Adaptation and initial validation of the Spanish version of the chronic otitis media questionnaire-12 (COMQ-12) and chronic otitis media benefit inventory (COMBI)

Background and objectives: The chronic otitis media questionnaire-12 (COMQ-12) and chronic otitis media benefit inventory (COMBI) aim to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to validate the Spanish adaptation of the COMQ-12 and COMBI.Patients and methodsMulticentre prospective instrument validation study. guidelines for the cross-cultural adaptation process were followed. The psychometric properties of the Spanish versions (“COMQ-12-Spa” for “COMQ-12-Spanish” and “COMBI-Spa” for “COMBI-Spanish”) were assessed in 25 consecutive adults undergoing tympanoplasty and in a separate cohort of 25 unaffected adults.ResultsCOMQ-12-Spa: test–retest reliability, r=0.98; internal consistency reliability, α=0.92. Item-subscale and item-total coefficients, ≥0.40. Between-group discrimination, p<0.0001. COMBI-Spa: internal consistency, α=0.96. A high-intensity relationship between the variables was shown, ≥0.40. Correlation between the COMBI-Spa and the Spanish Glasgow Benefit Inventory (GBI), r=0.89; p<0.01.ConclusionPsychometric testing of the Spanish versions of the COMQ-12-Spa and COMBI-Spa yielded satisfactory results, thus allowing pre- and postintervention assessment of the subjective severity of chronic otitis media in adult patients. (AU)

Antecedentes y objetivo: El Cuestionario de otitis media crónica-12 (COMQ-12) y el Inventario de beneficios en otitis media crónica (COMBI) valoran la calidad de vida relacionada con la otitis media crónica o su tratamiento quirúrgico. El objetivo del estudio fue validar la adaptación española de los originales británicos.Pacientes y métodosEstudio multicéntrico prospectivo de validación de instrumento. Se siguieron las pautas para el proceso de adaptación transcultural. Las propiedades psicométricas de las versiones españolas, COMQ-12-Spa y COMBI-Spa, fueron evaluadas en 25 adultos consecutivos intervenidos de timpanoplastia y en una cohorte separada de 25 adultos sanos.ResultadosCOMQ-12-Spa: fiabilidad test-retest, r=0,98; consistencia interna, α=0,92; coeficientes ítem-subescala e ítem-total, ≥0,40; discriminación entre grupos, p<0,0001. COMBI-Spa: consistencia interna, α=0.96. Se encontró una relación de intensidad elevada entre las variables, ≥0,40. Correlación entre COMBI-Spa y Glasgow Benefit Inventory español (GBI), r=0,89; p<0,01.ConclusionesLas pruebas psicométricas de las versiones españolas COMQ-12-Spa y COMBI-Spa ofrecieron resultados satisfactorios, lo que permite la valoración pre y postintervención de la severidad subjetiva de la otitis media crónica en pacientes adultos. (AU)

Particularidades del abordaje transcanal endoscópico de los tumores benignos de oído medio en adultos / Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients

Antecedentes y objetivo: La cirugía mínimamente invasiva de tumores benignos del oído medio es posible mediante el uso del endoscopio. La mejor iluminación y la visión más amplia que ofrece permiten el abordaje transcanal de estos raros tumores. El objetivo del presente trabajo es sintetizar los puntos clave de su diagnóstico y tratamiento, a través de una serie propia de casos.Materiales y métodosEstudio retrospectivo de tumores benignos de oído medio intervenidos exclusivamente por vía transcanal endoscópica en un hospital universitario de tercer nivel, de adultos, entre junio de 2018 y junio de 2020. El seguimiento postoperatorio se realizó mediante otoendoscopia y audiometría.ResultadosFueron intervenidos durante el periodo de estudio 6 pacientes; 5 fueron mujeres y uno fue hombre, con una edad media de 57,8 años (± 21,9). Cuatro tumores estaban en el oído izquierdo y 2 en el oído derecho. Estos incluían 4paragangliomas timpánicos (3 de tipo I y uno de tipo II), un neurinoma de cuerda de tímpano y un colesteatoma congénito. No hubo complicaciones postoperatorias graves. En el momento actual no se ha constatado recidiva tumoral en ninguno de los casos, con un seguimiento mínimo de 7 meses.ConclusionesEl presente estudio añade evidencia sobre la seguridad y eficacia de la cirugía transcanal endoscópica de oído, como técnica mínimamente invasiva, para el tratamiento de tumores benignos de oído medio confinados en la cavidad timpánica. (AU)

Background and objective: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarize its key points through a case series.Materials and methodsRetrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry.ResultsSix patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (± 21.9). Four tumours were in the left ear and 2 in the right ear. These included 4tympanic paragangliomas (3 type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months.ConclusionsThe present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity. (AU)

Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients.

BACKGROUND AND OBJECTIVE: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarise its key points through a case series. MATERIALS AND METHODS: Retrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry. RESULTS: Six patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (±21.9). Four tumours were in the left ear and 2 in the right ear. These included four tympanic paragangliomas (three type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months. CONCLUSIONS: The present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity.

