Archives of otolaryngology--head & neck surgery最新文献

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Analysis of factors predicting the success of the bone conduction device headband trial in patients with single-sided deafness. 单侧耳聋患者骨传导装置头带试验成功的预测因素分析。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.754
Hubert T Faber, Hanneke Kievit, Maarten J F de Wolf, Cor W R J Cremers, Ad F M Snik, Myrthe K S Hol
{"title":"Analysis of factors predicting the success of the bone conduction device headband trial in patients with single-sided deafness.","authors":"Hubert T Faber,&nbsp;Hanneke Kievit,&nbsp;Maarten J F de Wolf,&nbsp;Cor W R J Cremers,&nbsp;Ad F M Snik,&nbsp;Myrthe K S Hol","doi":"10.1001/jamaoto.2013.754","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.754","url":null,"abstract":"<p><strong>Objective: </strong>To determine factors predicting whether patients with single-sided deafness (SSD) opt for a bone conduction device (BCD) for the contralateral routing of sound (CROS) after a regular trial with a BCD on a headband.</p><p><strong>Design: </strong>Retrospective case-control study.</p><p><strong>Setting: </strong>Nijmegen, the Netherlands.</p><p><strong>Patients: </strong>Thirty consecutive patients with SSD.</p><p><strong>Interventions: </strong>Patients received a trial with a BCD headband as part of the regular workup for SSD. The patients were divided into 2 groups according to their decision to opt for a BCD (BCD+) or not (BCD-).</p><p><strong>Main outcome measures: </strong>Patients completed a questionnaire on satisfaction with the BCD headband, patient- and BCD-related factors, and benefit in listening situations.</p><p><strong>Results: </strong>Fourteen patients (47%) chose a percutaneous BCD application after the BCD headband trial. Hearing loss of the contralateral ear at 4.0 kHz was significantly larger in the BCD+ group for bone and air conduction (P = .05 and P = .02, respectively). Patients in the BCD+ group experienced more problems in several listening situations and used the BCD headband more frequently than patients did in the BCD- group.</p><p><strong>Conclusions: </strong>Several individual factors influence the decision of patients with SSD to opt for a BCD. Hearing loss in the contralateral ear at high frequencies seems to be a relevant factor to predict the success of the BCD headband trial. It is advisable to offer all patients with SSD the option to participate in the BCD headband trial for at least 1 week and create a realistic expectation for patients based on their unaided subjective hearing handicaps.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 18
Hemorrhagic petrous apex cholesterol granuloma: clinical correlation with imaging. 出血性岩尖胆固醇肉芽肿:临床与影像学的相关性。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.1024
Ananth Narayan, Rajan Jain, Wilson B Chwang, Michael Seidman, Jack Rock
{"title":"Hemorrhagic petrous apex cholesterol granuloma: clinical correlation with imaging.","authors":"Ananth Narayan,&nbsp;Rajan Jain,&nbsp;Wilson B Chwang,&nbsp;Michael Seidman,&nbsp;Jack Rock","doi":"10.1001/jamaoto.2013.1024","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.1024","url":null,"abstract":"C holesterol granulomas are commonly found in the petrous apex. Patients with cholesterol granulomas may present with headache or symptoms related to mass effect on adjacent structures and cranial nerves, and cholesterol granulomas often may be an incidental finding on neuroimaging for other reasons. Although these lesions may remain dormant for many years, they can also suddenly enlarge, with expansion and subsequent remodeling of the petrous apex. The most common explanation for expansion or enlargement of cholesterol granuloma is thought to be internal hemorrhage. The ability to identify cholesterol granuloma is crucial, since in the acute setting it can simulate an enlarging aggressive lesion.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.1024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Persistent foramen of Huschke mimicking a branchial cleft anomaly. 模仿鳃裂异常的持续性胡氏孔。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.729
Rodrigo C Silva, William O Collins
