American Journal of Otolaryngology最新文献

{"title":"Commentary on “Impact of time-to-surgery on survival and quality of life in oral cancer”","authors":"","doi":"10.1016/j.amjoto.2024.104443","DOIUrl":"10.1016/j.amjoto.2024.104443","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846415","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":"Features related to temporary tracheotomy in patients undergoing Transoral Robotic Surgery (TORS) for supraglottic squamous cell cancer of the larynx: A systematic review","authors":"","doi":"10.1016/j.amjoto.2024.104436","DOIUrl":"10.1016/j.amjoto.2024.104436","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this systematic review is to assess a relation between demographical, clinical and tumoral features and the need for a prophylactic tracheotomy during TORS procedure in patients affected by supraglottic laryngeal cancer.</p></div><div><h3>Methods</h3><p>PRISMA 2020 guidelines were applied in this systematic literature review. A computerized search was performed using the Embase/Pubmed, Scopus and Cochrane database, for articles published from 2007 to December 2023. A statistical univariate analysis including selected papers with low or intermediate risk of bias was performed.</p></div><div><h3>Results</h3><p>Through a study selection process 8 full texts were eligible for statistical univariate analysis. The most relevant factor related to a prophylactic tracheotomy was a contextual bilateral cervical nodes dissection, which increased the need for a tracheotomy of about 3 times. Other factors contribute with a minor impact, such as a patients age &gt;60 years at the time of the diagnosis, a cervical lymph node metastasis and a false vocal fold involvement. Each ones increase by 20–70 % the need for a tracheotomy. However, this rate is decreased by about 60 % by the epiglottis involvement.</p></div><div><h3>Conclusions</h3><p>The prophylactic tracheotomy is considered a temporary protection strategy to achieve a valid recovery after TORS procedure. However, there are no guidelines regarding its routinely use. Only 25 % of patients undergone tracheotomy during TORS to treat supraglottic laryngeal cancer. These preliminary results may add more significant evidence regarding the use of tracheotomy during the TORS procedure, in order possibly to help the surgeon decide preoperatively whether to perform it or not.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787057","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":"The “mini-extended” nasoseptal flap for reconstruction of sella to planum skull base defects","authors":"","doi":"10.1016/j.amjoto.2024.104437","DOIUrl":"10.1016/j.amjoto.2024.104437","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851214","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":"Healthcare utilization in patients with head and neck lymphatic malformations with the introduction of sirolimus","authors":"","doi":"10.1016/j.amjoto.2024.104422","DOIUrl":"10.1016/j.amjoto.2024.104422","url":null,"abstract":"<div><h3>Objectives</h3><p>Historically, head and neck lymphatic malformations (HNLM) have been managed through surgical and interventional procedures. Sirolimus was introduced in 2016 and has aided in symptomatic control of HNLM. The study objective was to assess healthcare utilization with the introduction of sirolimus for HNLM.</p></div><div><h3>Methods</h3><p>An observational cohort study of LM patients treated between 2008 and 2022 at a tertiary care children's hospital was performed. 588 charts were reviewed; patients with isolated, non-syndromic HNLM and at least 2 years of follow-up were included (<em>n</em> = 45). Data included sirolimus use, complications, presence of tracheostomy and/or gastrostomy-tube, and number and costs of HNLM-related sclerotherapies, procedures, hospitalizations, and emergency room visits. For patients who received sirolimus, encounters two years prior to and after sirolimus initiation were recorded. For the non-sirolimus group, encounters two years after the initial clinic visit for HNLM were recorded. Statistical analysis was used to compare the groups.