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1.
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2.
Objective
This study investigated the influence of the degree of bleeding from the remnant eardrum on the spontaneous healing of human traumatic tympanic membrane perforations (TMPs).Study design
A case series with chart review.Setting
A tertiary university hospital.Materials and methods
The clinical records of traumatic TMP patients who met the case selection criteria were retrieved and categorized into two groups based on the documented degree of bleeding from the remnant eardrum: with and without bleeding. The demographic data and spontaneous healing outcomes (i.e., healing rate and duration) of these two TMP types were analyzed using the chi-squared test or t-test.Results
One-hundred and eighty-eight cases met the inclusion criteria and were analyzed. Of these, 58.5% had perforations without bleeding and the remaining 41.5% had perforations with bleeding. The overall closure rate at the end of the 3-month follow-up period was 90.9% for perforations without bleeding and 96.2% for perforations with bleeding; the difference was not statistically significant (P > 0.05). However, the average closure time differed significantly between the two groups (P < 0.05): 29.4 ± 3.7 days for perforations without bleeding and 20.6 ± 9.2 days for perforations with bleeding. The closure rate was significantly different between the groups (62 vs. 15.6%, P < 0.01) within 2 weeks for medium-sized perforations. In total, 11 (39.3%) large-sized perforations achieved complete closure in the group with bleeding, while none of the large-sized perforations closed in the group without bleeding within 2 weeks. The closure rate of medium-sized perforations was not significantly different (79.2 vs. 92%, P > 0.05) between the groups without and with bleeding within 4 weeks, while the closure rate of large-sized perforations was significantly different between the groups without and with bleeding (27.2 vs. 75%, P = 0.0).Conclusion
This study shows that traumatic TMPs with bleeding significantly shortened the closure time compared to TMPs without bleeding. This finding indicates a significant correlation between the prognosis of traumatic TMPs and the degree of eardrum bleeding: severe bleeding from and a hematoma in the remnant eardrum appear to be good signs. 相似文献3.
Michael C. Topf David W. Hsu Douglas R. Adams Tingting Zhan Stanley Pelosi Thomas O. Willcox Brian McGettigan Kyle W. Fisher 《American journal of otolaryngology》2017,38(1):21-25
Purpose
To determine the rate of persistent tympanic membrane perforation after intratympanic steroid injection. To determine which comorbid conditions and risk factors are associated with prolonged time to perforation closure following intratympanic steroid injection.Materials and methods
Clinical data were gathered for patients who had undergone intratympanic steroid injection to treat sudden sensorineural hearing loss or Ménière's disease. Primary outcomes analysis included rate of persistent tympanic membrane perforation, defined as perforation at least 90 days following last injection, and time to perforation healing. Age, sex, number of injections, smoking status, diabetes mellitus, previous head and neck irradiation, and concurrent oral steroids, were analyzed as potential predictors of persistent perforation.Results
One hundred ninety two patients were included in this study. Three patients (1.6%) had persistent tympanic membrane perforations. All three patients received multiple injections. One patient underwent tympanoplasty for repair of persistent perforation. The median time to perforation healing was 18 days. There was no statistically significant variable associated with time to perforation healing. However, patients with prior history of head and neck radiation averaged 36.5 days for perforation healing compared to 17.5 days with no prior history of radiation and this approached statistical significance (p = 0.078).Conclusions
The rate of persistent tympanic membrane perforation following intratympanic steroid injection is low. Patients with a history of radiation to the head and neck may be at increased risk for prolonged time for closure of perforation. 相似文献4.
Mejd Jumaily Joel Franco James A. Gallogly Joshua L. Hentzelman Dary J. Costa Alan P.K. Wild Anthony A. Mikulec 《American journal of otolaryngology》2018,39(4):396-400
Purpose
In 1998, Dr. Eavey described the trans-canal inlay butterfly cartilage tympanoplasty technique, also known as cartilage button tympanoplasty. Many retrospective studies have since demonstrated its efficacy and decreased operative time when compared to underlay and overlay tympanoplasty techniques. The butterfly cartilage tympanoplasty approach uses only a cartilage graft to repair tympanic membrane perforations. The aim of this study was to review the literature for studies that examined butterfly cartilage tympanoplasty success rates and outcomes and compare them to outcomes from our cohort.Materials and methods
Butterfly cartilage tympanoplasties were performed in 23 pediatric patients and 7 adult patients. We evaluated the tympanic membrane perforation closure rate and hearing results measured by closure of the air-bone gap.Results
The reviewed studies evaluating butterfly cartilage tympanoplasties demonstrated perforation closure rates between 71%–100%. The hearing outcomes in the reviewed literature varied, although the majority reported improved hearing. In our cohort, 21 of the 32 repaired tympanic membrane perforations demonstrated complete perforation closure. The mean follow-up length was 13.4?months. The mean air-bone gap decreased from 13.4?dB to 6.9?dB.Conclusions
The butterfly cartilage/cartilage button technique is effective in closing tympanic membrane perforations and decreasing the air-bone gap in both adults and children. 相似文献5.
