This case report describes an otherwise healthy woman in her 30s who presented with left-ear hearing loss, tinnitus, distorted hearing, and occasional otalgia of a few months' duration.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BdQCSV
Πέμπτη 31 Ιανουαρίου 2019
Utilization of Nasal Endoscopy in the Medicare Population, 2000-2016
This study analyzes Medicare beneficiary and provider data from 2000 through 2016 to investigate trends in the number of nasal endoscopies performed among the Medicare population, reimbursement, and regional differences.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TsOf5W
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2TsOf5W
Variation in Care Delivery and Diagnostic Modality Among the Medicare Population
In this issue of JAMA Otolaryngology–Head & Neck Surgery, Hur et al suggest that during the past decade, the use of diagnostic nasal endoscopy in the Medicare population has increased substantially and this increase has not been paralleled by a similar increase in surgical ethmoidectomy. The overall increase in the number of endoscopies was also accompanied by marked variability in endoscopy utilization across different states, with some states showing a large increase and others showing smaller increases.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BdJrdz
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2BdJrdz
A Large Tonsillar Mass in a Healthy Teenager
A previously healthy 18-year-old woman presented with a growth in the right oropharynx of 4 months' duration as well as voice changes, recent weight loss, and decreased appetite. What is your diagnosis?
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tnan1q
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tnan1q
IDG Angiography to Identify Perfusion of Paramedian Forehead Flaps During Nasal Reconstruction
This cohort study examines the utility of indocyanine green angiography to identify clinical factors that may be associated with neovascularization of paramedian forehead flaps in patients requiring multiple-staged nasal reconstruction surgery.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1F8MM
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1F8MM
Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis
This cohort study assesses the treatment patterns (dosages and frequency) and the association of treatment with self-reported functional outcomes and quality of life among patients receiving onabotulinum toxin A for treatment of facial synkinesis.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CWcW3q
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CWcW3q
IDG Angiography to Identify Perfusion of Paramedian Forehead Flaps During Nasal Reconstruction
This cohort study examines the utility of indocyanine green angiography to identify clinical factors that may be associated with neovascularization of paramedian forehead flaps in patients requiring multiple-staged nasal reconstruction surgery.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1F8MM
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2S1F8MM
Treatment Patterns and Outcomes in Botulinum Therapy for Patients With Facial Synkinesis
This cohort study assesses the treatment patterns (dosages and frequency) and the association of treatment with self-reported functional outcomes and quality of life among patients receiving onabotulinum toxin A for treatment of facial synkinesis.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CWcW3q
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2CWcW3q
Differences in pain treatment between surgeons and anaesthesiologists in a physician staffed prehospital emergency medical service: a retrospective cohort analysis
Abstract
Background
Although pain treatment is an important objective in prehospital emergency medicine the incidence of oligoanalgesia is still high in prehospital patients. Given that prehospital emergency medicine in Germany is open for physicians of any speciality, the prehospital pain treatment may differ depending on the primary medical education. Aim of this study was to explore the difference in pain treatment between surgeons and anaesthesiologists in a physician staffed emergency medical service.
Methods
Retrospective single centre cohort analysis in a physician staffed ground based emergency medical service from January 2014 until December 2016. A total of 8882 consecutive emergency missions were screened. Primary outcome measure was the difference in application frequency of prehospital analgesics by anaesthesiologist or surgeon. Univariate and multivariate logistic regression analysis was used for statistical analysis including subgroup analysis for trauma and acute coronary syndrome.
Results
A total of 8238 patients were included in the analysis. There was a significant difference in the application frequency of analgesics between surgeons and anaesthesiologists especially for opioids (p < 0.001, OR 0.68 [0.56–0.82]). Fentanyl was the most common administered analgesic in the trauma subgroup, but significantly less common used by surgeons (p = 0.005, OR 0.63 [0.46–0.87]). In acute coronary syndrome cases there was no significant difference in morphine administration between anaesthesiologists and surgeons (p = 0.49, OR 0.88 [0.61–1.27]).
