Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale最新文献

{"title":"iHear: Canadian medical student based hearing assessment program for grade school children using a tablet audiometer.","authors":"Deanna Lammers,&nbsp;Adam Rocker,&nbsp;David S Chan,&nbsp;Deema Couchman,&nbsp;Yiqiao Wang,&nbsp;Amy Fraser,&nbsp;Johnna MacCormick,&nbsp;Matthew Bromwich","doi":"10.1186/s40463-021-00542-w","DOIUrl":"https://doi.org/10.1186/s40463-021-00542-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the progress and challenges of a hearing screening program as well as review the incidence of pediatric hearing loss in grade school children participating in this program.</p><p><strong>Methods: </strong>Medical students from the University of Ottawa established iHear, a grade school hearing assessment program that uses novel tablet audiometry. Over 3 years, children in grades 1 and 2 were assessed and those found to have abnormal results on iHear assessment were then referred to audiology for formal testing, and to otolaryngology if needed.</p><p><strong>Results: </strong>From 2014 to 2017, 753 children aged 5-9 years old were assessed for hearing loss. Mean age of participants was 6.7 years, 51.9% of whom were female. Of the children assessed, 86 (11.4%) had abnormal results and 6 (0.8%) had inconsistent results, necessitating 92 referrals for assessment by a professional audiologist. Of the 65 participants who completed secondary audiologic assessment, 54 (83.1%) were normal and 11 (16.9%) had a definitive hearing loss or abnormal tympanometry. A total of 32 children were lost to follow-up. A total of 118 medical students were involved in the iHear program.</p><p><strong>Conclusions: </strong>Hearing loss in grade school populations continues to go undetected across Canada. Programs such as iHear demonstrate that gaps in the provision of hearing assessment can be filled effectively by medical students equipped with tablet audiometry. Medical student exposure to audiology and otolaryngology increased through the iHear program.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"60"},"PeriodicalIF":3.4,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39663081","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}

{"title":"Choosing Wisely Canada - pediatric otolaryngology recommendations.","authors":"Mitchell McDonough,&nbsp;Kalpesh Hathi,&nbsp;Gerard Corsten,&nbsp;Christopher J Chin,&nbsp;Paolo Campisi,&nbsp;Jonathan Cavanagh,&nbsp;Neil Chadha,&nbsp;M Elise Graham,&nbsp;Murad Husein,&nbsp;Liane B Johnson,&nbsp;Jodi Jones,&nbsp;Bruce Korman,&nbsp;John Manoukian,&nbsp;Lily H P Nguyen,&nbsp;Doron D Sommer,&nbsp;Julie Strychowsky,&nbsp;Trina Uwiera,&nbsp;Warren Yunker,&nbsp;Paul Hong","doi":"10.1186/s40463-021-00533-x","DOIUrl":"https://doi.org/10.1186/s40463-021-00533-x","url":null,"abstract":"<p><p>The Choosing Wisely Canada campaign raises awareness amongst physicians and patients regarding unnecessary or inappropriate tests and treatments. Using an online survey, members of the Pediatric Otolaryngology Subspecialty Group within the Canadian Society of Otolaryngology - Head & Neck Surgery developed a list of nine evidence based recommendations to help physicians and patients make treatment decisions regarding common pediatric otolaryngology presentations: (1) Don't routinely order a plain film x-ray in the evaluation of nasal fractures; (2) Don't order imaging to distinguish acute bacterial sinusitis from an upper respiratory infection; (3) Don't place tympanostomy tubes in most children for a single episode of otitis media with effusion of less than 3 months duration; (4) Don't routinely prescribe intranasal/systemic steroids, antihistamines or decongestants for children with uncomplicated otitis media with effusion; (5) Don't prescribe oral antibiotics for children with uncomplicated tympanostomy tube otorrhea or uncomplicated acute otitis externa; (6) Don't prescribe codeine for post-tonsillectomy/adenoidectomy pain relief in children; (7) Don't administer perioperative antibiotics for elective tonsillectomy in children; (8) Don't perform tonsillectomy for children with uncomplicated recurrent throat infections if there have been fewer than 7 episodes in the past year, 5 episodes in each of the past 2 years, or 3 episodes in each of the last 3 years; and (9) Don't perform endoscopic sinus surgery for uncomplicated pediatric chronic rhinosinusitis prior to failure of maximal medical therapy and adenoidectomy.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"61"},"PeriodicalIF":3.4,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39575080","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}