Objectives
This study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI.Method
Eighty-one patients treated for non-odontogenic DNI over 5?years were retrospectively recruited into this study. Demographics, etiology, radiology results, treatments, duration/cost of hospital stay, and complications were recorded. Differences between DNIs with and without infrahyoid involvement, as defined based on an anatomical chart, were analyzed.Results
Sixty-two male and 19 female patients with a median age of 46.22?years were included. Fifteen patients had cellulitis, and 66 patients had abscesses. Streptococcus was the most commonly observed bacterium. Compared with DNIs only in suprahyoid spaces (n?=?60, 74.07%), DNIs with infrahyoid space involvement (n?=?21, 25.93%) were associated with higher incidences of the involvement of ≥3 spaces (85.71%, P?=?0.000), mediastinitis (38.10%, P?=?0.000), tracheostomy (28.57%, P?=?0.008), surgery using a transcervical approach (66.67%, P?=?0.000), and intensive care unit therapy (19.05%, P?=?0.004), as well as longer hospital stays (16?days, P?=?0.000) and higher costs ($2872, P?=?0.000).Conclusion
Infrahyoid involvement should be regarded as a high-risk factor in the management of deep neck infection (DNI). A relatively aggressive plan that includes transcervical surgery and tracheostomy should be considered at earlier stages for DNI with infrahyoid involvement. 相似文献6.
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7.
Objective
We evaluated the effects of fibroblast growth factor-2 (FGF-2) delivered via a Gelfoam patch on the regeneration of myringosclerotic traumatic tympanic membrane perforations (TMPs) lying close to the malleus.Study design
A prospective, randomized, controlled clinical study.Setting
A university-affiliated teaching hospital.Subjects and methods
We prospectively analyzed, in a randomized manner, the outcomes of treatment for traumatic TMPs constituting > 25% of the tympanic membrane. The closure rates, closure times, and otorrhea rates were compared among patients treated via FGF-2-containing Gelfoam patches, Gelfoam patches alone, and observation only.Results
We analyzed data from 138 patients. The perforation closure rates in the FGF-2 plus Gelfoam patch, Gelfoam patch, and observation alone groups were 97.9, 89.8, and 70.7%, respectively. Both the FGF-2 plus Gelfoam and Gelfoam alone groups exhibited significantly higher closure rates than the observational group (both p < 0.05).The mean closure times were 15.7 ± 5.1, 24.8 ± 4.9, and 35.7 ± 9.2 days in the FGF-2 plus Gelfoam patch, Gelfoam patch alone, and observation alone groups, respectively. The FGF-2 plus Gelfoam patch group exhibited a significantly shorter closure time than the Gelfoam patch alone and observation alone groups (p < 0.05). The incidences of purulent otorrhea were 14.6, 6.1, and 4.9% in the FGF-2 plus Gelfoam patch, Gelfoam patch alone, and observation alone groups, respectively. Surprisingly, 7 of 7 (100.0%) perforations associated with purulent otorrhea completely closed in the FGF-2 plus Gelfoam patch group; however, no such perforation healed in either the Gelfoam alone or observation alone group.Conclusions
FGF-2 plus Gelfoam patching significantly shortened the closure time compared to observation and Gelfoam patching alone, and it significantly improved the closure rate (compared to observation alone) of myringosclerotic perforations lying close the malleus. FGF-2 plus Gelfoam patching is a valuable, minimally invasive alternative treatment that may be readily applied to outpatient settings. 相似文献8.
