Comparison of functional and oncological treatment outcomes after transoral robotic surgery and open surgery for supraglottic laryngeal cancer.

OBJECTIVE: To compare functional and oncological treatment outcomes among patients with supraglottic laryngeal cancers who underwent transoral robotic supraglottic laryngectomy and open supraglottic laryngectomy. METHODS: A retrospective chart review was conducted of 17 patients treated by transoral robotic supraglottic laryngectomy and 20 patients treated by open supraglottic laryngectomy. RESULTS: No tracheostomy or prolonged intubation was needed in the transoral robotic surgery group. Furthermore, that group had a shorter oral feeding time, hospitalisation and recovery period. There was no difference between groups in terms of complications. There were no differences in overall survival time and disease-specific survival time between groups. CONCLUSION: Transoral robotic supraglottic laryngectomy for supraglottic laryngeal cancer is an oncologically safe and functional procedure with better results when compared to conventional open surgery.

Intra-observer and inter-observer reliability of leg circumference measurement among six observers: a single blinded randomized trial.

Hypothesis: Circumference measurement of extremities that was reported to be a reliable method as long as being standardized is commonly used both in clinical and home settings by clinicians or caregivers due to its cheapness and easy use. Objectives: The aims of this study were to determine the inter-observer and intra-observer reliability of manual circumference measurement among different observers and various measurement points. Methods and Results: A total of 58 lower limbs were included in the study. Both lower limbs of each subject were assessed by 6 observers randomly using circumference measurement method from 9 reference points specified with a Leg-O-Meter. All observers performed the measurements and they were blind to each other's measurements. Results: Measurement results from reference points were statistically significant between good to perfect (ICC 0.65-0.99, p<0.001). Interrater reliability of all observers' first and second measurements showed perfect reliability for both measurements (ICC: 0.92-0.99, p<0.001). Conclusions: This study demonstrated that the lower extremity manual circumference measurement is a reliable method for clinical practice. Abbreviations: BMI = Body Mass Index, ICC = Intraclass Correlation Coefficient, Metatarsal heads (cA), Ankle-heel (cY), Ankle (cB), Distal beginning point of gastrocnemius (cB1), The widest point for gastrocnemius (cC), Head of fibula (cD), Midline of knee (cE), Midline of thigh (cF), Groin level (cG).

Gastroesophageal reflux disease and tympanoplasty surgical outcome: is there a relationship?

OBJECTIVE: To investigate the possible clinical relationship between gastroesophageal reflux disease and the type one tympanoplasty surgical outcomes of adults with chronic otitis media, by using a simple, cost-effective, reliable questionnaire and physical findings. METHODS: Fifty-two of 147 patients undergoing type one tympanoplasty were studied. Gastroesophageal reflux disease symptoms were evaluated using the Frequency Scale for the Symptoms of Gastroesophageal Reflux Disease questionnaire. Laryngoscopic physical findings of laryngopharyngeal reflux were evaluated using the Reflux Finding Score. A successful outcome was defined as an intact tympanic membrane. Correlations between the two assessment tool results and the patient's surgical success were calculated. RESULTS: The gastroesophageal reflux disease questionnaire score was significantly higher in patients with unsuccessful tympanic membrane closure (group one) than in patients with successful closure (group two) (p < 0.05). The Reflux Finding Score was also significantly higher in group one than group two (p < 0.05). There was a significant positive relationship between the gastroesophageal reflux disease questionnaire score and the Reflux Finding Score (p < 0.01). CONCLUSION: Gastroesophageal reflux disease may be a significant prognostic factor for tympanoplasty failure. Therefore, reflux investigation may be important during the treatment of chronic otitis media, and positive cases may need reflux treatment as well as ear disease treatment.