Pub Date : 2024-04-01Epub Date: 2023-12-24DOI: 10.1177/00034894231219129
Benjamin Tam, Jessica Le, Dennis M Tang, Arthur W Wu, Martin L Hopp, Michela Borrelli, Dale H Rice, Bozena B Wrobel, Kevin Hur
Objectives: Among patients with chronic rhinosinusitis (CRS), gender differences in epidemiology as well as quality of life have been reported. However, whether gender differences in endoscopic sinus surgery (ESS) preoperative concerns exist is unclear.
Methods: CRS patients undergoing ESS at 3 tertiary care centers in Los Angeles completed the validated Western Surgical Concern Inventory - ESS assessing ESS preoperative concerns.
Results: Of the 75 patients included, female patients expressed greater concern than male patients in regard to nasal packing, undergoing anesthesia, impact of surgery on daily activities, and pain and discomfort following surgery.
Conclusion: This study suggests there are gender differences in ESS preoperative concerns and otolaryngologists should be aware of these possible concerns during preoperative discussions.
{"title":"Gender-Specific Differences in Preoperative Concerns in Patients Undergoing Endoscopic Sinus Surgery for Chronic Rhinosinusitis.","authors":"Benjamin Tam, Jessica Le, Dennis M Tang, Arthur W Wu, Martin L Hopp, Michela Borrelli, Dale H Rice, Bozena B Wrobel, Kevin Hur","doi":"10.1177/00034894231219129","DOIUrl":"10.1177/00034894231219129","url":null,"abstract":"<p><strong>Objectives: </strong>Among patients with chronic rhinosinusitis (CRS), gender differences in epidemiology as well as quality of life have been reported. However, whether gender differences in endoscopic sinus surgery (ESS) preoperative concerns exist is unclear.</p><p><strong>Methods: </strong>CRS patients undergoing ESS at 3 tertiary care centers in Los Angeles completed the validated Western Surgical Concern Inventory - ESS assessing ESS preoperative concerns.</p><p><strong>Results: </strong>Of the 75 patients included, female patients expressed greater concern than male patients in regard to nasal packing, undergoing anesthesia, impact of surgery on daily activities, and pain and discomfort following surgery.</p><p><strong>Conclusion: </strong>This study suggests there are gender differences in ESS preoperative concerns and otolaryngologists should be aware of these possible concerns during preoperative discussions.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-06DOI: 10.1177/00034894231223574
Bonnie Chen, Andrew Tran, Mohammed Alnijoumi, Mark R Gilbert
Objective: We present a case of propofol infusion syndrome (PRIS) following jet ventilation.
Method: Case report and review of literature.
Results: A 70-year-old man required CO2 laser endoscopic tracheoplasty for tracheal and subglottic stenosis due to A-frame deformity. Postoperatively, the patient was reintubated for respiratory distress and propofol was resumed. Over the next two days the patient developed acute kidney injury, leukocytosis, acute primary respiratory acidosis with high anion gap metabolic acidosis, multiple end organ damage, elevated cardiac markers, and worsening lactic acidosis. The patient was recognized as having propofol infusion syndrome and propofol was immediately discontinued and replaced with dexmedetomidine. Unfortunately the patient progressed to multi-organ failure complicated by rhabdomyolysis and distributive intravascular coagulopathy.
Conclusions: Propofol is often used as an anesthetic for jet ventilation during otolaryngologic airway surgery. Propofol related infusion syndrome is an uncommon but life-threatening peri-operative complication that should be considered in any patient with an unusual post-operative recovery characterized by metabolic acidosis, ECG changes, end organ damage, and elevated lactate.