{"title":"Persistent foramen of Huschke mimicking a branchial cleft anomaly.","authors":"Rodrigo C Silva,&nbsp;William O Collins","doi":"10.1001/jamaoto.2013.729","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.729","url":null,"abstract":"Apersistent foramen of Huschke, or foramen tympanicum, results from the defective ossification of the anteroinferior aspect of the tympanic portion of the temporal bone. We describe 2 girls, aged 5 and 6 years, with histories of recurrent cervical abscesses, draining submandibular sinuses, and defective tympanic plates adjacent to the tympanic ring. Surgical resection of the fistulous tract extending from the submandibular triangle to the bony ear canal successfully controlled the symptoms.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.729","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Laryngeal reinnervation for paralytic dysphonia in children younger than 10 years. 喉神经移植治疗10岁以下小儿麻痹性发声障碍。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.803
Marshall E Smith, Nelson Roy, Dan Houtz
{"title":"Laryngeal reinnervation for paralytic dysphonia in children younger than 10 years.","authors":"Marshall E Smith,&nbsp;Nelson Roy,&nbsp;Dan Houtz","doi":"10.1001/jamaoto.2013.803","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.803","url":null,"abstract":"<p><strong>Objective: </strong>To study the effectiveness of ansa-recurrent laryngeal nerve laryngeal reinnervation to improve glottal incompetence causing dysphonia and dysphagia for children with unilateral vocal fold paralysis. DESIGN We reviewed a series of consecutive cases treated from January 1, 2006, through December 31, 2011.</p><p><strong>Setting: </strong>Otolaryngology division of a children's hospital. PATIENTS Thirteen children with unilateral vocal fold paralysis.</p><p><strong>Main outcome measures: </strong>Surgical complications, parent surrogate quality-of-life measures, global overall assessment of improvement, and auditory perceptual assessment.</p><p><strong>Results: </strong>Thirteen children underwent laryngeal reinnervation. Ages ranged from 2.2 to 8.8 years (mean [SD] age, 5.3 [2.6] years). No major complications were identified. Nine children had preoperative and 6- to 12-month postoperative data on voice and swallowing. Mean parental global voice rating (0 indicates no voice; 100%, normal voice) changed from 43% (range, 20%-65%) preoperatively to 79% (range, 50%-100%) postoperatively. Regarding perceptual assessment, the mean GRBAS (Grade, Roughness, Breathiness, Asthenia, Strain) Rating Scale sum score (0 indicates normal voice; 15, profoundly abnormal voice) improved from 6.3 to 2.9. Parental assessment of dysphagia with liquids also improved for all children with preoperative symptoms and worsened for none.</p><p><strong>Conclusions: </strong>Our early experience suggests that ansa-recurrent laryngeal nerve laryngeal reinnervation is a safe and effective treatment for unilateral vocal fold paralysis with symptomatic dysphonia and dysphagia in young children. The procedure has advantages compared with other treatments. This option should be discussed with parents when the paralysis is identified. The child should be observed for several years in the event that voice and swallowing symptoms from glottal incompetence do not improve.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 43
Upper aerodigestive tract cancer in patients with chronic lymphocytic leukemia: incidence, stage, and outcome. 慢性淋巴细胞白血病患者的上呼吸道消化道肿瘤:发病率、分期和预后。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.723
Nitin A Pagedar, Thorvardur R Halfdanarson, Lucy H Karnell, Henry T Hoffman, Gerry F Funk
{"title":"Upper aerodigestive tract cancer in patients with chronic lymphocytic leukemia: incidence, stage, and outcome.","authors":"Nitin A Pagedar,&nbsp;Thorvardur R Halfdanarson,&nbsp;Lucy H Karnell,&nbsp;Henry T Hoffman,&nbsp;Gerry F Funk","doi":"10.1001/jamaoto.2013.723","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.723","url":null,"abstract":"<p><strong>Objective: </strong>To compare incidence, stage, and survival of upper aerodigestive tract (UADT) cancers in patients with and without chronic lymphocytic leukemia (CLL).</p><p><strong>Design: </strong>Inception cohort.</p><p><strong>Setting: </strong>National database.</p><p><strong>Patients: </strong>Individuals with CLL and UADT cancers included in the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Main outcome measures: </strong>Incidence was compared by computing standardized incidence ratio (SIR), the ratio of observed UADT cancers in patients with CLL, and the number of UADT cancers expected based on the characteristics of patients with CLL and population incidence of UADT cancers. The association between CLL and UADT cancer stage was measured using odds ratio (OR) calculations. Survival of patients with UADT cancer with and without CLL was compared.