Safety and Effectiveness of Endoscopic Ear Surgery: Systematic Review / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aims to evaluate that usefulness of the endoscopic ear surgery (EES) through the systematic review. SUBJECTS AND METHOD: We searched literatures in literature databases (MEDLINE, EMBASE, Cochrane Library, etc.). Inclusion criteria is 1) studies of patients with chronic otitis media, otitis media with effusion, cholesteatoma, conductive hearing loss, mixed hearing loss etc. 2) studies in which a transcanal endoscopic surgery was performed; and 3) studies in which one or more of the appropriate medical outcomes have been reported. We excluded that 1) non-human studies and pre-clinical studies; 2) non-original articles, for example, non-systematic reviews; editorial, letter and opinion pieces; 3) research not published in Korean and English; and 4) grey literature. Finally, 65 articles were selected and those results were analyzed. RESULTS: The safety of the EES was reported in 61 articles. Some studies reported damaged facial nerve or perilymph gusher but these are the complications that can arise due to the characteristics of the disease and not due to the EES and other reported complications were of similar or lower level in the intervention group rather than the microscopy group. The effectiveness of the EES was reported in 23 articles. The EES tended to show improved effects in terms of graft uptake status, cholesteatoma removal, and hearing improvement although effective outcomes of most studies reported no significant difference between EES and microscopic ear surgery. CONCLUSION: EES is a safe and effective technique and as it is less invasive than the microscopic ear surgery.

Safety and Effectiveness of Endoscopic Ear Surgery: Systematic Review / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#This study aims to evaluate that usefulness of the endoscopic ear surgery (EES) through the systematic review.SUBJECTS AND METHOD: We searched literatures in literature databases (MEDLINE, EMBASE, Cochrane Library, etc.). Inclusion criteria is 1) studies of patients with chronic otitis media, otitis media with effusion, cholesteatoma, conductive hearing loss, mixed hearing loss etc. 2) studies in which a transcanal endoscopic surgery was performed; and 3) studies in which one or more of the appropriate medical outcomes have been reported. We excluded that 1) non-human studies and pre-clinical studies; 2) non-original articles, for example, non-systematic reviews; editorial, letter and opinion pieces; 3) research not published in Korean and English; and 4) grey literature. Finally, 65 articles were selected and those results were analyzed.@*RESULTS@#The safety of the EES was reported in 61 articles. Some studies reported damaged facial nerve or perilymph gusher but these are the complications that can arise due to the characteristics of the disease and not due to the EES and other reported complications were of similar or lower level in the intervention group rather than the microscopy group. The effectiveness of the EES was reported in 23 articles. The EES tended to show improved effects in terms of graft uptake status, cholesteatoma removal, and hearing improvement although effective outcomes of most studies reported no significant difference between EES and microscopic ear surgery.@*CONCLUSION@#EES is a safe and effective technique and as it is less invasive than the microscopic ear surgery.

Diagnostic Performance of Shear Wave Elastography as Add-on Test in Thyroid Nodules: a Systematic Review and Meta-Analysis

BACKGROUND AND OBJECTIVES: The diagnostic performance of shear wave elastography (SWE) combined with ultrasound (US) in the differential diagnosis of thyroid nodules was evaluated. MATERIALS AND METHODS: 459 articles were collected using KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. The searching words were ‘{(elastography and shear).mp. OR SWE.mp. OR acoustic radiation force impulse.mp. OR ARFI.mp. OR acuson.mp. OR aixplorer.mp.}’. Two authors independently performed article selection and evaluation of the quality of studies with Scottish Intercollegiate Guidelines Network tool. RESULTS: 2582 specimens (thyroid nodules) from 11 studies selected were included in this review. Combined use of US and SWE was reported higher specificity in five literatures, lower specificity in five studies, and no changes in 1 study when compared to US. We performed meta-analysis using data from 10 studies. The pooled sensitivity and specificity of US and SWE group for the differential diagnosis of benign and malignant nodules were 0.91 (I2=83.4%), 0.73 (I2=95.9%). The pooled sensitivity and specificity of US alone group were 0.88 (I2=93.2%), 0.71 (I2=92.7%). CONCLUSION: SWE is not effective in the differential diagnosis of thyroid nodules to minimize unnecessary biopsy of nodules. The included studies showed significant heterogeneity of results.

A Systematic Review and Meta-Analysis on the Effects of Oral Stimulation Interventions on the Transition from Tube to Oral Feeding in Premature Infants / 임상간호연구

PURPOSE: The purpose of this study was to evaluate the effects of oral stimulation interventions on the transition from tube to oral feeding in preterm infants through systematic review. METHODS: The randomized clinical trials published between 1980 and 2015 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the SIGN and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan). RESULTS: Oral stimulation intervention in preterm infants decreased the transition time from tube to oral feeding (Post Menstrual Age, Day of life). Especially, a significant medium effect size was found in the number of days needed on the transition (ES=-4.95, p=.02). The oral stimulation intervention also had a significant large effect on the length of stay at hospital (ES=-8.33, p < .001). CONCLUSION: Based on the findings, oral stimulation interventions could be useful to facilitate the transition from tube to oral feeding in preterm infants in terms of reducing the length of stay at hospital and the number of days needed on transition.

Efficacy of Feeding Pump for Patients on Enteral Tube Feeding: A Systematic Literature Review and Analysis / 대한소화기학회지

BACKGROUND/AIMS: This study was conducted to establish a guideline on the utilizing of feeding pump in patients requiring enteral tube feeding. METHODS: As a first step, textbooks on nutrition and guidelines from regional clinical nutrition societies were analyzed. Afterwards, data on the efficacy, safety, and practicality of feeding pump application were collected and evaluated by systematically reviewing the related literature. As data sources, 8 domestic databases including KoreaMed and global databases such as Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library were utilized. A total of 2,016 related articles was selected by applying the keyword "(enteral feeding.mp AND pump.mp)". RESULTS: Textbooks and guidelines were not able to draw conclusions on the effects of the feeding pump because the injection speed, tube size, and etcetera were different for enteral feeding. Feeding pump assisted enteral tube feeding was an efficient, safe, and practical procedure for reducing maladjustment-related complications of enteral tube feeding, which are obvious obstacles for maintaining nutritional balances in patients requiring tube feeding. CONCLUSIONS: Feeding pump application can be considered an efficient and safe measure that is acceptable in patients on small intestinal tube feeding, critically-ill patients on gastro-intestinal tube feeding, premature babies, and critically-ill or severely malnourished children (recommendation grade D).