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Clinical Otolaryngology

W L Lodder, B Dorgelo, J Lancaster, R Hanlon, H Wieshmann, G H de Bock, B F A M van der Laan
Head and neck cancer is worldwide the sixth most common cancer. Prognosis is linked to tumour (primary tumours, nodal stage and distant metastasis) and general patients' characteristics. Currently, the TNM-staging system is the most used staging system in the world. Beside this TNM-staging system, other prognostic factors are used to select the best treatment for each individual patient. This article is protected by copyright. All rights reserved.
March 15, 2018: Clinical Otolaryngology
Sebastian Wallis, Lorcan O'Toole, Laszlo Karsai, Jose Jemy
Cancer of the unknown primary (CUP) makes up 2-4% of new head and neck squamous cell carcinoma (SCC) diagnoses. This scenario is recognised as a diagnostic challenge for head and neck surgeons. For all patients with proven cervical lymph node metastatic SCC without a clinically apparent primary site, the current UK guidelines recommends PET-CT, panendoscopy with directed biopsies and bilateral tonsillectomy as a standard of care. This article is protected by copyright. All rights reserved.
March 15, 2018: Clinical Otolaryngology
Kimberley Lau, Joseph Wilkinson, Ram Moorthy
OBJECTIVE: Following the announcement of the NHS Cancer Plan in 2000, anyone suspected of having cancer has to be seen by a specialist within two weeks of referral. Since this introduction, studies have shown that only 6.3-14.6% of 2-week referrals were diagnosed with a head and neck cancer and that majority of the cancer diagnoses were via other referral routes. These studies suggest that the referral scheme is not currently cost effective. Our aim is to develop a scoring system that determines the risk of head and neck cancer in a patient, which can then be used to aid GP referrals...
March 15, 2018: Clinical Otolaryngology
Adonye Banigo, Ahmad Moinie, Nigel Bleach, Meera Chand, Vicki Chalker, Theresa Lamagni
OBJECTIVES: To determine if there is a correlation between falling tonsillectomy numbers and increasing numbers of tonsillitis admissions and invasive Group A β-haemolytic streptococcus (iGAS) infection in children aged 14 and under in England. DESIGN: An observational cross-sectional study was performed. SETTING: The data extracted covered the period from 1991 until 2014. PARTICIPANTS: Hospital admissions for tonsillectomies, tonsillitis/pharyngitis, and and all diagnoses of iGAS in children aged 14 and under who had a tonsillectomy...
March 5, 2018: Clinical Otolaryngology
Cheryl Da Costa, Robert H Eikelboom, Angela Jacques, De Wet Swanepoel, Andrew J O Whitehouse, Sarra E Jamieson, Christopher G Brennan-Jones
OBJECTIVES: To examine the relationship between early life episodes of otitis media and later behavioural development with adjustment for confounders. DESIGN: Longitudinal cohort study. SETTING: The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnant women from King Edward Memorial Hospital (KEMH) in Perth, Western Australia, between 1989 and 1991. PARTICIPANTS: Data from the children born were collected at both the Year 3 and Year 5 follow up...
March 1, 2018: Clinical Otolaryngology
J C T Lau, A C Leong
The C-MAC® video monitor attachment is suitable for all otolaryngological scenarios, including post-operative follow up and difficult airway examination. Currently, there are no studies looking at the effectiveness of C-MAC® portable monitor with portable flexible nasoendoscopy. Our study demonstrates that the C-MAC® monitor with portable flexible nasoendoscopy is an excellent tool in terms of medical education, improving patient-doctor communication, efficiency of ward rounds and for medico-legal documentation, with distinct advantages over traditional direct flexible nasoendoscopy...
March 1, 2018: Clinical Otolaryngology
Li-Hsiang Cheng, Pei-Chuan Wu, Yuan-Yung Lin, Yueng-Hsiang Chu, Hsing-Won Wang
OBJECTIVES: Sumatriptan (Imigran) is a potent and highly selective 5-HT1 receptor agonist often used in treating acute migraine. Intranasal sumatriptan is well absorbed and is generally effective in relieving headache. However, the effects of Imigran on human nasal mucosa have rarely been well explored. To verify the effect of Imigran, which act on human nasal mucosa directly in vitro. DESIGN AND PARTICIPANTS: We examined the effectiveness of Imigran on human nasal mucosa by testing: 1) effect on human nasal mucosa resting tension; 2) effect on contraction caused by 10-6 M methoxamine as a sympathetic mimetic; 3) effect of the drugs on electrically induced on human nasal mucosa contractions...
