ABSTRACT
OBJECTIVE: To determine the prognostic factors that affect surgical and audiologic outcomes in inlay tympanoplasty after long-term follow-up. DESIGN: Case series study. SETTING: Tertiary referral center. PATIENTS: Sixty-two patients who underwent 71 procedures were enrolled in the study. Patient ages ranged from 31 to 87 years (mean [SD] age, 61.2 [12.9] years). Mean (SD) follow-up was 635.7 (284.7) days. The inclusion criteria were (1) inlay cartilage tympanoplasty performed using local anesthesia via a transcanal route, (2) chronic otitis media with stable perforation, and (3) dry ear without middle ear disease. MAIN OUTCOME MEASURES: The success rate and hearing change at the last follow-up visit. RESULTS: The overall success rate was 87.3% at the last visit. Using multivariate analysis, sex, age, size of perforation, side of perforation, and the presence of diabetes mellitus and external auditory canal otomycosis did not affect the success. Smoking was the only independent factor for the prognosis of surgical outcome (odds ratio [OR], 8.16; 95% confidence interval [CI], 1.74-36.89; P < .006). On the other hand, age (OR, 6.62; 95% CI, 1.13-38.47; P = .03) and perforation size (OR, 0.11; 95% CI, 0.10-0.79; P = .03) were independent factors for the prognosis of audiologic outcomes. CONCLUSIONS: The frequency of failure was significantly higher for smokers than for nonsmokers. To quit smoking is highly recommended preoperatively for individuals scheduled for chronic otitis media inlay tympanoplasty intervention. Younger patients and those with larger perforations (>50%) were more likely to benefit from this operation.
Subject(s)
Auditory Threshold , Cartilage/transplantation , Tympanic Membrane Perforation/surgery , Tympanoplasty/methods , Adult , Age Factors , Aged , Aged, 80 and over , Anesthesia, Local , Audiometry, Pure-Tone , Chronic Disease , Female , Follow-Up Studies , Humans , Male , Middle Aged , Otitis Media/complications , Otoscopy , Prognosis , Risk Factors , Smoking/adverse effects , Treatment Failure , Treatment OutcomeABSTRACT
To investigate the relationship between traffic air pollution exposure and development of childhood leukemia (14 yr of age or younger), a matched case-control study was conducted using childhood deaths that occurred in Taiwan from 1996 through 2006. Data on all eligible childhood leukemia deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of children who died from causes other than neoplasms or diseases that were not associated with respiratory complications. The controls were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data on the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The results showed that there was a significant exposure-response relationship between PSD and the risk of leukemia development in young children after controlling for possible confounders. The findings of this study warrant further investigation of the role of traffic air pollution exposure in the etiology of childhood leukemia.
Subject(s)
Air Pollutants/toxicity , Environmental Exposure/adverse effects , Leukemia/mortality , Petroleum/toxicity , Vehicle Emissions/toxicity , Adolescent , Air Pollutants/analysis , Air Pollution/adverse effects , Case-Control Studies , Chi-Square Distribution , Child , Child, Preschool , Environmental Monitoring , Epidemiological Monitoring , Female , Humans , Incidence , Infant , Infant, Newborn , Inhalation Exposure/adverse effects , Logistic Models , Male , Petroleum/analysis , Residence Characteristics , Risk Factors , Taiwan/epidemiologyABSTRACT
To investigate the relationship between petrochemical air pollution and childhood leukemia (19 yr of age or younger), the authors conducted a matched case-control study using childhood deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible childhood leukemia deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of children who died from causes other than neoplasms or diseases that were not associated with respiratory problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into three levels (< or =25th percentile; 25th-75th percentile; > 75th percentile) according to the levels of the index just described. After controlling for possible confounders, results showed that children who lived in the group of municipalities characterized by the highest levels of petrochemical air pollution had a statistically significant higher risk of developing leukemia than the group that lived in municipalities with the lowest petrochemical air pollution levels. The results of this study shed important light on the relationship between the Taiwan petrochemical industry and human health risks.