Pub Date : 2017-01-18DOI: 10.1017/S0022215116010033
V. Crolley, N. Gibbins
It has been 100 years since Erwin Payr first developed an operation to improve the effects of a paralysed vocal fold, and operations based on this technique are still in use today. This technique, medialisation thyroplasty, aims to improve the symptoms caused by vocal fold palsy by realigning the lateralised vocal fold into the midline. Whilst the effects of vocal fold palsy were recognised in antiquity, it was only with the development of indirect laryngoscopy in the late nineteenth century that the vocal fold paralysis could be identified as an aetiology for poor phonation and dysphagia. Payr, in 1915, was the first to perform a recognisable form of medialisation thyroplasty, which was further developed in the early twentieth century, but medialisation thyroplasty did not begin to be widely used until the development of the modern technique by Isshiki et al., in 1974. Since then, medialisation thyroplasty has continued to be developed and is currently the most widely used technique for correcting the effects of vocal fold palsy. However, a wide array of therapeutic options is now available for vocal fold palsy and it is impossible to say whether or not medialisation thyroplasty will still be used in another 100 years.
{"title":"One hundred years of external approach medialisation thyroplasty.","authors":"V. Crolley, N. Gibbins","doi":"10.1017/S0022215116010033","DOIUrl":"https://doi.org/10.1017/S0022215116010033","url":null,"abstract":"It has been 100 years since Erwin Payr first developed an operation to improve the effects of a paralysed vocal fold, and operations based on this technique are still in use today. This technique, medialisation thyroplasty, aims to improve the symptoms caused by vocal fold palsy by realigning the lateralised vocal fold into the midline. Whilst the effects of vocal fold palsy were recognised in antiquity, it was only with the development of indirect laryngoscopy in the late nineteenth century that the vocal fold paralysis could be identified as an aetiology for poor phonation and dysphagia. Payr, in 1915, was the first to perform a recognisable form of medialisation thyroplasty, which was further developed in the early twentieth century, but medialisation thyroplasty did not begin to be widely used until the development of the modern technique by Isshiki et al., in 1974. Since then, medialisation thyroplasty has continued to be developed and is currently the most widely used technique for correcting the effects of vocal fold palsy. However, a wide array of therapeutic options is now available for vocal fold palsy and it is impossible to say whether or not medialisation thyroplasty will still be used in another 100 years.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"1 1","pages":"202-208"},"PeriodicalIF":0.0,"publicationDate":"2017-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89658408","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 : 2017-01-18DOI: 10.1017/S0022215116009968
L. Tian, R. An, J. Zhang, Y. Sun, R. Zhao, M. Liu
OBJECTIVE The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy. METHODS Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups. RESULTS The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others. CONCLUSION The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.
{"title":"Effect of the patient-to-patient communication model on dysphagia caused by total laryngectomy.","authors":"L. Tian, R. An, J. Zhang, Y. Sun, R. Zhao, M. Liu","doi":"10.1017/S0022215116009968","DOIUrl":"https://doi.org/10.1017/S0022215116009968","url":null,"abstract":"OBJECTIVE\u0000The study aimed to evaluate the effect of a patient-to-patient communication model on dysphagia in laryngeal cancer patients after total laryngectomy.\u0000\u0000\u0000METHODS\u0000Sixty-five patients who had undergone total laryngectomy were randomly divided into three groups: a routine communication group, a patient communication group (that received the patient-to-patient communication model) and a physician communication group. Questionnaires were used to compare quality of life and swallowing problems among all patient groups.\u0000\u0000\u0000RESULTS\u0000The main factors causing dysphagia in total laryngectomy patients were related to fear and mental health. The patient communication group had improved visual analogue scale scores at one week after starting to eat. Quality of life in swallowing disorders questionnaire scores were significantly higher in the patient communication and physician communication groups than in the routine communication group. In addition, swallowing problems were much more severe in patients educated to high school level and above than in others.\u0000\u0000\u0000CONCLUSION\u0000The patient-to-patient communication model can be used to resolve swallowing problems caused by psychological factors in total laryngectomy patients.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"76 1","pages":"253-258"},"PeriodicalIF":0.0,"publicationDate":"2017-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85771897","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 : 2017-01-16DOI: 10.1017/S0022215116009932
Andrés Soto-Varela, A. Faraldo-García, María del-Río-Valeiras, Marcos Rossi-Izquierdo, Isabel Vaamonde-Sánchez-Andrade, P. Gayoso-Diz, Antonio Lirola-Delgado, S. Santos-Pérez
OBJECTIVE To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme. METHODS A prospective case-control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients' adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale - International questionnaire results, number of falls, and type of vestibular rehabilitation. RESULTS Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores). CONCLUSION The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.
