Pub Date : 2019-12-01DOI: 10.1017/S0022215119002433
M. Adeel, M. Faisal, A. Rashid, S. Rasheed, Riaz Hussain, K. Malik, M. Hameed, A. Jamshed
BACKGROUND Early laryngeal cancer treated with definitive radiotherapy or surgery has a high cure rate. This study evaluated the patterns of treatment failure and long-term results of early laryngeal cancers treated with definitive radiotherapy. METHOD From January 2002 to December 2014, a total of 242 patients with early-stage laryngeal cancers were treated with radical radiotherapy. RESULTS All patients had squamous cell carcinoma of the larynx (92 per cent male and 8 per cent female). Median follow-up was 4.5 years. The majority of patients were smokers (57.4 per cent). Local failure was seen in 12.5 per cent of stage I patients and 22.8 per cent of stage II patients. The 5-year overall survival and disease specific survival were 84 per cent and 91 per cent, respectively. CONCLUSION In summary, radiotherapy is a suitable treatment modality for patients with early-stage laryngeal cancer, with an overall locoregional control rate of 84 per cent. Patients who fail radiotherapy may still undergo salvage laryngectomy.
{"title":"Outcomes of definitive radiotherapy for early laryngeal cancer in terms of survival and patterns of failure.","authors":"M. Adeel, M. Faisal, A. Rashid, S. Rasheed, Riaz Hussain, K. Malik, M. Hameed, A. Jamshed","doi":"10.1017/S0022215119002433","DOIUrl":"https://doi.org/10.1017/S0022215119002433","url":null,"abstract":"BACKGROUND\u0000Early laryngeal cancer treated with definitive radiotherapy or surgery has a high cure rate. This study evaluated the patterns of treatment failure and long-term results of early laryngeal cancers treated with definitive radiotherapy.\u0000\u0000\u0000METHOD\u0000From January 2002 to December 2014, a total of 242 patients with early-stage laryngeal cancers were treated with radical radiotherapy.\u0000\u0000\u0000RESULTS\u0000All patients had squamous cell carcinoma of the larynx (92 per cent male and 8 per cent female). Median follow-up was 4.5 years. The majority of patients were smokers (57.4 per cent). Local failure was seen in 12.5 per cent of stage I patients and 22.8 per cent of stage II patients. The 5-year overall survival and disease specific survival were 84 per cent and 91 per cent, respectively.\u0000\u0000\u0000CONCLUSION\u0000In summary, radiotherapy is a suitable treatment modality for patients with early-stage laryngeal cancer, with an overall locoregional control rate of 84 per cent. Patients who fail radiotherapy may still undergo salvage laryngectomy.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"44 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74140200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-01DOI: 10.1017/S0022215119002494
R. Kumar, N. Banumathy, P. Sharma, Naresh K. Panda
BACKGROUND Disorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders. METHODS This study comprised 40 subjects aged 34-46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale, acoustic voice analysis, electroglottography, and voice range profiles. RESULTS The voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy. CONCLUSION Despite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.
{"title":"Normalisation of voice parameters in patients with unilateral vocal fold palsy: is it realistic?","authors":"R. Kumar, N. Banumathy, P. Sharma, Naresh K. Panda","doi":"10.1017/S0022215119002494","DOIUrl":"https://doi.org/10.1017/S0022215119002494","url":null,"abstract":"BACKGROUND\u0000Disorders of voice can limit an individual's participation and impair social interaction, thus affecting overall quality of life. Perceptual and objective evaluations can provide the clinician with detailed information regarding voice disorders.\u0000\u0000\u0000METHODS\u0000This study comprised 40 subjects aged 34-46 years, 20 of whom (10 male, 10 female) had unilateral vocal fold palsy. Data were obtained for all participants from: the Voice Handicap Index, the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale, acoustic voice analysis, electroglottography, and voice range profiles.\u0000\u0000\u0000RESULTS\u0000The voice evaluations revealed statistically significant (p < 0.05) differences between the controls and study group, both in males and females, pre- and post-therapy.\u0000\u0000\u0000CONCLUSION\u0000Despite the normalisation of vocal parameters, acoustic, perceptual and self-rated assessments revealed statistically significant differences after therapy. Hence, acoustic measures, namely electroglottographic perturbation, and voice frequency and intensity range, are recommended prior to termination of therapy.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"53 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78659232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-29DOI: 10.1017/S0022215119002299
L. Harrison, T. Mcculloch, N. Beasley
BACKGROUND Head and neck soft tissue sarcoma is uncommon. It is both histologically and clinically heterogeneous, ranging from an indolent, locally destructive tumour, to a locally aggressive neoplasm with metastatic potential. METHODS A retrospective review was conducted of all adult head and neck soft tissue sarcomas, including cases of malignant soft tissue sarcoma and all intermediate type tumours, diagnosed between 1997 and 2012. RESULTS Sixty-eight cases were identified in this series from the sarcoma multidisciplinary team. Seventeen different histological subtypes of sarcoma were identified. Neither age, gender nor tumour size were significant prognostic indicators for survival in this series. CONCLUSION Prognosis is dependent on histological subtype, underscoring the importance of histological classification. Some histological subtypes occur only once or twice in a decade, even within a large regional referral centre. An accumulation of evidence from relatively small case series is key in the long-term development of treatment strategies.
