{"title":"Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis.","authors":"E Fong, M Garcia, C M Woods, E Ooi","doi":"10.1017/S0022215116009269","DOIUrl":"10.1017/S0022215116009269","url":null,"abstract":"<p><strong>Background: </strong>Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.</p><p><strong>Methods: </strong>Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.</p><p><strong>Results: </strong>Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37-0.72). Hyaluronic acid use was not associated with any significant adverse events.</p><p><strong>Conclusion: </strong>Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.</p>","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"11 1","pages":"S2-S11"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81612054","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}
D. Chandran, Charmaine Woods, Shahid Ullah, Eng H. Ooi, T. Athanasiadis
{"title":"A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience","authors":"D. Chandran, Charmaine Woods, Shahid Ullah, Eng H. Ooi, T. Athanasiadis","doi":"10.1017/S0022215116009221","DOIUrl":"https://doi.org/10.1017/S0022215116009221","url":null,"abstract":"Abstract Objective: To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia. Methods: A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated. Results: Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p < 0.001), with no significant difference between general anaesthesia and local anaesthesia (p > 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively. Conclusion: Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"144 1","pages":"S41 - S46"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76589675","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}
{"title":"Temporomandibular disorder in otolaryngology: systematic review.","authors":"L Stepan, C-K L Shaw, S Oue","doi":"10.1017/S0022215116009191","DOIUrl":"10.1017/S0022215116009191","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular disorder poses a diagnostic challenge to otolaryngologists as orofacial pain, headache and otology symptoms are very common in temporomandibular disorder, and mimic a number of otolaryngological conditions. Missed diagnosis of temporomandibular disorder can lead to unnecessary investigation and treatment, resulting in further patient suffering.</p><p><strong>Objectives: </strong>To review the current literature and propose management pathways for otolaryngologists to correctly differentiate temporomandibular disorder from other otolaryngological conditions, and to initiate effective treatment for temporomandibular disorder in collaboration with other health professionals.</p><p><strong>Method: </strong>A systematic review using PubMed and Medline databases was conducted, and data on temporomandibular disorder in conjunction with otolaryngological symptoms were collected for analysis.</p><p><strong>Results: </strong>Of 4155 potential studies, 33 were retrieved for detailed evaluation and 12 met the study criteria. There are questionnaires, examination techniques and radiological investigations presented in the literature to assist with distinguishing between otolaryngological causes of symptoms and temporomandibular disorder. Simple treatment can be initiated by the otolaryngologist.</p><p><strong>Conclusion: </strong>Initial temporomandibular disorder treatment steps can be undertaken by the otolaryngologist, with consideration of referral to dentists, oral and maxillofacial surgeons, or physiotherapists if simple pharmacological treatment or temporomandibular disorder exercise fails.</p>","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"89 1","pages":"S50-S56"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90969993","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}
{"title":"Diversity and quality in otolaryngology research","authors":"R. Harvey","doi":"10.1017/S0022215116009865","DOIUrl":"https://doi.org/10.1017/S0022215116009865","url":null,"abstract":"This year starts with a tremendous demonstration of the breadth and quality of Australian research in otolaryngology. A quality effort from a Victorian research group demonstrates the impact of celecoxib, a cyclooxygenase 2 selective non-steroidal anti-inflammatory drug, on post-operative tonsillectomy outcomes. It is a great effort to produce a Consolidated Standards of Reporting Trials (‘CONSORT’; http://www.consortstatement.org/) compliant trial. This reporting statement represents an evidence-based, minimum set of recommendations for reporting randomised trials. It offers a standard way for authors to prepare reports of trial findings, facilitating their complete and transparent reporting, and aiding their critical appraisal and