World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

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A novel classification of tracheal defects and the reconstruction strategies: A retrospective study based on 106 cases. 气管缺损的新分类和重建策略:基于 106 个病例的回顾性研究。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-29 eCollection Date: 2023-03-01 DOI: 10.1016/j.wjorl.2021.08.001
Xin Xia, Xiao-Li Zhu, Ying-Ying Zhu, Wen-Wen Diao, Xing-Ming Chen
{"title":"A novel classification of tracheal defects and the reconstruction strategies: A retrospective study based on 106 cases.","authors":"Xin Xia, Xiao-Li Zhu, Ying-Ying Zhu, Wen-Wen Diao, Xing-Ming Chen","doi":"10.1016/j.wjorl.2021.08.001","DOIUrl":"10.1016/j.wjorl.2021.08.001","url":null,"abstract":"<p><strong>Objective: </strong>The study aims to present a novel classification of tracheal defects and the corresponding reconstruction strategies.</p><p><strong>Methods: </strong>The retrospective study was designed to analyze patients with diagnosed primary or secondary tracheal tumors from 1991 to 2020. Surgical techniques, complications and prognosis were reviewed. Airway status and patient outcomes were the principal follow-up measures. Tracheal defects were classified into two plane sizes (vertical (V) and horizontal (H) planes). Vertical defects were further categorized into three groups based on their tracheal ring numbers (V<sub>1</sub>, ≤ 5 rings; V<sub>2</sub>, 6-10 rings; and V<sub>3</sub>, > 10 rings). Tracheal defects with horizontal plane size H<sub>1</sub> and H<sub>2</sub> represent defects less and more than one-half the circumference of trachea. Thus, suitable reconstruction strategies were planned primarily based on \"V\" and \"H\" classifications. The reconstruction strategies performed were sleeve resection followed by an end-to-end anastomosis, window resection with sternocleidomastoid myoperiosteal flap reconstruction, defects conversion with rotation anastomosis, and modified tracheostomy with secondary flap reconstruction.</p><p><strong>Results: </strong>A total of 106 patients diagnosed with tracheal defects were enrolled in the study, of whom 59 patients underwent sleeve resection followed by end-to-end anastomosis; 40 patients received window resection alongside sternocleidomastoid (SCM) myoperiosteal flap reconstruction; five patients received converting defects with rotation anastomosis and two patients underwent modified tracheostomy with secondary stage flap reconstruction. Lumen stenosis occurred in three V<sub>2</sub>H<sub>1</sub> defect cases and were treated by a second reconstruction surgery. Iatrogenic unilateral recurrent laryngeal nerve paralysis occurred in two patients with the V<sub>3</sub>H<sub>2</sub> defect type, who were treated by temporary tracheotomy and partial vocal cord resection and extubated successfully during follow-up. All 106 patients achieved airway patency with adequate laryngeal function at the end of follow-up. No anastomotic dehiscence or bleeding occurred in any patient postoperatively.</p><p><strong>Conclusion: </strong>Though a significant number of multicenter studies concerning the reconstruction and classification of tracheal defects are needed, the study herein provides a novel classification of tracheal defects, which is primarily developed on the defect size. Therefore, the study might serve as a potential source for identifying suitable reconstruction strategies for practitioners.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"9 1","pages":"66-73"},"PeriodicalIF":0.0,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/d6/WJO2-9-66.PMC10050954.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9241496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Complications associated with energy-based devices during thyroidectomy from 2010-2020. 2010-2020 年甲状腺切除术中与能量设备相关的并发症。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-28 eCollection Date: 2023-03-01 DOI: 10.1016/j.wjorl.2021.04.008
Esther Lee, Jane Y Tong, Luke J Pasick, Daniel A Benito, Arjun Joshi, Punam G Thakkar, Joseph F Goodman
