Otolaryngology

RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis

23 May, 2023 | 13:06h | UTC

Summary: The NATTINA trial, a pragmatic multicentre, open-label, randomized controlled study, sought to compare the clinical and cost-effectiveness of conservative management versus tonsillectomy in adults with recurrent acute tonsillitis. Conducted across 27 UK hospitals, 453 participants aged 16 or older were randomly assigned to either undergo immediate tonsillectomy or receive standard non-surgical care.

The main finding was that participants in the immediate tonsillectomy group had fewer days of sore throat over a 24-month period than those in the conservative management group (median 23 vs. 30 days). After adjusting for site and baseline severity, the incident rate ratio of total sore throat days in the immediate tonsillectomy group was significantly lower than in the conservative management group (0.53, 95% CI 0.43 to 0.65, p < 0.0001). The most common adverse event related to tonsillectomy was bleeding, which occurred in 19% of participants.

The NATTINA trial is the largest to date assessing the clinical and cost-effectiveness of tonsillectomy in adults. The results indicate that immediate tonsillectomy is clinically effective and cost-effective for recurrent acute tonsillitis. However, patients should weigh the benefits of fewer sore throat days against the risks of surgery.

Article: Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial – The Lancet

News Release: Tonsillectomy both clinically and cost effective for adults – Newcastle University

Commentary on Twitter

Compared with conservative management, immediate tonsillectomy is clinically effective and cost-effective in adults with recurrent acute #tonsillitis, suggests trial. https://t.co/LvSjn6XUx0 pic.twitter.com/yKzH9RqY5J

— The Lancet (@TheLancet) May 18, 2023

Author Interview: Effectiveness of Self-fitting vs Audiologist-Fitted Hearing Aids – JAMA

Commentaries:

Self-Fitting, Over-the-Counter Hearing Aids Beneficial – HealthDay

How Do Over-the-Counter Hearing Aids Compare with Those Fitted by Audiologists? – NEJM Journal Watch (free for a limited period)

Commentary on Twitter

Findings suggest that a self-fitting OTC hearing aid may be an effective intervention option for individuals with mild to moderate #hearingloss and produce self-perceived and clinical outcomes similar to those of an audiologist-fitted #hearingaid. https://t.co/Zbc8URj2uA

— JAMA Otolaryngology – Head & Neck Surgery (@JAMAOto) April 13, 2023

M-A | Test characteristics of ultrasound for the diagnosis of peritonsillar abscess

19 Apr, 2023 | 13:15h | UTC

Test characteristics of ultrasound for the diagnosis of peritonsillar abscess: A systematic review and meta-analysis – Academic Emergency Medicine

Commentary: How Good is Ultrasound at Diagnosing PTA? – RebelEM

Cohort Study | Association between hearing aid use and all-cause and cause-specific dementia

17 Apr, 2023 | 13:07h | UTC

Association between hearing aid use and all-cause and cause-specific dementia: an analysis of the UK Biobank cohort – The Lancet Public Health

Commentaries: Preventing dementia through correcting hearing: huge progress but more to do – The Lancet Public Health

News Release: Hearing aids may protect against a higher risk of dementia associated with hearing loss, study suggests – Lancet

Dementia and hearing-aid use: a two-way street – Age and Ageing

Association of Hearing Loss With Dementia – JAMA Network Open

Commentary on Twitter

NEW—Hearing aids may protect against a higher risk of #dementia associated with hearing loss, a @TheLancetPH study suggests.https://t.co/Yliq2wT7SR pic.twitter.com/v3iuTuHYVI

— The Lancet (@TheLancet) April 13, 2023

RCT | Targeted hypoglossal nerve stimulation may benefit patients with obstructive sleep apnea

11 Apr, 2023 | 14:07h | UTC

Targeted Hypoglossal Nerve Stimulation for Patients With Obstructive Sleep Apnea: A Randomized Clinical Trial – JAMA Otolaryngology – Head & Neck Surgery

Commentary on Twitter

In this study, proximal targeted hypoglossal nerve responses proved safe and effective in treating sleep apnea and improving sleep architecture and quality of life, while comparing favorably with those in distal hypoglossal nerve stimulation trials. https://t.co/yorNGW9uoi

— JAMA Otolaryngology – Head & Neck Surgery (@JAMAOto) April 6, 2023

New Cochrane Reviews:

Systemic pharmacological interventions for Ménière’s disease – Cochrane Library

Intratympanic gentamicin for Ménière’s disease – Cochrane Library

Intratympanic corticosteroids for Ménière’s disease – Cochrane Library

Positive pressure therapy for Ménière’s disease – Cochrane Library

Lifestyle and dietary interventions for Ménière’s disease – Cochrane Library

Surgical interventions for Ménière’s disease – Cochrane Library

Cross-sectional study | Risk factors for hearing loss at birth in newborns with congenital CMV infection

28 Feb, 2023 | 13:20h | UTC

Risk Factors for Hearing Loss at Birth in Newborns With Congenital Cytomegalovirus Infection – JAMA Pediatrics (link to abstract – $ for full-text)