interpretation. Such statements are invaluable as they provide an easy template or checklist for what is expected in scientific literature. There was a terrific effort from Adelaide researchers to show compliance with Preferred Reporting Items for Systematic Reviews and MetaAnalyses (‘PRISMA’; http://www.prisma-statement. org/) as a template for their systematic review on hyaluronic acid sinus dressings. These structured reviews have a methodology to them to avoid author bias; in addition, they contrast with the more narrative reviews such as that on temporomandibular joint disorders, which are valuable, but are very much a clinician perspective. Another resource for systematic reviews is the Cochrane Handbook (http://training.cochrane. org/handbook). Although many of us may never produce a full systematic review or undertake a true randomised trial, these documents provide a learning platform for new manuscript writers. For lower levels of evidence, there exists a series of other guides: Meta-Analysis of Observational Studies in Epidemiology (‘MOOSE’; http://www.equator-network.org/reporting-guidelines/), Standards forReportingDiagnosticAccuracy (‘STARD’; http://www.stard-statement.org), Strengthening the Reporting of Observational Studies in Epidemiology (‘STROBE’; http://www.strobe-statement.org) (used in observational research, such as cohort, case–control and cross-sectional studies), and Consensus-based Clinical Case Reporting Guideline Development (‘CARE’; http://www.equator-network.org/reporting-guidelines/ care/). The latter guidelines are intended to ensure ‘completeness, transparency and data analysis in case reports and data from the point of care’. Any prospective author should consult these documents to ensure their submission meets the reporting standards. Some journals even request a completed Strengthening the Reporting of Observational Studies in Epidemiology guidelines checklist to ensure that appropriate due diligence has been undertaken by authors. This is a standard that we should all strive for. The range of research in this issue, from acute mastoiditis, to training, voice and factors impacting the quality of neck dissections, underpins the research efforts in the Australian otolaryngology comm","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"16 1","pages":"S1 - S1"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90844894","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}
{"title":"Inter-observer variability between radiologists reporting on cerebellopontine angle tumours on magnetic resonance imaging","authors":"S. Teh, S. Ranguis, P. Fagan","doi":"10.1017/S002221511600935X","DOIUrl":"https://doi.org/10.1017/S002221511600935X","url":null,"abstract":"Abstract Background: Studies demonstrate the significance of intra- and inter-observer variability when measuring cerebellopontine angle tumours on magnetic resonance imaging, with measured differences as high as 2 mm. Objective: To determine intra- and inter-observer measurement variability of cerebellopontine angle tumours in a specialised institution. Methods: The magnetic resonance imaging maximal diameter of 12 randomly selected cerebellopontine angle tumours were independently measured by 4 neuroradiologists at a tertiary referral centre using a standard definition for maximal tumour diameter. Average deviation and intraclass correlation were subsequently calculated. Results: Inter-observer difference averaged 0.33 ± 0.04 mm (range, 0.0–0.8 mm). Intra-observer measurements were more consistent than inter-observer measurements, with differences averaging 0.17 mm (95 per cent confidence interval = 0.27–0.06, p = 0.002). Inter-observer reliability was 0.99 (95 per cent confidence interval = 0.97–0.99), suggesting high reliability between the readings. Conclusion: The use of a standard definition for maximal tumour volume provided high reliability amongst radiologists' readings. To avoid oversizing tumours, it is recommended that conservative monitoring be conducted by the same institution with thin slice magnetic resonance imaging scans.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"94 1","pages":"S47 - S49"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85711340","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}
Tian-Tee Ng, D. Diamantaras, J. Priestley, J. Redman, N. D. de Silva, V. Mahanta