Conclusions
Increased training for prehospital pain treatment should be implemented, since opioids were administered notably less frequent by surgeons than by anaesthesiologists.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WwNGde
Effects of bupivacaine or levobupivacaine on cerebral oxygenation during spinal anesthesia in elderly patients undergoing orthopedic surgery for hip fracture: a randomized controlled trial
Abstract
Background
Bupivacaine and levobupivacaine have similar pharmacokinetic and pharmacodynamic characteristics, and are used regularly in spinal anesthesia. Whether potential differences in their hemodynamic and anesthetic profiles could determine a differential risk of complications in elderly subjects, is controversial. The main objective was to compare the effects of intrathecally administered levobupivacaine (LB) versus bupivacaine (B), on regional cerebral O2 saturation during spinal anesthesia, cognitive status and neurological complications in elderly patients undergoing surgery for hip fracture.
Methods
This was a randomized, controlled, single blind study. 58 patients aged 70 or older undergoing surgery for hip fracture with spinal anesthesia were allocated with a 1:1 ratio to receive LB or B, combined with fentanyl 15 μg, by intrathecal route. The primary outcome was the proportion of intraoperative time with regional cerebral desaturation (≥20% reduction in regional cerebral oxygen saturation from baseline), monitored by near –infrared spectroscopy. Secondary endpoints included hemodynamic parameters, level of sensory and motor block, changes in Short Portable Mental Status Questionnaire (SPMSQ), and neurological complications.
Results
The mean percentage of intraoperative time with desaturation in the B group was 6.1% (SD: 17.5) and 4.7% (SD: 11.9) in the left and right hemisphere respectively; in the LB group the mean was 4.8% (SD: 11.4) in the left hemisphere and 2.4% (SD: 8.3) in the right one. No statistically significant differences were found between treatment groups. The level of sensory block at the start of surgery was lower for LB than for B (Th10 vs Th8, p:0.047) and motor block at 15 min was lower for LB (2.5 vs 3, p:0.009). No differences in postoperative SPMSQ were observed. Neurological complications such as confusional state, agitation or disorientation were reported in 50% of patients in the B group and 21.4% of patients in the LB group, p = 0.05.
Conclusions
No statistically significant differences in regional cerebral oxygen saturation or hemodynamic parameters were observed between both treatment groups. Bupivacaine and levobupivacaine differed in sensory and motor block achieved. While no differences were observed in cognitive impairment measured by the SPMSQ between treatment groups neurological complications reported by the physician were more frequent with bupivacaine.
Trial registration
European Union Clinical Trials Register (EudraCT 2013–000846 -20) (April 9th, 2013).
ClinicalTrials.gov (NCT01960543) (September 23rd, 2013).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RvX3G6
Differences in pain treatment between surgeons and anaesthesiologists in a physician staffed prehospital emergency medical service: a retrospective cohort analysis
Abstract
Background
Although pain treatment is an important objective in prehospital emergency medicine the incidence of oligoanalgesia is still high in prehospital patients. Given that prehospital emergency medicine in Germany is open for physicians of any speciality, the prehospital pain treatment may differ depending on the primary medical education. Aim of this study was to explore the difference in pain treatment between surgeons and anaesthesiologists in a physician staffed emergency medical service.
Methods
Retrospective single centre cohort analysis in a physician staffed ground based emergency medical service from January 2014 until December 2016. A total of 8882 consecutive emergency missions were screened. Primary outcome measure was the difference in application frequency of prehospital analgesics by anaesthesiologist or surgeon. Univariate and multivariate logistic regression analysis was used for statistical analysis including subgroup analysis for trauma and acute coronary syndrome.
Results
A total of 8238 patients were included in the analysis. There was a significant difference in the application frequency of analgesics between surgeons and anaesthesiologists especially for opioids (p < 0.001, OR 0.68 [0.56–0.82]). Fentanyl was the most common administered analgesic in the trauma subgroup, but significantly less common used by surgeons (p = 0.005, OR 0.63 [0.46–0.87]). In acute coronary syndrome cases there was no significant difference in morphine administration between anaesthesiologists and surgeons (p = 0.49, OR 0.88 [0.61–1.27]).
