Pub Date : 2019-01-01DOI: 10.37532/JOR.2019.8(1).362
Clare Hutchinson, F. Toner, K. Trimble
Objective: Antrochoanal Polyps can be problematic to remove fully due to their location and instruments available. Method: Using a combination of paediatric and adult sized instruments, viewed with 30 and 70 degree endoscopes, we could partially remove the polyp through a large middle meatal antrostomy (MMA). Being unable to reach the remaining stalk, despite proceeding to an inferior antrostomy (IA), we realised the need for a more acute-angled instrument. By curving the monopolar Valleylab suction diathermy (MVSD), mimicking the curved microdebrider, we inserted this through our MMA. With an endoscope and a curved ball probe through the IA, we further increased the angle of the MVSD and cauterised the base of the polyp. Results: Clinically the polyp appeared to be fully resected. Conclusion: Consideration must be given to the infraorbital nerve and its relation to the base of the polyp. With this in mind, it is a safe technique.
{"title":"Debride and Conquer: A New Angle in Endoscopic Removal of Antrochoanal Polyps","authors":"Clare Hutchinson, F. Toner, K. Trimble","doi":"10.37532/JOR.2019.8(1).362","DOIUrl":"https://doi.org/10.37532/JOR.2019.8(1).362","url":null,"abstract":"Objective: Antrochoanal Polyps can be problematic to remove fully due to their location and instruments available. Method: Using a combination of paediatric and adult sized instruments, viewed with 30 and 70 degree endoscopes, we could partially remove the polyp through a large middle meatal antrostomy (MMA). Being unable to reach the remaining stalk, despite proceeding to an inferior antrostomy (IA), we realised the need for a more acute-angled instrument. By curving the monopolar Valleylab suction diathermy (MVSD), mimicking the curved microdebrider, we inserted this through our MMA. With an endoscope and a curved ball probe through the IA, we further increased the angle of the MVSD and cauterised the base of the polyp. Results: Clinically the polyp appeared to be fully resected. Conclusion: Consideration must be given to the infraorbital nerve and its relation to the base of the polyp. With this in mind, it is a safe technique.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2019 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69924961","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 : 2019-01-01DOI: 10.37532/JOR.2019.8(1).371
T. Kusunoki, Hirotomo Homma, Yoshinobu Kidokoro, Aya Yanai, S. Hara, R. Wada, Kazuya Saito, K. Ikeda
Sinonasal tumors with neuroendocrine differentiation are a rare group of neoplasms that account for only 5% of all sinonasal malignancies. Paranasal neoplasms very rarely arise postoperatively from the maxillary sinus. We encountered a case of neuroendocrine carcinoma arising in a wound after endoscopic sinus surgery for maxillary sinusitis. At the first medical examination, we tried to discriminate between maxillary tumor and postoperative recurrence of maxillary sinusitis.
{"title":"Neuroendocrine Carcinoma Arising in a Wound after Endoscopic Sinus Surgery for Maxillary Sinusitis","authors":"T. Kusunoki, Hirotomo Homma, Yoshinobu Kidokoro, Aya Yanai, S. Hara, R. Wada, Kazuya Saito, K. Ikeda","doi":"10.37532/JOR.2019.8(1).371","DOIUrl":"https://doi.org/10.37532/JOR.2019.8(1).371","url":null,"abstract":"Sinonasal tumors with neuroendocrine differentiation are a rare group of neoplasms that account for only 5% of all sinonasal malignancies. Paranasal neoplasms very rarely arise postoperatively from the maxillary sinus. We encountered a case of neuroendocrine carcinoma arising in a wound after endoscopic sinus surgery for maxillary sinusitis. At the first medical examination, we tried to discriminate between maxillary tumor and postoperative recurrence of maxillary sinusitis.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2019 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69925020","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 : 2019-01-01DOI: 10.37532/JOR.2019.8(3).376
A. Jeyakumar, Matthew Keisling
17 year old female with a history of stage IVS neuroblastoma diagnosed at the age of 4 months. She received cis-retinoic acid post radiation and completed all therapy at the age of 4 years. During a routine audio logic visit, she was noted to have a mass in her right ear (Figure 1). A CT scan was done which showed a small homogenous well circumscribed mass in the left external auditory canal (Figure 2). The mass was biopsied in both left and right ear and the pathology is shown in Figure 3, with a diagnosis of a Schwannoma.
