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Significance of age and sex in botulinum neurotoxin dosing for adductor spasmodic dysphonia

World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第2期9卷 168-173页

作者： Richard Heyes Charles H.Adler Nan Zhang David G.Lott stephen f.bansberg Department of Otorhinolaryngology-Head and Neck Surgery Mayo Clinic ArizonaPhoenixArizonaUSA Department of Neurology Mayo Clinic ArizonaPhoenixArizonaUSA Department of Biostatistics and Bioinformatics Mayo Clinic ArizonaPhoenixArizonaUSA

Objectives: This study aims to analyze the impact of age and sex on botulinum neurotoxin (BoNT-A) dosing and outcomes in adductor spasmodic dysphonia (AdSD).Methods: A database review of all spasmodic dysphonia patients treated with BoNT from 1989 to 2018 at the Mayo Clinic in Arizona was performed. Only patients who had received ≥4 injections of BoNT-A for AdSD were included. Patients were divided into two cohorts to analyze age, with an age of first treatment cutoff of 60 years. Patients were divided into male and female cohorts to analyze ***: The final analysis included 398 patients. The mean dose of BoNT-A per treatment was significantly higher in the younger cohort (4.4 vs. 3.9 units,p = 0.048). The mean maximal benefit was similar (72% vs. 70%,p = 0.48);however, the mean length of benefit was significantly shorter in younger patients (3.0 vs. 3.6 months,p ficantly higher in the female cohort (4.2 vs. 3.6 units,p = 0.02). The mean maximal benefit was similar (69% vs. 75%,p = 0.58), as was the mean length of benefit (3.2 vs. 3.5 months,p = 0.11).Conclusions: This study suggests that age and sex influence BoNT-A dosing and outcomes in AdSD.

关键词： adductor age gender outcomes sex spasmodic dysphonia

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Comparison of 3 mm versus 4 mm rigid endoscope in diagnostic nasal endoscopy

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2017年第1期3卷 -页

作者： Gregory S.Neel Ryan L.Kau stephen f.bansberg Devyani Lal Department of Otolaryngology Mayo ClinicPhoenixAZUSA

Objective:Compare nasal endoscopy with 3 mm versus conventional 4 mm rigid 30° endoscopes for visualization,patient comfort,and examiner ***:Ten adults with no previous sinus surgery underwent bilateral nasal endoscopy with both 4 mm and 3 mm endoscopes (resulting in 20 paired nasal endoscopies).Visualization,patient discomfort and examiner’s difficulty were assessed with every ***-nasal structures were checked on a list if visualized *** rated discomfort on a standardized numerical pain scale (0-10).Examiners rated difficulty of examination on a scale of 1-5 (1 =easiest).Results:Visualization with 3 mm endoscope was superior for the sphenoid ostium (P =0.002),superior turbinate (P =0.007),spheno-ethmoid recess (P =0.006),uncinate process (P =0.002),cribdform area (P =0.007),and Valve of Hasner (P =0.002).Patient discomfort was not significantly different for 3 mm vs.4 mm endoscopes but correlated with the examiners’ assessment of difficulty (r =0.73).The examiner rated endoscopy with 4 mm endoscopes more difficult (P =0.027).Conclusions:The 3 mm endoscope was superior in visualizing the sphenoid ostium,superior turbinate,spheno-ethmoid recess,uncinate process,cribriform plate,and valve of *** therefore may be useful in assessment of spheno-ethmoid recess,nasolacrimal duct,and cribriform area ***,patients tolerated nasal endoscopy *** patient discomfort was not significantly different between the endoscopes,most discomfort with 3 mm endoscopes was noted while examining structures difficult to visualize with the 4 mm ***’ discomfort correlated with the examiner’s assessment of difficulty.

关键词： Diagnostic Nasal endoscopy Pediatric endoscope 3 mm endoscope

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