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Elias CCL, Teixeira AR, Souza MECD, Rosito LPS, Costa SSD. Translation and cultural adaptation of "Glasgow Children's Benefit Inventory" into Brazilian Portuguese. Braz J Otorhinolaryngol 2024; 90:101353. [PMID: 38029656 PMCID: PMC10711033 DOI: 10.1016/j.bjorl.2023.101353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/28/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE Translate and cross-culturally adapt into Brazilian Portuguese the Glasgow Children's Benefit Inventory instrument used for the quality-of-life assessment after pediatric ENT interventions. METHOD This is a methodological study of translation and cross-cultural adaptation of the GCBI instrument following seven stages: 1) Translation of two versions by two independent translators, 2) Elaboration of a consensual synthetized version, 3) Assessment of the synthetized version by experts, 4) Assessment by the target audience, 5) Back-translation, 6) Pilot study and 7) Use of the instrument. The final version of the instrument was answered by a sample of 28 people responsible for children aged from 2 to 7 years, submitted to tonsillectomy between January 2019 and December 2021, in a public hospital in Porto Alegre. The collection considered patients with a minimum of 6-months and a maximum of 3-years of postoperative follow-up. RESULT The instrument final version was compared to the original version showing semantic equivalence, absence of consistent translation difficulties and appropriate cross-cultural adaptation, and well understood by the target audience. The application of the questionnaire in the sample showed a Cronbach alpha coefficient of 0.944 corresponding to a high degree of reliability of the instrument. CONCLUSION The translation and cross-cultural adaptation showed semantic appropriateness and its use when assessing ENT postoperative results in a pediatric population showed high reliability of the instrument. LEVEL OF EVIDENCE: 4
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Giunta G, Pirola F, Giombi F, Muci G, Pace GM, Heffler E, Paoletti G, Puggioni F, Cerasuolo M, Ferreli F, Salamanca F, Mercante G, Spriano G, Canonica GW, Malvezzi L. Care for Patients with Type-2 Chronic Rhinosinusitis. J Pers Med 2023; 13:jpm13040618. [PMID: 37109003 PMCID: PMC10146372 DOI: 10.3390/jpm13040618] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
In the last 20 years, growing interest in chronic rhinosinusitis (CRS) has become evident in medical literature; nevertheless, it is still difficult to identify the real prevalence of the disease. Epidemiological studies are few and focused on heterogeneous populations and diagnostic methods. Recent research has contributed to identifying CRS as a disease characterized by heterogeneous clinical scenarios, high impact on quality of life, and elevated social costs. Patient stratification with phenotypes and identification of the pathobiological mechanism at the origin of the disease (endotype) and its comorbidities are pivotal in the diagnostic process, and they should be addressed in order to properly tailor treatment. A multidisciplinary approach, shared diagnostic and therapeutic data, and follow-up processes are therefore necessary. Oncological multidisciplinary boards offer models to imitate in accordance with the principles of precision medicine: tracing a diagnostic pathway with the purpose of identifying the patient’s immunological profile, monitoring therapeutical processes, abstaining from having only a single specialist involved in treatment, and placing the patient at the center of the therapeutic plan. Awareness and participation from the patient’s perspective are fundamental steps to optimize the clinical course, improve quality of life, and reduce the socioeconomic burden.