{"title":"Unusual Ear Mass","authors":"A. Jeyakumar, Matthew Keisling","doi":"10.37532/JOR.2019.8(3).376","DOIUrl":"https://doi.org/10.37532/JOR.2019.8(3).376","url":null,"abstract":"17 year old female with a history of stage IVS neuroblastoma diagnosed at the age of 4 months. She received cis-retinoic acid post radiation and completed all therapy at the age of 4 years. During a routine audio logic visit, she was noted to have a mass in her right ear (Figure 1). A CT scan was done which showed a small homogenous well circumscribed mass in the left external auditory canal (Figure 2). The mass was biopsied in both left and right ear and the pathology is shown in Figure 3, with a diagnosis of a Schwannoma.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2019 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69925205","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 : 2018-10-11DOI: 10.4172/2324-8785.1000349
Alex, R. Gomes, R. Veloso-Teles, F. Silva, Rui Fonseca
Laryngocele is a rare benign dilatation of the laryngeal saccule, which is filled with air. Prevalence of laryngocele is five times higher in men; its aetiology is still unclear which includes some congenital and acquired conditions. In this study we have presented a case of 19 year-old-boy, an oboe player, who was observed with a bilateral swelling of the neck and after undertaking the Otorhinolaryngological examination, it revealed a bilateral painless mass in the neck that increased in size and also Computed tomography (CT) and histopathological report demonstrated it as laryngocele. We have performed bilateral cervical approach and removed the laryngoceles. We have reported rare association of laryngocele with laryngeal carcinoma, especially supraglottic carcinoma in this study
{"title":"Bilateral Mixed Laryngocele in an Oboe Player","authors":"Alex, R. Gomes, R. Veloso-Teles, F. Silva, Rui Fonseca","doi":"10.4172/2324-8785.1000349","DOIUrl":"https://doi.org/10.4172/2324-8785.1000349","url":null,"abstract":"Laryngocele is a rare benign dilatation of the laryngeal saccule, which is filled with air. Prevalence of laryngocele is five times higher in men; its aetiology is still unclear which includes some congenital and acquired conditions. In this study we have presented a case of 19 year-old-boy, an oboe player, who was observed with a bilateral swelling of the neck and after undertaking the Otorhinolaryngological examination, it revealed a bilateral painless mass in the neck that increased in size and also Computed tomography (CT) and histopathological report demonstrated it as laryngocele. We have performed bilateral cervical approach and removed the laryngoceles. We have reported rare association of laryngocele with laryngeal carcinoma, especially supraglottic carcinoma in this study","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48658927","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 : 2018-10-11DOI: 10.4172/2324-8785.1000353
P. Symeonides, S. Mirza
Introduction: Epistaxis is a very common presenting complaint. A small percentage of patients will require surgical intervention for severe epistaxis. Methods: We describe our experience in 3 consecutive patients and how we perform endoscopic sphenopalatatine artery ligation (ESPAL), as an elective procedure for patients with multiple hospital admissions for epistaxis. Results: All patients remain free of epistaxis up to date. Conclusions: Elective ESPAL is an effective treatment option for a carefully selected group of patients.
{"title":"Elective Sphenopalatine Artery Ligation for Recurrent Epistaxis","authors":"P. Symeonides, S. Mirza","doi":"10.4172/2324-8785.1000353","DOIUrl":"https://doi.org/10.4172/2324-8785.1000353","url":null,"abstract":"Introduction: Epistaxis is a very common presenting complaint. A small percentage of patients will require surgical intervention for severe epistaxis. \u0000Methods: We describe our experience in 3 consecutive patients and how we perform endoscopic sphenopalatatine artery ligation (ESPAL), as an elective procedure for patients with multiple hospital admissions for epistaxis. \u0000Results: All patients remain free of epistaxis up to date. Conclusions: Elective ESPAL is an effective treatment option for a carefully selected group of patients.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46220764","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 : 2018-10-11DOI: 10.4172/2324-8785.1000352
Rooney Ac, S. Malekzadeh, Richard Wagner, M. Hoa
Objective: To determine educational benefits for physicians abroad who participated in a United States-based medical mission training program in otologic pathology and surgery. Methods: The sample population included physicians from Peru and Paraguay who participated as trainees in a humanitarian program through the Global ENT Outreach organization. A written survey was distributed to 12 Peruvian participants after a temporal bone course in which surgical anatomy and operative procedures of the ear were taught. The survey was also emailed to 164 physicians who participated in the same temporal bone course in Peru and Paraguay in years past. The Kirkpatrick model for evaluating a training program was used as a guide for survey development. Participants rated their satisfaction with the training as well as knowledge, technical skill, and confidence in performing certain surgical procedures before versus after the training course. Descriptive statistics, the Wilcoxon rank-sum test, and the Wilcoxon- Mann-Whitney test were used for data analysis. Results: Overall, participants were highly satisfied with the quality of the training, with mean satisfaction rating of 4.2 ± 0.77 and would like the organization to return for further training (4.7 ± 0.57). Participants also agreed that they have changed or will change how they perform surgery after taking the course (4.2 ± 0.83). There was a statistically significant increase in self-rated knowledge of mastoid anatomy, middle ear anatomy, chronic otitis media, otosclerosis, and cholesteatoma (p<0.0001). There was also improved selfrated technical skill and confidence in performing tympanoplasty, mastoidectomy, stapedectomy, and ossiculoplasty procedures (p<0.0001). Conclusions: This study highlights positive opinions of communities abroad regarding a visiting humanitarian medical training program, and also suggests achievement of the program’s initial goals of improving knowledge of otologic pathology and increasing technical skill and confidence in performing various surgical procedures
