Biomedical subjects

Lanny Garth Close

Publications and source records attributed to Lanny Garth Close.

3 recordsLinked to original sources

PubMed2006

Quality of life and complications following image-guided endoscopic sinus surgery.

OBJECTIVES: To compare the quality of life (QOL) outcome and incidence of complications following image-guided versus non-image-guided endoscopic sinus surgery (ESS). STUDY DESIGN: The operative, office, and hospital charts of patients who underwent primary ESS for chronic sinusitis by a single surgeon with (2002-2005) or without (1997-2002) image guidance were reviewed for patient demographics, incidence of complications, and revision procedures. A telephone survey was used to administer the QOL survey to both cohorts. RESULTS: In comparing patients who underwent image-guided (60) versus non-image-guided surgery (179), respectively, there was no statistically significant difference in the incidence of major intraoperative complications (6.6% vs 5.6%), major postoperative complications (5% vs 3.9%), revision procedures (6.6% vs 7.3%), and postoperative SNOT-20 symptom scores (23.6 vs 23.4). A higher incidence of intraoperative cerebrospinal fluid leak was noted in the non-image-guided group (0% vs 2.2%). CONCLUSIONS: Our study does not demonstrate an improvement in the incidence of complications, need for revision procedures, or quality-of-life outcome for patients undergoing primary ESS for chronic sinusitis. The use of image guidance may result in a lower incidence of skull base trauma and cerebrospinal fluid leak. EBM RATING: B-2b.

Adolescent↗

PubMed2005

Endoscopic Lothrop procedure: when should it be considered?

PURPOSE OF REVIEW: The endoscopic Lothrop procedure has proved to be an effective intranasal approach to the treatment of frontal sinus disorders. When successful, the operation re-establishes normal or near-normal frontal sinus function (especially physiologic evacuation of frontal sinus contents). Recently, several authors have proposed the use of this procedure for the treatment of several disease processes in addition to chronic frontal sinusitis. RECENT FINDINGS: Although follow-up has been limited, the endoscopic Lothrop procedure has proved effective in the treatment of patients with the following: (1) failed prior endoscopic surgery, (2) frontal sinus mucocele, (3) frontoethmoid fractures, (4) failed osteoplastic flap frontal sinus obliteration, (5) resection of sinonasal neoplasms, and (6) removal of osteitic foci. SUMMARY: When used by an experienced endoscopic surgeon in selected clinical settings, the endoscopic Lothrop procedure offer acceptable to excellent results with relatively low morbidity and with several advantages over more standard surgical approaches for the treatment of specific disease entities.

Endoscopy↗

PubMed2002

Laryngopharyngeal manifestations of reflux: diagnosis and therapy.

Acid reflux--most often associated with heartburn--may also cause a wide range of laryngopharyngeal symptoms, including laryngitis and chronic cough. Symptoms of laryngopharyngeal reflux (LPR), like those of gastrooesophageal reflux disease, result from abnormal exposure of tissues to acid refluxate. Deranged sensorimotor function of the upper oesophageal sphincter appears to play a key role in the aetiology of LPR, but the disease is not completely understood. Among the significant long-term complications of LPR are bronchopulmonary disorders, recurrent pneumonia, chronic cough, chronic or recurrent laryngitis, and oral cavity disorders. It also appears to be a risk factor for the development of laryngeal carcinoma. Diagnosis of LPR is based on physical examination, medical history, and results of specific tests. At present, the test of choice for LPR diagnosis is intraluminal oesophageal pH monitoring. Barium contrast oesophagography, intraoesophageal acid perfusion challenge, and flexible endoscopic evaluation of swallowing with sensory testing may also be used in LPR diagnosis. Treatment for LPR includes changes to the diet and lifestyle, and acid-suppressing therapy. The Therapeutic Working Party at the First Multi-Disciplinary International Symposium on Supraesophageal Complications of Gastroesophageal Reflux Disease has recommended twice-daily dosing with a proton pump inhibitor as an initial therapy for LPR, with treatment continued between 4 weeks and 6 months. Such treatment has been found highly effective in resolving symptoms of LPR, and it may also prevent the serious long-term complications of this condition.

Gastroesophageal Reflux↗