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The Journal of Laryngology and Otology Jul 2016A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal... (Review)
Review
OBJECTIVE
A systematic review was performed to evaluate the safety and efficacy of different therapeutic interventions available for the management of isolated cricopharyngeal dysfunction.
METHODS
Studies were identified using the following databases: Ovid (Medline, Embase), the Cochrane Library, PubMed and Google Scholar. An initial search identified 339 articles. All titles and abstracts were reviewed. Fifty-six relevant articles were inspected in more detail; of these, 47 were included in the qualitative analysis.
RESULTS
No relevant randomised trials were found. A range of case series were used to perform a qualitative analysis. Botulinum toxin A injection and cricopharyngeal dilatation were associated with a higher risk of recurrence, but appear to be more suitable in elderly and co-morbid patients. In those patients requiring formal myotomy, endoscopic approaches appear to be as effective but less morbid when compared with classical open surgery.
CONCLUSION
There is good evidence for the safety and efficacy of the different therapeutic options for isolated cricopharyngeal dysfunction. However, further studies are required to compare the efficacy of the various treatment modalities.
Topics: Botulinum Toxins, Type A; Deglutition Disorders; Dilatation; Humans; Injections, Intramuscular; Laryngoscopy; Neuromuscular Agents; Pharyngeal Diseases; Pharyngeal Muscles
PubMed: 27194375
DOI: 10.1017/S0022215116007994 -
World Neurosurgery Feb 2017Acquired Chiari malformations (ACM) and associated syringomyelia secondary to space-occupying lesions can cause neurologic deficits independent of or in combination with... (Review)
Review
BACKGROUND
Acquired Chiari malformations (ACM) and associated syringomyelia secondary to space-occupying lesions can cause neurologic deficits independent of or in combination with the offending mass. Although type I Chiari malformations are traditionally treated with posterior fossa decompression, optimal surgical management of ACM and associated syringomyelia remains unclear. The purpose of this study is to review the current literature surrounding the management of ACM.
METHODS
A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Using the relevant keywords, articles were identified through multiple databases from inception to April 2016. Our primary outcome was postoperative resolution of tonsillar herniation, syringomyelia, and clinical symptoms and signs.
RESULTS
Thirty studies (27 case reports and 3 case series), encompassing 44 patients, were included in the review. Meningiomas (36%) and arachnoid cysts (32%) were the lesions most commonly associated with ACM. Offending lesions were usually large (85%) and almost all were found in the posterior fossa (89%). Syringomyelia was present in 82% of cases. Overall, all but 1 patient had improvement or resolution of their syringomyelia after surgery and none required a syrinx shunt. Rates of tonsillar ascent, syrinx resolution, and neurologic recovery were similar in patients who underwent lesion removal alone versus those who underwent posterior fossa decompression and lesion removal.
CONCLUSIONS
Space-occupying lesions in the posterior fossa are a rare cause of ACM and syringomyelia. Surgical management of the underlying lesion improves ACM and associated syringomyelia without the need for syrinx shunting.
Topics: Adolescent; Adult; Arachnoid Cysts; Arnold-Chiari Malformation; Child; Child, Preschool; Female; Humans; Male; Meningioma; Middle Aged; Pharyngeal Diseases; Radiology; Syringomyelia; Treatment Outcome; Young Adult
PubMed: 27894943
DOI: 10.1016/j.wneu.2016.11.080 -
International Journal of... 2015Tongue cancer is known to negatively affect both speech and swallowing function; however this is the first review to report speech-language pathology (SLP) intervention... (Review)
Review
PURPOSE
Tongue cancer is known to negatively affect both speech and swallowing function; however this is the first review to report speech-language pathology (SLP) intervention for both functions following partial glossectomy.
METHOD
Using a PRISMA approach, systematic screening of nine databases was undertaken. Original studies reporting SLP rehabilitation for speech and/or swallowing dysfunction with participants following partial glossectomy as primary cancer treatment were included.