{"title":"Adherence of older people with instability in vestibular rehabilitation programmes: prediction criteria.","authors":"Andrés Soto-Varela, A. Faraldo-García, María del-Río-Valeiras, Marcos Rossi-Izquierdo, Isabel Vaamonde-Sánchez-Andrade, P. Gayoso-Diz, Antonio Lirola-Delgado, S. Santos-Pérez","doi":"10.1017/S0022215116009932","DOIUrl":"https://doi.org/10.1017/S0022215116009932","url":null,"abstract":"OBJECTIVE\u0000To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme.\u0000\u0000\u0000METHODS\u0000A prospective case-control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients' adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale - International questionnaire results, number of falls, and type of vestibular rehabilitation.\u0000\u0000\u0000RESULTS\u0000Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores).\u0000\u0000\u0000CONCLUSION\u0000The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"5 1","pages":"232-238"},"PeriodicalIF":0.0,"publicationDate":"2017-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89236257","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 : 2016-12-01DOI: 10.1017/S0022215116009403
M. Stavrakas, P. Karkos, Konstantinos Markou, Nikolaos Grigoriadis
BACKGROUND Platelet-rich plasma is a novel material that is being used more frequently in many surgical specialties. METHODS A literature review on the current and potential uses of platelet-rich plasma in otolaryngology was performed. RESULTS There is limited evidence on the use of platelet-rich plasma in otolaryngology compared with other specialties: only 11 studies on various subspecialties (otology, rhinology and laryngology) were included in the final review. CONCLUSION Based on the limited number of studies, we cannot draw safe conclusions about the value of platelet-rich plasma in otolaryngology. Nevertheless, the available literature suggests that platelet-rich plasma holds promise for future research and may have a number of clinical applications.
{"title":"Platelet-rich plasma in otolaryngology.","authors":"M. Stavrakas, P. Karkos, Konstantinos Markou, Nikolaos Grigoriadis","doi":"10.1017/S0022215116009403","DOIUrl":"https://doi.org/10.1017/S0022215116009403","url":null,"abstract":"BACKGROUND\u0000Platelet-rich plasma is a novel material that is being used more frequently in many surgical specialties.\u0000\u0000\u0000METHODS\u0000A literature review on the current and potential uses of platelet-rich plasma in otolaryngology was performed.\u0000\u0000\u0000RESULTS\u0000There is limited evidence on the use of platelet-rich plasma in otolaryngology compared with other specialties: only 11 studies on various subspecialties (otology, rhinology and laryngology) were included in the final review.\u0000\u0000\u0000CONCLUSION\u0000Based on the limited number of studies, we cannot draw safe conclusions about the value of platelet-rich plasma in otolaryngology. Nevertheless, the available literature suggests that platelet-rich plasma holds promise for future research and may have a number of clinical applications.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"30 1","pages":"1098-1102"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78137711","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 : 2016-12-01DOI: 10.1017/S0022215116009245
A. Mudry, W. Lübbers, W. Pirsig
BACKGROUND The Blakesley fenestrated ethmoid forceps, eponymously named after Theodore Seward Blakesley, belong today in every set of endonasal surgical instruments. This study aimed to go back to Blakesley's original description, and to follow its introduction, variations and acceptation by rhinosurgeons. METHOD Historical review of literature. RESULTS In 1915, Blakesley described two nasal instruments: a submucous septum resection instrument and an ethmoid instrument. The history of the ethmoid instrument is in close relationship to another quite similar one described by Moriz Weil. The difference between the Weil and the Blakesley ethmoid forceps lies essentially in the base of the cutting jaws, which are narrower in Weil's instrument. CONCLUSION Blakesley's eponym must only be used for the instrument without the narrower base of the cutting jaws.