Commentary: Factors ID’d for Hearing Loss in Newborns With Congenital Cytomegalovirus – HealthDay

Commentaries on Twitter

Findings of this cross-sectional study suggest that newborns with congenital cytomegalovirus infection and petechiae at birth, periventricular cysts on MRI, or a seroconversion in the first trimester had a higher risk of congenital hearing loss. https://t.co/csecGRFjug

— JAMA Otolaryngology – Head & Neck Surgery (@JAMAOto) January 3, 2023

A study in @JAMAOto examines the association of clinical independent risk factors and hearing loss in congenital CMV https://t.co/n0ScC6eMuB #EBNEOalerts #neoEBM #neotwitter pic.twitter.com/j1R5law7bo

— Evidence-Based Neo (@EBNEO) January 18, 2023

Consensus Statement | Standardized imaging and reporting for thyroid ultrasound

24 Feb, 2023 | 13:52h | UTC

Standardized Imaging and Reporting for Thyroid Ultrasound: Korean Society of Thyroid Radiology Consensus Statement and Recommendation – Korean Journal of Radiology

Commentary: Web-Based System Works Well for Diagnosis, Treatment of Recurrent Vertigo – HealthDay

Commentary on Twitter

Patients may benefit from treating benign paroxysmal positional vertigo themselves using a web-guided system. https://t.co/9Hjwb0XGnl

— JAMA Neurology (@JAMANeuro) January 20, 2023

RCT | Intranasal mometasone furoate and saline are similarly effective for sleep-disordered breathing in children

23 Jan, 2023 | 13:39h | UTC

Effectiveness of Intranasal Mometasone Furoate vs Saline for Sleep-Disordered Breathing in Children: A Randomized Clinical Trial – JAMA Pediatrics (free for a limited period)

News Release: Simple nasal spray significantly reduces snoring and breathing difficulties in children – Murdoch Childrens Research Institute

Commentary: Pediatric Sleep-Disordered Breathing Managed in Primary Care with Corticosteroid or Saline – HCP Live

Commentary on Twitter

Study suggests that in primary care, first-line treatment of sleep-disordered breathing in children could include 6 weeks of intranasal saline, or corticosteroid, which may resolve symptoms in almost one-half of children. https://t.co/oWrwcjgkPS @kirstenperrett

— JAMA Pediatrics (@JAMAPediatrics) January 17, 2023

M-A | Efficacy of probiotics in the management of halitosis

20 Jan, 2023 | 14:33h | UTC

Efficacy of probiotics in the management of halitosis: a systematic review and meta-analysis – BMJ Open

Commentary: Probiotic bacteria found in fermented foods might help dispel bad breath – BMJ Open Blog

Vestibular migraine treatment: a comprehensive practical review

19 Jan, 2023 | 13:57h | UTC

Vestibular migraine treatment: a comprehensive practical review – Brain

Study shows younger age at first acute otitis media and daycare attendance are the most important predictors for recurrence

13 Jan, 2023 | 13:22h | UTC

Window of Susceptibility to Acute Otitis Media Infection – Pediatrics

Invited commentary: Predicting Recurrent Acute Otitis Media and the Need for Tympanostomy: A Powerful Tool – Pediatrics

RCT | Tonsillectomy shown to be clinically and cost-effective in adults with recurrent acute tonsillitis

Ear-related balance disorders: evidence and resources

Olfactory dysfunction: etiology, diagnosis, and treatment

M-A | Association of SARS-CoV-2 vaccination or infection with Bell palsy

RCT | Effectiveness of an over-the-counter self-fitting hearing aid compared with an audiologist-fitted hearing aid

M-A | Test characteristics of ultrasound for the diagnosis of peritonsillar abscess

Cohort Study | Association between hearing aid use and all-cause and cause-specific dementia

RCT | Targeted hypoglossal nerve stimulation may benefit patients with obstructive sleep apnea

Consensus Paper | Best management of patients with an acute sore throat

Cochrane Library | Hearing conditions: evidence, experience and resources

SR | Etiologies of vertigo in the elderly

M-A | Test characteristics of ultrasound for the diagnosis of peritonsillar abscess

International consensus statement on allergy and rhinology: allergic rhinitis

Evidence Analysis | Menière’s disease: experience, evidence gaps & treatment choices

Cross-sectional study | Risk factors for hearing loss at birth in newborns with congenital CMV infection

Consensus Statement | Standardized imaging and reporting for thyroid ultrasound

SR | Tranexamic acid for the reduction of bleeding during functional endoscopic sinus surgery

M-A | Complications of percutaneous tracheostomy in critically ill adults with obesity

Guideline | Diagnosis and management of otitis media with effusion in children

Podcast | Hearing loss, tinnitus, and Meniere’s disease

RCT | Effects of a web-guided system for self-treatment of recurrent benign paroxysmal positional vertigo

RCT | Intranasal mometasone furoate and saline are similarly effective for sleep-disordered breathing in children

M-A | Efficacy of probiotics in the management of halitosis

Vestibular migraine treatment: a comprehensive practical review

Study shows younger age at first acute otitis media and daycare attendance are the most important predictors for recurrence

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