Management of total laryngectomy patients over time: from the consultation announcing the diagnosis to long term follow-up

2011 ◽  
Vol 268 (10) ◽  
pp. 1407-1419 ◽  
Author(s):  
Emmanuel Babin ◽  
David Blanchard ◽  
Martin Hitier
Keyword(s):  
Total Laryngectomy ◽  
Long Term Follow Up ◽  
Over Time

Neoglottis Reconstruction Following Total Laryngectomy: The Emory Experience

1982 ◽  
Vol 90 (5) ◽  
pp. 569-575 ◽  
Author(s):  
Fred M.S. McConnel ◽  
John Teichgraeber
Keyword(s):  
Medical School ◽  
Revision Surgery ◽  
Total Laryngectomy ◽  
Perioperative Complications ◽  
Vocal Rehabilitation ◽  
Early Results ◽  
Emory University ◽  
Long Term Follow Up

A number of studies over the last decade have reported on a viability of the primary neoglottis reconstruction after total laryngectomy. Early results have been encouraging, although operative and perioperative complications are higher than with a classic laryngectomy. This article reports on a series of 13 neoglottis reconstructions performed at Emory University Medical School using the techniques developed by Mario Staffiert, MD. During the course of the study, the overall success rate has fallen from 80% at three years to 54% at five years. With each succeeding year there has been an increasing need for revision surgery. The series emphasizes the need for long-term follow-up in any vocal rehabilitation procedure.

Long-Term Follow-up of Tracheoesophageal Puncture Results

1996 ◽  
Vol 105 (7) ◽  
pp. 501-503 ◽  
Author(s):  
James A. Geraghty ◽  
Bonnie E. Smith ◽  
Barry L. Wenig ◽  
Louis G. Portugal
Keyword(s):  
Low Socioeconomic Status ◽  
Total Laryngectomy ◽  
Success Rates ◽  
Vocal Rehabilitation ◽  
Speech Rehabilitation ◽  
Long Term Follow Up ◽  
Tracheoesophageal Speech ◽  
Tracheoesophageal Puncture

Since its introduction by Blom and Singer in 1980, tracheoesophageal puncture with a voice prosthesis has become the most frequently recommended choice for speech rehabilitation of total laryngectomees. Many studies have reviewed the initial speech acquisition success rates following tracheoesophageal puncture; however, long-term follow-up in these initial successes has been lacking. In addition, factors predictive of long-term success with tracheoesophageal speech have not been defined. Over a 10-yearperiod, we retrospectively reviewed all total laryngectomy patients, including those who have undergone primary or secondary tracheoesophageal puncture, at the University of Illinois Hospital and Clinics and the Westside Veterans Administration Hospitals. Survival in the total laryngectomy cohort of 202 patients ranged from 35% to 50%. Forty of these patients underwent tracheoesophageal puncture, in whom survival was 75%. Short-term success with tracheoesophageal speech was approximately 70% for our patients, while long-term success was achieved in 66%. Despite low socioeconomic status and relatively high alcoholism rates, successful maintenance of tracheoesophageal speech was achieved in the majority of cases. Tracheoesophageal speech should therefore be considered as a primary method of vocal rehabilitation in all patients undergoing total laryngectomy.

A Trial of Biolite Ventilation Tubes in Children: Is Further Use Warranted?

1983 ◽  
Vol 91 (4) ◽  
pp. 437-440 ◽  
Author(s):  
Steven D. Handler ◽  
William P. Potsic ◽  
Roger R. Marsh
Keyword(s):  
Pilot Study ◽  
Middle Ear ◽  
Silicone Tube ◽  
Long Term Follow Up ◽  
Ventilation Tubes ◽  
Carbon Coated ◽  
Contralateral Ear ◽  
Over Time

A prospective controlled pilot study was undertaken in which Biolite (carbon-coated) ventilation tubes were placed in 44 ears and a conventional silicone tube in the contralateral ear. Long-term follow-up of these patients has revealed little difference in the incidence of tube occlusion or early extrusion. In addition, there were several disadvantages noted with the Biolite tubes: incomplete coating of the tube (especially within the lumen), shedding of the Biolite coating over time, “tattooing” of the tympanic membrane, poor otoscopic visibility, and the higher cost of these tubes. Since the Biolite tube has no documented advantages and, actually, several disadvantages, we believe its use in the treatment of middle ear disorders should be discontinued until significant benefits are demonstrated and present deficiencies are corrected.

