Treatment choice in single‐sided deafness and asymmetric hearing loss.

xlomafota13 shared this article with you from Inoreader Treatment choice in single‐sided deafness and asymmetric hearing loss. A prospective, multi‐center cohort study on 155 patients Via Clinical Otolaryngology Abstract Objectives To describe the treatment choice in a cohort of subjects with single‐sided deafness (SSD) and asymmetric hearing loss (AHL). To assess the reliability of the treatment trials. Design In this national, multi‐centre, prospective study, the choice of subjects was made after two consecutive trials of Contralateral Routing Of the Signal (CROS) hearing aids and a Bone Conduction Device (BCD) on a headband. Subjects could proceed with one of these two options, opt for cochlear implantation or decline all treatments. Setting Seven tertiary university hospitals. Participants 155 subjects with SSD or AHL fulfilling the candidacy criteria for cochlear implantation, with or without associated tinnitus. Main outcome measures After the two trials, the number of subjects choosing each option was described. Repeated assessments of both generic and auditory‐specific quality of life were conducted, as well as hearing assessments (speech recognition in noise and horizontal localization). Results CROS was chosen by 75 subjects, followed by cochlear implantation (n=51), BCD (n=18) and abstention (n=11). Patients who opted for cochlear implantation had a poorer quality of life (p=0.03). The improvement of quality of life indices after each trial was significantly associated with the final treatment choice (p=0.008 for generic indices, p=0.002 for auditory specific indices). The follow‐up showed that this improvement had been overestimated in the CROS group, with a long‐term retention rate of 52.5%. Conclusions More than one third of SSD/AHL subjects are unsatisfied after CROS and BCD trials. Repeated quality of life assessments help counselling the patient for his/her treatment choice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Singing voice range profile: new objective evaluation methods for voice change after thyroidectomy

xlomafota13 shared this article with you from Inoreader Singing voice range profile: new objective evaluation methods for voice change after thyroidectomy Via Clinical Otolaryngology Abstract Background After surgery in the thyroid region, patients may present with phonation or singing difficulty, even within their vocal range. We designed a novel voice evaluation method that reflects subjective and objective voice complications of the surgery. Methods This tool recorded patients' voice ranges while singing, which was named the singing voice range profile (singing VRP). Patients were asked to sing "Happy Birthday", which has a one‐octave scale, at a comfortable tone and intensity. The singing VRP, standard VRP, and voice handicap index‐10 (VHI‐10) results were recorded before thyroidectomy and 1 and 3 months after thyroidectomy for 128 patients. For subgroup analysis, a group where the maximum F0 of standard VRP in 1 month postoperatively was lower than the highest singing F0 of the preoperative singing VRP was defined as "Collapsed group" and the other group was "Preserved group". Results The changes in the highest, lowest, and range of singing fundamental frequency (F0) had decreased at 1 month postoperatively. Subsequently, they had improved significantly at 3 months postoperatively but were lower than those preoperatively (all p < .05, except for the change in the lowest singing F0 between 1 and 3 months postoperatively, p = .274). In the subgroup analysis, the singing range of the collapsed group (n = 65) showed significantly lower VHI‐10 scores, range of vocal F0, and singing F0 than those of the preserved group (n = 63) at 1 and 3 months postoperatively (all p < .001). At 3 months postoperatively, the singing F0 range in the preserved group had recovered to the range before surgery (13.0 ± 1.3 vs. 13.1 ± 1.4, p = .746 for the preserved group, and 13.0 ± 1.3 vs. 11.5 ± 2.4, p < .001 for the collapsed group). Conclusions Parameters measured by singing VRP showed a trend similar to the change in VHI‐10 and the maximum F0 of standard VRP. In addition, singing VRP allowed a qualitative classification of the postoperative voice function when combined with standard VRP. Therefore, it can be used as a supplementary voice evaluation tool to reflect the physiologic and functional aspects of voice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Facial and hearing outcomes in transmastoid nerve decompression for Bell’s palsy, with preservation of the ossicular chain

