Otolaryngology- Head and Neck Surgery最新文献

{"title":"Factors Precipitating Overnight Admission After Sialolithectomy.","authors":"Fahad Rind, Minka Schofield, Ricardo L Carrau","doi":"10.1002/ohn.845","DOIUrl":"https://doi.org/10.1002/ohn.845","url":null,"abstract":"<p><strong>Objective: </strong>To determine factors predicting overnight admission after sialolithectomy.</p><p><strong>Study design: </strong>Quality outcome database research.</p><p><strong>Setting: </strong>The National Surgical Quality Improvement Program American College of Surgeons Participant User Files.</p><p><strong>Methods: </strong>Current Procedural Terminology (CPT) codes 42330, 42335, and 42340 between 2007, and 2020 resulted 916 cases. Correlations between perioperative factors and overnight admission (ie, length of stay >0 days) were tested. Cases were stratified into endoscopic (ES) and nonendoscopic (NES) procedures using concurrent CPT codes 42660, 42669, and 42650.</p><p><strong>Results: </strong>After sialolithectomy, 13.7% (126 cases) were admitted at least overnight. Upon multivariate analysis, wound Class 4 (odds ratio [OR]: 2.15, 95% confidence interval: 1.05, 4.40), American Society of Anesthesiologists (ASA) 3 classification (OR: 2.17, 1.06-4.46, P = .035), and the operative time (OR: 1.01 [1.01-1.01], P < .001) correlated with overnight stay; while Class 2 wounds had a lower risk of overnight admission (OR: 0.31 [0.12-1.63], P < .001). The ES cohort had longer operative times (56.1 vs 73.6 minutes). In the NES cohort's multivariate analysis, ASA III (OR: 2.459 [1.13, 5.34], P < .001) and operative time (OR: 1.01 [1.01, 1.02], P < .001) correlated with overnight stay while Class 2 wound classifications protected against overnight stay (OR: 0.28 [0.15, 0.52], P < .001).</p><p><strong>Conclusion: </strong>This study highlights the correlation between intraoperative complexity, as operative time, wound classification and ASA Class 3, and the need for admission after a typically ambulatory sialolithectomy. The significantly longer operative time with evidence of a shorter length of stay in ES cases suggests a valuable trade off, within the limits of indication.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis of Management Options for Empty Nose Syndrome: A Proposed Management Algorithm.","authors":"Salman Hussain, Jafar Hayat, Hamad Almhanedi, Mohammad Alherz, Mahmoud Ebrahim, Ali Lari, Andrew Thamboo","doi":"10.1002/ohn.929","DOIUrl":"https://doi.org/10.1002/ohn.929","url":null,"abstract":"<p><strong>Objective: </strong>Empty nose syndrome (ENS) is an acquired condition characterized by paradoxical nasal obstruction and sensation of nasal dryness often accompanied by psychological disorders such as depression or anxiety, typically occurring after the loss of inferior turbinate tissue or volume in the setting of prior sinonasal surgery. This review aims to identify and evaluate the reported management options.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Web of Science.</p><p><strong>Review methods: </strong>The terms \"empty nose syndrome\" OR \"atrophic rhinitis\" were used in a systematic search of original articles since the year 1990, yielding 1432 individual studies. These were screened on the Covidence platform for inclusion if any intervention was reported for the treatment of ENS. A pooled analysis of standardized mean differences (SMDs) combined with a random effects model was employed to report outcomes in Empty Nose 6-Item Questionnaire (ENS6Q), Sino-Nasal Outcome Test (SNOT), anxiety, and depression scores.</p><p><strong>Results: </strong>A total of 35 articles were included, comprising 957 individual ENS patients. Surgical interventions mostly in the form of meatus augmentation implants accounted for 26 out of the 36 articles. The remaining ten articles included medical and psychological management options. SMD in SNOT, ENS6Q, anxiety, and depression scores were reported and demonstrated statistically significant improvements in follow-up periods of up to 1 year. All articles reported favorable outcomes following their chosen interventions.</p><p><strong>Conclusion: </strong>There is a paucity of evidence on the management of ENS and an absence of randomized controlled trials. Surgical intervention appears to be the current mainstay of treatment, but there is a potential role for psychological and medical management.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Impact of Smoking on Allergic Rhinitis: Disease Severity and Efficacy of Subcutaneous Immunotherapy.","authors":"Xuan Yuan, Liyuan Liu, Benjian Zhang, Shaobing Xie, Lai Meng, Wei Zhong, Jiaxin Jia, Hua Zhang, Weihong Jiang, Zhihai Xie","doi":"10.1002/ohn.937","DOIUrl":"https://doi.org/10.1002/ohn.937","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of smoking statuses on disease severity and subcutaneous immunotherapy (SCIT) efficacy in allergic rhinitis (AR).</p><p><strong>Study design: </strong>Open observational cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Methods: </strong>Five hundred and five AR patients undergoing dust mite allergen SCIT were categorized into never smokers, former smokers, and current smokers. AR severity was assessed using widely employed questionnaires. The changes in questionnaire scores pre- and post-SCIT were evaluated for SCIT efficacy. The differences in disease severity and SCIT efficacy were compared for different smoking statuses among AR patients.