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J Laryngol Otol [journal]
- Does early oral feeding increase the likelihood of salivary fistula after total laryngectomy? [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-7.
Objective: This study compared the incidence of salivary fistula between groups with an early or late reintroduction of oral feeding, and identified the predictive factors for salivary fistula. Methods: A randomised trial was performed using 89 patients with larynx or hypopharynx cancer, assigned to 2 groups (early or late). In the early group, oral feeding was started 24 hours after total laryngectomy or total pharyngolaryngectomy, and in the late group, it was started from post-operative day 7 onwards. The occurrence of salivary fistula was evaluated in relation to the following variables: early or late oral feeding, nutritional status, cancer stage, surgery performed, and type of neck dissection. Results: The incidence of salivary fistula was 27.3 per cent (n = 12) in the early group and 13.3 per cent (n = 6) in the late group (p = 0.10). The following variables were not statistically significant: nutritional status (p = 0.45); tumour location (p = 0.37); type of surgery (p = 0.91) and type of neck dissection (p = 0.62). A significant difference (p = 0.02) between the free margins and invasive carcinoma was observed. Conclusion: The early reintroduction of oral feeding in total laryngectomised patients did not increase the incidence of salivary fistula.
- Patient and public involvement: in theory and in practice. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-8.
Background: You've probably heard of patient and public involvement by now. You may even have 'involved' people in your research. But why involve patients, carers and members of the public at all? Is it just another hoop to jump through when preparing a research funding application for submission, or could it actually add something to your research? Could involving patients and members of the public even help you to design and deliver better research, with outcomes focused directly on the needs of your patient group? Objective: This article aims to answer some of these questions. It considers the theory underpinning patient and public involvement. This is followed by practical suggestions and advice to help you develop (or further develop if you already involve people!) patient and public involvement within your own research. There is also a case study to illustrate some of the main points, and extracts written by members of Research Design Service North East Consumer Panels.
- Investigation of the role of major respiratory viruses in the aetiology of nasal polyps using polymerase chain reaction technique. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-4.
Objective: We aimed to identify the role of major respiratory viruses in the aetiology of human nasal polyps using polymerase chain reaction technique. Methods: Thirty patients with nasal polyps and a group of 20 healthy patients (control group) were included in this study. Mucosa was obtained from the polyps of patients with nasal polyposis and from the middle turbinate of the control group patients by means of biopsy. The samples were stored at -80 °C until molecular analysis by polymerase chain reaction was carried out. Results: In the control group, the human coronavirus and human rhinovirus were diagnosed in one of the patients and the human respiratory syncytial virus in another. In the group with nasal polyposis, the influenza B virus was identified in one of the patients and the human coronavirus in another. Conclusion: The results did not demonstrate a statistically significant relationship between nasal polyposis and respiratory viruses.
- Pre-operative overnight pulse oximetry to predict high dependency unit intervention in children undergoing adenotonsillectomy for obstructive sleep apnoea. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-5.
Background: Post-operative high dependency unit beds are often requested for patients undergoing adenotonsillectomy for obstructive sleep apnoea. This study evaluated the utilisation of high dependency unit beds for such cases at our institution, a paediatric tertiary referral centre. Method: A retrospective case note review of patients admitted to the high dependency unit following adenotonsillar surgery for obstructive sleep apnoea, over a two-year period, was performed. Results: Sixty-six cases were identified. Thirty-nine patients underwent pre-operative overnight pulse oximetry; of these, 30 patients had desaturations noted. Seventeen patients had significant post-operative desaturations. These were predicted in all 11 patients who had undergone pre-operative pulse oximetry. The remaining six had not undergone pre-operative pulse oximetry. Nineteen patients required high dependency unit care; eight had experienced post-operative desaturations. Conclusion: High dependency unit care may be required following adenotonsillectomy for obstructive sleep apnoea. In this study, pre-operative overnight pulse oximetry had 100 per cent sensitivity in predicting post-operative desaturations, and may therefore aid the appropriate utilisation of high dependency unit beds for patients undergoing adenotonsillectomy for obstructive sleep apnoea.
- Protective effect of (-)-epigallocatechin-3-gallate against cisplatin-induced ototoxicity. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-6.
