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1.
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2.
Daisuke Sano Kenichiro Yabuki Hideaki Takahashi Yasuhiro Arai Yoshihiro Chiba Teruhiko Tanabe Goshi Nishimura Nobuhiko Oridate 《Auris, nasus, larynx》2018,45(4):846-853
Objective
The purpose of this study is to validate the concept of lymph node ratio (LNR) in head and neck squamous cell carcinoma (HNSCC).Methods
A total of 63 patients with HNSCC who underwent resection of the primary tumor combined with neck dissection in our institution were analyzed in this study. LNR was defined as the number of positive lymph nodes divided by the total number of lymph nodes excised. LNR was categorized into two groups (<0.068 and ≥0.068) according to the results of receiver-operating characteristic plots for determination of the cut-off value.Results
LNR ≥ 0.068 was associated with poor overall survival (OS), progression-free survival (PFS) and locoregional recurrence-free survival (LRFS) after resection of the primary tumor combined with neck dissection in patients with HNSCC. Univariate and multivariate data analysis showed that LNR ≥ 0.068 was an independent prognostic factor for OS, PFS and LRFS. Both pathological T stage status (pT3 or 4) and ≥3 positive LNs were also an independent prognostic factors for PFS in patients with HNSCC in our univariate and multivariate analysis.Conclusion
These results suggested that LNR could be useful tools in identifying HNSCC patients with poor outcomes. 相似文献3.
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4.
Objective
Several studies have demonstrated that abnormal glutathione peroxidases 1 (Gpx1) expression can influence the biological behavior of malignant cells. However, the roles of Gpx1 in laryngeal squamous cell carcinoma (LSCC) remain unknown. The purpose of this study is to analyze the Gpx1 expression and prognostic significance in LSCC patients.Methods
Gpx1 mRNA levels in laryngeal tissues were determined by qRT-PCR. Meanwhile, We examined the expression levels of Gpx1 protein in 140 primary tumor tissues and 28 cases of normal tissues by immunohistochemistry (IHC) analysis on tissue microarrays (TMA).Results
Our results revealed that the frequency of high Gpx1 was significantly higher in cancer tissue compared to normal surgical margins; Gpx1 expression correlated with clinical features and overall survival (OS). Gpx1 overexpression was significantly associated with lymph node metastasis (P = 0.023) and TNM stage (P = 0.008); Kaplan–Meier survival curves revealed that patients with high Gpx1 expression had worse prognoses than patients with low Gpx1 expression; By multivariate analysis, we revealed that high Gpx1 expression level (HR 2.101, 95%CI 1.011–4.367; P = 0.047) was an independent prognostic factor of survival in LSCC patients.Conclusion
We speculate that Gpx1 can be applied to predict the prognosis in LSCC patients. 相似文献5.
Terufumi Kawamoto Keiji Nihei Yujiro Nakajima Satoshi Kito Keisuke Sasai Katsuyuki Karasawa 《Auris, nasus, larynx》2018,45(5):1073-1079
Objective
In the treatment of head–neck cancer, parotid-sparing intensity-modulated radiotherapy (IMRT) could reduce the incidence of xerostomia. When the parotid glands cannot be sufficiently spared because of the widespread tumor, contralateral superficial lobe parotid-sparing (CSLPS)-IMRT could be used to reduce marginal recurrence, however the success of this approach remains to be determined. The primary purpose of this study was to compare the incidence of xerostomia between three-dimensional conformal radiotherapy (3D-CRT) and CSLPS-IMRT for oropharyngeal and hypopharyngeal cancer. In a second aim, we also compared the clinical efficacy of 3D-CRT and CSLPS-IMRT.Methods
We retrospectively reviewed the medical records of locally advanced oropharyngeal and hypopharyngeal cancer patients who were treated with definitive concurrent chemoradiotherapy between June 2007 and April 2014. We estimated the average mean dose delivered to the parotid glands, the incidence of xerostomia ≥ Grade 2, patterns of failure, and survival outcomes.Results
Seventeen patients received 3D-CRT and 21 received CSLPS-IMRT. The average mean dose delivered to the superficial lobe of the contralateral parotid gland was 45.3 Gy and 26.6 Gy (p < 0.001), and the incidence of xerostomia ≥ Grade 2 following treatment was 75% and 26% at 12 months (p = 0.012) and 67% and 18% at 24 months (p = 0.018) in the 3D-CRT and CSLPS-IMRT groups, respectively. Patterns of failure did not differ between the two groups. The 2-year progression-free survival was 59% and 62% (p = 0.73), and the 2-year overall survival rate was 71% and 71% in the 3D-CRT and CSLPS-IMRT groups, respectively (p = 0.76).Conclusion
Incidence of xerostomia was significantly lower in patients receiving CSLPS-IMRT compared with 3D-CRT, while clinical efficacy did not differ between two treatment strategies. 相似文献6.
