Hasil untuk "Otorhinolaryngology"

Samantha B. Landreth, Jordan C. Schramm, Nathan M. Money

Children who undergo adenotonsillectomy frequently return to the hospital, most commonly for post-operative dehydration, hemorrhage, and pain control. Post-operative systemic infectious complications are rarely observed and not well-described. In this case series, we present three cases of invasive Streptococcus pyogenes infection following adenotonsillectomy. Providers caring for ill-appearing children post-adenotonsillectomy should consider these complications to help avoid diagnostic and treatment delay. Postoperative risks of adenotonsillectomy should be carefully considered and discussed with families prior to operating, especially for children with chronic medical conditions.

M. Antoszewska, E. M. Sokolewicz, W. Barańska-Rybak

Hyaluronic acid (HA), as one of the main components of the extracellular matrix (ECM), plays an important role in the process of wound-healing and tissue-repair processes due to its unique properties and different physiological functions. HA has an ability to maintain a moist environment that promotes healing, the stimulation of growth factors and cellular constituents, and the migration of various cells essential for healing. This paper offers a review of HA use in the process of wound healing, with emphasis on hard-to-heal wounds, and examines its various applications in ophthalmology and otorhinolaryngology. It proves HA to be a versatile agent which finds its use in various fields of medicine for its antioxidant, anti-inflammatory, antibacterial properties and accelerated wound healing.

R. Yotsova, S. Peev

Bone defects represent an everyday challenge for clinicians who work in the fields of orthopedic surgery, maxillofacial and oral surgery, otorhinolaryngology, and dental implantology. Various bone substitutes have been developed and utilized, according to the needs of bone reconstructive surgery. Carbonate apatite has gained popularity in recent years, due to its excellent tissue behavior and osteoconductive potential. This systematic review aims to evaluate the role of carbonate apatite in bone reconstructive surgery and tissue engineering, analyze its advantages and limitations, and suggest further directions for research and development. The Web of Science, PubMed, and Scopus electronic databases were searched for relevant review articles, published from January 2014 to 21 July 2023. The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eighteen studies were included in the present review. The biological properties and medical applications of carbonate apatite (CO3Ap) are discussed and evaluated. The majority of articles demonstrated that CO3Ap has excellent biocompatibility, resorbability, and osteoconductivity. Furthermore, it resembles bone tissue and causes minimal immunological reactions. Therefore, it may be successfully utilized in various medical applications, such as bone substitution, scaffolding, implant coating, drug delivery, and tissue engineering.

Inga Marte Charlott Seuthe, Markus Ruwe, Franz Mitze et al.

Abstract Objectives VCP/p97 inhibition is known to upregulate PD-L1. This study investigated the correlation between PD-L1 and VCP/p97 expression in OPSCC, as well as the expression and prognostic significance of VCP/p97 in OPSCC. Methods The study retrospectively included 56 patients with OPSCC. Immunohistochemical staining was performed to detect VCP/p97 and PD-L1 expression. The staining intensity of VCP/p97 and PD-L1 TPS and CPS was determined. HPV status was evaluated using immunohistochemical staining against p16 and HPV PCR. In addition, iTILs were assessed. Results High VCP/p97 expression was observed in 67.9% of the tumors. A significant association was found between high VCP/p97 expression and low PD-L1 TPS (p = 0.025) and between high VCP/p97 and low iTILs (p = 0.015). No significant correlation was found between VCP/p97 and PD-L1 CPS. VCP/p97 showed no prognostic significance in OPSCC. Conclusion VCP/p97 is frequently overexpressed in OPSCC. The significant association of high VCP/p97 expression with low PD-L1 TPS and reduced iTILs could indicate that VCP/p97 inhibitor therapy may enhance the efficacy of PD-1 checkpoint inhibitor therapy in OPSCC.

Mary Jue Xu, Samuel Okerosi, Aslam Nkya et al.

The World Health Organization (WHO) has shifted from a multiple-dose human papillomavirus (HPV) vaccine schedule to a one-dose schedule prioritizing females aged 9–14 y. Given the burden of HPV-associated disease aside from cervical cancer and affecting both sexes, a shift toward emphasizing gender-neutral HPV vaccination strategies may improve vaccination coverage and more comprehensively address HPV-driven disease across both sexes, particularly for low- and middle-income countries.