{"title":"One hundred years ago: the physician magician Blakesley presented his ethmoid forceps.","authors":"A. Mudry, W. Lübbers, W. Pirsig","doi":"10.1017/S0022215116009245","DOIUrl":"https://doi.org/10.1017/S0022215116009245","url":null,"abstract":"BACKGROUND\u0000The Blakesley fenestrated ethmoid forceps, eponymously named after Theodore Seward Blakesley, belong today in every set of endonasal surgical instruments. This study aimed to go back to Blakesley's original description, and to follow its introduction, variations and acceptation by rhinosurgeons.\u0000\u0000\u0000METHOD\u0000Historical review of literature.\u0000\u0000\u0000RESULTS\u0000In 1915, Blakesley described two nasal instruments: a submucous septum resection instrument and an ethmoid instrument. The history of the ethmoid instrument is in close relationship to another quite similar one described by Moriz Weil. The difference between the Weil and the Blakesley ethmoid forceps lies essentially in the base of the cutting jaws, which are narrower in Weil's instrument.\u0000\u0000\u0000CONCLUSION\u0000Blakesley's eponym must only be used for the instrument without the narrower base of the cutting jaws.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"52 1","pages":"1086-1092"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79821224","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 : 2016-12-01DOI: 10.1017/S0022215116009257
N. Jufas, N. Deveau, M. Bance
BACKGROUND Imaging the Eustachian tube has proven difficult as it has an anatomical orientation that is not aligned with standard planes. In addition, the Eustachian tube is a dynamic structure, opening briefly during a variety of physiological manoeuvres. CASE REPORT A 54-year-old healthy and asymptomatic man underwent computed tomography utilising an area detector scanner. Multiplanar reconstruction was performed at 1 mm intervals. In addition, dynamic clips were constructed to demonstrate air and its movement in the field. Images and video were acquired whilst a Valsalva manoeuvre was being performed. CONCLUSION Although imaging techniques have been able to visualise the Eustachian tube well in the closed state, it may be more useful to have it imaged whilst open. Area detector computed tomography scanners can be used to acquire four-dimensional images. This allows dynamic imaging of the region, to assist in the diagnosis of various types of Eustachian tube dysfunction.
{"title":"Dynamic cine imaging of the Eustachian tube using four-dimensional computed tomography.","authors":"N. Jufas, N. Deveau, M. Bance","doi":"10.1017/S0022215116009257","DOIUrl":"https://doi.org/10.1017/S0022215116009257","url":null,"abstract":"BACKGROUND\u0000Imaging the Eustachian tube has proven difficult as it has an anatomical orientation that is not aligned with standard planes. In addition, the Eustachian tube is a dynamic structure, opening briefly during a variety of physiological manoeuvres.\u0000\u0000\u0000CASE REPORT\u0000A 54-year-old healthy and asymptomatic man underwent computed tomography utilising an area detector scanner. Multiplanar reconstruction was performed at 1 mm intervals. In addition, dynamic clips were constructed to demonstrate air and its movement in the field. Images and video were acquired whilst a Valsalva manoeuvre was being performed.\u0000\u0000\u0000CONCLUSION\u0000Although imaging techniques have been able to visualise the Eustachian tube well in the closed state, it may be more useful to have it imaged whilst open. Area detector computed tomography scanners can be used to acquire four-dimensional images. This allows dynamic imaging of the region, to assist in the diagnosis of various types of Eustachian tube dysfunction.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"11 1","pages":"1162-1164"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88395874","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 : 2016-12-01DOI: 10.1017/S0022215116008847
K. Padmanabhan, D T Pulimoottil
Dear Editors, It was a pleasure for us to read the article titled ‘Comparison of distortion product otoacoustic emissions and pure tone audiometry in occupational screening for auditory deficit due to noise exposure’ by Wooles et al., in your esteemed journal. It is a succinctly written article and we would like to commend the authors on their excellent effort. The topic is significant to us, as we have been conducting a similar study in our institution for the past three years, involving factory workers. Based on our experience in this area, we would like to mention a few points that we feel would enrich the above article. Exposure to short duration, high-level noise can cause either temporary or permanent hearing loss depending on the level, duration and spectral content of the traumatising stimulus. Various studies have validated the use of high-frequency pure tone audiometry in the detection of noise-induced hearing loss, and shown that extended high frequencies may be affected by noise sooner than is revealed by conventional audiometry. We feel that high-frequency audiometry is an effective and cost-efficient screening tool for occupational hearing loss, and distortion product otoacoustic emissions testing may be considered if the high-frequency pure tone audiometry results warrant it. Noise, as we know it, is excessive auditory stimulation. It elicits shear forces in the cochlea, leading to two pathways of cochlear injury, mechanical and metabolic. When the metabolic or mechanical stress is excessive, it leads to apoptosis or necrosis, and subsequent cell death. Vibration-induced hearing loss, another oft neglected but