Objectives:
The aim of this study was to compare the efficacy of bioabsorbable steroid-eluting sinus stents versus absorbable Nasopore packs after endoscopic sinus surgery (ESS) for the treatment of ...chronic rhinosinusitis (CRS).
Methods:
One hundred eighty-one patients with CRS who underwent ESS were randomly assigned to receive a steroid-eluting sinus stent in one ethmoid sinus cavity, whereas the contralateral control side received a Nasopore pack. Endoscopic evaluations were performed 14, 30, and 90 days after the ESS. Postoperative intervention, polyp formation, adhesions, and middle turbinate (MT) position were assessed as efficacy outcomes.
Results:
The stents were successfully deployed in all 181 sinuses. Thirty days after the ESS, the stents significantly reduced the need for surgical intervention compared to the Nasopore (P < .0001). The percentage of cases with polyp formation was significantly lower on the stent sides compared with the Nasopore sides (P < .0001) at 14, 30, and 90 days after ESS. The percentage of severe adhesion was significantly lower on the stents sides than on the Nasopore sides at postoperative day 90 (P = .0003), whereas they were not significantly lower at postoperative days 14 and 30. There were no significant differences between the stent sides and the Nasopore sides regarding the frequency of MT lateralization at all end points. No device-related adverse events occurred.
Conclusions:
Our study demonstrated significant improvement in the early postoperative outcomes by reducing the need for postoperative surgical intervention and polyp formation using steroid-eluting stents when compared with absorbable Nasopore packs. The steroid-eluting sinus stents and the Nasopore packs were each effective in preserving the ethmoid sinus patency and in preventing MT lateralization. A further prospective cohort study with long-term postoperative outcomes is warranted.
Objective
This study aimed to develop an objective and simple score for predicting the prognosis of patients with laryngeal contact granuloma (LCG) treated with local glucocorticoid injection ...combined with oral proton pump inhibitor (GI + PPI).
Methods
Cox regression analysis was used to analyze the effect of baseline variables on the prognosis of 507 patients with LCG treated with GI + PPI. An easy‐to‐apply RCGSG (Reflus, Cough, Gender, and Surgery in GI + PPI therapy) score was developed based on the independent risk factors selected by univariate and multivariate Cox regression analyses. The score was internally validated by receiver‐operating characteristic curve, calibration curve, and decision curve analysis.
Results
After univariate and multivariate analyses, male gender (hazard ratio HR 0.546, p < .001), laryngopharyngeal reflux (HR 0.702, p = .001), chronic cough (HR 0.709, p = .001), and history of surgical resection (HR 0.433, p < .001) were found to be the independent risk factors affecting the prognosis of LCG. According to the score, the median cure time was 3 months (95% confidence interval CI 2.81–3.19) in the low‐risk group, 4 months (95% CI 3.74–4.26) in the moderate‐risk group, and 5 months (95% CI 4.76–5.24) in the high‐risk group. The bootstrap method was used to plot calibration curves for internal validation.
Conclusion
The RCGSG score, developed based on laryngopharyngeal reflux, chronic cough, gender, and surgical resection history, has been internally verified to be a good predictor of the prognosis of patients with LCG receiving GI + PPI treatment.
Level of evidence
Level 4.
The RCGSG score, developed based on laryngopharyngeal reflux, chronic cough, gender, and surgical resection history, has been internally verified to be a good predictor of the prognosis of patients with laryngeal contact granuloma.
To study the surface electromyography (sEMG) changes of globus patients during swallowing and to discuss the cause of the globus.
The sEMG during swallowing was recorded in 126 healthy volunteers ...(control group) and 34 globus patients (globus group).Swallow included dry swallow and 20 ml water swallow. The durations and amplitudes of muscle activities during every swallow were recorded. The durations and amplitudes of the sEMG in two groups were compared using t test.
