자료유형  

 학위논문

Control Number  

0017160650

International Standard Book Number  

9798382321325

Dewey Decimal Classification Number  

610

Main Entry-Personal Name  

Abdou, Hisham.

Publication, Distribution, etc. (Imprint  

[S.l.] : Yale University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

48 p.

General Note  

Source: Dissertations Abstracts International, Volume: 85-11, Section: B.

General Note  

Advisor: Lerner, Michael Z.

Dissertation Note  

Thesis (M.D.)--Yale University, 2024.

Summary, Etc.  

요약Purpose: Superior laryngeal nerve (SLN) block utilizing triamcinolone (TA) or methylprednisolone acetate (MP) has been described as an efficacious treatment for refractory cough (RC). Particulate corticosteroid injection in the neck carries a risk of large-particle embolization and devastating neurologic sequela in the event of inadvertent intravascular injection. Herein, we compare the efficacy of a soluble steroid (dexamethasone, SS) with particulate steroids (PS) in reducing cough severity in RC-patients.Materials and Methods: Patient charts for those receiving SLN blocks by fellowship-trained laryngologists for the sole indication of RC were reviewed. Drug/dose, timing/laterality, and adjuvant treatments were compared using chi-squared test. A paired t-test was used to assess post-treatment improvement and a non-inferiority test was performed to compare improvement between two groups.Results: Of 40 patients included, 27 (67.5%) received SS. Patient and treatment characteristics did not significantly differ between the two cohorts. Significant improvement in cough suppression index (ΔCSI) post-treatment was found in both groups (PS, p=0.024; SS, p0.001); improvement in the SS group was statistically non-inferior (p=0.003) to that in the PS group.Conclusions: Our pilot study is the first to compare steroids in the field of Otolaryngology, specifically as a component of SLN blocks for refractory cough. Herein, we illustrate that dexamethasone may be a safe alternative to weaker particulate steroids while non-inferior as a treatment for RC. Generalizability is limited by our study's retrospective study design and small sample size limiting our ability to conduct multivariate analysis and adjust for follow-up time.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Pharmacology.

Subject Added Entry-Topical Term  

Neurosciences.

Subject Added Entry-Topical Term  

Pharmaceutical sciences.

Index Term-Uncontrolled  

Chronic cough

Index Term-Uncontrolled  

Nerve block

Index Term-Uncontrolled  

Particulate steroid

Index Term-Uncontrolled  

Superior laryngeal nerve

Index Term-Uncontrolled  

Soluble steroid

Added Entry-Corporate Name  

Yale University Yale School of Medicine

Host Item Entry  

Dissertations Abstracts International. 85-11B.

Electronic Location and Access  

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Control Number  

joongbu:658575