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Affiliation(s)
- Gianmarco Giunta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Francesca Pirola
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesco Giombi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Correspondence:
| | - Giovanna Muci
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Gian Marco Pace
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Enrico Heffler
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giovanni Paoletti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Francesca Puggioni
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Michele Cerasuolo
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Via Francesco Nava 31, 20159 Milan, Italy
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Fabrizio Salamanca
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Via Francesco Nava 31, 20159 Milan, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Otorhinolaryngology Head & Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Via Francesco Nava 31, 20159 Milan, Italy
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Pai KK, Omiunu A, Vedula S, Chemas-Velez MM, Fang CH, Baredes S, Eloy JA. Impact of Prolonged Operative Time on Complications Following Endoscopic Sinonasal Surgery. Laryngoscope 2023; 133:51-58. [PMID: 35174505 DOI: 10.1002/lary.30057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/21/2021] [Accepted: 01/24/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine how prolonged operative time (POT) impacts 30-day outcomes in patients undergoing endoscopic sinonasal surgery (ESNS). STUDY DESIGN Retrospective study. METHODS Data from patients who underwent ESNS (nonsinus, sinus, and extended sinus) between 2005 to 2018 were collected from the American College of Surgeons National Surgical Quality Improvement database. Univariate and multivariate analyses were performed to evaluate the effect of POT on postoperative outcomes. RESULTS Among 1,994 ESNS cases, 495 nonsinus procedures, 1,191 sinus procedures, and 308 extended sinus procedures were identified. Median OT was 90 minutes (interquartile range [IQR], 51-165 minutes) for nonsinus procedures, 113 minutes (IQR, 66-189 minutes) for sinus procedures, and 187 minutes (IQR, 137-251 minutes) for extended sinus procedures. Other than older age (P = .008), POT was not significantly associated with baseline demographics and comorbidities for patients undergoing non-sinus procedures. Older age (P < .001), White and Black race (P < .001), ASA physical classifications III or IV (P < .001), and several preoperative comorbidities, including obesity (P = .045), and hypertension (P < .001) were associated with POT for sinus procedures. Older age (P = .030), male sex (P = .010), and lower body mass index (P = .004) were associated with POT for extended sinus procedures. After risk-adjustment, POT was independently associated with prolonged hospital stay (LOS) for all procedure categories, and associated with overall surgical complications and postoperative bleeding for sinus and extended sinus procedures specifically. CONCLUSION POT is independently associated with several adverse outcomes following ESNS, including prolonged LOS, overall surgical complications, and bleeding. Preoperative planning should include optimizing modifiable patient risk factors for POT and identifying surgeon-specific factors to enhance surgical efficiency. LEVEL OF EVIDENCE 4 Laryngoscope, 133:51-58, 2023.
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Affiliation(s)
- Kavya K Pai
- University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, U.S.A
| | - Ariel Omiunu
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Sudeepti Vedula
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Maria Manuela Chemas-Velez
- Department of Otolaryngology and Maxilofacial Surgery, Pontificia Universidad Javeriana, Bogota, Colombia
| | - Christina H Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, U.S.A
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Otolaryngology and Facial Plastic Surgery, Saint Barnabas Medical Center-RWJBarnabas Health, Livingston, New Jersey, U.S.A
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Cystic fibrosis exacerbations treated with medical therapy with and without concurrent sinus surgery. Int J Pediatr Otorhinolaryngol 2022; 161:111249. [PMID: 35932623 DOI: 10.1016/j.ijporl.2022.111249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 06/30/2022] [Accepted: 07/14/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This analysis investigates any potential differences in pulmonary function test (PFT) outcomes among pediatric patients with cystic fibrosis (CF) receiving both medical management (MM) and functional endoscopic sinus surgery (FESS) versus MM alone for CF exacerbation. STUDY DESIGN Prospective cohort. SETTING Pediatric tertiary care facility. METHODS The data was prospectively collected from July 2011 to March 2020. Diagnosis of CF and age ≤ to 18 were required. All patients were hospitalized and treated for CF exacerbations with both FESS with MM and MM alone at variable time intervals, although the order of initial treatment received differed. Two-way ANOVA with repeated measures were used to determine the effect of receiving FESS with MM versus MM alone on PFT outcomes over time (during admission, at discharge, at 3 months, at 6 months, and at 12 months). RESULTS 13 pediatric patients, 7 of which had FESS with MM initially and 6 who had MM alone initially, and 20 events of both FESS and MM were included for analysis. For PFT outcomes, there was no statistically significant two-way interaction between treatment type and time following treatment, p = 0.492. The main effect of treatment did not show a statistically significant difference in FEV1 between treatment types, p = 0.737. There was no statistically significant association between treatment type and time between hospital readmission in months, p = 0.111. CONCLUSION There was no significant difference between PFT outcomes in pediatric patients hospitalized for CF exacerbation treated with MM with or without FESS at any time interval.
