Otolaryngology- Head and Neck Surgery最新文献

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The Role of Diet in Tympanostomy Tube Otorrhea. 饮食在鼓室造口管溢耳中的作用。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-26 DOI: 10.1002/ohn.1068
Kavita Dedhia, Alyssa Tindall, Jillian Karpink, Ashley Williams, Terri Giordano, Virginia Stallings
{"title":"The Role of Diet in Tympanostomy Tube Otorrhea.","authors":"Kavita Dedhia, Alyssa Tindall, Jillian Karpink, Ashley Williams, Terri Giordano, Virginia Stallings","doi":"10.1002/ohn.1068","DOIUrl":"https://doi.org/10.1002/ohn.1068","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the role of diet quality in children with tympanostomy tube placement (TTP) complicated by tympanostomy tube otorrhea (TTO).</p><p><strong>Study design: </strong>Three-day 24-hour diet recall.</p><p><strong>Setting: </strong>Tertiary care medical center.</p><p><strong>Methods: </strong>Children between the ages of 2 to 6 years old with TTP performed 6 months to 2 years prior to enrollment were included. Children with a history of Down syndrome, cleft palate, craniofacial syndromes, known immunodeficiency, g-tube dependent, or a non-English speaking family were excluded. The primary outcome variable was TTO. The primary predictor was total caloric intake measured by percent estimated energy rate (%EER).</p><p><strong>Results: </strong>A total of 120 families completed the 3-day diet recall. The median age was 27 months (interquartile range: 7.9-68.5), with 57% male sex. Most children reported dietary intake within the recommended range percent intake for carbohydrates and fat and less than recommended range for percent vitamin D. Within this cohort 63 (52.5%) participants had >1 TTO episode and 57 (47.5%) <math> <semantics><mrow><mo>≤</mo></mrow> <annotation>$le $</annotation></semantics> </math> 1 TTO episode. Children with an EER% that was average or high were at higher odds of >1 TTO episodes compared to participants with a low EER% with ORs of 4.6 (95% confidence interval [CI]: 1.4, 15.6) and 5.7 (95% CI: 1.5, 22.1) respectively.</p><p><strong>Conclusion: </strong>Children with a typical or high total daily caloric intake are approximately 5 to 6 times more likely to have multiple TTO episodes compared to those with low intake.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716691","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}
引用次数: 0
Association Between Perioperative Celecoxib, Acetaminophen, and Opioid Consumption After Palate Surgery for Obstructive Sleep Apnea. 阻塞性睡眠呼吸暂停腭部手术后围手术期塞来昔布、对乙酰氨基酚和阿片类药物用量之间的关系
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-26 DOI: 10.1002/ohn.1069
Ido Badash, Stephanie Wong, Kevin Biju, Kevin Hur, Emily Commesso, Eric J Kezirian
{"title":"Association Between Perioperative Celecoxib, Acetaminophen, and Opioid Consumption After Palate Surgery for Obstructive Sleep Apnea.","authors":"Ido Badash, Stephanie Wong, Kevin Biju, Kevin Hur, Emily Commesso, Eric J Kezirian","doi":"10.1002/ohn.1069","DOIUrl":"https://doi.org/10.1002/ohn.1069","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effect of perioperative celecoxib and acetaminophen administration on opioid consumption in the first 24 hours after palate surgery for obstructive sleep apnea (OSA).</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Methods: </strong>Adults with OSA undergoing soft palate surgery and admitted to the hospital postoperatively between July 2013 and June 2023 were included. Study participants were also included if they underwent concurrent nasal surgery but excluded if they underwent any pharyngeal surgery other than tonsillectomy or were taking opioids prior to surgery. Opioids administered after surgery were converted to morphine milligram equivalents (MME). Multiple linear regression was used to examine the association between total MME consumed in the first 24 hours postoperatively and celecoxib and acetaminophen usage.</p><p><strong>Results: </strong>A total of 210 study participants (15.7% female) were included with a mean age of 48.8 ± 37.5 years. The mean MME consumed in the first 24 hours after palate surgery was 80.2 ± 63.9. One hundred and twenty-six (60%) study participants received perioperative celecoxib, while 195 (93%) received perioperative acetaminophen. Celecoxib use was associated with lesser MME (-2.7 ± 1.1 MME per 100 mg; P = .018) consumed postoperatively, while acetaminophen was not (-0.3 ± 0.3 MME per 100 mg; P = .43). Female gender, Asian race, and African American race were also associated with lesser MME consumed postoperatively, while autoimmune/immunosuppressive conditions and tonsillectomy were associated with greater MME consumption.</p><p><strong>Conclusion: </strong>Perioperative celecoxib was associated with reduced MME consumption in the first 24 hours after palate surgery. No association was found between acetaminophen and postoperative opioid use.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716653","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}
