Pub Date : 2024-09-19DOI: 10.1177/01455613241282410
De Yu, Hai-Bo Xu, Gui-Ping Chen, San-Gang Wu
Objective: To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). Materials and methods: We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. Results: A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively (P < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) (P < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients (P = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) (P = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients (P = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, P = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, P < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. Conclusions: Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.
{"title":"Racial Disparities in Nasopharyngeal Carcinoma Characteristics and Survival.","authors":"De Yu, Hai-Bo Xu, Gui-Ping Chen, San-Gang Wu","doi":"10.1177/01455613241282410","DOIUrl":"https://doi.org/10.1177/01455613241282410","url":null,"abstract":"<p><p><b>Objective:</b> To investigate and compare the distribution of histological subtypes, stage at presentation, and survival outcomes among Chinese American, Non-Hispanic White, and African American patients with nasopharyngeal carcinoma (NPC). <b>Materials and methods:</b> We identified Chinese American, Non-Hispanic White, and African American patients with NPC who were diagnosed between 2010 and 2017. Statistical analyses were conducted using the chi-square test, propensity score matching, Kaplan-Meier analysis, and multivariate Cox proportional hazards models. <b>Results:</b> A total of 1646 eligible patients with NPC were included. Non-Hispanic White accounted for 1049 (63.7%), African Americans for 265 (16.1%), and Chinese Americans for 332 (20.2%), and their median age at diagnosis was 59, 55, and 53 years, respectively (<i>P</i> < .001). Chinese Americans most frequently harbored undifferentiated non-keratinizing squamous cell carcinoma subtype (n = 134, 40.4%) than Non-Hispanic White (n = 164, 15.6%) or African American patients (n = 44, 16.7%) (<i>P</i> < .001). Histological subtype distribution was similar between Non-Hispanic White and African American patients (<i>P</i> = .338). African American patients had the highest rate of stage III to IV disease (n = 206, 77.7%) compared to Non-Hispanic White (n = 704, 67.1%) and Chinese American patients (n = 210, 63.2%) (<i>P</i> = .009). No significant difference in stage distribution was observed between Chinese American and Non-Hispanic White patients (<i>P</i> = .494). Non-Hispanic White patients [hazard ratio (HR) 1.344, 95% confidence interval (CI) 1.007-1.479, <i>P</i> = .045] and African American patients (HR 2.314, 95% CI 1.405-3.813, <i>P</i> < .001) had significantly worse overall survival compared to Chinese American patients. However, race was not associated with NPC-specific survival in the multivariate analysis. Similar results were found after propensity score matching. <b>Conclusions:</b> Race influences the distribution of histological subtypes, stage at presentation, and survival outcomes in NPC.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304575","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 : 2024-09-18DOI: 10.1177/01455613241278755
Yuvatiya Plodpai, Kittisak Thepwongsa
Objective: Asymmetric sensorineural hearing loss (ASNHL) exhibits a higher prevalence among the elderly compared to younger individuals, yet optimal management remains subject to ongoing debate. We aimed to elucidate the clinical disparities among elderly patients with ASNHL, distinguishing between those with and without cerebellopontine angle (CPA) tumors. Methods: A retrospective analysis was conducted on elderly patients (aged ≥65 years) diagnosed with ASNHL who underwent magnetic resonance imaging (MRI) between January 2012 and December 2022 at our tertiary referral center. Results: A total of 119 patients were enrolled, with a median age of 71 years (range: 65-89 years). Among them, 11 patients (9.2%) exhibited abnormal MRI findings. In the CPA tumors group, vestibular schwannoma was the most prevalent abnormality (63.6%), with a mean growth rate of 0.53 mm/year (range: 0-1.33 mm/year). The prevalence of CPA tumors in patients with diabetes mellitus (DM) and ASNHL was significantly lower than in those without DM ( P = .021). Vertigo emerged as a significant associated symptom in cases with CPA tumors ( P = .011). However, there were no significant differences in mean hearing thresholds or asymmetry of hearing loss at individual frequencies between the 2 groups. Conclusions: Elderly patients with ASNHL and vertigo should undergo radiological assessment. Patients with DM exhibit a lower prevalence of CPA tumors than those without DM, warranting careful observation and follow-up due to the limited diagnostic yield of MRI. No discernible differences in audiometric patterns were detected between patients with and without CPA tumors.
