Hasil untuk "Otorhinolaryngology"

Hamza Ogun, Eray Metin Güler, Beyza Nur Özkan et al.

Objective:To investigate the relationship between obstructive sleep apnoea (OSA) severity and oxygen desaturation with biomarkers including ischaemia-modified albumin (IMA), interleukin-1β (IL-1β), thiol/ disulphide homeostasis parameters, and cardiac biomarkers (BNP, NT-proBNP). Material and Methods:This cross-sectional study included 88 patients who underwent polysomnography at the Bezmialem Vakif University Sleep Laboratory. Participants were categorised into normal/mild OSA (n=36) and moderate/severe OSA (n=52) groups based on the apnoea-hypopnoea index (AHI). Blood samples were analysed for BNP, NT-proBNP, IMA, IL-1β, and thiol/disulphide homeostasis parameters. Results:The moderate/severe OSA group showed significantly higher levels of IMA (0.94±0.04 vs 0.88±0.04, p<0.001), IL-1β (359.82±121.14 vs 231.45±83.76 pg/mL, p<0.001), and lower levels of native thiol (345.23±69.85 vs 395.62±58.71 µmol/L, p<0.001) compared to the normal/mild group. BNP and NT-proBNP levels were moderately elevated in the moderate/severe OSA group (p=0.012 and p=0.003, respectively). Conclusion: IMA, IL-1β, and native thiol demonstrate promise as potential biomarkers for OSA severity. These findings confirm that oxidative stress and inflammation play significant roles in the pathophysi ology of OSA and offer new opportunities for diagnosis and monitoring.

ZHANG Zhiyue, CHENG Qiaolu, LI Jiayue et al.

ObjectiveTo describe the incidence and mortality of adult head and neck cancer (HNC) in different regions worldwide and their temporal trends.MethodsBased on the GLOBOCAN 2022 database and the Global Burden of Disease (GBD) 2021 database, we described the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of HNC among adults aged ≥20 years by sex, region, and human development index (HDI). Incidence and mortality across different age groups were also analyzed. Furthermore, the projected number of new HNC cases in adults in 2040 was estimated.ResultsIn 2022, there were an estimated 1 750 871 new cases and 527 226 deaths from HNC among adults aged ≥20 years globally. Thyroid cancer showed the highest ASIR(14.9 per 100 000), while lip, oral cavity, and pharynx had the highest ASMR (6.4 per 100 000). Overall, adult males had higher HNC incidence (ASIR: 32.8 per 100 000 vs. 29.9 per 100 000) and mortality (ASMR: 13.5 per 100 000 vs. 4.4 per 100 000) than females. This disparity was particularly pronounced for cancers of the lip and oral cavity, pharynx, and nasopharynx. In contrast, females had higher incidence and mortality from thyroid cancer than males (ASIR: 22.3 per 100 000 vs. 7.5 per 100 000; ASMR: 0.9 per 100 000 vs. 0.6 per 100 000). In 2022, the incidence of thyroid cancer and nasopharyngeal cancer was higher in high-HDI regions, whereas cancers of the lip, oral cavity, and pharynx were more common in middle-HDI regions. Furthermore, low- and middle-HDI regions generally exhibited higher mortality rates across various HNC types. If incidence rates remain constant, the projected number of new HNC cases in adults aged ≥20 years globally in 2040 is estimated to be 2.354 million, representing a 34.4% increase compared to the 2022 estimate.ConclusionsHead and neck cancer constitutes a significant component of the global cancer burden in terms of both incidence and mortality among adults. Its epidemiological characteristics show marked variations by sex, age, geographic region, and cancer subtype, underscoring the need for tailored prevention and control strategies targeting high-risk populations and regions.

Minna Sirviö, Katri Aro, Mira Naukkarinen et al.

