| 1. |
- Aghajanzadeh, Susan, et al.
(författare)
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A 5-year prospective study of health-related quality of life in irradiated head and neck cancer patients: three trends of HRQL over time
- 2023
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 280:5, s. 2617-22
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Head and neck cancer (HNC) is one of the fastest increasing cancer-types, where both disease and oncologic treatment have severe impact on health-related quality of life (HRQL). This study aimed to report HRQL prospectively up to 5-years following radiotherapy-treatment in HNC and to, if possible, identify trends in HRQL over time. Methods This prospective study followed 211 patients receiving curatively intended radiotherapy pre-diagnosis, 3-, 6-, 12- and 60-months post-radiotherapy completion. HRQL was measured using EORTC QLQ-C30 and EORTC QLQ-HN35. Results A deterioration three months post-radiotherapy was reported in 14/15 domains of EORTC QLQ-C30. Eight out of 12 domains had recovered to baseline-values at 12 months post-radiotherapy and remained unchanged up to study endpoint. Corresponding figures for EORTC QLQ-HN35 were deteriorations in 15/16 domains at three months post-radiotherapy, with recovery of 5 domain at 12-months, whereas the other 11 domains remained significantly worse at 5-years post-RT compared to baseline. Conclusion Following the deterioration in HRQL seen immediately following radiotherapy, the continued course of HRQL can be divided into three trends: short-term deterioration, long-term deterioration and long-term improvements. The combination of disease- and diagnosis-specific questionnaires is crucial when assessing HRQL in the HNC population.
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| 2. |
- Aghajanzadeh, Susan, et al.
(författare)
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Postradiation trismus in head and neck cancer survivors: a qualitative study of effects on life, rehabilitation, used coping strategies and support from the healthcare system
- 2024
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Ingår i: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - 0937-4477 .- 1434-4726.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose This study aimed to explore the experiences of head and neck cancer (HNC) survivors with postradiation trismus, specifically how oncological treatment affected their lives, rehabilitation, use of coping strategies, and healthcare experiences. Methods: A qualitative descriptive approach was used and semi-structured interviews of 10 HNC survivors with postradiation trismus were conducted 6-30 months after completing oncological treatment. The interviews were transcribed verbatim and analyzed by qualitative content analysis.Results The analysis of interviews yielded four main categories: Bodily symptoms, Effects on life, Support from the healthcare system, and Strategies to handle life and symptoms. Participants reported ongoing problems with xerostomia, dysgeusia, eating, and limited physical fitness. Pain related to trismus was not a major issue in this cohort. Participants expressed limitations in their social lives due to their eating difficulties, yet a sense of thankfulness for life and overall satisfaction with the healthcare they received. Psychological and practical coping strategies developed by the participants were also revealed.Conclusion The results highlight areas of unmet need among HNC survivors that healthcare providers can target by establishing multi-professional teams dedicated to individualizing post-cancer rehabilitation care.
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| 3. |
- Ahn, Sang Hyeon, et al.
(författare)
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Comparison of the clinical characteristics of bilateral and unilateral fungal balls in Korea
- 2019
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer International. - 0937-4477 .- 1434-4726. ; 276:7, s. 1975-1980
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Tidskriftsartikel (refereegranskat)abstract
- Fungal rhinosinusitis occurs in different forms depending on race and region. While allergic fungal rhinosinusitis is common in Caucasians, fungal ball (FB) is more common in Asians. However, most cases are reported as unilateral, and clinical data on bilateral FB (BFB) are rare. Therefore, the purpose of this study was to analyze and to compare the clinical characteristics of BFB and unilateral FB (UFB) in Koreans.
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| 4. |
- Ali, Fatema Mohammed, et al.
(författare)
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Splenius capitis: sensitive target for the cVEMP in older and neurodegenerative patients
- 2019
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : SPRINGER. - 0937-4477 .- 1434-4726. ; 276:11, s. 2991-3003
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Tidskriftsartikel (refereegranskat)abstract
- Background The vestibular evoked myogenic potential (VEMP) is a technique used to assess vestibular function. Cervical VEMPs (cVEMPs) are obtained conventionally from the sternocleidomastoid (SCM) muscle; however, the dorsal neck muscle splenius capitis (SPL) has also been shown to be a reliable target alongside the SCM in young subjects. Objective This study aimed to compare cVEMPs from the SCM and SPL in two positions across young, older, and Parkinsons disease (PD) patients. Method Experiments were carried out using surface EMG electrodes placed over the SCM and SPL. cVEMPs were measured using a 30 s, 126 dB sound stimulus with 222 individual tone bursts, while subjects were in a supine and head-turned posture (also known as the head elevation method), and in a seated head-turned posture. Results When comparing cVEMPs across positions, the incidence of supine and seated SCM-cVEMPs diminished significantly in older and PD patients in comparison with young subjects. However, no statistically significant differences in incidences were found in seated SPL-cVEMPs when comparing young, older and PD patients. SPL-cVEMPs were present significantly more often than seated SCM-cVEMPs in PD patients. Conclusions SPL-cVEMPs are not altered to the same extent that SCM-cVEMPs are by aging and disease and its addition to cVEMP testing may reduce false-positive tests for vestibulopathy.
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| 5. |
- Alm, Fredrik, 1983-, et al.
