Πέμπτη 24 Ιανουαρίου 2019
Eine seltene Ursache der chronischen Otitis media
Laryngo-Rhino-Otol
DOI: 10.1055/a-0829-6950
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://bit.ly/2TeIJn1
Eine Gruppenintervention zur Förderung der Arbeitsfähigkeit für Patienten mit Kopf-Hals-Tumoren
Laryngo-Rhino-Otol
DOI: 10.1055/a-0829-6885
Einleitung Trotz hoher Belastung nimmt ein Großteil der Patienten mit Kopf-Hals-Tumoren keine psychosoziale Versorgung in Anspruch. Diese Patienten haben darüber hinaus ein höheres Risiko als andere Krebspatienten, nicht wieder in den Beruf zurückzukehren. Daher wurde eine Gruppenintervention entwickelt, die sich an Patienten mit Kopf-Hals-Tumoren richtet und deren Arbeitsfähigkeit, Lebensqualität, Selbstwirksamkeit und psychisches Wohlbefinden fördern soll. Material und Methoden In einem randomisiert-kontrollierten Design erhalten die Patienten eine Gruppenintervention oder eine sozialrechtliche Beratung. Eingeschlossen werden männliche Patienten mit Kopf-Hals-Tumoren mit hoher psychischer und arbeitsbezogener Belastung. Die Gruppenintervention besteht aus acht Sitzungen. Die Gruppen werden von einer Psychotherapeutin und einem ehemals Betroffenen eines Kopf-Hals-Tumors (sogenannter Peer) geleitet. Die Umsetzbarkeit und Akzeptanz der Intervention wurde anhand einer Pilotgruppe getestet. Die Teilnehmer der Pilotgruppe evaluierten jede Sitzung und wurden nach Abschluss der Intervention in halbstrukturierten Interviews zur Intervention befragt. Ergebnisse Von 113 Patienten persönlich angesprochenen Patienten nahmen zehn Patienten an einem Screening-Gespräch teil. Davon nahmen vier Patienten an der Pilotgruppe teil. Die Patienten gaben an, dass sich die Gruppenintervention gut mit ihrem Alltag vereinbaren ließe und dass sie die Gruppe insgesamt positiv wahrgenommen hätten. Drei Patienten betonten die Wichtigkeit des Peers. Diskussion Vor allem der Peers als Identifikationsfigur ist von zentraler Bedeutung. Zur Verbesserung der Rekrutierungszahlen sollen Einschlusskriterien erweitert und der Teilnahmeaufwand reduziert werden.
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© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://bit.ly/2B5daFc
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor Attarha et al recommended that sound therapies using white noise should be avoided as treatments for tinnitus. This advice might stem from the authors' collective lack of clinical experience assessing and treating patients with tinnitus, or from their unfamiliarity with tinnitus management techniques and associated literature. In any case, before recommending that white noise should be avoided by patients with tinnitus, Attarha et al should become more familiar with how a variety of sound therapies—including broadband sounds—often help this patient population.
http://bit.ly/2FMXWsK
http://bit.ly/2FMXWsK
Bullous Pemphigoid Presenting as Oropharyngeal Hemorrhage
This is a case report of a man who presented with oropharyngeal hemorrhage and impending airway compromise as the initial presentation of mucosal bullous pemphigoid.
http://bit.ly/2FVKNwA
http://bit.ly/2FVKNwA
Association Between Migraine and Benign Paroxysmal Positional Vertigo in South Korea
This study evaluates representative patient data from the Korean National Health Insurance Service-National Sample Cohort to trace the incidence of benign paroxysmal positional vertigo among adults who experience migraine.
http://bit.ly/2FMXWce
http://bit.ly/2FMXWce
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing—Reply
In Reply Critiques of our article by Folmer and Henry et al suggest the concerns we raised about the potential harmful effects of chronic exposure to broad-band noise (BBN) are overstated, citing a lack of clinical evidence demonstrating correspondence between human symptoms and maladaptive neuroplasticity recorded in animal studies. Although we acknowledged the paucity of human studies addressing these questions in our review, we do not think it is safe to assume humans will be exempt from substantial, negative impacts of chronic BBN exposure documented in the central auditory pathways of animals. A main goal of our report was to stimulate the audiology research and clinical communities to take these compelling animal studies more seriously—and to take on the long-delayed task of carefully documenting the impacts of chronic BBN exposure on residual human hearing, on accelerated aging, and on the evolution of tinnitus itself.
http://bit.ly/2FXHZ1S
http://bit.ly/2FXHZ1S
Speech Functioning and Neurocognition Before Head and Neck Cancer
This cohort study examines neurocognitive functioning in patients with head and neck cancer before treatment and investigates the association between neurocognition and speech functioning.