Abstract Warthin tumor (WT) is a benign tumor usually affecting the parotid gland. The main diagnostic tool remains ultrasound combined with fine-needle aspiration cytology (FNAC). This study aims to examine how reliably FNAC indicates WT for clinical decision making regarding surgical versus conservative management. We included all patients who underwent FNAC from a parotid gland lesion between 2016 and 2018 at our institution, and whose FNAC revealed WT suspicion. The FNACs were divided into three groups based on the cytology report: certain, likely, and possible WT. The patients were divided into two groups based on having had either surgery or follow-up. We sent a questionnaire to patients who had not undergone surgery in order to obtain follow-up for a minimum of four years. Altogether, 135 FNAC samples, from 133 tumors and 125 patients, showed signs of WT. Of the 125 patients, 44 (35%) underwent surgery, and 81 (65%) were managed conservatively. Preoperative misdiagnosis in FNAC occurred in three (7%) surgically treated tumors. Their FNACs were reported as possible WTs, but histopathology revealed another benign lesion. In the conservatively treated group, two patients underwent surgery later during the follow-up. Cytological statements of WT were seldom false, and none were malignant. The majority of the patients were only followed-up and rarely required further treatment. A certain or likely diagnosis of WT in the FNAC report by an experienced head and neck pathologist is highly reliable in selecting patients for conservative surveillance.

Ting Ye, Bing Zhou, Cheng Li et al.

Abstract Objective Although several mucosal flap techniques have been reported to improve the outcomes in Draf IIb and Draf III procedures, there is scant knowledge on frontal ostium neo‐osteogenesis after reconstruction with mucosa flap. This study evaluates the potential benefits of mucosa flaps on frontal ostium neo‐osteogenesis after frontal sinus drill‐out procedures. Methods Forty‐three patients who underwent extended Draf IIb and Draf III were enrolled. Among them, 20 patients had frontal neo‐ostium (FNO) reconstructed by mucosal flap (group A), and 23 patients did not have neo‐ostium reconstruction (group B). The cross‐sectional area of FNO, frontonasal bone, and the amount of frontal neo‐osteogenesis (FNOG) were measured with OsiriX®. In addition, the Global Osteitis Scoring Scale (GOSS), Lund–Mackay score (LMS), and Lund–Kennedy score (LKS) were also evaluated. Results At one year postoperatively, the remaining neo‐ostium area was significantly larger in group A (p = .001), and group A had significantly less FNOG (p < .05). The month 12 postoperative GOSS score was significantly decreased in group A. In contrast, it slightly increased in group B. Both the average LKS and LMS were significantly reduced in groups A and B at month 12 postoperatively. Still, the average LKS of group A significantly decreased than that of group B at month 12 postoperatively. Conclusion Coverage of the bare frontal bone with the mucosal flap could prevent excessive neo‐osteogenesis and keep the neo‐ostium open widely. Level of Evidence 2b

Behrouz Barati, Mahboobe Asadi, Fatemeh Jahanshahi

Introduction:Hemangiomas are benign vascular lesions frequently observed in infancy and childhood. Case Report:A 14-year-old boy was referred to the hospital with a left-sided ear canal mass and hearing impairment. Otoscopic examination revealed a mass that occluded the canal. The transcanal surgical excision was performed. The mass was dissected from the skin, no bony erosion was noted intraoperatively, and the skin was returned back properly. The histopathological report demonstrated a capillary hemangioma of the external auditory canal. Conclusions:Hemangiomas are relatively common in the head and neck, but rarely detected in the external ear canal and tympanic membrane. Hemangioma of the ear canal may be asymptomatic and accidentally observed. Despite the rarity of the mass, it is important to consider them in the differential diagnosis of external auditory canal masses. The computed tomography and magnetic resonance imaging with gadolinium help to reveal the vascular nature of the mass. Complete surgical excision is the treatment of choice.

Sandrina Körner, Tillman Pick, Florian Bochen et al.

