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Clinical Otolaryngology

Alexandra Fochtmann-Frana, Georg Haymerle, Helga Schachner, Johannes Pammer, Robert Loewe, Dontscho Kerjaschki, Christos Perisanidis, Boban M Erovic
BACKGROUND: The purpose of this study was to determine whether the expression of 15-lipoxygenase-1 (ALOX15) in primary tumor specimens predicts lymph node metastasis and subsequently clinical outcome in Merkel cell carcinoma (MCC) patients. METHODS: A retrospective medical chart review of 33 patients was performed between 1994-2014. 11 out of 33 (33%) Patients with primary MCC stages I and II were categorized as group I. 22 out of 33 (67%) Patients with regional lymph node metastases and/or distant metastases were defined as group II...
July 10, 2018: Clinical Otolaryngology
Maija Ylitalo-Heikkilä, Paula Virkkula, Harri Sintonen, Marie Lundberg, Risto P Roine, Maija Hytönen
BACKGROUND: Previous studies illustrated that chronic rhinosinusitis and allergic rhinitis represent individual and socioeconomic burdens to a patient. However, few studies exist on the health-related quality of life (HRQoL) amongst other rhinologic patients. Our study investigated the generic HRQoL in different rhinologic diseases. METHODOLOGY: Unselected adult rhinologic patients requiring special care at the Helsinki University Hospital were enrolled in this cross-sectional, questionnaire-based prospective study in February, May, August, and November 2014...
July 10, 2018: Clinical Otolaryngology
Mofiyinfolu Sokoya, Arash Bahrami, Jason Cohn, Raja Sahwney, Scott Kohlert, Yadranko Ducic
1.The ideal free flap for scalp reconstruction has adequate thickness, surface area, and vascular pedicle length 2.The simplest possible method of reconstruction should be considered in all patients while achieving adequate resection and a good functional outcome. 3.The radial forearm free flap provides excellent texture, color, pedicle length, and reliability. It provides for outstanding coverage of the forehead, temple, vertex, and occiput reconstruction. 4.In our experience, it is as hardy as the latissimus dorsi flap in withstanding postoperative adjuvant radiation, and confers multiple advantages over the latissimus dorsi free flap including faster healing times and shorter hospital stays...
July 10, 2018: Clinical Otolaryngology
Wytske J Fokkens, Benoit Pugin, Claus Bachert, Jean Bousquet, Guy Joos, Renaud Louis, Charles Pilette, Oliver Pfaar, David Price, Emmanuel Prokopakis, Glenis Scadding, Agnieszka Strzembosz, Anders Weilandt, Sven Seys, Peter W Hellings
The second Rhinology Future Debates organized by EUFOREA (European Forum for Research and Education in Allergy and Airways diseases) was held in Brussels in December 2017. These debates aim at bringing novel developments in the field of Rhinology to the attention of the medical, paramedical and patient community, in a credible and balanced context. Novel developments are presented by key experts from industry and/or key opinion leaders, and are followed by a lively debate on the potential positioning of new developments in care pathways, the strengths and weaknesses of the novel development(s), and comparisons with existing and/or competing products, devices, and/or molecules...
July 10, 2018: Clinical Otolaryngology
Saskia E Kok, Corrie E Erasmus, Arthur R T Scheffer, Karen van Hulst, Maroeska M Rovers, Frank J A van den Hoogen
OBJECTIVE: To evaluate the effectiveness of submandibular duct relocation in drooling children with neurological disorders. DESIGN: Prospective cohort study. SETTING: Academic Outpatient Saliva Control Clinic. PARTICIPANTS: Ninety-one children suffering from moderate to severe drooling. MAIN OUTCOME MEASURES: Direct observational drooling quotient (DQ; 0-100) and caretaker Visual Analogue Scale (VAS; 0-100)...
July 10, 2018: Clinical Otolaryngology
Benjamin Loader, Elisabeth Sterrer, Caroline Reichmayr, Alexandra Kaider, Wolfang Gstöttner, Wolf-Dieter Baumgartner, Erich Vyskocil
Cholesteatoma and chronic otitis media are common and regularly treated in surgical otology centers. Repeated surgeries are often required in order to eliminate residual disease and reconstruct functional hearing. Frequently, the posterior wall of the auditory canal has to be resected resulting in a canal wall down (CWD) technique with variable hearing outcome. This article is protected by copyright. All rights reserved.
