Catálogo de publicaciones - revistas

<jats:sec><jats:title>Objective</jats:title><jats:p>To determine the usefulness of both amplitude and threshold data from tone‐burst cervical vestibular evoked myogenic potential (cVEMP) testing for the evaluation of superior canal dehiscence syndrome (SCDS).</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Case series with chart review.</jats:p></jats:sec><jats:sec><jats:title>Subjects and Methods</jats:title><jats:p>Sixty‐seven patients underwent cVEMP testing. We correlated mean tone burst cVEMP amplitude and threshold data with temporal bone CT findings. Patients were excluded for Ménière's disease, middle ear disease, or otologic surgery.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Superior canal dehiscence patients had higher mean cVEMP amplitudes (SCDS 173.8 μV vs non‐SCDS 69.7 μV, <jats:italic>P</jats:italic> = 0.031) and lower mean thresholds (SCDS 72.8 dB nHL vs non‐SCDS 80.9 dB nHL) at 500 Hz.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Patients with SCDS have larger amplitudes and lower thresholds on cVEMP testing at 500 Hz. This study supports the utility of tone burst cVEMPs for the evaluation of SCDS and is one of few large single‐center studies to establish normative data.</jats:p></jats:sec>

<jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate temporal trends in the management of sinogenic intracranial suppuration and its outcomes in children.</jats:p></jats:sec><jats:sec><jats:title>Data Sources</jats:title><jats:p>A systematic search of databases was performed (Medline, Embase, Cochrane, ClinicalTrials.gov).</jats:p></jats:sec><jats:sec><jats:title>Review Methods</jats:title><jats:p>Studies in children (age &lt;18 years) with sinogenic subdural empyema, extradural abscess, and intraparenchymal abscess were included. Data on treatment strategies were extracted. Primary outcome was death &lt;90 days. Secondary outcomes were return to theater, neurologic disability at 6 months, and length of stay. Random effects meta‐analysis and meta‐regression were performed to investigate the effect of time and endoscopic sinus surgery (ESS) on these outcomes.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 32 retrospective observational studies involving 533 patients recruited across a 45‐year period (1975‐2020) were included. The pooled estimates for 90‐day mortality, permanent neurologic disability, and return to theater were 2.3% (95% CI, 1.1%‐3.6%; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 0, <jats:italic>P</jats:italic> &gt;. 99), 21.3% (95% CI, 15.3%‐27.3%; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 75.2%, <jats:italic>P</jats:italic> &lt;. 001), and 37.3% (95% CI, 29.5%‐45%; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 71.2%, <jats:italic>P</jats:italic> &lt;. 001), respectively, with no significant differences found across the study period. The pooled estimate for ESS was 58.4% (95% CI, 44.2%‐72.6%; <jats:italic>I</jats:italic><jats:sup>2</jats:sup> = 97.1%, <jats:italic>P</jats:italic> &lt;. 001) with a significantly increasing trend in its use in the more recent years. ESS was not associated with improved mortality, reduced need for revision surgery, or neurologic disability.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The outcomes of sinogenic intracranial complications have not changed over the last 45 years, and ESS was not associated with improved patient outcomes. Further high‐quality studies are required to determine the most appropriate treatment modalities to improve the burden of morbidity associated with sinogenic intracranial suppuration in children.</jats:p></jats:sec>

<jats:title>Abstract</jats:title><jats:p>Supraglottic laryngectomy has evolved from open to transoral endoscopic approaches with advancements in surgical techniques and instruments such as lasers, endoscopes, ultrasonic devices, and robotics. Transoral laser‐assisted microsurgery has emerged as an effective treatment option, offering faster functional recovery and serving as an alternative to partial laryngectomy or non‐surgical therapies. Traditional endoscopic supraglottic laryngectomy involves resection of both suprahyoid and infrahyoid supraglottic structures. However, in cases where the tumor is limited to the infrahyoid epiglottis, a new technique known as transoral laser‐assisted infrahyoid supraglottic laryngectomy allows for tumor removal while preserving the suprahyoid epiglottis, aryepiglottic folds, and vallecula, ensuring optimal preservation of laryngopharyngeal function. This procedure enables patients to swiftly return to their daily routines with minimal complications. This article discusses the surgical technique, potential indications, and advantages and disadvantages of the new approach for infrahyoid epiglottic cancer.</jats:p>

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>(1) To measure the change in auditory and vestibular symptoms following superior canal dehiscence (SCD) surgery, and (2) to determine differences in clinical features and surgical outcomes between superior canal dehiscence syndrome (SCDS) patients with primarily auditory or vestibular complaints.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>Retrospective cohort study.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>Single surgeon series at the tertiary academic medical center from 2002 to 2021.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective review of SCDS patients who underwent surgical repair. (1) Patients were administered a standardized symptom questionnaire at preoperative and follow‐up visits, and results were compared with paired statistical testing. (2) Patients were divided into 2 cohorts based on either auditory or vestibular chief complaint and differences in demographic, clinical, and outcome variables were examined.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Our study included 113 patients with 118 operated ears. Twenty‐seven patients (24%) had radiographic bilateral dehiscence. 10/11 auditory symptoms (91%) and 5/8 vestibular symptoms (63%) solicited on the questionnaire improved significantly with surgery, except for nonpulsatile tinnitus, sense of imbalance, positional dizziness, and oscillopsia. Analyses stratified by chief complaint (auditory vs vestibular) revealed overall similar characteristics and surgical outcomes. Patients with chief vestibular complaints underwent surgery at an earlier age (45.5 vs 53.9 years, <jats:italic>p</jats:italic> &lt; 0.05).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>SCD surgery alleviates a wide range of auditory and vestibular symptoms. Overall, we did not find significant differences between patients with chief auditory versus vestibular complaints, and both groups benefited from surgery. Symptoms are not directly linked to third‐window physiology and certain vestibular symptoms may be more likely to persist. Bilateral dehiscence may play an important role in persistent symptoms as well.</jats:p></jats:sec>