</p></div><div><h3>Results</h3><p>Median age at first clinic visit was 1.8 years (range 2 days–41 years). Tracheostomy was present in 43 % of sirolimus patients compared with 3 % of the non-sirolimus group (OR: 24.0, 95%CI: 1.55–1490, <em>p</em> = 0.02). Patients on sirolimus experienced significantly fewer sclerotherapy visits (z = 2.08, <em>p</em> = 0.03) compared to the non-sirolimus group. Minimal sirolimus-related side effects were reported. Total HNLM-related costs were significantly less in the sirolimus group during treatment (median $448.13, range $0–$7041.28) compared with before treatment (median $17,069.24, range $1999.16–$211,848.50, z = 2.20, <em>p</em> = 0.03). Median costs associated with sclerotherapy were less for the sirolimus groups during treatment compared with the non-sirolimus group (z = 1.97, <em>p</em> = 0.04). In the sirolimus group, costs associated with HNLM-related hospitalizations were significantly less during sirolimus treatment compared with before (z = 2.20, <em>p</em> = 0.03).</p></div><div><h3>Conclusion</h3><p>Sirolimus has improved the clinical course for HNLM patients by decreasing number of procedures and healthcare costs, with limited side effects. Larger cohorts matching type of HNLM and age are needed to assess healthcare utilization benefits of sirolimus.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0196070924002084/pdfft?md5=e610ce8da9fc4c32e1ca4adae16382da&pid=1-s2.0-S0196070924002084-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing national trends in indications for pediatric total thyroidectomy","authors":"","doi":"10.1016/j.amjoto.2024.104440","DOIUrl":"10.1016/j.amjoto.2024.104440","url":null,"abstract":"<div><h3>Purpose</h3><p>The most common indications for total thyroidectomy (TT) in children are malignancy and thyrotoxicosis due to Graves' disease (GD). However, the incidence of patients with GD among patients undergoing TT is unknown. This study aims to examine trends in pediatric TT.</p></div><div><h3>Materials and methods</h3><p>The US Agency for Health Research and Quality Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database (KID) was queried to identify patients who underwent TT between 1997 and 2019. Weighted national estimates were obtained. Statistical analysis was completed using univariate logistic regression and one-sided Mann-Kendall Test.</p></div><div><h3>Results</h3><p>An estimated 4803 pediatric patients underwent TT within the study years. GD was the indication in 25 % of cases. Mann-Kendall testing showed a trend toward an increasing proportion of TT for GD without reaching statistical significance (z = 1.3609, S = 12, <em>p</em> = 0.0688). Statistically significant univariate associations were found among those who underwent thyroidectomy for GD compared to other indications, as they were more likely to be female (β = 0.286, 95 % CI [0.058, 0.514], <em>p</em> <em>=</em> 0.014), Black, or Hispanic (β = 1.392 [1.064, 1.721], <em>p</em> &lt; 0.001; and β = 0.562 [0.311, 0.814], p &lt; 0.001, respectively). Additionally, they were less likely to have private insurance (β = −0.308 [−1.076, −0.753], <em>p</em> <em>=</em> 0.002) and more likely to live in a ZIP code associated with a median household income below the 50th percentile (β = 0.190 [0.012, 0.369], <em>p</em> = 0.036). The associations with the female sex, Black race, and Hispanic race persisted in multivariate analysis.</p></div><div><h3>Conclusion</h3><p>GD appears to be an increasingly prevalent indication for TT. Patient characteristics differ from those who undergo TT for other diagnoses.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764823","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":"Review of retropharyngeal and parapharyngeal nodal metastasis of papillary thyroid carcinoma","authors":"","doi":"10.1016/j.amjoto.2024.104438","DOIUrl":"10.1016/j.amjoto.2024.104438","url":null,"abstract":"<div><h3>Background</h3><p>Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer. In rare instances, PTC has metastasized to the retropharyngeal and parapharyngeal nodes. This is hypothesized to occur due to an aberrant lymphatic channel or via retrograde lymphatic flow following previous neck dissection. Methods: A literature search was conducted with keywords “parapharyngeal,” “retropharyngeal,” and “papillary thyroid carcinoma.” Results: 46 articles were identified for a total of 135 cases. The most common presenting symptom was lymphadenopathy followed by pharyngeal mass and dyspnea. 38.03 % of patients were asymptomatic. Of cases including initial treatment history, 94.44 % had a history of neck dissection. The transcervical approach was the most utilized to resect the tumors, although in recent years trans-oral robotic surgery (TORS) has also been used.</p></div><div><h3>Conclusion</h3><p>PTC metastatic to the retropharyngeal and parapharyngeal nodes is a rare occurrence that can be difficult to diagnose due its indolent nature.