Background: Flexible fiberoptic laryngoscopy is performed prior to thyroid surgery to evaluate the function of the recurrent laryngeal nerve. We assess the cost-effectiveness of preoperative laryngoscopy prior to total thyroidectomy for a low-risk thyroid cancer patient without dysphonia.
Methods: A decision tree analysis was performed from a third-party payer perspective. We assessed the cost-effectiveness of fiberoptic laryngoscopy prior to total thyroidectomy for T2N0M0 papillary thyroid carcinoma, such that an ipsilateral vocal fold paralysis alters the surgical plan to hemi-thyroidectomy, when permissible, to avoid the risk of bilateral vocal fold paralysis.
Results: Performing preoperative laryngoscopy to assess vocal fold function has an incremental cost-effectiveness ratio (ICER) of 45 193 USD/QALY compared to no laryngoscopy. At a willingness-to-pay of 100 K/QALY, the intervention is cost-effective if the incidence of vocal fold paralysis is at least 0.57%, or when the permissible rate of hemithyroidectomy in cases of incidental paralysis is at least 41%. Probabilistic sensitivity analysis shows that laryngoscopy is cost-effective in 90.9% of cases.
Conclusions: Fiberoptic laryngoscopy is a cost-effective prior to total thyroidectomy in asymptomatic, low-risk thyroid cancer patients.
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http://dx.doi.org/10.1002/hed.26312 | DOI Listing |
Diagnostics (Basel)
December 2024
Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, 10000 Zagreb, Croatia.
The relationship between symptoms of laryngopharyngeal reflux (LPR) and objective reflux measurements obtained through multichannel intraluminal impedance-pH (MII-pH) monitoring remains unclear. The aim of this study was to investigate the relationship between LPR symptoms and objective reflux episodes and possible associations between fibreoptic ENT findings, eosinophil counts, and serum IgE levels with reflux episodes detected by MII-pH. In this prospective study, MII-pH monitoring, fiberoptic laryngoscopy, nasal swabs for eosinophils, total serum IgE levels, and symptom assessment (Reflux Symptom Index, RSI) were performed in all children with suspected LPR.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Anaesthesia and Intensive Care, Policlinico-San Marco University Hospital, Via S. Sofia n 78, 95123 Catania, Italy.
Simulation offers the opportunity to train healthcare professionals in complex scenarios, such as those with as traumatized patients. We conducted an observational cross-sectional research simulating trauma with cervical immobilization. We compared five techniques/devices: direct laryngoscopy (DL), videolaryngoscopy (VLS, Glidescope or McGrath), combined laryngo-bronchoscopy intubation (CLBI) and articulating video stylet (ProVu).
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Anesthesiology, Kafkas University Medical Faculty, Kars, Turkey.
Abstarct: BACKGROUND: The optimal positioned double-lumen endotracheal tubes (DLT) is crucial in thoracic surgery requiring lung isolation. This study aims to compare the accuracy and complication rates of DLT placement using videolaryngoscopy (VL) versus conventional direct laryngoscopy (DL).
Methods: This retrospective single-center study included 89 patients who underwent thoracic surgery with DLT placement between July 2023 and May 2024.
Braz J Otorhinolaryngol
January 2025
Children's Hospital of Fudan University, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China. Electronic address:
Objectives: Lingual Thyroglossal Duct Cysts (LTDCs) are a rare variant of thyroglossal duct Cyst (LDC). This study aimed to explore the efficacy of transoral excision of LTDC and evaluate the added benefit of concomitant management of laryngomalacia during the surgical intervention.
Methods: Infants with LTDCs were retrospectively collected from our department from January 2009 to January 2022.
Head Neck
January 2025
Department of Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois, USA.
Background: Chondrosarcomas of the larynx, relatively rare tumors with low grade pathology in approximately 95% of cases, can most often be managed with conservation laryngeal procedures. Dedifferentiated chondrosarcomas are much more rare and aggressive requiring more aggressive surgical extirpation.
Methods: A patient underwent three debulking procedures for a laryngeal chondrosarcoma Grade I/II histologically over a 2.
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