RESULT
These studies are discussed in terms of SLP assessment and intervention trends as well as quality according to current research method standards (levels of evidence, Pedro-P, SCED) in order to determine suitability for guiding current clinical practice.
CONCLUSION
Publications were few (n = 7) and mostly of non-experimental design. This review highlights the gap in evidence and questions the rationale of current SLP rehabilitation following partial glossectomy.
Topics: Deglutition Disorders; Glossectomy; Humans; Speech Disorders; Speech-Language Pathology; Tongue Neoplasms
PubMed: 25515427
DOI: 10.3109/17549507.2014.979880 -
Annals of Epidemiology Sep 2023To estimate the burden of alcohol-attributable cancer in East Asian populations accounting for aldehyde dehydrogenase-2 (ALDH2) genotype-specific cancer risk and alcohol... (Meta-Analysis)
Meta-Analysis
PURPOSE
To estimate the burden of alcohol-attributable cancer in East Asian populations accounting for aldehyde dehydrogenase-2 (ALDH2) genotype-specific cancer risk and alcohol exposure.
METHODS
We conducted a systematic review and meta-analysis of eight databases on cancer risk to derive alcohol dose-response curves by ALDH2 genotype. A simulation-based approach using the Global Burden of Disease (GBD) modeling framework was applied to estimate the population attributable fraction, incidence, and disability-adjusted life-years (DALYs) lost to alcohol-attributable cancer.
RESULTS
We included 34 studies (66,655 participants) from China, Japan, and South Korea in the meta-analysis. Alcohol dose-response curves for liver, esophageal, and oral cavity/pharynx cancer showed an increased risk for people with the inactivated ALDH2 genetic polymorphism, resulting in a higher burden of alcohol-attributable cancer compared to GBD estimates. Our methods estimated annual incidence of cancer of 230,177 cases, an underestimate of 69,596 cases compared to GBD estimates. Similarly, total DALYs lost annually were underestimated by 1.20 million.
CONCLUSIONS
The burden of liver, esophageal, and oral cavity/pharynx cancer attributable to alcohol is underestimated in populations with the ALDH2 genetic polymorphism when compared to current estimates.
Topics: Humans; Alcohol Drinking; Asia, Eastern; Ethanol; Esophageal Neoplasms; Polymorphism, Genetic; Pharyngeal Neoplasms; Risk Factors; Aldehyde Dehydrogenase, Mitochondrial
PubMed: 37268241
DOI: 10.1016/j.annepidem.2023.05.013 -
Journal of Gastrointestinal Cancer Jun 2016Liposarcoma is the most common soft tissue sarcoma in adults. It represents approximately 20 % of all mesenchymal malignancies. It most frequently involves... (Review)
Review
PURPOSE
Liposarcoma is the most common soft tissue sarcoma in adults. It represents approximately 20 % of all mesenchymal malignancies. It most frequently involves retroperitoneum, trunk, and extremities. Hypopharyngeal and esophageal localization of liposarcoma is extremely rare.
METHODS
We performed a systematic review of literature and reported 26 and 33 cases of hypopharyngeal and esophageal liposarcoma. We analyzed natural history, imaging features, histology, treatment, and prognosis, with a specific focus to similarities and differences between tumors of hypopharynx and esophagus.
RESULTS
Hypopharyngeal and esophageal liposarcomas have more similarities than differences. Incidence has a peak at 6th and 7th decades. The diagnostic procedures are barium swallow, endoscopic examination, and CT/MR imaging. Well-differentiated liposarcoma represents the most frequent histological subtype. Surgical excision is the main treatment. Endoscopic resection can be useful for pedunculated tumors of hypopharynx and cervical esophagus. Differences between hypopharyngeal and esophageal liposarcoma are represented by local recurrence rate (greater for hypopharyngeal tumors), number of giant tumors, and time to recurrence (greater for esophageal tumors). Finally, liposarcomas of distal esophagus need more extended approaches.