摘要我们介绍了一例喷射通气后丙泊酚输注综合征(PRIS)病例:方法:病例报告和文献综述:一名 70 岁的男性因 A 框畸形导致气管和声门下狭窄,需要进行二氧化碳激光内窥镜气管成形术。术后,患者因呼吸困难再次插管,并恢复使用异丙酚。在接下来的两天里,患者出现了急性肾损伤、白细胞增多、急性原发性呼吸性酸中毒伴高阴离子间隙代谢性酸中毒、多脏器损伤、心脏标志物升高以及乳酸性酸中毒恶化。患者被确诊为异丙酚输注综合征,医生立即停用异丙酚,改用右美托咪定。不幸的是,患者因横纹肌溶解症和分布性血管内凝血病并发多器官衰竭:结论:在耳鼻咽喉气道手术中,丙泊酚经常被用作喷射通气的麻醉剂。丙泊酚相关输注综合征是一种不常见但危及生命的围手术期并发症,任何术后恢复异常的患者都应考虑这种并发症,其特点是代谢性酸中毒、心电图改变、内脏器官损伤和乳酸升高。
{"title":"Propofol Infusion Syndrome Following Endoscopic Tracheoplasty and Jet Ventilation: Case Report.","authors":"Bonnie Chen, Andrew Tran, Mohammed Alnijoumi, Mark R Gilbert","doi":"10.1177/00034894231223574","DOIUrl":"10.1177/00034894231223574","url":null,"abstract":"<p><strong>Objective: </strong>We present a case of propofol infusion syndrome (PRIS) following jet ventilation.</p><p><strong>Method: </strong>Case report and review of literature.</p><p><strong>Results: </strong>A 70-year-old man required CO2 laser endoscopic tracheoplasty for tracheal and subglottic stenosis due to A-frame deformity. Postoperatively, the patient was reintubated for respiratory distress and propofol was resumed. Over the next two days the patient developed acute kidney injury, leukocytosis, acute primary respiratory acidosis with high anion gap metabolic acidosis, multiple end organ damage, elevated cardiac markers, and worsening lactic acidosis. The patient was recognized as having propofol infusion syndrome and propofol was immediately discontinued and replaced with dexmedetomidine. Unfortunately the patient progressed to multi-organ failure complicated by rhabdomyolysis and distributive intravascular coagulopathy.</p><p><strong>Conclusions: </strong>Propofol is often used as an anesthetic for jet ventilation during otolaryngologic airway surgery. Propofol related infusion syndrome is an uncommon but life-threatening peri-operative complication that should be considered in any patient with an unusual post-operative recovery characterized by metabolic acidosis, ECG changes, end organ damage, and elevated lactate.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139106890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-01Epub Date: 2024-01-23DOI: 10.1177/00034894241227030
Caroline M Fields, Nicolas S Poupore, Jenna H Barengo, Hussein Smaily, Shaun A Nguyen, Jacqueline Angles, Clarice S Clemmens, Phayvanh P Pecha, William W Carroll
Objective: The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy.
Methods: This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI.
Results: A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, P = .218).
Conclusion: This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.