{"title":"Differences Among Elderly Patients Having Asymmetric Sensorineural Hearing Loss With and Without Cerebellopontine Angle Tumors","authors":"Yuvatiya Plodpai, Kittisak Thepwongsa","doi":"10.1177/01455613241278755","DOIUrl":"https://doi.org/10.1177/01455613241278755","url":null,"abstract":"Objective: Asymmetric sensorineural hearing loss (ASNHL) exhibits a higher prevalence among the elderly compared to younger individuals, yet optimal management remains subject to ongoing debate. We aimed to elucidate the clinical disparities among elderly patients with ASNHL, distinguishing between those with and without cerebellopontine angle (CPA) tumors. Methods: A retrospective analysis was conducted on elderly patients (aged ≥65 years) diagnosed with ASNHL who underwent magnetic resonance imaging (MRI) between January 2012 and December 2022 at our tertiary referral center. Results: A total of 119 patients were enrolled, with a median age of 71 years (range: 65-89 years). Among them, 11 patients (9.2%) exhibited abnormal MRI findings. In the CPA tumors group, vestibular schwannoma was the most prevalent abnormality (63.6%), with a mean growth rate of 0.53 mm/year (range: 0-1.33 mm/year). The prevalence of CPA tumors in patients with diabetes mellitus (DM) and ASNHL was significantly lower than in those without DM ( P = .021). Vertigo emerged as a significant associated symptom in cases with CPA tumors ( P = .011). However, there were no significant differences in mean hearing thresholds or asymmetry of hearing loss at individual frequencies between the 2 groups. Conclusions: Elderly patients with ASNHL and vertigo should undergo radiological assessment. Patients with DM exhibit a lower prevalence of CPA tumors than those without DM, warranting careful observation and follow-up due to the limited diagnostic yield of MRI. No discernible differences in audiometric patterns were detected between patients with and without CPA tumors.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251223","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 : 2024-09-18DOI: 10.1177/01455613241275320
Brendon K. Warner, Christopher C. Munhall, Sunny Shah, Chada Pitiranggon, Terence James M. Camilon, Shaun A. Nguyen, Robert F. Labadie
Objective: To assess whether preferential hiring practices, particularly self-hiring, are present in academic otolaryngology departments. Setting: A list of academic Otolaryngology—Head and Neck Surgery (O-HNS) departments ranked #1-40 was generated from the Doximity 2021 rankings. The educational background and training information of clinical faculty members and departmental leadership was extracted from each department’s online directories. Methods: Descriptive statistics were used to examine inter/intradepartmental relationships and affiliations of included clinical faculty and departmental leadership based on current employment and medical training sites. A “prior affiliation ratio” was calculated to assess the degree of self-hiring and account for multiple possible prior affiliations (medical school, residency, and fellowship) by dividing all prior self-hired affiliations of faculty by the total number of faculty at each department. Results: A total of 1344 clinical faculty were identified, and 596 (44.35%) had at least 1 prior affiliation with their department. The overall prior affiliation ratio was 0.6, and 7 departments had a value >0.8, with the highest being 1.27 (>1.0 indicating multiple prior affiliations per individual such as both residency and fellowship). A network map of departments #1-10 showed heavy intradepartmental faculty recruitment with 24% of faculty having completed a #1-10 residency, 24% a #11-20 residency, 13% a #21-30 residency, and 11% a #31-40 residency. Totaling this data, 76% of faculty at departments ranked #1-10 had completed training at a program ranked #1-40. Furthermore, our data shows high rates of self-hiring among departmental leadership, (40% of Departmental Chairs and 62.5% of Program Directors) though rates are not significantly higher than self-hiring among faculty overall. Conclusion: The top 40 ranked O-HNS departments have high rates of self-hiring, relying on prestige of training programs and prior affiliation in hiring decisions. The effect on departmental productivity and training is unclear.
