RESUMEN
BACKGROUND: The diagnosis and treatment of unilateral vocal fold palsy is a common part of otolaryngology practice. In those patients in whom resolution of symptoms is slow, the resulting dysphonia can have a dramatic effect on the patient's quality of voice and life. We have previously described the procedure of direct phonoplasty under local anaesthesia using the transnasal laryngoesophagoscope. OBJECTIVE: To examine the subjective and objective data for the first five patients to undergo this procedure, in the form of laryngographic speech analysis, perceptual assessment and therapy outcome measures. RESULTS: Analysis showed a statistically significant improvement in voice quality, in all the above assessment categories, following local anaesthetic direct phonoplasty using the transnasal laryngoesophagoscope. CONCLUSION: Collagen injection via transnasal flexible laryngoesophagoscopy is a particularly useful technique for treating vocal fold medialisation, especially in palliative care patients and those with shortened life expectancy.
Asunto(s)
Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Endoscopía/métodos , Laringoscopía/métodos , Parálisis de los Pliegues Vocales/cirugía , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Inyecciones , Masculino , Persona de Mediana Edad , Calidad de Vida , Resultado del Tratamiento , Calidad de la VozRESUMEN
The NHS Plan identified the need for changes in consent practice, and led to the issuing of a model consent policy and standard consent forms for use in the NHS. The aim of this study was to determine current consent practices for common rhinology and laryngology procedures. A telephone survey was conducted of 40 otolaryngology Senior House Officers (SHOs) across England and Wales, asking about local consent procedure, and the specific complications discussed before common operations. The responsibility for routine consenting belonged to SHOs in 95 per cent of departments. Model NHS consent forms were used in 72.5 per cent and information sheets given to patients in 25 per cent of departments. The specific operative risks mentioned to patients by the SHOs showed great variability. The provision of standardized consent protocols for each operation, together with information sheets and the model NHS forms, could aid juniors involved in consent and prove beneficial to our patients.