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1.
Sanjeev Mohanty Vinoth Manimaran Preethi Umamaheswaran Shivapriya Jeyabalakrishnan Sreenivas Chelladurai 《Auris, nasus, larynx》2018,45(5):936-942
Objective
Management of anterior perforations of tympanic membrane is a surgical challenge. The objective of this study is to analyse and compare the results of composite cartilage perichondrium island (CCPI) graft and temporalis fascia graft by endoscopic technique in anterior quadrant perforations.Methods
A prospective study was conducted in a tertiary care centre from 2012–16. A total of 187 ear drums(n) in 168 patients with perforations involving anterior quadrant were included in the study. All the patients were operated completely by endoscopic technique. Tragal Composite cartilage perichondrium island (CCPI) graft was used in 87 ears and temporalis fascia in 100. Each group was categorised into A and B depending on perforation size. The outcome parameters assessed include graft success with regard to perforation size, pre- and postoperative ABG, mean improvement in ABG, ABG closure ratio and graft medialisation/lateralisation status.Results
Cartilage group had 91.95% (80/87) success rate overall, while fascia had 79% (79/100). In category 1, the success rate for cartilage and temporalis fascia were 89.6% (26/29) and 68.9% (20/29) respectively (p = 0.51788). In category 2, the success rates were 93.1% (54/58) and 83.1% (59/71) respectively (p = 0.86356). The mean improvement in ABG for both groups were 17.52 ± 3.84 dB and 15.26 ± 5.56 dB respectively (p = 0.04). ABG closure ratio for both the groups were 62.84 ± 11.87 % and 53.6 ± 19.6 % respectively (p = 0.0008).Conclusion
Endoscopic composite cartilage perichondrium island graft is an effective technique in managing perforations of anterior quadrant barring the expertise required for endoscopic ear surgeries. 相似文献2.
3.
Peng Huang Shujun Zhang Xinhong Gong Xuesong Wang Zi-Han Lou 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(5):545-552
Introduction
In the last decade, there has been an increasing use of biomaterial patches in the regeneration of traumatic tympanic membrane perforations. The major advantages of biomaterial patches are to provisionally restore the physiological function of the middle ear, thereby immediately improving ear symptoms, and act as a scaffold for epithelium migration. However, whether there are additional biological effects on eardrum regeneration is unclear for biological material patching in the clinic.Objective
This study evaluated the healing response for different repair patterns in human traumatic tympanic membrane perforations by endoscopic observation.Methods
In total, 114 patients with traumatic tympanic membrane perforations were allocated sequentially to two groups: the spontaneous healing group (n = 57) and Gelfoam patch-treated group (n = 57). The closure rate, closure time, and rate of otorrhea were compared between the groups at 3 months.Results
Ultimately, 107 patients were analyzed in the two groups (52 patients in the spontaneous healing group vs. 55 patients in the Gelfoam patch-treated group). The overall closure rate at the end of the 3 month follow-up period was 90.4% in the spontaneous healing group and 94.5% in the Gelfoam patch-treated group; the difference was not statistically significant (p > 0.05). However, the total average closure time was significantly different between the two groups (26.8 ± 9.1 days in the spontaneous healing group vs. 14.7 ± 9.1 days in the Gelfoam patch-treated group, p < 0.01). In addition, the closure rate was not significantly different between the spontaneous healing group and Gelfoam patch-treated group regardless of the perforation size. The closure time in the Gelfoam patch-treated group was significantly shorter than that in the spontaneous healing group regardless of the perforation size (small perforations: 7.1 ± 1.6 days vs. 12.6 ± 3.9, medium-sized perforations: 13.3 ± 2.2 days vs. 21.8 ± 4.2 days, and large perforations: 21.2 ± 4.7 days vs. 38.4 ± 5.7 days; p < 0.01).Conclusion
In the regeneration of traumatic tympanic membrane perforations, Gelfoam patching not only plays a scaffolding role for epithelial migration, it also promotes edema and hyperplasia of granulation tissue at the edges of the perforation and accelerates eardrum healing. 相似文献4.