Mikko Saukkoriipi, Jaakko Sahlsten, Joel Jaskari et al.

Abstract Radiotherapy is the main treatment modality of oropharyngeal cancer (OPC), in which an accurate segmentation of primary gross tumor volume (GTVt) is essential but also challenging due to significant interobserver variability and the time consumed in manual tumor delineation. For such a challenge an interactive deep learning (DL) based approach offers the advantage of automatic high-performance segmentation with the flexibility for user correction when necessary. In this study, we investigate an interactive DL for GTVt segmentation in OPC by introducing a novel two-stage Interactive Click Refinement (2S-ICR) framework and implementing state-of-the-art algorithms. Using the 2021 HEad and neCK TumOR dataset for development and an external dataset from The University of Texas MD Anderson Cancer Center for evaluation, the 2S-ICR framework achieves a Dice similarity coefficient of 0.722 ± 0.142 without user interaction and 0.858 ± 0.050 after ten interactions, thus outperforming existing methods in both cases.

Luca Calabrese, Enrico Fazio, Sara Bassani et al.

Andre Jing Yuen Ang, Shu Ping Chee, Joyce Zhi En Tang et al.

Abstract Introduction 3D-printed temporal bone models enable the training and rehearsal of complex otological procedures. To date, there has been no consolidation of the literature regarding the developmental process of 3D-printed temporal bone models. A brief review of the current literature shows that many of the key surgical landmarks of the temporal bone are poorly represented in models. This study aims to propose a novel design and production workflow to produce high-fidelity 3D-printed temporal bone models for surgical simulation. Methods Developmental phases for data extraction, 3D segmentation and Computer Aided Design (CAD), and fabrication are outlined. The design and fabrication considerations for key anatomical regions, such as the mastoid air cells and course of the facial nerve, are expounded on with the associated strategy and design methods employed. To validate the model, radiological measurements were compared and a senior otolaryngologist performed various surgical procedures on the model. Results Measurements between the original scans and scans of the model demonstrate sub-millimetre accuracy of the model. Assessment by the senior otologist found that the model was satisfactory in simulating multiple surgical procedures. Conclusion This study offers a systematic method for creating accurate 3D-printed temporal bone models for surgical training. Results show high accuracy and effectiveness in simulating surgical procedures, promising improved training and patient outcomes.

Giuseppe Riva, Giancarlo Pecorari, Gian Marco Motatto et al.

T GS Basappa Varun, Angshuman Dutta, Rahul Naga et al.

Inroduction: Nasal obstruction is the most common complaint in an average ENT practice, and a deviated nasal septum is the most common cause of nasal obstruction. The deformities of the septum are usually congenital, developmental, traumatic, or iatrogenic in nature with traumatic and iatrogenic being the most common. The aim of the study was to evaluate patient-based outcomes on subjective-based opinion in patients undergoing endoscopic septoplasty. Methods: This study was conducted in a tertiary care hospital setting in western Maharashtra. This was a prospective observational study.The present study was conducted on 50 patients who presented with signs and symptoms attributed to septal deviation who underwent endoscopic septoplasty and followed up in the department of otorhinolaryngology, head and neck surgery, tertiary care hospital, Mumbai, Maharashtra.The results of our study were analyzed on SPSS Software using “Paired t-test”. Results: On the statistical analysis of the Nasal Obstruction Symptom Evaluation score of patients (n = 50) at baseline and at postoperative 3- and 6-month follow-up, mean + standard deviation was 61.2 ± 11.18, 9.1 ± 5.32, and 8.1 ± 4.51, respectively, with P < 0.0001 preoperative and 3-month postoperative follow-up which is highly significant and P > 0.05 for 3- and 6-month follow-up and hence insignificant. Conclusion: Endoscopic septoplasty results in significant improvement in disease-specific quality of life with high patient satisfaction.

Abdulrahman Nabil Fathi Abdulghffar, Hedayat El Sayed EL Fouly, Mohamed Sherif EL Minawi et al.

