JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Dec 2015
Multicenter StudyEarly Oral Tongue Squamous Cell Carcinoma: Sampling of Margins From Tumor Bed and Worse Local Control.
Positive margins are associated with poor prognosis among patients with oral tongue squamous cell carcinoma (SCC). However, wide variation exists in the margin sampling technique. ⋯ The margin sampling technique affects local control in patients with oral tongue SCC. Reliance on margin sampling from the tumor bed is associated with worse local control, most likely owing to narrower margin clearance and greater incidence of positive margins. A resection specimen-based margin assessment is recommended.
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JAMA Otolaryngol Head Neck Surg · Feb 2015
Randomized Controlled Trial Multicenter StudyThe use of clinical parameters to predict obstructive sleep apnea syndrome severity in children: the Childhood Adenotonsillectomy (CHAT) study randomized clinical trial.
It is important to distinguish children with different levels of severity of obstructive sleep apnea syndrome (OSAS) preoperatively using clinical parameters. This can identify children who most need polysomnography (PSG) prior to adenotonsillectomy (AT). ⋯ This study of more than 450 children with OSAS identifies a number of clinical parameters that are associated with OSAS severity. However, information on demographics, physical findings, and questionnaire responses does not robustly discriminate different levels of OSAS severity.
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JAMA Otolaryngol Head Neck Surg · Mar 2014
Multicenter StudySafety of adult tonsillectomy: a population-level analysis of 5968 patients.
Tonsillectomy is one of the most commonly performed otolaryngology procedures. The safety of this procedure in adults is based on small case series. To our knowledge, we report the first population-level analysis of the safety of adult tonsillectomies in the United States. ⋯ In the United States, adult tonsillectomy is a safe procedure with low rates of mortality and morbidity. The most common posttonsillectomy complications were infectious in etiology, and complications were independently associated with the need for reoperation.
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JAMA Otolaryngol Head Neck Surg · Mar 2014
Multicenter StudyHoarseness and laryngopharyngeal reflux: a survey of primary care physician practice patterns.
Current approaches to the diagnosis and subsequent management of specific voice disorders vary widely among primary care physicians (PCPs). In addition, sparse literature describes current primary care practice patterns concerning empirical treatment for vocal disorders. ⋯ Most PCPs who responded to our survey report empirically treating patients with chronic hoarseness of unknown origin. Many physician respondents were willing to empirically prescribe reflux medication as primary therapy, even when symptoms of gastroesophageal reflux disease were not present. These data suggest that PCPs strongly consider reflux a common cause of dysphonia and may empirically treat patients having dysphonia with reflux medication before referral.