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 · Jan 2017
The pre-treatment neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and red cell distribution width predict prognosis in patients with laryngeal carcinoma.
The aim of this study was to identify the potential prognostic roles of the preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and red cell distribution width (RDW) in patients with laryngeal squamous cell carcinoma (LSCC). 81 patients who underwent surgery for the larynx carcinoma were enrolled in the study. NLR, PLR and RDW were used as outcome measures. Local recurrence was detected in 30 (37.0 %) patients and neck lymph node metastasis was detected 6 (7.4 %) patients during follow-up period. ⋯ According to Cox regression analysis, a high PLR increases mortality 4.2 times and a high RDW 4.6 times. Although in univariate analysis MCV, RDW and tumor grade were predictors of mortality, RDW and tumor grade independent predictors were found. Further studies involving large patient groups are required.
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Eur Arch Otorhinolaryngol · Jan 2017
Meta Analysis Comparative StudyComparison of drain versus no-drain thyroidectomy: a meta-analysis.
Despite minimal evidence, thyroid drains are routinely used as a precaution against hematoma in thyroidectomy. We undertook the present meta-analysis to evaluate the patient outcomes associated with post-surgical drainage, and whether it offers any advantage over no drainage in patients undergoing thyroidectomy. Randomized and two-arm studies comparing the efficacy of total or partial thyroidectomy with or without post-surgery drainage, in patients undergoing thyroid surgery were included. ⋯ No statistically significant differences between the groups were found for hematoma, hemorrhage, hypoparathyroidism, recurrent laryngeal nerve palsy, and seroma. In conclusion, the current practice of post-surgical drainage in thyroidectomy did not offer any significant advantage. On the contrary, post-surgical infection rate and duration of hospital stay was higher in patients in the drain group.
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Eur Arch Otorhinolaryngol · Jul 2020
ReviewCOVID-19 in otolaryngologist practice: a review of current knowledge.
Otorhinolaryngological manifestations are common symptoms of COVID-19. This study provides a brief and precise review of the current knowledge regarding COVID-19, including disease transmission, clinical characteristics, diagnosis, and potential treatment. The article focused on COVID-19-related information useful in otolaryngologist practice. ⋯ Ear, nose and throat (ENT) symptoms may precede the development of severe COVID-19. During COVID-19 pandemic, patients with cough, sore throat, dyspnea, hyposmia/anosmia and a history of travel to the region with confirmed COVID-19 patients, should be considered as potential COVID-19 cases. An otolaryngologist should wear FFP3/N95 mask, glasses, disposable and fluid resistant gloves and gown while examining such individuals. Not urgent ENT surgeries should be postponed. Additional studies analyzing why some patients develop ENT symptoms during COVID-19 and others do not are needed. Further research is needed to determine the mechanism leading to anosmia.
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Eur Arch Otorhinolaryngol · Aug 2020
Comment LetterIndications and timing for tracheostomy in patients with SARS CoV2-related.
The indications and timing for tracheostomy in patients with SARS CoV2-related are controversial. ⋯ In our experience, tracheostomy does not seem to influence the clinical course and prognosis of the disease, in the face of possible risks of contagion for healthcare workers. The indication for tracheostomy in COVID-19 patients should be carefully evaluated and reserved for selected patients. Although it is not possible to define an optimal timing, it is our opinion that tracheostomy in a stable or clinically improved COVID-19 patient should not be proposed before the 20th day after orotracheal intubation.
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Eur Arch Otorhinolaryngol · Sep 2020
Proposal of a timing strategy for cholesteatoma surgery during the COVID-19 pandemic.
The COVID-19 infection is an aggressive viral illness with high risk of transmission during otolaryngology examination and surgery. Cholesteatoma is known for its potential to cause complications and scheduling of surgery during the pandemic must be done carefully. The majority of otological surgeries may be classified as elective and postponed at this time (e.g., stapedotomy, tympanoplasty); whereas, others are emergencies (e.g., complicated acute otitis media, complicated cholesteatoma with cerebral or Bezold's abscess, meningitis, sinus thrombosis) and require immediate intervention. What is the ideal time for the surgical management of Cholesteatoma during the COVID-19 pandemic? ⋯ Evidence on the timing of surgery of patients with cholesteatoma during the COVID-19 pandemic is lacking. This manuscript contains practical tips on how cholesteatoma surgery can be reorganized during this pandemic.