Robert T. Swanson Jane R. Schubart Michele M. Carr 《American journal of otolaryngology》2018,39(5):618-622
Objective
Evaluate post-tonsillectomy outcomes in children discharged with ibuprofen versus those without.Methods
This was a retrospective review of children who underwent tonsillectomy?±?adenoidectomy from 2012 to 2016 at a tertiary care children's hospital. Main outcome measures included bleed rates, ER visits, and nurse phone calls.Results
Seven hundred and seventy-three patients were included; 504 had ibuprofen at discharge (ID) and 269 did not (NID). There were significant differences in mean age, 6.7?years in the ID group years versus 8.6 for the NID group (P?<?0.001). Indication for surgery was sleep apnea in 70.5% of ID patients and 44.0% of NID patients (P?<?0.001). Post-tonsillectomy bleeds occurred in 8.7% in the ID group and 5.9% of the NID group (P?=?0.168). Other outcome measures revealed no significant differences between the two groups. There was no significant difference in the outcome measures between patients with sleep apnea or recurrent tonsillitis. Age was important; 12.1% of children 9–18?years versus 4.8% in children 3.1–6?years (P?=?0.006) had post-tonsillectomy bleeding. For children 9–18?years old, 16.7% in the ID group bled versus 7.5% in the NID group (P?=?0.039). Logistical regression revealed that age contributed to post-op bleeding, and ibuprofen contributed to number of ER visits.Conclusion
Ibuprofen is associated with significantly elevated post-tonsillectomy bleeding in older children, further research is needed and other analgesics should be considered. 相似文献9.
Daniel C. O&#x;Brien Yuti Desai Robert T. Swanson Uma Parekh Jane Schubart Michele M. Carr 《American journal of otolaryngology》2018,39(5):623-627
Objectives
To investigate the relationships between preoperative sleep study findings of children undergoing adenotonsillectomy anesthesia emergence time, recovery room time, and length of stay.Study design
Retrospective case series with chart review.Setting
Tertiary care children's hospital.Subjects and methods
All children aged 1–17?years who had undergone adenotonsillectomy between 2013 and 2016 were included. Apnea-hypopnea index (AHI), central apnea index (CAI), oxygen saturation nadir, and end-tidal carbon dioxide were compared with the in-operating room times, recovery room time, and length of stay.Results
Three hundred and fourteen patients with a mean age of 6.67 (95% CI 6.25–7.09) years were included. Mean AHI was 9.14 (95% CI 7.33–10.95), mean CI was 0.88 (95% CI 0.50–1.26), mean oxygen saturation nadir was 82.9% (95% CI 81.41–84.32), mean end-tidal carbon dioxide was 50.3 (95% CI 49.39–51.15). Mean emergence time was 16?min (95% CI 15:11–17:13?min), recovery room time was 66?min (95% CI 1:00–1:11?h), and length of stay was 25.7?h (95% CI 21:43–30:00?h).When controlled for age, gender and BMI, linear regression showed that children with a higher AHI had a significantly longer operating room and operative times (p?<?0.001), emergence time (p?<?0.001) and length of stay (p?=?0.01). CAI was related to shorter total operating room times (p?=?0.03). AHI, oxygen saturation nadir, CAI and end-tidal carbon dioxide were not associated with recovery room time.Conclusion
Preoperative sleep study indices are associated with longer in-operating room times and length of stay, and can be useful in planning operating room and hospital flow. 相似文献10.
Tamer M. Attia 《American journal of otolaryngology》2018,39(5):476-480
Objective
To compare the effect of Paracetamol/Prednisolone versus Paracetamol/Ibuprofen on post-operative recovery after adult tonsillectomy.Background
Various analgesic protocols have been proposed for the control of post-tonsillectomy morbidity with need for better control in adult population for having higher severity of post-operative pain and risk of secondary post-tonsillectomy bleeding.Methods
This is a prospective cohort study conducted on 248 patients with age of 12?years or older distributed as two equal groups; the first one receiving Paracetamol/Prednisolone and the second one receiving Paracetamol/Ibuprofen. Both groups were compared at 7?days post-operative regarding pain at rest, tiredness of speech, dietary intake, and decrease in sleep duration. Both groups were compared regarding incidence of nausea and vomiting at 2?days post-operative. The incidence and severity of secondary post-tonsillectomy hemorrhage was compared between the two groups.Results
Pain at rest (no swallowing - no talking) was less in group I but not reaching statistical significance (p?=?0.36). In addition, dietary intake was better in group I but not reaching statistical significance (P?=?0.17). However, talking ability was better with statistically significant difference (P?=?0.03) in group I. Impairment of sleep was less with group II but not reaching statistical significance (p?=?0.31). The incidence of vomiting at second post-operative day was less in group I with statistical significance (p?=?0.049). The incidence of secondary post-tonsillectomy bleeding was significantly higher in group II with statistical significance (p?=?0.046). The severity of bleeding episodes was also significantly higher in group II (p?=?0.045).Conclusion
Both ibuprofen and prednisolone were effective as a part of post-operative medication regimen after adult tonsillectomy. However, prednisolone was superior to ibuprofen regarding improvement of pain at rest, dietary intake, tiredness of speech and post-operative nausea and vomiting. However, ibuprofen had a better impact on sleep. The incidence and severity of secondary post-tonsillectomy hemorrhage were significantly higher with ibuprofen favoring the selection of prednisolone to be combined with paracetamol in the post-operative medication protocol following tonsillectomy. 相似文献11.
