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Long-term Health-Related Quality of Life in Survivors of Head and Neck Cancer [Original Article]
Funk, G. F., Karnell, L. H., Christensen, A. J. Mon, 16 Jan 2012 12:41:19 -0800
Objective To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores. Design Prospective, observational outcomes study. Setting Tertiary care institution. Patients A total of 337 patients diagnosed as having head and neck carcinoma between January 1995 and December 2004, who enrolled in the Outcomes Assessment Project and survived at least 5 years. Interventions While participating in the longitudinal Outcomes Assessment Project, patients filled out surveys measuring HRQOL at numerous points in time. Main Outcome Measures Outcomes included 5-year scores in eating, speech, aesthetics, social disruption, physical and mental health, depressive symptoms, and overall quality of life (QOL). In addition to analyzing patients' 5-year HRQOL outcomes, multivariate analyses were performed to determine which patient, clinical, treatment, and 1-year HRQOL factors independently predicted these 5-year outcomes. Results Overall, the cohort's long-term general health was similar to that to age-matched norms from the general population. But over 50% of these survivors had problems eating, 28.5% reported depressive symptoms, and 17.3% reported substantial pain. At long-term follow-up, 13.6% continued to smoke, and 38.9% used alcohol. Multivariate analyses demonstrated that 1-year pain and diet were the strongest independent predictors of 5-year HRQOL outcomes. Conclusions Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems that these survivors face. Early interventions addressing eating issues, swallowing problems, and pain management will be a crucial component in improving this patient population's long-term QOL, especially in those who are functioning poorly 1 year after diagnosis.
Sequential Bilateral Cochlear Implantation in Children: Quality of Life [Original Article]
Sparreboom, M., Snik, A. F. M., Mylanus, E. A. M. Mon, 16 Jan 2012 12:41:05 -0800
Objective To assess the effect of sequential bilateral cochlear implantation in children on their quality of life (QoL). Design Prospective cohort-control study. Setting Tertiary academic referral center. Patients Thirty children with prelingual deafness underwent sequential bilateral cochlear implantation (mean age at first implant, 1.8 years; mean age at second implant, 5.3 years). Nine children with a unilateral cochlear implant were also included in the study. All children had prelingual deafness, had good implant performance, and had no benefit from a contralateral conventional hearing aid. The groups were matched on duration of unilateral implant use, chronological age, and degree of bilateral hearing loss. Intervention Sequential bilateral cochlear implantation. Main Outcome Measures Quality of life was assessed before surgery of the second implant and after 12 and 24 months of bilateral implant use. In the children with a unilateral cochlear implant, QoL was assessed over time and was compared with the study group after 12 and 24 months. Six questionnaires were used to measure QoL: overall health status using a visual analog scale; the Health Utilities Index Mark 3 (HUI3); the Pediatric Quality of Life Inventory (PedsQL); the Glasgow Children's Benefit Inventory (GCBI); the Speech, Spatial, and Qualities of Hearing Scale (SSQ); and the Nijmegen Cochlear Implant Questionnaire (NCIQ). Results Results showed no significant gain in generic QoL measures associated with sequential bilateral cochlear implantation (P > .05). The nonsignificant effect yielded on the HUI3 could be attributed to the ceiling effect and the lack of resolution in the hearing domain obtained in cochlear implant recipients. The gain in QoL of +0.04 may, therefore, be underestimated. In contrast, the 3 disease-specific questionnaires showed a significant improvement in QoL (P < .05). Results also showed that, unlike the children with a unilateral implant, QoL measures continued to improve with longer durations of bilateral implant use. Within the study group, the age at second implantation had no influence on the gain in QoL (P > .05). Conclusion Sequential bilateral cochlear implantation in children is associated with an improvement in QoL, although this is predominantly reflected in the disease-related aspects of QoL and not necessarily in generic QoL.
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Long-term Health-Related Quality of Life in Survivors of Head and Neck Cancer [Original Article]
Funk, G. F., Karnell, L. H., Christensen, A. J. Mon, 16 Jan 2012 12:41:19 -0800
Objective To examine health-related quality of life (HRQOL) reported by 5-year head and neck cancer survivors and factors that predicted these long-term scores. Design Prospective, observational outcomes study. Setting Tertiary care institution. Patients A total of 337 patients diagnosed as having head and neck carcinoma between January 1995 and December 2004, who enrolled in the Outcomes Assessment Project and survived at least 5 years. Interventions While participating in the longitudinal Outcomes Assessment Project, patients filled out surveys measuring HRQOL at numerous points in time. Main Outcome Measures Outcomes included 5-year scores in eating, speech, aesthetics, social disruption, physical and mental health, depressive symptoms, and overall quality of life (QOL). In addition to analyzing patients' 5-year HRQOL outcomes, multivariate analyses were performed to determine which patient, clinical, treatment, and 1-year HRQOL factors independently predicted these 5-year outcomes. Results Overall, the cohort's long-term general health was similar to that to age-matched norms from the general population. But over 50% of these survivors had problems eating, 28.5% reported depressive symptoms, and 17.3% reported substantial pain. At long-term follow-up, 13.6% continued to smoke, and 38.9% used alcohol. Multivariate analyses demonstrated that 1-year pain and diet were the strongest independent predictors of 5-year HRQOL outcomes. Conclusions Eating problems due to poor oropharyngeal functioning and persistent pain are the most prevalent problems that these survivors face. Early interventions addressing eating issues, swallowing problems, and pain management will be a crucial component in improving this patient population's long-term QOL, especially in those who are functioning poorly 1 year after diagnosis.
