Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery (Clin Otolaryngol)

Publications in this journal

• Article: An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial.

  M Bresnihan, B Mehigan, A Curran
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  ABSTRACT: The primary objective of this study was to compare postoperative pain levels between Merocel and Series 5000 nasal packs. A prospective randomised, single blind, paired control trial. A single consultant in two tertiary Otolaryngology units. Twenty-four adults, ASA 1, who underwent septoplasty, endoscopic sinus surgery or both, were considered after exclusion criteria were applied: bleeding abnormalities, patients taking anticoagulant medications and any significant co-morbidity requiring admission beyond 24-h postoperatively. Twenty-one patients were randomly assigned to have one side of their nose packed with Merocel pack and the other with Series 5000 overnight. The difference in pain levels, using a visual analogue scale, both with the pack in situ and on removal. In 20 patients, the mean pain scores while the packs were in situ were 3.78 for Merocel and 3.62 for Series 5000 and was not found to be significantly different (P = 0.65. 95% CI = -0.57-0.89). The mean pain score on removal of the Merocel pack was five and for the Series 5000 was 3.08. The Series 5000 pack was significantly less painful than Merocel on removal (P < 0.0001. 95% CI = 1.11-2.7). Both were equally effective in their stability and haemostatic effect. Both the Merocel and Series 5000 packs are effective packs regarding haemostasis and have equivalent pain levels while in situ. However, the Series 5000 pack was significantly less painful on removal of the pack.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):352-5.
• Article: Type A personality in dizzy patients.

  J F Thong, C Woods, S Lo, J Knight
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):417-8.
• Article: Use of oral diazepam in patients with acute epistaxis.

  J F Thong, S Lo
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):406-7.
• Article: A proposed system for documenting the functional outcome of adult laryngotracheal stenosis.

  S A R Nouraei, S M Nouraei, T Upile, D J Howard, G S Sandhu
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):407-9.
• Article: Clinical and biological factors affecting response to radiotherapy in patients with head and neck cancer: a review.

  P Silva, J J Homer, N J Slevin, B T Musgrove, P Sloan, P Price, C M L West
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  ABSTRACT: The main aim of this article was to review the clinical and biological factors that have been shown to influence the response of the head and neck squamous cell carcinoma (HNSCC) to primary radiotherapy and briefly discuss how some of these factors could be exploited to improve outcome. Medline based search covering 1982-2006 to identify the HNSCC literature where the effect of clinical and biological factors on locoregional control and overall survival were investigated. Clinical factors are routinely used in management decisions. Nevertheless, identically staged tumours receiving the same treatment may have different outcomes. Biological factors such as hypoxia, proliferation and radio-sensitivity play an important role in radiation response. However, these are not currently used in practise because tests that are clinically reliable and feasible are not available. High-quality translational research will allow us to develop biological tests that can be used in routine clinical practise to tailor individual treatment, with the ability to improve patient outcome further by modifying the underlying tumour biology.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):337-45.
• Article: Olfactory function and nasal nitric oxide.

  H S Elsherif, B N Landis, M H Hamad, M Hugentobler, S M Bahig, A M Gamaa, J S Lacroix
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  ABSTRACT: To determine the relationship between nasal nitric oxide (nNO) concentration and its influence on olfactory function. Tertiary otolaryngology care centre. Sixty-four patients suffering from chronic rhinosinusitis and 20 healthy subjects participated. Prospective study. The nNO concentration was measured by chemiluminescence and olfactory thresholds were measured with the phenyl ethanol threshold of the Sniffin' Sticks. In chronic rhinosinusitis patients this measure was done preoperatively and 3 months after endoscopic sinus surgery. Healthy subjects had significantly higher nNO concentrations and better olfactory thresholds compared to the chronic rhinosinusitis patients, both before and after those had undergone sinus surgery. Olfactory thresholds and nNO concentrations remained unchanged after surgery in the chronic rhinosinusitis group. In the chronic rhinosinusitis group, nNO concentrations correlated positively with the olfactory threshold preoperatively (P < 0.0001) and 3 months after surgery (P < 0.05). In the control group, nNO production did not correlate with the olfactory thresholds (P > 0.05). Olfactory function and nNO concentration correlate in chronic rhinosinusitis patients but not in healthy subjects. This suggests that both parameters do rather not directly influence each other but it might be the inflammatory processes found in chronic rhinosinusitis that affects olfaction and nNO. Nasal nitric oxide produced by the paranasal sinuses seems not to directly influence olfactory function.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):356-60.
• Article: Teenage and adult tonsillectomy: dose-response relationship between diathermy energy used and morbidity.