{"title":"Educational Benefits for Local Healthcare Providers Participating in a Short-Term International Humanitarian Medical Training Program","authors":"Rooney Ac, S. Malekzadeh, Richard Wagner, M. Hoa","doi":"10.4172/2324-8785.1000352","DOIUrl":"https://doi.org/10.4172/2324-8785.1000352","url":null,"abstract":"Objective: To determine educational benefits for physicians abroad who participated in a United States-based medical mission training program in otologic pathology and surgery. Methods: The sample population included physicians from Peru and Paraguay who participated as trainees in a humanitarian program through the Global ENT Outreach organization. A written survey was distributed to 12 Peruvian participants after a temporal bone course in which surgical anatomy and operative procedures of the ear were taught. The survey was also emailed to 164 physicians who participated in the same temporal bone course in Peru and Paraguay in years past. The Kirkpatrick model for evaluating a training program was used as a guide for survey development. Participants rated their satisfaction with the training as well as knowledge, technical skill, and confidence in performing certain surgical procedures before versus after the training course. Descriptive statistics, the Wilcoxon rank-sum test, and the Wilcoxon- Mann-Whitney test were used for data analysis. Results: Overall, participants were highly satisfied with the quality of the training, with mean satisfaction rating of 4.2 ± 0.77 and would like the organization to return for further training (4.7 ± 0.57). Participants also agreed that they have changed or will change how they perform surgery after taking the course (4.2 ± 0.83). There was a statistically significant increase in self-rated knowledge of mastoid anatomy, middle ear anatomy, chronic otitis media, otosclerosis, and cholesteatoma (p<0.0001). There was also improved selfrated technical skill and confidence in performing tympanoplasty, mastoidectomy, stapedectomy, and ossiculoplasty procedures (p<0.0001). Conclusions: This study highlights positive opinions of communities abroad regarding a visiting humanitarian medical training program, and also suggests achievement of the program’s initial goals of improving knowledge of otologic pathology and increasing technical skill and confidence in performing various surgical procedures","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2018 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41906900","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 : 2018-10-06DOI: 10.4172/2324-8785.1000343
Nguyên Vt, T. Jagomagi
Objective: This study aimed to investigate the feelings of Vietnamese mothers having a child with cleft lip and/or palate (CL/P), their belief in the causation of CL/P, and changes in their postpartum life. Method: A total of 76 mothers participated in this retrospective study. Questionnaires were used to gather information. Results: The prominent feeling was sadness. Almost half of the mothers did not think about the reason of CL/P.A majority of the mothers received support from the husband and/or family members. No changes in the mother’s postpartum life were recorded in nearly half of the responses. Conclusions: Vietnamese mothers' feelings were negative but less extreme and intense. Many were not aware of the causes of the defect. Changes in their life were little.
{"title":"Maternal Experiences of Having a Child with a Cleft","authors":"Nguyên Vt, T. Jagomagi","doi":"10.4172/2324-8785.1000343","DOIUrl":"https://doi.org/10.4172/2324-8785.1000343","url":null,"abstract":"Objective: This study aimed to investigate the feelings of Vietnamese mothers having a child with cleft lip and/or palate (CL/P), their belief in the causation of CL/P, and changes in their postpartum life. \u0000Method: A total of 76 mothers participated in this retrospective study. Questionnaires were used to gather information. \u0000Results: The prominent feeling was sadness. Almost half of the mothers did not think about the reason of CL/P.A majority of the mothers received support from the husband and/or family members. No changes in the mother’s postpartum life were recorded in nearly half of the responses. \u0000Conclusions: Vietnamese mothers' feelings were negative but less extreme and intense. Many were not aware of the causes of the defect. Changes in their life were little.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46842194","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 : 2018-10-06DOI: 10.4172/2324-8785.1000345
B. Obradović
Lower, impacted third molar surgery (ITMS) is a common procedure in oral & maxillofacial surgery around the world. By its nature, it often results in pain, swelling, trismus, bleeding, nerve dysfunction and postoperative infection. The author presents clinical study on 18 patients where ITMS were performed. Modified incision as a minimally invasive approach to lower impacted third molars jointly with suitable preoperative and surgical management significantly reduce postoperative symptoms usually accompanied with this type of surgery.
