Annals of Otology Rhinology and Laryngology最新文献

{"title":"Preventive Effect of Controlled-Release Dexamethasone on Cochlear Ossification in Meningitis Model.","authors":"Fakih Cihat Eravcı, Ömer Kaplan, Fahriye Kılınç, Metin Doğan, Hamdi Arbağ, Miyase Orhan","doi":"10.1177/00034894251322616","DOIUrl":"https://doi.org/10.1177/00034894251322616","url":null,"abstract":"<p><strong>Objective: </strong>Despite vaccination and early antibiotic treatment, pneumococcal meningitis remains a disease with significant mortality and morbidity. The resulting inflammatory response can lead to cochlear fibrosis, ossification where cochlear implant surgeries are far challenging. Our study aimed to investigate the preventive effect of controlled-release dexamethasone implant in such cases in terms of structural integrity.</p><p><strong>Methods: </strong>Twenty-four rats were induced with pneumococcal meningitis and randomized into study (n = 16) and control (n = 8) groups. Controlled-release dexamethasone implants were placed transbullarly into the right round window of the study group. Bilateral cochleas underwent histological examination 3 months post-infection.</p><p><strong>Results: </strong>In the study, cochlear effects of pneumococcal meningitis were evaluated. The basal turn was significantly more affected by fibrosis and ossification (<i>P</i> = .013 and .010, respectively). Compared with control ears, the dexamethasone implant group showed less fibrosis in all turns and less ossification in the basal turn (<i>P</i> = .014, .003, .044, and .035, respectively).</p><p><strong>Conclusion: </strong>In pneumococcal meningitis, fibrosis and ossification occur more intensively in the basal turn of the cochlea. Controlled-release dexamethasone implants are effective in preventing cochlear ossification and fibrosis. The prevention from the structural damage indicates the potential role of these dexamethasone implants in post-meningitic hearing loss and easing cochlear implant surgeries.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251322616"},"PeriodicalIF":1.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-Center Randomized Study Assessing If Validated Short Videos Improve Sinus Education.","authors":"Christopher Eric Bailey, Cristina Cabrera-Muffly, Philip G Chen, Nyssa Farrell, Sanjeet V Rangarajan, Michael Yim, Joseph Irish, Christopher H Le, Eugene H Chang","doi":"10.1177/00034894251322653","DOIUrl":"https://doi.org/10.1177/00034894251322653","url":null,"abstract":"<p><strong>Objective: </strong>To determine if a short 10-minute video of either CT images (Video1: V1) or CT and endoscopic surgical videos (Video 2: V2) could be used to improve sinonasal anatomy knowledge in medical students (Med) and otolaryngology residents (OtoR).</p><p><strong>Background: </strong>YouTube is a widely used platform for surgical training, yet many educational videos are of poor quality. We developed and validated two 10-minute narrated videos of sinus anatomy, the first (V1) incorporated CT images of critical structures while the second (V2) combined CT images and surgical endoscopic video. In tandem, we developed a sinonasal assessment used to test sinonasal anatomy, surgical landmarks, and situational awareness.</p><p><strong>Methods: </strong>We performed a multicenter, randomized IRB-approved educational study evaluating the efficacy of the V1 and V2 videos by comparing pre-test (PrT) and post-test (PoT) scores in Med and OtoR subject groups. Subjects then watched the alternate video and preferences were assessed.</p><p><strong>Results: </strong>A total of 30 Med and 37 OtoR successfully completed the study at 6 different institutions. There were significant differences in pre-test knowledge with OtoR scoring higher than Med in all 3 pre-test subdomains [(S1: 4.3 v s2.9, <i>P</i> < .0001, S2: 4.4 vs 3.1, <i>P</i> < .0001, and S3: 4.6 vs 3.2, <i>P</i> < .0001)]. In the Med group, both V1 and V2 educational videos significantly improved post-test scores compared to pre-test scores (V1: 10.06 vs 12.59, <i>P</i> = .0005; V2: 8.23 vs 11.08, <i>P</i> = .0008). In the OtoR group, only the V2 educational video showed significant improvement (13.24 vs 14.76, <i>P</i> < .0001). Both groups thought the videos were helpful and improved their spatial awareness of sinus anatomy.</p><p><strong>Conclusions: </strong>Short, validated videos significantly improve sinonasal education and should be incorporated in modern training programs.