CONCLUSIONS
Liposarcomas of hypopharynx and cervical esophagus could be considered a unique pathological entity, with similar features and treatment options. Survival rate is dependent on histological type and location. Local recurrence is common, especially for hypopharyngeal liposarcoma, while the risk of lymph node or distant metastasis is very low. Patients should undergo regular examinations to rule out local recurrence, also for a long time, especially for esophageal tumors.
Topics: Adult; Aged; Aged, 80 and over; Esophagus; Female; Humans; Hypopharyngeal Neoplasms; Hypopharynx; Liposarcoma; Male; Middle Aged; Young Adult
PubMed: 26875081
DOI: 10.1007/s12029-016-9808-6 -
Otolaryngology--head and Neck Surgery :... Apr 2020An increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This...
OBJECTIVE
An increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This systematic review aims to provide insight into the effects of time to treatment intervals on oncologic and functional outcomes in oral cavity, pharyngeal, and laryngeal cancer.
DATA SOURCES
PubMed, EMBASE, and Cochrane library were searched.
REVIEW METHODS
All studies on delay or time to diagnosis or treatment in oral, pharyngeal, and laryngeal cancer were included. Quality assessment was performed with an adjusted version of the Newcastle-Ottawa scale. Outcomes of interest were tumor volume, stage, recurrence, survival, patient-reported outcome measures (PROMs), toxicity, and functionality after treatment.
RESULTS
A total of 51 studies were included. Current literature on the influence of delay in HNC is inconsistent but indicates higher stage and worse survival with longer delay. The effects on PROMs, toxicity, and functional outcome after treatment have not been investigated. The inconsistencies in outcomes were most likely caused by factors such as heterogeneity in study design, differences in the definitions of delay, bias of results, and incomplete adjustment for confounding factors in the included studies.
CONCLUSION
Irrespective of the level of evidence, the unfavorable effects of delay on oncologic, functional, and psychosocial outcomes are undisputed. Timely treatment while maintaining high-quality diagnostic procedures and decision making reflects good clinical practice in our opinion. This review will pose practical and logistic challenges that will have to be overcome.
Topics: Humans; Laryngeal Neoplasms; Mouth Neoplasms; Pharyngeal Neoplasms; Time-to-Treatment; Treatment Outcome
PubMed: 32093572
DOI: 10.1177/0194599820906387 -
The Cochrane Database of Systematic... Jul 2015Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their... (Review)
Review
BACKGROUND
Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness.
OBJECTIVES
To assess the effects of antibiotics in patients with recurrent sore throat.
SEARCH METHODS
The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent sore throat, defined as three or more sore throats in a year, examining the incidence of sore throat recurrence, with follow-up of at least 12 months post-antibiotic therapy.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response.
MAIN RESULTS
We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report.
AUTHORS' CONCLUSIONS
There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent sore throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent sore throat on the following outcomes: incidence of sore throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
Topics: Adult; Anti-Bacterial Agents; Child; Humans; Pharyngitis; Recurrence; Secondary Prevention
PubMed: 26171901
DOI: 10.1002/14651858.CD008911.pub2 -
Psychogeriatrics : the Official Journal... Jul 2021There is no consensus regarding the association between dysphagia and cognition. The aim of this study was to quantitatively and qualitatively analyze the available... (Meta-Analysis)
Meta-Analysis Review
There is no consensus regarding the association between dysphagia and cognition. The aim of this study was to quantitatively and qualitatively analyze the available evidence on the direction and strength of the association between dysphagia and cognition. PubMed, Scopus, Embase, and Web of Science were searched for studies about the association between dysphagia and cognition. A random effects model was used to determine weighted odds ratios and 95% confidence intervals. Sensitivity analysis was performed to determine the impact of each individual study on the pooled results. A total of 1427 participants showed that some cognitive disorders were significantly associated with dysphagia (odds ratio = 3.23, 95% confidence interval: 2.33-4.48). The association between cognition and swallowing disorders suggests that multiple neuroanatomical systems are involved in these two functions.