</p><p><strong>Results: </strong>Compared to never smokers, former and current smokers exhibited higher proportion of male, alcohol, and asthma (P < .05). Current smokers had a greater prevalence of allergic conjunctivitis than former smokers (P < .05). Before SCIT, AR severity was similar across 3 groups, even after adjusting for confounders (P > .05). Current smokers reported lower SCIT efficacy in the first year (P < .05). By the third year, 3 groups showed comparable long-term efficacy (P > .05). However, current smokers experienced a significant decrease in benefits 2 years post-SCIT (P < .05) and lower improvement rates at the end of the 3-years SCIT period and 2 years following SCIT (P < .05).</p><p><strong>Conclusion: </strong>AR patients across different smoking statuses demonstrated similar baseline disease severity and long-time SCIT efficacy. Active smoking was associated with increased asthma risk, delayed early SCIT efficacy perception, reduced improvement over 3 years, and diminished benefits 2 years after SCIT. Prompt smoking cessation is crucial to mitigate these effects.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtually Augmented Surgical Navigation in Endoscopic Sinus Surgery Simulation Training: A Prospective Trial of Repeated Measures.","authors":"Mackenzie Latour, Ivan Alvarez, Mark Knackstedt, Michael Yim","doi":"10.1002/ohn.945","DOIUrl":"https://doi.org/10.1002/ohn.945","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore the educational utility of virtually augmented surgical navigation (VASN) in simulation training for endoscopic sinus surgery.</p><p><strong>Study design: </strong>Prospective trial using within-subjects design.</p><p><strong>Setting: </strong>Single academic institution.</p><p><strong>Methods: </strong>Otolaryngology trainees (n = 15) were enrolled in a prospective trial of repeated measures. Participants performed unilateral functional endoscopic sinus surgery (FESS) on a 3-dimensional-printed sinus model without instruction. Participants then underwent educational intervention incorporating VASN tools-featuring anatomic overlay delineations, virtual planning points, proximity alerts, digital measurements, as well as artificial intelligence-generated endoscopic viewpoints. With the VASN tools activated, participants then performed FESS on the contralateral side of the model. Primary outcomes of interest included number of major complications, time to complete anterior fess, steps completed, and technical skills score. Descriptive statistics were performed to describe participant characteristics and bivariate analysis were used to evaluate differences in subjective and objective outcome measures.</p><p><strong>Results: </strong>A majority (93%) of residents strongly agreed that simulation intervention improved their confidence in surgical skills related to FESS. Complications decreased from 13 instances to 3 following interventions. Initial technical skills score of 45.2 increased to 54.4 postintervention (P < .0001) and global score also improved by 4.6 points on average (P < .001). Time to anterior FESS decreased from 1356 to 915 seconds (P = .006) and average number of completed surgical steps increased from 3.3 to 4.6 (P < .001).</p><p><strong>Conclusion: </strong>This simulation study contributes to growing evidence supporting utility of advanced technology in surgical education. Results suggest that VASN serves as a beneficial adjunct in FESS simulation training.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Tracheostomy Status on Sternal Wound Infections in Children Following Median Sternotomy.","authors":"Rohit Nallani, Brevin J Miller, Janelle R Noel-MacDonnell, Meghan Tracy, Jason R Brown, James E O'Brien, Daniel R Jensen","doi":"10.1002/ohn.939","DOIUrl":"https://doi.org/10.1002/ohn.939","url":null,"abstract":"<p><strong>Objective: </strong>Sternal wound infection (SWI) is a rare but potentially life-threatening complication in children following sternotomy. Risk factors include young age, extended preoperative hospitalization, and prolonged ventilatory support. Few studies have explored the impact of pre-existing tracheostomy on SWI in pediatric patients. The purpose of this study is to measure the effect of tracheostomy and other factors on SWI in children undergoing sternotomy.</p><p><strong>Study design: </strong>Retrospective cohort study of a 12 year period.</p><p><strong>Setting: </strong>Tertiary children's hospital.</p><p><strong>Methods: </strong>Children with a tracheostomy prior to sternotomy (TPS) were identified and matched by age, height, and weight to children who underwent sternotomy alone. Demographics, medical comorbidities, surgical details, SWI diagnosis and management information, and surgical outcomes were collected.</p><p><strong>Results: </strong>We identified 60 unique individuals representing 80 sternotomies. The incidence of SWI was 22.5% (n = 9) in children with a tracheostomy and 2.5% (n = 1) in those without. The incidence of SWI was greater in children with a tracheostomy (90% vs 10% in those without, P = .007) and underlying pulmonary disease (90% vs 10% in those without, P = .020). Infections in the TPS group also demonstrated greater frequency of Pseudomonas aeruginosa (n = 3) and polymicrobial growth (n = 2).