{"title":"Lower Impacted Third Molar Surgery - Small Things, Big Improvements","authors":"B. Obradović","doi":"10.4172/2324-8785.1000345","DOIUrl":"https://doi.org/10.4172/2324-8785.1000345","url":null,"abstract":"Lower, impacted third molar surgery (ITMS) is a common procedure in oral & maxillofacial surgery around the world. By its nature, it often results in pain, swelling, trismus, bleeding, nerve dysfunction and postoperative infection. The author presents clinical study on 18 patients where ITMS were performed. Modified incision as a minimally invasive approach to lower impacted third molars jointly with suitable preoperative and surgical management significantly reduce postoperative symptoms usually accompanied with this type of surgery.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2018 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2018-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41548131","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 : 2018-10-06DOI: 10.4172/2324-8785.1000348
A. Aa, M. Og, Swelam Sh, Saedii Aa, S. Moftah
Introduction: Otitis media is one of the most common diseases in children. It is believed that gastroesophageal reflux disease (GERD) is a predisposing factor in most upper respiratory tract problems including pharyngoesophagitis, croup, oropharyngeal adenophagia, rhinosinusitis, and otitis media. The probable role of H.pylori in otitis media with effusion (OME) was investigated in this study. Methods: Fresh stool specimens and serum samples from 40 children with OME were analyzed with antigen in stool and antibody in serum. The effusion samples were taken and analyzed using rapid urease test (RUT) and Polymerase Chain Reaction (PCR). Results: RUT was positive in 13 (32.5%) patients and PCR was positive in 15 (37.5%) patients. Ag in stool was positive in 27 (67.5%) and Ab in serum was positive 21 (52.5%). Conclusion: The presence of H.pylori in the middle ear effusion and stool indicates that this bacterium might be involved in the pathogenesis of OME.
{"title":"Study of Helicobacter pylori in Middle Ear Effusion in Children","authors":"A. Aa, M. Og, Swelam Sh, Saedii Aa, S. Moftah","doi":"10.4172/2324-8785.1000348","DOIUrl":"https://doi.org/10.4172/2324-8785.1000348","url":null,"abstract":"Introduction: Otitis media is one of the most common diseases in children. It is believed that gastroesophageal reflux disease (GERD) is a predisposing factor in most upper respiratory tract problems including pharyngoesophagitis, croup, oropharyngeal adenophagia, rhinosinusitis, and otitis media. The probable role of H.pylori in otitis media with effusion (OME) was investigated in this study. \u0000Methods: Fresh stool specimens and serum samples from 40 children with OME were analyzed with antigen in stool and antibody in serum. The effusion samples were taken and analyzed using rapid urease test (RUT) and Polymerase Chain Reaction (PCR). \u0000Results: RUT was positive in 13 (32.5%) patients and PCR was positive in 15 (37.5%) patients. Ag in stool was positive in 27 (67.5%) and Ab in serum was positive 21 (52.5%). \u0000Conclusion: The presence of H.pylori in the middle ear effusion and stool indicates that this bacterium might be involved in the pathogenesis of OME.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":"2018 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41620394","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 : 2018-10-06DOI: 10.4172/2324-8785.1000346
J. Waxman, Ho-sheng Lin, S. Raza
Objective: Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM), have undergone significant evolution for the treatment of oropharyngeal squamous cell (OPSCC). However, few have directly compared both methodologies. The objective of this work was to summarize and compare published data on surgical, functional, and oncological outcomes of TORS and TLM for the treatment of OPSCC. Methods: A literature search of MEDLINE, EMBASE, Web of Science, and The Cochrane Library databases was conducted to review studies that reported outcomes of TORS or TLM for primary OPSCC. Results: Studies that reported outcomes of TORS or TLM for primary OPSCC were included. 24 TORS studies including 801 patients and 14 TLM studies including 823 patients were identified. Only retrospective and non-randomized prospective studies were found. Despite significant heterogeneity and incomplete data, TORS and TLM resulted in similar hospital lengths of stay, operative times, positive margins, complication profiles, and tracheostomy and gastrostomy rates. Limited data suggests similar impacts on swallow function and quality of life; however, this assessment was confounded by adjuvant treatment. While TLM studies reported worse oncological outcomes, this is likely due to larger, more advanced tumors in the TLM group. Conclusions: Due to significant heterogeneity in study design, population characteristics, indications for adjuvant treatment, p16/ HPV status, and tumor stage, it was not possible to make any definitive conclusions about the superiority of one technique over the other. However, pooled analyses suggest that TORS and TLM result in similar surgical, functional, and oncological outcomes for the treatment of OPSCC. To accurately assess the impact of TORS versus TLM on outcomes, especially in combination with possible de-escalation adjuvant treatment protocols for HPV positive tumors, carefully constructed randomized controlled trials must be conducted.
