The Laryngoscope
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Study and detailed description of the large connections between the normally recurrent inferior laryngeal nerve (RILN) and the sympathetic trunk (ST) because these may be mistaken for a nonrecurrent inferior laryngeal nerve (NRILN). ⋯ 1) The CB between the RILN and the ST may have a diameter and course similar to an NRILN and may be confused with it. 2) The occurrence of the CB is greater than the occurrence referred to in previous studies. 3) The occurrence of the CB is similar by side and sex. 4) The CB may arise at different levels from the cervical ST and ganglia and end in the thyroid area. 5) Other neural elements may also be confused with an RILN, such as the cardiac nerves and the collateral branches from an NRILN to the trachea and esophagus.
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Comparative Study Clinical Trial
The effects of smoking on short-term quality of life outcomes in sinus surgery.
The purpose of this study was to prospectively compare the short-term benefit of endoscopic sinus surgery for smokers and nonsmokers using a disease specific, clinically validated, quality of life outcomes measure, the Sinonasal Outcomes Test-20 (SNOT-20). ⋯ This study confirms that smokers and nonsmokers achieve a highly significant short-term benefit from endoscopic sinus surgery using a clinically-validated symptom severity scale in a prospective study. Interestingly, smokers achieved a greater short-term benefit than nonsmokers did. This study calls into question the notion that current smokers are poorer candidates for endoscopic sinus surgery. Further prospective studies to confirm these results and provide long-term analysis should be performed.
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Comparative Study
Nerve of origin, tumor size, hearing preservation, and facial nerve outcomes in 359 vestibular schwannoma resections at a tertiary care academic center.
To determine nerve of origin, tumor size, hearing preservation rates, and facial nerve outcomes in a retrospective cohort study of patients undergoing translabyrinthine (TL), middle cranial fossa (MCF), and retrosigmoid/suboccipital (SO) approaches to vestibular schwannomas (VS). ⋯ Our retrospective data indicated that IVN tumors were twice as common as SVN tumors. The nerve of origin did not affect facial nerve outcomes but did impact hearing preservation rates. Patients with tumors <1 cm in size had the best chance for hearing preservation. Overall facial nerve preservation was excellent with >90% achieving HB 1 to 3 function at final follow-up.
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To determine whether injection laryngoplasty or medialization laryngoplasty is more effective in the treatment of unilateral vocal fold paralysis. ⋯ Injection and medialization laryngoplasty were comparable in their improvement of subjective and objective voice outcomes. Both treatment modalities should be included in the otolaryngologist's armamentarium for managing unilateral vocal fold paralysis.
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Randomized Controlled Trial Comparative Study
Impact of perioperative systemic steroids on surgical outcomes in patients with chronic rhinosinusitis with polyposis: evaluation with the novel Perioperative Sinus Endoscopy (POSE) scoring system.
The objective of this randomized, double-blind, placebo-controlled study was to assess the effect of perioperative systemic steroids on subjective and objective surgical outcomes for patients undergoing endoscopic sinus surgery (ESS) for chronic rhinosinusitis with polyposis (CRSwP). The secondary objective was to begin validation of the newly developed Perioperative Sinus Endoscopy (POSE) scoring system. ⋯ The data presented in this study support the practice of administering preoperative systemic steroids to patients undergoing ESS for CRSwP. Furthermore, in the practice of surgeons who provide intensive postoperative care post-ESS, including debridement and medical therapy based on the endoscopic findings, there is evidence to support administering systemic steroids in the postoperative period. The POSE scoring system compares favorably with the LKES and may confer advantages in terms of face/content validity and responsiveness to change and is worthy of further validation.