{"title":"Assessing Academic Preferential Hiring Practices in Highly Ranked Otolaryngology Departments","authors":"Brendon K. Warner, Christopher C. Munhall, Sunny Shah, Chada Pitiranggon, Terence James M. Camilon, Shaun A. Nguyen, Robert F. Labadie","doi":"10.1177/01455613241275320","DOIUrl":"https://doi.org/10.1177/01455613241275320","url":null,"abstract":"Objective: To assess whether preferential hiring practices, particularly self-hiring, are present in academic otolaryngology departments. Setting: A list of academic Otolaryngology—Head and Neck Surgery (O-HNS) departments ranked #1-40 was generated from the Doximity 2021 rankings. The educational background and training information of clinical faculty members and departmental leadership was extracted from each department’s online directories. Methods: Descriptive statistics were used to examine inter/intradepartmental relationships and affiliations of included clinical faculty and departmental leadership based on current employment and medical training sites. A “prior affiliation ratio” was calculated to assess the degree of self-hiring and account for multiple possible prior affiliations (medical school, residency, and fellowship) by dividing all prior self-hired affiliations of faculty by the total number of faculty at each department. Results: A total of 1344 clinical faculty were identified, and 596 (44.35%) had at least 1 prior affiliation with their department. The overall prior affiliation ratio was 0.6, and 7 departments had a value >0.8, with the highest being 1.27 (>1.0 indicating multiple prior affiliations per individual such as both residency and fellowship). A network map of departments #1-10 showed heavy intradepartmental faculty recruitment with 24% of faculty having completed a #1-10 residency, 24% a #11-20 residency, 13% a #21-30 residency, and 11% a #31-40 residency. Totaling this data, 76% of faculty at departments ranked #1-10 had completed training at a program ranked #1-40. Furthermore, our data shows high rates of self-hiring among departmental leadership, (40% of Departmental Chairs and 62.5% of Program Directors) though rates are not significantly higher than self-hiring among faculty overall. Conclusion: The top 40 ranked O-HNS departments have high rates of self-hiring, relying on prestige of training programs and prior affiliation in hiring decisions. The effect on departmental productivity and training is unclear.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251222","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}
CSF leak-related pneumocephalus is a rare complication of endoscopic transsphenoidal surgery (ETSS) and has been reported in previous studies. We are presenting a rare case of subdural pneumocephalus, unassociated with CSF leak, that developed in the sellar and suprasellar regions. This complication was diagnosed in an adult male 1 week after the removal of a large tumor in the same site via ETSS. The patient presented with a severe headache and visual deterioration. He was diagnosed by a CT scan and managed emergently via ETSS. The headache was relieved immediately after surgery, and the recent visual deterioration was reversed the next day. As far as we have reviewed in the context of complications of ETSS, no previous study has reported such a complication of pneumocephalus unassociated with CSF leak following ETSS. As a conclusion, pneumocephalus can occur with or without CSF leakage as a complication of ETSS, and it may be avoided by a good (water-tight) sealing of the surgical site.
{"title":"A suprasellar Aerocele as a Complication of Endoscopic Transsphenoidal Surgery: A Case Report","authors":"Abdulrahman Awad, Amjad Al-Ali, Aghyad Ahmad, Hussein Al-Abdullah","doi":"10.1177/01455613241276767","DOIUrl":"https://doi.org/10.1177/01455613241276767","url":null,"abstract":"CSF leak-related pneumocephalus is a rare complication of endoscopic transsphenoidal surgery (ETSS) and has been reported in previous studies. We are presenting a rare case of subdural pneumocephalus, unassociated with CSF leak, that developed in the sellar and suprasellar regions. This complication was diagnosed in an adult male 1 week after the removal of a large tumor in the same site via ETSS. The patient presented with a severe headache and visual deterioration. He was diagnosed by a CT scan and managed emergently via ETSS. The headache was relieved immediately after surgery, and the recent visual deterioration was reversed the next day. As far as we have reviewed in the context of complications of ETSS, no previous study has reported such a complication of pneumocephalus unassociated with CSF leak following ETSS. As a conclusion, pneumocephalus can occur with or without CSF leakage as a complication of ETSS, and it may be avoided by a good (water-tight) sealing of the surgical site.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251227","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}
Ewing’s sarcoma (EWS) is a rare malignant bone tumor that primarily affects children and young adults. While it typically affects long bones, it can occur in the head and neck region, including the paranasal sinuses in rare cases. We present a challenging case of a 45-year-old female diagnosed with an EWS of the sphenoidal and the right nasal fossa. A subtotal removal of the mass was performed on the patient followed by combined adjuvant radiotherapy and chemotherapy. Due to its rarity, the diagnosis and management of EWS in the paranasal sinuses are challenging.
