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Journal of Laryngology and Otology

T C Biggs, A Henderson, F Shelton, N N Patel
BACKGROUND: Flexible laryngoscopy is a commonly performed procedure in otolaryngology. Although this procedure is not considered painful, many patients describe it as uncomfortable. This study investigated the role of visual distraction as a form of pain relief during flexible laryngoscopy. METHODS: The study included patients undergoing flexible laryngoscopy at the University Hospital Southampton. Patients were self-allocated to one of four groups: with or without co-phenylcaine anaesthetic spray; and with and without visual distraction...
July 19, 2018: Journal of Laryngology and Otology
D Swanepoel, J L Clark
BACKGROUND: Hearing loss is a leading contributor to the global burden of disease, with more than 80 per cent of affected persons residing in low- and middle-income countries, typically where hearing health services are unavailable. OBJECTIVES: This article discusses the challenges to hearing care in remote and resource-limited settings, and describes recommended service delivery models, taking personnel and equipment requirements into consideration. The paper also considers the novel roles of telemedicine approaches in these contexts for improving access to preventative care...
July 19, 2018: Journal of Laryngology and Otology
L X Ngui, I P Tang
OBJECTIVES: To investigate the surgical and audiological outcomes of the Bonebridge transcutaneous bone conduction hearing implant among children with congenital aural atresia. METHODS: Six children were recruited and underwent Bonebridge transcutaneous bone conduction implant surgery. The patients' audiometric thresholds for air conduction, bone conduction and sound-field tests were assessed pre-operatively and at six months post-operatively. Patients' satisfaction was assessed at six months post-operatively with the Hearing Device Satisfaction Scale...
July 16, 2018: Journal of Laryngology and Otology
S Carr, A Dritsoula, R Thevasagayam
BACKGROUND: Anterior cricoid split is performed for grade 2 and 3 subglottic stenosis, which can be a cause of extubation failure. It can be performed endoscopically or as an open procedure. This paper describes a case series of endoscopic cricoid split procedures performed using a bespoke sickle knife. METHOD: Nine patients (six pre-term infants) underwent endoscopic cricoid split in a tertiary referral paediatric unit between August 2012 and March 2015. RESULTS: Six patients (67 per cent; four pre-term and two term infants) were on oxygen pre-operatively...
July 16, 2018: Journal of Laryngology and Otology
A K K Smith, T Sokdavy, C Sothea, M K R Pastrana, R F Ali, C T Huins, M P A Clark, J G Gollogly, M F Bhutta
BACKGROUND: Chronic suppurative otitis media is a massive public health problem in numerous low- and middle-income countries. Unfortunately, few low- and middle-income countries can offer surgical therapy. METHODS: A six-month long programme in Cambodia focused on training local surgeons in type I tympanoplasty was instigated. Qualitative educational and quantitative surgical outcomes were evaluated in the 12 months following programme completion. A four-month long training programme in mastoidectomy and homograft ossiculoplasty was subsequently implemented, and the preliminary surgical and educational outcomes were reported...
July 12, 2018: Journal of Laryngology and Otology
B McHale, C D Badenhorst, C Low, D Blundell
OBJECTIVE: A double-blinded, randomised, placebo-controlled trial was conducted to determine whether routine pre-operative analgesia is beneficial in reducing post-operative ear pain following bilateral myringotomy and tube placement. METHODS: Forty-five children (aged 3-15 years) were randomised to receive either pre-operative analgesics (paracetamol and ibuprofen) (n = 21) or placebo (n = 24). All children underwent sevoflurane gas induction with intranasal fentanyl (2 mcg/kg) to reduce the incidence of emergence agitation...