</p><p><strong>Results: </strong>For the SIR calculation, 36 985 patients with CLL contributed a mean 6.36 years of follow-up each, for a total of 235 314 person-years of follow-up. The SIR was 1.18 (95% CI, 0.97-1.41) for UADT cancers; 1.52 (95% CI, 1.18-1.93) for laryngeal cancer; and 1.92 (95% CI, 1.05-3.23) for cancers of the nasal cavity and paranasal sinuses. In the stage and survival analyses, 253 patients with CLL followed by a UADT cancer were compared with 133 840 patients with 1 UADT cancer only. Cancers of the UADT in patients with CLL were more likely localized (OR, 0.50; 95% CI, 0.37-0.68). Relative survival was worse in patients with CLL. In multivariate analysis, CLL was independently associated with poorer observed survival (hazard ratio, 1.45; 95% CI, 1.24-1.70).</p><p><strong>Conclusions: </strong>Larynx and nasal cavity cancers were more common in patients with CLL. Overall incidence of UADT cancers was not significantly elevated. Cancers of the UADT in patients with CLL were more likely to be localized at diagnosis than those in patients without CLL. Finally, CLL was associated with poorer survival outcomes.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.723","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The public health impact of pediatric caustic ingestion injuries. 儿童腐蚀性食入伤害的公共卫生影响。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.672
Christopher M Johnson, Matthew T Brigger
{"title":"The public health impact of pediatric caustic ingestion injuries.","authors":"Christopher M Johnson,&nbsp;Matthew T Brigger","doi":"10.1001/jamaoto.2013.672","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.672","url":null,"abstract":"<p><strong>Objective: </strong>To determine the current public health burden of injuries due to caustic ingestion in children.</p><p><strong>Design: </strong>The 2009 Kids' Inpatient Database provides data on a sample of all pediatric hospital discharges in the United States during that year. Children with caustic ingestion injuries requiring hospitalization were identified by corresponding codes from the International Classification of Diseases, Ninth Revision. Database analysis generated national estimates of summary statistics.</p><p><strong>Setting: </strong>A national database.</p><p><strong>Patients: </strong>Representative sample of all hospital discharge data on patients 18 years or younger.</p><p><strong>Main outcome measures: </strong>Public health burden related to caustic injury, including potential factors related to admission outcome, the necessity of a procedure during the admission, admission length of stay, and total charges for the admission.</p><p><strong>Results: </strong>We estimated the prevalence of pediatric caustic ingestion injuries requiring hospitalization in the United States in 2009 to be 807 (95% CI, 731-882) children. The annual economic burden was estimated at $22 900 000 (95% CI, $15 400 000-$30 400 000) in total hospital charges. The mean charge per patient was estimated at $28 860 (95% CI, $19 799-$37 922) with a median of $9848. The mean length of admission was 4.13 (95% CI, 3.22-5.03) days with a median of 2 days. Among the 807 patients, 45.3% underwent esophagoscopy, and those admitted to teaching hospitals were more likely to undergo a procedure during their stay (P = .02). Logistic regression models suggested significant median income (P < .001) and sex (P < .001) variations.</p><p><strong>Conclusions: </strong>The current public health burden of pediatric caustic ingestion injuries may be less than commonly cited. This finding supports the notion that legislative efforts have been successful. Despite these successes, these injuries continue to impose a significant burden on health care resources.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.672","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 45
Radiology quiz case 2. Postirradiation pseudoaneurysm of the petrous segment of the ICA. 放射学测试案例2。颈内动脉岩段放射后假性动脉瘤。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/2013.jamaoto.456a
Soroush Zaghi, Jonathan Yousefzadeh, Bob Armin, Michael Froehler, Reza Jahan, Marilene B Wang
{"title":"Radiology quiz case 2. Postirradiation pseudoaneurysm of the petrous segment of the ICA.","authors":"Soroush Zaghi,&nbsp;Jonathan Yousefzadeh,&nbsp;Bob Armin,&nbsp;Michael Froehler,&nbsp;Reza Jahan,&nbsp;Marilene B Wang","doi":"10.1001/2013.jamaoto.456a","DOIUrl":"https://doi.org/10.1001/2013.jamaoto.456a","url":null,"abstract":"Brachytherapy mediated bone damage in a rat model investigating maxillary osteoradionecrosis.","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamaoto.456a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