{"title":"Primary Ewing Sarcoma in the Sphenoidal Sinus: A Case Report","authors":"Mohamed Amin Chaabouni, Sirine Ayadi, Yasmine Sghaier, Nesrine Sellami, Slim Charfi, Malek Mnejja, Ilhem Charfeddine","doi":"10.1177/01455613241276775","DOIUrl":"https://doi.org/10.1177/01455613241276775","url":null,"abstract":"Ewing’s sarcoma (EWS) is a rare malignant bone tumor that primarily affects children and young adults. While it typically affects long bones, it can occur in the head and neck region, including the paranasal sinuses in rare cases. We present a challenging case of a 45-year-old female diagnosed with an EWS of the sphenoidal and the right nasal fossa. A subtotal removal of the mass was performed on the patient followed by combined adjuvant radiotherapy and chemotherapy. Due to its rarity, the diagnosis and management of EWS in the paranasal sinuses are challenging.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251225","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 : 2024-09-14DOI: 10.1177/01455613241258645
Frederick A. Godley
{"title":"Comment re: “Prevalence and Contributing Factors of Anxiety and Depression in Patients With Vestibular Migraine”","authors":"Frederick A. Godley","doi":"10.1177/01455613241258645","DOIUrl":"https://doi.org/10.1177/01455613241258645","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251226","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}
Background: The coexistence of tuberculosis (TB) and malignancy within the same lymph node is a rare, if not exceptional, pathology, with only a few cases reported. Methods: We collected patients who presented concomitant TB and malignancy within the same cervical lymph node diagnosed during the period (2010-2023). Results: Ten patients were included. They received or were receiving treatment for cancer or TB in 7 cases. All patients presented with recurrent or new lymph nodes despite being under treatment. The 3 remaining patients did not have a history of cancer or TB. Histopathological examination confirmed the coexistence of TB and malignancy within the same lymph node. Histological types of diagnosed cancers included laryngeal squamous cell carcinoma, papillary thyroid carcinoma, nasopharyngeal carcinoma, medullary carcinoma of the thyroid gland, Hodgkin lymphoma, and non-Hodgkin lymphoma. All patients received treatment for TB and cancer. Two patients died from septic complication in 1 case and from pulmonary complication due to miliary TB in 1 case. Conclusions: Concomitant TB and malignancy are possible, especially in countries with a high incidence of TB. Immunocompromised states related to cancer, and its treatments can add the risk of flare-up of a latent infection.
{"title":"Coexistence of Tuberculosis and Malignancy in a Single Cervical Lymph Node: A Case Series.","authors":"Sameh Mezri,Safa Jemli,Chaima Zitouni,Wadii Thabet","doi":"10.1177/01455613241276766","DOIUrl":"https://doi.org/10.1177/01455613241276766","url":null,"abstract":"Background: The coexistence of tuberculosis (TB) and malignancy within the same lymph node is a rare, if not exceptional, pathology, with only a few cases reported. Methods: We collected patients who presented concomitant TB and malignancy within the same cervical lymph node diagnosed during the period (2010-2023). Results: Ten patients were included. They received or were receiving treatment for cancer or TB in 7 cases. All patients presented with recurrent or new lymph nodes despite being under treatment. The 3 remaining patients did not have a history of cancer or TB. Histopathological examination confirmed the coexistence of TB and malignancy within the same lymph node. Histological types of diagnosed cancers included laryngeal squamous cell carcinoma, papillary thyroid carcinoma, nasopharyngeal carcinoma, medullary carcinoma of the thyroid gland, Hodgkin lymphoma, and non-Hodgkin lymphoma. All patients received treatment for TB and cancer. Two patients died from septic complication in 1 case and from pulmonary complication due to miliary TB in 1 case. Conclusions: Concomitant TB and malignancy are possible, especially in countries with a high incidence of TB. Immunocompromised states related to cancer, and its treatments can add the risk of flare-up of a latent infection.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189542","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 : 2024-09-12DOI: 10.1177/01455613241275331
