Archives of otolaryngology--head & neck surgery
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Arch. Otolaryngol. Head Neck Surg. · Mar 2010
Randomized Controlled TrialInformed consent in pediatric surgery: Do parents understand the risks?
To investigate parent understanding of the risks of pediatric ear, nose, and throat surgery after counseling with and without the use of informational aids. ⋯ Parents of children undergoing ear, nose, and throat surgery recall far less than 100% of counseled risks. The use of detailed surgical risk counseling improves measured parental understanding of surgical risk. Parental educational level and maternal vs paternal parent may affect risk counseling recall.
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Arch. Otolaryngol. Head Neck Surg. · Feb 2010
The impact of baseline intact parathyroid hormone levels on severity of primary hyperparathyroidism and outcomes in patients undergoing surgery.
To determine the impact of intact parathyroid hormone (iPTH) baseline levels on severity of primary hyperparathyroidism (PHPT) and outcomes following parathyroidectomy for PHPT. ⋯ Patients in the high baseline group undergoing surgery for PHPT had higher baseline levels of serum calcium, serum alkaline phosphatase, and parathyroid adenoma weights and lower serum 25-hydroxyvitamin D levels compared with the lower baseline group. Sestamibi scans were more likely to localize an adenoma in the high baseline group (83.7%) than in the low baseline group (68.9%) (P < .01). Despite an apparently lower rate of positive preoperative sestamibi scans for the low baseline group, patients were able to achieve a similar rate of disease cure as other patients with higher baseline iPTH levels. It seems that baseline iPTH level should not be used as a criterion to perform surgery or not perform surgery for patients with PHPT.
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Arch. Otolaryngol. Head Neck Surg. · Jan 2010
Diagnostic contributions of videolaryngostroboscopy in the pediatric population.
Videolaryngostroboscopy (VLS) is a standard technique used for evaluating adult patients with dysphonia. However, while pediatric dysphonia affects 5% of children, children with dysphonia are traditionally examined with a flexible nasal endoscope. The purpose of this study was to determine whether VLS provides additional diagnostic yield in children. ⋯ Patients with a history of prolonged dysphonia for whom treatment has failed should be referred for evaluation by VLS. Videolaryngostroboscopy elucidates subtle features of different disease processes; clarifies the differences between benign mucosal disorders that might require surgical intervention; and helps identify inflammatory processes that contribute to dysphonia. To our knowledge, these findings have not previously been reported in the pediatric population. Although most pediatric dysphonia can be attributed to benign nodules, our results show that inflammatory conditions and benign lesions other than nodules contribute to dysphonia and are often overlooked and undertreated.