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7.
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8.
Yousif Al-Ammar Bader Al-Mansour Omar Al-Rashood Mutahir A. Tunio Tahera Islam Mushabbab Al-Asiri Khalid Hussain Al-Qahtani 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(2):220-226
Introduction
Increased body mass index is known to be associated with the high prevalence of differentiated thyroid cancers; however data on its impact on survival outcome after thyroidectomy and adjuvant therapy is scanty.Objective
We aimed to evaluate the impact of body mass index on overall survival and disease free survival rates in patients with differentiated thyroid cancers.Methods
Between 2000 and 2011, 209 patients with differentiated thyroid cancers (papillary, follicular, hurthle cell) were treated with thyroidectomy followed by adjuvant radioactive iodine-131 therapy and thyroid-stimulating hormone suppression. Based on body mass index, patients were divided into five groups; (a) <18.5 kg/m2 (underweight); (b) 18.5–25 kg/m2 (normal weight); (c) 26–30 kg/m2 (overweight); (d) 31–40 kg/m2 (obese) and (e) >40 kg/m2 (morbid obese). Various demographic, clinical and treatment characteristics and related toxicity and outcomes (overall survival, and disease free survival) were analyzed and compared.Results
Median follow up period was 5.2 years (0.6–10). Mean body mass index was 31.3 kg/m2 (17–72); body mass index 31–40 kg/m2 was predominant (89 patients, 42.6%) followed by 26–30 kg/m2 seen in 58 patients (27.8%). A total of 18 locoregional recurrences (8.6%) and 12 distant metastasis (5.7%) were seen. The 10 year disease free survival and overall survival rates were 83.1% and 58.0% respectively. No significant impact of body mass index on overall survival or disease free survival rates was found (p = 0.081). Similarly, multivariate analysis showed that body mass index was not an independent prognostic factor for overall survival and disease free survival.Conclusion
Although body mass index can increase the risk of thyroid cancer, it has no impact on treatment outcome; however, further trials are warranted. 相似文献9.
Introduction
The presence of cervical lymph node metastases in patients with oral cavity squamous cell carcinoma reduces survival by up to 50%.Objective
The aims of this study are to assess the accuracy of clinical N staging versus pathological N staging and its impact on survival in order to identify predictive factors associated with the presence of occult neck metastases.Methods
Outcomes of 105 patients with oral cavity squamous cell carcinoma who underwent surgical treatment of the primary tumor and neck were retrospectively evaluated.Results
For pN0 and pN+ patients 5-year overall survival was respectively 53% and 27%; disease specific survival was 66% for pN0 and 33% for pN+. Patients with clinical negative lymph nodes were pathologically upstaged in 62% of cases. Disease specific survival according to staging discrepancy had statistically significant impact on survival (p = 0.009).Conclusion
Clinical staging usually underestimates the presence of nodal disease. Neck dissection should be performed in cN0 oral cavity squamous cell carcinoma. 相似文献10.
Tilman Huppertz Jessica Freiherr Bernhard Olzowy Ulrich Kisser Jutta Stephan Gunther Fesl Kathrin Haegler Berend Feddersen Rainald Fischer Klaus Mees Sven Becker 《Auris, nasus, larynx》2018,45(4):747-752
Objective
Acute mountain sickness (AMS) is caused by a low partial pressure of oxygen and may occur above 2500 m. The aim of this research was to evaluate olfactory and gustatory abilities of healthy subjects during baseline conditions and after seven hours of normobaric hypoxia.Methods
Sixteen healthy subjects were assessed using the Sniffin’ Sticks, as well as intensity and pleasantness ratings. Gustatory function was evaluated utilizing the Taste Strips. Experiments were carried out under baseline conditions (518 m altitude) followed by a second testing session after seven hours of normobaric hypoxia exposure (comparable to 4000 m altitude).Results
During normobaric hypoxia olfactory sensitivity and intensity estimates were significantly reduced.Conclusions
We conclude that normobaric hypoxia leads to a significant decrease of olfactory sensitivity and intensity ratings. 相似文献11.