xlomafota13 shared this article with you from Inoreader Facial and hearing outcomes in transmastoid nerve decompression for Bell's palsy, with preservation of the ossicular chain Via Clinical Otolaryngology Abstract Introduction Facial nerve decompression is a salvage treatment for Bell's palsy patients for whom a poor prognosis is anticipated with standard medical treatment. The transmastoid approach is a frequently performed approach, but it remains unknown if this surgery is effective when the ossicular chain is preserved. This study aimed to determine the efficacy of facial nerve decompression using the transmastoid approach in Bell's palsy. Methods This retrospective study included patients who had undergone transmastoid facial nerve decompression with ossicular chain preservation and patients who met the criteria for surgery, but received only medical treatment between January 2007 to May 2019, at a single centre. Results The recovery rate to House‐Brackmann grade I in the decompression group in the early phase (≤18 days after onset) was higher than that of the medical treatment group, although the difference was not significant (70% vs. 47%, P=0.160). However, within this early surgery group, a subgroup of cases with ≥95% facial nerve degeneration demonstrated a significant improvement in recovery rate (73% vs. 30%, P=0.018). Among surgeries performed in the late phase (≥19 days), only a subgroup with ≥95% facial nerve degeneration was available for analysis, and the difference in recovery rate was not significant compared with medical treatment alone (26% vs. 30%, P=1.00). Post‐surgical hearing evaluation demonstrated that average hearing deterioration was 1.3dB which was non‐significant, suggesting this procedure does not cause hearing loss. Conclusions Transmastoid facial nerve decompression with ossicular chain preservation in the early phase after symptom‐onset is an effective salvage treatment for severe Bell's palsy with ≥95% facial neve degeneration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Long‐term Swallowing Outcomes of Radiotherapy and Transoral Laser Microsurgery for T1 Glottic Cancer Treatment

xlomafota13 shared this article with you from Inoreader Long‐term Swallowing Outcomes of Radiotherapy and Transoral Laser Microsurgery for T1 Glottic Cancer Treatment Via Clinical Otolaryngology Abstract Both CO2 transoral laser microsurgery (CO2 TOLMS) and radiotherapy (RT) are standard of care in early glottic carcinoma. However, previous studies focus on voice outcomes rather than swallowing outcomes. This study aimed to compare the late post‐treatment effects of CO2 TOLMS and RT treatment on swallowing function in T1 glottic carcinoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Implications of vestibular telemetry for the management of Ménière’s Disease

xlomafota13 shared this article with you from Inoreader Implications of vestibular telemetry for the management of Ménière's Disease – Our experience with three adults Via Clinical Otolaryngology Abstract Ménière's disease is a chronic idiopathic condition affecting the inner ear that results in repeated episodes of vertigo. The duration of a characteristic episode of vertigo is between twenty minutes and twelve hours according to contemporary classification systems (1, 2). Advancements in the field of vestibular telemetry have allowed the continuous ambulatory assessment of individuals with dizziness, vertigo and balance disturbance (3, 4). This article outlines the findings from assessing three patients with Ménière's disease and discusses how the use of vestibular telemetry aided their management. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Changes in healthcare utilization for pediatric tonsillectomy and adenoidectomy

