Stratifying the risk of facial nerve palsy after benign parotid surgery

2014 ◽  
Vol 128 (2) ◽  
pp. 159-162 ◽  
Author(s):  
N Sethi ◽  
P H Tay ◽  
A Scally ◽  
S Sood

AbstractIntroduction:Post-operative facial palsy is the most important potential complication of parotid surgery for benign lesions. The published prevalence of facial weakness is up to 57 per cent for temporary weakness and up to 7 per cent for permanent weakness. We aimed to identify potential risk factors for post-operative facial palsy.Materials and methods:One hundred and fifty patients who had undergone parotid surgery for benign disease were retrospectively reviewed. Tumour factors (size, location and histopathology), patient factors (age and sex) and operative factors (operation, surgeon grade, surgeon specialty and use of intra-operative facial nerve monitoring) were all analysed for significant associations with post-operative facial palsy.Results and analysis:The overall incidence of facial palsy was 26.7 per cent for temporary weakness and 2.6 per cent for permanent weakness. The associations between facial palsy and all the above factors were analysed using Pearson's chi-square test and found to be non-significant.Conclusion:These outcomes compare favourably with the literature. No significant risk factors were identified, suggesting that atraumatic, meticulous surgical technique is still the most important factor affecting post-operative facial palsy.

2016 ◽  
Vol 6 (23) ◽  
pp. 161-165
Author(s):  
Georgiana Pasu

Abstract BACKGROUND. Intraoperative neural monitoring (IONM) has begun to be studied in detail by surgeons around the world since several decades ago from the need to verify functional integrity of the neural elements. Parotid gland surgery requires a thorough knowledge of the anatomy of this region by ENT surgeons. Also, the surgeons performing parotid surgery need to have important strategies of management which include: handiness to identify facial nerve, dissection nerve branches and application of neuromonitoring in order to preserve nerve functions. OBJECTIVE. This study has analysed the usefulness of intraoperative continuous monitoring in superficial or in total parotidectomy. It identifies the facial nerve and reduces the risk of postoperative facial palsy. We have been using intraoperative continuous monitoring - evoked facial nerve electromyograms (EMG). MATERIAL AND METHODS. Continuous intraoperative facial nerve monitoring was prospectively achieved in the case of three patients diagnosed with benign tumors, on which parotidectomy with the preservation of the nerve was carried out in order to highlight the value and efficacy of this method. RESULTS. In our country, continuous intraoperative facial nerve monitoring performance is still not a common practice in ENT Departments. It revealed postoperatively that the incidence of temporary or permanent facial palsy was 0% and the minimal stimulation was obtained at levels equal to 0,5 mA, which implies integral functioning of the facial nerve. CONCLUSION. In parotid surgery, facial nerve IONM represents the gold standard in recognition of real-time electrophysiological signals, electromyography waves and auditory signals to enable the correct approach wherever possible, avoiding extensive nerve damage. It is known the importance of continuous IONM in postoperative prognosis of the neural function and intraoperative decision making regarding the technical surgery.


2016 ◽  
Vol 56 (4) ◽  
pp. 226
Author(s):  
Yuni Purwanti ◽  
Sutaryo Sutaryo ◽  
Sri Mulatsih ◽  
Pungky Ardani Kusuma

Background Wilms tumor is the most common renal malignancy in children (95%) and one of the leading causes of death in children, with high mortality rates in developing countries. Identifying risk factors for mortality is important in order to provide early intervention to improve cure rates.Objective To identify risk factors for mortality in children with Wilms tumor.Methods We performed a case-control study of children (0-18 years of age) with Wilms tumor admitted to Dr. Sardjito Hospital between 2005 and 2012. The case group consisted of children who died of Wilms tumor, whereas the control group were children who survived. Data were collected from medical records. Statistical analyses using Chi-square and logistic regression tests were done to determine odds ratios and 95% CI of the potential risk factors for mortality from Wilms tumor.Results Thirty-five children with Wilms tumor were admitted to Dr. Sardjito Hospital during the study period. Nine (26%) children died and 26 survived. Stage ≥III was a significant risk factor for mortality in chidren with Wilms tumor (OR 62.8; 95%CI 5.6 to 70.5). Age ≥2 years (OR 1.4; 95%CI 0.1 to 14.3) and male sex (OR 1.2; 95%CI 0.1 to 10.8) were not significant risk factors for mortality.Conclusion Stage ≥III is a risk factor for mortality in children with Wilms tumor. 