frequently important factor under the umbrella of occupational hearing loss, acts via vibratory energy. This energy reaches the cochlea, and generates segmental compressions and expansions of the cochlear shell, affecting the fluid pathways of the inner ear. Although the iatrogenic role of vibration-induced hearing loss and the effect of vibration on the upper limbs have been studied in some detail, the role of occupational exposure to high-frequency vibration as a cause of hearing loss has not been fully explored, and we feel that this area warrants future research. We found very few articles in the available literature regarding short-term exposure to noise as an occupational hazard for health professionals. Specialists in otolaryngology, dental surgery and orthopaedic surgery are routinely exposed to short duration, high-frequency noises in the operating theatre. It would be worthwhile to study the long-term effects of this noise as an occupational hazard in these specialties; if warranted, protocols may be introduced to bring in measures for hearing protection in these specialties.
{"title":"Comparison of distortion product otoacoustic emissions and pure tone audiometry in occupational screening for auditory deficit due to noise exposure.","authors":"K. Padmanabhan, D T Pulimoottil","doi":"10.1017/S0022215116008847","DOIUrl":"https://doi.org/10.1017/S0022215116008847","url":null,"abstract":"Dear Editors, It was a pleasure for us to read the article titled ‘Comparison of distortion product otoacoustic emissions and pure tone audiometry in occupational screening for auditory deficit due to noise exposure’ by Wooles et al., in your esteemed journal. It is a succinctly written article and we would like to commend the authors on their excellent effort. The topic is significant to us, as we have been conducting a similar study in our institution for the past three years, involving factory workers. Based on our experience in this area, we would like to mention a few points that we feel would enrich the above article. Exposure to short duration, high-level noise can cause either temporary or permanent hearing loss depending on the level, duration and spectral content of the traumatising stimulus. Various studies have validated the use of high-frequency pure tone audiometry in the detection of noise-induced hearing loss, and shown that extended high frequencies may be affected by noise sooner than is revealed by conventional audiometry. We feel that high-frequency audiometry is an effective and cost-efficient screening tool for occupational hearing loss, and distortion product otoacoustic emissions testing may be considered if the high-frequency pure tone audiometry results warrant it. Noise, as we know it, is excessive auditory stimulation. It elicits shear forces in the cochlea, leading to two pathways of cochlear injury, mechanical and metabolic. When the metabolic or mechanical stress is excessive, it leads to apoptosis or necrosis, and subsequent cell death. Vibration-induced hearing loss, another oft neglected but frequently important factor under the umbrella of occupational hearing loss, acts via vibratory energy. This energy reaches the cochlea, and generates segmental compressions and expansions of the cochlear shell, affecting the fluid pathways of the inner ear. Although the iatrogenic role of vibration-induced hearing loss and the effect of vibration on the upper limbs have been studied in some detail, the role of occupational exposure to high-frequency vibration as a cause of hearing loss has not been fully explored, and we feel that this area warrants future research. We found very few articles in the available literature regarding short-term exposure to noise as an occupational hazard for health professionals. Specialists in otolaryngology, dental surgery and orthopaedic surgery are routinely exposed to short duration, high-frequency noises in the operating theatre. It would be worthwhile to study the long-term effects of this noise as an occupational hazard in these specialties; if warranted, protocols may be introduced to bring in measures for hearing protection in these specialties.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"13 1","pages":"1165"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80505000","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 : 2016-12-01DOI: 10.1017/s0022215116009373
A. Ferlito, P. Slootweg
OBJECTIVE To review reports of adenoid cystic carcinomas arising in the head and neck area outside of the major salivary glands, in order to enhance the care of patients with these unusual neoplasms. METHODS An international team of head and neck surgeons, pathologists, oncologists and radiation oncologists was assembled to explore the published experience and their own working experience of the diagnosis and treatment of adenoid cystic carcinomas arising in the vicinity of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal. RESULTS The behaviour of adenoid cystic carcinoma arising in head and neck sites exclusive of the major salivary glands parallels that of tumours with a similar histology arising in the major salivary glands - these are relentless, progressive tumours, associated with high rates of mortality. Of 774 patients reviewed, at least 41 (5.3 per cent) developed documented regional node metastases. CONCLUSION The relatively low overall incidence of nodal metastases in adenoid cystic carcinomas arising in the head and neck region outside of the major salivary glands suggests that routine elective regional lymph node dissection might not be indicated in most patients with these tumours.