Sanjana Vijay Nemade Kiran Jaywant Shinde Chetana Shivadas Naik Haris Qadri 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(3):318-323
Introduction
Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.Objective
To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.Methods
A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results.Results
Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB while in Group B; it was 22.5 ± 3.5 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.Conclusion
Double layered graft with drum-malleus as a ‘meat’ of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity. 相似文献5.
Sanjana Vijay Nemade Kiran Jaywant Shinde Pratibha Bharat Sampate 《Auris, nasus, larynx》2018,45(3):440-446
Introduction
Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich Tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.Objective
To describe and evaluate the modified sandwich graft (mediolateral double layer graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.Methods
A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay fascia technique. 48 patients (Group C) underwent type one tympanoplasty with underlay cartilage technique. We assessed the healing and hearing results.Results
Successful graft take up was accomplished in 47 patients (97.9%) in Group A, in 40 patients (83.3%) Group B, and in 46 (95.8%) patients in Group C. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB, in Group B, it was 22.5 ± 3.5 dB and in group C, it was 19.8 ± 2.6 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.Conclusion
Double layered graft with drum-malleus as a ‘meat’ of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity. 相似文献6.
Nesibe Gül Yüksel Aslıer Selhan Gürkan Mustafa Aslıer Günay Kirkim Enis Alpin Güneri Ahmet Ömer Ikiz 《Auris, nasus, larynx》2018,45(5):985-993
Objective
The purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty.Methods
Thirty-four operated ears of 32 patients and 70 ears of 35 control subjects were included. Differences of pure-tone audiometry thresholds and wideband ambient-pressure absorbance ratios with respect to the graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery were analyzed. Receiver operating characteristics curve was generated to detect the absorbance level at which the reconstructed tympanic membrane behaves as ‘near-normal tympanic membrane’.Results
In the surgical group, wideband energy absorbance ratios at all 1/2-octave band frequencies were significantly worse than normal ears. Energy absorbance ratios at 2000 and 2828 Hz frequencies were higher in patients with tragal cartilage grafts. Higher absorbance ratios at 250–750 Hz range were obtained in patients with 400 μm cartilage graft thickness, <50% cartilage surface area ratio and ≥5 years since surgery. A multivariate generalized linear model revealed common effects of the independent variables at 8000 Hz. The receiver operating characteristics analysis generated a cut-off level of 63.20% of sound energy absorbance at 1400 Hz with 83% sensitivity and 88% specificity.Conclusion
Even though no differences in hearing thresholds were observed; graft material, graft thickness, cartilage surface area ratio and elapsed time after surgery affected the course of sound energy absorbance after type 1 cartilage tympanoplasty as evidenced by wideband tympanometry. 相似文献7.
Objectives
This study aimed to compare the outcome of endoscopic tympanoplasty with sterile acellular dermal allograft (ADA) and conventional endaural microscopic tympanoplasty with tragal perichondrium.Methods
This was a retrospective comparative study of 53 patients (25 males and 28 females) with tympanic membrane perforation who underwent type I tympanoplasty in the department of otorhinolaryngology at a tertiary medical center from March 2011 to April 2017. The subjects were classified into two groups; transcanal endoscopic tympanoplasty with ADA (TET, n = 26), conventional endaural microscopic tympanoplasty with autologous tragal perichondrium (EMT, n = 27). Demographic data, perforation size of tympanic membrane at preoperative state, pure tone audiometric results preoperatively and 3 months postoperatively, operation time, sequential postoperative pain scale, and postoperative graft failure rate were evaluated.Results
The perforation size of the tympanic membrane in TET and EMT group was 22.3 ± 10.9% and 23.5 ± 9.7%, respectively (P = 0.143). Mean operation time of EMT (92.3 ± 16.5 min) was longer than that of the TET (65.3 ± 20.5 min) with a statistical significance (P = 0.004). Graft success rate in the TET and EMT group were 92.3% and 96.3%, respectively; the values were not significantly different (P = 0.610). Pre- and postoperative audiometric results including bone and air conduction thresholds and air-bone gap were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Pain in the immediate postoperative and day 1 after surgery were significantly less in the TET group.Conclusion
With human cadaveric ADA, minimal invasive endoscopic tympanoplasty can be achieved with similar postoperative results and less pain. 相似文献8.