xlomafota13 shared this article with you from Inoreader Changes in healthcare utilization for pediatric tonsillectomy and adenoidectomy in the Netherlands: a population‐based study Via Clinical Otolaryngology Abstract Objectives Tonsillectomy and adenoidectomy in children are controversial subjects with large regional variation in treatment, partly explained by cultural differences and lack of high‐quality evidence on indications. A quality of care cycle was executed on this topic in the Netherlands. The objective of this study was to estimate changes in healthcare utilization for pediatric tonsil surgery during and after the quality of care cycle. Methods Population‐based data on tonsillectomies and adenoidectomies in children up to age 10 was retrieved retrospectively from Dutch administrative databases between 2005 and 2018. A change point analysis was performed to find the most pivotal change point in surgical rates. Surgical patients' characteristics before and after this point were compared descriptively. Impact on healthcare budget and societal costs were estimated using current prices and cost‐effectiveness analyses. Results The annual number of adenotonsillectomies reduced by 10952 procedures (‐39%; from 12.9 per 1000 children to 8.7 per 1000 children) between 2005 and 2018, and the number of adenoidectomies by 14757 procedures (‐49%; from 13.8 per 1000 children to 7.8 per 1000 children). The most pivotal change point was observed around 2012, accompanied by small changes in patient selection for surgery before and after 2012. An estimated €5.3 million per year was saved on the healthcare budget and €10.4 million per year on societal costs. Conclusion The quality of care cycle resulted in fewer operations, with a concomitant reduction of costs. We suggest that part of these savings be invested in new research to maintain the quality of care cycle. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Factors influencing long‐term treatment response to botulinum toxin injection for spasmodic dysphonia

xlomafota13 shared this article with you from Inoreader Factors influencing long‐term treatment response to botulinum toxin injection for spasmodic dysphonia Via Clinical Otolaryngology Abstract Objective The purpose of this study was to evaluate the outcomes of long‐term botulinum toxin type A (BoNTA) treatment for adductor spasmodic dysphonia (AdSD) and to determine the factors predictive of treatment response by investigating dose stability and average intervals. Design Retrospective cohort study. Setting Academic tertiary medical center. Exposures A total of 470 patients with adductor spasmodic dysphonia, who received electromyography‐guided BoNTA injections over 12 years, were retrospectively enrolled in this study. Main Outcomes and Measures The patients' demographic data, baseline voice dynamics, and treatment profiles (dose, frequency, and intervals) were evaluated. Factors correlating with the dose adjustment ratio (number of increasing dosing/total number of BoNTA toxin injections) and changes in intervals between injections were statistically analyzed. Results A total of 122 patients, who received ≥ 4 injections and whose average treatment interval was < 240 days, were finally evaluated. Of them, 115 (94.3 %) were female and seven (5.7 %) were male, and the mean age at initial treatment was 34.89 ± 13.07 and 41.14 ± 12.71 years, respectively. On average, patients received 18.00 ± 13.33 injections (1.67 ± 0.60 U/injection) to alternating unilateral vocal folds. The treatment period was 65.07 ± 43.28 months and the mean interval between injections was 4.16 ± 1.28 months. The mean dose adjustment ratio among patients who received ≥ 4 injections was 0.15 ± 0.13, and dose changes occurred 4.36 times/patient. The patients' age and gender significantly affected the treatment response, where younger or female patients showed greater dosing variability and shorter intervals between injections. However, the baseline voice dynamics (voice handicap index, fundamental frequency, jitter, shimmer, noise‐to‐harmonic ratio, maximum p honation time, and degree of voice breaks) did not predict the dose adjustment ratio or interval changes. In addition, patients with fluctuating doses showed lower age and higher VHI subscale scores, and patients with long treatment interval (≥ 100 days and < 240 days) showed higher SDF0. Conclusions Almost all patients received stable low doses of BoNTA over time, irrespective of the baseline results. Patients' age, gender, and VHI scores were correlated with poor treatment responses, such as frequent dose changes and shorter intervals between injections. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Factors related to a non‐localising technetium 99m sestamibi scan result during parathyroid adenoma imaging in primary hyperparathyroidism