{"title":"Revised recommendations from the CSO-HNS taskforce on performance of tracheotomy during the COVID-19 pandemic - what a difference a year makes.","authors":"D D Sommer,&nbsp;D Cote,&nbsp;T McHugh,&nbsp;M Corsten,&nbsp;M A Tewfik,&nbsp;S Khalili,&nbsp;K Fung,&nbsp;M Gupta,&nbsp;N Sne,&nbsp;P T Engels,&nbsp;E Weitzel,&nbsp;T F E Brown,&nbsp;J Paul,&nbsp;K M Kost,&nbsp;J A Anderson,&nbsp;L Sowerby,&nbsp;D Mertz,&nbsp;I J Witterick","doi":"10.1186/s40463-021-00531-z","DOIUrl":"https://doi.org/10.1186/s40463-021-00531-z","url":null,"abstract":"<p><strong>Background: </strong>During the early part of the COVID-19 pandemic, the Canadian Society of Otolaryngology - Head & Neck Surgery (CSO-HNS) task force published recommendations on performance of tracheotomy. Since then, our understanding of the virus has evolved with ongoing intensive research efforts. New literature has helped us better understand various aspects including patient outcomes and health care worker (HCW) risks associated with tracheotomy during the COVID-19 pandemic. Accordingly, the task force has re-evaluated and revised some of the previous recommendations.</p><p><strong>Main body: </strong>Based on recent evidence, a negative reverse transcription polymerase chain reaction (RT-PCR) COVID-19 swab status is no longer the main deciding factor in the timing of tracheotomy. Instead, tracheotomy may be considered as soon as COVID-19 swab positive patients are greater than 20 days beyond initial symptoms and 2 weeks of mechanical ventilation. Furthermore, both open and percutaneous surgical techniques may be considered with both techniques showing similar safety and outcome profiles. Additional recommendations with discussion of current evidence are presented.</p><p><strong>Conclusion: </strong>These revised recommendations apply new evidence in optimizing patient and health care system outcomes as well as minimizing risks of COVID-19 transmission during aerosol-generating tracheotomy procedures. As previously noted, additional evidence may lead to further evolution of these and other similar recommendations.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"59"},"PeriodicalIF":3.4,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8527441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537285","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}

{"title":"Rate of malignancy for thyroid nodules with AUS/FLUS cytopathology in a tertiary care center - a retrospective cohort study.","authors":"Kalpesh Hathi,&nbsp;Tarek Rahmeh,&nbsp;Vicki Munro,&nbsp;Victoria Northrup,&nbsp;Ali Sherazi,&nbsp;Christopher J Chin","doi":"10.1186/s40463-021-00530-0","DOIUrl":"https://doi.org/10.1186/s40463-021-00530-0","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are stratified through fine-needle aspiration (FNA) and are often categorized using The Bethesda System for Reporting Thyroid Cytopathology, which estimates the risk of malignancy for six cytopathological categories. The atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) categories have varying malignancy rates reported in the literature which can range from 6 to 72.9%. Due to this heterogeneity, we assessed the malignancy rate and effectiveness of repeat FNA (rFNA) for AUS/FLUS thyroid cytopathology at our institution.</p><p><strong>Methods: </strong>Electronic health records of patients with AUS/FLUS thyroid cytopathology on FNA at our center since the implementation of the Bethesda System on May 1, 2014-December 31, 2019 were retrospectively reviewed. Patient demographics, treatment pathway, and pathology results were collected. The treatment pathway of the nodules, the rFNA results, and the malignant histopathology results were reported. Malignancy rates were calculated as an upper and lower limit estimate.</p><p><strong>Results: </strong>This study described 182 AUS/FLUS thyroid nodules from 177 patients. In total, 24 thyroid nodules were deemed malignant upon histopathology, yielding a final malignancy rate of 13.2-25.3%. All of the malignancies were variants of papillary thyroid carcinoma. The malignancy rate of the nodules which underwent resection without rFNA (21.5%) was lower than the malignancy rate of the nodules which underwent resection after rFNA (43.8%). 45.5% of the rFNA results were re-classified into more definitive categories.</p><p><strong>Conclusion: </strong>The malignancy rate of AUS/FLUS thyroid cytopathology at our center is in line with the risk of malignancy stated by the 2017 Bethesda System. However, our malignancy rate is lower than some other Canadian centers and approximately half of our rFNAs were re-classified, highlighting the importance of establishing center-specific malignancy and rFNA re-classification rates to guide treatment decisions.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"58"},"PeriodicalIF":3.4,"publicationDate":"2021-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39509084","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}

