OBJECTIVETo evaluate the safety and long‐term effectiveness of a new treatment for snoring using ... more OBJECTIVETo evaluate the safety and long‐term effectiveness of a new treatment for snoring using permanent palatal implants.STUDY DESIGNProspective study with 35 patients referred to the clinic for the treatment of snoring. The patients were followed for 1 year, and a sleep analysis was performed and repeated at 360 days. During the procedure, 3 braided polyethylene terephthalate implants were placed in the palate of each patient.RESULTSThe average duration for nonnarcotic analgesics was 1.3 days. No adverse events were observed. The mean snoring intensity was reduced from 7.1 at baseline to 4.8 at 1 year (P < 0.001). Bed partner satisfaction rate was very high at 70.6% after 1 year. Six patients (17.8%) experienced a total of 9 partial extrusions.CONCLUSIONSThe palatal implant system is safe, and the effectiveness in treating snoring is comparable to other surgical methods. Advantages are virtually no tissue damage and minimal patient discomfort as a result of one standardized, low‐cost procedure.
Sponsorships or competing interests that may be relevant to content are dis-closed at the end of ... more Sponsorships or competing interests that may be relevant to content are dis-closed at the end of this article. Objective. The Unified Airways Hypothesis suggests an invol-vement of the upper airways in asthma. We aimed to evaluate the association between subjective sino-nasal complaints, nasal air flow, and sino-nasal quality of life (QOL) in patients with asthma compared with nonasthmatic subjects. Study Design. Case-control study. Setting. A tertiary referral center. Subjects and Methods. Symptoms, quality of life, and nasal air-flow were assessed in 91 asthmatics and 95 nonasthmatic controls with Visual Analog Scale (VAS, 0-100), Sino-Nasal Outcome Test (SNOT-20), and Peak Nasal Inspiratory Flow (PNIF), respectively. Asthma and allergy status were assessed by Asthma Control Questionnaire (ACQ) and skin prick test or specific IgE. Results. Asthmatic patients (men/women, 37/54; mean age, 43.7 years; range, 19-64 years) reported significantly more
Purpose The aim of this study was to validate the Patient Reported Outcome Measure (PROM) in the ... more Purpose The aim of this study was to validate the Patient Reported Outcome Measure (PROM) in the Norwegian Tonsil Surgery Register (NTSR) and to examine whether any improvements to the questionnaire could be useful. Methods This is a prospective, descriptive study. NTSR collects data from patients who undergo tonsil surgery and the intention of the register is to improve the quality of treatment and to contribute to research. The patients answers questions about admission due to postoperative haemorrhage, infection and pain 30 days after surgery. 305 patients were contacted on phone 1–2 weeks after answering the questionnaires electronically (ePROM) and asked the same questions. 180 of 305 patients we contacted had some kind of complications after surgery. They were asked additional questions to search for possible points for improvement of the questionnaire. Results When comparing the results on the ePROM with the answers on phone, we found that 12 out of 14 variables achieve almos...
Background: Nasal polyposis (NP) is considered to be a subgroup of chronic rhinosinusitis (CRS). ... more Background: Nasal polyposis (NP) is considered to be a subgroup of chronic rhinosinusitis (CRS). However differences in cellular and mediator profiles suggest that they could be distinct entities. Objective: To look for group differences in characteristics and symptom severity before and after surgery in patients suffering from CRS and bilateral NP that could clinically support the hypothesis that NP and CRS are different pathological processes and to compare the effect of functional endoscopic sinus surgery (FESS) in CRS patients and NP patients. Materials and methods: Forty-five patients with CRS and 57 patients with bilateral NP were included in this prospective trial. We used t-tests for independent groups to compare preoperative symptoms as recorded on visual analogue scale (VAS). To evaluate if there were differences in symptom improvement between the groups we used analysis of covariance. Categorical variables were compared using exact tests. Results: Mean age was 38 years for the CRS group and 47 years for the NP group, the difference was significant (p = 0.0001). NP patients underwent significantly more posterior ethmoidectomies than patients suffering from CRS (p = 0.001), and asthma was significantly more prevalent in NP than in CRS (p = 0.007). Comparing preoperative symptoms as recorded on VAS we found significant differences. While patients with NP suffered significantly more from nasal blockage and change in their sense of smell than CRS patients, patients with CRS presented with more facial pain and headache. There were no differences in symptom improvement, as both conditions responded similarly to FESS. Conclusion: Differences in symptom severity, nasal endoscopy, age of patients and prevalence of asthma indicate that NP and CRS are different entities. Nevertheless, both conditions respond similarly to FESS.