Conclusions
Increased training for prehospital pain treatment should be implemented, since opioids were administered notably less frequent by surgeons than by anaesthesiologists.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2WwNGde
Effects of bupivacaine or levobupivacaine on cerebral oxygenation during spinal anesthesia in elderly patients undergoing orthopedic surgery for hip fracture: a randomized controlled trial
Abstract
Background
Bupivacaine and levobupivacaine have similar pharmacokinetic and pharmacodynamic characteristics, and are used regularly in spinal anesthesia. Whether potential differences in their hemodynamic and anesthetic profiles could determine a differential risk of complications in elderly subjects, is controversial. The main objective was to compare the effects of intrathecally administered levobupivacaine (LB) versus bupivacaine (B), on regional cerebral O2 saturation during spinal anesthesia, cognitive status and neurological complications in elderly patients undergoing surgery for hip fracture.
Methods
This was a randomized, controlled, single blind study. 58 patients aged 70 or older undergoing surgery for hip fracture with spinal anesthesia were allocated with a 1:1 ratio to receive LB or B, combined with fentanyl 15 μg, by intrathecal route. The primary outcome was the proportion of intraoperative time with regional cerebral desaturation (≥20% reduction in regional cerebral oxygen saturation from baseline), monitored by near –infrared spectroscopy. Secondary endpoints included hemodynamic parameters, level of sensory and motor block, changes in Short Portable Mental Status Questionnaire (SPMSQ), and neurological complications.
Results
The mean percentage of intraoperative time with desaturation in the B group was 6.1% (SD: 17.5) and 4.7% (SD: 11.9) in the left and right hemisphere respectively; in the LB group the mean was 4.8% (SD: 11.4) in the left hemisphere and 2.4% (SD: 8.3) in the right one. No statistically significant differences were found between treatment groups. The level of sensory block at the start of surgery was lower for LB than for B (Th10 vs Th8, p:0.047) and motor block at 15 min was lower for LB (2.5 vs 3, p:0.009). No differences in postoperative SPMSQ were observed. Neurological complications such as confusional state, agitation or disorientation were reported in 50% of patients in the B group and 21.4% of patients in the LB group, p = 0.05.
Conclusions
No statistically significant differences in regional cerebral oxygen saturation or hemodynamic parameters were observed between both treatment groups. Bupivacaine and levobupivacaine differed in sensory and motor block achieved. While no differences were observed in cognitive impairment measured by the SPMSQ between treatment groups neurological complications reported by the physician were more frequent with bupivacaine.
Trial registration
European Union Clinical Trials Register (EudraCT 2013–000846 -20) (April 9th, 2013).
ClinicalTrials.gov (NCT01960543) (September 23rd, 2013).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RvX3G6
Ten years follow‐up retrospective study on implant survival rates and prevalence of peri‐implantitis in implant‐supported full‐arch rehabilitations
Abstract
Objectives
The aim of the present paper was to present medium‐ and long‐term data on implant survival and on the prevalence of peri‐implantitis in a cohort of patients treated with full‐arch rehabilitations.
Materials and methods
Clinical records of all patients treated with immediately loaded full‐arch rehabilitation in the Dental Clinic of the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy supported by moderately rough implants were retrospectively examined to calculate survival curves for implant loss and for the occurrence of peri‐implantitis (both at implant‐ and at patient‐level). Regression methods were used to evaluate the correlation between the presence of periodontitis and smoking habits with the outcomes.