Various cancer types including head and neck squamous cell carcinomas (HNSCC) show a frequent amplification of chromosomal region 3q26 that encodes, among others, for the SEC62 gene. Located in the ER membrane, this translocation protein is known to play a critical role as a potential driver oncogene in cancer development. High SEC62 expression levels were observed in various cancer entities and were associated with a poor outcome and increased metastatic burden. Because of its intracellular localization the SEC62 protein is poorly accessible for therapeutic antibodies, therefore a functional SEC62 knockdown represents the most promising mechanism of a potential antineoplastic targeted therapy. By stimulating the Ca2+ efflux from the ER lumen and thereby increasing cellular stress levels, a functional inhibition of SEC62 bears the potential to limit tumor growth and metastasis formation. In this study, two potential anti-metastatic and -proliferative agents that counteract SEC62 function were investigated in functional in vitro assays by utilizing an immortalized human hypopharyngeal cancer cell line as well as a newly established orthotopic murine in vivo model. Additionally, a CRISPR/Cas9 based SEC62 knockout HNSCC cell line was generated and functionally characterized for its relevance in HNSCC cell proliferation and migration as well as sensitivity to SEC62 targeted therapy in vitro.

Felix Dewald, Isabelle Suárez, Ronja Johnen et al.

Dewald et al. combine a non-invasive sampling approach (Lolli-Test) with an RT qPCR-pool testing strategy to screen for SARS-CoV-2 infections in children and use the method for surveillance and infection control in > 4000 school and daycare settings.

Fazıl Apaydın, İsa Kaya, Mustafa Uslu et al.

Objective:Skin cancers occur most commonly in the head and neck region where the nose is the most commonly affected unit. The nose is the part of the face that is most exposed to trauma, sunlight, and other environmental factors. From the aesthetic and functional point of view, reconstruction of the defects occurring after skin cancer removal creates a great challenge for the surgeon. In this retrospective study, we present the success rates achieved in the past 20 years with paramedian forehead flaps used for repairing large defects of the nose.Methods:The study included 62 patients who underwent paramedian forehead flap due to nasal skin tumor [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)] in Ege University Faculty of Medicine Otolaryngology Department between 2000 and 2020. Data on follow-up time, patients’ age and gender, defect sizes, and tumor types were obtained retrospectively from patient files, histopathologic examination results and patient photographs. Additional diseases such as diabetes, hypertension, and coronary artery disease that could affect flap success, were noted.Results:Out of 62 patients 29 (46.8%) were female and 33 (53.2%) were male. Their mean age was 61.4 (range: 46–88) years. Mean follow-up period was 125.6 (8–244) months. Of the 62 patients 33 (53.2%) were operated on for BCC and 29 (46.8%) for SCC. Four patients (6.5%) had recurrences during their follow-up. There was no loss of the paramedian forehead flap.Conclusion:Paramedian forehead flap is a reliable option in the reconstruction of larger defects of the nose even in smokers and elderly patients who have comorbid diseases.

Alessandro Bozzato, Christoph Arens, Maximilian Linxweiler et al.

(1) Background: Computed tomography (CT) is considered mandatory for assessing the extent of pathologies in the paranasal sinuses (PNS) in chronic rhinosinusitis (CRS). However, there are few evidence-based data on the value of ultrasound (US) in CRS. This multicenter approach aimed to compare diagnostic imaging modalities in relation to findings during surgery. (2) Methods: 127 patients with CRS were included in this prospective multicenter study. Patients received preoperative US and CT scans. The sensitivity and specificity of CT and US were extrapolated from intraoperative data. (3) Results: CT scans showed the highest sensitivity (97%) and specificity (67%) in assessing CRS. Sensitivities of B-scan US were significantly lower regarding the maxillary sinus (88%), the ethmoid sinus (53%), and the frontal sinus (45%). The highest overall sensitivity was observed for assessing the pathology of the maxillary sinus. (4) Conclusions: We observed high accuracy with CT, confirming its importance in preoperative imaging in CRS. Despite the high US expertise of all investigators and a standardized examination protocol, the validity of CT was significantly higher than US. Ultrasound of the PNS sinuses is applicable in everyday clinical practice but lacks diagnostic accuracy. Nevertheless, it might serve as a complementary hands-on screening tool to directly correlate the clinical findings in patients with PNS disease.

