ABSTRACT
BACKGROUND: Endoscopic sinus surgery (ESS) has been used for decades to treat recurrent acute rhinosinusitis episodes (RARS) in adults. RARS results in infectious symptoms, antibiotic courses, sick leaves, and impaired quality of life. Theoretically, the ESS procedure, through improving the drainage of the paranasal sinuses, decreases the symptoms and enhances the quality of life of the RARS patients. Whether this is true has not been reported in a randomized trial yet. METHODS: We conduct a single-center, non-blinded, randomized, 6-month, parallel group superiority clinical study including 80 adult participants referred to surgical treatment for RARS. The participants will either have ESS or conservative medical treatment (control group). The primary outcome will be the difference between the mean disease-specific Sinonasal Outcome Test 22 (quality of life questionnaire) change scores (from baseline to 6 months) of ESS and control group. DISCUSSION: This study will add significant new information to the effect and harms of ESS procedure in the treatment of adults with RARS. TRIAL REGISTRATION: ClinicalTrials.gov NCT04241016 . Registered on 17 January 2020.
Subject(s)
Paranasal Sinuses , Rhinitis , Sinusitis , Adult , Chronic Disease , Endoscopy/adverse effects , Humans , Paranasal Sinuses/diagnostic imaging , Paranasal Sinuses/surgery , Quality of Life , Randomized Controlled Trials as Topic , Rhinitis/diagnosis , Rhinitis/surgery , Sinusitis/diagnostic imaging , Sinusitis/surgery , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the short term efficacy and safety of tonsillectomy for recurrent streptococcal pharyngitis in adults. Design Randomised controlled trial. SETTING: Academic referral centre in Finland. PARTICIPANTS: 70 adults with documented recurrent episodes of streptococcal group A pharyngitis. INTERVENTION: Instant tonsillectomy (n=36) or remaining on waiting list as control (n=34). MAIN OUTCOME MEASURES: Percentage change in the risk of an episode of streptococcal pharyngitis at 90 days. Rates of all episodes of pharyngitis and days with symptoms and adverse effects. RESULTS: The mean (SD) follow-up was 164 (63) days in the control group and 170 (12) days in the tonsillectomy group. At 90 days, streptococcal pharyngitis had recurred in 24% (8/34) in the control group and 3% (1/36) in the tonsillectomy group (difference 21%; 95% confidence interval 6% to 36%). The number needed to undergo tonsillectomy to prevent one recurrence was 5 (3 to 16). During the whole follow-up, the rates of other episodes of pharyngitis and days with throat pain and fever were significantly lower in the tonsillectomy group than in the control group. The most common morbidity related to tonsillectomy was postoperative throat pain (mean length 13 days, SD 4). CONCLUSIONS: Adults with a history of documented recurrent episodes of streptococcal pharyngitis were less likely to have further streptococcal or other throat infections or days with throat pain if they had their tonsils removed. TRIAL REGISTRATION: Clinical Trials NCT00136877.
Subject(s)
Pharyngitis/surgery , Streptococcal Infections/surgery , Tonsillectomy/methods , Acute Disease , Adolescent , Adult , Aged , Humans , Middle Aged , Recurrence , Streptococcus pyogenes , Tonsillectomy/adverse effects , Treatment OutcomeABSTRACT
Angiokeratoma is a rare, cutaneous vascular disorder that can occur in several clinically distinct conditions. It usually presents as multiple, red to blue or black, asymptomatic papules on the skin. Oral mucosal involvement is common in the systemic form, but very rare in the localized forms of angiokeratomas. We report the second case of a solitary papular angiokeratoma of the oral cavity.
