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  • McCoul, Edward D  (4)
  • 1
    Online Resource
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    Predictors of Gastrostomy Placement and Dependence in Oropharyngeal Cancer Patients Treated with Chemoradiotherapy
    Jaypee Brothers Medical Publishing ; 2010
    In:  International Journal of Head and Neck Surgery Vol. 1, No. 2 ( 2010-08), p. 79-85
    Details
    In: International Journal of Head and Neck Surgery, Jaypee Brothers Medical Publishing, Vol. 1, No. 2 ( 2010-08), p. 79-85
    Abstract: Treatment of oropharyngeal cancer (OPC) with primary chemoradiotherapy (CRT) may necessitate placement of a gastrostomy tube (GT). We sought to identify factors that may predict GT placement and dependence. Materials and methods A retrospective review of 61 consecutive patients receiving primary CRT for OPC over a 10-year period at a tertiary referral center. Patients with prior head and neck malignancy, distant metastasis, incomplete treatment course, or inadequate follow-up were excluded. Forty-four patients were included for analysis. Results Sixty-one percent of tumors were located in the tonsil and 62% were stage IV disease at presentation. Complete response to CRT occurred in 36 patients, among whom GT placement was more likely when weight loss occurred before the start of CRT than after CRT ( p = 0.028). Continued GT dependence was more likely in patients with GT placement after the start of CRT ( p = 0.019). Multivariate analysis showed significant associations of GT placement with post-treatment dysphagia and mucositis. Advanced tumor stage was a significant predictor of GT dependence. Conclusions Prophylactic GT placement may be advisable in patients receiving CRT for OPC who have pretreatment weight loss. Conversely, GT may be withheld from asymptomatic patients.
    Type of Medium: Online Resource
    ISSN: 0975-7899 , 0976-0539
    URL: Article
    DOI: 10.5005/jp-journals-10001-1014
    Language: English
    Publisher: Jaypee Brothers Medical Publishing
    Publication Date: 2010
    detail.hit.zdb_id: 2625884-5
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  • 2
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    Intramuscular Corticosteroids for Acute Upper Respiratory Infections Affects Healthcare Utilization
    SAGE Publications ; 2020
    In:  Annals of Otology, Rhinology & Laryngology Vol. 129, No. 10 ( 2020-10), p. 988-995
    Details
    In: Annals of Otology, Rhinology & Laryngology, SAGE Publications, Vol. 129, No. 10 ( 2020-10), p. 988-995
    Abstract: To examine the use of intramuscular corticosteroid (IMCS) injections for treatment of acute upper respiratory infections (URI) and the influence on healthcare utilization. Methods: This retrospective cohort study used patient encounter data from a large multicenter regional health care system between 2013 and 2017. Adult patients diagnosed with acute URI (acute pharyngitis, acute sinusitis, acute otitis media, and URI not otherwise specified) during ambulatory encounters were included. Follow-up encounters for a diagnosis of acute URI within 60 days were identified and patient characteristics, encounter details, and procedure codes were retrieved. Frequency data was used to calculate IMCS injection administration prevalence, utilization trends, and associations with covariates. Follow-up data for return encounters within 60 days for the same diagnosis was examined. Results: Of the 153 848 initial encounters, 34 600 (22.5%) patients received IMCS injection for acute URI. Injection rates varied from 0.85% to 49.1% depending on specialty and practitioner type. Internal medicine, family medicine, urgent care, and otorhinolaryngology clinics most commonly administered IMCS. 3788 patients returned for a second encounter of which 751 (19.8%) received an injection. IMCS injection during the first encounter was associated with increased odds of repeat visit within 60 days (OR: 1.74; 95% CI: 1.61–1.88). Conclusion: IMCS use in the treatment of acute URI is highly prevalent despite lack of evidence for impact and safety. Prevalence is variable across multiple medical and surgical specialties including otorhinolaryngology. Administration of IMCS injection may contribute to the likelihood of a subsequent healthcare visit for the same indication.
