The Laryngoscope
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Randomized Controlled Trial Comparative Study
A prospective, randomized, double-blind study comparing the efficacy of topical anesthetics in nasal endoscopy.
Transnasal endoscopy is commonly performed in an outpatient otolaryngology setting. Patients are typically administered a topical anesthetic and decongestant prior to this procedure to alleviate discomfort and improve visualization. There is no consensus on which topical anesthetic is most effective in optimizing patient experience during the procedure. ⋯ In patients undergoing transnasal endoscopy, use of either 2% tetracaine or 4% lidocaine has similar effect. Tetracaine may be a better choice in older patients, however.
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It has been recognized that chronic rhinosinusitis (CRS) involves intracranial vessels and may be associated with stroke occurrence. However, the detailed epidemiological profile of stroke risk among patients with CRS is still not well understood. Therefore, this study aimed to explore the frequency and risk for stroke among patients with CRS by conducting a large scale population-based cohort study in Taiwan. ⋯ Patients with CRS were at higher risk for stroke occurrence during the 5 year follow-up.
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Comparative Study
Gastroesophageal reflux evaluation in patients affected by chronic cough: Restech versus multichannel intraluminal impedance/pH metry.
Oropharyngeal (OP) pH monitoring has been developed to detect supra-esophageal gastric reflux (SEGR). The results obtained with OP pH-metry and multichannel intraluminal impedance/pH monitoring (MII/pH) were compared. ⋯ OP pH metry detected less reflux episodes than MII/pH; 35% of the OP events were swallows according to impedance. Time correlation between cough and reflux could not be demonstrated with OP pH metry.
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Comparative Study
Comparison of scholarly impact among surgical specialties: an examination of 2429 academic surgeons.
The h-index, a bibliometric indicator that objectively characterizes the impact of an author's scholarship, is an effective tool that may be considered by academic departments for decisions related to hiring and faculty advancement. Our objective was to characterize the scholarly productivity of academic surgeons from different specialties relative to otolaryngologists. ⋯ h-indices among the different surgical specialties vary and are potentially impacted by the number of practitioners as well as research emphasis within a field. The mean h-index of academic otolaryngologists falls in the lower values for academic surgeons. Because this metric varies among different fields, it is most relevant for comparison when examining values within a field. H-indices reliably increase with increasing academic rank through professor and offer a quantifiable and objective alternative to other metrics when evaluating faculty members for academic advancement.
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Airway obstruction is an uncommon presentation of unilateral laryngeal paralysis. We have observed two mechanisms of obstruction: arytenoid prolapse and inappropriate adduction of the paralyzed vocal fold. We evaluated arytenoid abduction (AAb) and recurrent laryngeal nerve (RLN) reinnervation as treatments for airway obstruction in patients with unilateral laryngeal paralysis. ⋯ Arytenoid prolapse and/or inappropriate laryngeal adduction can cause airway obstruction in patients with unilateral laryngeal paralysis. Treatment of airway obstruction should address the underlying pathophysiology. AAb and RLN transection with ansa reinnervation can be effective in selected patients.