</p><p><strong>Conclusion: </strong>The risk of developing a SWI in children undergoing sternotomy is significantly greater in those with a tracheostomy and underlying pulmonary disease. Further study is needed to understand other contributing factors and ways to mitigate this risk.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes.","authors":"Kevin Herrera, Marcela Moran Mojica, Karla Marlene Sintigo, Kevin Hur","doi":"10.1002/ohn.940","DOIUrl":"https://doi.org/10.1002/ohn.940","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the association between demographic characteristics and emergency department (ED) epistaxis management and outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>TriNetX US collaborative database.</p><p><strong>Methods: </strong>Adults presenting to the ED for epistaxis were retrospectively followed for 7 days. Spanish-speaking patients were propensity score matched to English-speaking patients by demographics and medical history. Outcomes included use of nasal decongestant, nasal packing or cautery, diagnostic nasal endoscopy, endoscopic control of hemorrhage, hospital admission, and mortality. The analysis was also performed with stratification by race and ethnicity.</p><p><strong>Results: </strong>Spanish-speaking patients were less likely to receive nasal packing or cautery [odds ratio, OR: 0.78; 95% confidence interval, CI: (0.68; 0.90)] or diagnostic nasal endoscopy [OR: 0.72; 95% CI: (0.52; 0.98)] compared to English-speaking patients. Black patients were more likely to receive treatment with a nasal decongestant spray [OR: 1.31; 95% CI: (1.27, 1.36)], but less likely to receive any other treatment compared to White patients. Asian patients were less likely to undergo nasal packing or cautery [OR: 0.90; 95% CI: (0.82; 0.99)], but had more ED visits [(1.37; 1.32) P < .01] compared to White patients. Hispanic patients were less likely to be admitted [OR: 0.93; 95% CI: (0.87; 0.98)], and averaged fewer ED visits [(1.27; 1.30) P = <.0001] compared to non-Hispanic patients.</p><p><strong>Conclusion: </strong>While demographic trends in ED epistaxis management are nuanced, our results suggest that Spanish-speaking, Black, Asian, and Hispanic patients are less likely to receive diagnostic and epistaxis control procedures. Additional research is needed to determine the etiology of these differences.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Speech Quality Perception in Unilateral Cochlear Implant Users With Single-Sided Deafness.","authors":"Scott Kelly, Megan E Kuhlmey, Meghan A Despotidis, Isaac L Alter, Tiffany P Hwa, Alexander Chern, Anil K Lalwani","doi":"10.1002/ohn.941","DOIUrl":"https://doi.org/10.1002/ohn.941","url":null,"abstract":"<p><strong>Objective: </strong>Cochlear implant (CI) users frequently complain about speech quality perception (SQP). In patients undergoing cochlear implantation for single-sided deafness, there is concern that poor SQP from the implanted ear will negatively impact binaural (CI + normal hearing [NH]) SQP. In this study, we investigate if binaural SQP is measurably different than unimplanted NH alone.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>Fifteen unilateral CI users with NH in the contralateral ear completed the validated Columbia Speech Quality Instrument. This instrument consists of 9 audio clips rated across 14 specific speech qualities using a 10-point visual analog scale. SQP was assessed in 3 conditions: CI only, NH only, and CI + NH.</p><p><strong>Results: </strong>Median speech quality scores were worse in the CI only condition compared to the NH only (50.0 vs 72.6, P = .0003) and binaural (50.0 vs 71.0, P = .007) conditions. Median speech quality scores were not significantly different between the NH only and binaural conditions (72.6 vs 71, P = .8). Compared to NH, CI speech quality sounded less clear, less natural, and more mechanical.</p><p><strong>Conclusion: </strong>Compared to NH, SQP is poorer with a CI alone. However, in contrast to expectation, there is no significant difference between NH and binaural SQP. This suggests poorer CI speech perception does not negatively impact binaural SQP in patients undergoing cochlear implantation for single-sided deafness.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Length of Stay in Reconstructive Head and Neck Surgery Patients: A Quality Improvement Initiative.","authors":"Nupur Bhatt, Jackie Yang, Lauren DeBaere, Ronald Shen Wang, Allison Most, Yan Zhang, Elan Dayanov, Wenqing Yang, Michele Santacatterina, Maria Kamberi, Jacqueline Mojica, Emily Kamen, Justin Savitski, John Stein, Adam Jacobson","doi":"10.1002/ohn.933","DOIUrl":"https://doi.org/10.1002/ohn.933","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether a new preoperative education and discharge planning protocol reduced unexpected discharge delays for patients undergoing reconstructive surgery for head and neck cancer.