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251322653"},"PeriodicalIF":1.3,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Completion Rates of the SNOT-22 Questionnaire.","authors":"Luv Amin, John Davis, Mishek Thapa, Syeda L Khalil, Arthur W Wu, Thomas S Higgins, Dennis M Tang","doi":"10.1177/00034894251320303","DOIUrl":"https://doi.org/10.1177/00034894251320303","url":null,"abstract":"<p><strong>Background: </strong>The 22-item Sinonasal Outcome Test (SNOT-22) is a widely used patient-reported outcome measure (PROM) for assessing chronic rhinosinusitis (CRS). However, incomplete surveys may impact its predictive utility.</p><p><strong>Aims: </strong>This study explores SNOT-22 completion rates, response trends, and potential factors influencing survey omissions aiming to optimize its predictive utility and practical application.</p><p><strong>Methods: </strong>SNOT-22 surveys were retrospectively collected from patients at various time points throughout their CRS treatment. Surveys with at least one question unanswered were included in the study. Completely unanswered surveys were excluded. Survey response dynamics and trends were analyzed and reported.</p><p><strong>Results: </strong>1,034 SNOT-22 surveys were collected, 18% of the surveys were incomplete. Questions on \"Ear fullness\" and \"Embarrassed\" were most unanswered, while \"Need to blow nose\" and \"Nasal blockage\" were least unanswered. Questions later in the survey showed a moderate positive correlation with missing responses. Mean scores per question were higher in incomplete than in complete surveys, though differences in SNOT-22 scores between partially and fully completed surveys weren't significant.</p><p><strong>Conclusion: </strong>Our study found that a large number of SNOT-22 surveys were incomplete, higher than rates reported in similar PROMs. Mean scores did not differ significantly between partial and complete surveys, suggesting interpretation should prioritize individual responses over total scores. Potential barriers to survey completion include question wording, symptom relevance, and survey length. Future research should further investigate survey completion through qualitative methods and randomized question ordering to refine survey design.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251320303"},"PeriodicalIF":1.3,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid-Stimulating Hormone Testing and Outcomes in Total Laryngectomy Patients.","authors":"James D Warren, Kacie R Oglesby, Carlton R Homan, Edmund Howe, Oishika Paul, Patrick Tassone, Anne C Kane","doi":"10.1177/00034894251320883","DOIUrl":"https://doi.org/10.1177/00034894251320883","url":null,"abstract":"<p><strong>Objective: </strong>Assess timing and prevalence of thyroid-stimulating hormone (TSH) testing after total laryngectomy (TL). Identify prevalence of postoperative hypothyroidism and determine associations between thyroidectomy, postoperative hypothyroidism, and wound complications, including pharyngocutaneous fistula (PCF).</p><p><strong>Methods: </strong>Retrospective chart review performed at 2 tertiary care centers of adult patients undergoing TL between 2013 and 2021. Demographic data, perioperative labs and post-operative outcomes were collected. Analysis was performed.</p><p><strong>Results: </strong>Of 237 patients identified, thyroid removal was performed in 156 (65.8%), including 23 (9.7%) total thyroidectomies and 133 (56.1%) hemi-thyroidectomies. Of the 191 (80.6%) receiving postoperative TSH testing, 98 (41.4%) had TSH testing within 90 days, and 112 (58.6%) developed hypothyroidism. Mean postoperative TSH testing interval was 222.0 days (SSD 400.2), with variations associated with age (<i>P</i> = .026), gender (<i>P</i> = .009), PCF formation (<i>P</i> < .001), history of radiation therapy (RT, <i>P</i> = .011), and preoperative levothyroxine use (<i>P</i> = .031). Partial or total thyroid removal significantly increased the likelihood of high postoperative TSH (OR = 2.631, <i>P</i> = .002, 95% CI [1.410, 4.911]). PCF occurred in 62 (26.2%) patients, and there were no significant associations between pre/postoperative TSH or thyroid removal and PCF development or wound complications.</p><p><strong>Conclusion: </strong>Thyroidectomy was associated with elevated postoperative TSH levels, adding support to prior literature for consideration of avoiding thyroid removal during TL when appropriate. The wide range of TSH testing intervals and prevalence of postoperative hypothyroidism in our cohort highlights the importance of monitoring thyroid function in TL patients during the perioperative period.