The learning curve of BiZact™ tonsillectomy.

Rates of post-tonsillectomy haemorrhage between BiZactTM and bipolar tonsillectomy—a retrospective study

Background The health—related quality of life (HRQoL) concept is nowadays increasingly and more broadly used for helping evaluate the effectiveness of medical treatment, superseding the earlier “quality of life” approach. The HRQoL concept likewise applies to otolaryngology and this narrative review study is focused on HRQoL outcomes in four key childhood otolaryngological diseases as reported in the literature. Study aim To retrospectively evaluate the literature on measuring HRQoL in children suffering from selected otolaryngological illnesses, during treatment. Materials and Methods Published studies/case reports were searched for in Medline, PubMed, Web of Science, Scopus and ORCID on the quality of life based on paediatric patient questionnaires, whether completed by subjects themselves or by their parents (by proxy). The following key words were used: health quality of life, otolaryngology/ENT, pediatrics/paediatrics. Studies before 1999 were omitted because hitherto, the “quality of life” had been imprecisely defined thus rendering any subsequent comparisions problematic. Results HRQoL scores and well-being were found to significantly deteriorate in child patients suffering from four important otolaryngological disorders: chronic sinusitis, nasal septum deviation, adenoid hypertrophy and hearing disease. The main problems found were infection, inflammation, disruption to family life and child-parental interaction, fitness-related issues, reduced ENT patencies and apnea. Conclusions The HRQoL appears to significantly deteriorate in children suffering from otolaryngological diseases. Further such studies are needed for other ENT diseases.

A review of health—related quality of life issues in children suffering from certain key otolaryngological illnesses

Introduction The concept of health-related quality of life (HRQOL) is nowadays increasingly and more broadly used for evaluating the effectiveness of medical treatment, superseding the earlier ‘quality of life’. The reason is that subjective parameters have now been added – such as health, freedom, and happiness – to previous objective parameters such as social development and material wellbeing. The HRQOL concept applies equally well to otolaryngology and this selective review of the literature focuses on HRQOL outcomes in four childhood ENT diseases. Study aim is to retrospectively evaluate the literature on HRQOL in children hospitalised for chronic sinusitis, nasal septum deviation, adenoid hypertrophy, or hearing disease. Material and methods Published studies and case reports were searched in Medline/PubMed, Web of Science, Scopus, and ORCID on quality of life based on paediatric patient questionnaires, whether completed by the subjects themselves or their parents. As well as confining results to the four selected illnesses, the following key words were used: health quality of life, otolaryngology/ENT, pediatrics/paediatrics. The review is selective, not comprehensive, with total results limited to 25 studies. Studies before 1999 were omitted because before then ‘quality of life’ was imprecisely defined. Results HRQOL scores and well-being were found to significantly deteriorate in pediatric patients suffering from chronic sinusitis, nasal septum deviation, adenoid hypertrophy, or hearing disease. The main problems found were infection, inflammation, disruption to family life and child–parent interaction, fitness-related issues, reduced ENT patencies, and apnea. Conclusions HRQOL significantly deteriorates in children suffering from the defined ENT diseases. Further studies are needed to cover all ENT diseases. 

/pdf/health-related-quality-of-life-in-children-hospitalised-due-15bckscz.pdf

Health-related quality of life in children hospitalised due to four ent illnesses: a selective review

Introduction Paediatric tonsillectomy performed for sleep disordered breathing or recurrent tonsillitis and the effects on a child’s quality of life symptoms while waiting for surgery in an Australian public health system have not previously been investigated. This study investigated parental perceptions of the effects of tonsillectomy on their child’s quality of life while awaiting tonsillectomy and following surgery. Design, Setting and Participants An observational study was undertaken at a tertiary Australian hospital. Parents of paediatric patients (2 to 16 years of age) listed for tonsillectomy completed a validated quality of life questionnaire (T—14 Paediatric Throat Disorders Outcome Test) at the initial consultation, on day of surgery, 6 weeks post-operatively and 6 months post-operatively. T-14 scores were compared using the Related-Samples Wilcoxon Signed Rank Test. Results Parents of 167 children participated in this study. There was a median wait time of 174 days (IQR 108 – 347) from the initial consultation until the day of surgery, with no significant change in median T-14 scores (35 [IQR 22 - 42] vs 36 [IQR 22 - 42]; n= 63; p &gt; 0.05). There was a significant decrease from pre-operative T-14 scores to 6 weeks post-operatively (33.5 [IQR 22 - 42] vs 2 [IQR 0 - 5]; n = 160; p &lt; 0.001), and this was sustained with a minor improvement at 6 months post-operatively (6-week 2 [IQR 0 - 5] vs 6-month 0 [IQR 0 - 2]; n = 148; p &lt; 0.001). Conclusion Paediatric tonsillectomy improves the patient’s quality of life as perceived by their parents with a sustained benefit in the long term. There is no improvement to the patient’s quality of life while awaiting tonsillectomy, thus patient welfare can be improved through reducing waiting times for surgery. 

/pdf/an-observational-pragmatic-quality-of-life-study-on-2rcn9ry0.pdf

An Observational Pragmatic Quality of Life Study on Paediatric Tonsillectomy and Waiting for Surgery

Objectives: The objective of this study was to assess the T-14 outcomes of the BizactTM device for tonsillectomy in a pediatric population. Methods: A case series chart review was undertaken at a public tertiary teaching hospital and private otolaryngology practice, with data collected from pediatric patients who underwent a BizactTM tonsillectomy between July 2016 and October 2019 for any indication, whose parents consented to completing the T-14 questionnaire providing a parental perspective of the child's quality of life. Primary outcomes were T-14 scores recorded preoperatively and 6 weeks post-operatively. Secondary outcome measures were postoperative complications, including hemorrhage and readmission. Results: 146 patients were identified. There was a significant improvement in T-14 scores from a median of 24 (Interquartile range (IQR) 18-33) prior to surgery to 2 (IQR 0-4) at 6 weeks postoperatively (p < 0.001). The post-tonsillectomy hemorrhage rate was 6.1% (9/146 participants). Conclusions: Pediatric BizactTM tonsillectomy is effective in treating common indications for pediatric tonsillectomy, reflected by improved parent-reported health-related quality of life T-14 scores postoperatively.

Health Related Quality of Life T-14 Outcomes for Pediatric Bizact Tonsillectomy

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Health Related Quality of Life T-14 Outcomes for Pediatric Bizact Tonsillectomy