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851307","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":"Learning disabilities in children with hearing loss: A systematic review","authors":"","doi":"10.1016/j.amjoto.2024.104439","DOIUrl":"10.1016/j.amjoto.2024.104439","url":null,"abstract":"<div><h3>Purpose</h3><p>The main aim of this systematic review was to investigate the possible association between hearing loss [and/or history of otitis media with effusion (OME)] and learning difficulties in children. Secondary aims were to: (i) investigate if deaf and hard of hearing (DHH) children with learning difficulties might show different clinical and neuropsychological features compared with those with other neurodevelopmental disorders; (ii) identify possible predictors of learning difficulty in DHH children.</p></div><div><h3>Methods</h3><p>A review was conducted of the scientific literature reported by Pubmed, Cochrane and Scopus databases. The following inclusion criteria were used: (i) studies published after 2000; (ii) studies conducted considering subjects with age &lt; 18 years; (iii) studies considering patients who showed both learning difficulties and hearing loss and/or episodes of OME; (iv) articles written in English. The exclusion criteria were: (i) presence in the studied cohort of any other proven comorbidities, other than hearing loss and/or OME; (ii) non-original studies.</p></div><div><h3>Results</h3><p>A total of 924 studies were identified. Four were reviewed after applying the above criteria<strong>.</strong> From their analysis it emerged that: (i) children with hearing loss who had undergone a diagnostic and rehabilitation program before 6 months of age had better levels of <em>K readiness</em> and language and literacy skills compared to those who had undergone it after 6 months; (ii) higher frequency of episodes of OME and the presence of a conductive hearing loss during the period of language acquisition was associated to lower scores in reading skills; (iii) reading difficulties found in subjects with hearing loss had similar characteristics to those with language difficulties.</p></div><div><h3>Conclusions</h3><p>There is a dearth of information about this topic. Further investigations are therefore necessary on children of various ages with hearing loss to disclose learning difficulties in reading and writing abilities using current diagnostic tools.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0196070924002254/pdfft?md5=81cfe1c594e0f3b042e370de1c652474&pid=1-s2.0-S0196070924002254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do high-risk head trauma sports athletes have impaired vestibular function?","authors":"","doi":"10.1016/j.amjoto.2024.104429","DOIUrl":"10.1016/j.amjoto.2024.104429","url":null,"abstract":"<div><h3>Purpose</h3><p>The primary aim of this study was to examine the vestibular function of athletes involved in high-risk head trauma sports by means of complete vHIT testing of all six semicircular canals (SCCs). The secondary objective was to investigate whether the vestibular function is significantly reduced among athletes within certain high-risk sports.</p></div><div><h3>Methods</h3><p>A prospective cross-sectional study of 137 adult athletes in football, handball, boxing, horseback riding, and ice hockey with a minimum of one reported sports-related head injury within the past five years. All subjects underwent screening with a complete examination of all six SCCs with vHIT and fulfillment of the dizziness handicap inventory (DHI).</p></div><div><h3>Results</h3><p>Two subjects (1.5 %) fulfilled the criteria of having a pathological vHIT. Some degree of impairment of the vestibular function was seen when data was divided into individual sports and time since the last head injury. Likewise, no subjective dizziness was seen in the group of athletes when evaluated by total DHI scores. This score did not differ significantly between groups when subgrouped into number of head injuries or time since the last head injury. When divided into type of sport, total DHI scores differed significantly between groups. These total DHI-scores did, however, all fall within the range of the “no dizziness handicap” classification.</p></div><div><h3>Conclusion</h3><p>The results suggest that the vestibular function of athletes in high-risk head trauma sports is unaffected by the practice of a high-risk head trauma sport. Therefore, vHIT has no clinical utility in the assessment of a sports-related concussion (SRC) in athletes with no subjective feeling of dizziness.