2013 ◽  
Vol 131 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Orlando Milhomem Mota ◽  
Maria Paula Curado ◽  
José Carlos Oliveira ◽  
Edesio Martins ◽  
Daniela Medeiros Milhomem Cardoso

CONTEXT AND OBJECTIVESEsophageal cancer is the eighth commonest type of cancer worldwide, occupying sixth place in terms of mortality. Smoking and alcohol use are known risk factors for this type of cancer. The aim here was to evaluate the risk factors for esophageal cancer in a low-incidence area.DESIGN AND SETTINGCase-control study in Goiânia, with 99 cases of esophageal cancer and 223 controls.METHODSThe variables were sociodemographic, dietary, occupational and lifestyle data. The sample was analyzed using the chi-square test, Mann-Whitney test and Mantel-Haenszel approach for multivariate analysis. Odds ratios (OR) were calculated with 5% significance and 95% confidence intervals.RESULTSThe risk of esophageal cancer was higher in patients ≥ 55 years (OR = 1.95; P < 0.001). Patients from rural areas were at greater risk of esophageal cancer (OR = 4.9; P < 0.001). Smoking was a risk factor among the cases (OR = 3.8; P < 0.001), as was exposure to woodstoves (OR = 4.42; P < 0.001). The practice of oral sex was not a risk factor (OR = 0.45; P = 0.04). Consumption of apples, pears, vegetables, cruciferous vegetables and fruit juices were protective against esophageal cancer.CONCLUSIONIn a region in which the incidence of esophageal cancer is low, the most significant risk factors were exposure to woodstoves, smoking and living in rural areas.


2020 ◽  
Author(s):  
Yaosen Chen ◽  
Mohamed AM ◽  
WANG Jinbo ◽  
ZHENG Ziwei ◽  
Maher Al-balaa ◽  
...  

Abstract Background The composite attachment loss during orthodontic clear aligner therapy is an adverse event that commonly happens in our daily practice. However, there is a lack of related statistical analysis, and studies analyzing the related risk factors. Therefore, the aim of this study is to assess the incidence of attachment loss during orthodontic clear aligner therapy and to identify rick factors that may predict such event.Methods The demographics and clinical variables of 94 patients undergoing clear aligner therapy (27 males and 67 females; average age: 27.60± 0.86 years) were recorded. Both patient-related and tooth-related attachment loss was recorded. The chi-square test and logistic regressive analysis were applied to identify the potential risk factors. SPSS for Mac (version 23.0, IBM, USA) was used for statistical analyses. P<0.05 was considered statistically significant. Results Our study suggested that the risk factors for attachment loss include: frequent aligner removal (>= 5 times a day) (losing rate=60.0%, P=0.005); aligner wear time less than 18 hours a day (losing rate=50.8%, P=0.014); eating without aligners inserted (losing rate=47.9%, P=0.034); utilizing aligner tray seaters (losing rate=48.2%, P=0.006) and unilateral mastication (losing rate=52.1%, P=0.002). The multivariable logistic regression analysis indicates that aligner wear time less than 18 hours a day (P=0.020, B=0.925), using aligner tray seaters (P=0.007, B=1.168) and unilateral mastication (P=0.034, B=-0.458) were considered independent factors that can predict the composite attachment loss in orthodontic clear aligner therapy.Conclusion Wearing aligner less than 18 hours a day, using aligner tray seaters and unilateral mastication may contribute to increased incidence of composite attachment loss during orthodontic clear aligner therapy.


