RESUMO
Objectives: As one of the world's only fully publicly administered, universal healthcare systems, Canada intends to provide equitable access to services for all patients. Socioeconomic status (SES) can affect treatment wait times with implications on health outcomes; however, this has not been evaluated in the setting of laryngeal disease, which incorporates urgent and elective conditions, in a universal healthcare system. This study aims to identify whether SES-affected treatment wait times for laryngeal therapies in this system. Methods: A retrospective review was conducted on a cohort of patients with laryngeal disease at an academic, tertiary center who underwent laryngeal surgery over a three-year period. Data retrieved through medical records; surgical and voice therapy wait times were normalized to each practitioner's average wait time for respective diagnostic categories. Income was used to assess SES and was derived from Statistics Canada census information based on patient postal codes. Results: Data analysis identified 578 patients (59% male). Mean wait time to surgery for all conditions was 123.5 (95% confidence interval 113.1-133.9) days. Analysis of variance analysis found no difference in wait times between different SES groups (p = .28), regardless of laryngeal disease category. Patients with cancer or airway obstruction had shorter wait times compared with benign conditions (p < .0001). Conclusions: SES did not affect treatment wait times for laryngeal therapies in a universal healthcare system. Wait times were shorter for oncologic and obstructive conditions compared with benign conditions, reflecting an ability to accommodate clinical needs without impacting care access at the detriment of different SES statuses. Level of Evidence: 4.
RESUMO
Cranial fasciitis (CF) is a rare benign fibroblastic lesion of the scalp, most commonly affecting the pediatric population. The authors conducted a literature review and include a summary of reported cases of CF. CF is most commonly located in the parietal and temporal regions of the skull. The majority of cases are found in males and in children under a few years of ago. We describe the clinical, pathological and radiological findings of the first reported case of CF of the mandible. In this case, the patient was a 12 month-old male who presented with a one-month history of a rapidly enlarging mass along his left mandibular ramus. Treatment of CF involves surgical resection and has a low rate of recurrence. The patient in question was managed surgically with no complications and has not had any evidence of disease recurrence.