{"title":"Complications associated with energy-based devices during thyroidectomy from 2010-2020.","authors":"Esther Lee, Jane Y Tong, Luke J Pasick, Daniel A Benito, Arjun Joshi, Punam G Thakkar, Joseph F Goodman","doi":"10.1016/j.wjorl.2021.04.008","DOIUrl":"10.1016/j.wjorl.2021.04.008","url":null,"abstract":"<p><strong>Objective: </strong>Harmonic Focus (Ethicon, Johnson and Johnson, Cincinnati, OH, USA), LigaSure Small Jaw (Medtronic, Covidien Products, Minneapolis, MN, USA), and Thunderbeat Open Fine Jaw (Olympus, Japan) are electrosurgical instruments used widely in head and neck surgery. The study aims to compare device malfunctions, adverse events to patients, operative injuries, and interventions related to Harmonic, LigaSure, and Thunderbeat use during thyroidectomy.</p><p><strong>Methods: </strong>The US Food and Drug Administration's Manufacture and User Facility Device Experience (MAUDE) database was queried for adverse events associated with Harmonic, LigaSure, and Thunderbeat from January 2005 to August 2020. Data were extracted from reports pertaining to thyroidectomy.</p><p><strong>Results: </strong>Of the 620 adverse events extracted, 394 (63.5%) involved Harmonic, 134 (21.6%) LigaSure, and 92 (14.8%) Thunderbeat. The reported device malfunctions most frequently associated with Harmonic was damage to the blade (110 (27.9%)), LigaSure was inappropriate function (47 (43.1%)), Thunderbeat was damage to the tissue or Teflon pad (27 (30.7%)), respectively. Burn injury and incomplete hemostasis were the most commonly reported adverse events. The operative injury reported most frequently when using Harmonic and LigaSure was burn injury. No operator injuries were reported with Thunderbeat use.</p><p><strong>Conclusion: </strong>The most frequently reported device malfunctions were damage to the blade, inappropriate function, and damage to the tissue or Teflon pad. The most frequently reported adverse events to patients was a burn injury and incomplete hemostasis. Interventions aimed at improving physician education may help reduce adverse events attributed to improper use.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"9 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ee/77/WJO2-9-35.PMC10050967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9241493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Patient safety and quality improvements in parotid surgery. 腮腺手术中的患者安全和质量改进。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-27 eCollection Date: 2022-06-01 DOI: 10.1002/wjo2.50
Vidit Talati, Hannah J Brown, Tasher Losenegger, Peter Revenaugh, Samer Al-Khudari
{"title":"Patient safety and quality improvements in parotid surgery.","authors":"Vidit Talati, Hannah J Brown, Tasher Losenegger, Peter Revenaugh, Samer Al-Khudari","doi":"10.1002/wjo2.50","DOIUrl":"10.1002/wjo2.50","url":null,"abstract":"<p><p>Parotidectomy is the mainstay treatment for tumors of the parotid gland. In an effort to improve clinical outcomes, several modern surgical techniques and perioperative interventions have been evaluated and refined. This review discusses current and actively debated perioperative interventions aimed at improving patient safety and the quality of parotidectomy. Relevant high-impact literature pertaining to preoperative diagnostic modalities, intraoperative surgical techniques, and postoperative care will be described.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"8 2","pages":"133-138"},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/9e/WJO2-8-133.PMC9242422.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40558875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Designing an evidence-based free-flap pathway in head and neck reconstruction. 在头颈部重建中设计以证据为基础的游离瓣路径。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-27 eCollection Date: 2022-06-01 DOI: 10.1002/wjo2.22
Michelle Mark, Michael Eggerstedt, Matthew J Urban, Samer Al-Khudari, Ryan Smith, Peter Revenaugh
{"title":"Designing an evidence-based free-flap pathway in head and neck reconstruction.","authors":"Michelle Mark, Michael Eggerstedt, Matthew J Urban, Samer Al-Khudari, Ryan Smith, Peter Revenaugh","doi":"10.1002/wjo2.22","DOIUrl":"10.1002/wjo2.22","url":null,"abstract":"<p><strong>Background: </strong>The use of autologous free-tissue transfer is an increasingly utilized tool in the ladder of reconstructive options to preserve and restore function in patients with head and neck cancer. This article focuses on the evidence surrounding perioperative care that optimizes surgical outcomes and describes one tertiary center's approach to standardized free-flap care.</p><p><strong>Data sources: </strong>This article examines English literature from PubMed and offers expert opinion on perioperative free-flap care for head and neck oncology.