The impact of acoustic neuroma on long-term quality-of-life outcomes in the United Kingdom

To quantify the impact of acoustic neuroma on the quality-of-life (QOL) patients in the United Kingdom. Online questionnaire survey. Members of the British Acoustic Neuroma Association received PANQOL questionnaires. Of the 880 BANA members contacted, 397 (45.1%) responded, although only 359 had complete datasets for analysis. Composite QOL scores were as follows: for microsurgery 58 (SD 35), for radiotherapy 56 (SD18), for combination of surgery and radiotherapy 49 (SD 14), and for the observation group 54 (SD 20). No statistical significance with ANOVA (p = 0.532). Mean (SD) composite QOL scores were as follows: for follow-up 10 years 65 (SD 45). Overall, these values were significantly different compared by ANOVA (p 10 years) QOL outcomes show no significant differences between the different treatment groups

Tumour thickness in oral cancer using an intra-oral ultrasound probe

To investigate tumour-thickness measurement with an intra-operative ultrasound (US) probe. A retrospective data analysis was undertaken for a total of 65 patients with a T1-2 oral cavity cancer, who were seen at a tertiary referral centre between 2004 and 2010. The correspondence between tumour thickness measured by ultrasonography and histopathology was assessed by Pearson's correlation coefficient, and also between tumour thickness and the development of neck metastasis. In 11 cases, intra-oral measurement was not optimal due to limited mouth opening (n = 2) or impossibility to depict the lesion (n = 9). Tumour thickness measured by US correlated well with histopathology (n = 23, R = 0.93). Tumour thickness of a parts per thousand currency sign7 mm carries a risk of lymph node metastasis of 12%, whereas in tumours exceeding 7 mm this risk is 57% (p = 0.001). Twenty-five percent developed neck metastasis and 19% had local recurrence. Tumour thickness is an important predictive marker for lymph node metastases. As such, it can help in decision-making with regard to management of the primary tumour and neck. Based upon our findings, a wait-and-see policy is only warranted for superficial lesions with tumour thickness of less than 7 mm, but only if regular follow-up using US-guided aspiration of the neck is ensure

Comparison of Voice Outcome After Vocal Fold Augmentation With Fat or Calcium Hydroxylapatite

Objectives/HypothesisTo evaluate the short-term voice outcomes of vocal fold augmentation using fat compared to calcium hydroxylapatite product Radiesse Voice (Merz Aesthetics). Study DesignRetrospective study design. MethodsSixty-six consecutive patients with vocal fold insufficiency were recruited, including the final 33 patients treated with fat and all 33 patients treated with calcium hydroxylapatite product. Before April 2011, fat augmentation was the standard treatment; from April 2011, only calcium hydroxylapatite product was used. For all subjects, videolaryngostroboscopic evaluation, s/z ratios, and voice handicap index (VHI) were analyzed. MethodsTreatment outcomes were evaluated 3 months after the augmentation. Two patients augmented with fat (both after 6 months), versus four augmented with calcium hydroxylapatite product (mean after 7 months), needed reintervention. Mean VHI decreased from 18 points in the fat augmentation group compared to 17 points in the calcium hydroxylapatite group. Mean s/z ratio changed -0.33 in the fat augmentation group compared to -0.46 in the calcium hydroxylapatite group. ConclusionThis retrospective cohort demonstrates that there are no short-term differences in VHI outcome or number of reinterventions for augmentation with fat compared to calcium hydroxylapatite product Radiesse Voice (Merz Aesthetics). Level of EvidenceLevel 4. Laryngoscope, 125:1161-1165, 201

Validation of the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale

The objective of this study is to evaluate the strength of content validity within the facial dysfunction domain of the Penn Acoustic Neuroma Quality-of-Life (PANQOL) Scale and to compare how it correlates with a facial dysfunction-specific QOL instrument (Facial Clinimetric Evaluation, FaCE). The study design is online questionnaire survey. Members of the British Acoustic Neuroma Association received both PANQOL questionnaires and the FaCE scale. 158 respondents with self-identified facial paralysis or dysfunction had completed PANQOL and FaCE data sets for analysis. The mean composite PANQOL score was 53.5 (range 19.2-93.5), whilst the mean total FaCE score was 50.9 (range 10-95). The total scores of the PANQOL and FaCE correlated moderate (r = 0.48). Strong correlation (r = 0.63) was observed between the PANQOL's facial dysfunction domain and the FaCE total score. Of all the FaCE domains, social function was strongly correlated with the PANQOL facial dysfunction domain (r = 0.66), whilst there was very weak-to-moderate correlation (range 0.01-0.43) to the other FaCE domains. The current study has demonstrated a strong correlation between the facial dysfunction domains of PANQOL with a facial paralysis-specific QOL instrument