xlomafota13 shared this article with you from Inoreader Factors related to a non‐localising technetium 99m sestamibi scan result during parathyroid adenoma imaging in primary hyperparathyroidism Via Clinical Otolaryngology Abstract Objectives The aim of this study is to investigate factors that are associated with having a non‐localising 99mTc‐sestamibi scan. Design A retrospective study was performed on patients that underwent parathyroid surgery performed within a single institution between 2001 and 2018. Setting Single tertiary centre for parathyroid surgery. Participants 230 patients underwent surgery for primary hyperparathyroidism due to a solitary parathyroid adenoma and had pre‐operative 99mTc‐sestamibi imaging. Main outcome measures Variables including age, gender, intra‐operative location of parathyroid adenoma, adenoma weight and pre‐ & post‐operative calcium and parathyroid hormone levels were investigated through univariate and multivariate analysis to identify any association with having a non‐localising (negative) 99mTc‐sestamibi scan result. Results Multivariate analysis identified that right‐sided adenomas (p=0.038), superior adenomas (p=0.042) and a lower pre‐operative PTH level (p=0.034) were all individual factors associated with having a negative 99mTc‐sestamibi scan result. Although the weight of the adenoma was significant on univariate analysis (p=0.029), this was not demonstrated on multivariate analysis (p=0.422). Conclusion Factors that were associated with having non‐localising 99mTc‐sestamibi scan were right‐sided adenomas, superior adenomas, and lower pre‐operative PTH level. Further large prospective multicentre studies are needed to further evaluate these initial findings. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Epstein‐Barr virus may contribute to the pathogenesis of adult‐onset recurrent respiratory papillomatosis: A preliminary study.

xlomafota13 shared this article with you from Inoreader Epstein‐Barr virus may contribute to the pathogenesis of adult‐onset recurrent respiratory papillomatosis: A preliminary study. Via Clinical Otolaryngology Abstract Objective Human papillomavirus (HPV) causes adult onset recurrent respiratory papillomatosis (AORRP), but AORPP prevalence is much lower than HPV prevalence. Thus, HPV infection is necessary, but not sufficient, to cause AORRP and other factors likely contribute to its pathogenesis. The present study aimed to investigate whether co‐infection with herpetic viruses may contribute to the pathogenesis of AORRP. Design Prospective case‐control study conducted from January 2018 to November 2019. Settings Tertiary referral center. Participants Eighteen consecutive patients with AORRP and 18 adults with healthy laryngeal mucosa (control group) undergoing surgery. Main outcome measures Cytomegalovirus, Epstein‐Barr virus (EBV), herpes simplex viruses 1 and 2, human herpesvirus 6, varicella zoster virus, and HPV (including genotyping) were detected in biopsies of papilloma or healthy mucosa using real‐time polymerase chain reaction and reverse line blot. Dysplasia and Ki67 levels were determined in papilloma specimens. Results EBV was present in 6 (33.3%) AORRP patients and no control patients (P=0.019). Presence was not dependent on tobacco exposure (P=0.413) or HPV genotype or concentration (P>0.999). EBV presence was strongly related to increased cell proliferation (P=0.005) and number of previous surgeries (P=0.039), but not dysplasia (P>0.999). Human herpesvirus 6 was found in 3 (16.7%) AORRP biopsies, with one false positive. No other herpetic virus was found. Conclusions Unlike other herpetic viruses, EBV seems to interact with HPV, enhancing cell proliferation and contributing to the pathogenesis and progression of AORRP. Further research is required to elucidate specific interactions and their role in the pathogenesis of AORRP. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pharyngeal Carriage of Beta-Haemolytic Streptococcus Species and Seroprevalence of Anti-Streptococcal Antibodies in Children in Bouaké, Côte d'Ivoire.

