Jan Christoffer Luers, MD; Maria Grosheva, MD; Markus Stenner, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):325-329. doi:10.1001/archoto.2010.238
ObjectiveTo detect prognostic factors for successful sialoendoscopic removal of salivary stones.DesignRetrospective case series.SettingTertiary referral hospital.PatientsForty-nine consecutive patients who underwent sialoendoscopy for sialolithiasis between January 1, 2008, and January 1, 2010, at University Hospital of Cologne, Cologne, Germany.InterventionsDiagnostic and interventional sialoendoscopy using local anesthesia.Main Outcome MeasuresStone removal rate, size, mobility, shape, and location, as well as clinical follow-up data.ResultsSixty-one percent (39 of 64) of all salivary stones were removed endoscopically. The cutoff point for endoscopic removal was between 5 and 6 mm in stone diameter. Small size, good mobility, round or oval, and distal location of a salivary stone were positive prognostic factors for sialoendoscopic removal, with sialolith mobility having the greatest effect in multivariate analysis.ConclusionSmall size, good mobility, round or oval, and distal location of a salivary stone in the main duct predict significantly greater probability of endoscopic removal and consequently are positive prognostic factors.
Andrew G. Shuman, MD; Emily Light, MS; Stephen H. Olsen, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):331-337. doi:10.1001/archoto.2011.46
Waqas Ullah Khan, BSc; Paolo Campisi, MSc, MD, FRCSC; Sanjeevan Nadarajah, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):339-344. doi:10.1001/archoto.2010.240
ObjectivesTo report (1) our experience with botulinum toxin A injections into the salivary glands of pediatric patients with sialorrhea, (2) the clinical outcomes of these interventions, and (3) the associated complication rates.DesignRetrospective cohort study.SettingUrban pediatric hospital and pediatric rehabilitation center.PatientsForty-five neurologically impaired children.InterventionsPatients received botulinum toxin A intrasalivary injections between January 2004 and May 2008 at the Hospital for Sick Children in Toronto, Ontario, Canada. All patients received sedation or general anesthesia for their botulinum toxin A injections, which were performed using ultrasonographic guidance.Main Outcome MeasuresPosttreatment assessments included the duration of effect, patient complications, saliva consistency, caregiver willingness to repeat the treatment, caregiver satisfaction with the treatment, and caregiver overall assessment of the child's posttreatment quality of life.ResultsForty-five subjects received a total of 91 botulinum toxin A treatments. The mean (SD) duration of effect was 4.6 (5.2) months. Duration of effect (log transformed) was significantly negatively associated with saliva quantity (P = .02), and there was a positive association with both increasing age and female sex, although neither reached statistical significance (P = .08 for each). Seven of the 24 documented complications were major, according to the Society of Interventional Radiology Classification System for Complications by Outcome scale. Thirty-six of the caregivers reported that this treatment improved the child's quality of life (80%).ConclusionUltrasonographically guided botulinum toxin A injections into the salivary glands are safe and efficacious in the management of sialorrhea in children with neurologic disorders.
David Bakhos, MD; Jean-Paul Trijolet, MD; Sylvain Morinière, MD, PhD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):346-350. doi:10.1001/archoto.2011.29
Nooshin Parhizkar, MD; Scott C. Manning, MD; Andrew F. Inglis Jr, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):352-357. doi:10.1001/archoto.2010.243
ObjectiveTo compare airway infantile hemangiomas (IHs) and venous malformations (VMs) clinically, radiographically, endoscopically, and histologically.DesignRetrospective cohort study.SettingTertiary care pediatric hospital.PatientsThe study included patients seen in the Vascular Anomaly Clinic, Seattle Children's Hospital, Seattle, Washington, between 2001 and 2008.MethodsAll patients with airway vascular anomalies were identified by searching the Vascular Anomaly Quality Improvement Database and hospital discharge data. The data, which were analyzed with descriptive statistics and the Fisher exact test, included presenting age, sex, presenting signs, lesion site, and radiographic, endoscopic, and histologic findings..ResultsSeventeen patients with airway lesions were identified, 6 with VMs and 11 with IHs. Patients with VMs presented at a mean (SD) age of 11.3 (13.7) months (age range, 3-39 months), while those with IHs presented at 3 (1.8) months of age (age range, 1-6 months) (P = .03). The patients with IHs were predominantly female (9 of 11 [81%]), while no sex difference was noted among the patients with VMs (3 of 6 [50%]). All patients with IHs presented with stridor and cutaneous lesions, whereas patients with VMs more often presented with hemoptysis or dysphagia (P = .001). Computed tomographic angiograms demonstrated enhancing endolaryngeal lesions in all IHs, while VMs enhanced poorly. Endoscopically, IHs were transglottic, while VMs were postcricoid or epiglottic (P < .001). Histologically, immunostained lesions showed submucosal lobules of capillaries lined by GLUT-1 (glucose transporter isoform 1)–positive endothelium in IHs, whereas VMs consisted of loosely organized venous channels that lacked GLUT-1 staining.ConclusionPatients with airway IHs and VMs differ in presenting age and signs, sex, airway lesion location, enhancement on computed tomographic angiograms, and histologic appearance.
Mark W. Willis, MD; Joshua L. Bonkowsky, MD, PhD; Rajendu Srivastava, MD, FRCP, MPH; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):359-362. doi:10.1001/archoto.2011.37
Eric M. Jaryszak, MD, PhD; Rahul K. Shah, MD; June Amling, MSN, RN, CNS, CCRN; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):363-366. doi:10.1001/archoto.2011.33
Philip K. Robb Jr, BA; Paul M. Weinberger, MD; Helen Perakis, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):368-372. doi:10.1001/archoto.2011.44
Hsin-Ching Lin, MD; Michael Friedman, MD; Hsueh-Wen Chang, PhD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):373-376. doi:10.1001/archoto.2011.53
Ilona Croy, MD; Basile N. Landis, MD; Thomas Meusel, MD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):377-382. doi:10.1001/archoto.2011.32
Xiaofang Wu, MD, MS; Melissa M. Amorn, MD; Pawandeep K. Aujla, MS; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):383-389. doi:10.1001/archoto.2011.34
George A. Gates, MD; Melissa L. Anderson, MS; Susan M. McCurry, PhD; et al.
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Arch Otolaryngol Head Neck Surg. 2011;137(4):390-395. doi:10.1001/archoto.2011.28