Clinical Otolaryngology最新文献

{"title":"Endoscopic Integrated Multipoint Laser System to Perform Quantitative Measurements for Anterior Skull Base Defects","authors":"Gani Nuredini, Priscilla Parmar, Andrew Hall, Annakan Navaratnam","doi":"10.1111/coa.14219","DOIUrl":"10.1111/coa.14219","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"150-154"},"PeriodicalIF":1.7,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Relationships Between Clinical Examination Findings, Subjective Reported Symptoms and Objective Nasal Patency Measures in Nasal Obstruction: A Baseline NAIROS Sub-Study Analysis","authors":"Pavithran Maniam,&nbsp;Alison Bray,&nbsp;Michael Drinnan,&nbsp;Tony Fouweather,&nbsp;M. Dawn Teare,&nbsp;Sean Carrie,&nbsp;James O'Hara","doi":"10.1111/coa.14221","DOIUrl":"10.1111/coa.14221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a sub-study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub-study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB–arbitrarily divided by &lt;50% and &gt;50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean NPR for left-sided, both-sided and right-sided septal deviation was −0.35, −0.02 and 0.51, respectively (<i>p</i> &lt; 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, <i>p</i> &lt; 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated &lt;50% and &gt;50%. The mean NPR for participants with ORAB &gt;50% was higher than for those with ORAB &lt;50% (0.51 vs. 0.41, <i>p</i> = 0.002). There was strong correlation between the DOASS and NPR (+0.737, <i>p</i> &lt; 0.001). The mean DOASS score for right-sided, both-sided and left-sided septal deviation was 0.32, 0.05 and −0.29, respectively (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"22-30"},"PeriodicalIF":1.7,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of In-Office Transnasal Oesophagoscopy and Balloon Dilatation for Patients Presenting With High Dysphagia: A 6-Year Retrospective Analysis","authors":"Chang Woo Lee,&nbsp;Virginia Fancello,&nbsp;Alex Dando,&nbsp;Fenella Bennett,&nbsp;Virginia Ludwig,&nbsp;Kate J. Heathcote","doi":"10.1111/coa.14222","DOIUrl":"10.1111/coa.14222","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"143-149"},"PeriodicalIF":1.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Management of Asymptomatic Unilateral Tonsillar Enlargement—Can We Avoid Diagnostic Surgery?","authors":"E. Tian Tan,&nbsp;Laura Simpson,&nbsp;Rory Braggins,&nbsp;Ovie Edafe","doi":"10.1111/coa.14218","DOIUrl":"10.1111/coa.14218","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"137-142"},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal Facial Function in the Sunnybrook Facial Grading System: Is the 100% Score too Restrictive?","authors":"Diane Picard,&nbsp;Remi Hervochon,&nbsp;Elodie Lannadere,&nbsp;Cloe Cabos,&nbsp;Loeiza Gourves,&nbsp;Frederic Tankere,&nbsp;Peggy Gatignol","doi":"10.1111/coa.14217","DOIUrl":"10.1111/coa.14217","url":null,"abstract":"&lt;p&gt;The Sunnybrook Facial Grading System (SFGS) is a widely recognized tool for assessing facial palsy and its subsequent recovery, offering a standardized approach for quantifying facial movements [&lt;span&gt;1&lt;/span&gt;]. This scale compares the paralyzed hemiface to the healthy hemiface of patients using a total composite score between 0% and 100%, where 100% corresponds to full recovery of facial function. The SFGS evaluate five facial movements, symmetry at rest and the presence of synkinesis. The total composite score is calculated by subtracting the symmetry and synkinesis scores from the dynamic movement score.&lt;/p&gt;&lt;p&gt;This scale and total composite score have proven to be a gold standard in clinical practice and research [&lt;span&gt;2&lt;/span&gt;]. Even if it has been shown to be more sensitive in detecting changes following therapeutic intervention, the SFGS remains largely subjective [&lt;span&gt;3&lt;/span&gt;]. Moreover, the widespread assumption of achieving a perfect 100% may not deal with the natural variations of face symmetry observed in healthy individuals and in patients with facial palsy [&lt;span&gt;4&lt;/span&gt;]. Indeed, there is valuable evidence of asymmetry in the production of facial expressions in the general population, even in the absence of facial palsy [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;This study aims to provide a more comprehensive understanding of the natural range of SFGS scores among healthy participants, thereby redefining the normative standards and advocating for a more patient-centred and holistic approach to facial rehabilitation.&lt;/p&gt;&lt;p&gt;Upon analyzing the SFGS scores, it was observed that the range differed depending on whether the right or left hemiface was considered the reference. Taking the right hemiface as a reference, SFGS-Total scores ranged from 65% to 100% (median = 96, IQR [91–100]). When the left hemiface was considered as the reference, scores ranged from 78% to 100% (median = 95; IQR [90–100]). No participants showed any synkinesis. No significant differences between the SFGS-Total scores according to the reference hemiface were found on the whole sample (&lt;i&gt;p&lt;/i&gt; = 0.517). The data are reported by age and gender in Table 1. Data distribution using violin plots is reported in Figure 1.&lt;/p&gt;&lt;p&gt;Consistency between evaluators were high for right and left SFGS-Total scores (respectively α = 0.953 and α = 0.926). Right and left SFGS-Rest scores showed also high inter-rater reliability (respectively α = 0.860 and α = 0.886) as well as right and left SFGS-Movement scores (respectively α = 0.957 and α = 0.816).