{"title":"Cervical lymph node metastasis in adenoid cystic carcinoma of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal: a collective international review.","authors":"A. Ferlito, P. Slootweg","doi":"10.1017/s0022215116009373","DOIUrl":"https://doi.org/10.1017/s0022215116009373","url":null,"abstract":"OBJECTIVE\u0000To review reports of adenoid cystic carcinomas arising in the head and neck area outside of the major salivary glands, in order to enhance the care of patients with these unusual neoplasms.\u0000\u0000\u0000METHODS\u0000An international team of head and neck surgeons, pathologists, oncologists and radiation oncologists was assembled to explore the published experience and their own working experience of the diagnosis and treatment of adenoid cystic carcinomas arising in the vicinity of the sinonasal tract, nasopharynx, lacrimal glands and external auditory canal.\u0000\u0000\u0000RESULTS\u0000The behaviour of adenoid cystic carcinoma arising in head and neck sites exclusive of the major salivary glands parallels that of tumours with a similar histology arising in the major salivary glands - these are relentless, progressive tumours, associated with high rates of mortality. Of 774 patients reviewed, at least 41 (5.3 per cent) developed documented regional node metastases.\u0000\u0000\u0000CONCLUSION\u0000The relatively low overall incidence of nodal metastases in adenoid cystic carcinomas arising in the head and neck region outside of the major salivary glands suggests that routine elective regional lymph node dissection might not be indicated in most patients with these tumours.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"82 1","pages":"1093-1097"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75389581","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 : 2016-12-01DOI: 10.1017/S0022215116008975
Ó. Gilheaney, Patrick Kerr, Sibylle Béchet, Margaret Walshe
OBJECTIVE To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease. DATA SOURCES Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched. REVIEW METHODS Data were extracted by two independent reviewers. Methodological quality was assessed independently using the PEDro scale and MINORS tool. RESULTS Of 2938 records identified, 2 studies were eligible. Risk of bias assessment indicated areas of methodological concern in the literature. Statistical analysis was not possible because of the limited number of eligible studies. CONCLUSION No determinations could be made regarding endoscopic cricopharyngeal myotomy effectiveness in the cohort of interest. Reliable and valid evidence on the following is required to support increasing clinical usage of endoscopic cricopharyngeal myotomy: optimal candidacy selection; standardised post-operative management protocol; complications; and endoscopic cricopharyngeal myotomy effects on aspiration of food and laryngeal penetration, mean upper oesophageal sphincter resting pressure and quality of life.