To investigate low-frequency vertex bone-conducted (BC) vibration for evoking ocular vestibular m... more To investigate low-frequency vertex bone-conducted (BC) vibration for evoking ocular vestibular myogenic potentials (oVEMPs) and its ability to discriminate between lesioned and healthy ears. oVEMPs were analysed in response to 125-Hz single cycle vertex BC vibration in healthy subjects (n=50) and in patients with severe unilateral vestibular loss (n=10). Both positive and negative initial stimulus motions were used. In most healthy subjects, vertex BC vibration oVEMPs was successfully and symmetrically evoked from both ears. The response was dependent on the direction of the stimulus motion. The latency was shorter with negative initial stimulus motion; however, a positive initial stimulus motion generated somewhat larger amplitudes. Furthermore, there was no significant response from lesioned ears, whereas oVEMPs from the patients' healthy ears were similar to the responses in healthy subjects. The oVEMP low-frequency BC response was dependent on the direction of the initial stimulus motion. Testing oVEMPs in response to low-frequency vertex vibration can discriminate patients with unilateral vestibular function loss from healthy controls. Low-frequency vertex BC vibration oVEMPs should be considered a possible clinical screening test to evaluate vestibular function.
ObjectiveData from the Norwegian Tonsil Surgery Register (NTSR) showed large differences between ... more ObjectiveData from the Norwegian Tonsil Surgery Register (NTSR) showed large differences between the hospitals in Norway in the readmission rate due to post-tonsillectomy haemorrhage (rrPTH; range, 0%–25%; national average, 8%). Because of these large variations in the rrPTH, we conducted a quality improvement project involving hospitals with good and bad readmission rates.MethodsSeven hospitals with readmission rates greater than 10% and four with rates lower than 5% participated in this project. We recorded videos of ear, nose and throat surgeons from the hospitals with low readmission rates when they performed extracapsular tonsillectomy, and these videos of cold dissection tonsillectomy were used as teaching material for examples of good surgical skills for the other hospitals. After a 2-day workshop, all participants from the hospitals went back to their institutions and prepared local plans to improve their results. We used the Plan–Do–Study–Act model. The primary outcome vari...
ObjectivesTo compare the application of indications, demographics, surgical and haemostatic techn... more ObjectivesTo compare the application of indications, demographics, surgical and haemostatic techniques in tonsil surgery in three countries.DesignNon-randomised, prospective, observational cohort.SettingAll patients registered in the National Tonsil Surgery Quality Registers in Sweden, Norway and West Jutland, Denmark.ParticipantsData were retrieved from 2017 to 2019; registered surgeries: Sweden: 20 833; Norway: 10 294 and West Jutland, Denmark: 505.ResultsTonsil surgery for obstruction was twice as common in Sweden (62.2%) compared with Norway (31%) and Denmark (27.7%). Recurrent tonsillitis was registered twice as frequently in Norway (35.7%) and Denmark (39%) compared with Sweden (16.7%). Chronic tonsillitis was registered more frequently in Norway (29.8%) than in Sweden (13.8%) and Denmark (12.7%). Day surgery (>76%) was comparable. The higher frequency of obstruction in Sweden affected age and gender distributions: Sweden (7 years, 50.4% boys), Norway (17 y, 42.1%) and Denm...