Maria Humeniuk-Arasiewicz Grażyna Stryjewska-Makuch Małgorzata A. Janik Bogdan Kolebacz 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(2):232-239
Introduction
Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator.Objective
Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature.Methods
Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied.Results
The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891).Conclusion
The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques. 相似文献9.
Vincenzo Landolfo Carmine Fernando Gervasio Giuseppe Riva Massimiliano Garzaro Rita Audisio Giancarlo Pecorari Roberto Albera 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(1):74-81
Introduction
Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer.Objectives
The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis–T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results.Methods
Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed.Results
Margin status is related to recurrence rate in both groups (p < 0.05) without significant differences between open and laser cordectomy (p > 0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p > 0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p < 0.05).Conclusions
Margin status has a prognostic role in T1a–T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes. 相似文献10.
Jae-Wook Kim Deok Soo Kim Sung-Dong Kim Sue Jean Mun Soo-Kweon Koo Kyu-Sup Cho 《Auris, nasus, larynx》2018,45(5):1027-1032
Objective
The aims of this study were to determine the associated factors affecting the success rate of limited palatal muscle resection (LPMR), and to investigate whether drug-induced sleep endoscopy (DISE) could predict the therapeutic response to LPMR in patients with obstructive sleep apnea obstructive sleep apnea (OSA).Methods
Twenty-one consecutive OSA patients underwent LPMR were enrolled. All patients received routine ENT examination, preoperative DISE, and polysomnography (PSG). Clinical, polysomnographic, cephalometric variables, and DISE findings were evaluated. The measurements were related to the success or failure of LPMR based on the results of preoperative and postoperative PSG.Results
The overall success rate of LPMR was 66.6%. Postoperative AHI and minimal oxygen saturation were significantly decreased after LPMR (p < 0.001). Comparison between success and failure groups revealed no significant differences in BMI, Friedman stage, preoperative AHI, minimal oxygen saturation, and all cephalometric parameters. However, the success of LPMR was significantly correlated with site, degree, and configuration of obstruction in DISE. In the velopharynx, complete obstruction (p = 0.006) with anterolateral or concentric pattern (p = 0.044) had significantly better success rate than partial obstruction with lateral pattern.Conclusion
DISE was only predictive method for identifying the success in OSA patients undergoing LPMR. Patients with anteroposterior or concentric total obstruction in the velopharynx might be suitable candidate for LPMR. 相似文献11.
Daniel Peñaranda Juan Manuel Garcia Maria Leonor Aparicio Felipe Montes Clemencia Barón Roberto C. Jiménez Augusto Peñaranda 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(3):324-331
Introduction
The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision.Objective
To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids.Methods
This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0 = none; Grade 1 = erythema; Grade 2 = erythema and discharge; Grade 3 = granulation tissue; and Grade 4 = inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit.Results
A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p = 0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications.Conclusion
Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of patients with bone-anchored hearing aids. 相似文献12.
Himani Lade Santosha Ram Choudhary Ashish Vashishth 《European archives of oto-rhino-laryngology》2014,271(7):1897-1902
The objectives of this study were to ascertain the feasibility of transcanal endoscopic underlay myringoplasty using temporalis fascia and compare the results with microscopic myringoplasty. This prospective randomized trial included 60 patients with mucosal chronic otitis media with tympanic membrane perforations of all sizes and locations apart from posteriorly based small or moderate sized perforations. In the endoscopy group, 30 patients underwent exclusive transcanal myringoplasty using tympanomeatal flap elevation with underlay graft placement. In the microscopy group, 30 patients underwent myringoplasty using the postaural approach. Intra-operative variables compared were canalplasty and canal wall curettage for assessment of ossicular status. Graft uptake, hearing outcomes using pure tone audiometry and subjective cosmetic outcomes were assessed 24 weeks post-operatively and compared in the two groups. Resident feedback on the feasibility of endoscopic myringoplasty was obtained using a questionnaire. In the microscopy group, 5/30 patients required canalplasty due to canal overhangs and 4/30 required canal wall curettage for ossicular assessment, whereas none of the patients in the endoscopy group required these procedures. A graft uptake rate of 83.3 % was observed in both groups post-operatively after 24 weeks. Mean air-bone gap pre- and post-operatively in the endoscopy group was 28.5 and 18.13 dB, respectively, whereas these values were 32.4 and 16.9 dB, respectively, in the microscopy group. Subjective cosmetic outcomes were better in the endoscopy group. Resident feedback on endoscopic myringoplasty was positive. Endoscopic myringoplasty appears to be an effective alternative to microscopic myringoplasty and results in excellent hearing with good cosmetic outcomes. 相似文献
13.