目的:目前尚不完全清楚快速眼动AHI在管理小儿阻塞性睡眠呼吸暂停(OSA)方面的作用。本研究旨在评估接受腺样体切除术的儿童术前 REM AHI 与术后 OSA 持续存在的关系:这项回顾性病历审查确定了因 OSA 而接受腺扁桃体切除术的 18 岁以下儿童,并进行了术前和术后多导睡眠图检查。不包括患有颅面或神经肌肉疾病或气管造口术的儿童。主要结果是术后OSA持续存在,即术后阻塞性呼吸暂停-低通气指数(oAHI)≥1.5次/小时。快速动眼期为主的 OSA 定义为快速动眼期/快速动眼期 AHI 比值≥ 2。REM AHI减去NREM AHI和REM AHI减去oAHI有助于识别REM AHI分布较大的患者:共纳入 353 名患者。232名(65.7%)患儿术后出现持续性 OSA。持续性 OSA 患儿的术前 REM AHI、REM AHI 减去 NREM AHI 以及 REM AHI 减去 oAHI 与 OSA 缓解的患儿没有显著差异。持续性 OSA 的比率在 REM 主导型 OSA 和 REM 依赖型 OSA 之间没有差异(63.8% vs 70.7%,P = .218):本研究表明,术前 REM AHI 可能无法预测腺样体切除术后 OSA 的持续情况。还需要进一步研究,以帮助确定术前 REM AHI 对临床医生的决策、家属咨询和建议有何影响。
{"title":"Does REM AHI Predict Persistent OSA After Pediatric Adenotonsillectomy?","authors":"Caroline M Fields, Nicolas S Poupore, Jenna H Barengo, Hussein Smaily, Shaun A Nguyen, Jacqueline Angles, Clarice S Clemmens, Phayvanh P Pecha, William W Carroll","doi":"10.1177/00034894241227030","DOIUrl":"10.1177/00034894241227030","url":null,"abstract":"<p><strong>Objective: </strong>The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy.</p><p><strong>Methods: </strong>This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI.</p><p><strong>Results: </strong>A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, <i>P</i> = .218).</p><p><strong>Conclusion: </strong>This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-20DOI: 10.1177/00034894231206902
Amirhossein Aghakhani, Milad Yousefi, Mir Saeed Yekaninejad
Background: Machine Learning models have been applied in various healthcare fields, including Audiology, to predict disease outcomes. The prognosis of sudden sensorineural hearing loss is difficult to predict due to the variable course of the disease. Hence, researchers have attempted to utilize ML models to predict the outcome of patients with sudden sensorineural hearing loss. The objectives of this study were to review the performance of these machine learning models and assess their applicability in real-world settings.
Methods: A systematic search was conducted in PubMed, Web of Science and Scopus. Only studies that built machine learning prediction models were included, and studies that used algorithms such as logistic regression only for the purpose of adjusting for confounding variables were excluded. The risk of bias was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST).
Results: After screening, a total of 7 papers were eligible for synthesis. In total, these studies built 48 ML models. The most common utilized algorithms were Logistic Regression, Support Vector Machine (SVM) and boosting. The area under the curve of the receiver operating characteristic curve ranged between 0.59 and 0.915. All of the included studies had a high risk of bias; hence there are concerns regarding their applicability.
Conclusion: Although these models showed great performance and promising results, future studies are still needed before these models can be applied in a real-world setting. Future studies should employ multiple cohorts, different feature selection methods, and external validation to further validate the models' applicability.
背景:机器学习模型已应用于各种医疗保健领域,包括听力学,以预测疾病结果。突发性感音神经性听力损失的预后很难预测,因为疾病的病程各不相同。因此,研究人员试图利用ML模型来预测突发性感音神经性听力损失患者的预后。本研究的目的是审查这些机器学习模型的性能,并评估它们在现实世界中的适用性。方法:在PubMed、Web of Science和Scopus上进行系统检索。只包括建立机器学习预测模型的研究,排除了仅为调整混杂变量而使用逻辑回归等算法的研究。使用预测模型偏倚风险评估工具(PROBAST)评估偏倚风险。结果:经过筛选,共有7篇论文符合合成条件。这些研究总共建立了48个ML模型。最常用的算法是逻辑回归、支持向量机和boosting。接收器工作特性曲线的曲线下面积在0.59和0.915之间。所有纳入的研究都有很高的偏倚风险;因此存在对其适用性的担忧。结论:尽管这些模型表现出了良好的性能和有希望的结果,但在这些模型应用于现实世界之前,还需要进一步的研究。未来的研究应该采用多个队列、不同的特征选择方法和外部验证来进一步验证模型的适用性。
{"title":"Machine Learning Models for Predicting Sudden Sensorineural Hearing Loss Outcome: A Systematic Review.","authors":"Amirhossein Aghakhani, Milad Yousefi, Mir Saeed Yekaninejad","doi":"10.1177/00034894231206902","DOIUrl":"10.1177/00034894231206902","url":null,"abstract":"<p><strong>Background: </strong>Machine Learning models have been applied in various healthcare fields, including Audiology, to predict disease outcomes. The prognosis of sudden sensorineural hearing loss is difficult to predict due to the variable course of the disease. Hence, researchers have attempted to utilize ML models to predict the outcome of patients with sudden sensorineural hearing loss. The objectives of this study were to review the performance of these machine learning models and assess their applicability in real-world settings.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Web of Science and Scopus. Only studies that built machine learning prediction models were included, and studies that used algorithms such as logistic regression only for the purpose of adjusting for confounding variables were excluded. The risk of bias was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST).