Quality of life outcome measures following partial glossectomy: assessment using the UW-QOL scale.
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BACKGROUND: The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL) in these patients. AIMS: To determine the QOL in head and neck cancer patients following a partial glossectomy operation. DESIGN AND SETTING: Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. MATERIALS AND METHODS: 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL) scale, version 4. STATISTICAL ANALYSIS: Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III). Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. RESULTS: The mean (sd) composite score of the QOL in our series was 73.6 (16.1). The majority (71.8%) quoted their QOL as good or very good. Swallowing (n = 16, 47.1%), speech (n = 15, 44.1%) and saliva (n = 15, 44.1%) were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.005). CONCLUSION: The composite score and overall QOL as assessed using the UW-QOL scale (version 4) were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores. (+info)
Endoscopic surgical treatment of paranasal sinus mucocele.
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Historically, the recommended treatment for paranasal sinus mucoceles is the complete excision of through an open approach to achieve a cure. Though with the advent of Endoscopic sinus surgery, transnasal Endoscopic sinus surgery has gained more attention in order to manage the sinus mucocele. The aim of this study is to present the efficacy of the Endoscopic marsupialization of sinus mucoceles. From 2001 to 2005, 18 patients with paranasal sinus mucoceles were treated endoscopically. This series includes 6 fronto-ethmoidal, 2 maxillary, 4 ethmoid, 2 sphenoid, and 4 middle turbinate. The presenting signs, symptoms, and radiological findings were reviewed. All patients underwent endoscopic-wide marsupialization of the mucocele; the mean follow up was 13 months. There are 10 male and 8 female subjects who were of an age range of 29-72 years. Patients were treated with endoscopic marsupialization of the mucocele. There were no recurrences in the mean 13-month follow-ups in 17(94%) of patients. Only one patient needed revision endoscopic surgery. Mucocele happens to be the most commonly benign lesion, which causes the paranasal sinus to expand. There is increasing evidence that endoscopic marsupialization of sinus mucocele results in long-term control with very low recurrence rate at or close to 0%. Thus this technique is safe and less invasive than external approaches. (+info)
Orbital exenteration in elderly patients: personal experience.
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Orbital exenteration is a disfiguring procedure which typically involves removal of the entire contents of the orbit including the periorbita, appendages, eyelids and, sometimes, a varying amount of surrounding skin. This operation is reserved for the treatment of potentially life-threatening malignancies arising from the orbit, paranasal sinuses or periocular skin. The marked increase in the average life span and resulting greater incidence of invasive malignant skin tumours of the face, typical of old age, is the reason for the increased rate of exenterations in elderly patients. The purpose of this report is to describe personal experience regarding 8 operations of orbital exenteration carried out on elderly patients, 6 males and 2 females, age range 66-85 years (mean 75), who came to our observation, from January 2002 to December 2007, on account of cancer (7 cases: 4 basal cell carcinomas; 1 squamous cell carcinoma; 1 fibrosarcoma; 1 melanoma) or infectious inflammatory disease (1 case of rhinocerebral mucormycosis) and were treated with type III orbital exenteration (2 cases) and type IV orbital exenteration (6 cases according to Meyer and Zaoli's classification). The methods used to reconstruct the eye-socket consisted of a full-thickness skin graft in 5 cases, pedicled myocutaneous flaps in 2 cases--a latissimus dorsi muscle flap alone, in one patient, and combined with a pectoralis major muscle flap in another - and a combined lateral-based frontal fasciocutaneous pedicled flap and full-thickness skin graft in the oldest patient. Regarding survival and the local clinical situation, 3 of the 4 patients with basal cell carcinomas are alive and disease-free after 6 years, 2 years and 20 months, respectively, while the oldest patient died of the disease after 10 months. The subject who underwent surgery for squamous cell carcinoma is alive and disease-free after 2 years. The patients with melanoma, fibrosarcoma and mucormycosis died. Although there are various options available for reconstruction, full-thickness skin graft or a pedicled muscolocutaneous flap provide the simplest solution in the elderly population with significant co-morbidities. The final outcome is, in our experience, comparable to that of more complex flap reconstruction, obtaining very good final results with minimal donor site morbility and a reduced operation time. (+info)
Magnetic acupressure for management of postoperative nausea and vomiting: a preliminary study.
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BACKGROUND: To assess the efficacy of magnetic acupressure in the prevention of postoperative nausea and vomiting (PONV). METHODS: Fifty-eight patients were included in this randomized, double blind, preliminary prospective study. Thirty-three underwent ear, nose, and throat (ENT) procedures and twenty-five underwent gynaecological procedures. A magnet patch (M) or a placebo patch (P) was applied to patients in each group randomly. The patch was applied 15 min before surgery to P6 a point situated above the wrist, on the medial aspect of the arm between the palmaris longus and flexor carpi radicis (REF point). Anaesthesia was standardized for all patients. Primary study endpoints included PONV scores and number of rescue antiemetic administrations. Secondary endpoints included pain scores, percentage of patients who required rescue analgesics and satisfaction scores. Study variables were measured on arrival in the PACU and 8, 16 and 24 h after surgery. RESULTS: The global incidence of PONV was 50%. We found no significant difference in the incidence of PONV between ENT patients (46%) and gynaecology patients (56%), and no difference between patients who received magnet treatment (47%) and those that did not (54%). Patients receiving the magnet had a similar satisfaction level (75% satisfied) to those receiving placebo (73% satisfied). In addition, magnet-treated patients had similar pain and PONV scores, and a similar percentage of patients in each groups received postoperative rescue analgesics. Finally, there was no difference in the number of rescue antiemetic administrations between the two groups. CONCLUSION: The use of magnetic acupressure as a prophylactic antiemetic treatment prior to ENT or gynaecology surgeries produced no benefit when compared to placebo. (+info)
Ear, nose and throat day-case surgery at a district general hospital.
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