The impact of comorbidity on treatment (chemoradiation and laryngectomy) of advanced, nondistant metastatic laryngeal cancer: a review of 16 849 cases from the national cancer database (2003-2008). 合并症对晚期非远处转移性喉癌治疗(放化疗和喉切除术)的影响:来自国家癌症数据库(2003-2008)的16849例病例的回顾。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.720
Jason Zhu, Stacey Fedewa, Amy Y Chen
{"title":"The impact of comorbidity on treatment (chemoradiation and laryngectomy) of advanced, nondistant metastatic laryngeal cancer: a review of 16 849 cases from the national cancer database (2003-2008).","authors":"Jason Zhu,&nbsp;Stacey Fedewa,&nbsp;Amy Y Chen","doi":"10.1001/jamaoto.2013.720","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.720","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether patients treated with laryngectomy had less comorbidity than those treated with chemoradiation, which could help explain the improved survival for the laryngectomy cohorts in recent studies.</p><p><strong>Design: </strong>Observational cross-sectional study.</p><p><strong>Patients: </strong>Patients receiving diagnoses of primary invasive advanced squamous cell carcinoma of the larynx between 2003 and 2008 were selected from the National Cancer Database, which collects information from more than 1400 facilities accredited by the American College of Surgeons' Commission on Cancer. Patient-level independent variables included age at diagnosis, sex, diagnosis year, race/ethnicity, primary payer status, and zip code-level education.</p><p><strong>Main outcome measures: </strong>Primary treatment information. The association between treatment and patient clinical, sociodemographic, and facility-level and zip code-level socioeconomic status variables were analyzed using univariate statistics and multivariate models. Charlson Deyo Comorbidity and The Washington University Head and Neck Comorbidity Index scores were calculated from the hospital face sheet.</p><p><strong>Results: </strong>The study demonstrated that receipt of treatment (chemoradiation vs total laryngectomy) was significantly associated with comorbidity. Treatment was not significantly associated with insurance status, race/ethnicity, or age. Patients with comorbidity were less likely to receive chemoradiation than subtotal or total laryngectomy, with a risk ratio (RR) of 0.84 (95% CI, 0.81-0.87) for patients with 1 or more comorbidities compared with those without any comorbidity, after controlling for factors such as tumor stage, age, race/ethnicity, insurance, and socioeconomic status. Patients were also less likely to receive chemoradiation than total laryngectomy if they had stage IV disease (RR, 0.81; 95% CI, 0.79-0.83) and if they had been diagnosed at a teaching or research institution (RR, 0.80; 95% CI, 0.77-0.84). Patients were more likely to receive chemoradiation if they were diagnosed after 2003 (RR, 1.37; 95% CI, 1.30-1.45) or if they lived in a zip code with a high percentage of high school graduates (RR, 1.1; 95% CI, 1.05-1.15).</p><p><strong>Conclusions: </strong>This is the first study, to our knowledge, that demonstrates that patients with advanced laryngeal cancer with 1 or more comorbidities are more likely to receive surgery than chemoradiation compared with patients without any comorbidity, independent of numerous clinical and nonclinical variables among a large national cohort. A limitation of this study is the use of comorbidity data from the National Cancer Database, which gathers its information from hospital discharge face sheets. We recognize that the National Cancer Database may be an imperfect system for the collection of comorbidity data and encourage discussion on different methods to improve the system","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.720","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 24
Selective use of radioactive iodine in intermediate-risk papillary thyroid cancer. 放射性碘在中度危险甲状腺乳头状癌中的选择性应用。
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.760
Iain J Nixon, Snehal G Patel, Frank L Palmer, Monica M Dilorenzo, R Michael Tuttle, Ashok Shaha, Jatin P Shah, Ian Ganly