Abstract Background Coronaviruses are large, encapsulated RNA viruses that can infect both humans and animals and cause minor respiratory illnesses. In December 2019, numerous cases of pneumonia of unknown origin were reported in Wuhan, China. Coronavirus Disease 2019 (COVID-19), the cause of these cases, was discovered on January 6, 2020. The new coronavirus was declared an epidemic by the WHO on March, 2020. Several studies on COVID-19 have found that auditory complaints and hearing impairment can be detected using various tests. Objectives Pure tone audiometry (PTA) and transient evoked otoacoustic emissions (TEOAEs) were used to assess hearing in recovered SARS-CoV-2 patients. Also, to compare the presence of patient's auditory complaints with the test findings. Methods A case- control study was conducted, with each case and control group consisting of 58 people who were age and sex matched and ranged in age from 18 to 50 years. PTA, Extended PTA and, TEOAEs were used to evaluate hearing in both groups. Results PTA revealed a statistically significant difference in right ear thresholds at 250 Hz, 500 Hz, 4 kHz, and 8 kHz and left ear thresholds at 250 Hz, 4 kHz, 8 kHz, and 12.5 kHz between patients and controls. Additionally, a statistically significant difference in TEOAEs' overall reproducibility and amplitude between patients and controls was discovered. Affection for PTA and TEOAEs were related to the patient's complaints of hearing loss and tinnitus, respectively. Conclusions Whether a patient is symptomatic or not, COVID-19 may have a negative impact on their hearing.

Sara Sainio, Karin Blomgren, Anu Laulajainen‐Hongisto et al.

Abstract Objective Kinetic oscillation stimulation (KOS) is a new treatment method for nonallergic rhinitis (NAR), usually delivered twice with a 2‐ to 4‐week interval, and thought to stabilize autonomous dysregulation in the nasal mucosa. We aimed to assess the long‐term (1 year) results following one KOS treatment amongst patients with NAR. Methods KOS was administered through a latex balloon placed in the patient's nasal cavity. The balloon is connected to a device that fills the balloon with air pulses, thus vibrating the balloon for 10 min per side. Outcomes were evaluated through patient‐reported outcome measures (Sino‐Nasal Outcome Test 22 [SNOT‐22], Total Nasal Symptom Score [TNSS], Nasal Obstruction Symptom Evaluation [NOSE], and 15D) and measures of patency (rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow [PNIF], and clinical inferior turbinate size). Pre‐treatment actions were repeated at 1, 3, 6, and 12 months. Results In all 49 patients, we found significant improvement in the SNOT‐22, NOSE, and TNSS scores. At 12 months, SNOT‐22 improved from 44 to 34, NOSE from 60 to 45, TNSS from 8 to 7, and PNIF from 80 to 100 L/min (p < .005 for all). We observed no major complications. Conclusion One KOS treatment appears to provide NAR patients with a subjective symptom improvement for at least 1 year, thus possibly decreasing the need for invasive treatment methods. Level of Evidence III.

Ni Ketut Susilawati, I Wayan Putu Sutirta Yasa, Wayan Suardana et al.

BACKGROUND:Purple sweet potato tuber ethanol extract (PSPTEE) has been known to have benefits in various disease, including to prevent nasopharyngeal carcinoma (NPC). However, there has been no research on PSPTEE in preventing the proliferation of nasopharyngeal mucosal epithelial cells induced by formaldehyde through the oxidative stress mechanisms and inflammatory process. Studies have proven the effect of PSP on various cancer cells, but the carcinogenesis process of the nasopharyngeal mucosal epithelium is still limited. Hence, this study aimed to demonstrate the mechanism for preventing histopathology changes with PSPTEE due to formaldehyde exposure. METHODS: Thirty-two formaldehyde-induced Wistar rats were treated with or without 1g/kgBW/day PSPTEE for 16 weeks. Malondialdehyde (MDA) level were examined with spectrophotometry method, while tumor necrosis factor (TNF)-α and p53 with enzyme linked immunosorbent assay (ELISA) method. The histopathology appearance of the nasopharyngeal epithelium was observed with hematoxylin-eosin (HE) staining. RESULTS: MDA and TNF-α levels in control and treatment group were 22.89±2.84 μM; 9.83±0.89 μM and 84.18±11.58 ng/L; 73.92±10.59 ng/L, respectively, and they showed significant difference. Meanwhile, the level of p53 showed no significant difference. Histopathology appearance showed a significant difference. Path analysis for MDA, TNF-α and p53 levels contributed 28.7% to histopathology appearance. MDA have an effect on significant direct effect on TNF-α. TNF-α has a significant direct effect to histopathological appearance. Indirect influence MDA on histopatological appearance were smaller than the direct effect. TNF-α has the greatest influence on histopatological appearance. CONCLUSION: Formaldehyde induces the histopathology appearance in nasopharyngeal epithelium. This study also demonstrates the mechanism to prevent the nasopharynx epithelial histopathology appearance by administration of PSPTEE. KEYWORDS: PSP, MDA, TNF-α, p53, nasopharynx epithelial

