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1.
Cameron C. Wick Nauman F. Manzoor Caileigh McKenna Maroun T. Semaan Cliff A. Megerian 《American journal of otolaryngology》2017,38(3):285-290
Objectives
To evaluate the long-term efficacy of endolymphatic sac shunt techniques with and without local steroid administration.Study design
Retrospective case series and patient survey.Setting
Tertiary university hospital.Patients
Meniere's disease (MD) patients that failed medical therapy and subsequently underwent an endolymphatic sac shunt procedure. All patients had definitive or probable MD and at least 18-months of follow-up.Interventions
Three variations on endolymphatic sac decompression with shunt placement were performed: Group A received no local steroids, Group B received intratympanic dexamethasone prior to incision, and Group C received dexamethasone via both intratympanic injection and direct endolymphatic sac instillation.Main outcome measure(s)
Vertigo control, hearing results, and survey responses.Results
Between 2002 and 2013, 124 patients with MD underwent endolymphatic sac decompression with shunt placement. 53 patients met inclusion criteria. Groups A, B, and C had 6 patients, 20 patients, and 27 patients, respectively. Mean follow-up was 56 months. Vertigo control improved in 66%, 83%, and 93% of Groups A, B, and C. Functional level improved for Group B (? 2.0) and Group C (? 2.2) but was unchanged in Group A. Pure-tone average and speech discrimination scores changed by + 22 dB and ? 30%, + 6 dB and ? 13%, and + 6 dB and ? 5% in Groups A, B, and C. The long-term hearing results were significantly better with steroids (Groups B and C) according to the AAO-HNS 1995 criteria but did not meet significance on non-parametric testing.Conclusions
Endolymphatic sac shunt procedures may benefit from steroid instillation at the time of shunt placement. 相似文献2.
William S. Tierney Scott L. Gabbard Claudio F. Milstein Michael S. Benninger Paul C. Bryson 《American journal of otolaryngology》2017,38(5):603-607
Objective
Laryngopharyngeal reflux (LPR) symptoms are often resistant to management and cause significant quality of life impairment to patients with this disease. This study assesses the utility of a sleep-positioning device (SPD) in treating LPR.Design
Single center prospective cohort study.Setting
Tertiary medical centerParticipants
27 adult patients with diagnosed laryngopharyngeal reflux.Intervention
An SPD consisting of a two-component wedge-shaped base pillow and a lateral positioning body pillow (Medcline, Amenity Health Inc.) was given to patients with a diagnosis of LPR. Subjects slept using the device for at least 6 h per night for 28 consecutive nights.Main outcomes
Primary outcomes were Nocturnal Gastroesophageal Reflux Symptom Severity and Impact Questionnaire (N-GSSIQ) and the Reflux Symptoms Index (RSI) survey instrument. Each was collected at baseline, after 14, and after 28 days of SPD use.Results
27 patients (19 female and 8 male; age 57.1 ± 12.8, BMI 29.0 ± 8.1) were recruited. At baseline mean N-GSSIQ was 50.1 ± 22.4 and mean RSI of 29.6 ± 7.7. Repeated measure analysis showed that subjects' total N-GSSIQ scores decreased by an average of 19.1 (p = 0.0004) points by two weeks and 26.5 points by 4 weeks (p < 0.0001). RSI decreased an average of 5.3 points by 2 weeks (p = 0.0425) and an average of 14.0 points by 4 weeks (p < 0.0001).Conclusions
In patients with LPR, SPD treatment significantly improves self-reported symptoms of nocturnal reflux as well as symptoms specific to LPR. These results support the therapeutic efficacy of a SPD for patients with LPR. 相似文献3.
Diana N. Kirke Chandala Chitguppi Samuel J. Rubin Minh T. Truong Scharukh Jalisi 《American journal of otolaryngology》2017,38(3):279-284
Background
The objective was to assess demographic and survival patterns in patients with adenoid cystic carcinoma of the base of tongue.Methods
Patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database from 1973 through 2012 and were categorized by age, gender, race, historical stage A, and treatment. Incidence and survival were compared with Kaplan Meier curves and mortality hazard ratios.Results
A total of 216 patients were included. After adjusting for age, gender, race and tumor-directed treatment, patients over the age of 70 years had a significantly increased mortality [HR = 2.847, 95% CI (1.499, 5.404) p = 0.0014]. Furthermore mortality among patients with distant disease was significantly increased [HR = 2.474 95% CI (1.459, 4.195) p = 0.00008].Conclusion
By examining the largest collection of patients we have demonstrated that there is a significant difference in mortality based on both the age at diagnosis and in the setting of distant disease. 相似文献4.
