1296
LETTERS TO THE EDITOR
We mentioned 78.9% of participants experienced an URI before OME, just implying the possible etiology. OME after URI usually resolves spontaneously within 2 weeks for older children and adults. Also, the various durations did not influence the comparative results between groups basing on randomization. The therapeutic efficacy evaluation was performed weekly by pneumatic otoscopy and scoring clinical symptoms, which were carried out before ITS operation. It was true that two times of face-to-face follow-ups after the end of ITS was insufficient, which certainly made the design imperfect. Nevertheless, we had to decrease the times of re-examination after ITS because of the inconvenience for most participants who were from other cities, and the following follow-up mainly relied on telephone inquiry effectively. The data from telephone follow-up were also included to perform survival analysis in Figure 2. In our study, we included subjects by pneumatic otoscopy (the golden diagnosis criteria). Also, during the administration of ITS and after treatment, besides symptoms evaluation and pure tone test, pneumatic otoscopy was an important indicator for assessing therapeutic efficacy. In Figure 2, ‘‘week 0’’ represented the beginning of evaluation of therapeutic efficacy, which was performed 1 week after the first ITS and exactly before the second ITS. The data 100% in all groups meant patients still had OME manifestation and were willing to receive further ITS at that follow-up, or they were totally cured. The ITS treatment varied 1 to 12 times in the three groups. The ‘‘survival event’’ defined in the Kaplan-Meier survival curves was a status of either the patients had been cured without recurrence in the follow-up or the patients were unhealed but sufficiently satisfied with ITS administration and willing to receive more. Of course, it should be clearer if we use ‘‘week 1’’ as the beginning of the x axis. Regarding the long-term preventive effect of ITS on the remission of OME, both the Bud and Dex had good effect. Once OME recovered, the recurrence was unusual in adults and older children. Therefore, the effect that remained after 25 weeks was understandable. Honestly, we appreciate the valuable comments by Dr. Lee. It was extremely helpful in our further practice. Ping An, M.D. Yu Zhao, Ph.D., M.D. Fengling Yang, M.D. Department of Otolaryngology Head and Neck Surgery West China Hospital, Sichuan University, Chengdu Sichuan, China [email protected] The authors disclose no conflicts of interest.
GIANT CELL REPARATIVE GRANULOMA OF THE TEMPORAL BONE TREATED WITH CALCITONINV10 YEARS ON
To the Editor: In 2006, in this journal, we published ‘‘Giant Cell Reparative Granuloma of the Temporal Bone Treated With Calcitonin’’ (1). At that stage, the biopsy-proven large temporal bone lesion was managed with 12 months of daily injections of calcitonin 100 units, which were selfadministered without difficulty. The original computed tomographic (CT) scan revealed a large expansile lesion filling the majority of the temporal bone with a soft tissue component expanding bone over the middle cranial fossa and eroding the floor of the right glenoid fossa. The lesion decreased in size, the patient’s conductive hearing loss was completely reversed, and the patient remained asymptomatic for a 2-year period at last follow-up. CT scanning showed resolution of the soft tissue mass and significant new bone formation involving the glenoid fossa and mastoid cortex. It is now 10 years since the patient ceased treatment, and he remains in excellent health, with symmetric hearing and no conductive component toward his hearing loss, a normal appearing ear canal and an unchanged CT scan. Surgical intervention for this lesion would have entailed an extensive resection of the lateral cranial base and temporomandibular joint or alternatively radiotherapy. Selfadministered calcitonin injections were administered without incident and have now achieved a very satisfactory long-term result. We feel that this form of management should definitely be considered, given the potentially extensive surgery required to manage these benign lesions.
Philip Bird, F.R.A.C.S. Melanie Souter, F.R.A.C.S. Department of Otolaryngology Christchurch Hospital; and University of Otago Christchurch, New Zealand [email protected] The authors disclose no conflicts of interest.
REFERENCE 1. Souter MA, Bird PA, Worthington JP. Giant cell reparative granuloma of the temporal bone treated with calcitonin. Otol Neurotol 2006;27:999Y1002.
Otology & Neurotology, Vol. 36, No. 7, 2015
Copyright © 2015 Otology & Neurotology, Inc. Unauthorized reproduction of this article is prohibited.