{"title":"30-day readmission rate in pediatric otorhinolaryngology inpatients: a retrospective population-based cohort study.","authors":"Katharina Geißler,&nbsp;Wido Rippe,&nbsp;Daniel Boeger,&nbsp;Jens Buentzel,&nbsp;Kerstin Hoffmann,&nbsp;Holger Kaftan,&nbsp;Andreas Mueller,&nbsp;Gerald Radtke,&nbsp;Orlando Guntinas-Lichius","doi":"10.1186/s40463-021-00536-8","DOIUrl":"https://doi.org/10.1186/s40463-021-00536-8","url":null,"abstract":"<p><strong>Objectives: </strong>Analysis of frequency and reasons for planned and unplanned 30-day readmission in hospitalized pediatric otorhinolaryngology patients using German Diagnosis Related Group (G-DRG) system data.</p><p><strong>Methods: </strong>A retrospective population-based cohort study in Thuringia, Germany, was performed for the year 2015 with 2440 cases under 18 years (55.6% male) out of a total number of 15.271 inpatient cases. The majority of pediatric patients were from 2 to 5 years old (54.5%). The most frequent diagnoses were hyperplasia of adenoids or/and tonsils (26.6%). 36 cases (1.5%) experienced readmission within 30-days.</p><p><strong>Results: </strong>30-day readmission was planned in 9 cases (25% of all readmission) and was unplanned in 27 cases (75%). The median interval between index and readmission treatment was 8 days. Postoperative bleeding after adenoidectomy, tonsillotomy/tonsillectomy or tracheostomy (33.4%) and infectious complications after surgery like acute otitis media, abscess formation or fever (36.2%) were the most frequent reasons for 30-day readmission. Compared to adults treated in 2015 in Thuringia, the readmission rate was higher in adult patients (8.9%) than in this pediatric cohort. In contrast to children, readmissions in adults were mainly planned (65.1%) with a different spectrum of underlying diseases and reasons for readmission.</p><p><strong>Conclusion: </strong>The 30-day readmission rate seemed to be lower for pediatric otolaryngology patients compared to adult patients. Unplanned readmissions dominated in pediatric patients, whereas planned readmissions dominated in adults.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"55"},"PeriodicalIF":3.4,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8454104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39455385","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}

{"title":"Extended high-frequency audiometry in healthy adults with different age groups.","authors":"Mingming Wang, Yu Ai, Yuechen Han, Zhaomin Fan, Peng Shi, Haibo Wang","doi":"10.1186/s40463-021-00534-w","DOIUrl":"10.1186/s40463-021-00534-w","url":null,"abstract":"<p><strong>Background: </strong>It was well-documented that extended high-frequency (EHF, above 8 kHz) hearing test could be more sensitive comparing with the conventional measurement on frequency below 8 kHz, regarding the early prediction of auditory damage in certain population. However, hardly any age-specific thresholds of EHF in population with normal hearing ability were observed. This study aims to monitor the age-dependent hearing thresholds at EHF (from 9 to 20 kHz) in healthy hearing population.</p><p><strong>Methods: </strong>A total of 162 healthy participants (from 21 to 70 years) with normal conventional pure tone audiograms were recruited and separated into five groups by age. Conventional pure tone average was performed with frequencies from 0.25 to 8 kHz under air conduction and from 0.25 to 4 kHz under bone conduction. EHF audiometry from 9 to 20 kHz was determined under air conduction.</p><p><strong>Results: </strong>The effects of aging on hearing were evident at frequencies above 4 kHz. The hearing thresholds of EHF were less than 26 dB HL before 30 years-olds. Hearing abilities in EHF were deteriorated starting from the 31 ~ 40 group and were most obvious in the 51 ~ 60 group and the 61 ~ 70 group with the maximum thresholds of 75 dB HL. Sensitivity of EHF was inversely proportional to the frequency within each age group, and to age among groups. Subjects under 30 years old were totally responsive up to 16 kHz, and 52.2% could respond to 20 kHz. Meanwhile, no responsiveness was recorded to 20 kHz in the 51 ~ 60 group and even to 18 kHz in the 61 ~ 70 group. No gender differences in hearing threshold was observed within each age group, except an obvious decline at frequencies of 4, 6, 8, and 9 kHz in male participants of the 41 ~ 50 group.</p><p><strong>Conclusions: </strong>Hearing thresholds at EHF from 9 to 20 kHz were more sensitive than at frequencies below 8 kHz for hearing measurement, and aging inversely affected hearing ability at EHF in healthy population. Hearing thresholds at EHF deteriorated with age and raising frequency, while the upper frequency limit decreased with aging.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"52"},"PeriodicalIF":2.2,"publicationDate":"2021-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39370256","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}