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251320883"},"PeriodicalIF":1.3,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Patient-Reported Outcomes: A Mixed Methods Qualitative Comparison Between Obturator and Surgically Reconstructed Maxillectomy Patients.","authors":"Ala Almanaseer, Cecilia Dong, Freeman Paczkowski, Francisco Laxague, S Danielle Macneil, Anthony C Nichols, John Yoo, Kevin Fung, Cecilia Aragon, Adrian Mendez","doi":"10.1177/00034894251320003","DOIUrl":"https://doi.org/10.1177/00034894251320003","url":null,"abstract":"<p><strong>Objectives: </strong>Cancers of the maxillary region are often treated surgically with a maxillectomy followed by rehabilitation involving surgical reconstruction or obturator insertion to improve functional outcomes. However, there is a lack of consensus regarding the specific indications for either rehabilitation method. The objective of this study was to identify unique functional domains for maxillectomy patients who underwent surgical reconstruction or obturator insertion post-op to provide standardized data that can inform selection of either method.</p><p><strong>Methods: </strong>This mixed-methods qualitative research was conducted from January 2020 to June 2022 at London Health Sciences Centre, a tertiary care center in London, Ontario, Canada. Phase I included open-ended patient interviews through grounded theory, while phase II incorporated focus groups through the Delphi technique. Phase I identified functional domains of interest, which were further refined based on importance to patients in phase II. Inclusion criteria consisted of adults, 18 years or older who underwent maxillectomy surgery for head and neck cancer.</p><p><strong>Results: </strong>A total of 22 patients were included in phase I and 8 patients were included in phase II. The top 4 functional domains that affected patients regardless of rehabilitation method were eating difficulties, speaking difficulties, social discomfort with public eating, and numbness. The top 4 unique functional domains identified for the surgical group were dry mouth, trismus, chewing difficulties, and eye-related symptoms. The top 4 unique functional domains for the obturator group were obturator discomfort, nasal regurgitation, weight loss, and voice changes.</p><p><strong>Conclusions: </strong>This study identified functional domains affecting maxillectomy patients, which can be used to inform decisions regarding selection of rehabilitation method in clinical practice. This data can also in the future to create the first patient-reported outcomes instrument for this patient population.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251320003"},"PeriodicalIF":1.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Otologic Surgery on Medical and Social Outcomes in Adults With Hearing Loss.","authors":"Natalie M Perlov, Marwin Li, Jena Patel, Ayan T Kumar, Zachary D Urdang, Thomas O Willcox, Rebecca C Chiffer","doi":"10.1177/00034894251320000","DOIUrl":"https://doi.org/10.1177/00034894251320000","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypothesis that surgical otologic intervention for any type of adult hearing loss decreases the odds for incident adverse life events (ALEs) and medical comorbidities (MCBs).</p><p><strong>Study design: </strong>Retrospective cohort database study.</p><p><strong>Methods: </strong>Electronic medical record data from the TriNetX Research Network were queried for adults (age ≥18 years) with congenital, sensorineural, conductive, and mixed hearing loss (HL). Patients were further stratified into 3 groups by presence or absence (HL-surgery) of surgical intervention at any point following diagnosis, including (1) stapes surgery (HL + stapes); (2) cochlear implantation and bone-anchored hearing aid (HL + CI); and (3) mastoidectomy alone and tympanoplasty with or without mastoidectomy (HL + TM). Primary outcomes were defined as odds for new ALEs or MCBs at any point given HL treatment status [Odds ratio with 95% confidence interval, (OR; 95% CI, <i>P</i>-value)]. Cohorts were balanced using propensity-score matching (PSM) based on US census-defined demographics and congenital comorbidities.</p><p><strong>Results: </strong>There were 2 577 153 patients included in this study. Matched analysis demonstrated that HL + stapes adults (n = 7985) had 0.37-lower odds (95% CI = 0.30-0.47, <i>P</i> < .0001) of experiencing any incident ALE versus HL-surgery adults (n = 2 518 409). Adults in the HL + CI cohort (n = 17 129) had 0.58-lower odds (0.52-0.66, <i>P</i> < .0001) of experiencing any incident MCB versus HL-surgery adults.</p><p><strong>Conclusions: </strong>This study highlights the benefit of surgical intervention for adult hearing loss on social and medical phenomes. These findings represent the largest cohort study to date demonstrating this association and further support that hearing restoration improves patient socioeconomic and medical outcomes.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251320000"},"PeriodicalIF":1.