</p><p><strong>Conclusion: </strong>Free-flap reconstruction for head and neck cancer is a process that, while individualized for each patient, is best supported by a comprehensive and standardized care pathway. Surgical optimization begins in the preoperative phase and a thoughtful approach to intraprofessional communication and evidence-based practice is rewarded with improved outcomes.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"8 2","pages":"126-132"},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/25/WJO2-8-126.PMC9242419.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40558879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A critical readability and quality analysis of internet-based patient information on neck dissections. 基于互联网的颈部解剖患者信息的可读性和质量分析。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-26 eCollection Date: 2023-03-01 DOI: 10.1016/j.wjorl.2021.07.001
Elysia M Grose, Joo Hyun Kim, Justine Philteos, Marc Levin, Jong Wook Lee, Eric A Monteiro
{"title":"A critical readability and quality analysis of internet-based patient information on neck dissections.","authors":"Elysia M Grose, Joo Hyun Kim, Justine Philteos, Marc Levin, Jong Wook Lee, Eric A Monteiro","doi":"10.1016/j.wjorl.2021.07.001","DOIUrl":"10.1016/j.wjorl.2021.07.001","url":null,"abstract":"<p><strong>Objective: </strong>Patients are increasingly turning to the Internet as a source of healthcare information. Given that neck dissection is a common procedure within the field of Otolaryngology - Head and Neck Surgery, the aim of this study was to evaluate the quality and readability of online patient education materials on neck dissection.</p><p><strong>Methods: </strong>A Google search was performed using the term \"neck dissection.\" The first 10 pages of a Google search using the term \"neck dissection\" were analyzed. The DISCERN instrument was used to assess quality of information. Readability was calculated using the Flesch-Reading Ease, Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, and Simple Measure of Gobbledygook Index.</p><p><strong>Results: </strong>Thirty-one online patient education materials were included. Fifty-five percent (<i>n</i> = 17) of results originated from academic institutions or hospitals. The mean Flesch-Reading Ease score was 61.2 ± 11.9. Fifty-two percent (<i>n</i> = 16) of patient education materials had Flesch-Reading Ease scores above the recommended score of 65. The average reading grade level was 10.5 ± 2.1. The average total DISCERN score was 43.6 ± 10.1. Only 26% of patient education materials (PEMs) had DISCERN scores corresponding to a \"good quality\" rating. There was a significant positive correlation between DISCERN scores and both Flesch-Reading Ease scores and average reading grade level.</p><p><strong>Conclusions: </strong>The majority of patient education materials were written above the recommended sixth-grade reading level and the quality of online information pertaining to neck dissections was found to be suboptimal. This research highlights the need for patient education materials regarding neck dissection that are high quality and easily understandable by patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"9 1","pages":"59-65"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ff/86/WJO2-9-59.PMC10050963.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Analysis of risk factors for lateral lymph node metastasis in papillary thyroid carcinoma: A retrospective cohort study. 甲状腺乳头状癌侧淋巴结转移的风险因素分析:一项回顾性队列研究。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-18 eCollection Date: 2022-09-01 DOI: 10.1016/j.wjorl.2021.01.002
Qiang Liu, Wen-Ting Pang, Yan-Bo Dong, Zhen-Xiao Wang, Ming-Hang Yu, Xue-Feng Huang, Liang-Fa Liu
{"title":"Analysis of risk factors for lateral lymph node metastasis in papillary thyroid carcinoma: A retrospective cohort study.","authors":"Qiang Liu, Wen-Ting Pang, Yan-Bo Dong, Zhen-Xiao Wang, Ming-Hang Yu, Xue-Feng Huang, Liang-Fa Liu","doi":"10.1016/j.wjorl.2021.01.002","DOIUrl":"10.1016/j.wjorl.2021.01.002","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).</p><p><strong>Methods: </strong>A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.</p><p><strong>Results: </strong>The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (<i>P</i> < 0.001), bilateral primary tumour (<i>P</i> = 0.020), extrathyroidal extension (ETE) (<i>P</i> < 0.001), central lymph node metastasis (CLNM) (<i>P</i> < 0.001), and CLNM number ≥ 5 (<i>P</i> < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (<i>OR</i> values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.