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Objective: To examine the construct validity, reliability and responsiveness of the Otology Questionnaire Amsterdam (OQUA)., Design: Multicentre, longitudinal study in 2 separate cohorts of patients visiting an ENT surgeon via an online survey programme., Setting: Tertiary ENT clinics., Participants: Cohort 1 consisted of patients at their first visit at an ENT outpatient clinic with an ear complaint. Cohort 2 consisted of patients who underwent surgery, with a 3-month follow-up post-surgery., Main Outcome Measures: Construct validity: Hypothesis testing, internal consistency and inter-item correlation. Reliability: Test-retest reliability. The construct approach was used for assessing responsiveness. Hypotheses were formulated based on the association between the OQUA and Glasgow Health Status Inventory (GHSI) or Global Rating Scale (GRS)., Results: Construct validity: The correlation between the individual items in the impact domain ranged from 0.424 to 0.737. Confirmatory factor analysis showed a good fit. As expected, the OQUA impact showed strong relationships with GHSI total and general scale. Reliability: The test-retest reliability coefficient ranged from 0.541 to 0.838. Responsiveness: All hypotheses were conformed. As expected, the change score of the OQUA showed good correlation between OQUA impact and GHSI and moderate correlation between the GRS and OQUA complaints., Conclusion: The OQUA has 8 complaint domains (earache, pressure sensation, itching, tinnitus, hearing loss, ear discharge, loss of taste and dizziness) and 1 impact domain. Each domain results in one score of 0-100. The OQUA shows good results for construct validity, (test-retest) reliability and responsiveness, supporting the potential benefit for the patient with an ear complaint visiting the ENT surgeon. The extensive validation furthermore confirms a certified generic otology PROM with an impact and a complaints' part, to be used in different types of otologic interventions and patient groups., (© 2020 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.)

Purpose: To assess awareness of, opinion about and adherence to evidence-based guidelines on chronic rhinosinusitis among Dutch Otolaryngologists., Methods: We assessed implementation of two guidelines, one Dutch and one European, that are both intended for diagnosis and treatment of patients with chronic rhinosinusitis. We invited 485 Otolaryngologists to fill out a questionnaire and report on their opinion on and adherence to the guidelines. The adherence was further tested by 4 clinical case scenarios, derived from guideline recommendations., Results: 166 (34%) completed the questionnaire. 99% of the respondents was aware of one or both guidelines. Most respondents (90%) consider the guidelines as directing or supportive for their clinical practice based on the clinical case scenarios, between 62 and 99% of the respondents act according to guidelines. Concerning diagnosis, CT-imaging is performed more and allergy testing less than recommended. Where multiple treatment options are recommended, the responses are more heterogeneous as a result of this. Nonetheless, high recommended treatment was chosen more often. Otolaryngologists were reluctant in surgical treatment as a first option, which is according to the guidelines., Conclusions: Overall, both the EPOS and CBO guideline are well known among Dutch Otolaryngologists and 90% indicates that the guideline is important in their daily practice. Adherence to the guidelines is sufficient to high. If multiple treatment or diagnostic options are recommended this leads to a more heterogeneous response pattern. Recommendations with a high grade of recommendation were followed up most often.

Objective: Analysis of the method of tonsillectomy in use in the Netherlands and the incidence of postoperative haemorrhage in an academic tertiary pediatric referral hospital., Study Design and Setting: (A) An explorative study of the Sluder tonsillectomy method in the Netherlands and (B) a retrospective case file review at the Sophia Children's Hospital in Rotterdam., Methods: (A) A telephone and e-mail survey amongst 107 hospitals in the Netherlands. (B) A review of patients younger than 16 years who underwent a tonsillectomy or adenotonsillectomy between January 1, 1998, and February 22, 2008. This part of the study surveyed the intubated Sluder method and analyzed the incidence of primary and secondary haemorrhage in an academic tertiary pediatric referral hospital., Results: (A) The Sluder method was commonly used in 102 (95.32%) hospitals; the traditional dissection technique was exclusively used only in five hospitals (4.67%). Of the 102 hospitals using the Sluder method, 67 (65.68%) report using only inhalation mask anaesthesia, while the remaining 35 use intubation. (B) Of 1797 patients studied, 40 patients experienced postoperative tonsillar haemorrhage (2.23%), with 35 (1.95%) patients primary haemorrhage of which 32 (1.78%) within 6 h after the surgery. Secondary haemorrhage occurred in five (0.28%) patients., Conclusions: The Sluder method is still generally used in the majority of hospitals in the Netherlands today. Because of the low incidence of especially secondary haemorrhage and most of the primary haemorrhages occurring within 6h after the surgery, this technique is ideally suited for day care tonsillectomy., (Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.)

Atresia of the external ear canal following recurrent external otitis or surgery for chronic otitis media was treated in 17 ears with a canalplasty procedure using a retroauricular incision. The stenotic meatus was widened by removing fibrous tissue, and the tympanic membrane was deepithelialized. The posterior, superior, and inferior bony canal was widened until the first mastoid cells were encountered. The anterior canal was widened in cases where there was an anterior bony overhang. The bony canal was lined with split-thickness skin grafts. Meatoplasty was performed, and split-thickness skin grafts were grafted onto the margins of the meatoplasty to cover the lateral part of the ear canal. Preoperative and postoperative surgical results, including hearing levels, are presented and compared with those from the few other series from the literature.

Endoscopic sinus surgery has become popular during recent years. We report the complications of endoscopic sinus surgery in 593 patients in whom 1235 sides were operated on. Forty-five patients had complications, in three of whom they were systemic. The remaining 42 patients had complications on 52 (4.2%) sides; these complications were mostly minor. In 0.3% of the sides operated on, potentially serious complications, such as orbital hematoma or cerebrospinal fluid leak, were seen. None of these patients developed loss of vision or meningitis. Absence of the middle turbinate is a risk factor for developing complications. We conclude that endoscopic sinus surgery is a safe procedure in experienced hands.