Kara M. Christopher Nosayaba Osazuwa-Peters Rebecca Dougherty Sarah A. Indergaard Christina Popp Ronald Walker Mark A. Varvares 《American journal of otolaryngology》2017,38(2):168-173
Purpose
The objective of this pilot study was to determine how different treatment modalities (surgery, radiation, and chemotherapy) impact quality of life (QOL) in a population of head and neck cancer (HNC) survivors.Methods
Fifty-nine newly diagnosed, biopsy-confirmed HNC patients were recruited between 2007-2012. They completed the EORTC Quality of Life Questionnaire and Head & Neck Module at 5 intervals pre- and post-treatment. Participants were grouped into four categories based on modality: surgery only, surgery/radiation, chemoradiation, or surgery/chemoradiation. Repeated measures ANOVA examined effect of treatment modality on QOL over time.Results
Xerostomia symptoms were significantly associated with chemoradiation (F(2.47, 59.27) = 3.57, p = 0.03), lowest at pretreatment and highest 6 months post-treatment. Time was significantly associated with head and neck pain, F(2.95,67.89) = 3.39, p = 0.02.Conclusions
HNC survivors exhibit different QOL related symptoms depending on combined treatment modalities, and time post-treatment. It is important to understand QOL differences based upon treatment modalities when developing treatment plans for HNC patients. 相似文献5.
Maxwell P. Kligerman Yohan Song David Schoppy Vasu Divi Uchechukwu C. Megwalu Bruce H. Haughey Davud Sirjani 《American journal of otolaryngology》2017,38(5):533-536
Purpose
The most common surgical method to remove benign parotid tumors remains the prograde approach. We examined if a retrograde surgical technique offers better outcomes than historical prograde controls.Materials and methods
A retrospective chart review at Stanford Hospital was conducted to identify retrograde parotidectomies between February 2012 and October 2014 that were staffed by the senior author (DS) with resident involvement. Facial nerve (FN) outcomes and other post-surgical parameters were recorded.Results
We identified 44 consecutive cases and found that 18.2% (n = 8) of patients experienced temporary paresis and 2.3% (n = 1) experienced minor (HB 2) permanent paresis limited to one branch. The average hospital length of stay was 0.64 days and complication rate was 6.8%.Conclusion
The retrograde technique has complication rates comparable to historical rates for the prograde technique and is amenable to minimally invasive outpatient superficial parotidectomy. 相似文献6.
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7.
Objective
To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule.Study design
A retrospective case series of 6 patients (7 ears).Patients
6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery.Intervention
Cochlear implantation of 7 ears. 5 patients with severe to profound sensorineural hearing loss received the Nucleus Contour Advance peri-modiolar electrode array with binaural implantation performed in one patient. One patient with mild to profound sensorineural hearing loss received a Cochlear® Nucleus Hybrid L24 device.Methods
Preoperative temporal bone CT, audiometric and speech perception testing scores were reviewed, confirming presence of otosclerosis of the cochlea as well as cochlear implant candidacy. Speech perception testing included CNC words, HINT sentences and AZ Bio scores to measure hearing outcomes post implantation.Results
All recipients of the contour advance device had a significant improvement in hearing at both 3 and 6 month follow up.The hybrid device recipient experienced loss of residual hearing in the implanted ear without improvement at 3 months and mild improvement at 6 months.Conclusion
Cochlear implantation has proven to be effective in the treatment of patients with sensorineural hearing loss, including those with otosclerosis of the cochlea.Hybrid candidacy in the setting of otosclerosis of the cochlea may require consideration of alternative electrode devices, most likely a peri-modiolar device. 相似文献8.
Objectives
A number of etiologies of idiopathic sudden sensorineural hearing loss (ISSNHL) have been proposed. Vascular disturbance is one cause of ISSNHL and has been reported to be associated with fibrinogen. We aimed to determine whether hyperfibrinogenemia is associated with poor outcome and whether a serial change in fibrinogen level is associated with outcome.Methods
Twenty-two patients with ISSNHL were enrolled. We compared the levels of fibrinogen in ISSNHL groups classified as improved and non-improved according to improvement of hearing. Blood samples were also collected from patients who visited the emergency room with coronary heart disease (CHD) as the control group.Results
Initial fibrinogen level was significantly different between the non-improved and improved ISSNHL group (350.63 ± 87.20 vs. 310.71 ± 81.06. The improved ISSNHL group showed a “surge phenomenon”, in which fibrinogen started to decrease at day 5 and increased at day 26. In the non-improved group, fibrinogen remained elevated throughout the course of therapy.Conclusion
It is important to measure not only the initial fibrinogen level but also to monitor its change throughout the course of therapy in order to predict the outcome of ISSNHL. 相似文献9.