OBJECTIVETo evaluate the safety and long‐term effectiveness of a new treatment for snoring using ... more OBJECTIVETo evaluate the safety and long‐term effectiveness of a new treatment for snoring using permanent palatal implants.STUDY DESIGNProspective study with 35 patients referred to the clinic for the treatment of snoring. The patients were followed for 1 year, and a sleep analysis was performed and repeated at 360 days. During the procedure, 3 braided polyethylene terephthalate implants were placed in the palate of each patient.RESULTSThe average duration for nonnarcotic analgesics was 1.3 days. No adverse events were observed. The mean snoring intensity was reduced from 7.1 at baseline to 4.8 at 1 year (P < 0.001). Bed partner satisfaction rate was very high at 70.6% after 1 year. Six patients (17.8%) experienced a total of 9 partial extrusions.CONCLUSIONSThe palatal implant system is safe, and the effectiveness in treating snoring is comparable to other surgical methods. Advantages are virtually no tissue damage and minimal patient discomfort as a result of one standardized, low‐cost procedure.
Sponsorships or competing interests that may be relevant to content are dis-closed at the end of ... more Sponsorships or competing interests that may be relevant to content are dis-closed at the end of this article. Objective. The Unified Airways Hypothesis suggests an invol-vement of the upper airways in asthma. We aimed to evaluate the association between subjective sino-nasal complaints, nasal air flow, and sino-nasal quality of life (QOL) in patients with asthma compared with nonasthmatic subjects. Study Design. Case-control study. Setting. A tertiary referral center. Subjects and Methods. Symptoms, quality of life, and nasal air-flow were assessed in 91 asthmatics and 95 nonasthmatic controls with Visual Analog Scale (VAS, 0-100), Sino-Nasal Outcome Test (SNOT-20), and Peak Nasal Inspiratory Flow (PNIF), respectively. Asthma and allergy status were assessed by Asthma Control Questionnaire (ACQ) and skin prick test or specific IgE. Results. Asthmatic patients (men/women, 37/54; mean age, 43.7 years; range, 19-64 years) reported significantly more
Purpose The aim of this study was to validate the Patient Reported Outcome Measure (PROM) in the ... more Purpose The aim of this study was to validate the Patient Reported Outcome Measure (PROM) in the Norwegian Tonsil Surgery Register (NTSR) and to examine whether any improvements to the questionnaire could be useful. Methods This is a prospective, descriptive study. NTSR collects data from patients who undergo tonsil surgery and the intention of the register is to improve the quality of treatment and to contribute to research. The patients answers questions about admission due to postoperative haemorrhage, infection and pain 30 days after surgery. 305 patients were contacted on phone 1–2 weeks after answering the questionnaires electronically (ePROM) and asked the same questions. 180 of 305 patients we contacted had some kind of complications after surgery. They were asked additional questions to search for possible points for improvement of the questionnaire. Results When comparing the results on the ePROM with the answers on phone, we found that 12 out of 14 variables achieve almos...
Background: Nasal polyposis (NP) is considered to be a subgroup of chronic rhinosinusitis (CRS). ... more Background: Nasal polyposis (NP) is considered to be a subgroup of chronic rhinosinusitis (CRS). However differences in cellular and mediator profiles suggest that they could be distinct entities. Objective: To look for group differences in characteristics and symptom severity before and after surgery in patients suffering from CRS and bilateral NP that could clinically support the hypothesis that NP and CRS are different pathological processes and to compare the effect of functional endoscopic sinus surgery (FESS) in CRS patients and NP patients. Materials and methods: Forty-five patients with CRS and 57 patients with bilateral NP were included in this prospective trial. We used t-tests for independent groups to compare preoperative symptoms as recorded on visual analogue scale (VAS). To evaluate if there were differences in symptom improvement between the groups we used analysis of covariance. Categorical variables were compared using exact tests. Results: Mean age was 38 years for the CRS group and 47 years for the NP group, the difference was significant (p = 0.0001). NP patients underwent significantly more posterior ethmoidectomies than patients suffering from CRS (p = 0.001), and asthma was significantly more prevalent in NP than in CRS (p = 0.007). Comparing preoperative symptoms as recorded on VAS we found significant differences. While patients with NP suffered significantly more from nasal blockage and change in their sense of smell than CRS patients, patients with CRS presented with more facial pain and headache. There were no differences in symptom improvement, as both conditions responded similarly to FESS. Conclusion: Differences in symptom severity, nasal endoscopy, age of patients and prevalence of asthma indicate that NP and CRS are different entities. Nevertheless, both conditions respond similarly to FESS.