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0196070924002151/pdfft?md5=bbcc73c461dec81a71d84d0d75c0726a&pid=1-s2.0-S0196070924002151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the spectrum of pediatric sialorrhea management: A narrative review","authors":"","doi":"10.1016/j.amjoto.2024.104433","DOIUrl":"10.1016/j.amjoto.2024.104433","url":null,"abstract":"<div><h3>Objective</h3><p>This review summarizes the approaches to pediatric sialorrhea management from least-to-most invasive: non-pharmacological management, anticholinergic medications, botulinum neurotoxin, non-invasive surgery, and invasive surgical intervention.</p></div><div><h3>Review methods</h3><p>An electronic literature review identified English-language articles on sialorrhea management in pediatric patients. Publications between 1982 and 2022 were used, with a focus on articles published from 2012 to 2022. Additional augmentation of pharmacologic information was obtained from the latest editions of medical textbooks supplemented with official package inserts of investigated medications.</p></div><div><h3>Conclusions</h3><p>Sialorrhea is abnormal in patients greater than four years of age. Severe cases warrant intervention to improve patient quality of life and reduce caregiver burden. Management starts with conservative approaches. Viable candidates begin with non-pharmacological management options. Anticholinergic medications can decrease saliva production, but adverse side effects may outweigh benefits. Botulinum neurotoxin injection of the salivary glands decreases salivary flow rate; however, relief is transient and thus multiple treatments are required. Non-invasive sclerotherapy is an emerging treatment option showing promising results for sialorrhea. In contrast, surgical intervention is reserved as a last-resort treatment for patients with severe symptoms, due to its higher risk for adverse consequences.</p></div><div><h3>Implications for practice</h3><p>Physicians should be familiar with the different pediatric sialorrhea management options, including advantages and disadvantages, to adequately facilitate shared decision making with caretakers of pediatric patients who require treatment.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787016","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":"Anesthetic recovery outcomes after 2 methods of nasal mucosal preparation for endoscopic sinus surgery","authors":"","doi":"10.1016/j.amjoto.2024.104414","DOIUrl":"10.1016/j.amjoto.2024.104414","url":null,"abstract":"<div><h3>Purpose</h3><p>Our institution uses two approaches for nasal mucosal preparation during endoscopic sinus surgery (ESS) to improve surgical field visualization: topical epinephrine (TE) versus topical cocaine with injection of lidocaine containing epinephrine (TCLE). We aimed to compare anesthetic outcomes after ESS using these techniques.</p></div><div><h3>Methods and materials</h3><p>We retrospectively identified adult patients at our institution who underwent ESS from May 2018 through January 2023 under general anesthesia with propofol and remifentanil infusions. Postoperative anesthetic outcomes, including pain and recovery time, were compared between patients who had mucosal preparation with TE versus TCLE using inverse probability of treatment weighting (IPTW) to adjust for potential confounders.</p></div><div><h3>Results</h3><p>Among 1449 patients who underwent ESS, 585 had TE, and 864 had TCLE. Compared with TE, during anesthetic recovery, the TCLE group had fewer episodes of severe pain (numeric pain score ≥ 7) (IPTW-adjusted odds ratio, 0.65; 95 % CI, 0.49–0.85; <em>P</em> = .002), less opioid analgesic administration (IPTW-adjusted odds ratio, 0.55; 95 % CI, 0.44–0.69; <em>P</em> &lt; .001), and shorter recovery room stay (IPTW-adjusted ratio of the geometric mean, 0.90; 95 % CI, 0.85–0.96; <em>P</em> = .002). Postoperative nausea and vomiting and postoperative sedation were similar between groups.</p></div><div><h3>Conclusions</h3><p>Patients who received preparation of the nasal mucosa with TCLE, compared with TE, were less likely to report severe pain or receive an opioid analgesic in the postanesthesia recovery room and had faster anesthetic recovery. This observation from our large clinical practice indicates that use topical and local anesthetic during endoscopic sinus surgery may have benefit for ambulatory ESS patients.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853353","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}