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Musleh A, Al-Zomia AS, Shahrani IM, Alshehri A, Alwadie A, Alqhtani F, Deajim M, Aljohani S. Olfactory Change Pattern After Endoscopic Sinus Surgery in Chronic Rhinosinusitis Patients. Cureus 2022; 14:e24597. [PMID: 35651459 PMCID: PMC9138177 DOI: 10.7759/cureus.24597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background Chronic rhinosinusitis (CRS) is a chronic inflammation of the sinonasal mucosa that is clinically associated with sinus pressure, nasal congestion, rhinorrhea, and a decreased sense of smell that lasts more than 12 weeks. Endoscopic sinus surgery (ESS) for medically refractory CRS is mainly undergone to improve sinus function and access to topical medicinal treatments. However, olfactory changes after ESS can be unpredictable. Aim The current study aimed to assess olfactory change patterns after endoscopic sinus surgery in patients with chronic rhinosinusitis. Methods A record-based retrospective study was conducted in Aseer Central Hospital (ACH) ear, nose, and throat outpatient (ENT OPD) department and Khamis Mushayt General Hospital from August 15, 2021, to December 15, 2021. Data were collected using pre-structured data extraction sheet to avoid errors. Data extracted and collected included patients' biodemographic data, CRS-associated symptoms, and endoscopic surgery-related data, including duration since surgery, presurgical medications, and duration of surgery. Also, postsurgical complications were extracted, especially olfactory complications. Results A total of 168 patients with chronic rhinosinusitis (CRS) and who had undergone endoscopic sinus surgery in the Aseer region were included. Patient ages ranged from 10 to 61 years, with a mean age of 39.8 ± 12.4 years old. Regarding the associated symptoms and complaints of the study patients, 110 (65.5%) complained of sinusitis, and 86 (51.2%) had allergic RS. The postsurgical complications of patients with CRS who had undergone endoscopic sinus surgery were olfactory dysfunction (OD) in 32 (19%), no complications in 115 (68.55%), and other nonspecific complications, such as headache, drowsiness, nose dryness, and bleeding, in 21 (12.55%). Also, 71 (42.3%) reported that they hardly perceive the fragrance in perfumeries. Conclusion In conclusion, olfactory impairment is a frequent clinical presentation in patients with CRS. In this study, olfactory dysfunction was improved, except among nearly one out of each five patients after ESS. Olfactory dysfunction was more among patients who had undergone recent surgery and those with chronic rhinosinusitis with nasal polyps (CRSwNP). Also, among patients who reported no complications, olfactory function did not return to normal in most patients as they hardly perceive fragrance.
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Affiliation(s)
- Abdullah Musleh
- Otolaryngology - Head and Neck Surgery, King Khalid University Hospital, Khamis Mushait, SAU
| | | | | | | | - Awad Alwadie
- Medicine and Surgery, King Khalid University, Abha, SAU
| | | | - Mosab Deajim
- Medicine and Surgery, King Khalid University, Abha, SAU
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Di Cicco ME, Bizzoco F, Morelli E, Seccia V, Ragazzo V, Peroni DG, Comberiati P. Nasal Polyps in Children: The Early Origins of a Challenging Adulthood Condition. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8110997. [PMID: 34828710 PMCID: PMC8620101 DOI: 10.3390/children8110997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 12/03/2022]
Abstract
Nasal polyps (NPs) are benign inflammatory masses causing chronic nasal obstruction, usually associated with underlying chronic rhinosinusitis (CRS), which are rarely reported in childhood. The interest in NPs has recently increased due to new therapeutic options, namely biological agents, such as dupilumab, and an update of the European position paper on this topic was released in 2020, providing a detailed classification for these lesions and also discussing diagnostic and therapeutic approaches also in children. In childhood, NPs usually represent red flags for systemic diseases, such as cystic fibrosis and immunodeficiencies. This review outlines the recent data on NPs in childhood, focusing on predisposing factors for CRS as well as on the potential endotypes in this particular age group, for which further studies are required in order to better clarify their pathogenesis and to identify molecular biomarkers that could help achieve more personalized treatments.
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Affiliation(s)
- Maria E. Di Cicco
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy; (F.B.); (E.M.); (D.G.P.); (P.C.)
- Allergology Section, Pediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
- Correspondence: ; Tel.: +39-050-992797
| | - Francesca Bizzoco
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy; (F.B.); (E.M.); (D.G.P.); (P.C.)
- Allergology Section, Pediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
| | - Elena Morelli
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy; (F.B.); (E.M.); (D.G.P.); (P.C.)
- Allergology Section, Pediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
| | - Veronica Seccia
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Via Trivella, 56124 Pisa, Italy;
| | - Vincenzo Ragazzo
- Paediatrics and Neonatology Division, Women’s and Children’s Health Department, Versilia Hospital, Via Aurelia n. 335, 55049 Lido di Camaiore, Italy;
| | - Diego G. Peroni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy; (F.B.); (E.M.); (D.G.P.); (P.C.)
