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Ear Nose and Throat specialist

Nathan Alexander, Ahmad Boota, Kenderic Hooks, John R White
Pediatric obstructive sleep apnea is known to cause neurocognitive problems, yet it often goes undetected or mistreated. The authors describe 9-year-old twins with snoring, enlarged tonsils, and excessive daytime sleepiness whose symptoms had been previously disregarded by health care professionals. At presentation, a dentist found the patients to be midface deficient and symptomatic. A home sleep test, prescribed by the dentist, revealed apnea-hypopnea index readings of 74/h and 16/h, respectively. The children were referred to an otolaryngologist, and a continuous positive airway pressure therapy trial resulted in improved cognition and temperament...
February 1, 2019: Journal of the American Osteopathic Association
Birgit Ehlken, Massoud Toussi, Abdus Samad, Sigal Kaplan, Mónika Domahidy, Hanka de Voogd, Stella Böhmert, Rita Silveira Ramos, Deepa Arora
WHAT IS KNOWN AND OBJECTIVE: The approved indication for trimetazidine (TMZ) was restricted to "add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies" in 2012 by the Committee for Medicinal Products for Human Use (CHMP). TMZ was no longer indicated for ophthalmology and otolaryngology (ENT) indications. This drug utilization study analysed actual utilization of TMZ before and after the restriction on its indications to evaluate the effectiveness of risk minimization measures (RMM)...
January 18, 2019: Journal of Clinical Pharmacy and Therapeutics
Johan Hellgren, Martin Beran
Continuous monitoring of the need to educate specialists is important in the planning of health care resources. In this article, the authors present a questionnaire-based tool that is answered by the heads of Departments of ear, nose and throat (ENT) across Sweden every year. In Stockholm, the movement of patients from university to private ENT has dramatically decreased specialist training in ENT, and this can be seen by the employment survey instrument called »Tjänsteenkäten«.
January 11, 2019: Läkartidningen
Susan P Jacups, Kate M McConnon
INTRODUCTION: Many specialist waitlists in Australian hospitals are long. One reason anecdotally reported for this is poor alignment of referrals with current recommended guidelines. This paper reports the findings of an audit undertaken in 2017 for ear, nose and throat (ENT) surgeon referrals submitted by primary health centres within Cape York, Australia. MATERIALS AND METHODS: 54 long-wait ENT referrals were reviewed against referral criteria for ENT presentations using the Clinical Prioritization Criteria (CPC) and two routinely applied clinical primary health care guidelines; with findings reported alongside patient demography...
December 31, 2018: Health Policy
Jane Vennik, Caroline Eyles, Mike Thomas, Claire Hopkins, Paul Little, Helen Blackshaw, Anne Schilder, Jim Boardman, Carl M Philpott
OBJECTIVES: To explore general practitioner (GP) and ears, nose and throat (ENT) specialist perspectives of current treatment strategies for chronic rhinosinusitis (CRS) and care pathways through primary and secondary care. DESIGN: Semi-structured qualitative telephone interviews as part of the MACRO programme (Defining best Management for Adults with Chronic Rhinosinusitis) SETTING: Primary care and secondary care ENT outpatient clinics in the UK. PARTICIPANTS: Twelve GPs and 9 ENT specialists consented to in-depth telephone interviews...
December 19, 2018: BMJ Open
Jessica O Boyce, Nicky Kilpatrick, Rodrigo P Teixeira, Angela T Morgan
CASE HISTORY: A 5-year-old girl presented with a suspected palatal abnormality, first observed by her general practitioner during a routine examination at 4 years. She had a history of conductive hearing loss on a background of recurrent otitis media, however her hearing had improved since grommet insertion at 4 years and 8 months. Her middle ear dysfunction was thought to be due to abnormal palatal muscles that also control Eustachian tube drainage. No difficulties with breast feeding or nasal regurgitation were reported...
December 19, 2018: Archives of Disease in Childhood. Education and Practice Edition
Di Deng, Jintao Du, Feng Liu, Bing Zhong, Yixin Qiao, Yafeng Liu
BACKGROUND: Internal carotid artery (ICA) pseudoaneurysms are associated with high mortality if lack of proper management. Patients with ICA pseudoaneurysms in the sphenoid sinus often visit a hospital's ear, nose and throat (ENT) department due to nasal bleeding. In such cases, simple examination and therapy will lead to misdiagnosis. OBJECTIVE: This study sought to investigate the clinical characteristics, diagnostic methods and treatment of ICA pseudoaneurysms in the sphenoid sinus...