Results
A total of 384 implants placed in 77 patients (96 rehabilitations) were evaluated for a mean period of 8.0 years (range 1.0 ‐ 13.7 years) from loading. After 10 years the cumulative survival rate was 96.11% (95% CI 99.17% ‐ 93.05%) (84 implants) while the cumulative rate of implants free from peri‐implantitis was 86.92% (95% CI: 82.14%, 91.71%) (60.69% (95% CI: 44.19%, 77.19%) at patient‐level). The cumulative proportion of implants without peri‐implantitis after 10 years was significantly higher in mandible (89.76%, 95% CI: 84.49%, 95.03%) than in maxilla (81.71%, 95% CI: 71.91%, 91.51%) (P=0.028). No correlation was found between periodontal and smoking status and outcomes.
Conclusions
The study reported high 10‐year implant survival rate for full‐arch rehabilitations since implant loss was relatively rare. Peri‐implantitis was relatively frequent in the examined population although the number of subjects available for 10‐year evaluation was limited.
This article is protected by copyright. All rights reserved.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ghk9P3
Ten years follow‐up retrospective study on implant survival rates and prevalence of peri‐implantitis in implant‐supported full‐arch rehabilitations
Abstract
Objectives
The aim of the present paper was to present medium‐ and long‐term data on implant survival and on the prevalence of peri‐implantitis in a cohort of patients treated with full‐arch rehabilitations.
Materials and methods
Clinical records of all patients treated with immediately loaded full‐arch rehabilitation in the Dental Clinic of the IRCCS Istituto Ortopedico Galeazzi in Milan, Italy supported by moderately rough implants were retrospectively examined to calculate survival curves for implant loss and for the occurrence of peri‐implantitis (both at implant‐ and at patient‐level). Regression methods were used to evaluate the correlation between the presence of periodontitis and smoking habits with the outcomes.
Results
A total of 384 implants placed in 77 patients (96 rehabilitations) were evaluated for a mean period of 8.0 years (range 1.0 ‐ 13.7 years) from loading. After 10 years the cumulative survival rate was 96.11% (95% CI 99.17% ‐ 93.05%) (84 implants) while the cumulative rate of implants free from peri‐implantitis was 86.92% (95% CI: 82.14%, 91.71%) (60.69% (95% CI: 44.19%, 77.19%) at patient‐level). The cumulative proportion of implants without peri‐implantitis after 10 years was significantly higher in mandible (89.76%, 95% CI: 84.49%, 95.03%) than in maxilla (81.71%, 95% CI: 71.91%, 91.51%) (P=0.028). No correlation was found between periodontal and smoking status and outcomes.
Conclusions
The study reported high 10‐year implant survival rate for full‐arch rehabilitations since implant loss was relatively rare. Peri‐implantitis was relatively frequent in the examined population although the number of subjects available for 10‐year evaluation was limited.
This article is protected by copyright. All rights reserved.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ghk9P3
Microwave ablation for the treatment of arterial epistaxis: “how I do it”
Background
Arterial epistaxis is commonly seen in the rhinology clinic and can have a significant impact on quality of life. Previous studies have explored various therapies to address epistaxis.
Methods
Patients were treated in the outpatient clinic or operating room by microwave ablation (MWA) with a 2450‐MHz cooled‐shaft antenna to treat an epistaxis bleeding point.
Results
Of the 481 patients with arterial epistaxis, bleeding was controlled within 1 to 2 minutes and only 2 patients with recurrent bleeding required re‐ablation. The shape of the thermal lesion was elliptical and it was approximately 2 mm in length, 1 mm in width, and 0.5 to 1 mm in penetration depth. Of the 481 patients, 167 (34.7%) complained of minor nasal pain on the same day of ablation. No patients complained of nasal pain or obstruction during the follow‐up period. In addition, 139 (28.9%) patients showed a minor increase in rhinorrhea during the first postoperative week. Of the 481 patients, 469 (97.5%) were followed‐up at 6 months with no severe MWA‐related complications, such as septal perforation, synechiae formation, or orbit and brain complications.