{"title":"Soft tissue head and neck sarcoma: experience of a tertiary referral centre over a 15-year period.","authors":"L. Harrison, T. Mcculloch, N. Beasley","doi":"10.1017/S0022215119002299","DOIUrl":"https://doi.org/10.1017/S0022215119002299","url":null,"abstract":"BACKGROUND\u0000Head and neck soft tissue sarcoma is uncommon. It is both histologically and clinically heterogeneous, ranging from an indolent, locally destructive tumour, to a locally aggressive neoplasm with metastatic potential.\u0000\u0000\u0000METHODS\u0000A retrospective review was conducted of all adult head and neck soft tissue sarcomas, including cases of malignant soft tissue sarcoma and all intermediate type tumours, diagnosed between 1997 and 2012.\u0000\u0000\u0000RESULTS\u0000Sixty-eight cases were identified in this series from the sarcoma multidisciplinary team. Seventeen different histological subtypes of sarcoma were identified. Neither age, gender nor tumour size were significant prognostic indicators for survival in this series.\u0000\u0000\u0000CONCLUSION\u0000Prognosis is dependent on histological subtype, underscoring the importance of histological classification. Some histological subtypes occur only once or twice in a decade, even within a large regional referral centre. An accumulation of evidence from relatively small case series is key in the long-term development of treatment strategies.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"15 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82465961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-29DOI: 10.1017/S002221511900241X
J. Ray, K. Lau, J. Moraleda, M. Yardley, M. Dawoud, P. Dimitriadis
OBJECTIVE To compare soft-tissue complications following implantation of different bone conduction hearing devices. METHODS Adults who underwent implantation of different bone conduction hearing devices, between January 2008 and December 2016, were included in the study. Five groups were identified depending on the soft-tissue approach: (1) split-thickness skin flap with use of dermatome; (2) Sheffield 'S'-shaped incision with skin thinning; (3) linear incision without skin thinning (hydroxyapatite-coated abutment); (4) 'C'-shaped full-thickness incision for passive transcutaneous bone conduction hearing devices; and (5) post-aural incision for active transcutaneous bone conduction hearing devices. The main outcome measures were different soft-tissue complications. RESULTS The study comprised 120 patients (group 1 = 20 patients, group 2 = 35, group 3 = 35, group 4 = 20, and group 5 = 10). Soft tissue related problems were encountered in 55 per cent of patients from group 1, 26 per cent in group 2, 3 per cent in group 3, and 0 per cent in groups 4 and 5. CONCLUSION There was a reduction in soft tissue related complications with reduced soft-tissue handling. In addition, there was a shift from an initial skin-penetrating (percutaneous) approach to a non-skin-penetrating (transcutaneous) approach.