LETTERS TO THE EDITOR
We mentioned 78.9% of participants experienced an URI before OME, just implying the possible etiology. OME after URI usually resolves spontaneously within 2 weeks for older children and adults. Also, the various durations did not influence the comparative results between groups basing on randomization. The therapeutic efficacy evaluation was performed weekly by pneumatic otoscopy and scoring clinical symptoms, which were carried out before ITS operation. It was true that two times of face-to-face follow-ups after the end of ITS was insufficient, which certainly made the design imperfect. Nevertheless, we had to decrease the times of re-examination after ITS because of the inconvenience for most participants who were from other cities, and the following follow-up mainly relied on telephone inquiry effectively. The data from telephone follow-up were also included to perform survival analysis in Figure 2. In our study, we included subjects by pneumatic otoscopy (the golden diagnosis criteria). Also, during the administration of ITS and after treatment, besides symptoms evaluation and pure tone test, pneumatic otoscopy was an important indicator for assessing therapeutic efficacy. In Figure 2, ‘‘week 0’’ represented the beginning of evaluation of therapeutic efficacy, which was performed 1 week after the first ITS and exactly before the second ITS. The data 100% in all groups meant patients still had OME manifestation and were willing to receive further ITS at that follow-up, or they were totally cured. The ITS treatment varied 1 to 12 times in the three groups. The ‘‘survival event’’ defined in the Kaplan-Meier survival curves was a status of either the patients had been cured without recurrence in the follow-up or the patients were unhealed but sufficiently satisfied with ITS administration and willing to receive more. Of course, it should be clearer if we use ‘‘week 1’’ as the beginning of the x axis. Regarding the long-term preventive effect of ITS on the remission of OME, both the Bud and Dex had good effect. Once OME recovered, the recurrence was unusual in adults and older children. Therefore, the effect that remained after 25 weeks was understandable. Honestly, we appreciate the valuable comments by Dr. Lee. It was extremely helpful in our further practice. Ping An, M.D. Yu Zhao, Ph.D., M.D. Fengling Yang, M.D. Department of Otolaryngology Head and Neck Surgery West China Hospital, Sichuan University, Chengdu Sichuan, China [email protected] The authors disclose no conflicts of interest.
GIANT CELL REPARATIVE GRANULOMA OF THE TEMPORAL BONE TREATED WITH CALCITONINV10 YEARS ON
To the Editor: In 2006, in this journal, we published ‘‘Giant Cell Reparative Granuloma of the Temporal Bone Treated With Calcitonin’’ (1). At that stage, the biopsy-proven large temporal bone lesion was managed with 12 months of daily injections of calcitonin 100 units, which were selfadministered without difficulty. The original computed tomographic (CT) scan revealed a large expansile lesion filling the majority of the temporal bone with a soft tissue component expanding bone over the middle cranial fossa and eroding the floor of the right glenoid fossa. The lesion decreased in size, the patient’s conductive hearing loss was completely reversed, and the patient remained asymptomatic for a 2-year period at last follow-up. CT scanning showed resolution of the soft tissue mass and significant new bone formation involving the glenoid fossa and mastoid cortex. It is now 10 years since the patient ceased treatment, and he remains in excellent health, with symmetric hearing and no conductive component toward his hearing loss, a normal appearing ear canal and an unchanged CT scan. Surgical intervention for this lesion would have entailed an extensive resection of the lateral cranial base and temporomandibular joint or alternatively radiotherapy. Selfadministered calcitonin injections were administered without incident and have now achieved a very satisfactory long-term result. We feel that this form of management should definitely be considered, given the potentially extensive surgery required to manage these benign lesions.
Philip Bird, F.R.A.C.S. Melanie Souter, F.R.A.C.S. Department of Otolaryngology Christchurch Hospital; and University of Otago Christchurch, New Zealand [email protected] The authors disclose no conflicts of interest.
REFERENCE 1. Souter MA, Bird PA, Worthington JP. Giant cell reparative granuloma of the temporal bone treated with calcitonin. Otol Neurotol 2006;27:999Y1002.
Otology & Neurotology, Vol. 36, No. 7, 2015
Copyright © 2015 Otology & Neurotology, Inc. Unauthorized reproduction of this article is prohibited.
