| Transoral Robotic Surgery Using the Thulium:YAG Laser: A Prospective Study [Original Article] |
| Archives of Otolaryngology February 1, 2012, 12:00 pm |
| Objective To compare thulium:YAG laser–assisted transoral robotic surgery (TY:TORS) and conventional electrocautery-equipped TORS (EC:TORS) in patients undergoing transoral resection of upper aerodigestive tract malignant neoplasms.
Design Prospective matched cohort study.
Setting Tertiary academic referral center.
Patients Fifteen patients undergoing TY:TORS were matched on the basis of tumor site, clinical T stage, sex, and age with 30 control subjects undergoing EC:TORS.
Main Outcome Measures The primary outcome was a comparison between the feasibility of TY:TORS compared with EC:TORS. The secondary outcome was a comparison between the safety and functional outcome of TY:TORS compared with EC:TORS in patients undergoing resection of upper aerodigestive tract malignant neoplasms.
Results All the tumors underwent complete excision with negative margins. Estimated blood loss was minimal (<150 mL) for 87% of TY:TORS patients (13 of 15) and 63% of EC:TORS controls (19 or 30). Intraoperative pharyngotomy was reported in 8% of TY:TORS patients (1 of 13) and 42% of EC:TORS controls (11 of 30) (P = .03). Postoperative pain was greater in EC:TORS compared with TY:TORS (P = .02). No statistically significant differences were noted in hemostasis, postoperative bleeding rates, or other complications.
Conclusions Compared with EC:TORS, TY:TORS seems feasible and safe. In addition, TY:TORS resulted in fewer intraoperative pharyngotomies and less postoperative pain than did EC:TORS, which may be because of decreased collateral thermal damage, improved visualization, and finer cutting using the thulium laser. |
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| Incidence of Pediatric Acute Mastoiditis: 1997-2006 [Original Article] |
| Archives of Otolaryngology April 16, 2012, 12:00 pm |
| Objectives To evaluate the incidence of acute mastoiditis in children in the United States over the years 1997 through 2006 and to explore possible explanations for the conflicting conclusions of recent studies of this topic.
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| Incidence of Pediatric Acute Mastoiditis: 1997-2006 [Original Article] |
| Archives of Otolaryngology April 16, 2012, 12:00 pm |
| Objectives To evaluate the incidence of acute mastoiditis in children in the United States over the years 1997 through 2006 and to explore possible explanations for the conflicting conclusions of recent studies of this topic.
Design Comparison of periodic incidence over a decade.
Setting Academic and community, general, and pediatric specialty hospitals |
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