July 10, 2018: Clinical Otolaryngology
Benjamin Stew, Nuwan Dharmawardana, Stephen Shih-Teng Kao, Anna Jane Elias, Eng Hooi Ooi
The smartphone endoscopic adaptors: endoscope-I, Storz smart scope and Clearwater Clearscope were assessed for colour, realism, and clarity. The endoscope-i was rated higher in a colour and resolution standardization test. The Storz Smart Scope was rated higher with colour, clarity and realism of photos taken from the nose and laryngopharynx of study participants. The endoscope-i was the easiest adaptor to use and cost the least. Smartphone adaptors offer portability, ease of use, and image capture ability as a suitable alternative to office based camera systems...
July 6, 2018: Clinical Otolaryngology
Christian M Meerwein, Masashi Nakadate, Paul Stolzmann, Domenic Vital, Grégoire B Morand, Daniel F Zweifel, Gerhard F Huber, Martin W Huellner
Radionecrosis is a feared complication after high-dose radiation therapy (RT) of head and neck squamous cell cancer (HNSCC). The aim of our retrospective study on 37 HNSCC patients was to evaluate the performance of different (18F)fluoro-deoxy-D-glucose (FDG) positron emission tomography (PET) / computed tomography (CT) parameters for distinguishing radionecrosis and tumor persistence/recurrence. Histopathological work-up revealed osteoradionecrosis in 21/37 (57%) patients, chondroradionecrosis in 8/37 (21...
July 5, 2018: Clinical Otolaryngology
Daniele Bernardeschi, Giuseppina Canu, Daniele De Seta, Francesca Yoshie Russo, Evelyne Ferrary, Isabelle Mosnier, Olivier Sterkers
Rhinologic disease was significantly more frequent in patients undergoing revision stapes surgery compared with primary surgery. The sensitivity of the pre-operative high-resolution CT scan related to intraoperative findings was low for incus causes of failure, whereas it was higher in detecting malleus or piston related causes. Air-bone gaps ≤10 dB and ≤20 dB were obtained in 60% and 85% of patients, respectively, with a statistically significant difference compared to primary cases performed by the same surgeons...
July 4, 2018: Clinical Otolaryngology
Vinidh Paleri, Rupali Sawant, Hisham Mehanna, Holly Ainsworth, Deborah Stocken
BACKGROUND: Clinicians have recognised the role of narrow band imaging (NBI) in the management of head and neck cancer in several studies. However, a recent systematic review was unable to pool the data on diagnostic efficacy in this setting owing to the heterogeneity in the published data. METHODS: Secondary analysis of data, utilising Bayes' theorem, from meta-analyses and randomised trials RESULTS: In patients with a histological diagnosis of mild dysplasia who show no abnormalities on NBI, the post-test probability of malignancy is 2...
July 4, 2018: Clinical Otolaryngology
Rémi Hervochon, Nadim Khoueir, Nicolas Le Clerc, Clément Jourdaine, Romain Kania, Philippe Herman, Benjamin Verillaud
Though most authors agree that TESPAL (transnasal endoscopic sphenopalatine artery ligation) should be considered in case of epistaxis resistant to nasal packing, there is no consensus on the indication for a unilateral/bilateral procedure. In this retrospective study of 83 patients with spontaneous intractable unilateral spontaneous epistaxis, we compared the outcomes of unilateral (n=36) vs bilateral (n=47) TESPAL. The main outcome was failure, defined as bleeding recurrence requiring another therapeutic procedure under general anaesthesia...
July 4, 2018: Clinical Otolaryngology
Chrystelle Cailleaux, Jean-François Papon, Jérôme Nevoux
The obstruction of the Hasner valve is the main cause of congenital obstruction of the lacrimal pathway. Before one year of age, the probability of spontaneous permeabilization is high. For patients between one and five years of age, treatments proposed are often complex, and results are inconsistent. The dacryocystorhinostomy, which is the treatment of choice in adults, is not practical in young children. We propose an efficient surgical technique that can be performed in children older than one year in the refractory cases of congenital obstruction of the lacrimal pathway: an endonasal endoscopic surgery for permeabilization of the distal region of the lacrimal pathway...
July 2, 2018: Clinical Otolaryngology
E M Kuiper, B A van den Berge, J R Spoo, J Kuiper, J B Terra
OBJECTIVE: Mohs micrographic surgery (MMS) is the treatment of choice for high-risk primary basal cell carcinoma (BCC) and recurrent BCC of the head and neck, showing fewer recurrences compared with surgical excision (SE). The objectives of this study were to determine the recurrence rate of head and neck BCC after MMS and to develop a prediction model with significant risk factors for recurrence. DESIGN: A retrospective study of patient records. METHODS: All BCCs treated with MMS between 1 January 1995 and 1 July 2013 at the University Medical Center Groningen (UMCG) were selected retrospectively...