Weiwei Han Dongliang Wang Yunqin Wu Zhenyi Fan Xu Guo Qiongfeng Guan 《American journal of otolaryngology》2018,39(6):751-753
Purpose
To investigate the relationship between cerebrovascular risk factors, including carotid plaques, and vestibular neuritis (VN).Materials and methods
According to the inclusion and exclusion criteria, this retrospective study included 90 VN patients and 74 age- and sex-matched healthy controls from January 2016 to December 2017. All subjects' records of cerebrovascular risk factors, such as age, sex, height, weight, history of hypertension and diabetes mellitus, living habits, serum levels of glucose, lipids, glycosylated haemoglobin (HbA1c), creatinine (CR), albumin (ALB), haemoglobin (HGB); and results of carotid colour Doppler ultrasound, were obtained and compared.Results
No significant differences in age; sex ratio; body mass index; history of hypertension or diabetes mellitus; or mean serum lipids, glucose, creatinine, haemoglobin or HbA1c were found between patients with VN and healthy controls (all P?>?0.05). The mean serum ALB level was significantly lower in VN patients than in healthy controls (40.65?±?3.77 vs 42.84?±?4.32, P?=?0.001).The prevalence of carotid plaques was significantly higher in VN patients than in healthy controls (36.67% vs. 16.22%, P?=?0.003). Regression analyses demonstrated that a high frequency of carotid plaques was associated with VN with an odds ratio of 2.252 (95% CI 1.165–5.458, P?=?0.019).Conclusion
A high frequency of carotid plaques may be a risk factor for VN. 相似文献12.
Importance
Repair of nasal septal perforations is challenging regardless of surgical technique due to their location and the health of surrounding tissue. There is currently no surgical procedure which is completely effective in the treatment of anteriorly located perforations.Objective
To report a novel method of closing anterior septal perforations using an inferiorly based mucosal rotation flap and an acellular dermal interposition graft, as well as expand upon a previous series.Design
The study includes patients who underwent surgical repair for septal perforations by the senior author between 2003 and 2015.Setting
The study took place at MetroHealth Medical Center in Cleveland, Ohio.Participants
Thirty-nine patients (15 male) with septal perforations of various size and etiology underwent endonasal repair using rotation flaps. The average age of patients was 42-years old (range 10–67 years).Intervention for clinical trials or exposure for observational studies
Five patients had perforations such that we used inferiorly based flaps, while 35 cases utilized posteriorly based flaps. Acellular dermis was used in addition to a unilateral rotation flap.Main outcomes and measures
The primary outcome desired was a complete closure of the septal perforation. The success, or lack thereof, was monitored after healing from surgery.Results
Thirty-seven of the forty surgical procedures demonstrated complete closure of the perforation, a 92.5% success rate. Perforations were separated based upon size. Small perforations (< 1 cm) had a 93.3% success rate, medium (1–2 cm) 88.9%, and all seven large perforations (> 2 cm) were closed successfully. In addition, all five of the inferiorly based procedures resulted in complete closure of the perforation. Of the failed repairs, one required revision surgery to repair a recurring perforation, while the other two were asymptomatic following the procedure.Conclusions and relevance
Endonasal repair using inferiorly based mucosal rotation flaps coupled with an acellular dermal interposition graft is a valid technique for the repair of septal perforations. Posterior rotation flaps are preferred due to major septal blood supply from branches of the sphenopalatine artery, but inferiorly based flaps are also viable options for repair for perforations located in the anterior septum. 相似文献13.