(författare)
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Patient reported pain-related outcome measures after tonsil surgery: an analysis of 32,225 children from the National Tonsil Surgery Register in Sweden 2009-2016
- 2017
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 274:10, s. 3711-3722
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to describe factors affecting pain after pediatric tonsil surgery, using patient reported pain-related outcome measures (pain-PROMs) from the National Tonsil Surgery Register in Sweden. In total, 32,225 tonsil surgeries on children (1 to < 18 years) during 2009-2016 were included; 13,904 tonsillectomies with or without adenoidectomy (TE +/- A), and 18,321 tonsillotomies with or without adenoidectomy (TT +/- A). Adjustments were made for variables included in the register to compensate for contributable factors in the analysis. When compared to TE +/- A for surgical indication obstruction, TT +/- A resulted in lower pain-PROMs, shorter use of postoperative analgesics, earlier return to regular food intake, and lower risk for contact with health care services due to pain. Children who underwent TE +/- A because of obstruction problems stopped taking painkillers and returned to normal eating habits sooner, compared to children who underwent TE +/- A for infectious indications. In both indication groups, TE +/- A performed with hot rather than cold technique (dissection and haemostasis) generally resulted in higher pain-PROMs. Older children reported more days on analgesics and a later return to regular food intake after TE +/- A than younger ones. No clinically relevant difference between sexes was found. Between 2012 and 2016 (pre-and post-implementation of Swedish national guidelines for pain treatment), the mean duration of postoperative analgesic use had increased. In conclusion, TE +/- A caused considerably higher ratings of pain-related outcome measures, compared to TT +/- A. For TE +/- A, cold surgical techniques (dissection and haemostasis) were superior to hot techniques in terms of pain-PROMs. Older children reported higher pain-PROMs after TE +/- A than younger ones.
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| 6. |
- Alm, Fredrik, 1983-, et al.
(författare)
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Postoperative pain, pain management, and recovery at home after pediatric tonsil surgery
- 2021
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer. - 0937-4477 .- 1434-4726. ; 278, s. 451-461
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore the severity and duration of postoperative pain, the management of analgesics, and postoperative recovery in children undergoing tonsil surgery.METHOD: Participants included 299 children aged 4-17 years undergoing tonsillotomy ± adenoidectomy (TT ± A) or tonsillectomy ± adenoidectomy (TE ± A). Data were collected up to 12 days. The child rated pain on the Face Pain Scale-Revised (FPS-R) and recovery using the Postoperative Recovery in Children (PRiC) questionnaire. Caregivers assessed their child's pain, anxiety, and nausea on a numeric analog scale and kept a log of analgesic administration.RESULTS: High pain levels (FPS-R ≥ 4) were reported in all surgical and age groups (TT ± A age 4-11, TE ± A age 4-11, TE ± A age 12-17), but there were variations in pain intensity and duration within and between groups. The TE ± A group scored more days with moderate to very excruciating pain and lower recovery than the TT ± A group, with the worst outcomes reported by older TE ± A children. The majority of the children used paracetamol + COX-inhibitors at home, but regular administration of analgesics was lacking, particularly during late evening and at night. Few were received rescue medication (opioid or clonidine) despite severe pain. Physical symptoms and daily life activities were affected during the recovery period. There was moderate agreement between child and the caregiver's pain assessment scores.CONCLUSION: Children reported a troublesome recovery with significant postoperative pain, particularly older children undergoing tonsillectomy. Pain treatment at home was suboptimal and lacked regular analgesic administration. Patient information needs to be improved regarding the importance of regular administration of analgesics and rescue medication.
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| 7. |
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| 8. |
- Arbin, Linn, et al.
(författare)
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Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel : a randomised blinded study
- 2017
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 274:5, s. 2281-2285
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Tidskriftsartikel (refereegranskat)abstract
- To compare the postoperative pain following bipolar diathermy scissors tonsillectomy (higher temperature dissection) with harmonic scalpel tonsillectomy (lower temperature dissection). Sixty patients aged 7-40 years planned for tonsillectomy with no other concurrent surgery were randomised to either bipolar diathermy scissors or harmonic scalpel as surgical technique. Blinded to the surgical technique, the patients recorded their pain scores (VAS, 0-10) at awakening and the worst pain level of the day in the postoperative period. All intake of pain medication was also recorded. No statistically significant differences were found between the two groups regarding postoperative pain levels or consumption of pain medication. Usage of the harmonic scalpel does not render less postoperative pain following tonsillectomy when compared with usage of the bipolar diathermy scissors.
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| 9. |
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| 10. |
- Axelsson, Lars, et al.
(författare)
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Bioelectrical phase angle at diagnosis as a prognostic factor for survival in advanced head and neck cancer.
- 2018
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Ingår i: European Archives of Oto-Rhino-Laryngology. - : Springer Science and Business Media LLC. - 0937-4477 .- 1434-4726. ; 275:9, s. 2379-2386
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Tidskriftsartikel (refereegranskat)abstract
- Bioelectrical impedance analysis (BIA) is used to measure the patient's body composition, fat-free mass, phase angle (PA), and standardized phase angle (SPA), which are affected by malnutrition. Low values of PA and SPA have been found to be negative prognostic factors for survival in different types of cancer and other severe diseases. The aim of the current study was to investigate whether PA and SPA can be used to predict survival in head and neck (HN) cancer.One hundred twenty-eight patients with advanced HN cancer treated in Western Sweden 2002-2006 were examined with BIA at diagnosis, and PA and SPA were calculated. Patients' age, gender, tumor site, TNM stage, and performance status were obtained, and weight, height, and BIA were measured. Survival up to 12years was ascertained.The mean PA was 5.85° and the median was 5.91°. Lower PA and SPA values were significantly associated with shorter overall survival in univariate analyses, together with higher age, oral cancer, higher T class, worse performance status, more weight loss before diagnosis, lower: weight, height, BMI, and reactance. Age, performance status, T class, and PA were significant factors for the overall survival in the multivariable analysis. A PA cutoff value at 5.95° provided the best prediction of 5-year survival.PA and SPA at diagnosis are significant factors for survival in patients with advanced HN cancer. They are promising prognostic tools to use in treatment planning; further studies are needed.
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