Conclusion
MWA is a technically feasible alternative method for patients with arterial epistaxis.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Us2h7K
In‐vitro evaluation of a ciprofloxacin‐ and ivacaftor‐coated sinus stent against Pseudomonas aeruginosa biofilms
Background
We recently developed a novel ciprofloxacin‐coated sinus stent capable of releasing antibiotics over a sustained period of time. Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator that has synergistic bactericidal activity with ciprofloxacin and also enhances sinus mucociliary clearance. The objective of this study was to optimize and evaluate the efficacy of a ciprofloxacin‐ and ivacaftor‐releasing biodegradable sinus stent (CISS) in vitro.
Methods
A CISS was created by coating ciprofloxacin/ivacaftor‐embedded nanoparticles with an acrylate and ammonium methacrylate copolymer onto a biodegradable poly‐L‐lactic acid stent. In‐vitro evaluation of the CISS included: (1) assessment of drug stability in nanoparticles by zeta potential, and drug‐coating stability within the CISS using scanning electron microscopy (SEM); (2) determination of ciprofloxacin‐ and ivacaftor‐release kinetics; and (3) assessment of anti‒Pseudomonas aeruginosa biofilm formation by calculating relative optical density units (RODUs) compared with control stents at 590‐nm optical density.
Results
The presence of drugs and a uniform coating on the stent were confirmed by zeta potential and SEM. Sustained drug release was observed through 21 days without an initial burst release. Anti‐biofilm formation was observed after placing the CISS for 3 days onto a preformed 1‐day P aeruginosa biofilm. The CISS significantly reduced biofilm mass compared with bare stents and controls (RODUs at 590‐nm optical density; CISS, 0.31 ± 0.01; bare stent, 0.78 ± 0.12; control, 1.0 ± 0.00; p = 0.001; n = 3).
Conclusion
The CISS maintains a uniform coating and sustained delivery of drugs providing a marked reduction in P aeruginosa biofilm formation. Further studies evaluating the efficacy of CISS in a preclinical model are planned.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DLQsDK
Does bilateral inferior turbinate reduction affect long‐term quality‐of‐life outcomes in patients undergoing endoscopic sinus surgery?
Background
The objective of this study was to evaluate the impact of bilateral inferior turbinate reduction (BITR) on patient‐reported quality of life (QOL) following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).
Methods
This was a prospective cohort study. Patients with CRS, who were recruited from 10 different otolaryngologic practices between 2011 and 2014, completed the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), Chronic Sinusitis Survey (CSS), and EuroQol 5 Dimension (EQ‐5D) survey at baseline, and at 12, 24, 36, and 48 months after ESS. A total of 113 patients who underwent ESS with BITR were compared to 788 patients who underwent ESS without BITR.
Results
Significant demographic and comorbid differences between BITR and non‐BITR cohorts included age (41 vs 49 years, p < 0.0001), presence of asthma (19% vs 36%, p < 0.0001), prior sinus surgery (22% vs 53%, p < 0.0001), and concurrent septoplasty (80% vs 53%, p < 0.0001), respectively. On univariate analysis, patients who underwent ESS with or without BITR were found to have statistically significant improvement in disease‐specific (SNOT‐22 and CSS) and general (EQ‐5D) QOL scores at years 1 through 4 (p < 0.05). On multivariate regression, however, the performance of BITR was not associated with any improvements in these outcome measures.
Conclusion
Patients undergoing ESS achieve similar long‐term improvement in both disease‐specific and general QOL regardless of the performance of concurrent BITR.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UvFLuB
Microwave ablation for the treatment of arterial epistaxis: “how I do it”
Background
Arterial epistaxis is commonly seen in the rhinology clinic and can have a significant impact on quality of life. Previous studies have explored various therapies to address epistaxis.
Methods
Patients were treated in the outpatient clinic or operating room by microwave ablation (MWA) with a 2450‐MHz cooled‐shaft antenna to treat an epistaxis bleeding point.