Shirley Hu Samuel N. Helman Elyse Hanly Ilya Likhterov 《American journal of otolaryngology》2017,38(3):337-350
Objective
To elucidate the role of surgery in the management of anaplastic thyroid cancer.Methods
Ovid MEDLINE, Cochrane Library, and Google Scholar databases were searched for publications from December 2000 to July 2016. Selection criterion was a focus on the management of anaplastic thyroid cancer in adults. Studies addressing only nonsurgical management and review articles were excluded. Data extraction was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Kaplan-Meier analysis was performed on a subset of patients.Results
40 publications were included in the study. Approaches to unresectability and interpretations of resection varied widely. For patients undergoing primary surgery, the median survival was 6.6 months. The median survival for non-surgical patients was 2.1 months. In the subgroup analysis, the median survival time for patients undergoing surgery was significantly longer in Stage IVB (p = 0.022) but not IVC disease. Negative margins did not afford a statistically significant survival benefit.Conclusion
Surgery is a mainstay of treatment for Stage IVA and IVB disease. For Stage IVC cancer, distant metastasis was not a strict criterion against surgical candidacy among surgeons. The extent of resection and the definition of resectability remain controversial. Negative margins did not significantly increase survival. 相似文献10.
Sameep Kadakia Arvind Badhey Jared Inman Moustafa Mourad Yadranko Ducic 《American journal of otolaryngology》2017,38(6):688-691
Purpose
To report the outcomes of 47 patients with temporal bone osteoradionecrosis treated primarily with surgical resection in order to analyze whether flap type and hyperbaric oxygen use affect wound breakdown.Materials and methods
Between January 1998 and January 2016, 47 patients were treated for temporal bone osteoradionecrosis with surgery. Some patients were also treated with hyperbaric oxygen. Resection of grossly necrotic temporal bone was followed by immediate reconstruction with local, regional, or free flaps. Minimum follow-up was 6 months. If patients had breakdown of their initial reconstructions, secondary reconstruction was performed with either a regional or free flap. During the post-operative period, wound breakdown, flap complications, and patient survival were noted.Results
30 patients developed ORN from primary radiotherapy while 17 had post-operative radiation. It was found that wound breakdown was significantly associated with type of flap reconstruction (p = 0.02) with local flap reconstruction portending a poorer prognosis. Hyperbaric oxygen was not associated with decreased wound breakdown (p = 0.5).Conclusions
Surgical treatment can be an effective treatment for temporal bone osteoradionecrosis, without hyperbaric oxygen providing any additional benefit. Reconstruction with regional or free flaps may be a more reliable method to resurface defects compared to local flaps. 相似文献11.
Matthew M. Dedmon Brendan P. O&#x;Connell Austin S. Adams George B. Wanna David S. Haynes 《American journal of otolaryngology》2017,38(5):526-528
Objective
To increase otolaryngology resident experience with drilling and dissection of the internal auditory canal (IAC) via a translabyrinthine approach.Study design
Pilot study involving temporal bone education and drilling with completion of pre- and post-drilling surveys.Methods
Participants observed an educational presentation on IAC anatomy and drilling, followed by manipulation of IAC nerves using a prosected cadaveric temporal bone. Participants then drilled the IAC and identified nerves using temporal bones with previously drilled mastoidectomies and labyrinthectomies. Pre- and post-drilling 5-point Likert-based surveys were completed.Results
7 participants were included in this study ranging in experience from PGY1 through PGY 5. The median number of times the IAC had been drilled previously was 0. Participants reported statistically significantly improved familiarity with the translabyrinthine approach after the session with median scores increasing from 2 to 3 (p = 0.02), and a near-significant increase in familiarity with IAC anatomy with median scores increasing from 3 to 4 (p = 0.06). Prior to the session, 71% of participants either disagreed or strongly disagreed that they had an idea of what the procedure would be like in a real operating room, whereas after the session 0% reported disagreement. 100% of participants were very satisfied with the overall experience.Conclusions
An educational session and temporal bone drilling experience using prosected bones significantly increased the reported familiarity with the translabyrinthine approach. Experiences such as this may enhance resident exposure to advanced lateral skull base approaches in a safe environment, and increase comprehension of the complex anatomic relationships of the IAC. 相似文献12.
