J Laryngol Otol [journal]
- Genetic polymorphisms affecting antioxidant enzymes are present in tympanosclerosis patients. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 18.:1-6.
This study investigated genetic polymorphisms affecting the inducible nitric oxide synthase, superoxide dismutase and catalase enzymes in chronic otitis media patients with and without tympanosclerosis, and the role of genetic susceptibility in the disease aetiology.A total of 162 patients who underwent surgery for chronic otitis media were divided into two study groups: a tympanosclerosis group and a chronic otitis media group. A third, the control, group comprised 188 healthy volunteers. Venous blood samples were evaluated using reverse transcriptase polymerase chain reaction.There was a significant difference in GG genotype distribution of the -277A>G polymorphism in the NOS2 gene between the tympanosclerosis and control groups (p T) polymorphism in the SOD2 gene (p > 0.05). There were significant differences in the TT genotype distribution of the -21A>T polymorphism in the CAT gene between the tympanosclerosis and control groups, and between the chronic otitis media and control groups (p < 0.05).These results suggest that genetic predisposition may play a role in the aetiopathogenesis of tympanosclerosis.
- Prevalence of GJB2 gene mutation in 330 cochlear implant patients in the Jiangsu province. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 18.:1-5.
GJB2 gene mutations are highly prevalent in pre-lingual hearing loss patients from China. Pre-lingual deafness is a sensorineural disorder that can only be treated with cochlear implantation.The prevalence of GJB2 gene mutations was examined in 330 randomly selected patients treated with cochlear implantation.Overall, 276 patients (83.64 per cent) carried variations in the GJB2 gene. Seventeen different genotypes were identified, including 10 confirmed pathogenic mutations (c.235delC, c.299delAT, c.176del16, p.E47X, p.T123N, p.V167M, p.C218Y, p.T86R, p.V63L and p.R184Q), 3 polymorphisms (p.V27I, p.E114 G and p.I203 T) and 2 unidentified mutations (p.V37I and c.571 T > C).A total of 103 patients (31.2 per cent) carried 2 confirmed pathogenic mutations. The frequency of c.235delC was higher than that reported previously in the Jiangsu province. The two novel mutations identified, 69C > G and 501G > A, are likely to be polymorphisms.
- Longitudinal and long-term effects of radiotherapy on swallowing function after tongue reconstruction. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 17.:1-8.
This study evaluated the longitudinal and long-term effects of radiotherapy on swallowing function after tongue reconstruction.The study comprised 16 patients who had: undergone glossectomy and tongue reconstruction with free flap transfer, received adjuvant radiotherapy, and survived without recurrence for at least 1 year. Swallowing function, as indicated by tolerance of oral intake, was evaluated before radiotherapy, at radiotherapy completion, and at 6 and 12 months after radiotherapy completion.Before radiotherapy, all patients could tolerate oral intake. At radiotherapy completion, only three patients could consume all nutrition orally. However, swallowing function improved over time, and by 12 months after radiotherapy completion it had returned nearly to that before radiotherapy.Acute dysphagia due to radiotherapy after tongue reconstruction is severe, but can improve gradually. Multidisciplinary support of patients during percutaneous endoscopic gastrostomy dependence is important to improve long-term functional outcomes.
- Is pharyngeal pouch stapling superior to open pharyngeal pouch repair? An analysis of a single institution's series. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 12.:1-5.
Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.
- Polydimethylsiloxane elastomer injection in the management of the patulous eustachian tube. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 12.:1-6.
To determine the effectiveness of augmentation surgery using polydimethylsiloxane elastomer injection for the management of patulous eustachian tube.All patients were treated with eustachian tube injection augmentation performed via a combined transnasal-transoral endoscopic approach. Clinical presentation, volume of injection, complications and initial response were all prospectively recorded. Longer-term follow up was conducted through structured telephone interviews using previously described patient-reported outcome measures.Overall, 8 of 11 patients (73 per cent) derived complete or significant symptom improvement; 1 patient had significant improvements but was dissatisfied, and in 2 patients the symptoms were unchanged. The eight satisfied patients showed improvement in their quality-of-life scores.This study describes an effective treatment option for patulous eustachian tube. Unlike many prior published reports, previously described patient-reported outcome measures were utilised in order to allow more direct comparison.
- New inflammatory parameters in laryngopharyngeal reflux. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 8.:1-5.