- Allergology Section, Pediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
| | - Pasquale Comberiati
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma n. 55, 56126 Pisa, Italy; (F.B.); (E.M.); (D.G.P.); (P.C.)
- Allergology Section, Pediatrics Unit, Pisa University Hospital, Via Roma n. 67, 56126 Pisa, Italy
- Department of Clinical Immunology and Allergology, I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
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Kubba H, Whitmer WM. Exploring the Factor Structure of the Glasgow Children's Benefit Inventory: New Recommendations for Reporting Results. Ann Otol Rhinol Laryngol 2020; 130:614-622. [PMID: 33063521 DOI: 10.1177/0003489420965634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Patient-reported outcomes can be useful for reporting benefit from non-life-saving interventions, but often they report a single overall score, which means that much information on the specific areas of benefit is lost. Our aim was to perform a new factor analysis on the Glasgow Children's Benefit Inventory (GCBI) to create subscales reflecting domains of benefit. Further aims were to assess the internal consistency of the GCBI, and to develop guidelines for reporting both a total score and sub-scales in future studies. METHODS We collected 4 existing datasets of GCBI data from children who have undergone tonsillectomy, ventilation tube insertion, pinnaplasty, and submucous diathermy to the inferior turbinates. We performed exploratory factor analysis with principal axis factoring with varimax rotation, we sought redundancy in question items, and we measured internal consistency. RESULTS Using the combined dataset of 772 cases, we found 4 factors which accounted for 64% of the variance and which we have labeled "Psycho-social," "Physical health," "Behavior," and "Vitality." Subscale results varied in predictable ways depending on the nature of the intervention. Cronbach's alpha was 0.928. Item-total correlations were high, and no item could be deleted to improve alpha. Floor effects were apparent for various questions but were not consistent between different interventions. CONCLUSIONS The GCBI contains a range of questions which each add value in different clinical interventions. We can now make recommendations for reporting the results of the GCBI and its 4 new subscales.
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Affiliation(s)
- Haytham Kubba
- Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland
| | - William M Whitmer
- Hearing Sciences (Scottish Section), University of Nottingham, Glasgow Royal Infirmary, Glasgow, Scotland
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Alekseenko S, Karpishchenko S. Comparison of the efficiency and safety of endonasal and open rhinosurgery in children. Laryngoscope 2019; 130:1056-1063. [PMID: 31211431 DOI: 10.1002/lary.28145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/01/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS The objective of this study was to compare the efficiency and safety of endonasal endoscopic maxillary surgery and the Caldwell-Luc approach in children. STUDY DESIGN Case series. METHODS A total of 121 children aged 9 to 17 years with chronic rhinosinusitis were included in the study. The patients were operated on using Caldwell-Luc (n = 36) and endoscopic maxillary surgery (n = 85) procedures. Efficiency and safety of the surgeries were assessed using pre- and postoperative endoscopic evaluation of the mucosa of the nasal cavity, 20-item Sino-Nasal Outcome Test (SNOT-20), and subjective (both children's and parents') evaluation of the outcomes. RESULTS Endoscopic investigation of the mucosa of the nasal cavity demonstrated a significant improvement after both Caldwell-Luc and endoscopic surgery, although the Caldwell-Luc procedure did not result in significant improvement in mucosal color. However, no significant group difference was observed. Both techniques resulted in a significant improvement of mucosal edema and fluid characteristics. Based on the results of the SNOT-20, endoscopic maxillary surgery was characterized by a significant improvement in headache frequency, waking up at night, reduced concentration, ear pain, and emotional suppression as compared to Caldwell-Luc surgery. Although no significant group difference in efficiency between the Caldwell-Luc approach and endoscopic surgery was observed, the latter was characterized by a lower rate of scar formation, and reduced sensitivity, local painfulness, lacrimation, and psychologic discomfort. CONCLUSIONS The obtained data demonstrate the higher efficiency and safety of endoscopic sinus surgery as compared to the Caldwell-Luc approach in children. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1056-1063, 2020.