Results
Of the 481 patients with arterial epistaxis, bleeding was controlled within 1 to 2 minutes and only 2 patients with recurrent bleeding required re‐ablation. The shape of the thermal lesion was elliptical and it was approximately 2 mm in length, 1 mm in width, and 0.5 to 1 mm in penetration depth. Of the 481 patients, 167 (34.7%) complained of minor nasal pain on the same day of ablation. No patients complained of nasal pain or obstruction during the follow‐up period. In addition, 139 (28.9%) patients showed a minor increase in rhinorrhea during the first postoperative week. Of the 481 patients, 469 (97.5%) were followed‐up at 6 months with no severe MWA‐related complications, such as septal perforation, synechiae formation, or orbit and brain complications.
Conclusion
MWA is a technically feasible alternative method for patients with arterial epistaxis.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Us2h7K
In‐vitro evaluation of a ciprofloxacin‐ and ivacaftor‐coated sinus stent against Pseudomonas aeruginosa biofilms
Background
We recently developed a novel ciprofloxacin‐coated sinus stent capable of releasing antibiotics over a sustained period of time. Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator that has synergistic bactericidal activity with ciprofloxacin and also enhances sinus mucociliary clearance. The objective of this study was to optimize and evaluate the efficacy of a ciprofloxacin‐ and ivacaftor‐releasing biodegradable sinus stent (CISS) in vitro.
Methods
A CISS was created by coating ciprofloxacin/ivacaftor‐embedded nanoparticles with an acrylate and ammonium methacrylate copolymer onto a biodegradable poly‐L‐lactic acid stent. In‐vitro evaluation of the CISS included: (1) assessment of drug stability in nanoparticles by zeta potential, and drug‐coating stability within the CISS using scanning electron microscopy (SEM); (2) determination of ciprofloxacin‐ and ivacaftor‐release kinetics; and (3) assessment of anti‒Pseudomonas aeruginosa biofilm formation by calculating relative optical density units (RODUs) compared with control stents at 590‐nm optical density.
Results
The presence of drugs and a uniform coating on the stent were confirmed by zeta potential and SEM. Sustained drug release was observed through 21 days without an initial burst release. Anti‐biofilm formation was observed after placing the CISS for 3 days onto a preformed 1‐day P aeruginosa biofilm. The CISS significantly reduced biofilm mass compared with bare stents and controls (RODUs at 590‐nm optical density; CISS, 0.31 ± 0.01; bare stent, 0.78 ± 0.12; control, 1.0 ± 0.00; p = 0.001; n = 3).
Conclusion
The CISS maintains a uniform coating and sustained delivery of drugs providing a marked reduction in P aeruginosa biofilm formation. Further studies evaluating the efficacy of CISS in a preclinical model are planned.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2DLQsDK
Does bilateral inferior turbinate reduction affect long‐term quality‐of‐life outcomes in patients undergoing endoscopic sinus surgery?
Background
The objective of this study was to evaluate the impact of bilateral inferior turbinate reduction (BITR) on patient‐reported quality of life (QOL) following endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS).
Methods
This was a prospective cohort study. Patients with CRS, who were recruited from 10 different otolaryngologic practices between 2011 and 2014, completed the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), Chronic Sinusitis Survey (CSS), and EuroQol 5 Dimension (EQ‐5D) survey at baseline, and at 12, 24, 36, and 48 months after ESS. A total of 113 patients who underwent ESS with BITR were compared to 788 patients who underwent ESS without BITR.
Results
Significant demographic and comorbid differences between BITR and non‐BITR cohorts included age (41 vs 49 years, p < 0.0001), presence of asthma (19% vs 36%, p < 0.0001), prior sinus surgery (22% vs 53%, p < 0.0001), and concurrent septoplasty (80% vs 53%, p < 0.0001), respectively. On univariate analysis, patients who underwent ESS with or without BITR were found to have statistically significant improvement in disease‐specific (SNOT‐22 and CSS) and general (EQ‐5D) QOL scores at years 1 through 4 (p < 0.05). On multivariate regression, however, the performance of BITR was not associated with any improvements in these outcome measures.
Conclusion
Patients undergoing ESS achieve similar long‐term improvement in both disease‐specific and general QOL regardless of the performance of concurrent BITR.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2UvFLuB
Εγγραφή σε:
Αναρτήσεις (Atom)