Evidence-Based Laryngology

206 Pages·2021·2.643 MB·English

by  David E. Rosow, Chandra M. Ivey (ed.)

Evidence-Based
Laryngology
David E. Rosow
Chandra M. Ivey
Editors
123
Evidence-Based Laryngology
David E. Rosow • Chandra M. Ivey
Editors
Evidence-Based
Laryngology
Editors
David E. Rosow Chandra M. Ivey
Department of Otolaryngology Department of Otolaryngology
University of Miami Miller Head and Neck Surgery
School of Medicine Icahn School of Medicine at
Miami, FL Mount Sinai
USA New York, NY
USA
ISBN 978-3-030-58493-1 ISBN 978-3-030-58494-8 (eBook)
https://doi.org/10.1007/978-3-030-58494-8
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I dedicate this work to the memory of my father, Carl
Rosow, MD, PhD, the greatest role model I could ask
for, whose professional mantra was always “show me
the evidence.”
—David E. Rosow, MD, FACS
I would like to acknowledge my children, Maddock and
Caitlin Marsallo, who fuel my gratitude and inspire my
curiosity and passion daily.
—Chandra M. Ivey, MD, FACS
Preface
How do we make clinical decisions in laryngology? It may seem
like an overly broad question, but the answer usually boils down
to one of four options:
1. My fellowship director told me.
2. I read a paper on it once.
3. In my experience, this works best for me.
4. I personally conducted a systematic review of all available
high-quality literature on this topic, synthesizing multiple ran-
domized, double-blinded, placebo-controlled trials to arrive at
my conclusion.
This is an obvious oversimplification, but it does emphasize
how frequently the answer is one of the first three options and how
rarely we can choose Option 4. Despite the long history of our
field, we have been slow to adopt the tenets of practicing evidence-
based medicine, with many of our decisions guided by retrospec-
tive case series and expert opinions.
Evidence-based medicine is defined as the application of the
best-available (i.e., most reliable) evidence gained from the scien-
tific method to guide clinical decision-making [1]. One early
description of evidence-based medicine noted that our recom-
mended treatment policies must be tied to “evidence instead of
standard-of-care practices or the beliefs of experts.” [2]
There are many ratings scales that can be used to determine the
quality of evidence in a published research paper. The Oxford
University Centre for Evidence-Based Medicine maintains
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probably the best-known rating system, and for this text, we will
use a simplified version of this system [3].
Randomized controlled trials (RCTs)
Level 1 Meta-analysis or systematic review of RCTs showing
consistent results
Prospective comparative studies
Level 2 Meta-analysis or systematic review of Level 1 or 2
studies with inconsistent results
Retrospective cohort studies
Level 3 Case control studies
Meta-analysis or systematic review of Level 3 studies
Case series
Level 4
Cross-sectional survey study
Level 5 Case report, expert opinion, personal observation
Please note that this system does not automatically mean
that higher level evidence is necessarily “better”; there are
many factors that go into determining the quality of research,
and this is only a simple guide. For example, an observational
study with a large number of subjects and significant treatment
effect is potentially more useful than a Cochrane review of a
few small studies with no conclusive result. Furthermore, there
are areas of medicine that are not amenable to randomized con-
trol trials. One frequently told joke holds that there are no pla-
cebo-controlled trials of the effects of using a parachute when
jumping out of an airplane, so how can we really know that they
work?
Keeping all this in mind, we have sought to create a manual for
otolaryngologists, residents, speech-language pathologists, and
any other clinicians who manage laryngological problems and
would like to know the evidence basis behind different treatment
options. This is purposefully not a comprehensive reference text-
book—there are many well-written ones currently available—but
to the best of our knowledge, they do not focus specifically on the
evidence justification for their statements.
Each chapter in a reference text may have dozens of refer-
ences, which can make casual browsing through the evidence
Preface ix
difficult. In this book, we have sought to summarize the key evi-
dence for each section in boxes such as the following:
Level of evidence Conclusion
Prospective cohort data shows muscle tension
2 dysphonia (MTD) may be a marker of vocal fold
paralysis/paresis
We recognize that the value of research cannot be easily dis-
tilled into a single number, but recommend readers use this text
simply as a guide concerning current laryngology practices. We
expect practitioners to decide for themselves if there is a signifi-
cant evidence basis to support their personal clinical decisions;
this book strives to make it more efficient and convenient to do so.
Miami, FL, USA David E. Rosow, MD
New York, NY, USA Chandra M. Ivey, MD
References
1. Evidence based medicine. (n.d.) Segen’s Medical Dictionary. (2011).
Retrieved 29 June 2020.
2. Eddy DM.  Practice policies: guidelines for methods. JAMA.
1990;263(13):1839–41.
3. OCEBM Levels of Evidence Working Group. The Oxford 2011 levels of
evidence. Oxford Centre for Evidence-Based Medicine. http://www.
cebm.net/index.aspx?o=5653. Retrieved 29 June 2020.
Contents
1 Vocal Fold Nodules . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Patrick O. McGarey Jr and C. Blake Simpson
2 Recurrent Respiratory Papillomatosis . . . . . . . . . . . . 11
David E. Rosow and Chandra M. Ivey
3 Early Glottic Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Nupur Kapoor Nerurkar, Gauri Kapre,
and Abhishek Vaidya
4 Unilateral Vocal Fold Paralysis and Paresis . . . . . . . . 41
Keith A. Chadwick and Lucian Sulica
5 Spasmodic Dysphonia and Vocal Tremor . . . . . . . . . . 73
Diana N. Kirke and Andrew Blitzer
6 Laryngopharyngeal Reflux . . . . . . . . . . . . . . . . . . . . . 89
Fermin M. Zubiaur
7 Chronic Cough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Christopher D. Dwyer, Juliana K. Litts,
and VyVy N. Young
8 Laryngotracheal Stenosis . . . . . . . . . . . . . . . . . . . . . . . 143
David E. Rosow, Debbie R. Pan,
and James W. Bao
9 Dysphagia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Angelina Schache and Ashli O’Rourke
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
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Contributors
James W. Bao, BA Department of Otolaryngology, University of
Miami Miller School of Medicine, Miami, FL, USA
Andrew  Blitzer, MD, DDS Department of Otolaryngology,
Head and Neck Surgery, Columbia University College of
Physicians and Surgeons, New York, NY, USA
Keith A. Chadwick, MD The Sean Parker Institute for the Voice,
Department of Otolaryngology-Head & Neck Surgery, Weill
Cornell Medical College – New York Presbyterian Hospital, New
York, NY, USA
Christopher  D.  Dwyer, MD UCSF Voice and Swallowing
Center, Department of Otolaryngology-Head and Neck Surgery,
University of California, San Francisco, San Francisco, CA, USA
Chandra M. Ivey, MD Department of Otolaryngology, Head
and Neck Surgery, Icahn School of Medicine at Mount Sinai, New
York, NY, USA
Gauri Kapre, MBBS, MS (ENT) Neeti Clinics Pvt Ltd, Depart-
ment of ENT, Nagpur, Maharashtra, India
Diana N. Kirke, MD Department of Otolaryngology, Head and
Neck Surgery, Icahn School of Medicine at Mount Sinai, New
York, NY, USA
Juliana K. Litts, MA, CCC-SLP Department of Otolaryngol-
ogy, University of Colorado School of Medicine, Aurora, CO,
USA
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