http://bit.ly/2FLAqvZ
http://bit.ly/2FLAqvZ
The Increasing Role of Social Media in Otolaryngology
This Viewpoint examines the increasing role of social media in the practice of otolaryngology.
http://bit.ly/2FVKAcM
http://bit.ly/2FVKAcM
No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor We are writing in response to the article by Attarha, Bigelow, and Merzenich, which concluded, "Sound therapies using unstructured, random (white) noise should be avoided as a treatment for tinnitus."(E1) Their recommendation was based on animal studies that revealed long-term exposure to low-level broadband noise (BBN) resulted in central auditory changes that "bear striking phenomenological overlap with the persistent, widespread disinhibition of the auditory system thought to underlie tinnitus in humans."(E2) They noted that BBN delivered from ear-level devices to treat tinnitus produces the same type of acoustic stimuli used in the animal studies. It therefore seems plausible that continuous use of BBN could affect the human auditory system in the same manner as seen in animals, suggesting the need for research to evaluate the premise. The authors, however, pointed to the animal findings as justifying a broad recommendation against the use of ear-level noise generators.
http://bit.ly/2FJicLP
http://bit.ly/2FJicLP
Morbidity and mortality among patients with head and neck cancer in the emergency department: A national perspective
Abstract
Background
Emergency departments are playing an increasing role in cancer management. Emergency department utilization by patients with head and neck cancer, however, is unknown.
Methods
The 2009‐2011 Nationwide Emergency Department Sample was queried for patients with a principle diagnosis of head and neck cancer. Descriptive analysis was performed to characterize patient and hospital characteristics, outcomes, and charges. Logistic regression identified predictors of admission and mortality.
Results
A total of 31 390 patients were seen in the emergency department with head and neck cancer: 72.8% were admitted, 0.5% died in the emergency department, and 5.0% died during admission. Patients with cancer of unknown primary site had the greatest odds of admission (odds ration [OR]: 2.83; P < 0.0001). Privately insured patients (OR: 1.78; P = 0.001), those from higher income zip codes (OR: 1.56; P = 0.008), and those with oropharyngeal cancer (OR: 2.02; P = 0.0003) had the greatest odds of death.
Conclusion
These findings have direct implications for preventing unnecessary and costly emergency department visits, improving hospital and physician preparedness, and improving patient outcomes.
http://bit.ly/2S9wBq8
Ultrasonographic swallowing examination for early detection of neopharyngeal fistula after salvage total laryngectomy: A preliminary study
Abstract
Background
The current study investigated the feasibility of ultrasonographic swallowing examination (USSE) for the evaluation of neopharynx and early detection of neopharyngeal fistula after salvage total laryngectomy.
Methods
A prospective case series‐based study involving 16 patients who underwent salvage total laryngectomy was conducted. USSE was performed on postoperative days 5‐7, and oral diet initiation was determined based on the USSE results.
Results
Fistula of the neopharynx was detected in four patients (25%) via USSE, as was the specific site of the fistula. In these patients, oral diet was delayed and immediate interventions including ultrasound‐guided fluid aspiration and compression dressing were applied, and all fistulas were subsequently closed. In the remaining 12 patients with no neopharyngeal fistula on USSE, an oral diet was started immediately and no fistula occurred.
Conclusions
USSE is a promising method for neopharynx evaluation and early detection of neopharyngeal fistula after salvage total laryngectomy.
http://bit.ly/2S5fB4q
Feasibility of carbon‐ion radiotherapy for oral non‐squamous cell carcinomas
Abstract
Background
This study evaluated carbon‐ion radiotherapy (C‐ion RT) for oral non‐squamous cell carcinomas (non‐SCC).
Methods
We retrospectively obtained data from 74 patients who underwent C‐ion RT for oral malignancies between April 1997 and March 2016. The C‐ion RT was administered in 16 fractions at a total dose of 57.6 or 64.0 Gy (relative biological effectiveness).
Results
Forty‐three patients had salivary gland carcinomas, 29 patients had mucosal melanoma, and 2 patients had other types of pathologies. The tumors were classified as T1‐T3 (24 cases), T4a (21 cases), or T4b (29 cases). The median follow‐up was 49 months. The 5‐year rates were 78.8% for local control, 36.2% for progression‐free survival, and 58.3% for overall survival. Although 10 patients developed grade 3 osteoradionecrosis after C‐ion RT, all patients maintained their mastication and deglutition functions after sequestrectomy and prosthesis placement.
Conclusion
C‐ion RT was effective for oral non‐SCC and had acceptable toxicities.
http://bit.ly/2sFzQrc
Pathology International
Cells Tissues Organs
Case Reports in Pathology
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