Yasser Ahmed Fouad Mohammad Abdelhady Mohammad El-Anwar Ezzat Merwad 《American journal of otolaryngology》2018,39(6):741-745
Objectives
To evaluate the effect of adding platelet rich plasma (PRP) or Hyaluronic acid (HA) to fat graft myringoplasty (FGM) for medium sized central tympanic membrane (TM) perforations.Methods
This is a retrospective study conducted on 69 patients with medium sized central TM perforations. In 21 patients, PRP was used with the FGM; and in 23 patients, HA was used with the FGM; while in 25 patients, pure FGM was performed without adding an enhancing material.Results
Successful TM perforation repair was achieved in 18 ears (85.7) with using PRP with FGM and in 20 ears (87%) with using HA with FGM and in 15 ears (60%) with pure FGM.Conclusion
FGM with adding PRP or HA is more successful in closure of TM perforation than pure FGM in case of medium sized central TM perforation. 相似文献14.
Khoi Anh Nguyen Truong Xuan Bui Hue Van Nguyen Richard O. Wein 《American journal of otolaryngology》2018,39(3):317-320
Objective
The purposes of the study was to evaluate for the functional improvement of outcomes of patients undergoing surgical management for tongue cancer at varying periods after surgery.Design
Case series with intervention.Participants
Thirty consecutive patients, from 2011 to 2015, with carcinoma of the tongue undergoing surgical resection and reconstruction with a radial forearm free flap.Main measures
The Speech Intelligibility Test (SIT) is used for objective evaluation of speech function. The 7-point ordinal scale Functional Oral Intake Score (FOIS) was used to estimate the swallowing function.Results
The patients included were 25 men and 5 women with a mean age of 50.4?years (range – 27–65). All tumors were squamous cell carcinomas and all patients underwent a hemiglossectomy. There were two complete flap failures, with a resultant flap success rate of 93.3%. The initial mean speech intelligibility scores at 1-month increased from 72.3?±?0.2 to 77.7?±?8.9 at 6-months after surgery (p?=?0.05). Similarly, the mean score of swallowing function improved from 6.1 at 1-month to 6.8 at 6-months after surgery (p?=?0.05).Conclusion
Reconstruction of hemiglossectomy defects with a radial forearm free flap offers functional benefits in speech and deglutition that demonstrate progressive improvement when 1- and 6-month post-surgical assessments are compared. 相似文献15.
Hongcun Sun Xiaowen Qiu Jiandao Hu Zhaoxin Ma 《American journal of otolaryngology》2018,39(5):531-535
Objective
This study aimed to compare the efficacy of intratympanic dexamethasone (ITD) therapy and hyperbaric oxygen(HBO) therapy for the salvage treatment of patients with high-frequency sudden sensorineural hearing loss (SSNHL) after the failure of conventional therapy.Materials and methods
104 refractory high-frequency SSNHL patients were enrolled in our study. Among them, 31 received ITD alone (ITD group), 32 received HBO alone (HBO group) and 41 received no salvage therapies (control group). Hearing outcomes were determined by pure-tone average measured by audiometry. The total effective rates in the hearing recovery and improvement of tinnitus were calculated before and after salvage treatment.Results
There was no significant difference of the total effective rates in the hearing recovery between ITD and HBO group (p?=?0.368). However, ITD therapy showed much better improvements of tinnitus than HBO therapy (p?=?0.039). After ITD and HBO therapy, there were no significant differences in hearing gains at 2 and 4?KHz between ITD and HBO group (p?=?0.468 and 0.934, respectively). Nevertheless, ITD therapy showed significant improvements of hearing gains at 8?KHz (p?=?0.049) compared to that of HBO therapy.Conclusion
ITD therapy may have better improvements of tinnitus and hearing gains at 8 KHz than HBO therapy in patients with refractory high-frequency SSNHL. 相似文献16.
Objective
Eagle syndrome, a spectrum of disease resulting from an elongated styloid process and/or calcified stylohyoid ligament, lacks standardized recommendations regarding indications for surgical intervention and approach.Study design
Retrospective cohort study.Setting
Single tertiary care institution.Subjects
Patients treated surgically for Eagle syndrome between January 2011 and June 2017.Methods
Patients were diagnosed with Eagle syndrome based on thorough clinical workup and assessment. The primary outcome was improvement in pain severity following surgery, with complete resolution of pain being considered clinically meaningful. Wilcoxon rank-sum tests and Fisher's exact were used to compare numerical and categorical variables, respectively.Results
Twenty-one patients were diagnosed with Eagle syndrome and underwent surgical resection of the styloid process. Patients most often complained of neck pain (81%), throat pain (62%), and ear pain (48%). Among these patients, 57% of procedures featured a transcervical approach, while the remaining 43% were transoral. The vast majority (90%) of patients experienced improvement in pain severity from a median of 6.0 before surgery to 0.0 afterwards (p?<?0.01) as 62% experienced complete resolution. Using multivariable linear regression to model changes in pain severity, neck pain (β?=??1.69, p?<?0.01) and jaw pain (β?=??0.93, p?=?0.03) predicted greater relief, while headache (β?=?0.82, p?=?0.04) predicted an inferior response. Adverse events were uncommon and typically resolved within three months, with 24% experiencing first bite syndrome and 19% reporting numbness.Conclusions
Transcervical and transoral styloidectomy are effective treatments for Eagle syndrome with minimal adverse effects. Patients with classic symptoms of neck or jaw pain benefit most from surgery. 相似文献17.
