
19.
Thomas Guenzel Stephan Hoch Niels Heinze Thomas Wilhelm Christian Gueldner Achim Franzen Annekathrin Coordes Anja Lieder Susanne Wiegand 《Auris, nasus, larynx》2019,46(5):797-802
ObjectiveTo demonstrate the safety and efficiency of holmium laser-assisted lithotripsy during sialendoscopy of the submandibular gland using a retrospective, interventional consecutive case series.MethodsWe performed 374 sialendoscopies between 2008 and 2015 and evaluated all patients regarding clinical symptoms, clinical findings, therapy and outcome. We performed 109 procedures of holmium laser-assisted lithotripsy in 64 patients whose sialoliths measured 5 mm or more in diameter. In addition to retrospective case note reviews, we performed telephone interviews of all patients in January 2017.ResultsWe performed 374 consecutive submandibular gland sialendoscopy procedures in 276 patients between 2008 to 2015. Sialolithiasis had either previously been diagnosed, or symptoms highly suggestive of sialolithiasis of the submandibular gland presented in 197 patients.Holmium laser-assisted Laser lithotripsy was performed in 109 cases (64.9%). Smaller mobile concrement was removed directly either by forceps or wire basket, or following marsupialisation of the submandibular duct. This was the case in 88 patients (29.1%). Three patients (0.8%) required surgical removal of the submandibular gland due to early abscess. The majority of patients (n = 374 procedures; 90.1%) remained symptom-free after two or more years following intervention. In the remaining procedures (n = 37 procedures; 9.9%), patients reported discreet postprandial problems but did not seek medical attention. In total, we managed to preserve the submandibular gland and avoid open surgery in 99% of patients through endoscopic management of submandibular concrement and duct stenosis.ConclusionHolmium laser-assisted lithotripsy is a simple, safe, and effective procedure for treating patients with sialolithiasis of the submandibular gland. Removal of the gland is rarely required, and removing the gland without prior sialendoscopy is no longer recommended. It should be offered to all patients with submandibular gland sialolithiasis, or such patients should be referred to the appropriate centre for sialendoscopy before submandibulectomy is considered. 相似文献
20.
A.T. Day L. Tang U.A. Patel J.D. Richmon K.S. Emerick 《American journal of otolaryngology》2018,39(5):518-521