Adaptation and initial validation of the Spanish version of the chronic otitis media questionnaire-12 (COMQ-12) and chronic otitis media benefit inventory (COMBI).

BACKGROUND AND OBJECTIVES: The chronic otitis media questionnaire-12 (COMQ-12) and chronic otitis media benefit inventory (COMBI) aim to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to validate the Spanish adaptation of the COMQ-12 and COMBI. PATIENTS AND METHODS: Multicentre prospective instrument validation study. guidelines for the cross-cultural adaptation process were followed. The psychometric properties of the Spanish versions ("COMQ-12-Spa" for "COMQ-12-Spanish" and "COMBI-Spa" for "COMBI-Spanish") were assessed in 25 consecutive adults undergoing tympanoplasty and in a separate cohort of 25 unaffected adults. RESULTS: COMQ-12-Spa: test-retest reliability, r=0.98; internal consistency reliability, α=0.92. Item-subscale and item-total coefficients, ≥0.40. Between-group discrimination, p<0.0001. COMBI-Spa: internal consistency, α=0.96. A high-intensity relationship between the variables was shown, ≥0.40. Correlation between the COMBI-Spa and the Spanish Glasgow Benefit Inventory (GBI), r=0.89; p<0.01. CONCLUSION: Psychometric testing of the Spanish versions of the COMQ-12-Spa and COMBI-Spa yielded satisfactory results, thus allowing pre- and postintervention assessment of the subjective severity of chronic otitis media in adult patients.

Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients. / Particularidades del abordaje transcanal endoscópico de los tumores benignos de oído medio en adultos.

BACKGROUND AND OBJECTIVE: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarize its key points through a case series. MATERIALS AND METHODS: Retrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry. RESULTS: Six patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (± 21.9). Four tumours were in the left ear and 2 in the right ear. These included 4tympanic paragangliomas (3 type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months. CONCLUSIONS: The present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity.

Timing, Complications, and Safety of Tracheotomy in Critically Ill Patients With COVID-19.

IMPORTANCE: The current coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented needs for invasive ventilation, with 10% to 15% of intubated patients subsequently requiring tracheotomy. OBJECTIVE: To assess the complications, safety, and timing of tracheotomy performed for critically ill patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study assessed consecutive patients admitted to the intensive care unit (ICU) who had COVID-19 that required tracheotomy. Patients were recruited from March 16 to April 10, 2020, at a tertiary referral center. EXPOSURES: A surgical tracheotomy was performed for all patients following recommended criteria for use of personal protective equipment (PPE). MAIN OUTCOMES AND MEASURES: The number of subthyroid operations, the tracheal entrance protocol, and use of PPE. Infections among the surgeons were monitored weekly by reverse-transcriptase polymerase chain reaction of nasopharyngeal swab samples. Short-term complications, weaning, and the association of timing of tracheotomy (early [≤10 days] vs late [>10 days]) with total required days of invasive ventilation were assessed. RESULTS: A total of 50 patients (mean [SD] age, 63.8 [9.2] years; 33 [66%] male) participated in the study. All tracheotomies were performed at the bedside. The median time from intubation to tracheotomy was 9 days (interquartile range, 2-24 days). A subthyroid approach was completed for 46 patients (92%), and the tracheal protocol was adequately achieved for 40 patients (80%). Adequate PPE was used, with no infection among surgeons identified 4 weeks after the last tracheotomy. Postoperative complications were rare, with minor bleeding (in 6 patients [12%]) being the most common complication. The successful weaning rate was higher in the early tracheotomy group than in the late tracheotomy group (adjusted hazard ratio, 2.55; 95% CI, 0.96-6.75), but the difference was not statistically significant. There was less time of invasive mechanical ventilatory support with early tracheotomy compared with late tracheotomy (mean [SD], 18 [5.4] vs 22.3 [5.7] days). The reduction of invasive ventilatory support was achieved at the expense of the pretracheotomy period. CONCLUSIONS AND RELEVANCE: In this cohort study, with the use of a standardized protocol aimed at minimizing COVID-19 risks, bedside open tracheotomy was a safe procedure for patients and surgeons, with minimal complications. Timing of tracheotomy may be important in reducing time of invasive mechanical ventilation, with potential implications to intensive care unit availability during the COVID-19 pandemic.

Juvenile recurrent respiratory papillomatosis treated with combined erlotinib and celecoxib: Initial report.

Recurrent respiratory papillomatosis (RRP) is a chronic disease caused by human papillomavirus (HPV). RRP is a clinical challenge because of the high recurrence rate, poor surgery response, extension to tracheobronchial tree and because of the risk of malignancy in some cases. There is no consensus on which adjuvant therapy is better for those patients with highly recurrent course. Because papilloma cells overexpress the epidermal growth factor receptor (EGFR), together with an increased expression of COX-2 and prostaglandin E2, the combination of erlotinib and celecoxib seems plausible, and could be proposed for patients with poor response to previous lines of treatment.