引用次数: 0
Understanding the Composition of a Comprehensive Otolaryngologist's Practice Through Medicare Reimbursements. 通过医疗保险报销了解综合耳鼻喉科医生的业务构成。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-26 DOI: 10.1002/ohn.1071
Sina J Torabi, Sagar Vasandani, Rahul A Patel, R Peter Manes, Edward C Kuan
{"title":"Understanding the Composition of a Comprehensive Otolaryngologist's Practice Through Medicare Reimbursements.","authors":"Sina J Torabi, Sagar Vasandani, Rahul A Patel, R Peter Manes, Edward C Kuan","doi":"10.1002/ohn.1071","DOIUrl":"https://doi.org/10.1002/ohn.1071","url":null,"abstract":"<p><strong>Objective: </strong>With a rising number of otolaryngology (ORL) graduates completing a fellowship, the number of generalists (also known as comprehensive ORLs [c-ORLs]), arguably the group of ORLs most needed, is likely to decrease. However, the practice and reimbursement patterns of c-ORLs have yet to be examined.</p><p><strong>Study design: </strong>Cross-sectional retrospective analysis.</p><p><strong>Setting: </strong>2019 Medicare Provider Utilization and Payment Datasets.</p><p><strong>Methods: </strong>All ORLs were isolated (n = 8959), and then a random 10% sample was obtained. These 897 ORLs were queried for fellowship completion, isolating out those who have not completed a fellowship, and characterizing their practice patterns with regards to Medicare, the largest insurer in the US.</p><p><strong>Results: </strong>Within the random sample, 554 (61.8%) were c-ORLs, of which 47 (8.5%) practiced in an academic setting. c-ORLs billed a mean of 52.9 (SD: 26.6) Current Procedural Terminology (CPT), and community-based c-ORLs had a more diverse practice (P < .001). On average, Medicare paid $138,942 ($117,563) to each c-ORL for 1982.2 (2614.7) services for 451.7 (296.9) patients. Ninety-five percent of their total reimbursements were office-based. Of 250 unique CPT codes billed, 52.8% of all c-ORLs reimbursements were from evaluation and management services, 17.8% from rhinology, 9.7% from otology/neurotology, and 9% from laryngology.</p><p><strong>Conclusion: </strong>Though surgery is an integral aspect of all ORLs' training and practice, c-ORLs practice in a largely office-based setting, at least with regard to Medicare patients. While c-ORLs clearly practice with a diverse skill set, their reimbursement patterns suggest rhinology makes up the largest proportion of their procedural practice.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716706","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}
引用次数: 0
Split-Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations. 内窥镜修复全鼓膜穿孔和鼓膜次全穿孔的分层厚度软骨移植与软骨周围相结合。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-26 DOI: 10.1002/ohn.1070
Ahmed Mohammed Abdelghany, Hossam Abdelhay Gadulhaq
{"title":"Split-Thickness Cartilage Graft Combined With Perichondrium for Endoscopic Repair of Total and Subtotal Drum Perforations.","authors":"Ahmed Mohammed Abdelghany, Hossam Abdelhay Gadulhaq","doi":"10.1002/ohn.1070","DOIUrl":"https://doi.org/10.1002/ohn.1070","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to describe our new modification to cartilage tympanoplasty for endoscopic repair of total and subtotal tympanic membrane perforations and evaluate its outcomes.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Multiple institutions.</p><p><strong>Methods: </strong>The study was conducted using records of patients who underwent tympanoplasty for subtotal and total perforations from January 2018 to June 2022. Utilizing an endoscopic transcanal approach, we employed a double graft consisting of outer tragal perichondrium supported by inner split-thickness tragal cartilage as separate layers, both placed in an underlay fashion lateral to the malleus, without the need to elevate a tympanomeatal flap. Anatomical success was defined as complete primary closure of the perforation, while functional success was defined as achieving an air-bone gap of ≤20 dB at 12 months postoperative.</p><p><strong>Results: </strong>The series involved 64 patients, predominantly males (53%). The mean age was 30.8 years. 56.3% of patients had subtotal perforations. The anatomical success rate was 90.6% while the functional success rate was 87.5%. Postoperative speech discrimination scores significantly increased in all patients.</p><p><strong>Conclusion: </strong>Our modification provides effective anatomical and audiological outcomes. This technique reliably resists graft displacement and shrinkage before adequate healing. It avoids problems of elevating tympanomeatal flaps with comparable results to traditional approaches.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716685","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}
引用次数: 0
Debunking the Myth: Should Pierre Robin be Credited for Defining the Pierre Robin Sequence? 揭穿神话:皮埃尔-罗宾是否应为皮埃尔-罗宾序列的定义而感到自豪?