Sequential Bilateral Cochlear Implantation in Children: Quality of Life [Original Article]
Sparreboom, M., Snik, A. F. M., Mylanus, E. A. M. Mon, 16 Jan 2012 12:41:05 -0800
Objective To assess the effect of sequential bilateral cochlear implantation in children on their quality of life (QoL). Design Prospective cohort-control study. Setting Tertiary academic referral center. Patients Thirty children with prelingual deafness underwent sequential bilateral cochlear implantation (mean age at first implant, 1.8 years; mean age at second implant, 5.3 years). Nine children with a unilateral cochlear implant were also included in the study. All children had prelingual deafness, had good implant performance, and had no benefit from a contralateral conventional hearing aid. The groups were matched on duration of unilateral implant use, chronological age, and degree of bilateral hearing loss. Intervention Sequential bilateral cochlear implantation. Main Outcome Measures Quality of life was assessed before surgery of the second implant and after 12 and 24 months of bilateral implant use. In the children with a unilateral cochlear implant, QoL was assessed over time and was compared with the study group after 12 and 24 months. Six questionnaires were used to measure QoL: overall health status using a visual analog scale; the Health Utilities Index Mark 3 (HUI3); the Pediatric Quality of Life Inventory (PedsQL); the Glasgow Children's Benefit Inventory (GCBI); the Speech, Spatial, and Qualities of Hearing Scale (SSQ); and the Nijmegen Cochlear Implant Questionnaire (NCIQ). Results Results showed no significant gain in generic QoL measures associated with sequential bilateral cochlear implantation (P > .05). The nonsignificant effect yielded on the HUI3 could be attributed to the ceiling effect and the lack of resolution in the hearing domain obtained in cochlear implant recipients. The gain in QoL of +0.04 may, therefore, be underestimated. In contrast, the 3 disease-specific questionnaires showed a significant improvement in QoL (P < .05). Results also showed that, unlike the children with a unilateral implant, QoL measures continued to improve with longer durations of bilateral implant use. Within the study group, the age at second implantation had no influence on the gain in QoL (P > .05). Conclusion Sequential bilateral cochlear implantation in children is associated with an improvement in QoL, although this is predominantly reflected in the disease-related aspects of QoL and not necessarily in generic QoL.
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Sites:
CRS - Center for Research and Studies Amplifon: About this non-profit Organization founded in 1971. Includes courses and conferences, library, ENT net guide, newsletter and technologies. Based in Milan, Italy.ENTLinx.com: Otolaryngologists keep informed with free medical news and daily newsletters. ENTLinx and MDLinx combine the most current medical journal news and research from premier medical and healthcare journals and news sources. Comprehensive, specialized content--updated every day on the web...and in emai...
ENTonline: enter a description here
Head and Neck Surgery of the University of South Florida: Department of Otolaryngology information for patients and physicians on diseases of the ears nose and throat, listing of services and physicians and links to medical sites.
London Snoring Center: London Snoring Center.
Mayo Clinic Vestibular Rehabilitation Program: Vestibular/Balance Lab, Mayo Clinic in Rochester, Minn.
Oto-Rhino-Laryngology: Oto Rhino Laryngolgy web (www.orl.nl) is the Ear Nose & Threat information source including voice rehabiliation, conference news, politzer meeting ....... .
Otohns.net: Site for otolaryngologists with multiple features including an employment board and online discussions.
Otolaryngology examination: RJ's medical pages: Aa collection of medical information and links, maintained by Raza Jafri.
Otolaryngology Houston: Dr. Ghorayeb specializes in otolaryngology head and neck surgery. Diseases and surgery of the ear nose and throat, Houston, Texas. Laser surgery for snoring. Endoscopic sinus surgery. Vertigo, balance and equilibrium disorders. Audiology and hearing aids. Patient education links. Informed consen...
Otolaryngology jobs: Otolaryngology jobs are listed at Physician Employment and offfering an automatic email update for all new jobs as they are listed.
Piedmont Ear, Nose and Throat Associates: Penta Otolaryngology practice in Winston-Salem, NC. Describing services, frequently asked questions, and links.
Puget Sound Otolaryngology: Puget Sound Otolaryngology is focused on providing our patients with the best care and medical services. Our practice specializes in diseases of the ear, nose, and throat; with surgeons who specialize in head & neck, and plastic surgery., Puget Sound Otolaryngology is focused on providing our pa...
Rhinocare - Laser Nose Surgery Centers - Dr. Hayward L. Eubanks.: Laser procedures, treatment for nasal and sinus disorders. No pains and discomfort, quick patient surgery, immediate recovery. Insurance plans accepted, no inflammations.
Université catholique de Louvain: Multidisciplinary approach of head and neck cancer at University Hospital St Luc, Brussels, Belgium. Information on physicians, research, and contacts.
University of Michigan Otolaryngology Department: Specializes in diagnosis and treatment of sinus disorders. Also specializes in voice disorders for anyone who having vocal difficulties.
VCU/MCV Otolaryngology: Virginia Commonwealth University Medical College of Virginia Campus, Head and Neck Surgery Department. Faculty, staff and information. (Richmond, VA)
Voice Disorders: Surgical and medical information about your voice by James P. Thomas, MD., a physician specializing in the diagnosis and treatment of voice disorders including Vocal nodules, polyps, spasmodic dysphonia, throat cancer and all causes of hoarseness. Photos, audio and video recordings of various voi...
Voice Rehabilitation: prosthetic voice rehabilitation after laryngectomy using different voice prosthesis, like Blom-Singer VoiceMaster and Provox. electrolarynx and alaryngeal voice restoration
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