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  • 1
    Online Resource
    Online Resource
    The Supratarsal Approach for Correction of Anterior Frontal Bone Fractures
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Craniofacial Surgery Vol. 29, No. 7 ( 2018-10), p. 1906-1909
    Details
    In: Journal of Craniofacial Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 7 ( 2018-10), p. 1906-1909
    Abstract: To approach isolated anterior frontal bone fracture, coronal incision is the common surgical access of choice. This approach has complications such as aesthetically undesirable scarring and alopecia along the incision line. An alternative approach to these fractures is through a supratarsal incision. The aim of the present study was to correct the frontal bone fracture, through supratarsal approach. Methods: Six consecutive patients with frontal bone fracture were operated through supratarsal incision and evaluated regarding: patient cosmetic satisfaction, forehead contour, scarring, sensibility and motility in forehead and upper eyelids. Results: Seven months (6–12) postoperatively, all the patients had normal mobility in the forehead and the upper eyelids and 17% (n = 1) had hypoesthesia of superior orbital nerve. The forehead contour was excellent in all patients. About 83% (n = 5) of the patients were very satisfied and 17% (n = 1) were satisfied with the surgical result. Conclusion: Correction of anterior frontal bone fracture through a supratarsal approach appears to be safe and offers a sufficient exposure to the frontal bone fracture correction with excellent contouring results and no noticeable scarring.
    Type of Medium: Online Resource
    ISSN: 1049-2275 , 1536-3732
    URL: Article
    DOI: 10.1097/SCS.0000000000004984
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2060546-8
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  • 2
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    Remission, complications, and overall survival in transsphenoidal pituitary surgery—a Swedish single-center experience of 578 patients
    Springer Science and Business Media LLC ; 2023
    In:  Acta Neurochirurgica Vol. 165, No. 3 ( 2023-01-20), p. 685-692
    Details
    In: Acta Neurochirurgica, Springer Science and Business Media LLC, Vol. 165, No. 3 ( 2023-01-20), p. 685-692
    Abstract: Surgical treatment of pituitary lesions causing hormonal overproduction or mass effect is standard procedure. There are few reports on the results and complications related to these surgeries from Northern Europe. Our aim was to evaluate the outcome and complications of a single tertiary surgical center over more than a decade. Methods This was a retrospective study on all patients that underwent pituitary surgery from 1st of January 2005 to 31st of December 2017. The analysis included type of lesion, surgical method, pre- and postoperative need for hormonal substitution, hormonal outcome, complications to surgery, survival, need for revision surgery, or stereotactic radiation. Appropriate statistical analyses were made to evaluate surgical results, complications, and survival. Results Five hundred seventy-eight patients were included in the study. Remission was achieved in 58% of patients with GH-producing and 94% of ACTH-releasing adenomas. Sixty-six percent had no preoperative hormonal substitution compared to 39% postoperatively. Rhinosinusitis (10%) was the most commonly reported postoperative complication followed by leakage of cerebrospinal fluid (8%) and meningitis (4%). Standardized mortality rate for the study population was higher ( p  = 0.18) when compared to the general population. Conclusion Our results regarding remission rates and complications are in comparison with previous studies. Surgery of pituitary lesion can be considered a safe and efficient surgery. We noted lower rates of CSF leakage in the later part of the study period and believe that this, in part, was an effect by the introduction of a multidisciplinary surgical skull base team and increased surgical experience.