March 1, 2018: Clinical Otolaryngology
Enny-Sonia Xu, Muh-Hwa Yang, Chih-Yi Liu, Kai-Wen Liu, Ting-Ting Yang, Teh-Ying Chou, Tzer-Zen Hwang, Chao-Tien Hsu
OBJECTIVES: Cytokeratins (CKs) are mainly expressed in epithelial carcinomas and are valuable for making diagnoses and identifying metastatic status. Changes in the expression of individual CKs in certain carcinoma may be relevant to establishing a prognosis. However, the prognostic significance of CKs in head and neck squamous cell carcinoma (HNSCC) remains elusive. Herein, we investigated the diverse and unique expression patterns of Cytokeratin 13 (CK13) and Cytokeratin 17 (CK17) and assessed the role of CK17 as a predictor for HNSCC metastasis and prognosis...
March 1, 2018: Clinical Otolaryngology
Justin Michel, Thomas Radulesco, Jade Graziani, Martin Penicaud, Patrick Dessi
Endoscopic or transfacial external frontal sinus approaches do not provide good monitoring of the frontal sinus lateral extent. Moreover, endoscopic or transfacial external approaches remain associated with numerous complications or therapeutic failure, e.g. frontal sinus drainage pathway synechia, healing problems or residual hypoesthesia. We propose a rapid, easy-to-perform, 5-step procedure called the transpalpebral approach which is indicated in case of sequestered disease within the lateral extent of the frontal sinus...
February 26, 2018: Clinical Otolaryngology
M Berlucchi, N Nassif, L O Redaelli de Zinis
MLS, FL, and exolaryngoscopy represent the traditional endoscopic technique to treat laryngeal disorders. The authors describe a novel holder laryngeal system that allows performing rigid endoscopic laryngeal surgery simultaneously using both hands in operative way. This surgical procedure is easy, less expensive and allows obtaining very good images of the surgical filed and operating under endoscopic control. This article is protected by copyright. All rights reserved.
February 26, 2018: Clinical Otolaryngology
D Moualed, J Humphries, J D Ramsden
The Threshold Equalising Noise (TEN) test can be used to detect cochlear dead regions Patients with cochlear dead regions may gain limited benefit from conventional amplification The TEN test can be used to assess selected cochlear implant candidates who do not meet pure tone audiometry criteria for implantation Our patients with cochlear dead regions had good outcomes following cochlear implantation This article is protected by copyright. All rights reserved.
February 24, 2018: Clinical Otolaryngology
Peyman Zamani, Zahra Soleymani, Seyedeh Maryam Mousavi, Negar Akbari
OBJECTIVE: Previous studies have highlighted that narrative skill is critical to the development of the literacy skills by children. Children with cochlear implants (CI) and hearing-aids (HA) may have problems in narrative development compared to peers with healthy hearing (HH). There is no exact data about the narrative writing ability of Persian-speaking students who are hearing-impaired. The current study was undertaken to compare the microstructure and macrostructure scores for narrative writing of Persian-speaking students who are hearing-impaired and peers with HH...
February 16, 2018: Clinical Otolaryngology
Thomas Radulesco, Julien Mancini, Martin Penicaud, Patrick Dessi, Justin Michel
OBJECTIVES: The goal of this study was to determine normal values for the FACE-Q Rhinoplasty Module. DESIGN: A prospective monocentric observational cohort study. SETTING: We tested FACE-Q Satisfaction with Nose and Satisfaction with Nostrils in two groups of patients, seeking or not a rhinoplasty. PARTICIPANTS: One hundred and four patients were included in the study, fifty-two in each group. MAIN OUTCOME MEASUREMENTS: Primary outcome was to identify possible cutting scores to establish normal values for each of the FQRM questionnaires...
