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A Case Series of the Probability Density and Cumulative Distribution of Laryngeal Disease in a Tertiary Care Voice Center.
- Source :
-
The Annals of otology, rhinology, and laryngology [Ann Otol Rhinol Laryngol] 2017 Nov; Vol. 126 (11), pp. 748-754. Date of Electronic Publication: 2017 Sep 26. - Publication Year :
- 2017
-
Abstract
- Objective: To examine the distribution of clinic and operative pathology in a tertiary care laryngology practice.<br />Methods: Probability density and cumulative distribution analyses (Pareto analysis) was used to rank order laryngeal conditions seen in an outpatient tertiary care laryngology practice and those requiring surgical intervention during a 3-year period.<br />Results: Among 3783 new clinic consultations and 1380 operative procedures, voice disorders were the most common primary diagnostic category seen in clinic (n = 3223), followed by airway (n = 374) and swallowing (n = 186) disorders. Within the voice strata, the most common primary ICD-9 code used was dysphonia (41%), followed by unilateral vocal fold paralysis (UVFP) (9%) and cough (7%). Among new voice patients, 45% were found to have a structural abnormality. The most common surgical indications were laryngotracheal stenosis (37%), followed by recurrent respiratory papillomatosis (18%) and UVFP (17%).<br />Conclusions: Nearly 55% of patients presenting to a tertiary referral laryngology practice did not have an identifiable structural abnormality in the larynx on direct or indirect examination. The distribution of ICD-9 codes requiring surgical intervention was disparate from that seen in clinic. Application of the Pareto principle may improve resource allocation in laryngology, but these initial results require confirmation across multiple institutions.
- Subjects :
- Cost of Illness
Cough diagnosis
Cough surgery
Dysphonia diagnosis
Dysphonia surgery
Humans
Laryngostenosis diagnosis
Laryngostenosis surgery
Papilloma diagnosis
Papilloma surgery
Respiratory Tract Neoplasms diagnosis
Respiratory Tract Neoplasms surgery
Tennessee
Tertiary Care Centers
Tracheal Stenosis diagnosis
Tracheal Stenosis surgery
Vocal Cord Paralysis diagnosis
Vocal Cord Paralysis surgery
Laryngeal Diseases diagnosis
Laryngeal Diseases surgery
Tertiary Healthcare
Subjects
Details
- Language :
- English
- ISSN :
- 1943-572X
- Volume :
- 126
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- The Annals of otology, rhinology, and laryngology
- Publication Type :
- Academic Journal
- Accession number :
- 28949246
- Full Text :
- https://doi.org/10.1177/0003489417728945