</p><p><strong>Results: </strong>After screening, a total of 7 papers were eligible for synthesis. In total, these studies built 48 ML models. The most common utilized algorithms were Logistic Regression, Support Vector Machine (SVM) and boosting. The area under the curve of the receiver operating characteristic curve ranged between 0.59 and 0.915. All of the included studies had a high risk of bias; hence there are concerns regarding their applicability.</p><p><strong>Conclusion: </strong>Although these models showed great performance and promising results, future studies are still needed before these models can be applied in a real-world setting. Future studies should employ multiple cohorts, different feature selection methods, and external validation to further validate the models' applicability.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-12-04DOI: 10.1177/00034894231216288
Christine J Colasacco, Samantha Morgan, Rivka Bornstein, Elizabeth Drugge, Katrina R Stidham
Objectives: Previous research has shown the positive effects of cochlear implantation in children with a short duration of single sided deafness (SSD). This case series assessed the impact of cochlear implantation in a cohort of children with a longer average duration of SSD.
Methods: A retrospective chart review of 6 children who received a cochlear implant for SSD. The mean age at time of cochlear implantation was 14.7 years old (median = 15.5, interquartile range (IQR) = 2.5) and mean duration of hearing loss before cochlear implantation was 10.8 years (median = 11.5, IQR = 5.3). Pre- and post-operative audiometric data for aided speech perception testing, sentence recognition in quiet, sentence recognition in noise, and word recognition scores were analyzed.
Results: When compared to preoperative hearing aid scores a 24% significant increase in median word score and a 64% significant increase in median sentence recognition score in quiet was observed at 12 months post-op.
Conclusion: Cochlear implantation in children with a longer duration of SSD can provide benefit to speech recognition.
Lay summary: This retrospective case series of children with prolonged single sided deafness demonstrated an improvement in word and sentence recognition within 12 months of receiving a cochlear implant.
{"title":"Cochlear Implantation in Children With a Long Average Duration of Single Sided Deafness.","authors":"Christine J Colasacco, Samantha Morgan, Rivka Bornstein, Elizabeth Drugge, Katrina R Stidham","doi":"10.1177/00034894231216288","DOIUrl":"10.1177/00034894231216288","url":null,"abstract":"<p><strong>Objectives: </strong>Previous research has shown the positive effects of cochlear implantation in children with a short duration of single sided deafness (SSD). This case series assessed the impact of cochlear implantation in a cohort of children with a longer average duration of SSD.</p><p><strong>Methods: </strong>A retrospective chart review of 6 children who received a cochlear implant for SSD. The mean age at time of cochlear implantation was 14.7 years old (median = 15.5, interquartile range (IQR) = 2.5) and mean duration of hearing loss before cochlear implantation was 10.8 years (median = 11.5, IQR = 5.3). Pre- and post-operative audiometric data for aided speech perception testing, sentence recognition in quiet, sentence recognition in noise, and word recognition scores were analyzed.</p><p><strong>Results: </strong>When compared to preoperative hearing aid scores a 24% significant increase in median word score and a 64% significant increase in median sentence recognition score in quiet was observed at 12 months post-op.</p><p><strong>Conclusion: </strong>Cochlear implantation in children with a longer duration of SSD can provide benefit to speech recognition.</p><p><strong>Lay summary: </strong>This retrospective case series of children with prolonged single sided deafness demonstrated an improvement in word and sentence recognition within 12 months of receiving a cochlear implant.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138479210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-03DOI: 10.1177/00034894231204720
Jordan I Gewirtz, Songzhu Zhao, Guy Brock, Michael D Luttrull, Shruthi Sethuraman, Stephen Y Kang, Kyle K VanKoevering, Nolan B Seim
Objective: To identify factors influencing volume change in non-osseous oral free flap reconstruction using postoperative cross-sectional imaging and 3-dimensional segmentation of the free flap's muscular and adipose tissue content.