2015 ◽  
Vol 36 (6) ◽  
pp. 3757 ◽  
Author(s):  
Soraia Figueiredo de Souza ◽  
Luciana Dos Santos Medeiros ◽  
Adriane De Souza Belfort ◽  
Andrey Luiz Lopes Cordeiro ◽  
Michelle Federle ◽  
...  

Blood samples were collected from 89 cats to assess the prevalence of IgG antibodies against Toxoplasma gondii by indirect immunofluorescence (IIF) and the possible risk factors associated with feline Toxoplasma gondii infection. An epidemiological questionnaire was developed and implemented for owners of domestic cats domiciled in Rio Branco, Acre. The results were statistically evaluated with the odds ratio and chi-square tests, considering the significance level of 5%. Of 89 animals’ samples, 22 had antibodies against Toxoplasma gondii. Among the 22 reactive animals, 15 (68.19%) were female, 15 (68.19%) were less than one year old and 20 (90%) were cross breed. Concerning risk factors, there was no difference (p > 0.05) between the variables evaluated by the chi-square test. Moreover, 16 (72%) cats were fed a mixed diet, 20 (90%) of the cats had hunting habits, 18 (81%) had contact with animals of another species, 11 (50%) had access to the street, and 22 (95%) lived in homes that had areas of grass or dirt. In conclusion, the prevalence of anti-Toxoplasma gondii in domestic cats was 22.7%, and there were no significant risk factors for feline toxoplasmosis in the municipality of Rio Branco, Acre.


2016 ◽  
Vol 29 (1) ◽  
pp. 9-14
Author(s):  
Omole Ohonsi Abiodun ◽  
Belga Francis

Objective (s): To determine the aetiological factors of preterm deliveries at Aminu Kano Teaching Hospital, Kano, Nigeria..Materials and methods: This case-control study was conducted between 1st June 2006 and 31st May 2007.One hundred and forty eight women with preterm deliveries (cases) were compared with seven hundred and forty women who delivered at term (control). Data analysis was done using Epi- Info software (6.0 CDC Atlanta Georgia, USA). Univariate and multivariate logistic regression analysis were performed and the results were expressed as odds ratio (OR) with 95% confidence interval (CI). The contribution of the risk factors were estimated using chi square test and a p-value of < 0.05 was taken as significant.Results: The period incidence of preterm deliveries was 69 per 1000 births. Unbooked and low socioeconomic statuses, primigravidity, previous preterm deliveries, multiple pregnancies, pre-eclampsia, and malaria in pregnancy were significant risk factors that were associated with preterm delivery. These associations were still demonstrable after adjusting for confounding variables.Conclusion: Early girl marriage and childbearing and spontaneous pre-labour rupture of membranes not to be independent risk factors in this study. Women with risk factors should be managed in specialist hospitals.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 9-14


Author(s):  
Waleed Hasan Mohammed AL-Marrani ◽  
Hassan A. Al-Shamahy

Occupational exposure of public health center cleaners (PHCCs) to blood and body fluids after skin injury or mucous membrane contact constitutes a risk for transmission of blood-borne pathogens. In the industrialized world, occupational surveillance is performed to assess and monitor health hazards related to blood borne pathogens. In contrast, in developing countries as Yemen, exposure and health impacts are rarely monitored and much remains to be done to protect PHCCs. The objective of this study was to determine the prevalence of HBV and HCV and their potential risk factors among PHCCs.  A cross sectional prospective study was conducted among 388 PHCCs. Data was collected using pre-tested and structured questions. Venous blood was collected and the sera were tested for HBV surface antigen and anti-hepatitis C antibodies using enzyme-linked immune sorbent assay technique. The data were analysis by EPI-Info. Chi square and Odds ratio tests were used to assess the association of risk factors with HBV and HCV positivity. Results revealed that among the total 388 PHCCs examined, HBV and HCV were detected in 32 (8.2%), and 4 (1.03%) of them respectively.  There was significant risk factors of hepatitis viruses with age group 20-24 years (OR=2.8), exposure to patients blood (OR=3), accidental stick of used needles (OR=2.3), sharp injury (OR=5.6), history of blood transfusion (OR=2.5), and hospital admission (OR=2.7). Also significant protected roles for HBV vaccine was found with infection. In conclusion high prevalence rates of HBV and HCV occurred in PHCCs. Unfortunately; all workers did not take training on medical waste and few workers use protective measures consistently as vaccination. There is needed to make vaccination of health care workers against HBV infection a firm policy and ensure complete and consistent adherence to work standard safety measures.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14594-e14594
Author(s):  
Thorvardur Ragnar Halfdanarson ◽  
William R Bamlet ◽  
Robert R. McWilliams ◽  
Timothy J. Hobday ◽  
Patrick A. Burch ◽  
...  