Luiz Felipe Palma Fernanda Aurora Stabile Gonnelli Marcelo Marcucci Adelmo José Giordani Rodrigo Souza Dias Roberto Araújo Segreto Helena Regina Comodo Segreto 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(2):227-231
Introduction
The procedure used to evaluate salivary flow rate is called sialometry. It can be performed through several techniques, but none appears to be really efficient for post-radiotherapy patients.Objective
To adequate sialometry tests for head and neck cancer patients submitted to radiotherapy.Methods
22 xerostomic patients post-radiotherapy (total radiation dose ranging from 60 to 70 Gy) were included in this study. Ten patients were evaluated using sialometries originally proposed by the Radiation Therapy Oncology Group and twelve were assessed by our modified methods. Unstimulated and stimulated sialometries were performed and the results were classified according a grading scale and compared between both groups.Results
There was no statistically significant difference between the salivary evaluations of both groups (p = 0.4487 and p = 0.5615). Also, most of these rates were classified as very low and low.Conclusion
This novel method seems to be suitable for patients submitted to radiotherapy. 相似文献14.
Isa Kaya Murat Benzer Sercan Gode Furkan Sahin Cem Bilgen Tayfun Kirazli 《Auris, nasus, larynx》2018,45(4):722-727
Objective
Tympanoplasty is a commonly used procedure in children as in adults. The purposes of this study were to evaluate and report the long term results of type 1 cartilage tympanoplasty in pediatric population. Short term and long term hearing outcomes were compared according to age and perforation location.Methods
We retrospectively evaluated a total of 76 of 93 patients who had regularly come to visits (38 male and 38 female) with chronic otitis media (COM) and who were younger than 16 years (range, 9–16 years) and underwent a primary type 1 tympanoplasty in tertiary medical center. We divided our population into 2 groups; a younger group (age <12 years) and an older group (age ≥12 years). Age, gender, follow-up time, prior to surgery and at postoperative 6th and minimum 48th month follow-up pure tone audiometry (PTA) thresholds and if any residual perforation were noted.Results
Successful closure occurred 74 in 76 patients and success rate was 97,03%. The mean 6th month follow-up bone conduction threshold values were 7,61 ± 3,89 and 6,89 ± 6,28 <12 years old and ≥12 years old children, respectively. The mean 48th month follow-up bone conduction threshold values were 6,93 ± 4,00 and 7,12 ± 6,40, <12 years old and ≥12 years old children, respectively. The mean 6th month follow-up air conduction threshold values were 23,75 ± 8,38 and 24,73 ± 10,41 <12 years old and ≥12 years old children, respectively. The mean 48th month follow-up air conduction threshold values were 17,15 ± 6,04 and 20,30 ± 10,30, <12 years old and ≥12 years old children, respectively. Among all children; preoperative mean air conduction differed significantly from postoperative 6th and 48th month follow-up mean air conduction thresholds (p < 0.001). They had significant improvement in their ABG compared with their preoperative ABG scores. In addition according to groups, there was no significantly difference between pre and postoperative ABG improvement in both 6th and 48th month follow-up between <12 years old and ≥12 years old patient group.Conclusion
In pediatric patients type 1 tympanoplasty with cartilage graft, gives statistically significant success in long term follow up. Long term hearing results of primary type 1 cartilage tympanoplasty is seem to be better than short term hearing results as well. We consider that cartilage graft could be the best graft material for pediatric tympanoplasty for long term success. 相似文献15.
