Hasil untuk "Otorhinolaryngology"

Yong Li, Keqian Cheng, Na Zheng et al.

Fernanda Barriga‐Chambi, Fabricio Ccami‐Bernal, Frank Zela‐Coila et al.

ABSTRACT Background The microbiota may play a role in maintaining and perpetuating inflammation in chronic rhinosinusitis (CRS). This study aimed to induce CRS in rats and evaluate microbiota composition compared to controls. Methods Sixteen male Wistar rats were used. Eight rats received intranasal instillations of Aspergillus oryzae protease and ovalbumin three times weekly for 12 weeks (CRS group). The remaining eight received PBS (control group) under the same conditions. At week 13, microbiological samples were surgically collected, and the rats were euthanized. Microbiological cultures for aerobic, anaerobic bacteria and fungi were performed, and colonies were identified using MALDI‐TOF MS. Relative abundance was analyzed at the phylum and genus levels, and species richness was assessed using the Chao1 index. Histopathological analysis evaluated mucosal, vascular, and epithelial changes to confirm chronic inflammation. Results Histopathological changes were more frequent in the CRS group compared to controls, especially mucosal changes (100% vs. 25%; p = 0.01, Chi‐square test). Firmicutes were more abundant in CRS rats (60.3% vs. 38.4%), driven by an increase in Staphylococcus (33.6% vs. 77.7%). Species richness was higher in the CRS group (Chao1: 85.0 ± 23.3 [61.7–108.3]) compared to controls (31.3 ± 9.0 [22.2–40.3]; p = 0.004; Mann–Whitney U test). Conclusions Chronic inflammation induces significant microbiota changes, with an increase of species richness in the CRS group. These findings suggest microbiota shifts may result from inflammatory environments rather than being the primary cause. Level of Evidence Basic science.

Yu‐Hsiang Lin, Tzu‐Yen Huang

M. Kohanski, L. J. Lo, M. Waring

The coronavirus disease‐2019 (COVID‐19) pandemic has heightened the awareness of aerosol generation by human expiratory events and their potential role in viral respiratory disease transmission. Concerns over high severe acute respiratory syndrome‒coronavirus‐2 (SARS‐CoV‐2) viral burden of mucosal surfaces has raised questions about the aerosol‐generating potential and dangers of many otorhinolaryngologic procedures. However, the risks of aerosol generation and associated viral transmission by droplet or airborne routes for many otorhinolaryngology procedures are largely unknown. Indoor aerosol and droplet viral respiratory transmission risk is influenced by 4 factors: (1) aerosol or droplet properties; (2) indoor airflow; (3) virus‐specific factors; and (4) host‐specific factors. Herein we elaborate on known aerosol vs droplet properties, indoor airflow, and aerosol‐generating events to provide context for risks of aerosol infectious transmission. We also provide simple but typically effective measures for mitigating the spread and inhalation of viral aerosols in indoor settings. Understanding principles of infectious transmission, aerosol and droplet generation, as well as concepts of indoor airflow, will assist in the integration of new data on SARS‐CoV‐2 transmission and activities that can generate aerosol to best inform on the need for escalation or de‐escalation from current societal and institutional guidelines for protection during aerosol‐generating procedures.

Ayushi Ghosh Moulic, S. Gaurkar, Prasad T Deshmukh

With technological advancements, artificial intelligence (AI) has progressed to become a ubiquitous part of human life. Its aspects in otorhinolaryngology are varied and are continuously evolving. Currently, AI has applications in hearing aids, imaging technologies, interpretation of auditory brain stem systems, and many more in otology. In rhinology, AI is seen to impact navigation, robotic surgeries, and the determination of various anomalies. Detection of voice pathologies and imaging are some areas of laryngology where AI is being used. This review gives an outlook on the diverse elements, applications, and advancements of AI in otorhinolaryngology. The various subfields of AI including machine learning, neural networks, and deep learning are also discussed. Clinical integration of AI and otorhinolaryngology has immense potential to revolutionize the healthcare system and improve the standards of patient care. The current applications of AI and its future scopes in developing this field are highlighted in this review.