Andrew Stefan, Thai Cung, Bianca Siegel

Foreign body aspiration (FBA) can be difficult to differentiate from asthma exacerbation in a child. Typical presentation includes witnessed aspiration and symptoms of respiratory distress, cough, and abnormal breath sounds. However, it is not uncommon for patients to have an atypical presentation, making the diagnosis of FBA less obvious. The suspicion for FBA should be raised if a patient is being treated for acute asthma exacerbation and does not show clinical improvement following escalation of therapy and ventilator support. If FBA is suspected, an otolaryngologist or critical care specialist will perform a direct bronchoscopy to confirm the diagnosis and remove the aspirated object. Early diagnosis and treatment of FBA is important, as a delayed diagnosis can result in various complications, including pneumonia, respiratory arrest, atelectasis, and even death. While rare, gastric tube cap aspiration can occur in a PEG tube-dependent patient with new onset, dyspnea after a witnessed seizure. It is important to keep a broad differential and have a high index of suspicion for FBA when evaluating a patient with difficulty in breathing.

Jéssica Dayane da Silva, Lilian Ferreira Muniz, Mariana de Carvalho Leal Gouveia et al.

Introduction: The brainstem auditory evoked potential with speech stimulus, BAEP-speech, has been applied to observe how speech sounds are manifested in the brainstem. This tool can be used in children to assess central auditory processing, allowing preventive and early interventions. Objective: To assess the results found in the brainstem auditory evoked potential with speech stimulus in the pediatric population with and without oral language disorders, through a systematic literature review. Method: The search was carried out in the scientific databases Portal BVS, Pubmed, Lilacs, Medline, Scielo and Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster and The New York Academy of Medicine. A systematic literature review was performed using the descriptors: auditory evoked potentials, children and their synonyms, combined by the Boolean operators AND and OR. The search filter “age: child” was used. The studies were independently read by peers and, in case of disagreement regarding the inclusion of studies, a third researcher was consulted. Original case-control articles that performed BAEP-speech without competitive noise, carried out in the pediatric population without and with oral language disorders, were included. Result: 14 articles published between 2008 and 2019 were included in this review. Methodological variability was observed in the exam, with the syllable / da / being the most frequently used as the stimulus. When performing the average of the groups, it was observed that the population with specific language disorders showed greater latency delays in the sustained portion, lower amplitude values and VA complex slope. The group with phonological disorders had higher values in the transient portion of the responses. Conclusion: Children with language disorders of different etiologies have different patterns of BAEP-speech responses when compared to children with typical development. Resumo: Introdução: O potencial evocado auditivo de tronco encefálico com estímulo de fala (PEATE-fala) tem sido aplicado para observar como os sons da fala se manifestam no tronco encefálico. Esta ferramenta pode ser utilizada em crianças na avaliação do processamento auditivo central, permitindo realização de intervenções preventivas e precoces. Objetivo: Conhecer os resultados encontrados no potencial evocado auditivo de tronco encefálico com estímulo de fala na população pediátrica com e sem transtornos de linguagem oral, por meio de revisão sistemática da literatura. Método: As buscas foram realizadas nas bases de dados científicos Portal BVS, Pubmed, Lilacs, Medline, Scielo e Web of Science, OpenGrey.eu, DissOnline, OpenDoar, OAIster eThe New York Academy of Medicine. Foi realizada revisão sistemática da literatura, com os descritores auditory evoked potentials, children e seus sinônimos, combinados pelos operadores booleanos AND e OR. Foi utilizado o filtro de pesquisa “idade: criança”. A leitura dos estudos foi realizada por pares de forma independente e, em caso de discordância na inclusão de estudos um terceiro pesquisador foi consultado. Foram incluídos artigos originais do tipo caso-controle que realizaram o PEATE-fala sem ruído competitivo na população pediátrica sem e com transtornos de linguagem oral. Resultado: Foram incluídos 14 artigos publicados entre 2008 e 2019 na presente revisão. Foi observada variabilidade metodológica na realização do exame, a sílaba /da/ foi a mais utilizada para estimulação. Realizando médias dos grupos observou-se que a população com distúrbio específico de linguagem apresentou maiores atrasos de latência na porção sustentada, menores valores de amplitude eslope do complexo VA. O grupo com transtorno fonológico obteve maiores valores na porção transiente das respostas. Conclusão: Crianças com alterações de linguagem de diferentes etiologias apresentam padrões de respostas do PEATE-fala distintos quando comparadas às crianças com desenvolvimento típico.