Modified neoglottis reconstruction following total laryngectomy: Long-term follow-up and results

1995 ◽  
Vol 105 (7) ◽  
pp. 714-716 ◽  
Author(s):  
James H. Brandenburg ◽  
Namrata Patil ◽  
Edie W. Swift
Keyword(s):  
Total Laryngectomy ◽  
Long Term Follow Up

scholarly journals Long-term follow-up of the RESONATE phase 3 trial of ibrutinib vs ofatumumab

Blood ◽  
2019 ◽  
Vol 133 (19) ◽  
pp. 2031-2042 ◽  
Author(s):  
John C. Byrd ◽  
Peter Hillmen ◽  
Susan O’Brien ◽  
Jacqueline C. Barrientos ◽  
Nishitha M. Reddy ◽  
...  
Keyword(s):  
Single Agent ◽  
The United States ◽  
Lymphocytic Leukemia ◽  
Baseline Risk ◽  
Phase 3 ◽  
Long Term Study ◽  
Long Term Follow Up ◽  
Over Time

Abstract Ibrutinib, a once-daily oral inhibitor of Bruton tyrosine kinase, has greatly improved outcomes for patients with chronic lymphocytic leukemia (CLL). The phase 3 RESONATE trial, which compared single-agent ibrutinib to ofatumumab in high-risk, relapsed patients with CLL, provided support for approval of ibrutinib in the United States and Europe. We describe long-term follow-up of patients treated in RESONATE, where continued superiority of progression-free survival (PFS) (hazard ratio [HR], 0.133; 95% confidence interval [CI], 0.099-0.178) was observed. Overall survival benefit continues (HR, 0.591; 95% CI, 0.378-0.926), although with decreased magnitude relative to that seen before crossover to ibrutinib was implemented for patients on ofatumumab (HR, 0.426; 95% CI, 0.220-0.823). Notably, overall response to ibrutinib increased over time, with 91% of patients attaining a response. The PFS benefit with ibrutinib was independent of baseline risk factors, although patients with ≥2 prior therapies had shorter PFS than those with <2 prior therapies, and the presence of TP53 or SF3B1 mutations showed a trend toward shorter PFS vs without these factors. Median duration of ibrutinib was 41 months, with 46% remaining on treatment at a median follow-up of 44 months. Grade ≥3 adverse events generally decreased over time, causing only a small proportion of patients to cease therapy. Ibrutinib was discontinued due to progressive disease in 27% of patients. This long-term study provides support for sustained efficacy and safety of ibrutinib in relapsed/refractory CLL and consideration of study provisions that allow crossover to investigational therapy when benefit has been clearly demonstrated. This trial was registered at www.clinicaltrials.gov as #NCT01578707.

scholarly journals Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) Database

2017 ◽  
Vol 24 (10) ◽  
pp. 505-518 ◽  
Author(s):  
Patrick Petrossians ◽  
Adrian F Daly ◽  
Emil Natchev ◽  
Luigi Maione ◽  
Karin Blijdorp ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Thyroid Nodules ◽  
Sleep Apnea Syndrome ◽  
Multiple Treatment ◽  
Long Term Follow Up ◽  
Study Population ◽  
Apnea Syndrome ◽  
Over Time

Acromegaly is a rare disorder caused by chronic growth hormone (GH) hypersecretion. While diagnostic and therapeutic methods have advanced, little information exists on trends in acromegaly characteristics over time. The Liège Acromegaly Survey (LAS) Database, a relational database, is designed to assess the profile of acromegaly patients at diagnosis and during long-term follow-up at multiple treatment centers. The following results were obtained at diagnosis. The study population consisted of 3173 acromegaly patients from ten countries; 54.5% were female. Males were significantly younger at diagnosis than females (43.5 vs 46.4 years; P < 0.001). The median delay from first symptoms to diagnosis was 2 years longer in females (P = 0.015). Ages at diagnosis and first symptoms increased significantly over time (P < 0.001). Tumors were larger in males than females (P < 0.001); tumor size and invasion were inversely related to patient age (P < 0.001). Random GH at diagnosis correlated with nadir GH levels during OGTT (P < 0.001). GH was inversely related to age in both sexes (P < 0.001). Diabetes mellitus was present in 27.5%, hypertension in 28.8%, sleep apnea syndrome in 25.5% and cardiac hypertrophy in 15.5%. Serious cardiovascular outcomes like stroke, heart failure and myocardial infarction were present in <5% at diagnosis. Erythrocyte levels were increased and correlated with IGF-1 values. Thyroid nodules were frequent (34.0%); 820 patients had colonoscopy at diagnosis and 13% had polyps. Osteoporosis was present at diagnosis in 12.3% and 0.6–4.4% had experienced a fracture. In conclusion, this study of >3100 patients is the largest international acromegaly database and shows clinically relevant trends in the characteristics of acromegaly at diagnosis.