June 28, 2018: Clinical Otolaryngology
Katie M Phillips, Lloyd P Hoehle, David S Caradonna, Stacey T Gray, Ahmad R Sedaghat
OBJECTIVE: To determine the minimum clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in individuals undergoing medical management for their chronic rhinosinusitis (CRS). DESIGN: Prospective observational study. SETTING: Academic, tertiary care center. PARTICIPANTS: A total of 247 adults undergoing medical management for CRS. MAIN OUTCOME MEASURE: At enrollment, participants completed a SNOT-22...
June 28, 2018: Clinical Otolaryngology
Catriona M Douglas, Theofano Tikka, Benedict Broadbent, Nick Calder, Jenny Montgomery
Epistaxis affects most people over their lifetime. It is the commonest ear, nose and throat emergency. Hospital admission and socioeconomic deprivation have been associated with mental health disorders1 , respiratory illness2 and with emergency hospital admissions3 . Low socioeconomic status has never previously been associated with epistaxis, a common reason for admission to ear, nose and throat departments throughout the UK. METHODS: Demographics from Information Services Division Scotland were analysed over a period of 20 years...
June 28, 2018: Clinical Otolaryngology
Casey Vaughan, Amanda Bartolo, Nimisha Vallabh, Samuel C Leong
BACKGROUND: Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an uncommon yet potentially lethal fungal infection. Although most cases originate from developing countries, an aging population and increased prevalence of chronic illness may mean some clinicians practicing in developed countries will encounter ROCM cases in their careers. Yohai et al published a systematic review of 145 case reports from 1970 to 1993 assessing prognostic factors for patients presenting with this disease. We present an updated review of the literature and assess whether survival outcomes have changed...
June 26, 2018: Clinical Otolaryngology
Akihiro Sakai, Kenji Okami, Koji Ebisumoto, Hikaru Yamamoto, Kosuke Saito, Daisuke Maki, Hiroyuki Furuya, Masahiro Iida
Although methods to expose the hypopharynx are available, it was difficult to use them to obtain a satisfactory visual field. To address this problem, we devised a novel method by modifying the Killian position, which we refer to as the Modified Killian's (MK) method. The MK method makes it possible to easily perform circumferential observations of the hypopharyngeal space. We examined 20 subjects to validate the advantage of the MK method by comparing the conventional method. There were significant differences between MK method and Valsalva maneuver in grading (p<0...
June 19, 2018: Clinical Otolaryngology
Dilesh Mogre, Gyorgy Banhegyi, Hoo Kee Tsan, Samuel C Leong
Facial pain is not an uncommon reason for referral to an otolaryngologist, frequently misdiagnosed as sinusitis by primary care professional. However, many of these 'sinus headache' patients do not have concomitant clinical symptoms suggestive of sinus infection such as purulent discharge or pyrexia [1]. Most actually suffer from non-sinugenic facial pain conditions such as atypical migraine or tension headache [2]. This article is protected by copyright. All rights reserved.
June 16, 2018: Clinical Otolaryngology
G Guerra-Jiménez, E Domènech-Vadillo, M G Álvarez-Morujo de Sande, R González-Aguado, H Galera-Ruiz, C Morales Angulo, A J Martín-Mateos, E Figuerola-Massana, Á Ramos-Macías, E Domínguez-Durán
OBJECTIVES: To compare the outcome of the Epley maneuver (EM) in benign paroxysmal positional vertigo of the posterior canal (CSP-BPPV) depending on the definition used for recovery. DESIGN: Multicenter observational prospective study. SETTING: Otoneurology Units of five tertiary reference hospitals. PARTICIPANTS: All patients presenting with unilateral CSP-BPPV assisted for one-year period. EXCLUSION CRITERIA: Spontaneous nystagmus, positive McClure-Pagnini maneuver, positive bilateral Dix-Hallpike maneuver (DHM), positive DHM for vertigo but negative for nystagmus and atypical nystagmus...
June 15, 2018: Clinical Otolaryngology
Douglas R Farquhar, Rounak B Rawal, Maheer M Masood, Wade G McClain, Lauren A Kilpatrick, Austin S Rose, Carlton J Zdanski
Thyroglossal duct cysts (TGDC) excisions was traditionally an inpatient procedure, but there has been a recent trend towards outpatient surgery. Our aim is to use the NSQIP-P to examine overall thirty-day outcomes for TGDC excision, and to determine whether they are affected by admission status and surgeon specialty. We assessed the demographics, preoperative risk factors, and negative outcomes of admitted and same-day surgery TGDC patients, and TGDC patients of surgeons with different training. Outcomes were thirty-day rates for readmissions, reoperations, unplanned reintubations, major complications, and minor complications...
June 14, 2018: Clinical Otolaryngology
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