Methods: Oral tongue free flap reconstruction cases (2014-2019) were reviewed with inclusion of patients with 3 postoperative, cross-sectional imaging studies with 1 within 6 months, 1 within 1 year, and 1 that spanned 2 years post-reconstruction. Exclusion criteria included recurrence, significant dental artifact, bony reconstruction, and flap failure. Demographics, risk factors, and surgical/clinical treatments were identified. Flap volumes were measured using Materialise MIMICS.
Results: Twenty-two patients met strict inclusion criteria. Four flaps were anterolateral thighs and 18 radial forearms. Median percent volume loss greater than 2 years post-reconstruction was 53.2% overall, 58.1% for radial forearms, and 45.4% for ALTs (21.4% for adipose tissue and 57.4% for muscular tissue). Univariate analysis revealed glossectomy amount was associated with percent volume loss (P = .0417). Each successive postoperative month, the flap decreased by 1.54% (P < .0001). Checking for the interaction effect, the percent of flap loss across time was different for glossectomy amount (P = .0093), obesity status (P = .0431), and base of tongue involvement (P = .0472).
Conclusion: Glossectomy type, and thus flap size, is a positive predictor for flap atrophy. Obesity and base of tongue involvement are negative predictors for flap atrophy. The amount of tissue loss may differ from classical teachings with median atrophy 53.2% greater than 2 years post-reconstruction.
{"title":"A Pilot Study: Free Flap Atrophy in Tongue Reconstruction Using 3D Volumetric Analysis.","authors":"Jordan I Gewirtz, Songzhu Zhao, Guy Brock, Michael D Luttrull, Shruthi Sethuraman, Stephen Y Kang, Kyle K VanKoevering, Nolan B Seim","doi":"10.1177/00034894231204720","DOIUrl":"10.1177/00034894231204720","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors influencing volume change in non-osseous oral free flap reconstruction using postoperative cross-sectional imaging and 3-dimensional segmentation of the free flap's muscular and adipose tissue content.</p><p><strong>Methods: </strong>Oral tongue free flap reconstruction cases (2014-2019) were reviewed with inclusion of patients with 3 postoperative, cross-sectional imaging studies with 1 within 6 months, 1 within 1 year, and 1 that spanned 2 years post-reconstruction. Exclusion criteria included recurrence, significant dental artifact, bony reconstruction, and flap failure. Demographics, risk factors, and surgical/clinical treatments were identified. Flap volumes were measured using Materialise MIMICS.</p><p><strong>Results: </strong>Twenty-two patients met strict inclusion criteria. Four flaps were anterolateral thighs and 18 radial forearms. Median percent volume loss greater than 2 years post-reconstruction was 53.2% overall, 58.1% for radial forearms, and 45.4% for ALTs (21.4% for adipose tissue and 57.4% for muscular tissue). Univariate analysis revealed glossectomy amount was associated with percent volume loss (<i>P</i> = .0417). Each successive postoperative month, the flap decreased by 1.54% (<i>P</i> < .0001). Checking for the interaction effect, the percent of flap loss across time was different for glossectomy amount (<i>P</i> = .0093), obesity status (<i>P</i> = .0431), and base of tongue involvement (<i>P</i> = .0472).</p><p><strong>Conclusion: </strong>Glossectomy type, and thus flap size, is a positive predictor for flap atrophy. Obesity and base of tongue involvement are negative predictors for flap atrophy. The amount of tissue loss may differ from classical teachings with median atrophy 53.2% greater than 2 years post-reconstruction.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-11-05DOI: 10.1177/00034894231209540
Naushin S Ali, Thomas H Fitzpatrick Iv, Albina S Islam, Ryan S Nord
Objective: This study aims to define the incidence of infection with upper airway stimulation (UAS) devices requiring explantation in a single academic center and identify factors that may influence the risk of infection.
