European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Eur Arch Otorhinolaryngol · Sep 2018
ReviewDay case adenotonsillectomy for paediatric obstructive sleep apnoea: a review of the evidence.
Tonsillectomy and adenoidectomy are two of the most commonly performed procedures by otolaryngologist, especially in the paediatric population. Most common indications for adenotonsillectomy in the paediatric population include recurrent tonsillitis, otitis media (glue ear) and obstructive sleep apnoea (OSA). Whilst adenotonsillectomy is routinely performed as a day case for recurrent tonsillitis, many surgeons advocate an overnight stay for patients for OSA. The practice of keeping these patients in overnight for saturation monitoring is widely undertaken. There has been some dispute as to whether this is required. ⋯ Day case adenotonsillectomy for children between 3 and 17 years who appears to be a safe option with a growing body of evidence. Large randomised control trials would likely add weight to this conclusion and help change the mind-set of clinicians.
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Eur Arch Otorhinolaryngol · May 2016
ReviewA novel distending laryngoscope: implications in transoral surgery.
The objective is to describe an innovative laryngoscope developed to improve visualization, provide greater exposure, and enhance precision and success during transoral procedures. A retrospective review of 170 patients who underwent transoral surgery with a new distending laryngoscope was conducted. We compared and contrasted our exposure within the oropharynx, hypopharynx, and larynx using the laryngoscope with that of currently available instrumentation. ⋯ Direct laryngoscopic technique and instrumentation have continued to evolve. Over the last two decades, there has been a significant movement towards minimally invasive transoral surgical techniques fueling innovative concepts and advancement in laryngoscopic design and application. We present our experience with an innovative laryngoscope allowing for improved visualization, greater exposure, and enhanced proficiency with transoral technique.
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Eur Arch Otorhinolaryngol · Apr 2017
p16INK4 expression is of prognostic and predictive value in oropharyngeal cancers independent of human papillomavirus status: a Hungarian study.
Head and neck cancer treatment protocols still lack well-established biomarkers of prognostic and predictive value. It is well known that human papillomavirus (HPV)-related and non-HPV-related oropharyngeal cancers are distinct entities concerning tumor biology and clinical outcome. However, there is an ongoing debate whether tumor suppressor p16INK4 status alone or both p16INK4 and HPV detection should be used in clinical settings. ⋯ Improved response rates to neoadjuvant chemotherapy were observed both in p16INK4-immunolabelled and p16INK4- immunolabelled/HPV DNA- containing groups (Fisher's exact test: p = 0.025 and p = 0.009). In conclusion, p16INK4 immunohistochemistry proved to be a reliable and affordable tool for prognostic and predictive testing of head and neck squamous cell cancers. The p16INK4 immunopositivity status alone was confirmed to be an equally precise indicator of clinical outcome as p16INK4/HPV DNA PCR double testing.
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Eur Arch Otorhinolaryngol · Jan 2017
Total analysis of clinical factors for surgical success of adenotonsillectomy in pediatric OSAS.
The objective of this study is the total evaluation of most common clinical factors influencing the successful rate of adenotonsillectomy for pediatric obstructive sleep apnea syndrome (OSAS). Retrospectively, 63 pediatric patients ranged from 2 to 16 years old were included. Syndromics and patients who had received orthodontic treatment or orthognathic surgery were excluded. ⋯ Pre-operative cephalometry parameters, BMI and age did not show significant correlation with surgical success, however, pre-op AHI and tonsil size correlated with surgical success. Higher pre-op AHI value and higher tonsil grade showed higher rate of surgical success. Based on the total evaluation of clinical data, surgical success after adenotonsillectomy might be predicted by pre-op AHI severity and tonsil grade.