Ceki Paltura Tuba Selçuk Can Behice Kaniye Yilmaz Mehmet Emre Dinç Ömer Necati Develioğlu Mehmet Külekçi 《American journal of otolaryngology》2017,38(4):414-416
Objective
To evaluate the effect of ET diameter on Chronic Otitis Media (COM) pathogenesis.Study design
Retrospective.Subjects and methods
Patients with unilateral COM disease are included in the study. The connection between fibrocartilaginous and osseous segments of the Eustachian Tube (ET) on axial Computed Tomography (CT) images was defined and the diameter of this segment is measured. The measurements were carried out bilaterally and statistically compared.Results
154 (76 (49%) male, 78 (51%) female patients were diagnosed with unilateral COM and included in the study. The mean diameter of ET was 1947 mm (Std. deviation ± 0.5247) for healthy ears and 1788 mm (Std. deviation ± 0.5306) for diseased ears. The statistical analysis showed a significantly narrow ET diameter in diseased ear side (p < 0.01).Conclusion
The dysfunction or anatomical anomalies of ET are correlated with COM. Measuring of the bony diameter of ET during routine Temporal CT examination is recommended for our colleagues. 相似文献13.
Deguang Zhang Lei Xie Gaofei He Liang Fang Yuwen Miao Zhezhe Wang Li Gao 《American journal of otolaryngology》2017,38(2):115-120
Purpose
Video-assisted lateral neck dissection (VALND) for papillary thyroid carcinoma (PTC) with lateral neck lymph node metastases (LNM) has been described previously, however, the advantages and drawbacks of VALND have not been demonstrated in previous studies. The aim of this study was to compare the surgical outcomes of video-assisted and open lateral neck dissection for PTC with lateral neck LNM.Materials and methods
Between May 2013 and November 2014, 92 consecutive patients with PTC and lateral neck lymph node metastases underwent total thyroidectomy with central compartment neck dissection and unilateral lateral neck dissection. These included 54 individuals who underwent video-assisted surgery, and 38 in whom an open approach was used. The two groups were retrospectively compared with respect to their clinicopathological characteristics, surgical outcomes and oncological completeness.Results
The mean follow-up period was 18.6 months. The mean tumor size, tumor stage, mean numbers of retrieved lymph nodes, mean postoperative serum thyroglobulin levels, complication rates, and mean postoperative hospital stay were similar between the two groups. The mean operation time was longer (p = 0.0001) and mean age was lower (p = 0.0354) in the video-assisted group. The cosmetic results, evaluated by numerical scale and verbal response scale, were in favor of the video-assisted group (p = 0.0003 and p < 0.0001, respectively).Conclusions
The safety and oncological completeness of VALND was similar to that of open procedures, but the VALND resulted in improved cosmetic results. VALND is an effective treatment for the selected cases of PTC with lateral neck LNM. 相似文献14.
Uri Alkan Yuval Nachalon Aron Popovtzer Sharon Tzelnick Dan Yaniv Jacob Shvero 《American journal of otolaryngology》2017,38(3):316-320
Objective
To determine if the clinical behavior of T1 glottic squamous cell carcinoma varies by its location on the medial free edge or upper aspect of the vocal cords.Study design
Retrospective cohort.Setting
Single tertiary university-affiliated medical center.Subjects and methods
Clinical, treatment, and outcome data were collected for 104 patients with T1N0M0 glottic squamous cell carcinoma who were treated and followed at our center in 1995–2013. Findings were compared between those with a tumor on the medial (n = 60, 57.7%) or superior (n = 44, 42.3%) aspect of the cords.Results
Mean follow-up time was 4.15 years. No between-group differences were found in demographic or risk factors. There was a significant association of anterior commissure involvement with disease recurrence (P = 0.0012) and of superior (vs medial) location with higher rates of anterior commissure involvement (P < 0.001) and recurrence (P = 0.01) and shorter time to recurrence (P < 0.001).Conclusions
T1 squamous cell carcinomas on the superior aspect of the vocal cords have a poorer prognosis than medial tumors and should be closely monitored for recurrence. 相似文献15.