Methods: A database of patients who underwent UAS at a single tertiary referral academic center from 2017 to 2021 was retrospectively reviewed to identify patients who developed surgical site infections, with and without subsequent explantation. Additional data for cases complicated by infection was extracted from the electronic medical record (EMR) and included: demographic information, medical history, complications and management, and overall outcomes. In March 2021, 2 modifications to infection control protocols were implemented: double skin preparation with Betadine and chlorhexidine, and MRSA decolonization. Statistical analysis was performed to compare infectious risk before and after these protocol changes.
Results: In the study period, 215 patients underwent UAS in the specified time period and 3 cases (1.4%) of postoperative infections were identified, all of which required explantation. The infection rate did not significantly change after modifications to the surgical prep protocol (P = .52).
Conclusions: While no significant difference in infection risk was noted after modifying infection control protocols, additional longer-term study is warranted to elucidate effective infection reduction strategies.
{"title":"Mitigating Infection Risk in Upper Airway Stimulation.","authors":"Naushin S Ali, Thomas H Fitzpatrick Iv, Albina S Islam, Ryan S Nord","doi":"10.1177/00034894231209540","DOIUrl":"10.1177/00034894231209540","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to define the incidence of infection with upper airway stimulation (UAS) devices requiring explantation in a single academic center and identify factors that may influence the risk of infection.</p><p><strong>Methods: </strong>A database of patients who underwent UAS at a single tertiary referral academic center from 2017 to 2021 was retrospectively reviewed to identify patients who developed surgical site infections, with and without subsequent explantation. Additional data for cases complicated by infection was extracted from the electronic medical record (EMR) and included: demographic information, medical history, complications and management, and overall outcomes. In March 2021, 2 modifications to infection control protocols were implemented: double skin preparation with Betadine and chlorhexidine, and MRSA decolonization. Statistical analysis was performed to compare infectious risk before and after these protocol changes.</p><p><strong>Results: </strong>In the study period, 215 patients underwent UAS in the specified time period and 3 cases (1.4%) of postoperative infections were identified, all of which required explantation. The infection rate did not significantly change after modifications to the surgical prep protocol (<i>P</i> = .52).</p><p><strong>Conclusions: </strong>While no significant difference in infection risk was noted after modifying infection control protocols, additional longer-term study is warranted to elucidate effective infection reduction strategies.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-12-21DOI: 10.1177/00034894231219127
Nizamettin Burak Avci, Betul Cicek Cinar
Objectives: Spatial cognition is a perceptual-motor function that pertains to the comprehension and processing of two-dimensional and three-dimensional space. The impairment of any sensory system can have adverse effects on cognitive functioning. The objective of this study is to examine spatial cognition in adults with hearing impairments.
Methods: There were a total of 61 individuals in this study: thirty-six with hearing loss and 25 with normal hearing. The Spatial Orientation Test (SOT), the Mental Rotation test (MR), and the Money's Road Map Test (RMT) were administered to assess participants' spatial learning-orientation, mental imagery-rotation, and spatial navigation abilities. A high number of errors in RMT, high angle difference in SOT and a low score in MR suggest poor spatial abilities.