Hassan Alalawi,Abdullah F Alharbi,Hoda Alsayid,Mazin Merdad,Almoaidbellah Rammal,Mohammed A Algarni,Hadi A Al-Hakami,Rajab A Alzahrani,Mohammed Nujoom,Amani Alhozali,Shaza Samargandy,Hani Z Marzouki
Background: Understanding the relationship between aging and postoperative complications is critical because it may influence how the condition is managed. The safety of thyroidectomy in the older age group is debated in literature. All previous studies were conducted outside of the Middle East, and there is a scarcity of data in the literature describing the relationship between age and postoperative outcomes after thyroidectomy. This study aimed to compare the clinical trends of patients undergoing thyroidectomy between younger and older age groups. Methodology: A multicenter retrospective study was conducted at 3 tertiary care centers in Jeddah, Saudi Arabia. Our inclusion criteria consisted of patients of all ages of both sexes who underwent thyroidectomy. Patients were divided into 2 age groups, <60 years and ≥60 years. Chi-square test and independent t test were used to evaluate the differences between qualitative and continuous variables. Logistic regression analysis was performed with postoperative complications and length of hospitalization as the dependent variables. Results: A total of 798 patients were included in this study. The <60 years age group was comprised of 81% female patients and 19% male patients, compared to 63.4% female patients and 36.6% male patients in the ≥60 years age group (P < .001). The ≥60 years age group had a statistically significant longer mean postoperative length of hospitalization (5.37 ± 7.21 days) compared to the <60 age group (3.33 ± 4.24 days; P = .003). A total of 14.4% of the patients in the <60 years age group developed at least one postoperative complication compared to 17.9% of the patients in the ≥60 years age group (P = .385). Seroma and recurrent laryngeal nerve injury occurred more commonly in the ≥60 years age group compared to the <60 years age group with a statistically significant difference (P = .003 and P < .001, respectively). In contrast, hypocalcemia occurred more commonly in patients of the <60 years age group with a statistically significant difference (P = .044). These findings were further verified by multivariate logistic regression after adjustment for gender, type of procedure, and type of diagnosis. Conclusion: In our region, the overall risk of developing postoperative complications was not different between the younger and older age groups. However, certain complications were more likely to develop in the older age group which requires vigilance from surgeons performing thyroidectomy. Likewise, the length of hospitalization was significantly longer in the older population. Awareness of complications and challenges of thyroidectomy in the older age group is crucial to improve care.
{"title":"Age-Related Trends of Thyroidectomies in Saudi Arabia: A Multicenter Retrospective Study.","authors":"Hassan Alalawi,Abdullah F Alharbi,Hoda Alsayid,Mazin Merdad,Almoaidbellah Rammal,Mohammed A Algarni,Hadi A Al-Hakami,Rajab A Alzahrani,Mohammed Nujoom,Amani Alhozali,Shaza Samargandy,Hani Z Marzouki","doi":"10.1177/01455613241275331","DOIUrl":"https://doi.org/10.1177/01455613241275331","url":null,"abstract":"Background: Understanding the relationship between aging and postoperative complications is critical because it may influence how the condition is managed. The safety of thyroidectomy in the older age group is debated in literature. All previous studies were conducted outside of the Middle East, and there is a scarcity of data in the literature describing the relationship between age and postoperative outcomes after thyroidectomy. This study aimed to compare the clinical trends of patients undergoing thyroidectomy between younger and older age groups. Methodology: A multicenter retrospective study was conducted at 3 tertiary care centers in Jeddah, Saudi Arabia. Our inclusion criteria consisted of patients of all ages of both