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Validity of a Pediatric Drug-Induced Sleep Endoscopy Grading System (PedDISE-8).","authors":"Hussein Jaffal, Steven W Coutras, John Dewey, Erica McArdle, Ruifeng Cui","doi":"10.1177/00034894251318158","DOIUrl":"https://doi.org/10.1177/00034894251318158","url":null,"abstract":"<p><strong>Objectives: </strong>Drug-induced sleep endoscopy (DISE) is increasingly being used in children with obstructive sleep apnea (OSA) to identify specific sites of upper airway obstruction and plan surgical interventions. This study aims to test the reliability and validity of a new grading system for pediatric DISE procedures (PedDISE-8).</p><p><strong>Methods: </strong>We conducted a retrospective chart review of children 0 to 18 years old with OSA who underwent DISE. Four independent raters reviewed and graded each video recording twice using the PedDISE-8. Eight upper airway sites were evaluated: inferior turbinates, adenoid, velum, tonsils/lateral pharyngeal walls, lingual tonsils, tongue base, epiglottis, and supra-arytenoid tissue. Intraclass correlation coefficients were calculated to determine inter-rater and intra-rater rating reliability for each site. External validity was assessed by analyzing the correlation between the number of sites with severe obstruction and polysomnographic data.</p><p><strong>Results: </strong>DISE recordings were reviewed for 86 pediatric patients, 59.5% of whom were male and 26.7% were obese. The median age was 3.5 (IQR 2.4-5.3) years, and the median obstructive apnea-hypopnea index (oAHI) was 5.5 (IQR 3.1-10.4). Moderate to good inter-rater and intra-rater reliability were found for all eight sites (intraclass correlation coefficient 0.67 to 0.88 and 0.71 to 0.87, respectively). The number of sites with severe obstruction correlated positively with the oAHI (τ = 0.119, <i>P</i> = .004).</p><p><strong>Conclusions: </strong>The PedDISE-8 grading system demonstrated good inter-rater and intra-rater reliability and external validity. It can be used in children undergoing DISE for OSA.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251318158"},"PeriodicalIF":1.3,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Experience of Awake Laryngoscopy Procedures.","authors":"Andrea R Hsu, Heather L Johns, Ivonne Arguelles, Jamie O'Byrne, Dale Ekbom, Diana Orbelo, Semirra Bayan","doi":"10.1177/00034894251315339","DOIUrl":"https://doi.org/10.1177/00034894251315339","url":null,"abstract":"<p><strong>Objective(s): </strong>To quantify and compare pre-procedure worry versus the experience of pain, gagging, and dyspnea during in-office laryngoscopy procedures in patients who did or did not receive pre-procedure anxiolytics, and to explore patient perception of intra-procedure interventions.</p><p><strong>Methods: </strong>Patients undergoing awake laryngology procedures at a quaternary care center were enrolled. The State-Trait Anxiety Inventory (STAI) Y1 and Y2 questionnaires were administered to establish baseline levels of state anxiety and trait anxiety, respectively. Pre-procedure and post-procedure surveys assessed patient perception of select interventions.</p><p><strong>Results: </strong>34 patients were enrolled (35.3% female, 91.2% white, mean age 60 years). Pre-procedure, 51.5% of patients reported some degree of worry about pain, 61.8% about gagging, 52.9% about dyspnea, and 55.9% about having something in their nose/throat. Post-procedure, 54.5% reported experiencing pain to some degree, 63.6% had gagging, 39.4% had dyspnea, and 78.7% were bothered by having something in their nose/throat. Patients who received a pre-procedure anxiolytic were significantly more likely to report more pain compared to those who did not. The highest rated interventions were pre-procedural education (97.0% \"Very helpful\"), verbal reassurance (96.9%), provider communicating steps of the procedure (96.9%), and reminders to breathe (87.5%).</p><p><strong>Conclusion: </strong>For patients undergoing awake laryngology procedures, the anticipation of gagging, pain, trouble breathing, and scope-related discomfort are worrisome factors. Of these, scope-related discomfort and gagging are the most often-reported sources of intraprocedural discomfort. The interventions patients found most helpful were based on preprocedural education and clear intraprocedural communication, which suggests that purposeful communication has a role in relieving anxiety.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251315339"},"PeriodicalIF":1.