{"title":"Soft-tissue outcomes following implantation of different types of bone conduction hearing devices in a single centre.","authors":"J. Ray, K. Lau, J. Moraleda, M. Yardley, M. Dawoud, P. Dimitriadis","doi":"10.1017/S002221511900241X","DOIUrl":"https://doi.org/10.1017/S002221511900241X","url":null,"abstract":"OBJECTIVE\u0000To compare soft-tissue complications following implantation of different bone conduction hearing devices.\u0000\u0000\u0000METHODS\u0000Adults who underwent implantation of different bone conduction hearing devices, between January 2008 and December 2016, were included in the study. Five groups were identified depending on the soft-tissue approach: (1) split-thickness skin flap with use of dermatome; (2) Sheffield 'S'-shaped incision with skin thinning; (3) linear incision without skin thinning (hydroxyapatite-coated abutment); (4) 'C'-shaped full-thickness incision for passive transcutaneous bone conduction hearing devices; and (5) post-aural incision for active transcutaneous bone conduction hearing devices. The main outcome measures were different soft-tissue complications.\u0000\u0000\u0000RESULTS\u0000The study comprised 120 patients (group 1 = 20 patients, group 2 = 35, group 3 = 35, group 4 = 20, and group 5 = 10). Soft tissue related problems were encountered in 55 per cent of patients from group 1, 26 per cent in group 2, 3 per cent in group 3, and 0 per cent in groups 4 and 5.\u0000\u0000\u0000CONCLUSION\u0000There was a reduction in soft tissue related complications with reduced soft-tissue handling. In addition, there was a shift from an initial skin-penetrating (percutaneous) approach to a non-skin-penetrating (transcutaneous) approach.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"50 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89321614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-27DOI: 10.1017/s0022215119002329
Boon Han Kevin Ng, Boon Han Kevin Ng, Boon Han Kevin Ng, I. Tang, I. Tang, Prepageran Narayanan, Rajagopalan Raman, Ricardo L. Carrau
BACKGROUND Nasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery. OBJECTIVE To evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery. METHODS A pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy. RESULTS Patients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin. CONCLUSION Nasal lavage with mupirocin seems to yield better outcomes regarding patients' symptoms and endoscopic findings.
{"title":"Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study.","authors":"Boon Han Kevin Ng, Boon Han Kevin Ng, Boon Han Kevin Ng, I. Tang, I. Tang, Prepageran Narayanan, Rajagopalan Raman, Ricardo L. Carrau","doi":"10.1017/s0022215119002329","DOIUrl":"https://doi.org/10.1017/s0022215119002329","url":null,"abstract":"BACKGROUND\u0000Nasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery.\u0000\u0000\u0000OBJECTIVE\u0000To evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery.\u0000\u0000\u0000METHODS\u0000A pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy.\u0000\u0000\u0000RESULTS\u0000Patients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin.\u0000\u0000\u0000CONCLUSION\u0000Nasal lavage with mupirocin seems to yield better outcomes regarding patients' symptoms and endoscopic findings.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"39 4 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90475054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-19DOI: 10.1017/S0022215119002330
T. Pitts-Tucker, T. Biggs, N. Patel
BACKGROUND Lateral neck radiographs are commonly used in the investigation and management of patients presenting with suspected fish bone impaction. The effectiveness of these is questioned, as many fish do not have radio-opaque bones. OBJECTIVE This study evaluated the utility of lateral neck radiographs in the management of patients presenting with fish bones retained in the upper aerodigestive tract, with the creation of a treatment algorithm to guide further management. METHODS An audit of practice was undertaken at the University Hospital of Southampton, identifying all patients admitted with potential fish bone impaction in the upper aerodigestive tract. Following analysis, a treatment algorithm was constructed for use by junior doctors. RESULTS In total, 34 per cent of patients with a normal radiograph were subsequently found to have a fish bone present under local or general anaesthetic assessment. The sensitivity of radiographs in the detection of fish bones was found to be 51.6 per cent. CONCLUSION Lateral neck radiographs have limited value in the management of suspected fish bone impaction, and should only be used following detailed clinical examination of the upper aerodigestive tract.