C. Galletti, M. A. Barbieri, Francesco Ciodaro et al.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is characterized by a type 2 pattern of inflammation resulting in the production of some cytokines. Dupilumab radically changes the treatment of CRSwNP, but, considering its recent approval, it may be useful to evaluate its safety profile in a real-world setting. This work aimed to prospectively highlight the effectiveness and safety profile of dupilumab in patients with CRSwNP enrolled in the Otorhinolaryngology Unit of the University Hospital of Messina. An observational cohort study was carried out considering all patients treated with dupilumab. A descriptive analysis was conducted reporting all demographic characteristics, endoscopic evaluations, and symptom conditions. A total of 66 patients were treated with dupilumab, but three patients were excluded due to a lack of adherence during the observational period. A statistically significant reduction in the Sino-Nasal Outcome Test 22 (SNOT-22) and nasal polyps score (NPS) was shown at the 6th and 12th months compared to baseline values (SNOT-22, −37 and −50, p < 0.001 for both comparisons; NPS, −3 and −4, p < 0.001 for both comparisons). During the follow-up, eight patients (12.7%) had a reaction at the site of injection, and seven (11.1%) had transient hypereosinophilia. Given the optimal treatment response and the minimal adverse effects observed, clinicians should consider dupilumab a safe and effective treatment. Further studies are necessary to better understand the long-term effects.

J. Urbančič, Domen Vozel, S. Battelino et al.

Choanal atresia is the most common congenital anatomical abnormality of the nasal cavities, manifested with a clinical picture of neonatal respiratory distress. The treatment requires interdisciplinary management based mainly on tertiary referral centre experiences. However, there is a lack of high-quality evidence in the available literature. Recommendations were prepared based on a systematic review of the supporting literature: on a website survey addressed to the participating authors consisting of 28 questions and on five live meetings. The initial response to the recommendations was determined at their presentation at the sectional meeting of the section for otorhinolaryngology of the Slovenian Medical Association. Then, reactions from the professional public were accepted until the recommendations were presented at the Expert Council for Otorhinolaryngology of the Slovenian Medical Association. A systematic literature review identified eight systematic reviews or meta-analyses and four randomized controlled clinical trials. Thirty-four recommendations for diagnosis, treatment and postoperative management were consolidated. The paper presents the proposal and first Slovenian recommendations for treating patients with choanal atresia. They are based on foreign medical institutions’ published literature and our clinical experience. They represent the basic requirements of diagnostics and may represent an essential guide in treatment.

Minju Kim, Sung-Woo Cho, T. Won et al.

Objectives. Systemic inflammation plays a key role in the pathogenesis of obstructive sleep apnea (OSA); however, easy-to-use methods to evaluate the severity of systemic inflammation have yet to be developed. This study investigated the association between systemic inflammation markers that could be derived from the complete blood count (CBC) profile and sleep parameters in a large number of patients with OSA. Methods. Patients who visited our hospital’s Otorhinolaryngology Sleep Clinic between January 2017 and April 2022 underwent polysomnography and routine laboratory tests, including a CBC. Associations between three systemic inflammatory markers—the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR)—and polysomnographic and demographic factors including age, sex, body mass index, the apnea-hypopnea index (AHI), the hypopnea index (HI), lowest oxygen saturation (%), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, and percentages of non-rapid eye movement (REM) sleep stage 3, REM sleep, and snoring time were analyzed. The inflammation markers were compared among OSA subgroups, and associations were also analyzed in subgroups with different OSA severities. Results. In total, 1,102 patients (968 men and 134 women) were included, and their mean AHI was 33.0±24.3. PSQI was significantly associated with SII (P=0.027). No independent significant factors were identified for the NLR or PLR. Within the simple snoring and mild OSA subgroups, no significant association was found between sleep parameters and the SII. In the severe OSA subgroup, the AHI (P=0.004) and PSQI (P=0.012) were independently associated with the SII. Conclusion. Our study analyzed systemic inflammatory markers based on the CBC, a simple, relatively cost-effective test, and showed that the AHI and SII were significantly correlated only in the severe OSA subgroup.

C. Martu, Maria-Alexandra Mârțu, G. Maftei et al.

The maxillary sinus is a structure at the border of specialties: otorhinolaryngology and maxillofacial surgery. Due to this fact, regarding etiology, it can be affected by both the rhinogenic and odontogenic path and can impose diagnostic difficulties. The etiopathogenic mechanisms that can affect the Schneiderian membrane are mainly inflammatory, iatrogenic, traumatic, and tumorous in nature. From a microbiological point of view, the bacteriology is polymorphic, including both aerobic and anaerobic species in acute OS, the predominating species in acute OS being aerobic, and in chronic anaerobic germs. The role of fungi in the determination of this pathology and in the production of the biofilm that leads to resistance to antibiotic treatment is also discussed. The present paper aims to present the etiopathogenesis, bacteriology, clinical manifestations, as well as treatment of odontogenic sinusitis (OS) from an updated perspective through reviewing the literature. If unilateral maxillary sinusitis is usually due to odontogenic causes, this does not clinically exclude the possibility of strictly rhinogenic causes in the occurrence of sinusitis. This underlines the important role of complex oral and rhinological clinical examination as well as the role of preclinical examinations in specifying the certainty diagnosis. Simple radiography, orthopantomography, CT, and CBCT are compared in terms of diagnostic accuracy. The treatment of OS is complex, involving medication, dental, and surgical measures. The value of endoscopic surgery is emphasized, comparing its advantages over the classic Caldwell-Luc technique.