</p><p><strong>Conclusion: </strong>This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":"274-278"},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/30/WJO2-8-274.PMC9479478.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33484001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Programmed death 1 (PD-1) and ligand (PD-L1) inhibitors in head and neck squamous cell carcinoma: A meta-analysis. 头颈部鳞状细胞癌中的程序性死亡 1 (PD-1) 和配体 (PD-L1) 抑制剂:一项荟萃分析。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-18 eCollection Date: 2022-09-01 DOI: 10.1002/wjo2.15
Dylan A Levy, Jaimin J Patel, Shaun A Nguyen, W Nicholas Jungbauer, David M Neskey, Ezra E W Cohen, Chrystal M Paulos, John A Kaczmar, Hannah M Knochelmann, Terry A Day
{"title":"Programmed death 1 (PD-1) and ligand (PD-L1) inhibitors in head and neck squamous cell carcinoma: A meta-analysis.","authors":"Dylan A Levy, Jaimin J Patel, Shaun A Nguyen, W Nicholas Jungbauer, David M Neskey, Ezra E W Cohen, Chrystal M Paulos, John A Kaczmar, Hannah M Knochelmann, Terry A Day","doi":"10.1002/wjo2.15","DOIUrl":"10.1002/wjo2.15","url":null,"abstract":"<p><strong>Background: </strong>PD-1 and PD-L1 inhibitors have emerged as promising treatments for patients with head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Methods: </strong>Systematic review and meta-analysis of PD-1 and PD-L1 inhibitors in HNSCC. Outcomes: median overall survival (mOS), median progression-free survival (mPFS), Response Evaluation Criteria in Solid Tumors (RECIST) and treatment-related adverse events (TRAEs).</p><p><strong>Results: </strong>Eleven trials reported data on 1088 patients (mean age: 59.9 years, range: 18-90). The total mOS was 7.97 months (range: 6.0-16.5). Mean mPFS for all studies was 2.84 months (range: 1.9-6.5). PD-1 inhibitors had a lower rate of RECIST Progressive Disease than PD-L1 inhibitors (42.61%, 95% confidence interval [CI]: 36.29-49.06 vs. 56.79%, 95% CI: 49.18-64.19, <i>P</i> < 0.001). The rate of TRAEs of any grade (62.7%, 95% CI: 59.8-65.6) did not differ.</p><p><strong>Conclusions: </strong>Meta-analysis shows the efficacy of PD-1 and PD-L1 inhibitors in HNSCC and suggests a possible difference in certain RECIST criterion between PD-1 and PD-L1 inhibitors. Future work to investigate the clinical significance of these findings is warranted.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"8 3","pages":"177-186"},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/a7/WJO2-8-177.PMC9479482.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9627554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical wound classification in otolaryngology: A state-of-the-art review. 耳鼻喉科手术伤口分类:最新综述。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-18 eCollection Date: 2022-06-01 DOI: 10.1002/wjo2.63
Jeffrey D Bernstein, David J Bracken, Shira R Abeles, Ryan K Orosco, Philip A Weissbrod
{"title":"Surgical wound classification in otolaryngology: A state-of-the-art review.","authors":"Jeffrey D Bernstein, David J Bracken, Shira R Abeles, Ryan K Orosco, Philip A Weissbrod","doi":"10.1002/wjo2.63","DOIUrl":"10.1002/wjo2.63","url":null,"abstract":"<p><strong>Objective: </strong>To describe the issues related to the assignment of surgical wound classification as it pertains to Otolaryngology-Head & Neck surgery, and to present a simple framework by which providers can assign wound classification.</p><p><strong>Data sources: </strong>Literature review.</p><p><strong>Conclusion: </strong>Surgical wound classification in its current state is limited in its utility. It has recently been disregarded by major risk assessment models, likely due to inaccurate and inconsistent reporting by providers and operative staff. However, if data accuracy is improved, this metric may be useful to inform the risk of surgical site infection. In an era of quality-driven care and reimbursement, surgical wound classification may become an equally important indicator of quality.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"8 2","pages":"139-144"},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/1d/WJO2-8-139.PMC9242420.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40558874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is the clinical head impulse test helpful in cochlear implantation candidacy evaluation? 临床头脉冲测试对人工耳蜗植入候选评估有帮助吗?