Hongbo Shan Yunfei Gao Liran Liu Mingtian Li Xiaoyan Gao Yin Li Xi Wang Dian Ouyang Zhuming Guo 《American journal of otolaryngology》2018,39(5):511-514
Objective
This study aimed to present a novel technique for stapler-assisted laryngectomy under direct visualization using a videoendoscope with narrow-band imaging (NBI-endoscopy).Methods
A case series of five consecutive patients were treated with stapler-assisted total laryngectomy from December 2014 to March 2016. The technique involved monitoring the stapler closure of laryngopharyngeal cavity under NBI-endoscopic vision, triple checking of neo-pharynx cavity by an endoscopic view inside and transillumination verification outside, air leakage test, and guiding the insertion of feeding tube under direct visualization. The main evaluation of this study was pharyngocutaneous fistula, surgical margin, and oral feeding time.Results
All the patients healed well without a pharyngocutaneous fistula. The mean of surgical time, oral feeding, and hospitalization time were 40?min, 6?days, and 8?days, respectively.Conclusion
This study demonstrated a technique simple to learn and associated with decreased complication rates, which could be safe and efficient for stapler-assisted laryngectomy. 相似文献18.
Mustafa Sitki Gozeler Muhammed Sedat Sakat Korhan Kilic Ozgur Ozmen Abdullah Can Ilker Ince 《American journal of otolaryngology》2018,39(6):726-730
Purpose
Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty.Material and methods
50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n?=?25) was administered 100?mL iv saline solution 30?min preoperatively, while Ibuprofen group (n?=?26) received 800?mg ibuprofen iv. in 100?mL saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible.Results
VAS scores at 10, 20, and 30?min and at 1, 2, 4, 8, 12 and 24?h were lower in the ibuprofen group than in the control group (p?<?0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8?±?86.4?mcq vs 338.00?±?81.00?mcq), respectively.Conclusion
We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800?mg 30?min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores. 相似文献19.
Mofiyinfolu Sokoya Joseph R. Gonzalez Andrew A. Winkler 《American journal of otolaryngology》2018,39(3):303-306
Objective
To evaluate whether a diagnosis of allergic rhinitis affects surgical outcomes of open septorhinoplasty (OSR) and to examine whether OSR provides the same level of improvement in quality of life to patients with and without allergic rhinitis.Study design, setting, subjects and methods
We performed a retrospective evaluation of 646 patients who underwent open septorhinoplasty in a tertiary otolaryngology practice between 2008 and 2015. Preoperative and postoperative quality of life (QoL) measurement using the validated Nasal Obstruction Symptom Evaluation (NOSE) Scale was performed on 307 patients meeting inclusion criteria. These patients were then divided into two groups based on a diagnosis of allergic rhinitis (non-AR vs AR). Comparisons were then made based on quality of life improvements by the NOSE score.Results
There were 213 patients in the non-AR group vs. 94 patients in the AR group. After OSR, patients in both groups experienced significant improvement in nasal airway obstruction. Pre-op NOSE score averages were similar for the non-AR and AR groups (69.9 vs 73.4 p?=?0.087). Average improvement in NOSE score for the non-AR and AR groups at 30?days was 48.6 vs 45.9 (p?=?0.41); and at 90?day of 48.1 vs 51.5 (p?=?0.402).Conclusion
Patients with and without allergic rhinitis experience similar OSR outcomes as measured by the NOSE score. Open septorhinoplasty addresses multiple components contributing to nasal airway obstruction, and may offset the effects of allergic rhinitis. When indicated, it should be offered to patients with allergic rhinitis after complete medical management. 相似文献20.
Peng Huang Shujun Zhang Xinhong Gong Xuesong Wang Zi-Han Lou 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(5):545-552