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-26 DOI: 10.1002/ohn.1064
Maëlys Leger, Robin Baudouin, Briac Thierry
{"title":"Debunking the Myth: Should Pierre Robin be Credited for Defining the Pierre Robin Sequence?","authors":"Maëlys Leger, Robin Baudouin, Briac Thierry","doi":"10.1002/ohn.1064","DOIUrl":"https://doi.org/10.1002/ohn.1064","url":null,"abstract":"<p><p>The Pierre Robin Sequence is a rare craniofacial malformation that invariably combines retrognathism, glossoptosis, and upper airway obstruction, with a prevalence ranging from 1 in 8000 to 1 in 14,000 newborns. Although formally described by the French physician Pierre Robin in 1923, older and even ancient as far back as the Babylonian times, descriptions have been identified. Dr Pierre Robin's perspicacity lay in putting up a treatment for the patients presenting those symptoms. That is why his successors honored his work by naming this disease after him.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716657","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}
引用次数: 0
Early Septoplasty Versus Closed Reduction for Acute Nasoseptal Fracture: A Systematic Review and Meta-analysis. 早期鼻中隔成形术与闭合复位术治疗急性鼻中隔骨折:系统综述与元分析》。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-22 DOI: 10.1002/ohn.1007
Elizabeth W Wadsworth, Kelsey A Duckett, Shaun A Nguyen, Krishna G Patel
{"title":"Early Septoplasty Versus Closed Reduction for Acute Nasoseptal Fracture: A Systematic Review and Meta-analysis.","authors":"Elizabeth W Wadsworth, Kelsey A Duckett, Shaun A Nguyen, Krishna G Patel","doi":"10.1002/ohn.1007","DOIUrl":"https://doi.org/10.1002/ohn.1007","url":null,"abstract":"<p><strong>Objective: </strong>Accurate management of acute nasoseptal fractures can mitigate cosmetic and functional complications. There is a lack of consensus on the ideal approach to manage acute nasoseptal fractures, which are often addressed with closed nasal and/or septal reduction (CN/SR) but sometimes addressed using an open approach with septoplasty. We aimed to systematically assess and compare outcomes of CN/SR versus open approaches to treat acute nasoseptal fractures.</p><p><strong>Data sources: </strong>PubMed, Scopus, and CINAHL.</p><p><strong>Review methods: </strong>Studies evaluating outcomes of adults with acute nasoseptal fractures treated within 3 weeks of injury with either CN/SR or open approach were included. Meta-analysis was performed to examine the pooled frequency of complications including persistent obstruction, cosmetic deformity, and need for revision surgery.</p><p><strong>Results: </strong>Of 1630 unique articles identified, 27 were included (63% retrospective, 29.6% prospective, 7.4% randomized controlled trial). Data included 1117 patients (n = 712 CN/SR, n = 423 open approach), with a mean age of 30.5 years. Patients who underwent CN/SR only were more likely to experience persistent obstruction compared to patients who underwent open approach (22.2% [95% confidence interval, CI, 8.7%-39.5%] vs 5.9% [95% CI, 2.4%-10.7%], P < .0001). Patients who underwent CN/SR were more likely to require revision surgery within 3 years (30.9% [95% CI, 15.8%-48.4%] vs 6.0% [95% CI, 3.3%-9.9%], P < .0001.</p><p><strong>Conclusion: </strong>Patients with nasoseptal fractures who underwent open septoplasty in the acute period were less likely to experience complications. Prospective trials are needed to confirm results of this meta-analysis.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688170","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}
引用次数: 0
Refractory Chronic Cough: A State-of-the-Art Review for Otolaryngologists. 难治性慢性咳嗽:耳鼻喉科医生的最新研究综述》。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-22 DOI: 10.1002/ohn.1019
Gabriela L Lilly, Thomas Carroll, Kristine Pietsch, Vaninder Dhillon, Paul C Bryson, Lee M Akst