Yi-Wen Tsai Yu-Hsi Liu Hsing-Hao Su 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(5):532-539
Introduction
Peritonsillar abscess is the most common deep neck infection. The infectious microorganism may be different according to clinical factors.Objective
To identify the major causative pathogen of peritonsillar abscess and investigate the relationship between the causative pathogen, host clinical factors, and hospitalization duration.Methods
This retrospective study included 415 hospitalized patients diagnosed with peritonsillar abscess who were admitted to a tertiary medical center from June 1990 to June 2013. We collected data by chart review and analyzed variables such as demographic characteristics, underlying systemic disease, smoking, alcoholism, betel nut chewing, bacteriology, and hospitalization duration.Results
A total of 168 patients had positive results for pathogen isolation. Streptococcus viridans (28.57%) and Klebsiella pneumoniae (23.21%) were the most common microorganisms identified through pus culturing. The isolation rate of anaerobes increased to 49.35% in the recent 6 years (p = 0.048). Common anaerobes were Prevotella and Fusobacterium spp. The identification of K. pneumoniae increased among elderly patients (age > 65 years) with an odds ratio (OR) of 2.76 (p = 0.03), and decreased in the hot season (mean temperature > 26 °C) (OR = 0.49, p = 0.04). No specific microorganism was associated with prolonged hospital stay.Conclusion
The most common pathogen identified through pus culturing was S. viridans, followed by K. pneumoniae. The identification of anaerobes was shown to increase in recent years. The antibiotics initially selected should be effective against both aerobes and anaerobes. Bacterial identification may be associated with host clinical factors and environmental factors. 相似文献12.
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13.
Objectives
The aim of this study was to evaluate the impact of CSC on insensitivity to radiotherapy in HNSCC.Methods
A radioresistant cell line, FaDu-R, was established using fractionated ionizing radiation. Cells with high and low CD44/ALDH activity were isolated.Results
FaDu-R cells demonstrated significantly increased cell viability after radiation exposure compared with parental cells. CD44high/ALDHhigh FaDu-R cells demonstrated significantly faster wound closure (p < 0.05) and more efficient invasion (p < 0.05) compared to the CD44high/ALDHhigh FaDu cells or the CD44low/ALDHlow FaDu-R cells. There was a significant difference in tumor volume between the CD44high/ALDHhigh FaDu-R cells and the CD44high/ALDHhigh FaDu cells (p < 0.05) as well as the CD44low/ALDHlow FaDu-R cells (p < 0.05).Conclusion
Cancer stem cells (CSC) were associated with invasion and tumorigenesis in a radioresistant head and neck squamous cell carcinoma (HNSCC) cell line. This concept might help to improve the understanding of these mechanisms and to develop drugs that can overcome radioresistance during radiotherapy. 相似文献14.
Marina Carvalho S. Côrtes Pedro Weslley Rosario Gabriela Franco Mourão Maria Regina Calsolari 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(4):448-452
Introduction
In patients with papillary thyroid carcinoma who have negative serum thyroglobulin after initial therapy, the risk of structural disease is higher among those with elevated antithyroglobulin antibodies compared to patients without antithyroglobulin antibodies. Other studies suggest that the presence of chronic lymphocytic thyroiditis is associated with a lower risk of persistence/recurrence of papillary thyroid carcinoma.Objective
This prospective study evaluated the influence of chronic lymphocytic thyroiditis on the risk of persistence and recurrence of papillary thyroid carcinoma in patients with negative thyroglobulin but elevated antithyroglobulin antibodies after initial therapy.Methods
This was a prospective study. Patients with clinical examination showing no anomalies, basal Tg < 1 ng/mL, and elevated antithyroglobulin antibodies 8–12 months after ablation were selected. The patients were divided into two groups: Group A, with chronic lymphocytic thyroiditis on histology; Group B, without histological chronic lymphocytic thyroiditis.Results
The time of follow-up ranged from 60 to 140 months. Persistent disease was detected in 3 patients of Group A (6.6%) and in 6 of Group B (8.8%) (p = 1.0). During follow-up, recurrences were diagnosed in 2 patients of Group A (4.7%) and in 5 of Group B (8%) (p = 0.7). Considering both persistent and recurrent disease, structural disease was detected in 5 patients of Group A (11.1%) and in 11 of Group B (16.1%) (p = 0.58). There was no case of death related to the disease.Conclusion
Our results do not support the hypothesis that chronic lymphocytic thyroiditis is associated with a lower risk of persistent or recurrent disease, at least in patients with persistently elevated antithyroglobulin antibodies after initial therapy for papillary thyroid carcinoma. 相似文献15.