{"title":"The utility of lateral neck radiographs in the management of fish bones.","authors":"T. Pitts-Tucker, T. Biggs, N. Patel","doi":"10.1017/S0022215119002330","DOIUrl":"https://doi.org/10.1017/S0022215119002330","url":null,"abstract":"BACKGROUND\u0000Lateral neck radiographs are commonly used in the investigation and management of patients presenting with suspected fish bone impaction. The effectiveness of these is questioned, as many fish do not have radio-opaque bones.\u0000\u0000\u0000OBJECTIVE\u0000This study evaluated the utility of lateral neck radiographs in the management of patients presenting with fish bones retained in the upper aerodigestive tract, with the creation of a treatment algorithm to guide further management.\u0000\u0000\u0000METHODS\u0000An audit of practice was undertaken at the University Hospital of Southampton, identifying all patients admitted with potential fish bone impaction in the upper aerodigestive tract. Following analysis, a treatment algorithm was constructed for use by junior doctors.\u0000\u0000\u0000RESULTS\u0000In total, 34 per cent of patients with a normal radiograph were subsequently found to have a fish bone present under local or general anaesthetic assessment. The sensitivity of radiographs in the detection of fish bones was found to be 51.6 per cent.\u0000\u0000\u0000CONCLUSION\u0000Lateral neck radiographs have limited value in the management of suspected fish bone impaction, and should only be used following detailed clinical examination of the upper aerodigestive tract.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"98 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2019-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79839142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-18DOI: 10.1017/S0022215119002408
M. Wilkie, D. Chudek, Christopher J. Webb, Alessandro Panarese, G. Bánhegyi
OBJECTIVE This study sought to compare disease recidivism rates between canal wall up mastoidectomy and a canal wall down with obliteration technique. METHODS Patients undergoing primary cholesteatoma surgery at our institution over a five-year period (2013-2017) using the aforementioned techniques were eligible for inclusion in the study. Rates of discharge and disease recidivism were analysed using chi-square statistics. RESULTS A total of 104 ears (98 patients) were included. The mean follow-up period was 30 months (range, 12-52 months). A canal wall down with mastoid obliteration technique was performed in 55 cases and a canal wall up approach was performed in 49 cases. Disease recidivism rates were 7.3 per cent and 16.3 per cent in the canal wall down with mastoid obliteration and canal wall up groups respectively (p = 0.02), whilst discharge rates were similar (7.3 per cent and 10.2 per cent respectively). CONCLUSION Our direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate.
{"title":"Canal wall down mastoidectomy with obliteration versus canal wall up mastoidectomy in primary cholesteatoma surgery.","authors":"M. Wilkie, D. Chudek, Christopher J. Webb, Alessandro Panarese, G. Bánhegyi","doi":"10.1017/S0022215119002408","DOIUrl":"https://doi.org/10.1017/S0022215119002408","url":null,"abstract":"OBJECTIVE\u0000This study sought to compare disease recidivism rates between canal wall up mastoidectomy and a canal wall down with obliteration technique.\u0000\u0000\u0000METHODS\u0000Patients undergoing primary cholesteatoma surgery at our institution over a five-year period (2013-2017) using the aforementioned techniques were eligible for inclusion in the study. Rates of discharge and disease recidivism were analysed using chi-square statistics.\u0000\u0000\u0000RESULTS\u0000A total of 104 ears (98 patients) were included. The mean follow-up period was 30 months (range, 12-52 months). A canal wall down with mastoid obliteration technique was performed in 55 cases and a canal wall up approach was performed in 49 cases. Disease recidivism rates were 7.3 per cent and 16.3 per cent in the canal wall down with mastoid obliteration and canal wall up groups respectively (p = 0.02), whilst discharge rates were similar (7.3 per cent and 10.2 per cent respectively).\u0000\u0000\u0000CONCLUSION\u0000Our direct comparative data suggest that canal wall down mastoidectomy with obliteration is superior to a canal wall up technique in primary cholesteatoma surgery, providing a lower recidivism rate combined with a low post-operative ear discharge rate.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"1 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89355904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-18DOI: 10.1017/S0022215119002305
A. Thakur, S. Gupta, J. Thakur, R. S. Minhas, R. Azad, M. S. Vasanthalakshmi, D. Sharma, N. Mohindroo
OBJECTIVE To assess the effect of tranexamic acid in head and neck surgical procedures. METHODS A prospective, double-blind and randomised, parallel group, placebo-controlled clinical trial was conducted. Ninety-two patients undergoing various head and neck surgical procedures were randomised. Subjects received seven infusions of coded drugs (tranexamic acid or normal saline) starting at the time of skin closure. Haematological, biochemical, blood loss and other parameters were observed by the staff, who were blinded to patients' group allocation (case or control). RESULTS Patients were analysed on the basis of type of surgery. Fifty patients who had undergone surgical procedures, including total thyroidectomy, total parotidectomy, and various neck dissections with or without primary tumour excision, were included in the first group. The second group comprised 41 patients who had undergone hemithyroidectomy, lobectomy or superficial parotidectomy. There was no statistical difference in blood parameters between both groups. There was a reduction in post-operative drain volume, but this was not significant. CONCLUSION Although this prospective, randomised, placebo-controlled clinical trial found a reduction in post-operative drain volume in tranexamic acid groups, the difference was not statistically significant between the various head and neck surgical procedure groups.