    Type of Medium: Online Resource
    ISSN: 0003-4894 , 1943-572X
    URL: Article
    DOI: 10.1177/0003489420929717
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2033055-8
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  • 3
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    Symptom Localization May Differentiate Subtypes of Eustachian Tube Dysfunction
    Wiley ; 2023
    In:  The Laryngoscope Vol. 133, No. 8 ( 2023-08), p. 1818-1823
    Details
    In: The Laryngoscope, Wiley, Vol. 133, No. 8 ( 2023-08), p. 1818-1823
    Abstract: To evaluate the predictive ability of symptom self‐localization to distinguish obstructive eustachian tube dysfunction from non‐obstructive salpingitis. Methods Adult (age ≥18 years) patients with a primary complaint of aural discomfort who underwent diagnostic nasal endoscopy and tympanometry at a tertiary academic center were enrolled. Symptoms were self‐localized by using a single finger on the affected side. All patients completed the 7‐item Eustachian Tube Dysfunction Questionnaire (ETDQ‐7) and underwent scoring of eustachian tube inflammation using the Endoscopic Evaluation of the Eustachian Tube (3ET) system. Results Seventy‐three patients were included in the study. Symptoms were localized to the external auditory canal (EAC) in 28 (38.4%), to the infratemporal fossa (ITF) below the lobule in 37 (50.7%), and to the preauricular region in 8 (11.0%). Demographics and medical history were similar between groups. The EAC group had significantly more negative tympanometric peak pressure (TPP) (median, −92.0 daPa; IQR, 95.5) and higher 3ET scores. In contrast, the ITF group had normal TPP (median, −2.0 daPa; IQR, 7.0) and higher 3ET scores. The preauricular group was more likely to have temporomandibular joint or pterygoid muscle pain. ETDQ‐7 scores did not differ significantly between groups. Conclusion Symptom localization is associated with specific objective findings in the evaluation of aural discomfort. Patients with pain localizing to the ITF are more likely to have findings of eustachian tube salpingitis without obstruction whereas patients with symptoms deep in the EAC are more likely to have findings consistent with obstructive eustachian tube dysfunction. Level of Evidence 3 Laryngoscope , 133:1818–1823, 2023
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v133.8
    DOI: 10.1002/lary.30436
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2026089-1
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  • 4
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    Frontal Sinus Surgery: The State of the Art
    Jaypee Brothers Medical Publishing ; 2016
    In:  International Journal of Head and Neck Surgery Vol. 7, No. 1 ( 2016-03), p. 5-12
    Details
    In: International Journal of Head and Neck Surgery, Jaypee Brothers Medical Publishing, Vol. 7, No. 1 ( 2016-03), p. 5-12
    Abstract: Review and describe the essential components of modern frontal sinus surgery. Background Frontal sinus surgery has evolved considerably over the last century, and advances in imaging, optics, and instrumentation have contributed to contemporary treatment paradigms. Outcomes assessment has had an important role in identifying indications for surgery and future areas of research. Review results Numerous advancements are part of modern frontal sinus surgery and the treatment of frontal sinusitis. Anatomic studies have revealed variations that are associated with disease and pose challenges for surgery. Open approaches remain relevant in situations of difficult disease or as part of combined approaches. Endoscopic surgery, however, is central to contemporary surgical management of frontal sinus disease. Evolving instrumentation and the development of new implantable devices are increasingly relevant in the endoscopic era. Outcomes research has refined indications for surgery and identifies areas for ongoing research. Conclusion State-of-the-art frontal sinus surgery is the product of significant evolution and advancement. Modern surgery is reflective of improved optics and new instrumentation, and the central role of endoscopic approaches in treating frontal sinus disease. Outcomes research has been essential for developing an evidenced-based approach to frontal sinus surgery. Clinical significance A review of the essential components of state-of-the-art frontal sinus surgery for the practicing otolaryngologist. How to cite this article Marino MJ, McCoul ED. Frontal Sinus Surgery: The State of the Art. Int J Head Neck Surg 2016;7(1): 5-12.
    Type of Medium: Online Resource
    ISSN: 0975-7899 , 0976-0539
    URL: Article
    DOI: 10.5005/jp-journals-10001-1257
    Language: English
    Publisher: Jaypee Brothers Medical Publishing
    Publication Date: 2016
    detail.hit.zdb_id: 2625884-5
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