xlomafota13 shared this article with you from Inoreader Pharyngeal Carriage of Beta-Haemolytic Streptococcus Species and Seroprevalence of Anti-Streptococcal Antibodies in Children in Bouaké, Côte d'Ivoire. Via Laryngologie Related Articles Pharyngeal Carriage of Beta-Haemolytic Streptococcus Species and Seroprevalence of Anti-Streptococcal Antibodies in Children in Bouaké, Côte d'Ivoire. Trop Med Infect Dis. 2020 Nov 27;5(4): Authors: Monemo P, Demba N, Touré FS, Traoré A, Avi C, N'Guessan MA, Tadet JO, Gobey AR, Anoh AE, Diarrassouba A, Tuo MN, Cissé A, Saric J, Utzinger J, Tia H, Kouassi-N'Djeundo J, Becker SL, Akoua-Koffi C Abstract The pharynx of the child may serve as a reservoir of pathogenic bacteria, including beta-haemolytic group A streptococci (GAS), which can give rise to upper airway infections and post-streptococcal diseases. The objective of this study was to determine the prevalence of beta-haemolytic Streptococcus spp. in pharyngeal samples stemming from children aged 3-14 years in Bouaké, central Côte d'Ivoire. Oropharyngeal throat swabs for microbiological culture and venous blood samples to determine the seroprevalence of antistreptolysin O antibodies (ASO) were obtained from 400 children in March 2017. Identification was carried out using conventional bacteriological methods. Serogrouping was performed with a latex agglutination test, while an immunological agglutination assay was employed for ASO titres. The mean age of participating children was 9 years (standard deviation 2.5 years). In total, we detected 190 bacteria in culture, with 109 beta-haemolytic Streptococcus isolates, res ulting in an oropharyngeal carriage rate of 27.2%. Group C streptococci accounted for 82.6% of all isolates, whereas GAS were rarely found (4.6%). The ASO seroprevalence was 17.3%. There was no correlation between serology and prevalence of streptococci (p = 0.722). In conclusion, there is a high pharyngeal carriage rate of non-GAS strains in children from Bouaké, warranting further investigation. PMID: 33261048 [PubMed] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of free vascularized iliac bone flap grafting versus pedicled iliac bone flap grafting for treatment of osteonecrosis of the femoral head.

xlomafota13 shared this article with you from Inoreader Comparison of free vascularized iliac bone flap grafting versus pedicled iliac bone flap grafting for treatment of osteonecrosis of the femoral head. Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS Related Articles Comparison of free vascularized iliac bone flap grafting versus pedicled iliac bone flap grafting for treatment of osteonecrosis of the femoral head. J Plast Reconstr Aesthet Surg. 2020 Nov 10;: Authors: Cao Z, Ou Q, Pang X, Wu P, Du W, Tang J Abstract BACKGROUND: A high incidence of osteonecrosis of the femoral head (ONFH), a commonly seen and intractable disease, has been reported. This retrospective study aims to compare the reconstructive outcomes by free vascularized iliac bone flap (FVIBF) with those by vascularized pedicled iliac bone flap (PIBF) to determine which one is better for ONFH patients. METHODS: From January 2010 to December 2017, 35 patients (40 hips) were treated by PIBF grafting, and 32 patients (36 hips) were treated by FVIBF grafting. The two groups were then compared in terms of the preoperative baseline conditions, intraoperative data, and postoperative Harris hip score (HHS). RESULTS: In the PIBF group, the operating time was significantly longer than the FVIBF group (195.5 ± 26.4 vs 147.2 ± 17.7 min, respectively), and the intra-operative blood loss was significantly heavier (330.0 ± 63.9 vs 240.3 ± 37.5 ml, respectively). Meanwhile, the recipient site morbidity rate in the PIBF group outnumbered that in the FVIBF group (27.5% vs 8.3%, respectively), and a higher rate of lateral femoral cutaneous nerve (LFCN) injury was observed in the PIBF group than in the FVIBF group (27.5% vs 8.3%, respectively). No difference was found in postoperative HHS score between the two groups. In both groups, the recovery effect of the patients in stage II was better than that in stage III. CONCLUSION: While maintaining a similar clinical effect, the FVIBF grafting exhibited a distinct advantage over the PIBF grafting, in terms of shorter operative time, less blood loss, and lower risk of LFCN injury. PMID: 33262056 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.