Yoshihiro Chiba Daisuke Sano Yukiko Ikui Goshi Nishimura Kenichiro Yabuki Yasuhiro Arai Teruhiko Tanabe Hidetaka Ikemiyagi Hiroshi Hyakusoku Nobuhiko Oridate 《Auris, nasus, larynx》2018,45(6):1214-1220
Objective
The Hyodo scoring system during the endoscopic procedure has been proposed as a new tool for evaluating oral intake feasibility. However, the effectiveness of the information obtained from this procedure in predicting aspiration is not fully elucidated. The aim of this study was to assess the significance of clinical factors, including Hyodo scores, for predicting the risk of aspiration.Methods
Five hundred and twenty-eight endoscopic swallowing examinations were performed. Clinical factors, including age, sex, disease type, history of aspiration pneumonia, cognitive function, presence of tracheostomy, presence of vocal cord paralysis, consciousness level on the Japan Coma Scale, ECOG Performance Status, serum albumin level and Hyodo score, were obtained for each examination. The relationship between each of these factors and the presence of aspiration during endoscopic procedure was evaluated.Results
Three hundred and thirty-two patients (62.9%) were scored less than 5, 153 (29.0%) were scored between 5 and 8, and 43 (8.1%) were scored above 8. The number of patients with aspiration was 133 (25.2%). ROC analysis revealed that a cut-off point of 6 for Hyodo score was effective for predicting aspiration, with a sensitivity of 0.65 and a specificity of 0.86. History of aspiration pneumonia (OR 1.87, P < 0.001), vocal cord paralysis (OR 2.23, P < 0.001), PS ≥ 3 (OR 2.47, P < 0.001) and Hyodo score > 6 (OR 9.08, P < 0.001) were found to be independent predictive factors for aspiration.Conclusion
The Hyodo scoring method was easy for otolaryngologists to perform and the scores were useful for predicting aspiration with moderate sensitivity and high specificity. Hyodo score > 6, history of aspiration pneumonia, vocal cord paralysis, and PS ≥ 3 were independent predictive factors for aspiration and that a Hyodo score above 6 was the statistically strongest predictor for aspiration. 相似文献16.
Kong Yew Liew Abu Bakar Zulkiflee 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(6):764-771
Introduction
Nasopharyngeal carcinoma is a geographically and racially variable disease which has a high incidence in Malaysia. Based on current concepts in tumour related inflammation the inflammatory marker, neutrophil–lymphocyte ratio was tested to find its relationship with prognosis in nasopharyngeal carcinoma.Objective
To investigate the effect of the neutrophil–lymphocyte ratio on prognosis in non-metastatic primary nasopharyngeal carcinoma patients and to further refine the cut off between high and low neutrophil–lymphocyte ratio values.Methods
The medical charts of patients with histologically confirmed nasopharyngeal carcinoma from 1st January 2005 until 31st December 2009 were reviewed retrospectively and theneutrophil–lymphocyte ratio was calculated to see if there was any association between their higher values with higher failure rates.Results
Records of 98 patients (n = 98) were retrieved and reviewed. Only neutrophil–lymphocyte ratio (p = 0.004) and tumor node metastasis staging (p = 0.002) were significantly different between recurrent and non-recurrent groups, with the neutrophil–lymphocyte ratio being independent of tumor node metastasis staging (p = 0.007). Treatment failure was significantly higher in the high neutrophil–lymphocyte ratio group (p = 0.001). Disease free survival was also significantly higher in this group (p = 0.000077).Conclusion
High neutrophil–lymphocyte ratio values are associated with higher rates of recurrence and worse disease free survival in non-metastatic nasopharyngeal carcinoma patients undergoing primary curative treatment. 相似文献17.