Topics: Cognition; Cognition Disorders; Deglutition Disorders; Humans; Odds Ratio
PubMed: 33934446
DOI: 10.1111/psyg.12704 -
Acta Bio-medica : Atenei Parmensis Aug 2022We performed a systematic review on the early assessment of swallowing function after cerebrovascular stroke.
PURPOSE
We performed a systematic review on the early assessment of swallowing function after cerebrovascular stroke.
MATERIALS AND METHODS
A systematic review of the English language literature of the past 20 years was performed regarding swallowing function and cerebrovascular stroke. All articles reporting swallowing evaluation through clinical examination validated scores, and diagnostic tools were included in the summary.
RESULTS
The systematic review of the literature identified 1,768 potentially relevant studies with 7 papers retrieved with a total of 589 stroke dysphagic patients. While at the clinical neurological assessment, The National Institutes of Health Stroke Scale was more frequently used as a clinical outcome predictor. The Bedside screening approach was carried out in 6 papers to assess patients with probable swallowing disorders. Among the diagnostic tools, seven studies performed the Flexible Fiberoptic Endoscopic evaluation assessing scoring validated system while two papers reported early swallowing outcomes Videofluoroscopic Swallow Study.
CONCLUSIONS
Our systematic review revealed the findings significantly associated with dysphagia in post-cerebrovascular patients. Endoscopic evaluation of swallowing proved to be the most used method in the literature, effective in identifying early predictors of dysphagia. Given the presence of different assessing scores employed and reduced study samples enrolled, further studies with large courts are necessary for a greater significance.
Topics: Deglutition; Deglutition Disorders; Endoscopy; Humans; Stroke
PubMed: 36043981
DOI: 10.23750/abm.v93i4.12135 -
International Journal of Pediatric... Jan 2017Pediatric head and neck Squamous cell carcinoma (PHNSCC) is a rare disease. The optimum treatment and outcome remains poorly understood because of rarity. (Review)
Review
INTRODUCTION
Pediatric head and neck Squamous cell carcinoma (PHNSCC) is a rare disease. The optimum treatment and outcome remains poorly understood because of rarity.
METHODS
We conducted an individual patient data analysis of PHNSCC. Two authors independently searched PubMed, google search, and Cochrane library for eligible studies using following search words: Pediatric Head and neck squamous cell carcinoma, Head and neck squamous cell carcinoma under age of 20, Head and neck squamous cell carcinoma in young, PHNSCC till June 1, 2016 published in English language.
RESULTS
Total of 217 patients of PHNSCC were found in the literature. Median age among the cohort was 15 years (Range: 0-20 years) with a clear male preponderance. Oral cavity tumors were commonest 75 (70%) followed by laryngeal neoplasms 16(15%). Median disease free survival was 9 months (Range: 0-216 months). Median overall survival was 48 months (Range: 1-216 months). In univariate analysis treatment modality had significant impact on disease free survival (DFS). Whereas, patients treated with Surgery, Laryngeal primary had significantly better OS. Patients with associated fanconis anemia had significantly worse overall survival (OS).
CONCLUSION
PHNSCC is a rare disease with poorer outcome. Associated DNA defects leads to poorer OS. Patients treated with surgery alone or surgery followed by adjuvant radiation had better DFS and OS. Molecular profiling and personalized therapy may improve survival with limited toxicity.
Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Brachytherapy; Carcinoma, Squamous Cell; Chemoradiotherapy; Chemoradiotherapy, Adjuvant; Child; Child, Preschool; Comorbidity; Disease-Free Survival; Fanconi Anemia; Female; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Laryngeal Neoplasms; Male; Mouth Neoplasms; Neoplasm Staging; Otorhinolaryngologic Surgical Procedures; Pharyngeal Neoplasms; Precision Medicine; Prognosis; Radiotherapy; Radiotherapy, Adjuvant; Sex Distribution; Squamous Cell Carcinoma of Head and Neck; Survival Rate; Young Adult
PubMed: 28012539
DOI: 10.1016/j.ijporl.2016.11.005