The durations of sEMG at dry swallow and 20 ml water swallow were (1.128 ± 0.191)s and (1.091 ± 0.208)s, while the amplitudes were (0.313 ± 0.110) mV and (0.286 ± 0.106) mV in control group. The durations of sEMG at dry swallow and 20 ml water swallow were (1.178 ± 0.252)s and (1.127 ± 0.178)s, while the amplitudes were (0.341 ± 0.116) mV and (0.316 ± 0.094) mV in globus group. There were no significant differences between globus patients and healthy volunteers in the durations and amplitudes of sEMG at dry swallow and 20 ml water swallow (P > 0
ObjectivesThis study aimed to investigate the status of the current knowledge about laryngopharyngeal reflux disease (LPRD) among Chinese otolaryngologists.DesignMulti-centre cross-sectional ...survey.Setting220 medical centres in different regions of China.ParticipantsA total of 2254 otolaryngologists from 220 medical centres in China who were successfully on-site surveyed between November 2019 and December 2020.Main outcome measuresAwareness about LPRD included knowledge about risk factors, symptoms, laryngoscope signs, related diseases, current diagnostic methods and treatments.ResultsThe percentage of participants who had heard of LPRD was 96.4%, with academic conferences as the most common source of information (73.3%). The most commonly known risk factor, symptom, laryngoscope sign, related disease, diagnostic method and treatment were alcohol consumption (44.0%), pharyngeal foreign body sensation (66.9%), hyperaemia (52.4%), pharyngolaryngitis (54.8%), pH monitoring (47.6%) and medication (82.1%), respectively. Only 28.3% of all participants knew that 24 h pH or multichannel intraluminal impedance pH monitoring was the most accurate diagnostic test. As many as 73.1% of all participants knew that proton pump inhibitors were the first-line treatment drugs. An analysis of the overall status of awareness using a scoring system suggested that otolaryngologists were better aware owing to more access, working at 3A hospitals, and postgraduate or above educational background (all p<0.05).ConclusionAlthough the majority of Chinese otolaryngologists had heard of LPRD, their overall awareness about the disease was not encouraging. More efforts are needed to increase the knowledge about LPRD among this group of physicians.Trial registration numberChiCTR1900025581
Objective
To study the value of multitime point salivary pepsin testing (MTPSPT) for the diagnosis of laryngopharyngeal reflux (LPR).
Study Design
Prospective noncontrolled.
Methods
For patients who ...met the enrollment criteria, the reflux symptom index (RSI) and reflux finding score (RFS) were calculated and salivary pepsin testing was performed. The pepsin test was performed every hour from 7:00 a.m. to 6:00 p.m. by collecting fresh saliva samples. A single positive test result was needed for the diagnosis of LPR. The consistency in the diagnosis of LPR between the two methods was compared with the weighted Cohen's kappa statistic.
Results
A total of 204 patients were included. The kappa value between the two methods was 0.566 (p = .00). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MTPSPT were 76.43%, 85.94%, 92.24%, and 62.5%, respectively. We also compared a single pepsin measure at 7 a.m. with the screening results based on the RSI and RFS, and found a much lower kappa agreement value (0.223, p = .00). The sensitivity, specificity, PPV, NPV, and false‐negative rate of pepsin testing at 7 a.m. (fasting) were 37.86%, 92.18%, 91.38%, 40.41%, and 58.57%, respectively.
Conclusion
The use of the result of a single salivary pepsin test in the morning yields a relatively higher rate of missed diagnosis of LPR, and multitime point testing through a day increased the accuracy and sensitivity of detection of LPR twofold compared to a single morning fasting sample.
Level of Evidence
3
Transoral supraglottic laryngectomy (TSL) has been widely applied in the treatment of supraglottic cancers. The aim of this study is to evaluate a simplified technique for excising properly selected ...supraglottic tumors with a transoral coblation-assisted system.
Eight patients with T1-3N2M0 supraglottic cancer were treated with TSL with the coblation-assisted system.
Tumors in all patients were en bloc resected with negative surgical margins and the selective neck dissection was also performed. The mean operation time for TSL was 39 minutes (25-65 minutes). The average time for the removal of the nasogastric tube was 8.6 days (1-28 days). All patients were extubated and shifted to the ward after operation. None of the patients required tracheotomy.
Coblation-assisted TSL is a relatively simple, easy approach with low risk. It could be a feasible and safe procedure for patients with properly selected supraglottic cancer.
To investigate the clinical characteristics, short and long term effect of quick repositioning maneuver along the sagittal plane for patients with benign paroxysmal positional vertigo who were ...induced vertigo in the straight head-hanging test.
The clinical data of 38 patients affected by benign paroxysmal positional vertigo who were induced vertigo in the straight head-hanging test from July 2009 to July 2014 in the Department of Otolaryngology Head and Neck Surgery of Navy General Hospital were retrospectively analyzed. After diagnosis, the patients were underwent quick repositioning maneuver along the sagittal plane.
Of the 38 cases studied, 15 patients (39.5%) were males and 23 patients (60.5%) were females. The age of the patients ranged from 33 to 71 years with a mean of 55 ± 12 years. The median duration between symptoms and diagnosis was 8 days. The total improvement was 33 cases (86.8%) in patients with superior semicircular canal BPPV when they were re-evaluated at 1 week and 32 cases (84.2%) at 3 mo
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