January 2019: American Journal of Otolaryngology
D G Balatsouras, G Koukoutsis, A Fassolis, A Moukos, A Apris
Balance disorders, unsteadiness, dizziness and vertigo in the elderly are a significant health problem, needing appropriate treatment. One third of elderly patients with vertigo were diagnosed with benign paroxysmal positional vertigo (BPPV), the most common cause of dizziness in both primary care specialist Neurology and Ear Nose Throat settings. BPPV presents a specific paroxysmal positional nystagmus which can be obtained using the appropriate diagnostic positional test and can be treated effectively using specific therapeutic maneuvers...
2018: Clinical Interventions in Aging
Angelica Tiotiu, Davor Plavec, Silviya Novakova, Stefan Mihaicuta, Plamena Novakova, Marina Labor, Andras Bikov
Ear, nose and throat (ENT) comorbidities are common in patients with asthma and are frequently associated with poorer asthma outcomes. All these comorbidities are "treatable traits" in asthma. Identification and management of these disorders may spare medication usage and contribute to improved asthma control and quality of life, and a decrease in exacerbation rates.This review summarises recent data about the prevalence, clinical impact and treatment effects of ENT comorbidities in asthma including allergic rhinitis, chronic rhinosinusitis with and without nasal polyposis, aspirin-exacerbated respiratory disease, obstructive sleep apnoea and vocal cord dysfunction...
December 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Gonca Hanedan Uslu, Gamze Çebi, Bengü Çobanoğlu
One of the standard treatments in laryngeal cancer is radiotherapy (RT). Many short- and long-term complications can occur in the region that has received radiotherapy. Definitive treatment of the emerging complications is still debatable, and treatment is challenging for radiation oncologists and ear nose throat specialists. Recently, hyperbaric oxygen treatment (HBOT) has become a promising alternative for the treatment of these complications. The aim of this report is to discuss the effectiveness of HBOT in the treatment of late-term RT-related potential complications in a patient with laryngeal cancer...
2018: Contemporary Oncology Współczesna Onkologia
Ian Gerard Parker, Gunter Hartel, Jennifer Paratz, Nancy Low Choy, Ann Rahmann
OBJECTIVES: To determine the typical proportions of diagnoses for patients presenting with dizziness or vertigo based on clinical speciality and to assess the change in proportions of diagnoses over time. DATA SOURCES: Following PRISMA guidelines, systematic searches of PubMed and CINAHL databases and follow-up reference searches were performed for articles published in English up to October 2016. STUDY SELECTION: Analysis of searches yielded 42 studies meeting the criteria of case series of adult patients with dizziness and/or vertigo presenting to general practice, emergency departments or specialist outpatient clinics...
November 13, 2018: Otology & Neurotology
Günay Arsoy, Ahmet Varış, Louai M Saloumi, Abdikarim Abdi, Bilgen Başgut
BACKGROUND AND OBJECTIVE: the global prevalence of allergic rhinitis (AR) is rising and yet there is scarce information concerning the diagnosis, management and treatment patterns of AR in Northern Cyprus (NC). This study aims to provide a unique perspective on AR management as well as assessing the effectiveness of the pharmacist-led educational intervention for improving care of AR patients. METHODS: across-sectional survey was carried out with community pharmacists ( n = 70), patients ( n = 138) and ear, nose and throat (ENT) specialists ( n = 12) in NC...
November 7, 2018: Medicina
Sanjeev Davey, Chaitanya Maheshwari, Santosh Kumar Raghav, Nirankar Singh, Khursheed Muzammil, Prakhar Pandey
Introduction: In National Programme for Prevention and Control of Deafness (NPPCD), the management of ear diseases of rural India is now guided by Revised Indian Public Health Standards (IPHS) for Rural Health Facilities for providing quality ear care. However, despite the IPHS existence, coverage and quality ear care is questionable. Moreover, this issue has not yet been studied till now in the Indian context. The objective of the study was to assess the role of Private Medical College Training Center (Rural Health Training Centre [RHTC]) in augmenting quality of ear care services in NPPCD at district level by adopting IPHS Standards...