Persistent triple antiphospholipid antibody positivity as a strong risk factor of first thrombosis, in a long-term follow-up study of patients without history of thrombosis or obstetrical morbidity

Lupus ◽  
2016 ◽  
Vol 26 (2) ◽  
pp. 163-169 ◽  
Author(s):  
C M Yelnik ◽  
G Urbanski ◽  
E Drumez ◽  
V Sobanski ◽  
H Maillard ◽  
...  
Keyword(s):  
Antiphospholipid Antibody ◽  
Increased Risk ◽  
Long Term Follow Up ◽  
Antibody Positivity ◽  
History Of ◽  
Thrombosis Rate ◽  
Over Time ◽  
Aspirin Prophylaxis

Introduction The long-term risk of first thrombosis and benefit of prophylaxis in antiphospholipid antibody (aPL) carriers without history of thrombosis or obstetrical morbidity is poorly known. This study aimed to evaluate the long-term rate and risk factors associated with a first thrombosis in those patients. Patients and methods After a prior study ended in December 2005 and was already published, we extended the follow-up period of our cohort of aPL carriers. Results Ninety-eight of the 103 patients of the previous study were included. The annual first thrombosis rate was 2.3% per patient-year during a median of 13 years (6–17). None of the baseline characteristics was predictive of risk of first thrombosis, but persistent aPL over time were associated with an increased risk. The stronger association was found in triple aPL-positive carriers: OR 3.38 (95% CI: 1.24–9.22). Of note, conversely to our previous findings, no benefit of aspirin prophylaxis was observed. Conclusion The risk of first thrombosis in aPL carriers without history of thrombosis or obstetrical morbidity was significant, persisted linearly over time and was associated with persistent aPL. This risk was especially increased in triple aPL-positive carriers, in whom a close follow-up seems to be necessary. Nevertheless, the benefit of aspirin prophylaxis remained unclear.

scholarly journals Damage in the anca-associated vasculitides: long-term data from the European Vasculitis Study group (EUVAS) therapeutic trials

2013 ◽  
Vol 74 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Joanna Robson ◽  
Helen Doll ◽  
Ravi Suppiah ◽  
Oliver Flossmann ◽  
Lorraine Harper ◽  
...  
Keyword(s):  
A Priori ◽  
Damage Index ◽  
Study Group ◽  
Therapeutic Trials ◽  
Long Term Follow Up ◽  
Frequent Items ◽  
Vasculitis Damage Index ◽  
Over Time

ObjectivesTo describe short-term (up to 12 months) and long-term (up to 7 years) damage in patients with newly diagnosed antineutrophil-cytoplasm antibody-associated vasculitis (AAV).MethodsData were combined from six European Vasculitis Study group trials (n=735). Long-term follow-up (LTFU) data available for patients from four trials (n=535). Damage accrued was quantified by the Vasculitis Damage Index (VDI). Sixteen damage items were defined a priori as being potentially treatment-related.ResultsVDI data were available for 629 of 735 patients (85.6%) at baseline, at which time 217/629 (34.5%) had ≥1 item of damage and 32 (5.1%) ≥5 items, reflecting disease manifestations prior to diagnosis and trial enrolment. LTFU data were available for 467/535 (87.3%) at a mean of 7.3 years postdiagnosis. 302/535 patients (56.4%) had VDI data at LTFU, with 104/302 (34.4%) having ≥5 items and only 24 (7.9%) no items of damage. At 6 months and LTFU, the most frequent items were proteinuria, impaired glomerular filtration rate, hypertension, nasal crusting, hearing loss and peripheral neuropathy. The frequency of damage, including potentially treatment-related damage, rose over time (p<0.01). At LTFU, the most commonly reported items of treatment-related damage were hypertension (41.5%; 95% CI 35.6 to 47.4%), osteoporosis (14.1%; 9.9 to 18.2%), malignancy (12.6%; 8.6 to 16.6%), and diabetes (10.4%; 6.7 to 14.0%).ConclusionsIn AAV, renal, otolaryngological and treatment-related (cardiovascular, disease, diabetes, osteoporosis and malignancy) damage increases over time, with around one-third of patients having ≥5 items of damage at a mean of 7 years postdiagnosis.

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