Πέμπτη 30 Δεκεμβρίου 2021

Postoperative Inhaled Steroids Following Glottic Airway Surgery Reduces Granulation Tissue Formation

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Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211065805. doi: 10.1177/00034894211065805. Online ahead of print.

ABSTRACT

OBJECTIVES: Transoral laser surgery for glottic stenosis (transverse cordotomy and anteromedial arytenoidectomy (TCAMA)) is often complicated by granulation tissue (GT) formation. GT can cause dyspnea and may require surgical removal to alleviate airway obstruction. Inhaled corticosteroids (ICS) have been shown to reduce benign vocal fold granulomas, however its use to prevent GT formation has not been described. We aimed to analyze the effect of immediate postoperative ICS on GT formation in patients undergoing transoral laser surgery for glottic stenosis.

METHODS: A retrospective analysis of patients that had transoral laser surgery for glottic stenosis from 2000 to 2019 was conducted. Surgical instances were grouped into those that received postoperative ICS and those that did not. Demographics, diagnosis, comorbidities, intraoperative adjuvant therapy, and perioperative medications were collected. Differences in GT formation and need for surgical removal were compared between groups. A multivariate exact logistic regression model was performed.

RESULTS: Forty-four patients were included; 16 required 2 glottic airway surgeries (60 surgical instances). Of the 23 instances where patients received immediate postoperative ICS, 0 patients developed GT; and of the 37 instances that did not receive postoperative ICS, 15 (40.5%) developed GT (P < .0001). Eight (53.3%) of these cases returned to the OR for GT removal. ICS use was solely associated with the absence of GT formation (P = .042) in the multivariate analysis.

CONCLUSIONS: Immediate postoperative use of ICS seems to be a safe and effective method to prevent granulation tissue formation and subsequent surgery in patients following transoral laser airway surgery for glottic stenosis.

PMID:34965742 | DOI:10.1177/00034894211065805

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High-Definition 3-D Exoscope for Micro-Laryngeal Surgery: A Preliminary Clinical Experience in 41 Patients

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Ann Otol Rhinol Laryngol. 2021 Dec 30:34894211063741. doi: 10.1177/00034894211063741. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this prospective clinical study is to evaluate the feasibility of the micro-laryngeal surgery (MLS) using a 3D operating exoscope (OE) in substitution to a conventional operating microscope (OM).

METHODS: A total of 41 consecutive patients were included (male: 26; median age: 55.0 years; IQR: 46.0-68.0). After each procedure, the s urgeon and the scrub nurse were asked to fill out a tailored questionnaire on a 3-point Likert scale (1-not acceptable, 2-acceptable, 3-good) including 12 items.

RESULTS: The majority of the procedures were therapeutic (n = 31, 75.6%), while the remaining were diagnostic (n = 10, 24.4%). All surgeries were successfully completed without the support of the OM, and no complications or unwanted delays were detected. The majority of the individual items were judged "good" either by surgeons (n = 399, 81.1%) and scrub nurses (n = 287, 87.5%). The natural posture during the procedure, and the ease of use the joystick and focusing were the best-rated items by the surgeons.

CONCLUSIONS: This study demonstrates the feasibility of MLS using the OE. Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope and to better define advantages and disadvantages.

PMID:34965750 | DOI:10.1177/00034894211063741

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Associations of Hearing Loss and Dual Sensory Loss With Mortality

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This systematic review and meta-analysis assesses the epidemiol ogical associations of hearing loss and dual sensory loss with mortality among adults.
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Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery

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This randomized clinical trial examines the efficacy of an anim ated surgical guide in helping Canadian patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process.
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