Incidental Histopathologic Finding of Sinonasal Inverted Papilloma Among Surgically Excised Polyps Increases the Risk of Tumor Recurrence.

Inverted papilloma (IP) is a benign tumor remarkable for its tendency toward recurrence. Local relapse implicates incomplete resection concerning the bone adjacent to tumor base. The high false negative rates on biopsies, mainly when nasal polyps coexist, may affect the surgical management and outcomes. Our objective was to study the impact of preoperative histologic diagnosis in IP recurrence, particularly in patients with pre-surgical diagnosis of inflammatory polyps. A retrospective analysis of 62 patients treated for IP was conducted. Demographic data and information about smoking status, alcohol intake, tumor location, histology, presence of nasal polyps, staging, malignancy, previous biopsies and surgical approach were evaluated to identify factors associated with recurrence. Prevalence of nasal polyps was higher in patients with recurrence. Smoking history, alcohol abuse, staging, histologic type, malignancy and surgical approach were not associated with recurrence. The presence of nasal polyps at endoscopy was inversely associated with the diagnosis of IP at incisional biopsy. Incidental histologic diagnosis of IP after surgery increased the risk of recurrence more than tenfold. Biopsy reporting the diagnosis of IP previous to surgery was inversely associated to recurrence. In patients with IP, coexistence of nasal polyps at initial endoscopy and lack of pathological IP diagnosis prior to surgery are strongly associated with a higher risk of recurrence. When excisional biopsy reports IP incidentally, an early revision surgery should be considered in order to avoid future aggressive surgeries because of tumor recurrence.

Otoplasty Using the Combined Mustardé-Furnas Technique: Satisfaction and Objective Results.

BACKGROUND: To understand the level of satisfaction among patients undergoing otoplasty using the combined Mustardé-Furnas technique. To evaluate surgery outcomes using McDowell/Wright (MW) criteria. OBJECTIVES: The authors sought to analyze any possible correlation between satisfaction level and surgery outcome. METHODS: The authors conducted a retrospective study on patients who underwent combined Mustardé and Furnas otoplasty between 1996 and 2016. All patients were assessed 12 months after surgery employing MW goals and satisfaction surveys. RESULTS: The study includes 172 patients who underwent 343 otoplasty procedures. There were 134 patients (77.9%) who had all 6 of the criteria for surgical success as defined by MW 12 months after surgery, reporting satisfaction levels of 9 to 10. Fifteen patients (9.3%) had 5 of the 6 MW criteria, reporting satisfaction levels of 9 to 10, and 22 patients (12.79%) had only 4 MW objectives and reported satisfaction levels of 7 to 10. The Spearman rho coefficient was 0.545 and the Kendall coefficient was 0.375, with a statistically significant association (P < 0.001). CONCLUSIONS: Patient satisfaction increases as the number of MW goals are met, although the correlation is moderate to low. Patients perceive the results of the surgery as satisfactory or very satisfactory, even when ENT surgeons consider outcomes to be poor according to MW criteria.

Translation, Cultural Adaptation, and Preliminary Evaluation of the Spanish Version of the Transgender Voice Questionnaire for Male-to-Female Transsexuals (TVQ MtF).

OBJECTIVE: This study aimed to perform translation, cross-cultural adaptation, and validation of the Spanish version of the Transsexual Voice Questionnaire for Male-to-Female Transsexuals (TVQ MtF). STUDY DESIGN: This is a prospective study. SETTING: The study was conducted by the Gender Identity Unit and the Voice Unit of a tertiary hospital referral center for surgical feminization of the voice. SUBJECTS AND METHODS: The study had two parts: translation and adaptation of the TVQ MtF with the following actions: translation (with authorization and consensus of the authors of the original questionnaire), back-translation, pretesting, and final version; and preliminary study of the psychometric properties (feasibility, internal consistency, test-retest reliability, construct validity, discriminant validity, and ceiling and floor effects). Thirty male-to-female transsexual women filled out the questionnaire, and 18 of the 30 filled out the questionnaire approximately 2 weeks after filling it out for the first time. RESULTS: Feasibility was 100%. Cronbach α was 0.976. The intraclass correlation coefficient was 0.885. The Spearman correlation coefficient between TVQ MtF and the physical component of SF-12 v2 was 0.102 (P value = 0.592) and between TVQ MtF and the mental component was -0.263 (P value = 0.161). A ceiling effect was not found. A floor effect was found in two questionnaires (6.7%). CONCLUSION: Feasibility, internal consistency, and reliability outcomes in our study support the validity of the authorized Spanish version of the TVQ MtF.