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Affiliation(s)
- Svetlana Alekseenko
- I. I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.,K. A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia
| | - Sergey Karpishchenko
- Department of Otorhinolaryngology, First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
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Wu PW, Huang CC, Yang SW, Huang Y, Huang CC, Chang PH, Lee YS, Lee TJ. Endoscopic sinus surgery for pediatric patients: Prognostic factors related to revision surgery. Laryngoscope 2019; 130:1051-1055. [PMID: 31169921 DOI: 10.1002/lary.28106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/16/2019] [Accepted: 05/22/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In the past two decades, endoscopic sinus surgery (ESS) has been performed frequently in children with medically recalcitrant chronic rhinosinusitis (CRS). However, surgical success rates vary according to age. The causes of failure and prognostic factors for revision ESS remain unclear. The aims of the present study were to evaluate prognostic factors related to revision surgery after ESS, and to determine the most optimal timing for surgery in the pediatric population. METHODS This was a retrospective review in a tertiary medical center. Children who underwent ESS for CRS between 2004 and 2017 were enrolled. Demographics, sinonasal examination findings, previous operation history, laboratory data, comorbidities, and computed tomography (CT) results were collected from medical records. Prognostic factors for revision surgery were analyzed. RESULTS A total of 188 pediatric patients were enrolled in this study. Twenty-four patients (12.8%) required revision surgery. Multivariate logistic regression analysis identified patients with nasal allergy (OR = 6.258; P = .010) and higher Lund-Mackay score on preoperative sinus CT (OR = 1.658; P = .043) had worse outcomes, while older age was a positive prognostic factor (OR = 0.702; P = .018). A cut-off point of 15.68 years of age and mean Lund-Mackay score of 10.5 showed the best predictive power for revision surgery. CONCLUSION Because ESS is performed with increasing frequency in children, knowledge of prognostic factors for revision surgery is important. In this study, patients with younger age, nasal allergy, and higher Lund-Mackay score on preoperative sinus CT had worse outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1051-1055, 2020.
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Affiliation(s)
- Pei-Wen Wu
- Division of Rhinology, Department of Otolaryngology, Linkou branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Keelung branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chien-Chia Huang
- Division of Rhinology, Department of Otolaryngology, Linkou branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Wei Yang
- Department of Otolaryngology-Head and Neck Surgery, Keelung branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yenlin Huang
- Department of Anatomic Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chi-Che Huang
- Division of Rhinology, Department of Otolaryngology, Linkou branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Po-Hung Chang
- Division of Rhinology, Department of Otolaryngology, Linkou branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yun-Shien Lee
- Genomic Medicine Research Core Laboratory, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Biotechnology, Ming Chuan University, Taoyuan, Taiwan
| | - Ta-Jen Lee
- Division of Rhinology, Department of Otolaryngology, Linkou branch, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Xiamen Chang Gung Hospital, Xiamen, People's Republic of China
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McKeon M, Medina G, Kawai K, Cunningham M, Adil E. Readmissions following ambulatory pediatric endoscopic sinus surgery. Laryngoscope 2019; 129:2681-2686. [PMID: 30821352 DOI: 10.1002/lary.27898] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 12/27/2018] [Accepted: 02/11/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVES/HYPOTHESIS Endoscopic sinus surgery (ESS) is indicated in select pediatric patients with medically refractory sinus disease. Our objectives were to examine indications and rates of readmission following ambulatory pediatric ESS and identify specific subgroups that may benefit from inpatient admission. STUDY DESIGN Retrospective database review. METHODS The Pediatric Health Information Systems (PHIS) 2004-2016 database was retrospectively reviewed for patients age <18 years who underwent ambulatory ESS between January 2011 and December 2016 and were readmitted within 30 days postoperatively. Data regarding demographics, extent of surgery, comorbidities, adjunctive procedures, and cost were collected. A multivariable mixed-effects logistic regression model was employed for analysis. RESULTS We identified 3,669 unique pediatric ESS cases with 128 readmissions within 30 days (3.5%; 95% confidence interval [CI]: 2.9%-4.1%). Median cost of readmission was $980 (mean, $5,890; standard deviation, $13,421). The most common indication for readmission was epistaxis (17.2%), followed by nausea/abdominal pain (14.1%). Respiratory infection (13.3%) and sinusitis (10.2%) presented a combined readmission rate exceeding that of epistaxis alone. Multivariable analysis indicated age <3 years (odds ratio [OR]: 3.41, 95% CI: 1.96-5.93) and a prior diagnosis of asthma (OR: 2.88, 95% CI: 1.99-4.18) or cystic fibrosis (OR: 1.57, 95% CI: 1.00-2.44) significantly increased the risk of readmission. Extent of ESS and simultaneous adenoidectomy, septoplasty, or turbinate reduction had no significant impact on readmission rates. CONCLUSIONS ESS is a relatively safe outpatient surgical procedure in pediatric patients, with an overall readmission rate of 3.5%. Clinicians should consider careful preoperative evaluation of very young patients and those with cystic fibrosis or asthma to optimize perioperative management and determine if postoperative admission is warranted, given their significantly higher readmission rates. LEVEL OF EVIDENCE NA Laryngoscope, 129:2681-2686, 2019.