Kosuke Akiyama Yasushi Samukawa Satoshi Takahashi Youhei Ouchi Hiroshi Hoshikawa 《Auris, nasus, larynx》2018,45(4):765-771
Objective
The preservation or resection of the middle turbinate (MT) during endoscopic sinus surgery (ESS) currently remains a matter of debate. The present study aimed to investigate the effects of submucosal middle turbinectomy (SMT) in ESS for eosinophilic chronic rhinosinusitis (ECRS).Methods
The study included 38 ECRS patients (63 sides) who had undergone full-house ESS with SMT and 20 ECRS patients (40 sides) without SMT as a control group. Post-operative middle turbinate lateralization (MTL), synechia formation, and the patency grade of the olfactory cleft (OC) were assessed as the primary outcomes 3 months after surgery. CT scans and the T&T test were performed on the SMT group 3 months after surgery and assessed as secondary outcomes.Results
MTL and synechia formation rates were slightly higher in the control group than in the SMT group (20% vs. 7.9%, p = 0.072, 17.5% vs. 9.5%, p = 0.235), although neither reached statistically significance. The mean patency score of OC was significantly better in the SMT group than in the control group (0.5 ± 0.6 vs. 1.3 ± 0.7, <0.001). CT findings and T&T test scores showed good improvements after SMT combined with ESS. No major adverse events occurred due to SMT.Conclusion
We demonstrated the potential advantages of SMT for ECRS patients. This method may avoid physiological functional loss through its preservation of the mucosa and structure of the MT. 相似文献18.
Objective
Eosinophilic chronic rhinosinusitis (ECRS) is frequently complicated by asthma, and recognized as refractory and persistent rhinosinusitis. However, the detailed pathophysiology of ECRS has not been elucidated yet. In this study, we investigated the association between recurrent ECRS and intradermal testing to multi-antigens including Candida albicans.Methods
The subjects were 49 cases of bilateral chronic rhinosinusitis including 24 ECRS cases. They underwent endoscopic sinus surgery and submitted to pathological examination. Prior to surgery, peripheral blood eosinophil count, total and antigen-specific IgE levels (11 categories), and intradermal tests (5 categories) were carried out in all patients. These patients were followed-up for longer than 3 months. We compared the results of preoperative and postoperative clinical examination data between ECRS and non-ECRS (NECRS) cases.Results
Positive reaction of the delayed type of intradermal testing to C. albicans was significantly more often observed in ECRS than NECRS cases. (P < 0.01) Additionally, these positive reaction cases exhibited significantly higher recurrence of nasal polyps and symptoms of ECRS (P < 0.05).Conclusion
These results suggest the involvement of (Coombs) type IV allergic reaction to C. albicans in the pathophysiology of ECRS. 相似文献19.
Bo Hae Kim Yung Jin Jeon Young Ju Jin Woo-jin Jeong Sung Joon Park Soon-Hyun Ahn 《Auris, nasus, larynx》2018,45(5):1061-1065
Objective
This study describes the clinical characteristics and course of conservative treatment using anti-Tb medication and dressing in patients with tuberculous cervical fistula resulting from abscess formation, and to investigate factors prognostic of dressing and treatment duration.Methods
The medical records of patients with tuberculous cervical lymphadenitis were reviewed, and 38 of these patients who presented with cutaneous fistula that resulted from abscess formation were included in the study.Results
The mean duration of dressing until fistula closure was 3.7 ± 2.0 months (range 0.2–8.5), and the mean duration of treatment with anti-Tb medication was 10.6 ± 2.6 months (range 6.0–16.0). Patients with concomitant Tb, beyond the cervical lymph nodes showed significantly prolonged duration of dressing (4.6 months vs. 3.2 months, p = 0.025) and anti-Tb medication (11.8 months vs. 9.8 months, p = 0.015).Conclusion
Our results indicate that about 3.7 months of dressing was required for fistula closure. Tuberculous cervical lymphadenitis patients with fistula who had Tb beyond the cervical lymph nodes could be expected to require dressing for 4.6 months and prolonged and anti-Tb medication treatment. 相似文献20.
Daniel H. Coelho Taylor S. Pence Mostafa Abdel-Hamid Richard M. Costanzo 《Auris, nasus, larynx》2018,45(5):1000-1005