Luca Paoluzzi, Thomas J Ow

Immunotherapies directed at T-cell activation through antibodies targeting checkpoint proteins, such as programmed cell death 1 (PD1), are rapidly becoming the new standard of care in the treatment of several malignancies. Cemiplimab is a monoclonal antibody targeting PD1 that has recently emerged as a highly active treatment for locally advanced and metastatic cutaneous squamous cell carcinoma (CSCC). Patients who have received an organ transplant (OTRs) have been traditionally excluded from clinical trials with checkpoint inhibitors (CIs), given concerns for organ rejection. Renal transplant recipients (RTRs) are more likely to develop cancers than the general population, and skin cancers are among the most frequent malignancies. We report the case of a 72-year-old man with a history of a kidney transplant who presented with a rapidly growing, locally advanced squamous cell carcinoma (SCC) of the scalp that recurred within four weeks from surgical resection. The patient was able to safely receive ten cycles of cemiplimab so far with significant clinical benefit, and no issues with his kidney function, while continuing immunosuppression with low dose prednisone alone. An ongoing clinical trial (NCT04339062) is further exploring the safety of CIs in patients with metastatic CSCC who have previously received allogeneic hematopoietic stem cell transplant or a kidney transplant.

Ho Yun Lee

Copyright © 2020 by Korean Society of Otorhinolaryngology-Head and Neck Surgery. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Clinical and Experimental Otorhinolaryngology Vol. 13, No. 1: 2-3, February 2020 https://doi.org/10.21053/ceo.2019.01949

Ram Rajmani Singh, Nikesh Meghji Gosrani, Tejal Patel et al.

Introduction Oral foreign bodies and perioral injuries are common occurrence among paediatric population. These may range from benign occurrences to those that may threaten the airway. One such injury is tongue entrapment into objects like plastic bottle neck. Tongue entrapment in bottle neck is rare with very few cases reported in literature. Case Report A case of a 9-year old mentally retarded male child with tongue haemangioma who got his tongue tightly entrapped inside a plastic bottle neck is presented. Since such cases are very rare, treatment often requires creative and novel approach to ensure safe removal of constricting object without causing any injury to surrounding structures. When conventional methods using Mayo’s scissors failed to cut open the bottle neck, we used Gigli saw wire in a safe manner to cut it open. It took a few minutes to relieve the entrapment of tongue   without traumatising the surrounding structure. Discussion This case highlights the result of careless and often dangerous play and misadventures of children and the challenge of management. It calls for vigilance and close supervision of children by caregivers at home and at school. Early presentation, immediate intervention and treatment can prevent grave consequences.

Can Alper Çağıcı, Süheyl Asma, Mesut Şener

Laura Fröhlich, Ian S. Curthoys, Sabrina Kösling et al.

Objective: To evaluate ocular and cervical vestibular evoked myogenic potentials (oVEMPs and cVEMPs) in patients with solely intracochlear localization of an intralabyrinthine schwannoma (ILS).Study Design: Retrospective analysis of a series of cases.Setting: Monocentric study at a tertiary referral center.Patients: Patients with intracochlear schwannoma (ICS) and VEMP measurements.Outcome Measures: Signed asymmetry ratio (AR) of cVEMPs and oVEMPs to air conducted sound with AR cut-offs considered to be asymmetrical when exceeding ±30% for cVEMPs and ±40% for oVEMPs with respect to the side affected by the tumor (reduced amplitudes on the affected side indicated by negative values, enhanced amplitudes by positive values); VEMP amplitudes and latencies; tumor localization in the cochlear turn and scala.Results: Nineteen patients with a solely intracochlear tumor (ICS patients) [10 males, 9 females, mean age 57.1 (SD: 13.4) years] were included in the study. On the affected side, cVEMPs were absent or reduced in 47% of the patients, normal in 32%, and enhanced in 21%. Ocular VEMPs on the affected side were absent or reduced in 53% of the patients, normal in 32% and enhanced in 15%. Latencies for cVEMPs and oVEMPs were not significantly different between the affected and non-affected side. In all patients with enhanced VEMPs, the tumor was located in the scala tympani and scala vestibuli.Conclusions: As a new and unexpected finding, VEMP amplitudes can be enhanced in patients with intracochlear schwannoma, mimicking the third window syndrome.