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Affiliation(s)
- Mallory McKeon
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts
| | - Genevieve Medina
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts
| | - Kosuke Kawai
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Michael Cunningham
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Eelam Adil
- Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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11
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Rezaeian A, Hashemi SM, Dokhanchi ZS. Effect of Sphenopalatine Ganglion Block With Bupivacaine on Postoperative Pain in Patients Undergoing Endoscopic Sinus Surgery. ALLERGY & RHINOLOGY 2019; 10:2152656718821282. [PMID: 30719401 PMCID: PMC6348495 DOI: 10.1177/2152656718821282] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Postoperative pain is one of the most complications in endoscopic sinus surgery. We aimed to evaluate the effect of the sphenopalatine ganglion block (SPGB) with bupivacaine on postoperative pain in patients undergoing endoscopic sinus surgery.Methods and Materials: In this clinical trial, 40 patients who indicated functional endoscopic sinus surgery were selected and then divided into 2 parallel groups as intervention and control. The intervention group was received 1.5 mL of bupivacaine 0.5% (injected to sphenopalatine ganglion) and while control was injected 1.5 mL of normal saline at the same injection site. Also, the visual analogue scale (VAS) was recorded immediately after anesthesia, along with 6, 12, 24, 48 h, 7 days, and 21 days after the operation for all patients. Results Immediately after anesthesia, as well as 6, 12, and 24 h after the operation, VAS in the intervention group was significantly lower than in the control group (P < .05, for all). However, there were no significant differences between the 2 groups regarding VAS 48 h as well as 7 and 21 days after surgery (P > .05, for both). Also, the rescue analgesia in the intervention group was significantly lower than in the control group (P = .01). Conclusion SPGB with bupivacaine 0.5% (1.5 mL) was a simple, effective, safe, and noninvasive method for the management of postoperative pain in the patients undergoing endoscopic sinus surgery.
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Affiliation(s)
- Ahmad Rezaeian
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyed Mostafa Hashemi
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Sadat Dokhanchi
- Department of Otorhinolaryngology, Head and Neck Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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12
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Burton BN, Gilani S, Desai M, Saddawi-Konefka R, Willies-Jacobo L, Gabriel RA. Perioperative Risk Factors Associated With Morbidity and Mortality Following Pediatric Inpatient Sinus Surgery. Ann Otol Rhinol Laryngol 2019; 128:13-21. [PMID: 30328698 DOI: 10.1177/0003489418805504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES: Pediatric sinus surgery is indicated for a wide range of sinonasal and skull base pathologies, but it is most commonly performed for recalcitrant chronic rhinosinusitis or complicated acute sinusitis. The authors aim to report medical risk factors of morbidity and mortality following inpatient sinus surgery in the pediatric population. METHODS: Using data from the Kids' Inpatient Database from 2003 to 2012, patients with International Classification of Diseases, Ninth Revision, procedure codes for primary sinus surgery were identified. Mixed-effect multivariable logistic regression was used to identify risk factors of inpatient postoperative morbidity and mortality. RESULTS: The final sample included a weighted estimate of 4965 pediatric patients. The rates of inpatient morbidity and mortality were 6% and 1%, respectively. Respiratory complications (2.5%) were the most prevalent postoperative adverse events. The most prevalent comorbidities were chronic sinusitis (59.8%), acute sinusitis (27.8%), and cystic fibrosis (26.4%). Compared with patients who did not experience any morbidity, patients with inpatient morbidity had higher rates of pneumonia, mycoses, and nasal or paranasal benign neoplasm ( P < .05). The odds of inpatient morbidity and mortality were highest for patients with leukemia (odds ratio, 2.74; 95% confidence interval, 1.59-4.72; P < .001) and mycoses (odds ratio, 15.84; 95% confidence interval, 6.45-38.89; P < .001), respectively. CONCLUSIONS: This study is the first to report the national comorbidity burden and risk factors for postoperative adverse events following inpatient sinus surgery. Knowledge of the comorbidities and independent factors associated with morbidity and mortality will help in directing preoperative optimization and counseling. LEVEL OF EVIDENCE: 2c.