{"title":"Tranexamic acid has no advantage in head and neck surgical procedures: a randomised, double-blind, controlled clinical trial.","authors":"A. Thakur, S. Gupta, J. Thakur, R. S. Minhas, R. Azad, M. S. Vasanthalakshmi, D. Sharma, N. Mohindroo","doi":"10.1017/S0022215119002305","DOIUrl":"https://doi.org/10.1017/S0022215119002305","url":null,"abstract":"OBJECTIVE\u0000To assess the effect of tranexamic acid in head and neck surgical procedures.\u0000\u0000\u0000METHODS\u0000A prospective, double-blind and randomised, parallel group, placebo-controlled clinical trial was conducted. Ninety-two patients undergoing various head and neck surgical procedures were randomised. Subjects received seven infusions of coded drugs (tranexamic acid or normal saline) starting at the time of skin closure. Haematological, biochemical, blood loss and other parameters were observed by the staff, who were blinded to patients' group allocation (case or control).\u0000\u0000\u0000RESULTS\u0000Patients were analysed on the basis of type of surgery. Fifty patients who had undergone surgical procedures, including total thyroidectomy, total parotidectomy, and various neck dissections with or without primary tumour excision, were included in the first group. The second group comprised 41 patients who had undergone hemithyroidectomy, lobectomy or superficial parotidectomy. There was no statistical difference in blood parameters between both groups. There was a reduction in post-operative drain volume, but this was not significant.\u0000\u0000\u0000CONCLUSION\u0000Although this prospective, randomised, placebo-controlled clinical trial found a reduction in post-operative drain volume in tranexamic acid groups, the difference was not statistically significant between the various head and neck surgical procedure groups.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"37 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81937839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-18DOI: 10.1017/S0022215119002391
S. G. Kütük, T. Özdaş
OBJECTIVE To evaluate the impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes. METHODS Patients who underwent tympanoplasty type 1 surgery were randomised into temporal fascia graft alone (n = 55) and temporal fascia graft plus platelet-rich fibrin therapy (n = 36) groups. Graft survival and hearing outcomes were recorded. RESULTS Graft survival rates were significantly higher in the temporal fascia graft plus platelet-rich fibrin therapy group than in the temporal fascia graft alone group at one (100.0 vs 85.5 per cent, p = 0.020), three (97.2 vs 80.0 per cent, p = 0.024) and six months post-operatively (94.4 vs 74.5 per cent, p = 0.031). The difference in hearing gain between groups was not significant. CONCLUSION Our findings revealed that the use of a platelet-rich fibrin plus temporal fascia graft for type 1 tympanoplasty was associated with more favourable post-operative outcomes than the use of temporal fascia alone, both in terms of tympanic membrane healing and graft survival; hearing restoration outcomes were similar.