July 12, 2018: Journal of Laryngology and Otology
A K Abou-Foul, A Taghi, N S Tolley, Z Awad
OBJECTIVE: To assess the feasibility of using cumulative sum analysis to show trainees' performance curves and highlight concerns in tonsillectomy surgery. METHODS: In this prospective study, the performance of eight otolaryngology trainees (in their first 6-12 months in the specialty) was compared to that of experts (over 150 tonsillectomies performed) in terms of operative time and post-operative complications. Cumulative sum analysis curves were generated to highlight trainees' performance, and were updated after each performance...
July 12, 2018: Journal of Laryngology and Otology
M P A Clark, B D Westerberg, D Nakku, P Carling
BACKGROUND: At the heart of surgical care needs to be the education and training of staff, particularly in the low-income and/or resource-poor setting. This is the primary means by which self-sufficiency and sustainability will ultimately be achieved. As such, training and education should be integrated into any surgical programme that is undertaken. Numerous resources are available to help provide such a goal, and an open approach to novel, inexpensive training methods is likely to be helpful in this type of setting...
July 12, 2018: Journal of Laryngology and Otology
M E Dinc, S Ulusoy, E Sahin, N Bozan, M O Avincsal, B Tutar, Y Uyar
OBJECTIVE: This prospective, controlled study assessed how placing a stent into a newly formed ostium affects ostial patency, success and complication rates in endoscopic dacryocystorhinostomy patients. METHODS: In group 1 (40 eyes of 36 patients), both silicone tube intubation and tube stenting were performed. In group 2 (36 eyes of 34 patients), only silicone tube intubation was performed. Success, operative time and post-surgical complications were investigated two months post-operatively in each group...
July 12, 2018: Journal of Laryngology and Otology
Y Liu, H-J Yu, H-T Zhen
OBJECTIVE: Various surgical approaches have been described to remove tumours in the parapharyngeal space. This study investigated the feasibility of a transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths and extending toward the skull base. METHODS: Thirty-two patients were selected and underwent a transoral or an endoscope-assisted transoral approach in the surgical management of parapharyngeal space benign tumours located in the medial portion of the carotid sheaths...
July 12, 2018: Journal of Laryngology and Otology
F Hassannia, S D Carr, E Yu, J A Rutka
OBJECTIVE: Carotid artery aneurysm is a potentially fatal complication of skull base osteomyelitis. It is important to know the warning signs for this complication, as early diagnosis is of great importance. This report aimed to determine whether the pattern of cranial nerve involvement may predict the occurrence of aneurysm involving the internal carotid artery in skull base osteomyelitis. METHODS: Two diabetic patients with skull base osteomyelitis were incidentally diagnosed with pseudo-aneurysm of the petrous internal carotid artery on follow-up magnetic resonance imaging...
July 12, 2018: Journal of Laryngology and Otology
S A Schrøder, S Eickhardt, T Bjarnsholt, T Nørgaard, P Homøe
OBJECTIVE: Bacterial infection is a common finding in acute sialadenitis and may play a role in the chronicity of the condition. This study investigated if bacterial biofilm is present in submandibular chronic obstructive sialadenitis. METHODS: A descriptive case-control study was conducted that compared 10 histological sections of submandibular glands with chronic obstructive sialadenitis, to 10 histological sections of the healthy part of submandibular glands with pleomorphic adenoma...
July 10, 2018: Journal of Laryngology and Otology
O Ismi, T Kara, G Polat, O Bobusoglu, Y Vayısoglu, K Gorur, C Ozcan
BACKGROUND: Although the role of neurotrophins such as nerve growth factor and brain-derived neurotrophic factor in nasal polyps development has been studied, the contribution of neurotrophin-3 has not been evaluated yet. This study aimed to investigate the possible role of neurotrophin-3 in nasal polyps pathogenesis. METHODS: The study group comprised 70 non-allergic nasal polyps patients and the control group consisted of 53 patients with middle turbinate concha bullosa...