S. Swain, Bulu Nahak, Loknath Sahoo et al.

Santosh Kumar Swain1, Bulu Nahak2, Loknath Sahoo3, Sampada Munjal4, Mahesh Chandra Sahu5 From 1Professor, 2Assistant Professor, 3Senior Resident, 4Junior Resident, Department of Otorhinolaryngology, 5Assistant Professor, Department of Medical Research Laboratory, Institute of Medical Sciences and SUM Hospital, Siksha “O” Anusandhan University (Deemed to be), Bhubaneswar, Odisha, India Correspondence to: Dr. Santosh Kumar Swain, Department of Otorhinolaryngology, Institute of Medical Sciences and SUM Hospital, Siksha “O” Anusandhan University (Deemed to be), Bhubaneswar, Odisha, India. E-mail: santoshvoltaire@yahoo.co.in Received 25 December 2018 Initial Review 27 January 2019 Accepted 28 January 2019

S. Swain, I. Behera, Loknath Sahoo

Santosh Kumar Swain1, Ishwar Chandra Behera2, Loknath Sahoo3 From 1Professor, 3Senior Resident, Department of Otorhinolaryngology, IMS and SUM Hospital, 2Professor, Department of Community Medicine, IMS and SUM Hospital, Siksha “O” Anusandhan University (Deemed to be), Bhubaneswar, Odisha, India Correspondence to: Dr. Santosh Kumar Swain, Department of Otorhinolaryngology, IMS and SUM Hospital, Bhubaneswar, Odisha, India. E-mail: santoshvoltaire@yahoo.co.in Received 18 January 2019 Initial Review 05 February 2019 Accepted 14 February 2019

Hemanth Narayan Shetty, Navya Bilijagalemole Nanjundaswamy

Abstract Introduction Studies have reported that although speech perception in noise was unaltered with and without digital noise reduction (DNR), the annoyance toward noise measured by acceptable noise level (ANL) was significantly improved by DNR with the range between 2.5 and 4.5 dB. It is unclear whether a similar improvement would be observed in those individuals who have an ANL ≥ 14 dB (predictive of poor hearing aid user) often rejects their aid because of annoyance toward noise. Objectives (a) To determine the effect of activation of DNR on the improvement in the aided ANL from low- and high-ANL groups; and (b) to predict the change in ANL when DNR was activated. Method Ten bilateral mild to severe sloping sensorineural hearing loss (SNHL) participants in each of the low- and high-ANL groups were involved. These participants were bilaterally fitted with receiver in canal (RIC) hearing aids (Oticon, Smorum, Egedal, Denmark) with a DNR processor. Both SNR-50% (Signal to noise ratio (in dB) required to achieve 50 % speech recognition) and ANL were assessed in DNR-on and DNR-off listening conditions. Results Digital noise reduction has no effect on SNR-50 in each group. The annoyance level was significantly reduced in the DNR-on than DNR-off condition in the low-ANL group. In the high-ANL group, a strong negative correlation was observed between the ANL in DNR off and a change in ANL after DNR was employed in the hearing aid (benefit). The benefit of DNR on annoyance can be effectively predicted by baseline-aided ANL by linear regression. Conclusion Digital noise reduction reduced the annoyance level in the high-ANL group, and the amount of improvement was related to the baseline-aided ANL value.

Lena L. N. Wong, Yuan Chen, Qianran Wang et al.