{"title":"Refractory Chronic Cough: A State-of-the-Art Review for Otolaryngologists.","authors":"Gabriela L Lilly, Thomas Carroll, Kristine Pietsch, Vaninder Dhillon, Paul C Bryson, Lee M Akst","doi":"10.1002/ohn.1019","DOIUrl":"https://doi.org/10.1002/ohn.1019","url":null,"abstract":"<p><strong>Objective: </strong>Patients with refractory chronic cough (RCC) are being seen in increasing numbers within otolaryngology clinics. Identifying the next steps in the evaluation and management of cough in patients who have had first-line treatment for gastroesophageal reflux, sinonasal disease, pulmonary disease, and angiotensin-converting enzyme inhibitor-related cough is paramount. This state-of-the-art review focuses on emerging treatments for RCC from an otolaryngology perspective.</p><p><strong>Data sources: </strong>Pubmed.</p><p><strong>Review methods: </strong>The available literature on chronic cough, with a focus on RCC, emerging paradigms concerning pathophysiology, and evolving treatment approaches was reviewed and summarized.</p><p><strong>Conclusions: </strong>Guided by a more detailed understanding of refractory cough physiology, a myriad of new treatment options have been developed to treat RCC. These are primarily aimed at disrupting what is thought to be a hypersensitive cough reflex, whether by a dampening of its sensory inputs or an alteration in motor activity, and are inclusive of neuromodulator treatments, superior laryngeal nerve blockade, vocal fold augmentation, botulinum toxin injection, topical capsaicin, and potentially the eventual use of P2X3 antagonists. Improved laryngopharyngeal reflux diagnosis and management, as well as the potential benefit of behavioral cough suppression therapy, are also discussed.</p><p><strong>Implications for practice: </strong>The literature supporting each of these strategies is growing-and as more patients with RCC seek otolaryngology care, knowledge of these various approaches may improve the overall treatment of this condition.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688385","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}
引用次数: 0
Prevalence of Pain and Associated Clinical Characteristics in 10-Year Survivors of Head and Neck Cancer. 头颈癌 10 年存活者的疼痛发生率及相关临床特征。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-22 DOI: 10.1002/ohn.1066
M Bryant Howren, Nitin A Pagedar
{"title":"Prevalence of Pain and Associated Clinical Characteristics in 10-Year Survivors of Head and Neck Cancer.","authors":"M Bryant Howren, Nitin A Pagedar","doi":"10.1002/ohn.1066","DOIUrl":"https://doi.org/10.1002/ohn.1066","url":null,"abstract":"<p><strong>Objective: </strong>Pain prevalence in long-term head and neck cancer (HNC) survivors is important but understudied to date. The present investigation examined pain prevalence, associated clinical characteristics, and disease-specific health-related quality of life (HRQOL) in a cohort of survivors 10 years postdiagnosis (N = 187).</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single-institution tertiary care center.</p><p><strong>Methods: </strong>Pain was assessed using a single-item numeric rating scale. Clinical characteristics were abstracted from the patient medical record and HNC-specific HRQOL scores were measured using the Head and Neck Cancer Inventory (HNCI) and are presented by the pain subgroup.</p><p><strong>Results: </strong>At 10 years postdiagnosis, 56.7% reported no pain, 20.3% reported mild pain, 16.0% reported moderate pain, and 7.0% reported severe pain. Most patients with moderate or severe pain at the 10-year follow-up assessment also had advanced-stage disease at diagnosis. Multiple linear regression analyses indicated that advanced-stage disease at diagnosis was a significant predictor of pain at 10 years postdiagnosis controlling for age, sex, and comorbidity status (β = .184, t = 2.193, P = .030, sr<sup>2</sup> = 0.025). Across all HNC-specific HRQOL domains, those reporting moderate/severe pain at 10 years postdiagnosis failed to reach a score of 70 which is indicative of high functioning on the HNCI in the areas of aesthetics, eating, speech, and social disruption.</p><p><strong>Conclusion: </strong>Pain is a significant issue in long-term HNC survivors up to 10 years postdiagnosis. More research is needed to understand the correlates and types of long-term pain exhibited after treatment, including the implementation of screening and intervention into clinical workflow to improve outcomes and optimize HNC survivorship care.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688383","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}