Amjad F. Nuseir Mohammad Alsalem Mouhamad Alzahr Muthanna Ababneh Ahmad I. Alomari Firas Alzoubi 《American journal of otolaryngology》2017,38(2):135-138
Rationale and objectives
Adhesions are the most common complication after nasal surgery and revision. 5-Fluorouracil (5-FU) reduces various adhesions and epithelial growth related complications. The aim of this study was to evaluate the effects of 5-flurouracil application in the nasal cavity after a multi-procedure nasal surgery in term of complications frequency.Materials and methodology
Institutional ethical approval was granted and a double-blinded prospective clinical trial was conducted to study the effect of 5-fu on post-operative complications. At the end of a combined endoscopic inferior turbinoplasty with one or more other nasal surgeries, 5-flurouracil-soaked cottonoid with 1 mL of 5-flurouracil (5 mg/mL) was applied in one side of nasal cavity and saline-soaked cottonoid was applied contralaterally and left for 5 min. Patients were assessed over 2 months postoperatively by a blinded observer in terms of adhesions, crustation, discharge, pain, discharge, loss of smell and other complications and nasal symptoms.Results
On the 1st follow up week postoperatively, adhesions were observed in (24 patients) 35%, bilateral in (6 patients) 9% and unilateral in (18 patients) 26%. Unilateral Adhesions were statistically significantly higher in control sides than those in 5-FU sides (22% vs 4% respectively) (p = 0.025). Crustation, continued to statistically significantly diminish over time (p = 0.035). On the 8th follow up week, adhesions reduction was still statistical significant at the 5-FU treated side (p = 0.01).Conclusion
5-FU is safe and effective in preventing adhesions formation when applied during combined endoscopic inferior turbinoplasty procedure with other nasal procedure surgery. 相似文献16.
Pawel Golusinski Jakub Pazdrowski Mateusz Szewczyk Piotr Pieńkowski Ewa Majchrzak Augusto Schneider Michal M. Masternak Wojciech Golusinski 《American journal of otolaryngology》2017,38(2):148-152
Background
The use of a free flap has become a mainstay of reconstruction following the ablative surgery in head and neck. The success rates are about 90%, however, several factors have been described to have an adverse effect on free flap survival.Methods
We have performed a retrospective analysis of the treatment outcome of 93 microvascular flaps and evaluated the factors influencing the risk of flap loss including patients' age, body mass index, smoking, general medical history and previous oncological treatment.Results
Out of 93 flaps the total necrosis have been observed in 15 flaps with gradual improvement in the consecutive years. In individual analysis the patients age, BMI, and comorbidities did not reveal any significant relation. The history of any previous oncological treatment represented a significant adverse factor of success rate (p = 0.035), and was even more significant when patients experienced all treatment modalities prior to the reconstructive procedure (p = 0.009). Multivariate logistic regression model indicated that only surgery (p = 0.0008), chemotherapy (p = 0.02), cardiovascular diseases (p = 0.05) and patient's age (p = 0.02) represented significant factors impairing the success rate.Conclusion
Incorporating multivariate analysis represents important statistical approach for better prediction of free flaps survival in head and neck reconstructive surgery. Incorporation of additional collective information could provide more precise approach in the risk of the flap loss assessment. 相似文献17.
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18.
Abdul-Latif Hamdan Ghina Fakhri Ghassan Haddad Gabriel Dunya Doja Sarieddine Bilal Turfe Georges Tabet Sami Azar 《American journal of otolaryngology》2017,38(3):333-336
Objective
To investigate the effect of vitamin D deficiency on the laryngopharyngeal tract.Study design
Prospective cohort study.Setting
Tertiary care center.Subjects and methods
A total of 38 human subjects were prospectively recruited, equally divided into two groups. The Vitamin D deficiency group defined as 25-OH < 25 ng/dl and the control subjects with normal vitamin D level defined as 25-OH > 25 ng/dl. The presence and severity of vocal tract symptoms was assessed using the Vocal Tract Discomfort score.Results
There was no significant difference in vocal tract discomfort score for frequency and severity between patients with Vitamin D deficiency and patients with no vitamin D deficiency (p value 0.272). However there was a significant difference in the mean frequency of burning, aching, soreness and lump sensation (p value < 0.05) in patients with vitamin D deficiency compared to those with no vitamin D deficiency. There was also a significant difference in the means of vocal tract severity symptoms, namely for burning and aching between patients with vitamin D deficiency compared to patients with no vitamin D deficiency (p value < 0.05).Conclusion
Subjects with vitamin D deficiency do not have a higher vocal tract discomfort score than subjects with no vitamin D deficiency. However the frequency and severity of certain vocal tract discomfort symptoms was higher and can be based hypothetically on the similarity in structure between the laryngopharyngeal complex and the musculoskeletal system. 相似文献19.
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20.
Blake Smith Claudio Milstein Bryan Rolfes Samantha Anne 《American journal of otolaryngology》2017,38(2):230-232