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- Bidarian-Moniri, Armin, et al.
(författare)
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A NEW AUTOINFLATION DEVICE FOR TREATMENT OF OTITIS MEDIA WITH EFFUSION
- 2016
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Ingår i: World Summit on Pediatrics. Porto 23-26 June, 2016.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: Otitis media with effusion (OME) is caused by accumulation of fluid in the middle ear, without the signs or symptoms of an acute inflammation or infection. OME is the most common cause of hearing impairment in children and the most common cause of surgical intervention under general anaesthesia in children. Autoinflation is an alternative treatment based on the opening of the Eustachian tube, by forced introduction of air either by the Valsalva manoeuvre or the Politzer method. Methods:A new autoinflation device (Moniri‐Otovent ®, Abigo Medical, Askersund, Sweden) for home treatment of children with persistent OME was used in this study. Forty‐four children, aged between two and eight years, with persistent bilateral OME for at least three months and history of subjective hearing loss, waiting for grommet surgery were treated with the autoinflation device during four weeks. Another forty‐five children, aged between three and eight years, submitted to grommet surgery were compared to the autoinflation group. Both groups underwent otomicroscopy, tympanometry and audiometry at inclusion. The exams were repeated at one, six and twelve months in both groups with the exception of tympanometry in the grommet group. Results: In the autoinflation group after four weeks of treatment, the mean hearing level improved from 22 to 16 dB and the number of ears with hearing thresholds of≥20 dB was reduced from 60 (77%) to 16 (22%). During the follow‐up period, 12 children were treated at least one more time with the device, of which seven were subjected to further follow‐up at the end of the study and five were submitted to grommet surgery. No complications were reported. In the grommet groups the mean hearing threshold improved from 24 to 15 dB and the number of ears with hearing threshold of≥20 dB was reduced from 82 (91%) to 15 (18%). During the follow‐up period a total of 31 (34%) complications were reported related to the grommets. Fourteen ears (16%) presented otorrhea, six ears (7%) early extrusion, four tubes (4%) were obstructed, 12 ears (13%) had recurrence of effusion and one ear (1%) presented persistent perforation after tube extrusion. Conclusions: This study reveals that autoinflation may reduce middle ear effusion and improve hearing in children with OME. Given the non‐invasive character of autoinflation therapy, it may be reasonable to apply this method as a first‐line treatment before considering surgery in children with OME.
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- Karlsson, Therese, et al.
(författare)
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Survival outcome depending on different treatment strategies in advanced stages III and IV laryngeal cancers: an audit of data from two European centres.
- 2014
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Ingår i: 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. - : Springer Science and Business Media LLC. - 1434-4726. ; 271:3, s. 547-554
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Tidskriftsartikel (refereegranskat)abstract
- In light of continued uncertainty regarding efficacy of treatment of Stages III and IV laryngeal tumours, this study aims to evaluate organ-preservation strategies, comprising radiotherapy and chemoradiotherapy versus surgical treatment (laryngectomy±adjuvant treatment) by encompassing the long-established practice at two internationally acclaimed tertiary centres not previously presented in published literature. Retrospective review was conducted of non-randomised prospectively maintained Stages III and IV disease patient databases at two tertiary centres: Sahlgrenska University Hospital (SU) in Gothenburg, Sweden, and Aberdeen Royal Infirmary (ARI) in Aberdeen, Scotland. Primary outcome measures included 3-year overall, disease-specific survival and local control depending on treatment. A total of 176 patients were identified. Sixty-five patients (37%) presented with Stage III tumours, of which 51 patients received organ-preserving treatment and 14 underwent total laryngectomy. The corresponding figures for the 111 patients (63%) presenting with Stage IV disease were 42 and 69. Three-year overall and disease-specific survival for Stage III was 58 and 73%, respectively. The corresponding figures for Stage IV disease were 42 and 53%. The choice of treatment did not appear to significantly influence survival for Stage III (p=0.56) or IV (p=0.93) disease. The choice of treatment, whether organ preservation or surgery, does not seem to significantly influence the overall or disease-specific survival. Therefore, other factors such as quality of life and voice and efficacy of salvage treatments are perhaps more likely to indicate the preferred treatment options, but larger randomised trials are needed.
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