To investigate low-frequency vertex bone-conducted (BC) vibration for evoking ocular vestibular m... more To investigate low-frequency vertex bone-conducted (BC) vibration for evoking ocular vestibular myogenic potentials (oVEMPs) and its ability to discriminate between lesioned and healthy ears. oVEMPs were analysed in response to 125-Hz single cycle vertex BC vibration in healthy subjects (n=50) and in patients with severe unilateral vestibular loss (n=10). Both positive and negative initial stimulus motions were used. In most healthy subjects, vertex BC vibration oVEMPs was successfully and symmetrically evoked from both ears. The response was dependent on the direction of the stimulus motion. The latency was shorter with negative initial stimulus motion; however, a positive initial stimulus motion generated somewhat larger amplitudes. Furthermore, there was no significant response from lesioned ears, whereas oVEMPs from the patients' healthy ears were similar to the responses in healthy subjects. The oVEMP low-frequency BC response was dependent on the direction of the initial stimulus motion. Testing oVEMPs in response to low-frequency vertex vibration can discriminate patients with unilateral vestibular function loss from healthy controls. Low-frequency vertex BC vibration oVEMPs should be considered a possible clinical screening test to evaluate vestibular function.
ObjectiveData from the Norwegian Tonsil Surgery Register (NTSR) showed large differences between ... more ObjectiveData from the Norwegian Tonsil Surgery Register (NTSR) showed large differences between the hospitals in Norway in the readmission rate due to post-tonsillectomy haemorrhage (rrPTH; range, 0%–25%; national average, 8%). Because of these large variations in the rrPTH, we conducted a quality improvement project involving hospitals with good and bad readmission rates.MethodsSeven hospitals with readmission rates greater than 10% and four with rates lower than 5% participated in this project. We recorded videos of ear, nose and throat surgeons from the hospitals with low readmission rates when they performed extracapsular tonsillectomy, and these videos of cold dissection tonsillectomy were used as teaching material for examples of good surgical skills for the other hospitals. After a 2-day workshop, all participants from the hospitals went back to their institutions and prepared local plans to improve their results. We used the Plan–Do–Study–Act model. The primary outcome vari...
ObjectivesTo compare the application of indications, demographics, surgical and haemostatic techn... more ObjectivesTo compare the application of indications, demographics, surgical and haemostatic techniques in tonsil surgery in three countries.DesignNon-randomised, prospective, observational cohort.SettingAll patients registered in the National Tonsil Surgery Quality Registers in Sweden, Norway and West Jutland, Denmark.ParticipantsData were retrieved from 2017 to 2019; registered surgeries: Sweden: 20 833; Norway: 10 294 and West Jutland, Denmark: 505.ResultsTonsil surgery for obstruction was twice as common in Sweden (62.2%) compared with Norway (31%) and Denmark (27.7%). Recurrent tonsillitis was registered twice as frequently in Norway (35.7%) and Denmark (39%) compared with Sweden (16.7%). Chronic tonsillitis was registered more frequently in Norway (29.8%) than in Sweden (13.8%) and Denmark (12.7%). Day surgery (>76%) was comparable. The higher frequency of obstruction in Sweden affected age and gender distributions: Sweden (7 years, 50.4% boys), Norway (17 y, 42.1%) and Denm...
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