{"title":"Selective use of radioactive iodine in intermediate-risk papillary thyroid cancer.","authors":"Iain J Nixon,&nbsp;Snehal G Patel,&nbsp;Frank L Palmer,&nbsp;Monica M Dilorenzo,&nbsp;R Michael Tuttle,&nbsp;Ashok Shaha,&nbsp;Jatin P Shah,&nbsp;Ian Ganly","doi":"10.1001/jamaoto.2013.760","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.760","url":null,"abstract":"<p><p>OBJECTIVE To describe the outcomes with the selective use of radioactive iodine (RAI) in patients who are at intermediate risk of death from papillary thyroid cancer, focusing on 2 subgroups: patients older than 45 years with low-risk tumors and patients younger than 45 years with high-risk tumors. DESIGN Retrospective case review. SETTING Tertiary referral US cancer center. PATIENTS The study incluced 532 consecutive patients who were surgically treated between 1986 and 2005. INTERVENTIONS All patients underwent total thyroidectomy; 307 also received RAI. MAIN OUTCOME MEASURES Disease-specific survival (DSS) and recurrence-free survival (RFS). RESULTS Of 344 patients older than 45 years with low-risk tumors, 148 (43%) received RAI and 196 (57%) were selected not to receive RAI. The patients who were treated without RAI were more likely to be female and have pT1N0 disease. The 5-year DSS and RFS were 100% and 98%, respectively. The presence of nodal metastases predicted poorer 5-year RFS within this group (99% vs 91%; P = .004). Of 188 patients younger than 45 years with high-risk tumors, 159 (85%) received RAI, and only 29 (15%) were selected not to receive RAI. The 5-year DSS and RFS for these patients were 100% and 95%, respectively. The presence of nodal metastases predicted poorer 5-year RFS within this group (100% vs 86%; P = .02). CONCLUSION Our study shows that the subgroup of patients who are older than 45 years with tumors that are smaller than 4 cm in greatest dimension and confined to the thyroid gland and who do not have nodal metastases can safely be treated without RAI.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31233155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 15
Endoscopic sinus surgery in adults with cystic fibrosis: effect on lung function, intravenous antibiotic use, and hospitalization. 成人囊性纤维化的内镜鼻窦手术:对肺功能、静脉抗生素使用和住院的影响
Archives of otolaryngology--head & neck surgery Pub Date : 2012-12-01 DOI: 10.1001/jamaoto.2013.810
Oswaldo A Henriquez, Lindy L Wolfenden, Arlene Stecenko, John M Delgaudio, Sarah K Wise
{"title":"Endoscopic sinus surgery in adults with cystic fibrosis: effect on lung function, intravenous antibiotic use, and hospitalization.","authors":"Oswaldo A Henriquez,&nbsp;Lindy L Wolfenden,&nbsp;Arlene Stecenko,&nbsp;John M Delgaudio,&nbsp;Sarah K Wise","doi":"10.1001/jamaoto.2013.810","DOIUrl":"https://doi.org/10.1001/jamaoto.2013.810","url":null,"abstract":"<p><strong>Objective: </strong>To ascertain the effect of endoscopic sinus surgery (ESS) on lung function, intravenous (IV) antibiotic use, and hospitalization in adults with cystic fibrosis (CF).</p><p><strong>Design: </strong>Retrospective analysis.</p><p><strong>Settings: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Fifteen adults with a diagnosis of CF undergoing ESS between March 1, 2006, and June 31, 2008.</p><p><strong>Main outcome measures: </strong>Twelve-month preoperative and 12-month postoperative pulmonary function testing (forced vital capacity [FVC] and forced expired volume in 1 second [FEV1]), number of IV antibiotic courses, total number of days of intravenous antibiotic use, and number of inpatient hospital days (IHDs) were assessed.</p><p><strong>Results: </strong>Twenty-two adults with CF underwent ESS; 15 patients had adequate data for evaluation. No significant differences were found between mean preoperative and postoperative FEV1 (61.3% vs 59.5%; P = .41) or FVC (76.4% vs 76.1%; P = .97) or between best preoperative and postoperative FEV1 (67.4% vs 67.0%; P = .95) or FVC (84.2% vs 83.0%; P = .86) (paired samples t test). The number of IV antibiotic courses and the total number of days of IV antibiotic use did not differ between the preoperative and postoperative periods (Wilcoxon signed rank test P = .61 and P = .10, respectively). However, the number of IHDs was significantly lower in the 1-year postoperative period (36.7 days) vs the 1-year preoperative period (59.1 days) (Wilcoxon signed rank test, z = -2.20, P = .03).</p><p><strong>Conclusions: </strong>This preliminary study of ESS in adult CF patients indicates significant reduction in the number of IHDs in the postoperative period. However, there is no evidence that ESS improved lung function or the need for IV antibiotics.</p>","PeriodicalId":8285,"journal":{"name":"Archives of otolaryngology--head & neck surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamaoto.2013.810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31128616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 21
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