Objective: Ototoxicity due to cisplatin therapy interferes with treatment and often forces a reduction in the dosage, duration and frequency of the cisplatin therapy. (-)-Epigallocatechin-3-gallate is known to have the highest antioxidant potency among all tea catechins. This study aimed to investigate the effect of (-)-epigallocatechin-3-gallate on cisplatin ototoxicity in an auditory cell line: House Ear Institute-Organ of Corti 1 cells. Methods: Cultured House Ear Institute-Organ of Corti 1 cells were exposed to cisplatin with or without pre-treatment with (-)-epigallocatechin-3-gallate. Cell viability was evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Hoechst 33258 staining was used to identify cells undergoing apoptosis. Western blot analysis was conducted to determine whether (-)-epigallocatechin-3-gallate inhibited cisplatin-induced caspase activation. Intracellular reactive oxygen species production was examined to investigate whether (-)-epigallocatechin-3-gallate was capable of scavenging cisplatin-induced reactive oxygen species accumulation. Results: Cell viability significantly increased in cells pre-treated with (-)-epigallocatechin-3-gallate compared with cells exposed to cisplatin alone. Cisplatin increased cleaved caspase-3 on Western blot analysis; however, pre-treatment with (-)-epigallocatechin-3-gallate inhibited the expression of caspase-3. (-)-Epigallocatechin-3-gallate attenuated reactive oxygen species production and apoptosis in House Ear Institute-Organ of Corti 1 cells. Conclusion: (-)-Epigallocatechin-3-gallate protected against cisplatin cytotoxicity through anti-apoptotic and anti-oxidative effects. Therefore, (-)-epigallocatechin-3-gallate could play a preventive role in cisplatin-induced ototoxicity.
- Hearing outcome of early postnatal exposure to hypoxia in Sprague-Dawley rats. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 15.:1-5.
Objective: To determine the effect of experimentally induced hypoxia, in the first 10 days of life, on physiological hearing in a Sprague-Dawley rat model. Methods: A prospective, controlled animal study was carried out using 22 male rat pups. The rats in the hypoxic group (n = 12) were reared in hypoxia for the first 10 days of life, and subsequently reared in normoxia, while those in the control group (n = 10) were reared in normoxia for the duration of the experiment. Hearing was assessed using auditory brainstem response testing at approximately 72 days of age. Results: The hypoxia group had higher auditory brainstem response thresholds for all frequencies tested (more pronounced at 16 kHz), compared with controls. Wave I-V inter-peak latencies were more prolonged in the hypoxic rats, while both groups had similar wave I latencies. Conclusion: Chronic postnatal hypoxia induced permanent hearing loss in this Sprague-Dawley rat model. Prolonged wave I-V inter-peak latencies suggested functional abnormality in the central auditory pathway.
- Authors’ reply. [Comment, Letter]
- J Laryngol Otol 2014 Feb; 128(2):216-7.
- Anatomical variation of the extracranial course of the optic nerve in the floor of the sphenoid sinus. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 10.:1.
- Rare occurrence of renal metastasis from thyroid carcinoma: lessons not to forget in evaluation. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 8.:1.
- Causes and consequences of anterior pharyngeal pouch after total laryngectomy. [JOURNAL ARTICLE]
- J Laryngol Otol 2014 Apr 8.:1-4.
Objectives: To assess the frequency of anterior pharyngeal pouch formation after total laryngectomy, and to discuss the causes and consequences of anterior pharyngeal pouch formation. Study design: A prospective, observational study of 43 patients undergoing total laryngectomy. Methods: Data collected included laryngeal defect closure type, tumour staging and demographic information. A barium swallow was performed on day 7-14 after surgery to assess for anterior pharyngeal pouch formation and fistula formation. Results: The incidence of anterior pharyngeal pouch formation was 47 per cent. Patients who did not have an anterior pharyngeal pouch on swallow imaging assessment were less likely to develop a pharyngo-cutaneous fistula. There was no statistically significant association between laryngeal defect closure type and anterior pharyngeal pouch formation. Conclusion: The anterior pharyngeal pouch is a dynamic phenomenon best investigated with a fluoroscopic swallow imaging study. Its causes are multi-factorial. Absence of an anterior pharyngeal pouch appears to confer protection against pharyngo-cutaneous fistula formation, hastening commencement of adjuvant therapy and an oral diet.