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss Secondary to <i>TECTA</i> Gene Mutations.","authors":"Rocío González-Aguado, Esther Onecha, Jaime Gallo-Terán, Carmelo Morales-Angulo","doi":"10.1177/00034894251315550","DOIUrl":"https://doi.org/10.1177/00034894251315550","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the prevalence and clinical characterization of variants in the <i>TECTA</i> gene among individuals with bilateral sensorineural hearing loss of unknown etiology in northern Spain.</p><p><strong>Methods: </strong>A 6-year (2018-2024) observational, prospective, and descriptive study was conducted on patients with bilateral sensorineural hearing loss at a tertiary hospital. Next generation sequencing using a gene panel for sensorineural hearing loss was performed to detect pathogenic, likely pathogenic, or variants of unknown significance in the <i>TECTA</i> gene.</p><p><strong>Results: </strong>Among 326 patients, pathogenic or likely pathogenic <i>TECTA</i> variants were found in 7 patients (2.14%), including c.3107G>A (n = 6) and c.5383+6T>A (n = 1). Variants of unknown significance were found in 8 patients (2.45%). About 14 of 15 probands had a family history of hearing loss with autosomal dominant inheritance. Eight relatives with confirmed pathogenic variants were also included, totalling 23 cases. Six patients with pathogenic variants and 3 with variants of unknown significance had moderate mid-frequency hearing loss, while others had severe high-frequency loss. Hearing loss was typically progressive, ranging from congenital onset to the fifth decade. Most were treated with hearing aids; none required cochlear implants.</p><p><strong>Conclusions: </strong><i>TECTA</i> gene variants are relatively common in this population, with c.3107G>A being the most frequent. The typical phenotype is slowly progressive, mid-to-high frequency sensorineural hearing loss, often starting in childhood and usually requiring hearing aids fitting with good results in improving speech intelligibility.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251315550"},"PeriodicalIF":1.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mask Anesthesia, Straight Laryngoscope, and Alligator Forceps for Cervical Esophageal Coin Removal: A Comparison with Traditional Methods.","authors":"Hemali P Shah, Craig Cameron Brawley, Lauren Gabra, John Maddalozzo, Sarah Maurrasse, Douglas Johnston","doi":"10.1177/00034894251318161","DOIUrl":"https://doi.org/10.1177/00034894251318161","url":null,"abstract":"<p><strong>Objective(s): </strong>Coins are the most frequently ingested foreign bodies by children. While rigid esophagoscopy with concomitant intubation is frequently used for removal, it has the potential for serious complications. We aimed to assess and compare the safety, efficacy, and efficiency of two different techniques for pediatric cervical esophageal coin removal.</p><p><strong>Methods: </strong>Retrospective chart review identified patients who underwent esophageal coin removal from January 2017-August 2023 at one of two tertiary academic centers: Ann & Robert H. Lurie Children's Hospital and Yale-New Haven Hospital. Patients with foreign bodies other than coins were excluded. Patients underwent one of two approaches for cervical esophageal coin removal depending on surgeon preference: (1) induction of general anesthesia, intubation, rigid esophagoscopy, and coin extraction with optical forceps (esophagoscope group) or (2) mask ventilation, insertion of a straight laryngoscope blade into the esophagus orifice, and coin extraction with alligator forceps (straight laryngoscope group). Primary outcomes were successful removal of the esophageal coin, regarded a marker of efficacy, as well as operative and anesthesia times, which were regarded as measures of efficiency. Secondary outcomes were postoperative complications, regarded as markers of safety.</p><p><strong>Results: </strong>Of the 108 patients meeting inclusion criteria, 23 (21.3%) were in the straight laryngoscope group and 85 (78.7%) in the esophagoscope group. Mean operative time was significantly shorter for the straight laryngoscope group compared to the esophagoscope group (2.8 ± 1.5 minutes vs 13.8 ± 17.2 minutes, respectively, <i>p</i> < .0001). Mean anesthesia time was significantly shorter for the straight laryngoscope group compared to the esophagoscope group (24.2 ± 6.4 minutes vs 44.7 ±1 6.2 minutes, respectively, <i>p</i> < .0001). There were no intra- or post-operative complications in the straight laryngoscope group and two minor complications in the esophagoscope group.</p><p><strong>Conclusions: </strong>Esophagoscopy using a straight laryngoscope blade under mask anesthesia can represent a safe and efficient alternative for impacted esophageal coin removal.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251318161"},"PeriodicalIF":1.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}