sexes who underwent thyroidectomy. Patients were divided into 2 age groups, <60 years and ≥60 years. Chi-square test and independent t test were used to evaluate the differences between qualitative and continuous variables. Logistic regression analysis was performed with postoperative complications and length of hospitalization as the dependent variables. Results: A total of 798 patients were included in this study. The <60 years age group was comprised of 81% female patients and 19% male patients, compared to 63.4% female patients and 36.6% male patients in the ≥60 years age group (P < .001). The ≥60 years age group had a statistically significant longer mean postoperative length of hospitalization (5.37 ± 7.21 days) compared to the <60 age group (3.33 ± 4.24 days; P = .003). A total of 14.4% of the patients in the <60 years age group developed at least one postoperative complication compared to 17.9% of the patients in the ≥60 years age group (P = .385). Seroma and recurrent laryngeal nerve injury occurred more commonly in the ≥60 years age group compared to the <60 years age group with a statistically significant difference (P = .003 and P < .001, respectively). In contrast, hypocalcemia occurred more commonly in patients of the <60 years age group with a statistically significant difference (P = .044). These findings were further verified by multivariate logistic regression after adjustment for gender, type of procedure, and type of diagnosis. Conclusion: In our region, the overall risk of developing postoperative complications was not different between the younger and older age groups. However, certain complications were more likely to develop in the older age group which requires vigilance from surgeons performing thyroidectomy. Likewise, the length of hospitalization was significantly longer in the older population. Awareness of complications and challenges of thyroidectomy in the older age group is crucial to improve care.","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142189571","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 : 2024-09-12DOI: 10.1177/01455613241271686
Jeong Wook Kang, Joo Kyung Noh, Min Kyeong Lee, Yeon Seo Lee, Young Chan Lee, Jung-Woo Lee, Moonkyoo Kong, Seong-Gyu Ko, Young-Gyu Eun
Objective : The size of T4 tumor could vary in oropharyngeal squamous cell carcinoma (OPSCC). Using the Surveillance, Epidemiology, and End Results (SEER) database, this study aimed to investigate the role of tumor size in the prognosis of patients with T4 OPSCC. Study Design: Retrospective cross-sectional. Setting: SEER-Medicare-linked database. Methods: This study enrolled 1153 patients diagnosed with T4 OPSCC from the SEER registry between 2010 and 2016. The primary study variables were tumor size, human papillomavirus (HPV) infection, and disease-specific survival (DSS). Primary tumor size and clinicopathological variables according to HPV status were analyzed using Kaplan–Meier survival curves and Cox proportional hazards regression. Results: The 5-year DSS of patients with HPV-negative T4 OPSCC tumors ≤1 cm was worse than that of patients with tumors >1 cm ( P < .001). The results were consistent even after propensity score matching ( P = .002). Tumors ≤1 cm had a hazard ratio (HR) as high as that of distant metastasis (HR 2.8 vs HR 2.6, P = .006). A decreased DSS of ≤ 1 cm tumors was observed in HPV-negative T4 OPSCC, but not in HPV-positive T4 OPSCC ( P < .001 vs P = .96). Conclusion: A tumor diameter ≤1 cm was associated with poor prognosis in patients with HPV-negative T4 OPSCC. Tumor diameter ≤1 cm could be a predictive factor for poor outcomes in HPV-negative T4 OPSCC.
目的：口咽鳞状细胞癌（OPSCC）T4肿瘤的大小可能有所不同。本研究利用监测、流行病学和最终结果（SEER）数据库，旨在研究肿瘤大小在T4 OPSCC患者预后中的作用。研究设计：回顾性横断面研究。研究地点SEER-医保链接数据库。研究方法本研究从SEER登记处招募了1153名在2010年至2016年间被诊断为T4 OPSCC的患者。主要研究变量为肿瘤大小、人乳头瘤病毒（HPV）感染和疾病特异性生存（DSS）。采用卡普兰-梅耶生存曲线和考克斯比例危险度回归分析了HPV状态下的原发肿瘤大小和临床病理变量。结果显示HPV阴性T4 OPSCC肿瘤≤1厘米患者的5年DSS比肿瘤>1厘米的患者差（P< .001）。即使在倾向评分匹配后，结果也是一致的（P = .002）。肿瘤≤1厘米的危险比（HR）与远处转移的危险比（HR 2.8 vs HR 2.6，P = .006）一样高。在HPV阴性的T4 OPSCC中观察到≤1厘米肿瘤的DSS降低，但在HPV阳性的T4 OPSCC中未观察到（P < .001 vs P = .96）。结论肿瘤直径≤1厘米与HPV阴性T4 OPSCC患者的不良预后有关。肿瘤直径≤1厘米可能是HPV阴性T4 OPSCC预后不良的一个预测因素。
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