Jiwang Liang, Xiangyu Zhu, Wei Zeng et al.

Introduction: Stomal recurrence is a troublesome complication after total laryngectomy. Despite a large number of studies having been performed, there is still controversy about which risk factors are most significant for the development of stomal recurrence. Objective: The objective of the present meta-analysis was to analyze the potential factors leading to stomal recurrence after total laryngectomy. Methods: PubMed, Web of Science, Cochrane Library, and Ovid databases were systematically searched using multiple search terms. Eighteen studies with 6462 patients were identified. The quality of evidence was assessed by The National Institute for Health and Clinical Excellence. Results: The results showed that, tumor subsite (supraglottic vs. subglottic, RR = 0.292, 95% CI 0.142–0.600, p = 0.001; glottic vs. subglottic, RR = 0.344, 95% CI 0.175–0.676, p = 0.002), T stage (RR = 0.461, 95% CI 0.286–0.742, p = 0.001), preoperative tracheotomy (RR = 1.959, 95% CI 1.500–2.558, p < 0.001) were the high-risk factors associated with the development of stomal recurrence. Conclusion: From the results of our study, tumor subsite, T stage and preoperative tracheotomy were the significant risk factors for stomal recurrence. Methodologically high-quality comparative investigations are needed for further evaluation. Resumo: Introdução: A recorrência estomal pós-laringectomia total e é uma complicação de difícil manejo. Apesar de um grande número de estudos ter sido feito, ainda há controvérsias sobre quais fatores de risco são mais significativos para o seu desenvolvimento. Objetivo: O objetivo da presente meta-análise foi analisar os fatores potenciais para recorrência estomal após a laringectomia total. Método: As bases de dados PubMed, Web of Science, Cochrane Library e Ovid foram sistematicamente pesquisadas com vários termos de busca. Dezoito estudos com 6.462 pacientes foram identificados. A qualidade da evidência foi avaliada pelo National Institute for Health and Clinical Excellence. Resultados: Os resultados mostraram que o subsítio tumoral (supraglótico vs. subglótico, RR = 0,292, IC 95% 0,142 ± 0,600, p = 0,001; glótico vs. subglótico, RR = 0,344, IC 95% 0,175 ± 0,676, p = 0,002), estágio T (RR = 0,461, IC 95% 0,286 ± 0,742, p = 0,001), traqueotomia pré-operatória (RR = 1,959, IC 95% 1.500 ± 2.558, p < 0,001) foram os fatores de alto risco associados ao desenvolvimento de recorrência estomal. Conclusão: Com base nos resultados de nosso estudo, o subsítio do tumor, o estágio T e a traqueotomia pré-operatória foram fatores de risco significativos para recorrência estomal. São necessárias investigações comparativas metodologicamente de alta qualidade para maior avaliação.