{"title":"Outcomes of endoscopic chemo- and laser-cauterizations and open fistulectomy for pyriform sinus fistula.","authors":"Hiroo Masuoka,&nbsp;Akira Miyauchi,&nbsp;Takahiro Sasaki,&nbsp;Tsutomu Sano,&nbsp;Akihiro Miya","doi":"10.1186/s40463-021-00537-7","DOIUrl":"https://doi.org/10.1186/s40463-021-00537-7","url":null,"abstract":"<p><strong>Background: </strong>Acute suppurative thyroiditis through the congenital pyriform sinus fistula (PSF) often recurs if the fistula is not resected. Although endoscopic chemo-cauterization (ECC) to obliterate the orifice of the fistula is less invasive than open fistulectomy, it may require repeated treatments. We recently adopted an endoscopic diode laser-cauterization (ELC) system with the intention of improving treatment outcomes in PSF. Here, we describe ELC and compare the outcomes of these three modalities.</p><p><strong>Methods: </strong>We evaluated 83 patients with PSF who underwent treatment between 2007 and 2018 at Kuma Hospital, a tertiary thyroid treatment hospital. ECC and ELC were implemented in 2007 and 2015, respectively. Patients who were ineligible for the endoscopic procedures underwent open fistulectomy. Barium swallow studies and computed tomography scan under a trumpet maneuver were performed after treatment to evaluate obliteration or removal of the fistula.</p><p><strong>Results: </strong>In total, 70 of the 81 (86%) patients who underwent barium swallow studies after the first treatment achieved obliteration or removal of the fistula. The success rates for open fistulectomy, ECC, and ELC were 100% (9/9), 83% (49/59), and 100% (13/13), respectively. ECC and ELC had significantly shorter operative times and lower blood loss than open fistulectomy. Insufficient opening of the mouth was the major reason for converting endoscopic procedures to open fistulectomy.</p><p><strong>Conclusions: </strong>ELC may yield superior outcomes and is therefore the optimal treatment modality for PSF. However, it is still associated with certain limitations. Thus, treatment selection remains dependent on the shape and size of the PSF and the mouth opening of the individual patient.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"49"},"PeriodicalIF":3.4,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39315494","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}

{"title":"Correction to: A smartphone application to objectively monitor music listening habits in adolescents.","authors":"Danique E Paping,&nbsp;Jantien L Vroegop,&nbsp;Simone P C Koenraads,&nbsp;Carlijn M P le Clercq,&nbsp;André Goedegebure,&nbsp;Robert J Baatenburg de Jong,&nbsp;Marc P van der Schroeff","doi":"10.1186/s40463-021-00532-y","DOIUrl":"https://doi.org/10.1186/s40463-021-00532-y","url":null,"abstract":"","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"50"},"PeriodicalIF":3.4,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39315498","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}