{"title":"Effectiveness of endoscopic cricopharyngeal myotomy in adults with neurological disease: systematic review.","authors":"Ó. Gilheaney, Patrick Kerr, Sibylle Béchet, Margaret Walshe","doi":"10.1017/S0022215116008975","DOIUrl":"https://doi.org/10.1017/S0022215116008975","url":null,"abstract":"OBJECTIVE\u0000To determine the effectiveness of endoscopic cricopharyngeal myotomy on upper oesophageal sphincter dysfunction in adults with upper oesophageal sphincter dysfunction and neurological disease.\u0000\u0000\u0000DATA SOURCES\u0000Published and unpublished studies with a quasi-experimental design investigating endoscopic cricopharyngeal myotomy effects on upper oesophageal sphincter dysfunction in humans were considered eligible. Electronic databases, grey literature and reference lists of included studies were systematically searched.\u0000\u0000\u0000REVIEW METHODS\u0000Data were extracted by two independent reviewers. Methodological quality was assessed independently using the PEDro scale and MINORS tool.\u0000\u0000\u0000RESULTS\u0000Of 2938 records identified, 2 studies were eligible. Risk of bias assessment indicated areas of methodological concern in the literature. Statistical analysis was not possible because of the limited number of eligible studies.\u0000\u0000\u0000CONCLUSION\u0000No determinations could be made regarding endoscopic cricopharyngeal myotomy effectiveness in the cohort of interest. Reliable and valid evidence on the following is required to support increasing clinical usage of endoscopic cricopharyngeal myotomy: optimal candidacy selection; standardised post-operative management protocol; complications; and endoscopic cricopharyngeal myotomy effects on aspiration of food and laryngeal penetration, mean upper oesophageal sphincter resting pressure and quality of life.","PeriodicalId":76651,"journal":{"name":"The Journal of laryngology and otology. Supplement","volume":"24 1","pages":"1077-1085"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87939149","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 : 2016-12-01DOI: 10.1017/S0022215116009701
J. Fishman, R. Youngs, E. Fisher, M. Hussain
As the year draws to an end, it gives me time to reflect on what a momentous year it has been for The Journal of Laryngology & Otology. Earlier this year, The Journal supported the publication of the fifth edition of the UK Head and Neck Cancer Guidelines, a truly collaborative, multidisciplinary project which guides clinicians on best practice in head and neck cancer, endorsed by leading national specialty associations involved in head and neck cancer care. Another collaborative effort on an international scale comes in this month’s issue, with the publication of an article written by members and invitees of the International Head and Neck Scientific Group. The group have studied and reported on the behaviour of adenoid cystic tumours arising in rare sites outside of the salivary glands, including the sinonasal tract, nasopharynx, lacrimal gland and external auditory canal. Of the 774 patients identified worldwide, only 5.3 per cent developed documented regional lymph node metastases. The authors conclude that elective neck dissection is not routinely indicated in most patients with these tumours. In addition, the behaviour of adenoid cystic carcinoma at these sites was shown to parallel its behaviour in major salivary glands. Imaging of the Eustachian tube in real time has proven difficult up until now, both because of its anatomical orientation, and the dynamic nature of its open and closed states. A state-of-the-art technique reported by Jufas et al. in this month’s issue overcomes some of the challenges associated with conventional computed tomography (CT) imaging of the Eustachian tube by applying a novel imaging modality known as four-dimensional (4D) CT. This imaging technique provides a fourth dimension to CT sequences of the Eustachian tube (namely time), enabling dynamic imaging. Accompanying the article is a featured video demonstrating a 4D CT cine sequence of the Eustachian tube during a Valsalva manoeuvre (downloadable from: https://goo.gl/AzeLtO). This innovative technique may assist in the diagnosis of patients with abnormal Eustachian tube states, such as Eustachian tube dysfunction or patulous Eustachian tube. Another advantage includes its ability to monitor responses to newer treatments. An elegant study by Mahajan et al. in this month’s issue measured various cardiopulmonary physiological parameters in 25 children with adenotonsillar hypertrophy, both preand post-operatively. The authors found that adenotonsillar hypertrophy affects cardiopulmonary function, which eventually becomes irreversible with time. Furthermore, the authors found significant improvements in pulmonary flow acceleration time, mean pulmonary arterial pressure and tricuspid regurgitation following adenotonsillectomy. The article argues in favour of early intervention in children with obstructive sleep apnoea secondary to adenotonsillar hypertrophy, in order to avoid the development of irreversible cardiopulmonary complications. Also featuring in this mont
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