To investigate new inflammatory markers in patients with laryngopharyngeal reflux and determine whether these inflammatory parameters change in response to laryngopharyngeal reflux treatment.Complete blood count was evaluated to obtain platelet count and mean platelet volume and calculate neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Laryngopharyngeal reflux patients underwent three-month lansoprazole treatment.The study included 45 laryngopharyngeal reflux patients (9 men (20 per cent); mean age, 37.4 ± 11.6 years) and 35 healthy age- and sex-matched controls (7 men (20 per cent); mean age, 38.6 ± 8.9 years). The study group had significantly higher platelet-to-lymphocyte ratios and lower mean platelet volumes than the control group (p = 0.004 and p = 0.047, respectively). There was a significant correlation between platelet-to-lymphocyte ratios and initial inflammatory symptoms (reflux symptom index, p = 0.025; reflux finding score, p = 0.013). There was also a significant correlation between mean platelet volume increase and symptom resolution in the first and third months of treatment (p = 0.04 and p = 0.03, respectively).Platelet-to-lymphocyte ratio, a new inflammatory marker of chronic inflammation, was significantly higher in laryngopharyngeal reflux patients. Moreover, these patients had significantly lower mean platelet volume values, which increased with post-treatment symptom improvement.
- Migration of an ingested fish bone into the paraglottic space. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 8.:1-2.
Ingested foreign bodies are common emergencies encountered in otolaryngology practice. The vast majority can be managed with endoscopic removal. Migration of foreign bodies into the paraglottic space is a rare event that often necessitates using a more invasive procedure for removal.A 68-year-old man presented with sore throat and odynophagia 4 days after ingesting a fish bone.A computed tomography scan revealed a 2.5 cm linear foreign body embedded in the larynx within the right paraglottic space. The patient underwent endoscopic examination and transcervical exploration of the paraglottic space via a posterolateral approach, with successful removal of the foreign body on the second attempt.This is the first case report of an ingested paraglottic space foreign body managed by transcervical exploration using a posterolateral approach to the paraglottic space.
- Role of the pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage laryngectomy. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 8.:1-5.
This study aimed to assess the utility of onlay pectoralis major myofascial flap in preventing pharyngocutaneous fistula following salvage total laryngectomy.A retrospective analysis was performed of 172 patients who underwent salvage laryngectomy for recurrent carcinoma of the larynx or hypopharynx between 1999 and 2014. One hundred and ten patients underwent primary closure and 62 patients had pectoralis major myofascial flap onlay.The overall pharyngocutaneous fistula rate was 43 per cent, and was similar in both groups (primary closure group, 43.6 per cent; onlay flap group, 41.9 per cent; p = 0.8). Fistulae in the onlay flap group healed faster: the median and mean fistula duration were 37 and 55 days, respectively, in the primary closure group and 20 and 25 days, respectively, in the onlay flap group (p = 0.008).Use of an onlay pectoralis major myofascial flap did not decrease the pharyngocutaneous fistula rate, although fistula duration was shortened. A well-designed randomised-controlled trial is needed to establish parameters for its routine use in clinical practice.
- Use of potassium titanyl phosphate (KTP) laser Dermastat in the treatment of recurrent anterior epistaxis - a new technique. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 8.:1-5.
To evaluate the short- to medium-term effectiveness of potassium titanyl phosphate (KTP) laser Dermastat in patients with recurrent anterior epistaxis.Fifty-eight patients presenting with recurrent anterior epistaxis were treated using potassium titanyl phosphate laser Dermastat. Those with recurrent epistaxis arising from prominent vessels in Little's area, and/or those for whom treatment with silver nitrate cautery failed, were included. The main outcome measure was resolution of epistaxis at two months.Fifty-eight patients were treated; 27 were under 18 years old. Thirty patients had prominent vessels. Thirty-one patients had undergone previous cautery treatment. Thirty-eight patients had treatment to the left side, 19 to the right and 1 to both. At two months, 74 per cent reported resolution of epistaxis with no complications. This increased to 78 per cent at further follow up.Our technique is a successful, safe treatment for recurrent anterior epistaxis in an otherwise treatment-resistant group. A single procedure is effective. The handpiece and tip are reusable and sterilisable, resulting in cost-effectiveness.
- Investigating the risk factors of vestibular dysfunction and the relationship with presbyacusis in Singapore. [JOURNAL ARTICLE]
- J Laryngol Otol 2016 Aug 4.:1-6.
This study aimed to determine the prevalence of vestibular dysfunction in the Singaporean elderly and its association with presbyacusis, age and other associated risk factors.A cross-sectional study was undertaken in a tertiary otorhinolaryngology department and the community. Healthy adults aged 40 years and above who participated in the institution's community presbyacusis screening programme were invited to participate. The main outcome measures including pure tone audiometry and vestibular assessment were obtained using a modified Clinical Test of Sensory Interaction on Balance.The prevalence of vestibular dysfunction and presbyacusis in the study population of 216 participants was 30.1 per cent (95 per cent confidence interval, 24.0 to 36.2 per cent) and 55.6 per cent (95 per cent confidence interval, 49.0 to 62.2 per cent), respectively. The median age was 60 years (range, 40-86 years). The adjusted odds ratio for vestibular dysfunction increased by 6.2 per cent with every year of life (p 0.05).Vestibular dysfunction is independently associated with ageing and presbyacusis. Further research into the benefits of additional screening for vestibular dysfunction in elderly presbyacusis patients is warranted.