July 5, 2018: Journal of Laryngology and Otology
D D Maharaj, R S Virk, S Bansal, A K Gupta
OBJECTIVES: To compare combined conventional Freer medialisation and controlled synechiae, performed for middle meatal access (during the initial steps of functional endoscopic sinus surgery) and post-operative middle turbinate medialisation, with basal lamella relaxing incision, the latter of which is a single step for achieving both middle meatal access and post-operative medialisation. The study also compared the effects of controlled synechiae and basal lamella relaxing incision on post-operative olfaction...
July 2, 2018: Journal of Laryngology and Otology
R Smee, J R Williams, D P Kotevski
OBJECTIVES: To assess five-year local control and ultimate local control rates of patients treated for locally advanced T3-4 glottic carcinoma with surgery only, radiotherapy only, or surgery plus radiotherapy. Cancer-specific survival, overall survival and rates of malignancy development were also assessed. METHODS: A retrospective review was conducted on patients from 1967 to 2015, with analysis of local control, ultimate local control, overall survival and cancer-specific survival performed using Kaplan-Meier and Cox regression...
July 2, 2018: Journal of Laryngology and Otology
G de Bonnecaze, B Chaput, A Dupret-Bories, S Vergez, E Serrano
OBJECTIVE: Trimethoprim/sulfamethoxazole has been suggested as a treatment option for chronic rhinosinusitis with purulence. This study aimed to assess the functional and endoscopic outcomes after a three-month course of low-dose trimethoprim/sulfamethoxazole. METHODS: A prospective study was performed, comprising patients referred to a tertiary care medical centre with a diagnosis of chronic rhinosinusitis with purulence. Trimethoprim/sulfamethoxazole was prescribed at 960 mg/day for three months...
July 2, 2018: Journal of Laryngology and Otology
R Mhawej, C Ghorra, S Naderi, N Khoueir, W Abou Hamad, A E Melkane
OBJECTIVES: To evaluate for the first time the prevalence of human papillomavirus in oropharyngeal squamous cell carcinoma in a Middle-Eastern population, and to determine associations between human papillomavirus profiles and clinicopathological characteristics. METHODS: A retrospective chart review was conducted of all patients treated for oropharyngeal squamous cell carcinoma at the Hotel Dieu de France University Hospital (Beirut, Lebanon) between January 2010 and 2016...
June 29, 2018: Journal of Laryngology and Otology
C van den Boer, A L Wiersma, J P Marie, J T van Lith-Bijl
BACKGROUND: Laryngeal re-innervation in paediatric unilateral vocal fold paralysis is a relatively new treatment option, of which there has been little reported experience in Europe. METHODS: In this European case report of a 13-year-old boy with dysphonia secondary to left-sided unilateral vocal fold paralysis after cardiac surgery, the patient underwent re-innervation using an ansa cervicalis to recurrent laryngeal nerve transfer, in combination with fat augmentation, after 12 years of nerve denervation...
June 29, 2018: Journal of Laryngology and Otology
R Jackson, A B Addison, P R Prinsley
BACKGROUND: Cholesteatoma is widely considered to be more aggressive in children than adults, yet few studies have directly compared the operative findings and surgical outcomes between these two groups. This study aimed to assess differences between childhood and adult cholesteatoma. METHODS: The operative caseload of a single consultant surgeon was reviewed between January 2006 and May 2017 using the online Common Otology Audit database. Extracted data were categorised according to patient age (children, aged below 16 years, and adults, aged 16 years or over) and compared...
June 18, 2018: Journal of Laryngology and Otology
E H Stefanescu, S Motoi
OBJECTIVE: To evaluate the usefulness and reliability of a research software application for the estimation of an individual's cochlear duct length as a basis for electrode selection. METHODS: In this prospective cohort study, 21 consecutive patients (23 ears) implanted with a cochlear electrode were investigated. The study comprised 19 children (2 bilateral) and 2 adults. RESULTS: The measured 'A' distances (the largest distance from the round window to the contralateral wall) corresponded to cochlear duct lengths of 28...
June 18, 2018: Journal of Laryngology and Otology
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