目的评价1型鼓室成形术中富血小板纤维蛋白治疗对移植物存活率和频率特异性听力结果的影响。方法将1型鼓室成形术患者随机分为单纯颞筋膜移植组(n = 55)和颞筋膜移植+富血小板纤维蛋白治疗组(n = 36)。记录移植物存活和听力结果。结果颞筋膜移植联合富血小板纤维蛋白治疗组术后1个月(100.0 vs 85.5%， p = 0.020)、3个月(97.2 vs 80.0%， p = 0.024)和6个月(94.4 vs 74.5%， p = 0.031)的移植存活率均显著高于单纯颞筋膜移植组。各组间听力增益差异不显著。结论:我们的研究结果显示，在鼓膜愈合和移植物存活方面，使用富血小板纤维蛋白加颞筋膜移植物进行1型鼓室成形术的术后结果比单独使用颞筋膜更有利;听力恢复结果相似。
{"title":"Impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes: a retrospective analysis in patients with tympanic membrane perforation due to chronic otitis media.","authors":"S. G. Kütük, T. Özdaş","doi":"10.1017/S0022215119002391","DOIUrl":"https://doi.org/10.1017/S0022215119002391","url":null,"abstract":"OBJECTIVE\u0000To evaluate the impact of platelet-rich fibrin therapy in tympanoplasty type 1 surgery on graft survival and frequency-specific hearing outcomes.\u0000\u0000\u0000METHODS\u0000Patients who underwent tympanoplasty type 1 surgery were randomised into temporal fascia graft alone (n = 55) and temporal fascia graft plus platelet-rich fibrin therapy (n = 36) groups. Graft survival and hearing outcomes were recorded.\u0000\u0000\u0000RESULTS\u0000Graft survival rates were significantly higher in the temporal fascia graft plus platelet-rich fibrin therapy group than in the temporal fascia graft alone group at one (100.0 vs 85.5 per cent, p = 0.020), three (97.2 vs 80.0 per cent, p = 0.024) and six months post-operatively (94.4 vs 74.5 per cent, p = 0.031). The difference in hearing gain between groups was not significant.\u0000\u0000\u0000CONCLUSION\u0000Our findings revealed that the use of a platelet-rich fibrin plus temporal fascia graft for type 1 tympanoplasty was associated with more favourable post-operative outcomes than the use of temporal fascia alone, both in terms of tympanic membrane healing and graft survival; hearing restoration outcomes were similar.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"64 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2019-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89759305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-14DOI: 10.1017/S0022215119002251
S. Dodhia, S. Patel, G. Beghal, K. Pandey, C. Hopkins
OBJECTIVE Opioid analgesics are often prescribed following rhinology surgery. This study aimed to evaluate whether the quantity of opioid analgesics prescribed is justified. METHODS Patients were asked about their pain management post-operatively. Parameters recorded included: current pain (using a 10-point Likert scale); type of operation; the opioid analgesics prescribed; and the quantity of opioid tablets taken and other methods of pain relief used. RESULTS Thirty-five patients were successfully contacted. The median pain score at one week post-operation was 1 (interquartile range, 0-3). Of these 35 patients, 16 were prescribed opioids, whilst 19 were not. Patients prescribed opioids took a median of 8 tablets (interquartile range, 0.8-10.5) out of the 28 tablets prescribed. CONCLUSION The study shows that the quantity of post-operative opioid analgesics prescribed does not compare with the amount consumed by patients to relieve pain, resulting in a surplus of opioid medication which has the potential to be abused.
{"title":"A study of the use of post-operative opioid analgesics following rhinology surgery in 35 patients.","authors":"S. Dodhia, S. Patel, G. Beghal, K. Pandey, C. Hopkins","doi":"10.1017/S0022215119002251","DOIUrl":"https://doi.org/10.1017/S0022215119002251","url":null,"abstract":"OBJECTIVE\u0000Opioid analgesics are often prescribed following rhinology surgery. This study aimed to evaluate whether the quantity of opioid analgesics prescribed is justified.\u0000\u0000\u0000METHODS\u0000Patients were asked about their pain management post-operatively. Parameters recorded included: current pain (using a 10-point Likert scale); type of operation; the opioid analgesics prescribed; and the quantity of opioid tablets taken and other methods of pain relief used.\u0000\u0000\u0000RESULTS\u0000Thirty-five patients were successfully contacted. The median pain score at one week post-operation was 1 (interquartile range, 0-3). Of these 35 patients, 16 were prescribed opioids, whilst 19 were not. Patients prescribed opioids took a median of 8 tablets (interquartile range, 0.8-10.5) out of the 28 tablets prescribed.\u0000\u0000\u0000CONCLUSION\u0000The study shows that the quantity of post-operative opioid analgesics prescribed does not compare with the amount consumed by patients to relieve pain, resulting in a surplus of opioid medication which has the potential to be abused.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"72 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84739783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：