{"title":"Is celecoxib a useful adjunct in the treatment of post-tonsillectomy pain in the adult population? A randomised, double-blind, placebo-controlled study","authors":"Tian-Tee Ng, D. Diamantaras, J. Priestley, J. Redman, N. D. de Silva, V. Mahanta","doi":"10.1017/S0022215116009476","DOIUrl":"https://doi.org/10.1017/S0022215116009476","url":null,"abstract":"Abstract Objective: To evaluate the efficacy and safety of celecoxib for pain management in post-tonsillectomy adult patients. Design: A randomised, double-blind, placebo-controlled, phase 3 clinical trial was conducted in an adult population (aged 18–55 years), with a parallel group design using an allocation ratio of 1:1. Methods: Eighty patients underwent elective tonsillectomy or adenotonsillectomy, operated on by one surgeon. They were discharged home with randomly assigned celecoxib or placebo, together with regular post-tonsillectomy medications (paracetamol and Endone). Pain scores were measured from post-operative days 1 to 10. All patients were assessed on post-operative days 5, 12 and 28. Results: There were no statistically significant differences in the daily or overall pain scores, the total intake of Endone, or the time taken to achieve freedom from pain after tonsillectomy between the study arms (n = 40 each arm). The celecoxib-treated group experienced significantly more vomiting (celecoxib vs placebo p < 0.001 (Mann–Whitney test), confidence interval = 0.57 to 0.76). Conclusion: Celecoxib usage was associated with significantly more vomiting and did not reduce narcotic analgesia requirement post-tonsillectomy.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"33 1-2","pages":"S18 - S28"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91521666","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}
{"title":"Risk factors for secondary post-tonsillectomy haemorrhage following tonsillectomy with bipolar scissors: four-year retrospective cohort study","authors":"T. Harju, J. Numminen","doi":"10.1017/S0022215116009518","DOIUrl":"https://doi.org/10.1017/S0022215116009518","url":null,"abstract":"Abstract Objective: To analyse risk factors associated with secondary post-operative bleeding when only one technique, namely bipolar scissors, is used. Methods: The medical records of all consecutive patients aged six years or older who underwent tonsillectomy or adenotonsillectomy between 1 December 2010 and 30 November 2014 were retrospectively analysed. Results: A total of 1734 patients were included in the study. A secondary haemorrhage occurred in 208 patients (12 per cent). Patients aged 15 years or older were 4.5 times (95 per cent confidence interval = 2.6–7.9; p < 0.001) more likely to experience secondary haemorrhage. In cases of acute quinsy, patients aged 15 years or older had an 8.1-fold (95 per cent confidence interval = 1.1–59.6; p = 0.02) increased likelihood of experiencing secondary haemorrhage. Conclusion: Patients aged 15 years or older have a higher risk for bleeding regardless of the primary indication for the tonsillectomy. The risk for secondary haemorrhage does not seem to depend on the primary indication itself.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"79 1","pages":"155 - 161"},"PeriodicalIF":0.0,"publicationDate":"2016-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72950478","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}
Y. D. Huang, H. W. Yu, S. Xia, Z. Kang, Y. S. He, D. Y. Han
{"title":"Expression of maspin in invasive fungal rhinosinusitis","authors":"Y. D. Huang, H. W. Yu, S. Xia, Z. Kang, Y. S. He, D. Y. Han","doi":"10.1017/S0022215116009890","DOIUrl":"https://doi.org/10.1017/S0022215116009890","url":null,"abstract":"Abstract Objective: This study aimed to test the expression of maspin in invasive fungal rhinosinusitis and explore its value in diagnosing invasive fungal rhinosinusitis. Methods: Forty-two fungal rhinosinusitis cases (12 invasive and 30 non-invasive) were selected as the experimental group, and 30 chronic rhinosinusitis cases comprised the control group. Maspin expression was assessed in nasal mucous membrane specimens by immunohistochemical staining. Results: Compared with the control group, maspin expression was down-regulated in the fungal rhinosinusitis group (p < 0.05). Furthermore, the staining score for maspin was lowest in the invasive fungal rhinosinusitis group, as compared with both the non-invasive fungal rhinosinusitis group and the control group (p < 0.05). A maspin staining score of 5.70 was the critical value for diagnosis of invasive fungal rhinosinusitis, with sensitivity and specificity of 91.7 per cent and 88.3 per cent, respectively. Conclusion: The results of this study suggest that the maspin staining score may be a biomarker for effective and rapid diagnosis of invasive fungal rhinosinusitis.","PeriodicalId":22781,"journal":{"name":"The Journal of Laryngology & Otology","volume":"101 1","pages":"150 - 154"},"PeriodicalIF":0.0,"publicationDate":"2016-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80209363","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}