目的：经口机器人手术（TORS）和经口激光显微外科（TLM）在治疗口咽鳞状细胞（OPSCC）方面取得了重大进展。然而，很少有人直接比较这两种方法。这项工作的目的是总结和比较已发表的关于TORS和TLM治疗OPSCC的手术、功能和肿瘤学结果的数据。方法：检索MEDLINE、EMBASE、Web of Science和The Cochrane Library数据库的文献，回顾报告原发性OPSCC的TORS或TLM结果的研究。结果：纳入了报告原发性OPSCC的TORS或TLM结果的研究。确定了24项TORS研究（包括801名患者）和14项TLM研究（包括823名患者）。只发现了回顾性和非随机前瞻性研究。尽管存在显著的异质性和不完整的数据，但TORS和TLM导致了相似的住院时间、手术时间、阳性边缘、并发症情况以及气管造口术和胃造口术的发生率。有限的数据表明，对吞咽功能和生活质量也有类似的影响；然而，这种评估被辅助治疗所混淆。虽然TLM研究报告了更差的肿瘤学结果，但这可能是由于TLM组中更大、更晚期的肿瘤。结论：由于研究设计、人群特征、辅助治疗指征、p16/HPV状态和肿瘤分期的显著异质性，不可能对一种技术优于另一种技术得出任何明确的结论。然而，汇总分析表明，TORS和TLM在OPSCC的治疗中产生了相似的手术、功能和肿瘤学结果。为了准确评估TORS与TLM对结果的影响，特别是与HPV阳性肿瘤可能的降级辅助治疗方案相结合，必须进行精心构建的随机对照试验。
{"title":"Transoral Robotic Surgery versus Transoral Laser Microsurgery for Oropharyngeal Squamous Cell Carcinoma: A Systematic Review","authors":"J. Waxman, Ho-sheng Lin, S. Raza","doi":"10.4172/2324-8785.1000346","DOIUrl":"https://doi.org/10.4172/2324-8785.1000346","url":null,"abstract":"Objective: Transoral robotic surgery (TORS) and transoral laser microsurgery (TLM), have undergone significant evolution for the treatment of oropharyngeal squamous cell (OPSCC). However, few have directly compared both methodologies. The objective of this work was to summarize and compare published data on surgical, functional, and oncological outcomes of TORS and TLM for the treatment of OPSCC. \u0000Methods: A literature search of MEDLINE, EMBASE, Web of Science, and The Cochrane Library databases was conducted to review studies that reported outcomes of TORS or TLM for primary OPSCC. \u0000Results: Studies that reported outcomes of TORS or TLM for primary OPSCC were included. 24 TORS studies including 801 patients and 14 TLM studies including 823 patients were identified. Only retrospective and non-randomized prospective studies were found. Despite significant heterogeneity and incomplete data, TORS and TLM resulted in similar hospital lengths of stay, operative times, positive margins, complication profiles, and tracheostomy and gastrostomy rates. Limited data suggests similar impacts on swallow function and quality of life; however, this assessment was confounded by adjuvant treatment. While TLM studies reported worse oncological outcomes, this is likely due to larger, more advanced tumors in the TLM group. \u0000Conclusions: Due to significant heterogeneity in study design, population characteristics, indications for adjuvant treatment, p16/ HPV status, and tumor stage, it was not possible to make any definitive conclusions about the superiority of one technique over the other. However, pooled analyses suggest that TORS and TLM result in similar surgical, functional, and oncological outcomes for the treatment of OPSCC. To accurately assess the impact of TORS versus TLM on outcomes, especially in combination with possible de-escalation adjuvant treatment protocols for HPV positive tumors, carefully constructed randomized controlled trials must be conducted.","PeriodicalId":90613,"journal":{"name":"Journal of otology & rhinology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2018-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45757212","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}
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