    Type of Medium: Online Resource
    ISSN: 0942-0940
    URL: Article
    DOI: 10.1007/s00701-022-05456-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1464215-3
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  • 3
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    Evaluation of different hydrocortisone treatment strategies in transsphenoidal pituitary surgery
    Springer Science and Business Media LLC ; 2019
    In:  Acta Neurochirurgica Vol. 161, No. 8 ( 2019-8), p. 1715-1721
    Details
    In: Acta Neurochirurgica, Springer Science and Business Media LLC, Vol. 161, No. 8 ( 2019-8), p. 1715-1721
    Type of Medium: Online Resource
    ISSN: 0001-6268 , 0942-0940
    URL: Article
    DOI: 10.1007/s00701-019-03885-6
    RVK:
    XA 10000
    RVK:
    XA 12300
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 1464215-3
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  • 4
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    Morbidity after pediatric tonsillotomy versus tonsillectomy: A population‐based cohort study
    Wiley ; 2019
    In:  The Laryngoscope Vol. 129, No. 11 ( 2019-11), p. 2619-2626
    Details
    In: The Laryngoscope, Wiley, Vol. 129, No. 11 ( 2019-11), p. 2619-2626
    Abstract: To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil‐related upper airway obstruction. Study Design Retrospective population‐based cohort study based on data from the Swedish National Patient Register (NPR). Methods All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (± adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity. Results In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20‐4.77). Conclusions This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil‐related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason. Level of Evidence 2b Laryngoscope , 129:2619–2626, 2019
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v129.11
    DOI: 10.1002/lary.27665
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2026089-1
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  • 5
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    Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults? Retrospective cohort study from Sweden
    BMJ ; 2019
    In:  BMJ Open Vol. 9, No. 11 ( 2019-11), p. e033817-
    Details
    In: BMJ Open, BMJ, Vol. 9, No. 11 ( 2019-11), p. e033817-
    Abstract: To assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis. Design Retrospective cohort study. Setting Data were retrieved from the VEGA register, a comprehensive regional cohort in Sweden. Participants 1044 children ( 〈 15 years) and 2244 adults. Intervention Tonsillectomy/adenotonsillectomy compared with no surgical treatment. Main outcome measures Changes in yearly mean rates of medical care visits due to pharyngitis/tonsillitis. Results In children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p 〈 0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p 〈 0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up. Conclusion In this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2019-033817
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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  • 6
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    Comparison of clinical practice of tonsil surgery from quality register data from Sweden and Norway and one clinic in Denmark
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 4 ( 2022-04), p. e056551-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 4 ( 2022-04), p. e056551-
    Abstract: To compare the application of indications, demographics, surgical and haemostatic techniques in tonsil surgery in three countries. Design Non-randomised, prospective, observational cohort. Setting All patients registered in the National Tonsil Surgery Quality Registers in Sweden, Norway and West Jutland, Denmark. Participants Data were retrieved from 2017 to 2019; registered surgeries: Sweden: 20 833; Norway: 10 294 and West Jutland, Denmark: 505. Results Tonsil surgery for obstruction was twice as common in Sweden (62.2%) compared with Norway (31%) and Denmark (27.7%). Recurrent tonsillitis was registered twice as frequently in Norway (35.7%) and Denmark (39%) compared with Sweden (16.7%). Chronic tonsillitis was registered more frequently in Norway (29.8%) than in Sweden (13.8%) and Denmark (12.7%). Day surgery ( 〉 76%) was comparable. The higher frequency of obstruction in Sweden affected age and gender distributions: Sweden (7 years, 50.4% boys), Norway (17 y, 42.1%) and Denmark (19 y, 38.4%). For obstructive disorders, tonsillotomy with adenoidectomy was used in a majority of Swedish children (72%), whereas tonsillectomy with or without adenoidectomy dominated in Norway (53.5%) and Denmark (57.9%). Cold steel was the technique of choice for tonsillectomy in all three countries. For tonsillotomy, hot dissection techniques dominated in all countries. Disparities were observed with regard to haemostatic techniques. Bipolar diathermy was commonly used in all countries. Monopolar diathermy was practically only used in Sweden. Infiltration with epinephrine in the tonsillar bed was registered in Sweden and Norway but not at all in Denmark. Combined cold surgical and cold haemostatic techniques were more commonly used in Sweden (22.7%) than in Norway (10.4%) and Denmark (6.2%). Conclusions This study demonstrates disparities among the Nordic countries in tonsil surgery in terms of indications plus surgical and haemostatic techniques. Increased coverage and further monitoring of outcomes is needed to identify best practices and ideal guidelines for improved care.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-056551
    Language: English
    Publisher: BMJ
    Publication Date: 2022
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  • 7
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    Long-term symptom relief after septoplasty