引用次数: 0
Patient Perspectives in Postlaryngectomy Communication Rehabilitation and Outcomes. 喉切除术后交流康复中的患者视角与效果。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-20 DOI: 10.1002/ohn.1062
Mollie Perryman, Shannon Kraft
{"title":"Patient Perspectives in Postlaryngectomy Communication Rehabilitation and Outcomes.","authors":"Mollie Perryman, Shannon Kraft","doi":"10.1002/ohn.1062","DOIUrl":"https://doi.org/10.1002/ohn.1062","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate patient-reported outcomes in postlaryngectomy communication rehabilitation.</p><p><strong>Study design: </strong>Cross-sectional survey study.</p><p><strong>Setting: </strong>(a) Patients who underwent laryngectomy at a single institution and (b) members of the International Association of Laryngectomees (IAL).</p><p><strong>Methods: </strong>We examined demographics, treatment history, speech rehabilitation methods and outcomes postlaryngectomy.</p><p><strong>Results: </strong>A total of 157 participants responded to the survey (124 IAL; 33 institutional cohort). The most used primary methods of communication were tracheoesophageal puncture (TEP) 61.5%, electrolarynx (EL) 24.4%, and writing 9%. In all categories, except for communication in a noisy environment, alaryngeal voice was rated superior to aphonic communication (P < .05). Subset analysis of the alaryngeal voice cohort demonstrated higher communication efficacy for TEP compared to other modalities in all environments except for conversation with family and friends. Among TEP users, a history of a regional flap for reconstruction compared to free tissue transfer was associated with higher communication effectiveness scores (16.3 vs 10.6; P = .0085). Neither treatment modality (primary vs. salvage laryngectomy vs. radiation therapy) nor engagement in speech therapy impacted communication effectiveness scores for alaryngeal voice users.</p><p><strong>Conclusion: </strong>Alaryngeal voice users reported higher efficacy of communication in most social contexts compared to aphonic communicators. Among alaryngeal voice users, TEP speech performed better in most social situations compared to an EL. Treatment characteristics including timing of surgery and radiation therapy were not associated with the ability to acquire alaryngeal voice, while the extent of resection and the type of reconstruction did show potential to impact voicing outcomes in patients who desire to pursue alaryngeal voicing techniques.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676399","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}
引用次数: 0
Potential Cost-Saving Model Utilizing Mark Cuban Cost Plus Drug Company for Purchasing Common Otolaryngology Medications. 利用 Mark Cuban Cost Plus Drug Company 购买耳鼻喉科常用药物的潜在成本节约模式。
IF 2.6 3区 医学
Otolaryngology- Head and Neck Surgery Pub Date : 2024-11-19 DOI: 10.1002/ohn.1058
Zachary Buxo, John D Cramer
{"title":"Potential Cost-Saving Model Utilizing Mark Cuban Cost Plus Drug Company for Purchasing Common Otolaryngology Medications.","authors":"Zachary Buxo, John D Cramer","doi":"10.1002/ohn.1058","DOIUrl":"10.1002/ohn.1058","url":null,"abstract":"<p><p>The persistent challenge of high pharmaceutical prices has led to the emergence of vertically integrated direct-to-consumer distributors like Mark Cuban Cost Plus Drug Company (MCCPDC). This study aims to evaluate a cost-saving alternative method for medication sourcing. The most frequently prescribed medications by otolaryngologists were identified through analysis of Medicare Part D data, utilizing prescriber type as a filter. Medications were assessed for availability on the MCCPDC website and drug form consistency. Cost analysis was conducted comparing current pharmaceutical spending against MCCPDC pricing. Potential otolaryngology-driven savings were estimated at $55.6 million and $1 billion if in effect across all specialties. Our findings suggest considerable potential savings for Medicare by purchasing generic medications at MCCPDC prices.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668566","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}
引用次数: 0
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