O. Laccourreye, Q. Lisan, C. Vincent et al.

OBJECTIVE To evaluate reviewing and editorial decision for articles submitted to the European Annals of Otorhinolaryngology Head & Neck Diseases. MATERIALS AND METHODS A retrospective analysis was made of reviewers' comments on 1,133 scientific articles (700 original articles, 96 literature reviews, and 337 case reports), originating from 69 countries, consecutively submitted on-line between January 1st, 2020 and December 31st, 2021. The main objective was to document the acceptance rate and decision time. Accessory objectives were to synthesize the main comments and to screen for correlations between acceptance and the main characteristics of first authors, articles and reviewers' comments. RESULTS In total, 4.1% of submitted articles were accepted. Median decision time differed significantly (P<0.0001), at 1 month in case of refusal and 4 months in case of acceptance. Reviewers mentioned failure to adhere to the journal's authors' guide, to use the appropriate EQUATOR guidelines and to adopt the recommended P<0.005 significance threshold in 94.8%, 54.2%, and 39.9% of cases, respectively. On multivariate analysis, 3 variables significantly impacted acceptance, which increased from 1.3% to 44.6% (P<0.0001) when an appropriate EQUATOR guideline was used and from 0.3% to 57.4% (P<0.0001) when the significance threshold was set at P<0.005, and decreased from 10.5% to 1.1% (P=0.0001) when the article did not originate from a French-speaking country (member of the Francophonie organization). CONCLUSION Adhesion to modern scientific medical writing rules increased acceptance rates for articles in the European Annals of Otorhinolaryngology Head & Neck Diseases. Teaching modern scientific medical writing needs to be enhanced in otorhinolaryngology.

M. El-Anwar, S. Elzayat, Y. Fouad

Objective to detect, analyze and discuss the different ear nose throat (ENT) manifestations those were reported in COVID19 positive patients in the reviewed and published literatures. Methods We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords; COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, ear, nose, throat, otorhinolaryngology, ORL, pharynx, ORL, smell, larynx, different ENT related symptoms. We reviewed published and peer reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. Results within the included 1773 COVID-19 laboratory-confirmed positive patients, the most common ENT manifestations of COVID-19 were sore throat (11.3%) and headache (10.7%). While the other reported ENT manifestations were pharyngeal erythema (5.3%), nasal congestion (4.1%), runny nose or rhinorrhea (2.1%), upper respiratory tract infection (URTI) (1.9%), and tonsil enlargement (1.3%). Conclusion ENT manifestations for COVID-19 are not common as fever and cough. But, a universal questionnaire using well-defined COVID-19 manifestations is needed to make the COVID-19 data precisely defined, complete and homogenous.

Hsin-Yi Tseng, Tzu-Yen Huang, Yi-Chu Lin et al.

ObjectivesQuantum molecular resonance (QMR) devices have been applied as energy-based devices in many head and neck surgeries; however, research on their use in thyroid surgery is lacking. This study aimed to investigate the safety parameters of QMR devices during thyroidectomy when dissection was adjacent to the recurrent laryngeal nerve (RLN).MethodsThis study included eight piglets with 16 RLNs, and real-time electromyography (EMG) signals were obtained from continuous intraoperative neuromonitoring (C-IONM). QMR bipolar scissor (BS) and monopolar unit (MU) were tested for safety parameters. In the activation study, QMR devices were activated at varying distances from the RLN. In the cooling study, QMR devices were cooled for varying time intervals, with or without muscle touch maneuver (MTM) before contacting with the RLN.ResultsIn the activation study, no adverse EMG change occurred when QMR BS and MU were activated at distances of 2 mm or longer from the RLNs. In the cooling study, no adverse EMG change occurred when QMR BS and MU were cooled in 2-second intervals or immediately after MTM.ConclusionQMR devices should be carefully used when performing RLN dissection during thyroid surgery. According to the activation and cooling safety parameters in this study, surgeons can avoid RLN injury by following standard procedures when using QMR devices.