    Springer Science and Business Media LLC ; 2015
    In:  European Archives of Oto-Rhino-Laryngology Vol. 272, No. 10 ( 2015-10), p. 2871-2875
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 272, No. 10 ( 2015-10), p. 2871-2875
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-014-3406-7
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 1459042-6
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  • 8
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    Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register: a case study
    Springer Science and Business Media LLC ; 2018
    In:  European Archives of Oto-Rhino-Laryngology Vol. 275, No. 6 ( 2018-6), p. 1631-1639
    Details
    In: European Archives of Oto-Rhino-Laryngology, Springer Science and Business Media LLC, Vol. 275, No. 6 ( 2018-6), p. 1631-1639
    Type of Medium: Online Resource
    ISSN: 0937-4477 , 1434-4726
    URL: Article
    DOI: 10.1007/s00405-018-4942-3
    RVK:
    XA 26650
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1459042-6
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  • 9
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    Correlates of excessive daytime sleepiness in obstructive sleep apnea: Results from the nationwide SESAR cohort including 34,684 patients
    Wiley ; 2022
    In:  Journal of Sleep Research Vol. 31, No. 6 ( 2022-12)
    Details
    In: Journal of Sleep Research, Wiley, Vol. 31, No. 6 ( 2022-12)
    Abstract: Excessive daytime sleepiness (EDS) is a hallmark symptom in obstructive sleep apnea (OSA). It is commonly eliminated by obstructive sleep apnea therapy and constitutes a major treatment indication. This study aimed to identify determinants of excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS) scores in the large, representative national obstructive sleep apnea patient cohort of the Swedish Sleep Apnea Registry (SESAR, www.sesar.se ). Data from 34,684 patients with obstructive sleep apnea recruited at 23 sites (33% females, mean age 55.7 ± 13.7 years, BMI 30.2 ± 6.3 kg/m 2 , AHI 29.1 ± 22.3, and ODI 24.9 ± 21.4 events/h) had a mean ESS score in the mild to moderate excessive daytime sleepiness range (9.7 ± 4.9). The proportion of patients with excessive daytime sleepiness was 41.4% in men and 44.6% in women. Independent predictors of excessive daytime sleepiness included gender, age, and hypoxic markers (high ODI and low mean saturation). Univariate and multivariate analyses were used to identify significant predictors for the ESS score and for excessive daytime sleepiness (ESS ≥10) amongst anthropometric factors, sleep apnea frequency (apnea‐hypopnea index (AHI)), markers of intermittent hypoxia (oxygen desaturation index (ODI), mean saturation (mSaO 2 )), as well as prevalent comorbidities. Depression was associated with higher ESS scores and hypertension/atrial fibrillation with lower scores. The oxygen desaturation index provided a stronger predictor of excessive daytime sleepiness than the apnea‐hypopnea index. The severity of obstructive sleep apnea, captured as the apnea‐hypopnea index, was only weakly associated with daytime sleepiness in this representative obstructive sleep apnea patient cohort. Age had different effects in men and women.The impact of obstructive sleep apnea in a wider patient related perspective needs to be determined after the inclusion of factors other than the apnea‐hypopnea index.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.v31.6
    DOI: 10.1111/jsr.13690
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2007459-1
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  • 10
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    Factors related to COVID ‐19 mortality among three Swedish intensive care units—A retrospective study
    Wiley ; 2023
    In:  Acta Anaesthesiologica Scandinavica Vol. 67, No. 6 ( 2023-07), p. 788-796
    Details
    In: Acta Anaesthesiologica Scandinavica, Wiley, Vol. 67, No. 6 ( 2023-07), p. 788-796
    Abstract: Mortality due to acute hypoxemic respiratory failure (AHRF) in patients with coronavirus disease‐19 (COVID‐19) differs across units, regions, and countries. These variations may be attributed to several factors, including comorbidities, acute physiological derangement, disease severity, treatment, ethnicity, healthcare system strain, and socioeconomic status. This study aimed to explore the features of patient characteristics, clinical management, and staffing that may be related to mortality among three intensive care units (ICUs) within the same hospital system in South Sweden. Methods We retrospectively analyzed ICU patients with COVID‐19 and AHRF in Region Jönköping County, Sweden. The primary outcome was the 90‐day mortality rate. We used univariate and multivariable logistic regression analyses to investigate the relationship of predictors with outcomes. Results Between March 15, 2020, and May 31, 2021, 331 patients with AHRF and COVID‐19 were admitted to the three ICUs. There were differences in disease severity, treatments, process‐related factors, and socioeconomic factors between the units. These factors were related to 90‐day mortality. After multivariable adjustment, age, severity of acute respiratory distress syndrome, and the number of nurses per ICU‐bed independently predicted 90‐day mortality. Conclusion Age, disease severity, and nurse staffing, but not treatment or socioeconomic status, were independently associated with 90‐day mortality among critically ill patients with AHRF due to COVID‐19. We also identified variations in care related processes, which may be a modifiable risk factor and warrants future investigation.
    Type of Medium: Online Resource
    ISSN: 0001-5172 , 1399-6576
    URL: Issue
    URL: Article
    DOI: 10.1111/aas.v67.6
    DOI: 10.1111/aas.14232
    RVK:
    XA 11250
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2004319-3
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