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Refractory Neurogenic Cough Management: The Non-Inferiority of Soluble Steroids to Particulate Suspensions for Superior Laryngeal Nerve Blocks.
Refractory Neurogenic Cough Management: The Non-Inferiority of Soluble Steroids to Particulate Suspensions for Superior Laryngeal Nerve Blocks.
상세정보
- 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
- 로그인을 한후 보실 수 있는 자료입니다.
- Control Number
- joongbu:658575
MARC
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■020 ▼a9798382321325
■035 ▼a(MiAaPQ)AAI31142189
■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a610
■1001 ▼aAbdou, Hisham.
■24510▼aRefractory Neurogenic Cough Management: The Non-Inferiority of Soluble Steroids to Particulate Suspensions for Superior Laryngeal Nerve Blocks.
■260 ▼a[S.l.]▼bYale University. ▼c2024
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2024
■300 ▼a48 p.
■500 ▼aSource: Dissertations Abstracts International, Volume: 85-11, Section: B.
■500 ▼aAdvisor: Lerner, Michael Z.
■5021 ▼aThesis (M.D.)--Yale University, 2024.
■520 ▼aPurpose: 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.
■590 ▼aSchool code: 0265.
■650 4▼aMedicine.
■650 4▼aPharmacology.
■650 4▼aNeurosciences.
■650 4▼aPharmaceutical sciences.
■653 ▼aChronic cough
■653 ▼aNerve block
■653 ▼aParticulate steroid
■653 ▼aSuperior laryngeal nerve
■653 ▼aSoluble steroid
■690 ▼a0564
■690 ▼a0317
■690 ▼a0419
■690 ▼a0572
■71020▼aYale University▼bYale School of Medicine.
■7730 ▼tDissertations Abstracts International▼g85-11B.
■790 ▼a0265
■791 ▼aM.D.
■792 ▼a2024
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17160650▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