Results: Participants with hearing loss had a greater number of RMT errors and SOT angle difference, but lower MR scores than those with normal hearing (P < .001). Hearing impairment negatively impacted all 3 spatial cognitive assessments. Hearing loss was associated with a 6.9 increase in the number of RMT errors (95% Confidence Interval (CI): 4.8, 9), a 23.6 increase in the SOT angle difference (95% CI: 16, 31.2), and an 8.5 decrease in the MR score (95% CI: -10.8, -6.2).
Conclusions: The study found that individuals with hearing loss exhibited lower performance in various cognitive tasks related to spatial orientation, navigation, spatial learning, mental imagery, and rotation abilities when compared to an age and sex matched control group. In future study, it is imperative to place greater emphasis on hearing loss as a potential detrimental factor in the prediction of spatial cognition impairment.
目的:空间认知是一种感知运动功能,涉及对二维和三维空间的理解和处理。任何感官系统受损都会对认知功能产生不利影响。本研究的目的是考察听力障碍成人的空间认知能力:本研究共有 61 人参加,其中听力损失者 36 人,听力正常者 25 人。通过空间定向测试(SOT)、心理旋转测试(MR)和钱氏路线图测试(RMT)来评估参与者的空间学习-定向、心理想象-旋转和空间导航能力。RMT的错误次数多、SOT的角度差大以及MR的得分低都表明空间能力差:结果:与听力正常者相比,听力损失者的 RMT 误差和 SOT 角度差较大,但 MR 得分较低(P 结论:听力损失者的 RMT 误差和 SOT 角度差较大,但 MR 得分较低):研究发现,与年龄和性别匹配的对照组相比,听力损失患者在与空间定向、导航、空间学习、心理想象和旋转能力相关的各种认知任务中表现较差。在今后的研究中,必须更加重视听力损失这一预测空间认知障碍的潜在不利因素。
{"title":"Does Hearing Impairment Impact Spatial Orientation, Navigation, and Rotation Abilities?","authors":"Nizamettin Burak Avci, Betul Cicek Cinar","doi":"10.1177/00034894231219127","DOIUrl":"10.1177/00034894231219127","url":null,"abstract":"<p><strong>Objectives: </strong>Spatial cognition is a perceptual-motor function that pertains to the comprehension and processing of two-dimensional and three-dimensional space. The impairment of any sensory system can have adverse effects on cognitive functioning. The objective of this study is to examine spatial cognition in adults with hearing impairments.</p><p><strong>Methods: </strong>There were a total of 61 individuals in this study: thirty-six with hearing loss and 25 with normal hearing. The Spatial Orientation Test (SOT), the Mental Rotation test (MR), and the Money's Road Map Test (RMT) were administered to assess participants' spatial learning-orientation, mental imagery-rotation, and spatial navigation abilities. A high number of errors in RMT, high angle difference in SOT and a low score in MR suggest poor spatial abilities.</p><p><strong>Results: </strong>Participants with hearing loss had a greater number of RMT errors and SOT angle difference, but lower MR scores than those with normal hearing (<i>P</i> < .001). Hearing impairment negatively impacted all 3 spatial cognitive assessments. Hearing loss was associated with a 6.9 increase in the number of RMT errors (95% Confidence Interval (CI): 4.8, 9), a 23.6 increase in the SOT angle difference (95% CI: 16, 31.2), and an 8.5 decrease in the MR score (95% CI: -10.8, -6.2).</p><p><strong>Conclusions: </strong>The study found that individuals with hearing loss exhibited lower performance in various cognitive tasks related to spatial orientation, navigation, spatial learning, mental imagery, and rotation abilities when compared to an age and sex matched control group. In future study, it is imperative to place greater emphasis on hearing loss as a potential detrimental factor in the prediction of spatial cognition impairment.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-14DOI: 10.1177/00034894231206898
Aseem Jain, Gregory R Dion, Rebecca J Howell, Aaron D Friedman
{"title":"A Novel Rigid Telescope Holder for Endoscopic Surgery in Otolaryngology.","authors":"Aseem Jain, Gregory R Dion, Rebecca J Howell, Aaron D Friedman","doi":"10.1177/00034894231206898","DOIUrl":"10.1177/00034894231206898","url":null,"abstract":"","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-28DOI: 10.1177/00034894231208260
Rahiq Rahman, Ching Siong Tey, Saria Matthews, Nandini Govil
Objective: The primary objective of this pilot study is to describe the impacts of bullying and peer victimization (BPV) in children with hearing loss.