Noise reduction systems have been implemented in hearing aids to improve signal-to-noise ratio and listening comfort. The aim of this study was to evaluate the efficacy of hearing aid noise reduction for Mandarin speakers. The results showed a significant improvement in acceptable noise levels and speech reception thresholds with noise reduction turned on. Sound quality ratings also suggested that most listeners preferred having noise reduction turned on for listening effort, listening comfort, speech clarity, and overall sound quality. These results suggest that the noise reduction system used in this study might improve sentence perception in steady-state noise, noise tolerance, and sound quality, although not all listeners preferred aggressive noise reduction. However, due to large interindividual variation, clinical application of the results should be on an individual basis.

Aryé Weinberg, Andreas Eberhard Albers

A 36-year-old woman presented herself to our out-patient clinic because she noticed that her tongue turned turned partially hairy. She has been smoking 25 cigarettes a day for the last 17 years. Otherwise the patient was healthy. Clinical exam showed a soft yellowish tongue with a hairy center. The rest of the clinical exam was normal. A hairy tongue is a commen benign clinical condition caused by proliferation of the papillae facilitating the collection of bacteria and debris and finially in discoloartion. The discoloration can vary from black, brown to yellow. Contributing factors are smoking, excessive consumation of coffee, alcohol, poor oral hygienes, hyposalivation, eating a soft diet and the use of certain antibiotics such as tetracyclines. The treatment consists of the correction of the contributing factors. In our case the cessation of smoking and the improvement of oral hygiene was recommended.

S. Marone

In recent years we have seen a special attention being given to disabled individuals in all areas of society and public health care. Early diagnosis, treatment, rehabilitation and prevention policies have involved legislators, managers and multidisciplinary health care professionals with the aim of reducing as much as possible the, often times, devastative effects disabilities can cause. Hearing development follows gradual stages of complexity, already starting in the uterus. Thus, for a child to acquire language and develop speech, this child must be able to detect sounds, locate them, discriminate them, memorize them, recognize them and, finally, understand them. Any of these stages, especially the early ones, are very important for the process to complete. Its interruption can cause important functional loss to the child’s development. Thus, action must be taken as soon as possible in order to minimize the difficulties brought about by sensorial disorders. In developed countries, sensorineural hearing loss affects 1 in every 1,000 newborns, and 40% of the cases may be due to hereditary factors, 30% to the many acquired etiologies and 20% still have unknown etiology. The Central Nervous System has great plasticity, when stimulated earlier on, especially before 12 months of age, enabling an increase in nervous connections and providing better results in the auditory rehabilitation and language development of children affected by hearing impairment. The first six months of life are decisive for the child’s future development, and for these reasons otorhinolaryngologists, speech and hearing therapists and pediatricians have been concerned with campaigns to bring awareness to the population and health care professionals about the importance of an early identification and diagnosis of hearing loss, immediately following the medical and speech and hearing intervention measures. Because of the increase in the number of hospitals implementing Universal Neonatal Hearing Screening Programs (UNHS), and also because of the approval of municipal and state laws, we decided to give a professional opinion on UNHS, aiming at guiding the actions of the health care professionals involved. The multiprofessional Committee on Hearing Health (COMUSA), created in 2007, is a committee that involves Speech and Hearing Therapists, Otologists, Otorhinolaryngologists and Pediatricians. Its goals are to discuss and recommend actions regarding the hearing health of newborns, infants, pre-school aged children, school-aged children, teenagers, adults and the elderly. During two years we discussed, studied and created a text initially considering the UNHS. COMUSA is made up of representatives from the Brazilian Academy of Audiology (ABA), Brazilian Association of Otorhinolaryngology and Neck and Facial Surgery (ABORL), Brazilian Society of Speech and Hearing Therapy (SBFa), Brazilian Society of Otology (SBO) and Brazilian Society of Pediatrics (SBP), all signing this document we present in this issue of our Journal. I hope reading this text can help minimize and prevent the effects of hearing impairment in children and involve the largest possible number of otorhinolaryngologists in these programs.