  A A J Cardozo, C Hallikeri, H Lawrence, V Sankar, S Hargreaves
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  ABSTRACT: To determine whether an increase in the use of bipolar diathermy energy to perform a tonsillectomy is associated with an increase in postoperative pain and haemorrhage. Prospective study. District General Hospital. In all, 101 patients above the age of 13 years who underwent a tonsillectomy that involved the use of bipolar diathermy during the study period were included. The cumulative amount of diathermy energy used to perform each tonsillectomy was calculated with the help of a digital stop clock timing device connected to the diathermy foot-pedal. Postoperative pain scores and the incidence of secondary haemorrhage were recorded for each patient at four points in time following surgery, up to the tenth postoperative day. The haemorrhage rates were categorised into three groups (no bleeding, minor bleeding and major bleeding) according to severity. Associations between the diathermy energy used to perform each tonsillectomy and the corresponding postoperative pain scores and secondary bleeding rates were investigated. There was a statistically significant positive relationship between the total amount of bipolar diathermy energy used per tonsillectomy and the pain scores at all the four recorded points in time (r(s) = 0.44-0.72, P < 0.001). When the median energy consumption in the three groups (no bleeding, minor bleeding and major bleeding) were compared using the Kruskal-Wallis test, we found that there was limited evidence of a difference between the groups, but this was not statistically significant at the 5% level [H (2) = 5.374, P = 0.065, 99% CI 0.058-0.071]. Increased use of bipolar diathermy during the performance of a tonsillectomy is associated with a statistically significant increased amount of postoperative pain. The dose-response relationship between diathermy energy and postoperative bleeding is less clear. This suggests that there could be other important factors such as surgical instrument characteristics and degree of tonsillar adherence that have an additional influence and are therefore possible areas for future research.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):366-71.
• Article: The difficulties of designing a psychometric test to aid in the selection of future surgical trainees.

  J F Thong, S Lo, N Eze, V Moore-Gillon
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):409-10.
• Article: Establishing a method to predict the outcome of vestibular schwannoma surgery based on one's own results.

  D Hastan, W P Godefroy, M J A Malessy, A G L van der Mey
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  ABSTRACT: To establish a prognostication method based on our own results of vestibular schwannoma surgery. Retrospective data analysis. Tertiary referral centre. 141 ambulatory patients operated for unilateral vestibular schwannoma by the translabyrinthine approach in the period 1996--2003. Facial impairment defined by House Brackmann grade III-VI, and the relation with tumor size. For our institution we found that in a range of tumor sizes the tumor size of 17.5 mm was the cut-off point associated with highest sensitivity and specificity values available concerning the prediction of facial impairment, these were 0.86 and 0.61. Compared to a random cut-off point (11 mm), this leads to 36% more accurate predictions. By establishing sensitivity and specificity values of predictions, one is aware of the rate of false predictions. By Receiver Operating Curve analysis the rate of false predictions can be minimised. In vestibular schwannoma surgery this leads to more precise predictions concerning outcome, as we have demonstrated for the facial function.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):346-51.
• Article: Prognostic relevance of volumetric analysis in tumour specimens of hypopharyngeal cancer.

  M Baghi, S Bisdas, K Engels, M Yousefi, J Wagenblast, M Hambek, R Knecht
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  ABSTRACT: The purpose of this study was to investigate the prognostic relevance of the tumour specimen's volume in patients with squamous cell cancers of the hypopharynx. Tumour specimens of 67 patients treated primarily with surgery were evaluated, prospectively. Pathologic tumour volume was described as the product of the three longest diameters of the tumour in cubic millimeters (mm(3)). Statistical analysis was performed to determine the relation of pathologic tumour volume to pTNM stages as well as to patients' survival. This study has been approved by our institutional review board. Pathologic tumour volume was significantly associated with pT (P = 0.006) and pN (P = 0.01). The univariate evaluation of tumour variables showed pathologic tumour volume (P = 0.01) and pN (P = 0.04) as the only parameters which were significantly associated with overall survival. Entering these variables in a Cox regression model, pathologic tumour volume had the most impact on overall survival (P = 0.03). Most important thereby is the fact that we could distinguish within the pN0 group between the more and the less favourable cases. Pathologic tumour volume could be an essential prognostic indicator and the inclusion of this parameter in future clinical trials is recommended.
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):372-7.
• Article: Pressure application for the management of anterior epistaxis.

  F Shakir, P Stimpson
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):420.
• Article: The NPTA may have underestimated tonsillectomy complications: a case note review of data submitted by two hospitals.

  D D Pothier, P C Nankivell, W Matthee, S Hunasaghatta
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):414-6.
• Article: Endoscopic dacryocystorhinostomy simplified.

  N Bartal, J Bahyr, V Kizhner
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):413.
• Article: Lump in the throat.

  M W M Bridger
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):404; author reply 404-5.
• Article: Antimicrobial prophylaxis in otorhinolaryngology/head and neck surgery.

  F D L Walker, L D Cooke
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):405; author reply 406.
• Article: A new method of construction of obturators for nasal septal perforations and evidence of outcomes.

  S Yadlapalli, D Roy
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):402; author reply 402-3.
• Article: Pinna haematomas of the conchal bowl.

  N Calder
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):401; author reply 401-2.
• Article: Is there a seasonal trend in non-attendance at ENT outpatient clinics?

  M Damodara, M Krishnan, S Powell, V Shanker
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):410-1.
• Article: Songs from childhood in the head.

  H J Gilhuis, A Dara Hama-Amin, W Renier
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):419-20.
• Article: Concurrent chemoradiotherapy is not the only answer.

  D G Grant, M A Birchall
  Clinical otolaryngology: official journal of ENT-UK; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 11/2007; 32(5):416-7.