July 2018: Journal of Family Medicine and Primary Care
José Tawil, Ronnie Fass
Globus is an area of interest for many medical specialists including otorhinolaryngologists, gastroenterologist, allergists, and psychiatrists. It may be caused by an organic disease, but it is not uncommon that an underlying etiology remains unidentified even after a full workup has been performed. Patients who suffer from globus usually visit several physicians from different specialties without finding a solution for their symptoms. Identifying the underlying cause of globus is not always a simple task; therefore, structural or functional abnormalities of the thyroid, larynx, pharynx, and esophagus should be investigated...
November 2018: Journal of Clinical Gastroenterology
Annemiek Buizert, J C Verboon, Paul W Wirtz, Jan Pieter Koopman, Roland M van Roosmalen, Bart C Jacobs, S F T M de Bruijn
OBJECTIVE: To compare the diagnostic work-up and treatment strategy of Bell's palsy by: general practitioners (GPs); ear, nose and throat (ENT) specialists; and neurologists in the Netherlands. DESIGN: Cross-sectional survey. METHOD: GPs, ENT specialists and neurologists were asked to participate in an online survey on the diagnosis and treatment of Bell's palsy. Results per specialty were analysed using descriptive statistics and chi-squared test...
August 16, 2018: Nederlands Tijdschrift Voor Geneeskunde
Sanda Lah Kravanja, Irena Hocevar-Boltezar, Maja Marolt Music, Ana Jarc, Ivan Verdenik, Maja Ovsenik
Background Tongue posture plays an important role in the etiology of anterior open bite (AOB) and articulation disorders, and is crucial for AOB treatment planning and posttreatment stability. Clinical assessment of tongue posture in children is unreliable due to anatomical limitations. The aim of the study was to present functional diagnostics using three-dimensional ultrasound (3DUS) assessment of resting tongue posture in comparison to clinical assessment, and the associations between the improper tongue posture, otorhinolaryngological characteristics, and articulation disorders in preschool children with AOB...
September 11, 2018: Radiology and Oncology
Stefano Spina, Vittorio Scaravilli, Giovanni Cavenaghi, Dario Manzolini, Chiara Marzorati, Enrico Colombo, Davide Savo, Alessia Vargiolu, Giuseppe Citerio
BACKGROUND: Brain-injured patients frequently require tracheostomy, but no technique has been shown to be the gold standard for these patients. We developed and introduced into standard clinical practice an innovative bedside translaryngeal tracheostomy (TLT) technique aided by suspension laryngoscopy (modified TLT). During this procedure, the endotracheal tube is left in place until the airway is secured with the new tracheostomy. This study assessed the clinical impact of this technique in brain-injured patients...
August 29, 2018: Journal of Neurosurgical Anesthesiology
Jennifer Bach, Qazi Azher, Anas Salih
A 17-year-old man initially presented to his primary care physician with throat pain for 1 week and was started on amoxicillin. After four additional days of ongoing pain and difficulty swallowing with decreased oral intake, he presented to the emergency department. Exam showed fullness to the right posterior oropharynx and palpable mass in the right neck without stridor. Initial imaging was soft tissue neck CT with contrast, which showed cystic 8 cm mass in the parapharyngeal space. Patient additionally underwent MRI, which showed an 8...
August 20, 2018: BMJ Case Reports
Anne Hurren, Nick Miller, Paul Carding
Perceptual assessment of tracheoesophageal voice quality following total laryngectomy with surgical voice restoration is essential to investigate functional outcomes in relation to surgical procedure and rehabilitation regimes. There is no current tool with established reliability and validity to fulfill this purpose. This study describes the development of a set of new perceptual scales, in relation to core validity and reliability issues. These were investigated using voice stimuli from 55 voice prosthesis speakers and evaluated by 22 judges-12 speech and language therapists (SLTs), 10 Ear, Nose, and Throat surgeons-classified into experienced or not at assessing voice...
July 30, 2018: Journal of Voice: Official Journal of the Voice Foundation
Don Ly, Johan Hellgren
OBJECTIVE: Are patients with symptomatic unilateral maxillary sinusitis sent for a dental evaluation of odontogenic maxillary sinusitis (OMS)? PATIENTS AND METHODS: The medical records of all patients diagnosed with sinusitis at a university Ear-nose and throat (ENT) clinic from 2010 to 2015 were scrutinized for symptomatic unilateral maxillary sinusitis verified on CT. Any dental evaluation was recorded, as well as symptoms of OMS, duration to dental evaluation, diagnosis of OMS and dental treatment...
July 25, 2018: Acta Odontologica Scandinavica
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