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Economics, epidemiology and outcomes

Published online by Cambridge University Press:  22 June 2016

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Abstract

Type
Editorial
Copyright
Copyright © JLO (1984) Limited 2016 

This month's issue of The Journal of Laryngology & Otology provides much room for thought. The economic impact of recurrent respiratory papilloma, a benign disease with a natural history that is relapsing and remitting over several years, has not previously been estimated in the UK. Harrison et al. have now done so and the costs are significant.Reference Harrison, Montgomery and Macgregor1 The case for prevention and combined concurrent adjunctive treatment remains strong and holds promise.Reference Kim and Baizhumanova2

The hypothesis that the age of onset of Ménière's disease is increasing as the elderly take to work with its attendant stressReference Shojaku, Watanabe, Fujisaka, Tsubota, Kobayashi and Yasumura3 has not been corroborated by Van Esch and colleagues' epidemiological study from the Netherlands.Reference van Esch, van Benthem, van der Zaag-Loonen and Bruintjes4 Ménière's disease has a peak incidence between 40 and 69 years in the Netherlands, as in most other countries.Reference Lüscher, Theilgaard and Edholm5

The age for closure of a child's perforated eardrum has been a controversial matter.Reference Carr, Strachan and Raine6 Singh et al. show that the comparative outcomes of tympanoplasty in younger children are no different from those in older children.Reference Singh, Arora, Garg, Kumar and Kumar7 In cases of small vestibular schwannomas with serviceable hearing, Peng and Wilkinson's systematic review on the outcomes of microsurgery in relation to observation and stereotactic radiation shows that, for patients under the age of 65 years, microsurgery via the middle fossa offers durable preservation of hearing.Reference Peng and Wilkinson8 One of the vicissitudes that occasionally occurs in thyroid surgery is incidental parathyroidectomy. Hone et al. report that concurrent neck dissection is an independent predictor of incidental parathyroidectomy and increases the risk by a factor of four.Reference Hone, Tikka, Kaleva, Hoey, Alexander and Balfour9

References

1Harrison, A, Montgomery, J, Macgregor, FB. Economic impact of recurrent respiratory papillomas in a UK adult population. J Laryngol Otol 2016;130:645–9CrossRefGoogle Scholar
2Kim, HT, Baizhumanova, AS. Is recurrent respiratory papillomatosis a manageable or curable disease? Laryngoscope 2016;126:1359–64CrossRefGoogle ScholarPubMed
3Shojaku, H, Watanabe, Y, Fujisaka, M, Tsubota, M, Kobayashi, K, Yasumura, S et al. Epidemiologic characteristics of definite Ménière's disease in Japan. A long-term survey of Toyama and Niigata prefectures. ORL J Otorhinolaryngol Relat Spec 2005;67:305–9CrossRefGoogle ScholarPubMed
4van Esch, BF, van Benthem, PP, van der Zaag-Loonen, HJ, Bruintjes, TD. Age of onset of Ménière's disease in the Netherlands: data from a specialised dizziness clinic. J Laryngol Otol 2016;130:624–7Google Scholar
5Lüscher, M, Theilgaard, S, Edholm, B. Prevalence and characteristics of diagnostic groups amongst 1034 patients seen in ENT practices for dizziness. J Laryngol Otol 2014;128:128–33Google Scholar
6Carr, SD, Strachan, DR, Raine, CH. Factors affecting myringoplasty success. J Laryngol Otol 2015;129:23–6Google Scholar
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8Peng, KA, Wilkinson, EP. Optimal outcomes for hearing preservation in the management of small vestibular schwannomas. J Laryngol Otol 2016;130:606–10CrossRefGoogle ScholarPubMed
9Hone, RW, Tikka, T, Kaleva, AI, Hoey, A, Alexander, V, Balfour, A et al. Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery. J Laryngol Otol 2016;130:669–73CrossRefGoogle ScholarPubMed