Effects of oxymetazoline on nasal flow and maximum aerobic exercise performance in patients with inferior turbinate hypertrophy.

OBJECTIVES/HYPOTHESIS: To determine the effect of topical intranasal oxymetazoline on nasal resistance and aerobic exercise performance in patients with nasal congestion caused by inferior turbinate hypertrophy. STUDY DESIGN: Individual randomized controlled trial. METHODS: Eight patients with inferior turbinate hypertrophy performed a set of exercise tests to exhaustion 1 week apart. They were given oxymetazoline or a placebo before each of the two test sessions according to a random pattern. Changes in nasal airflow were measured as peak nasal flow and ventilatory efficiency parameters, ventilatory equivalents, end-expiratory pressure, oxygen consumption, cardiac efficiency, rate of perceived exertion, and maximal and submaximal mechanical power. RESULTS: Ten minutes after use of the drug or placebo, improvements in maximum nasal airflow were seen in the oxymetazoline group (P < 0.05). However, exercise tests showed improvements in both groups (P < 0.05). After exertion, there was no difference between the two groups in maximum nasal airflow (P > 0.05). There were no differences between groups in oxygen consumption, rate of perceived exertion, respiratory exchange ratio, ventilation, or ventilatory equivalents for oxygen. CONCLUSION: Oxymetazoline increased nasal airflow in patients with turbinate hypertrophy, but this change did not translate into gains in physical exercise parameters or perceived exertion. LEVEL OF EVIDENCE: 1b.

Incidencia, estancia hospitalaria y factores de riesgo asociados a la aparición de fístula faringocutánea poslaringectomía / Incidence, hospital stay and risk factors associated with the occurrence of pharyngo-cutaneous fistula after total laryngectomy

Introducción y objetivos: La fístula faringocutánea (FFC) constituye uno de los principales problemas para los pacientes sometidos a laringectomía total. Son numerosos los factores de riesgo descritos y asociados a la aparición de la FFC, sin embargo algunos de ellos se encuentran en discusión. El objetivo es analizar la incidencia de la FFC, la estancia hospitalaria y los factores de riesgo asociados en los pacientes intervenidos de laringectomía total en un hospital de segundo nivel. Métodos: Estudio analítico observacional en una cohorte retrospectiva. Se incluyeron todos los pacientes intervenidos de laringectomía total entre los años 2006 y 2011. Se tuvieron en cuenta variables sociodemográficas, clínicas y la mayoría de los factores de riesgo estudiados en la literatura por otros autores (traqueostomía, estadificación tumoral, quimio/radioterapia previa, etc.). Los análisis estadísticos se llevaron a cabo mediante el programa SPSS® v.15.0 y el Epidat® v.3.1. Resultados: Se analizaron 70 laringectomías totales. La incidencia de FFC en el período de estudio fue del 48,6%. Hubo diferencias significativas entre la estancia hospitalaria media de los pacientes con y sin FFC. Se encontró como único factor de riesgo para la aparición de la FFC la presencia de adenopatías lo corregionales afectadas [RR= 1,60 (1,006-2,54)]. Conclusión: La aparición de FFC se encuentra asociada a la presencia de adenopatías locorregionales afectadas, y no se asocia con la traqueostomía, la administración de radio/quimioterapia previa a la intervención o la localización tumoral (AU)

Introduction and objectives: Pharyngo-cutaneous fistula (PCF) is one of the main problems for patients undergoing total laryngectomy. There are many risk factors described and associated with the appearance of PCF; however, some of these are currently under discussion. The aim of this work is to analyse the incidence of PCF, hospital stay and associated risk factors in patients undergoing total laryngectomy in a secondary hospital. Methods: This was an observational study in a retrospective cohort. We included all patients who underwent total laryngectomy between 2006 and 2011. We considered sociodemographic and clinical items, and most of the risk factors studied in the literature by other authors (tracheostomy, tumour stage, chemotherapy or radiotherapy before surgery, etc.). Statistical analyses were performed using SPSS® 15.0 and Epidat® 3.1. Results: We analysed 70 total laryngectomies. The incidence of PCF in the time period studied was 48.6%. There were significant differences between the mean hospital stay of patients with and without PCF. Affected locoregional lymph nodes were found to be the only risk factor for the occurrence of PCF [RR=1.60 (1.006-2.54)]. Conclusion: The incidence of PCF is associated with the presence of affected locoregional lymph nodes. It is not associated with tracheostomy, administration of radio/chemotherapy before surgery or tumour location (AU)

[Incidence, hospital stay and risk factors associated with the occurrence of pharyngo-cutaneous fistula after total laryngectomy]. / Incidencia, estancia hospitalaria y factores de riesgo asociados a la aparición de fístula faringocutánea poslaringectomía.

INTRODUCTION AND OBJECTIVES: Pharyngo-cutaneous fistula (PCF) is one of the main problems for patients undergoing total laryngectomy. There are many risk factors described and associated with the appearance of PCF; however, some of these are currently under discussion. The aim of this work is to analyse the incidence of PCF, hospital stay and associated risk factors in patients undergoing total laryngectomy in a secondary hospital. METHODS: This was an observational study in a retrospective cohort. We included all patients who underwent total laryngectomy between 2006 and 2011. We considered sociodemographic and clinical items, and most of the risk factors studied in the literature by other authors (tracheostomy, tumour stage, chemotherapy or radiotherapy before surgery, etc.). Statistical analyses were performed using SPSS(®) 15.0 and Epidat(®) 3.1. RESULTS: We analysed 70 total laryngectomies. The incidence of PCF in the time period studied was 48.6%. There were significant differences between the mean hospital stay of patients with and without PCF. Affected locoregional lymph nodes were found to be the only risk factor for the occurrence of PCF [RR=1.60 (1.006-2.54)]. CONCLUSION: The incidence of PCF is associated with the presence of affected locoregional lymph nodes. It is not associated with tracheostomy, administration of radio/chemotherapy before surgery or tumour location.