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-18 eCollection Date: 2023-03-01 DOI: 10.1002/wjo2.52
Nicole T Jiam, Yi Cai, Katherine C Wai, Colleen Polite, Kurt Kramer, Jeffrey D Sharon
{"title":"Is the clinical head impulse test helpful in cochlear implantation candidacy evaluation?","authors":"Nicole T Jiam, Yi Cai, Katherine C Wai, Colleen Polite, Kurt Kramer, Jeffrey D Sharon","doi":"10.1002/wjo2.52","DOIUrl":"10.1002/wjo2.52","url":null,"abstract":"<p><strong>Objective: </strong>Vestibular dysfunction is a known risk of cochlear implantation (CI). However, the utility of the physical exam to screen CI candidates for vestibular dysfunction is not well-studied. The objective of this study is to evaluate the preoperative role of the clinical head impulse test (cHIT) in subjects undergoing CI surgery evaluation.</p><p><strong>Study design setting and subjects: </strong>We conducted a retrospective review of 64 adult CI candidacy cases between 2017 and 2020 at a tertiary health care center.</p><p><strong>Methods: </strong>All patients underwent audiometric testing and evaluation by the senior author. Patients with an abnormal catch-up saccade contralateral to their worse hearing ear during cHIT were referred for formal vestibular testing. Outcomes included clinical and formal vestibular results, operated ear with regard to audiometric and vestibular results, and postoperative vertigo.</p><p><strong>Results: </strong>Among all CI candidates, 44% (<i>n </i>= 28) reported preoperative disequilibrium symptoms. Overall, 62% (<i>n </i>= 40) of the cHITs were normal, 33% (<i>n </i>= 21) were abnormal, and 5% (<i>n </i>= 3) were inconclusive. There was one patient who presented with a false positive cHIT. Among the patients who endorsed disequilibrium, 43% had a positive preoperative cHIT. Fourteen percent of the subjects (<i>n </i>= 9) without disequilibrium had an abnormal cHIT. In this cohort, bilateral vestibular impairment (71%) was more common than unilateral vestibular impairment (29%). In 3% of the cases (<i>n </i>= 2), surgical management was revisited or altered due to cHIT findings.</p><p><strong>Conclusion: </strong>There is a high prevalence of vestibular hypofunction in the CI candidate population. Self-reported assessments of vestibular function are often not congruent with cHIT results. Clinicians should consider incorporating cHITs as part of the preoperative physical exam to potentially avoid bilateral vestibular dysfunction in a minority of patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":"9 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/86/WJO2-9-45.PMC10050961.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9246301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Survival differences of low-grade versus high-grade head and neck pleomorphic dermal sarcomas and a review of a scalp case. 低级别头颈部多形真皮肉瘤与高级别头颈部多形真皮肉瘤的生存差异及头皮病例回顾。
World Journal of OtorhinolaryngologyHead and Neck Surgery Pub Date : 2022-04-18 eCollection Date: 2023-03-01 DOI: 10.1002/wjo2.64
Tyler A Janz, Barry D Long, Rohan R Joshi, Orly M Coblens
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