M. Marx, E. Younes, S. Chandrasekhar et al.

Sakie Akasaka, Tadashi Nishimura, Hiroshi Hosoi et al.

Severe conductive hearing loss due to unilateral aural atresia leads to auditory and developmental disorders, such as difficulty in hearing in challenging situations. Bone conduction devices compensate for the disability but unfortunately have several disadvantages. The aim of this study was to evaluate the benefits of cartilage conduction (CC) hearing aids for speech perception in unilateral aural atresia. Eleven patients with unilateral aural atresia were included. Each participant used a CC hearing aid in the atretic ear. Speech recognition scores in the binaural hearing condition were obtained at low speech levels to evaluate the contribution of aided atretic ears to speech perception. Speech recognition scores were also obtained with and without presentation of noise. These assessments were compared between the unaided and aided atretic ear conditions. Speech recognition scores at low speech levels were significantly improved under the aided atretic ear condition (<i>p</i> < 0.05). A CC hearing aid in the unilateral atretic ear did not significantly improve the speech recognition score in a symmetrical noise presentation condition. The binaural hearing benefits of CC hearing aids in unilateral aural atresia were predominantly considered a diotic summation. Other benefits of binaural hearing remain to be investigated.

Noriaki Aoi, Takafumi Fuchiwaki, Ichiro Morikura et al.

Background: Microbial infection or exposure to endotoxin later in life exacerbates established asthma. Mast cells are involved in the exacerbation of asthma. This exacerbation involves a toll-like receptor (TLR)–mediated response of mast cells. In the clinical practice of otolaryngology, otolaryngologists experience an exacerbation of nasal congestion when infectious rhinitis develops in patients with allergic rhinitis, but the mechanisms are unknown. Therefore, this study investigated the effect of lipopolysaccharide (LPS) on allergic rhinitis using a mouse allergic rhinitis model. Methods: Female BALB/c mice, <i>TLR4</i> gene mutant C3H/HeJ mice or mast cell–deficient WBB6F1-^W/Wv mice were sensitized intraperitoneally with ovalbumin (OVA)/alum, and were intranasal challenged with OVA and/or LPS. Nasal symptoms and histologic changes were examined. Cytokines in nasal tissue were examined by Western blot. The effects of LPS on degranulation and cytokine production of bone marrow–derived mast cells (BMMCs) were investigated. Results: Nasal administration of LPS together with the antigen exacerbated nasal symptoms, eosinophil infiltration of the nasal mucosa, and increased IL-5 production in the nasal mucosa. It was not observed in C3H/HeJ mice and WBB6F1-^W/Wv mice. The addition of LPS increased the production of IL-5 from BMMCs in a dose-dependent manner, but no effect on degranulation was observed. Conclusions: Intranasal administration of LPS exacerbates allergic rhinitis through Th2 cytokine production from mast cells. This observation provides clues to the mechanism of exacerbation of allergic rhinitis caused by an infection in daily clinical practice.

Kang Lo, Nguyen Thanh Tung, Chih-Da Wu et al.

Abstract The effects of the restriction policies on human mobility and on the prevention of SARS-CoV-2 (coronavirus disease 2019 (COVID-19) transmission were reported. The efficiency of human mobility restriction due to the social distancing measures of cities on preventing SARS-CoV-2 spread remains unclear. The objective of this study was to investigate the mediating effects of air pollution on the association between human mobility and daily confirmed COVID-19 cases. Daily mobility data (i.e., walking, driving, and using public transport), air pollutants, and confirmed COVID-19 cases were collected in Taiwan during 1 to 30 May 2021. Associations of air pollution with 7-day-lag confirmed COVID-19 cases and with mobility were examined by linear regression models, while the mediating effects were assessed using a PROCESS analysis. We observed that an increase in air pollution was associated with an increase in confirmed COVID-19 cases (p < 0.05). We found that 1 min spent on mobility was associated with changes in air pollution levels (p < 0.05). We observed that levels of particulate matter with an aerodynamic diameter of < 10 µm (PM10), PM2.5, NO2, and CO mediated associations of walking, driving, and using public transport with confirmed COVID-19 cases (p < 0.05). Our findings suggest that the nationwide restrictions (social distancing measures) may reduce human mobility and activities, which was associated with a decrease in confirmed COVID-19 cases due to the mediating effects of air pollution. Reductions in human mobility and air pollution could be effective measures for controlling COVID-19 transmission.