&lt;/p&gt;&lt;p&gt;There was a slight negative correlation between age and SFGS-Total scores. Indeed, the older the participants, the lower their scores (right side as reference: ρ (109) = −0.37, &lt;i&gt;p&lt;/i&gt; &lt; 0.0001, 95% CI [−0.52, −0.20]; left side as reference: ρ (109) = −0.25; &lt;i&gt;p&lt;/i&gt; = 0.009; 95% CI [−0.42, −0.06], Figure 2). Post hoc comparisons using Kruskall–Wallis test indicated that there was a significant difference in the SFGS-Total scores (right","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"132-136"},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our experience: Pharyngeal Pouches, a Multimodal Approach to Treatment Under a Single Anaesthetic. A Retrospective Analysis of a Cohort of 105 Cases","authors":"Tom Bradish,&nbsp;David Hamilton,&nbsp;James O'Hara","doi":"10.1111/coa.14209","DOIUrl":"10.1111/coa.14209","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"833-836"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of McGill Oximetry Score in Improving the Diagnostic Capability of Paediatric OSA","authors":"Wannitta E. Ting Wong,&nbsp;Jeyasakthy Saniasiaya,&nbsp;Nur Syazwani Mohd Salehuddin,&nbsp;Shih Ying H'ng,&nbsp;Anna Marie Nathan","doi":"10.1111/coa.14214","DOIUrl":"10.1111/coa.14214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>This prospective diagnostic accuracy study was divided into two phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study was conducted at a quaternary teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Polysomnograms performed from 1 April 2014 to 31 December 2021 were included. In Phase 1, the parameters of 95 oximetry trend graphs were evaluated, and a modified scoring system was constructed. In Phase 2, the modified scoring system was employed in 272 oximetry trend graphs, and its diagnostic accuracy was determined. A logistic regression model was used to assess the ability of each scoring system to predict paediatric OSAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 367 patients were recruited. In Phase 1, a four-tier severity classification system was constructed. In Phase 2, its diagnostic accuracy was found to be 53.3% sensitive, 97% specific, with positive predictive value of 98.5% and negative predictive value of 34.6%. The lowest detectable apnoea–hypopnoea index (AHI) was 4.5. The inter-rater reliability calculated was 80%. Logistic regression was applied to assess associations of the modified McGill score (MMS) or McGill oximetry score (MOS) with OSAS. The area under the receiver operating characteristic curve was higher for the MMS than for MOS (0.78 [95% CI 0.73–0.84] vs. 0.59 [95% CI 0.51–0.66]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that our modified scoring system had increased sensitivity at detecting OSAS at a much lower AHI and showed a much greater ability to predict paediatric OSAS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"801-809"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Patient and Tumor Characteristics With Outcomes in Young Head and Neck Squamous Cell Carcinoma Patients","authors":"Ronan W. Hsieh,&nbsp;William E. Gooding,&nbsp;Marci Nilsen,&nbsp;Mark Kubik,&nbsp;Zahra Kelly,&nbsp;Shaum Sridharan,&nbsp;Heath Skinner,&nbsp;Uzoma Iheagwara,&nbsp;Jose P. Zevallos,&nbsp;Umamaheswar Duvvuri,&nbsp;Seungwon Kim,&nbsp;Robert L. Ferris,&nbsp;Dan P. Zandberg","doi":"10.1111/coa.14215","DOIUrl":"10.1111/coa.14215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We retrospectively studied young patients with head and neck squamous cell carcinoma (HNSCC) to identify factors associated with disease-specific survival (DSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient and tumor characteristics of patients aged ≤45 who received treatments for non-metastatic HNSCC were collected to identify factors associated with DSS. Proportional hazards regression was applied separately for surgical and non-surgical patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>230 patients were included. Surgical and non-surgical patients had similar DSS. Higher pathologic stages, positive margins, perineural invasion (PNI), extranodal extension and negative HPV status were associated with worse DSS for surgical patients and negative HPV status for non-surgical patients. In the multivariate analysis, pathologic stages, positive margins, and PNI were associated with worse DSS in surgical patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pathologic stages, positive margins, and PNI are independently associated with worse DSS in young surgical HNSCC patients. PNI is a uniquely strong prognostic factor for young patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"15-21"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar Cautery as a Simple Yet Effective Technique for Epiglottopexy in Laryngomalacia","authors":"Mila Roode,&nbsp;Adam J. Donne","doi":"10.1111/coa.14216","DOIUrl":"10.1111/coa.14216","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"128-131"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Fistula Development After Parotid Gland Surgery: Lateral Parotidectomy Versus Extracapsular Dissection Technique","authors":"Nadia Sadok,&nbsp;Tobias Bastian,&nbsp;Noemi Voss,&nbsp;Kerstin Stähr,&nbsp;Diana Arweiler-Harbeck,&nbsp;Stephan Lang,&nbsp;Moritz Meyer","doi":"10.1111/coa.14213","DOIUrl":"10.1111/coa.14213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (OR_adjusted = 2.6, 4.1% vs. 12.5%, <i>p</i> = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, <i>p</i> = 0.333).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"793-800"},"PeriodicalIF":1.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}