February 16, 2018: Clinical Otolaryngology
Mayra S Ferreira, João Mangussi-Gomes, Ivan Elias Rassi, Fernando Oto Balieiro, Aldo C Stamm
Nasal irrigation using a saline solution is one of the primary treatments for patients with sinonasal inflammatory diseases and following endonasal surgeries. Irrigation devices and the solutions used often become contaminated, and patients are advised to adopt disinfection techniques (1,2). However, there are currently no guidelines for how patients should perform this task. This article is protected by copyright. All rights reserved.
February 16, 2018: Clinical Otolaryngology
Arjan J Bosman, Ivo J Kruyt, Emmanuel Am Mylanus, Myrthe Ks Hol, Ad Fm Snik
OBJECTIVES: Performance of an abutment-level superpower sound processor for bone-anchored hearing, the Ponto 3 SuperPower from Oticon Medical (BCD2), was compared to an earlier model from Oticon Medical (BCD1). DESIGN: A comparative study in which each patient serves as its own control. SETTING: Tertiary clinic. PARTICIPANTS: Eighteen experienced BCD1 users with profound mixed hearing loss. MAIN OUTCOME MEASURES: speech reception thresholds in noise; APHAB and SSQ questionnaires...
February 16, 2018: Clinical Otolaryngology
Jerome R Lechien, Serge Blecic, Kathy Huet, Véronique Delvaux, Myriam Piccaluga, Virginie Roland, Bernard Harmegnies, Sven Saussez
INTRODUCTION: To investigate voice quality (VQ) impairments in idiopathic Parkinson's disease (IPD) and to explore the impact of medical treatments and L-Dopa challenge testing on voice. METHODS: Relevant studies published between January 1980 and June 2017 describing VQ evaluations in IPD were retrieved using PubMed, Scopus, Biological Abstracts, BioMed Central, and Cochrane databases. Issues of clinical relevance, including IPD treatment efficiency and voice quality outcomes, were evaluated for each study...
February 14, 2018: Clinical Otolaryngology
Yi-Chan Lee, Li-Ang Lee, Wei-Chieh Chao, Cheng-Ming Luo, Yi-Hsuan Lee, Shih-Wei Yang
Septoplasty for a deviated caudal septum is a technique challenging surgery. The two goals of surgery are adequate correction of the deviated septum and maintenance of the nasal tip structural support. Use of an autologous bony crossbar graft to correct a deviate caudal septum offers the following advantages. No difficult drilling or suturing procedure is needed because the graft was kept in place by the elastic properties of the buttonhole cartilage incisions. Second, a simple endonasal approach is sufficient to expose the entire surgical field...
February 14, 2018: Clinical Otolaryngology
Matthew Haywood, Liam Masterton, Aaron Cronin, Ananth Vijendren, Thayahlan Iyngkaran, Prasad Kothari, Chi-Hwa Chan, Andrew Camilleri
There has been a recent move towards image-guided surveillance of N2/N3 disease in HNSCC and neck dissection only in selected cases PET-CT demand is rising and alters management in a third of HNSCC patients PET-CT is expensive and can lead to unnecessary and harmful investigations, delaying treatment The MDT is significantly less likely to request an inappropriate PET-CT than the individual clinician Collaboration among specialists may minimise the ordering of inappropriate PET-CTs, reducing costs and improving patient safety and management...
February 12, 2018: Clinical Otolaryngology
Elinor Warner, Rogan Corbridge
Direct oesophagoscopy is largely a diagnostic procedure performed for a variety of symptoms (e.g. unilateral otalgia or odonophagia) or as part of a panendoscopy to exclude a synchronous primary; therefore good visualisation of abnormal mucosa is essential. The current standard oesophagoscopy technique involves direct visualisation from approximately 25cm down a narrow, illuminated oesophagoscope limiting visualisation of abnormal mucosa. Usually performed by a single operator, the technique is difficult to teach, as the trainee is unable to visualise what the trainer is seeing endoluminally and visa versa...
February 12, 2018: Clinical Otolaryngology
Mei Zhu, Line Wang, Xue Bai, Kevin A Peng
OBJECTIVES: The hard onset, also known as a hard attack, or glottal onset, is a technique of vocal production in which the vocal folds are adducted prior to exhalation and forced open to begin phonation. In this study, we assessed the short-term efficacy of voice therapy incorporating hard onset techniques for patients with functional hypoadduction and presbyphonia. DESIGN: Prospective cohort study. SETTING: Tertiary academic medical center...
February 11, 2018: Clinical Otolaryngology
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