e14594 Background: PNETs are uncommon malignancies and little is known about risk their factors and association with other cancers. Our aim was to evaluate smoking, alcohol use, personal history of diabetes and a family history of PNET and other cancers as potential risk factors. Methods: PNET cases seen at Mayo Clinic Rochester from 2000 to 2011 were evaluated. Insulinoma and high-grade PNETs were excluded. Primary care patients served as controls and were matched (2:1 ratio) to cases on age, sex and region of residence. Cases and controls completed questionnaires at the time of evaluation. Categorical variables were compared with the chi-square test; continuous variables were compared using a two-sample t test. Results: 355 cases were evaluated, mean age was 56.6 years, 52% were males and 96% were White. Personal smoking history was not associated with PNETs (cases 51%, controls 47%, p=0.24). Ever-alcohol use was less common among cases (54% vs. 67%, p=0.001). 19% of cases reported a history of diabetes compared with 11% of controls (p<0.001). Cases were more likely than controls to report a family member with sarcoma (p=0.02), PNET (p=0.024), gall bladder cancer (p=0.024), ovarian cancer (p=0.04) and stomach cancer (p=0.01). Conclusions: Cases with PNETs were more likely than controls to report a history of diabetes and less likely to report alcohol use. There was no association with smoking. Several types of cancer were more commonly reported in family members of cases than controls.


2005 ◽  
Vol 133 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Thomas R. Lowry ◽  
Thomas J. Gal ◽  
Joseph A. Brennan

OBJECTIVE: To determine current patterns of use of facial nerve monitoring during parotid gland surgery by otolaryngologists in the United States. STUDY DESIGN AND SETTING: A questionnaire encompassing surgeon training background, practice setting, patterns of facial nerve monitor usage during parotid gland surgery, and history of permanent facial nerve injury or legal action resulting from parotid surgery was mailed to 3139 otolaryngologists in the United States. Associations between facial nerve monitor usage and dependent variables were examined by using the χ 2 test. Magnitudes of the associations were determined from odds ratios calculated using logistic regression. RESULTS: A 49.3% questionnaire response rate was achieved. Sixty percent of respondents who perform parotidectomy employed facial nerve monitoring some or all of the time. Respondents were 5.6 times more likely to use the monitor in practice if they used it in training and 79% more likely to use it if they performed more than 10 parotidectomies per year. Respondents were 35% less likely to have a history of inadvertent nerve injury if they performed more than 10 parotidectomies per year. Surgeons who employed monitoring in their practice were 20.8% less likely to have a history of a parotid surgery-associated lawsuit. Additional information regarding surgeon demographics, types of nerve monitors used, and reasons for and against monitor usage are discussed. CONCLUSION: Permanent facial nerve paralysis after parotidectomy occurs in 0-7% of cases. Currently, a majority of otolaryngologists in the United States are employing facial nerve monitoring during parotid surgery some or all of the time, even though no studies to date have demonstrated improved outcomes with its use. Physician training background and surgery caseload were significant factors influencing usage of facial nerve monitoring in this study.


Sign in / Sign up

Export Citation Format

Share Document