Objective
The purpose of this study was to analyze the impact of lymph node harvest on the lymph node ratio (LNR).Methods
We retrospectively reviewed 106 patients diagnosed preoperatively with PTMC (papillary thyroid microcarcinoma), no evidence of central or lateral neck nodal metastasis, and who underwent a total thyroidectomy and bilateral central lymph node neck dissection (CND).Results
The median number of retrieved lymph nodes in the central compartments was 7 ± 6.59 (range: 1–42). The mean number of metastatic lymph nodes in the central compartments on pathology was 1.1 ± 1.79 (range: 0–7). The high node volume group (>7) had a significantly higher rate of central lymph node (CLN) metastasis than the low node volume group (≤7) in the final pathologic report (p < 0.001). With the linear regression method, the number of CLN metastasis increased as the number of retrieved lymph nodes increased (correlation coefficient = 0.286, p = 0.003). The multivariate analysis confirmed the number of retrieved lymph nodes in the central compartments was a risk factor for high LNR (p = 0.008, odds ratio 3.737). The rates of vocal fold palsy and hypoparathyroidism did not differ according to the number of retrieved lymph nodes.Conclusion
The lymph node ratio in the final pathologic report is larger when a greater number of lymph nodes are retrieved during the central compartment neck dissection. 相似文献16.
Takayuki Imai Shigemi Ito Tomoyuki Oikawa Yukinori Asada Ko Matsumoto Takefumi Miyazaki Tomoko Yamazaki Ikuro Satoh Tetsuya Noguchi Kazuto Matsuura 《Auris, nasus, larynx》2019,46(3):424-430
Objective
Hypopharyngeal cancer is a head and neck cancer with a poor prognosis, and most cases show metastases on diagnosis. Cervical lymph node (LN) metastasis is a poor prognostic factor in hypopharyngeal cancer patients. The identification of risk factors for LN metastasis can help guide surgical treatment strategies for these patients.Methods
This retrospective study included 93 superficial hypopharyngeal cancer patients with 109 histopathologically examined lesions treated by endoscopic resection between January 2007 and December 2017. Tumor thickness quantification, quantification of budding nests, immunostaining and other histopathological analyses in paraffin-embedded, formalin-fixed tissue sections (3-μm) of surgical specimens were performed by a certified pathologist.Results
Cervical LN metastasis was positive in 18 out of 93 cases (19.3%) and 18 out of 109 lesions (16.5%). No differences were detected in patient characteristics between LN-positive and LN-negative cases, except for tumor thickness, which was significantly larger in LN-positive cases (3119.4 ± 602.2 μm vs. 1015.5 ± 129.6 μm, respectively; p < 0.0001). Univariate analysis showed that tumor thickness ≥1000 μm (odds ratio: 5.559, p = 0.003), lesions with high budding grade (odds ratio: 5.188, p = 0.01) and vascular invasion (odds ratio: 12.710, p = 0.007) were significantly associated with cervical LN metastasis. Multivariate analysis revealed tumor thickness ≥ 1000 μm as the most significant risk factor for cervical LN metastasis in superficial hypopharyngeal cancer (odds ratio: 3.639, p = 0.04).Conclusions
We demonstrate for the first time that high budding grade may serve as powerful predictors of LN metastasis and tumor thickness ≥1000 μm is a significant risk factor for LN metastasis of superficial hypopharyngeal cancer. These results should be further examined in future larger scale studies. 相似文献17.
