Publications by authors named "Markus Lilja"

6 Publications

  • Page 1 of 1

Long-Term Follow-Up After Maxillary Sinus Balloon Sinuplasty and ESS.

Ear Nose Throat J 2021 Feb 19:145561320986030. Epub 2021 Feb 19.

Skin and Allergy Hospital, 159841Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Objectives: The aim of this controlled follow-up study was to compare the need for revision surgery, long-term efficacy, and satisfaction in chronic rhinosinusitis patients who had undergone maxillary sinus operation with either balloon sinuplasty or traditional endoscopic sinus surgery (ESS) technique.

Methods: Thirty-nine ESS patients and 36 balloon patients of our previously described cohort, who had been primarily operated in 2008 to 2010, were contacted by phone. Symptoms, satisfaction, and need for revision surgery were asked. In addition, we collected data of patients who had undergone primary maxillary sinus balloon sinuplasty in the Helsinki University Hospital during the years 2005 to 2019. As a control group, we collected data of patients who had undergone primary maxillary sinus ESS at 3 Finnish University Hospitals, and 1 Central Hospital in years 2005, 2008, and 2011.

Results: Altogether, 77 balloon patients and 82 ESS patients were included. The mean follow-up time was 5.3 years in balloon group and 9.8 years in ESS group. Revision surgery was performed on 17 balloon patients and 6 ESS patients. In the survival analysis, the balloon sinuplasty associated significantly with a higher risk of revision surgery compared to ESS. According to the phone interviews, 82% of ESS patients and 75% of balloon patients were very satisfied with the primary operation.

Conclusion: Although the patient groups expressed equal satisfaction and change in symptoms after the operations, the need for revision surgery was higher after balloon sinuplasty than after ESS. This should be emphasized when counselling patients regarding surgical options.
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February 2021

Sinonasal Oncocytic Papilloma-A Series of 20 Cases With Special Emphasis on Recurrences.

Laryngoscope Investig Otolaryngol 2019 Dec 30;4(6):567-572. Epub 2019 Sep 30.

Department of Otorhinolaryngology-Head and Neck Surgery University of Helsinki and HUS Helsinki University Hospital Helsinki Finland.

Objective: Reports on sinonasal oncocytic papilloma (SNOP) are scarce. The aim of this retrospective study was to evaluate the clinical features of this rarest form of sinonasal papilloma with special emphasis on the pattern of recurrences and on the potential factors predicting them.

Study Design: Retrospective study.

Methods: Between the years 1994 and 2016, 20 patients (mean age 66 years; range 30-87) were diagnosed with SNOP at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Hospital charts were reviewed to record various medical and sociodemographic patient characteristics, and the archived histological specimens were re-evaluated. Postoperative follow-up time varied between 26 days and 167 months.

Results: Maxillary sinus was the most common (60%) tumor location. None of the tissue samples showed dysplasia. Recurrence rate was 39% and the median time span to the first recurrence was 25 months (range 7-71). Smokers had more often a recurrence than nonsmokers (75% vs. 31%). Patients with perioperative purulent rhinosinusitis during the primary surgery had a higher recurrence rate compared with those without (60% vs. 31%). Tumors located in the sinuses recurred more often than those located in the nasal cavity (45% vs. 29%). However, all these findings remained statistically nonsignificant. None of the cases showed malignant transformation during the follow-up.

Conclusion: SNOP has a propensity to recur. History of smoking, purulent rhinosinusitis during the primary surgery, and tumor location in the sinuses outside the nasal cavity seem to contribute to an increased trend in the risk of recurrence.

Level Of Evidence: 4.
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December 2019

Olfactory and gustatory functions after free flap reconstruction and radiotherapy for oral and pharyngeal cancer: a prospective follow-up study.

Eur Arch Otorhinolaryngol 2018 Apr 27;275(4):959-966. Epub 2018 Jan 27.

Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, P.O. Box 263, FI-00029 HUS,, Helsinki, Finland.

Background: The senses of smell and taste can be adversely affected by both tumour- and treatment-related factors amongst head and neck cancer patients. The consequences may negatively impact nutritional status as well as quality of life in this patient population.

Patients And Methods: This prospective longitudinal follow-up study is consisted of 44 patients treated for oral cavity, oropharyngeal or hypopharyngeal cancer with tumour resection and microvascular free tissue transfer reconstruction at the Helsinki University Hospital, Helsinki, Finland. Thirty-nine (89%) of them also received radiotherapy. The senses of smell (odour detection, identification and threshold test) and taste (electrogustometry) and quality of life (UW-QOL) were evaluated preoperatively, and at 6 weeks, 3 months, 6 months and 12 months, postoperatively.

Results: There were higher scores in the odour detection values in the 6-week and 3-month tests compared with preoperative values for the tumour side. Other detection scores did not differ statistically from the preoperative values neither in the tumour nor the contralateral side. However, in the odour identification test, all posttreatment values were statistically significantly higher than pretreatment ones. In the olfactory threshold test, no statistically significant differences were found between pre- and posttreatment values. Electrogustometry values for the taste on the tumour side were statistically significantly impaired at 6 weeks (p < 0.05) and at 3 months (p < 0.01) compared with the pretreatment results. They were also impaired at 6 months and at 12 months, although the differences were not statistically significant. The quality of life was impaired after treatment in this patient series. However, the correlation between quality of life and sense of taste was found only at one time point (3 months) and only with contralateral side measurements.