</p><p><strong>Methods: </strong>A quality improvement (QI) intervention was implemented in January 2021 with several components to address historically prolonged observed lengths of stay (LOS) with head and neck cancer patients. The intervention added a preoperative educational visit with a head and neck cancer advanced practice provider, a standardized preoperative speech and swallow assessment, a personalized patient care plan document, discussion of inpatient hospital stay expectations, and early discharge planning. The intervention group included patients who underwent the preoperative education protocol from February to December 2021. For comparison, an age and sex-matched control group was constructed from inpatients who had been admitted for similar procedures in the 2 years prior to the QI intervention (2019-2020) and received standard of care counseling.</p><p><strong>Results: </strong>Our study demonstrated a significant reduction in observed to expected LOS ratio after implementation of the intervention (1.24 ± 0.74 control, 0.95 ± 0.52 intervention; P = .012).</p><p><strong>Discussion: </strong>We discuss a preoperative education QI intervention at our institution. Our findings demonstrate that our intervention was associated with decreased LOS for patients undergoing head and neck reconstructive surgeries.</p><p><strong>Implications for practice: </strong>This QI study shows the benefit of a new standardized preoperative education and discharge planning protocol for patients undergoing head and neck reconstructive surgeries.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chimeric Versus Multiple Simultaneous Free Flaps for Head and Neck Reconstruction.","authors":"Johnny Wang, Theresa Tharakan, Ryan S Jackson, Sidharth V Puram, Patrik Pipkorn","doi":"10.1002/ohn.922","DOIUrl":"https://doi.org/10.1002/ohn.922","url":null,"abstract":"<p><strong>Objective: </strong>To describe our experience with chimeric flaps and to assess the surgical outcomes and postoperative complications associated with chimeric flaps compared to multiple flaps.</p><p><strong>Study design/methods: </strong>Patients undergoing chimeric and multiple simultaneous free tissue transfer between June 2016 and October 2023 were retrospectively reviewed. The primary outcome of interest was the complication rate. Major complications required takeback to the operating room, hospital readmission, or transfer to the intensive care unit. Minor complications were managed conservatively. Secondary outcomes included operative time, length of hospitalization, and flap survival.</p><p><strong>Setting: </strong>Academic tertiary care center.</p><p><strong>Results: </strong>Our analysis included 113 patients (chimeric n = 38, multiple n = 75). We found no significant difference in operative times or minor complications. Chimeric flaps were associated with a shorter length of hospitalization. The major complication rate was higher for chimeric flaps (42.1% vs 22.7%, P = .03), but each cohort only had 1 instance of total flap loss.</p><p><strong>Conclusion: </strong>The complexity of large head and neck defects poses a reconstructive challenge for microvascular surgeons. Our findings suggest that chimeric and multiple flaps both produce acceptable complication rates when used appropriately. Differences in complication rates may reflect differences in utilization. The chimeric flap remains a valuable option for those with prior radiation or radical resection, but it remains unclear the degree to which they lessen the inherent risk of postoperative complications within this population. Each technique must be weighed in context of the patient's reconstructive profile and the institution's surgical capabilities to optimize long-term outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Demography and Treatment Strategy of Vestibular Migraine in Neurotologic Perspective.","authors":"Kuei-You Lin, Steven D Rauch","doi":"10.1002/ohn.923","DOIUrl":"https://doi.org/10.1002/ohn.923","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to describe the demographic features of vestibular migraine (VM) compared to other common peripheral vestibulopathies, and to assess the efficacy of trigger management as primary VM treatment.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Tertiary referral medical center.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients presenting with dizziness in a tertiary neurotology clinic. Among the newly diagnosed dizzy patients, those with a diagnosis of either VM, Ménière's disease, benign paroxysmal positional vertigo, or vestibular neuritis/labyrinthitis were selected for comparisons of the disease demographics. VM patients with multiple clinic visits in the study period were included for the treatment strategy analysis.</p><p><strong>Results: </strong>A total of 1285 patients met the study inclusion criteria. In the newly diagnosed dizzy group comprising 814 patients, VM patients accounted for the largest (25%) and youngest (mean age 47 years) cohort, showing an obvious female preponderance of approximately 3.3:1. Furthermore, prevalence of VM declined significantly with advancing age, from 69%, to 34%, to 11%, in age groups of ≤30, 31 to 60, and >60 years, respectively. Trigger management, when employed as the primary VM first-year treatment, was effective for both sexes. Notably, it was more effective for women aged over than under 45 years.</p><p><strong>Conclusion: </strong>In our tertiary referral neurotologic center, VM was the most common diagnosis in newly diagnosed dizzy patients aged under 60 years, especially in women. For primary VM treatment, trigger management is an effective option deserving consideration.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}