{"title":"Combination of the endoscopic septonasal flap technique and bioabsorbable steroid-eluting stents for repair of congenital choanal atresia in neonates and infants: a retrospective study.","authors":"Peng-Peng Wang,&nbsp;Li-Xing Tang,&nbsp;Jie Zhang,&nbsp;Xiao-Jian Yang,&nbsp;Wei Zhang,&nbsp;Yang Han,&nbsp;Xiao Xiao,&nbsp;Xin Ni,&nbsp;Wen-Tong Ge","doi":"10.1186/s40463-021-00535-9","DOIUrl":"https://doi.org/10.1186/s40463-021-00535-9","url":null,"abstract":"<p><strong>Background: </strong>Multiple surgical approaches have been proposed to repair the congenital choanal atresia. However, there remains no general consensus about the optimal surgical technique. This study aimed to describe and evaluate outcomes of the endoscopic septonasal flap technique combined with bioabsorbable steroid-eluting stents for repair of congenital choanal atresia in neonates and infants.</p><p><strong>Methods: </strong>Clinical data of 37 neonates and infants with congenital choanal atresia who received nasal endoscopic surgery with the flap technique between January 2018 and July 2020 were analyzed retrospectively. All patients underwent the ultra‑low‑dose paranasal sinus computed tomography imaging preoperatively to confirm diagnosis and plan the surgery. In these patients, the mirrored L-shaped flap technique was performed for bilateral atresia and the cross-over L-shaped flap technique was performed for unilateral atresia. A total of 22 patients had silicone stents postoperatively and 15 patients had bioabsorbable steroid-eluting stents postoperatively. Silicone stents were removed at one month postoperatively under secondary general anesthesia, while no anesthesia was needed to remove the bioabsorbable steroid-eluting stents. Postoperative follow-up ranged from 10 months to 3 years.</p><p><strong>Results: </strong>The septonasal flap technique was performed in all patients. Compared with the silicone stents group, the average operative duration and the hospital length of stay in the bioabsorbable steroid-eluting stents group were decreased [(97.46 ± 15.37) min vs (83.49 ± 19.16) min t = 13.733, P < 0.001] [(12.8 ± 3.22) d vs (7.67 ± 3.91) d t = 15.082, P < 0.001], the average number of procedures was reduced [(2.04 ± 0.64) vs (1.00 ± 0.001), t = 82.689, P < 0.001], the differences were statistically significant. There were no reports of postoperative restenosis and complications in the bioabsorbable steroid-eluting stents group, and follow-up endoscopic examinations showed patency and stable nasal passages in all cases.</p><p><strong>Conclusions: </strong>The endoscopic septonasal flap technique can effectively expose and expand the choanal bony structure for repair of congenital choanal atresia in neonates and infants. The combined use of this technique along with bioabsorbable steroid-eluting stents can help prevent the need for revision procedures and also against stent-related injuries.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"51"},"PeriodicalIF":3.4,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39305372","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}

{"title":"A national study of choanal atresia in tertiary care centers in Canada - part II: clinical management.","authors":"Josee Paradis,&nbsp;Agnieszka Dzioba,&nbsp;Hamdy El-Hakim,&nbsp;Paul Hong,&nbsp;Frederick K Kozak,&nbsp;Lily H P Nguyen,&nbsp;Demitri Perera,&nbsp;Evan Jon Propst,&nbsp;Jennifer M Siu,&nbsp;Monika Wojtera,&nbsp;Murad Husein","doi":"10.1186/s40463-021-00503-3","DOIUrl":"https://doi.org/10.1186/s40463-021-00503-3","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical management of choanal atresia (CA) in tertiary centers across Canada.</p><p><strong>Methods: </strong>Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with choanal atresia to a participating center.</p><p><strong>Results: </strong>The health charts of 215 patients (59.6% female) with choanal atresia (CA) were reviewed. Mean age of initial surgical repair was 0.8 months for bilateral CA, and 48.6 months for unilateral CA. Approaches of surgical repair consisted of endoscopic transnasal (31.7%), non-endoscopic transnasal (42.6%), and transpalatal (25.2%). Stents were used on 70.7% of patients. Forty-nine percent of patients were brought back to the OR for a planned second look; stent removal being the most common reason (86.4%). Surgical success rate of initial surgeries was 54.1%. Surgical technique was not associated with rate of restenosis [χ² (2) = 1.6, p = .46].</p><p><strong>Conclusions: </strong>The present study is the first national multi-institutional study exploring the surgical outcomes of CA over a 30-year period. The surgical repair of CA presents a challenge to otolaryngologists, as the rate of surgical failure is high. The optimal surgical approach, age at surgical repair, use of stents, surgical adjuncts, and need for planned second look warrant further investigation.</p>","PeriodicalId":520683,"journal":{"name":"Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale","volume":" ","pages":"46"},"PeriodicalIF":3.4,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40463-021-00503-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39180059","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}