Conclusions: We conclude that in oral and pharyngeal cancer patients the postoperative taste problems are related to the impairment on the taste sensation in the tongue but not with the sense of smell. Moreover, the impairment in the quality of life is not clearly related to the impaired sense of taste.
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April 2018

Does septoplasty enhance the quality of life in patients?

Eur Arch Otorhinolaryngol 2012 Dec 25;269(12):2497-503. Epub 2012 Jan 25.

Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Central Hospital and University of Helsinki, P.O. Box 220, 00029 Helsinki, HUS, Finland.

Evaluation of the severity of disease and the effectiveness of operative treatment is commonly done by registering pre- and postoperative symptoms. During the preceding decade, greater awareness has focused not only on the symptoms but also on patients' quality of life (QoL). The aim of the study was to determine the effect of septoplasty, as measured by generic and disease-specific QoL questionnaires. The generic 15D and disease-specific SNOT-22 questionnaires were given to patients before the operation and 6 months after the operation. Data analysis consisted originally of 188 septoplasty patients. One-hundred and twenty-six patients (67%) answered the SNOT-22 questions, and in the 15D, the response rate was 76%. In the post-operative SNOT-22, the need to blow the nose, sneezing, runny nose, nasal obstruction, loss of smell or taste, post-nasal discharge, facial pain/pressure, difficulty in falling asleep and waking up at night improved significantly. However in the 15D the mean QoL, i.e., general well-being, became significantly poorer. The QoL became increasingly poor especially in the older age groups and among the patients in which the improvement achieved in nasal symptoms postoperatively was minor. The more nasal symptoms the patients had pre- or postoperatively, the poorer the QoL was in general. Based on our results, critical evaluation of the symptoms and findings in the patients is essential in deciding whether surgery or other treatment should be given to individual patients having nasal blockage symptoms. Especially in patients with mild symptoms or among older patients, adequate medical treatment has to be tried before even considering surgery. The results also encourage the use of a systematic questionnaire to estimate the severity of symptoms in daily clinical practice.
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December 2012

[Surgical techniques of the inferior nasal turbinates in the treatment of nasal obstruction].

Duodecim 2010 ;126(17):2023-31

HYKS:n korva-, nenä- ja kurkkutautien klinikka, PL 220, 00029 HUS.

Chronic nasal obstruction causes sleep disorders and has an adverse effect on quality of life. Inferior turbinate enlargement due to hypersensitive rhinitis is one of the main causes of chronic nasal obstruction. Many of these cases respond to topical corticosteroids. Long standing swelling may become irreversible and a surgical approach to enlarged turbinate becomes necessary. In septal deviation, a compensatory enlargement of contralateral inferior turbinate may indicate reduction at the time of septoplasty. A number of techniques for turbinate reduction have been described. Main target for the operation is submucosal soft tissue and less frequently bony tissue. Radiofrequency ablation, submucosal operation techniques and microdebrider techniques are the methods of choise in reducing inferior turbinate with diminished adverse side effects.
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December 2010

Meconium contaminated amniotic fluid and infant otitis media. Is it a risk factor in children surviving aspiration and initial distress of respiration?

Int J Pediatr Otorhinolaryngol 2006 Apr 26;70(4):655-62. Epub 2005 Sep 26.

Department of Otolaryngology, Helsinki University Central Hospital, Haartmaninkatu 4E, FIN-00290 Helsinki, Finland.

Objective: Histological studies show that amniotic fluid cellular content (AFCC) causes in the middle ear a foreign body reaction, the extent and severity of which depends upon the massiveness of contamination. We studied how factors related to birth and environment affect proneness to acute otitis media (AOM) in infants born through meconium contaminated amniotic fluid.

Methods: From the birth records of infants born from 1996 to 2000 a list was made of those born through meconium contaminated amniotic fluid with pulmonary aspiration and tracheal suctioning, followed by treatment in a neonatal intensive care unit. Thirty-seven such children formed the study group, 43 children matching the study cases but born through clear fluids formed the control group. Birth and environmental factors together with the frequency and number of episodes of AOM were analyzed in all, based on a verified questionnaire. In addition, 27 children in the study group and 21 in the control group received a specialist ENT examination, hearing tests and tympanometry.

Results: The events at delivery were highly significantly different between the two groups, manifested by the lower Apgar points in the study group (p<0.001) while other birth and environmental factors appeared equalized. The first episode of AOM in the study group came earlier than in the control group and their frequency was significantly higher during the 1st and 2nd year of life and during the entire observation period (p<0.001). Tympanostomy was performed more often in the study group. Tympanometry showed more cases of reduced static admittance and negative pressure than in the control group and hearing was poorer.

Conclusions: Cases with compromised delivery through meconium contaminated fluids, resulting in pulmonary aspiration and in need of intensive care treatment, form a risk group, which should be closely followed. Early nasopharyngeal suctioning of AFCC may reduce its entry into the middle ear. A prolonged episode of AOM suggests mucosal involvement of several middle ear compartments, shown by histological studies to occur in all cases of massive contamination. Placement of a ventilation tube after the first prolonged AOM allows regression of the granulation tissue in the air spaces together with the secretory elements in the mucosa.
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April 2006