Study design: Prospective clinical survey study.
Methods: This pilot study enrolled children between 8 and 18 years who were administered validated surveys at an outpatient clinic between July 2020 and March 2022. Surveys included health-related quality of life questionnaires (PedsQL and EQ-5D-Y), along with bullying and peer victimization questionnaires ("My Life in School" and the multidimensional peer victimization scale). Responses were scored with multivariate analysis. Clinical histories and active ICD-10 codes were also collected.
Results: About 105 patients were recruited with a mean age of 13.1 years (SD = 3.15) and hearing loss (n = 30) among the top otolaryngological diagnoses. When surveying patients with hearing loss, 50.0% (n = 15) actively used a hearing aid device. Children (ages 8-12 years) with hearing loss reported a significantly lower psychosocial health-related quality of life than their peers without hearing loss (P = .007), though this was not the case for adolescents (ages 13-18 years) with hearing loss (P = .099). These trends did not change significantly before or after students resumed in-person classes. Children who wore hearing aids did not report a different BPV level than their peers.
Conclusion: In this small sample of school-aged children, any hearing loss, even with mild severity, was associated with diminished health-related quality of life; however, this was unrelated to hearing aid use. Wearing a hearing aid did not appear to be linked to higher bullying and peer victimization rates. Along with further studies on BPV with larger sample sizes, the findings in this study may help physicians counsel parents and children on the psychosocial aspects of hearing loss treatment and guide care decisions.
{"title":"Bullying, Peer Victimization, and Quality of Life in Pediatric Hearing Loss Patients: A Pilot Study.","authors":"Rahiq Rahman, Ching Siong Tey, Saria Matthews, Nandini Govil","doi":"10.1177/00034894231208260","DOIUrl":"10.1177/00034894231208260","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this pilot study is to describe the impacts of bullying and peer victimization (BPV) in children with hearing loss.</p><p><strong>Study design: </strong>Prospective clinical survey study.</p><p><strong>Methods: </strong>This pilot study enrolled children between 8 and 18 years who were administered validated surveys at an outpatient clinic between July 2020 and March 2022. Surveys included health-related quality of life questionnaires (PedsQL and EQ-5D-Y), along with bullying and peer victimization questionnaires (\"My Life in School\" and the multidimensional peer victimization scale). Responses were scored with multivariate analysis. Clinical histories and active ICD-10 codes were also collected.</p><p><strong>Results: </strong>About 105 patients were recruited with a mean age of 13.1 years (SD = 3.15) and hearing loss (n = 30) among the top otolaryngological diagnoses. When surveying patients with hearing loss, 50.0% (n = 15) actively used a hearing aid device. Children (ages 8-12 years) with hearing loss reported a significantly lower psychosocial health-related quality of life than their peers without hearing loss (<i>P</i> = .007), though this was not the case for adolescents (ages 13-18 years) with hearing loss (<i>P</i> = .099). These trends did not change significantly before or after students resumed in-person classes. Children who wore hearing aids did not report a different BPV level than their peers.</p><p><strong>Conclusion: </strong>In this small sample of school-aged children, any hearing loss, even with mild severity, was associated with diminished health-related quality of life; however, this was unrelated to hearing aid use. Wearing a hearing aid did not appear to be linked to higher bullying and peer victimization rates. Along with further studies on BPV with larger sample sizes, the findings in this study may help physicians counsel parents and children on the psychosocial aspects of hearing loss treatment and guide care decisions.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61566039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}