M. Roux O. Dassonville M. Ettaiche E. Chamorey G. Poissonnet A. Bozec 《European annals of otorhinolaryngology, head and neck diseases》2017,134(3):151-154
Objectives
The aims of this study were to assess oncologic and functional outcome in primary total laryngectomy or pharyngolaryngectomy (TL/TL/TPL) for laryngeal or hypopharyngeal cancer with extra-laryngeal extension (T4) and to determine the predictive factors of these results.Material and methods
A retrospective analysis was performed on the computerized medical records of all patients undergoing primary TL/TPL for T4 larynx or hypopharynx squamous cell carcinoma between 2000 and 2014 at our institution. Predictive factors of oncologic and functional outcome were investigated on univariate and multivariate analysis.Results
Sixty-three patients (58 men, 5 women; mean age, 68.8 ± 9.7 years) were included. Overall and disease-specific survivals were 69% and 80% at 3 years, and 56% and 69% at 5 years, respectively. On multivariate analysis, gender (female, P < 0.001), ASA score (ASA ≥ 3; P = 0.006) and vascular embolism (P = 0.006) had significant pejorative impact on overall survival. Six months after end of treatment, 90% of patients had recovered independent oral feeding and 83% of those with tracheoesophageal voice prostheses had recovered an intelligible voice.Conclusion
Primary TL/TPL remains the gold standard treatment for T4 larynx or hypopharynx cancer. It provides satisfactory oncologic and functional outcomes. 相似文献18.
Sinan Uluyol Omer Ugur Ilker Burak Arslan Ozlem Yagiz Murat Gumussoy Ibrahim Cukurova 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(5):608-613
Introduction
Canal wall down tympanomastoidectomy is commonly used to treat advanced chronic otitis media or cholesteatoma. The advantages of canal wall down mastoidectomy are excellent exposure for disease eradication and postoperative control of residual disease; its disadvantages include the accumulation of debris requiring life-long otological maintenance and cleaning, continuous ear drainage, fungal cavity infections, and the occurrence of dizziness and vertigo by changing temperature or pressure.Objective
To evaluate whether cavity-induced problems can be eliminated and patient comfort can be increased with mastoid cavity reconstruction.Methods
In total, 11 patients who underwent mastoid cavity reconstruction between March 2013 and June 2013 comprised the study group, and 11 patients who had dry, epithelialized CWD cavities were recruited as the control group. The study examined three parameters: epithelial migration, air caloric testing, and the Glasgow Benefit Inventory. Epithelial migration, air caloric testing, and the Glasgow Benefit Inventory were evaluated in the study and control groups.Results
The epithelial migration rate was significantly faster in study group (1.63 ± 0.5 mm/week) than control group (0.94 ± 0.37 mm/week) (p = 0.003, p < 0.05). The mean slow component velocity of nystagmus of the study group (13.33 ± 5.36°/s) was significantly lower when compared to control group (32.11 ± 9.12°/s) (p = 0.018). The overall the Glasgow Benefit Inventory score was ?7.21, and the general subscale, physical and social health scores were ?9.71, ?21.09, and +20.35, respectively in the control group. These were +33.93, +35.59, +33.31, and +29.61, respectively in the study group. All but the social health score improved significantly (0.007, 0.008, 0.018, and 0.181, respectively).Conclusions
Cavity reconstruction improves epithelial migration, normalizes caloric responses and increases the quality of life. Thus, cavity rehabilitation eliminates open-cavity-induced problems by restoring the functional anatomy of the ear. 相似文献19.
Objective
The aim of this study was to evaluate the hearing outcomes and complications of stapedotomy in which the stapes superstructure was preserved (Takagi’s stapedotomy). In this surgical approach, the lenticular process of the incus rather is removed, than the superstructure of the stapes.Methods
A single-center retrospective observational study was performed. We included all patients having Takagi’s stapedotomy for otosclerosis between January 2005 and April 2016. Both primary and revision stapes surgery were included. We evaluated audiometric outcomes and surgical complications.Results
Twenty-four patients who underwent stapedotomy preserving superstructure were included in this study. The postoperative air-bone gap at 1 year postoperatively was?≤10 dB in 66.7% of patients and?≤20 dB in all cases. In longer follow-up period, elevation of the air-bone gap was not observed over the 5 postoperative years in available cases. The postoperative air-bone gap was?≤10 dB in 72.2% at 3 years and 81.8% at 5 years postoperatively.Conclusion
Takagi’s stapedotomy restore ossicular conduction without the removal of superstructure of stapes. The air-bone gap did not get worse in long-term follow-up, although audiometric results would be unsatisfactory. Further larger studies are needed to evaluate the efficacy and safety of Takagi’s stapedotomy. 相似文献20.