The Laryngoscope
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Observational Study
What drives quality of life in patients with sporadic vestibular schwannoma?
To investigate the influence of posttreatment audiovestibular symptoms, facial neuropathy, and headache on long-term quality-of-life outcomes in patients with sporadic vestibular schwannoma (VS) utilizing the Short Form 36 (SF-36) Health Survey and the Penn Acoustic Neuroma Quality of Life (PANQOL) scale. ⋯ Ongoing dizziness and headache are the strongest predictors of long-term quality-of-life reduction in patients with sporadic VS, while the impact of hearing loss, facial nerve function, and tinnitus are less by comparison. This information may be valuable for patient counseling, refinement of VS quality-of-life assessment instruments, and determining high-yield targets for therapy in efforts to further improve patient outcomes.
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Otitis media (OM) is highly prevalent and represents a major public health concern. We evaluate National Institutes of Health (NIH) funding support for OM research and examine the role of otolaryngology primary investigators (PIs). ⋯ The NIH provided considerable grant support for researchers studying OM as awards to practitioners in numerous specialties exceeded a quarter of a billion dollars since 2000. Although awards to otolaryngologists were significant, the share of grants awarded to otolaryngologists has declined, suggesting that increased recruitment of basic scientists and enhanced cooperation with other specialists may facilitate further scholarship. These findings suggest a need for improving initiatives that prepare otolaryngology trainees interested in translational OM research for the rigorous NIH peer-review grant process.
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In 2008, the Centers for Medicare and Medicaid Services discontinued reimbursement for postoperative venous thromboembolism (VTE) events such as deep venous thrombosis and pulmonary embolism, citing them as preventable postoperative complications. We examined the impact of postoperative VTE on patients undergoing pituitary surgery. ⋯ Analysis of the data from the NIS database showed that risk factors for the development of VTE following pituitary surgery include older age, preexisting coagulopathy, peripheral vascular disorder, and weight loss. Patients who developed postoperative VTE had a longer length of hospital stay, higher hospital charges, and increased morbidity and mortality.
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Angiotensin II receptor antagonists have been proposed as a replacement therapy after the occurrence of either an angiotensin converting enzyme (ACE) inhibitor-induced angioedema or cough. However, recent studies indicate that angioedema is associated with elevated bradykinin levels in a small fraction of patients treated with angiotensin-II-receptor blockers, suggesting a common pathophysiological mechanism. To date, a standard treatment for angiotensin II receptor blocker-induced angioedema does not exist. ⋯ Icatibant is a safe and effective substance for the treatment of angiotensin II receptor blocker-induced angioedema. Although the pathophysiology of angiotensin II receptor blocker-induced angioedema remains unclear, it appears to be associated with the bradykinin pathway.