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Affiliation(s)
- Brittany N Burton
- 1 School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Sapideh Gilani
- 2 Division of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Milli Desai
- 1 School of Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Robert Saddawi-Konefka
- 2 Division of Otolaryngology - Head and Neck Surgery, University of California, San Diego, La Jolla, CA, USA
| | | | - Rodney A Gabriel
- 4 Department of Anesthesiology, University of California, San Diego, La Jolla, CA, USA
- 5 Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA, USA
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Abstract
Purpose of review Pediatric chronic rhinosinusitis (CRS) is a common condition that is often misdiagnosed and can be challenging to treat. This review aims to 1) Review definitions, presentation, complications, and management of CRS in children. 2) Highlight the paucity of evidence in the management of pediatric CRS. Recent findings There are few studies supporting the usual recommended medical therapy for pediatric CRS (antibiotics, nasal saline irrigations, intranasal steroid). Adenoidectomy remains a mainstay of surgical treatment, but recent evidence demonstrates the utility of balloon sinuplasty and functional endoscopic sinus surgery (FESS) for patients who fail adenoidectomy alone. Summary Pediatric CRS is distinct from ARS and adult CRS. It is a common problem that is poorly studied, in part because of significant symptomatic overlap with related conditions. Recent evidence supports the use of surgical treatment in children who fail medical management. However, further outcome studies are needed to better evaluate the effectiveness of current medical and surgical management protocols.
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Affiliation(s)
- Lourdes Quintanilla-Dieck
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, PV-01, Portland, OR 97239-3098
| | - Derek J Lam
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, PV-01, Portland, OR 97239-3098
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Yu H, Ju J, Liu J, Li D. Aberrant expression of miR-663 and transforming growth factor-β1 in nasal polyposis in children. Exp Ther Med 2018; 15:4550-4556. [PMID: 29849780 DOI: 10.3892/etm.2018.5927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 04/11/2017] [Indexed: 12/22/2022] Open
Abstract
The aim of the present study was to investigate the expression of microRNA (miR)-663 and its regulatory effects on the pathogenesis of nasal polyposis in children. Nasal polyp tissue, as well as serum and peripheral blood eosinophils were collected from 35 children diagnosed with nasal polypectomy between August 2013 and August 2015. As a control, the inferior nasal concha, serum and peripheral blood eosinophils were collected from 46 patients with nasal septal deviation complicated by inferior turbinate hypertrophy or patients with simple inferior turbinate hypertrophy who had undergone surgical removal of the inferior nasal concha. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to measure the expression of miR-663 and transforming growth factor-β1 (TGF-β1) in the nasal polyp tissue, serum and peripheral blood eosinophils of patients with nasal polyposis and controls. Western blotting was used to measure the expression of TGF-β1 protein in nasal tissue and eosinophils and an enzyme-linked immunosorbent assay was used to measure serum level of TGF-β1 protein. A dual luciferase reporter assay was used to determine whether TGF-β1 was a target gene of miR-663. Compared with the control group, levels of TGF-β1 mRNA and protein were significantly increased in all three types of specimens from pediatric patients with nasal polyposis (P<0.05). miR-663 expression was significantly decreased in nasal polyp tissue and peripheral blood eosinophils (P<0.05). The dual luciferase reporter assay confirmed that TGF-β1 was a target gene of miR-663. The current study suggests that the upregulation of TGF-β1 may be associated with the downregulation of miR-663 in nasal polyposis in children. miR-663 may have regulatory effects on the pathogenesis of nasal polyposis by regulating TGF-β1 and may be developed as a genetic marker of nasal polyposis in children.
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Affiliation(s)
- Hailing Yu
- Department of Otolaryngology, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
| | - Jianbao Ju
- Department of Otolaryngology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266033, P.R. China
| | - Jingdong Liu
- Department of Medicine, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
| | - Da Li
- Department of Otolaryngology, The Women and Children's Hospital of Qingdao, Qingdao, Shandong 266033, P.R. China
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