Hasil untuk "Otorhinolaryngology"

Daniel Fu, Aman M. Patel, Lucy Revercomb et al.

Abstract Objective To develop and validate a machine learning model to identify patients at high risk of 30‐day mortality and hospital readmission using routinely collected health care data. Study Design Prognostic predictive modeling and retrospective cohort study. The study was conducted in 2024 using data from 2006 to 2018, with at least a 30‐day follow‐up. Setting The 2006 to 2018 National Cancer Database (NCDB). Methods The study used deidentified NCDB data on 103,891 head and neck squamous cell carcinoma (HNSCC) patients who underwent surgical resection. Machine learning models were trained on 80% of the data, tested on the remaining 20%, and evaluated using the area under the curve (AUC) and SHapley Additive exPlanations (SHAP) analysis to identify key predictors for 30‐day mortality and readmission. Results Among 103,891 patients, 5838 (5.6%) were readmitted, and 829 (0.8%) died within 30 days. The median age was 62, 69% male, and 89% white. Predictors included demographic and clinical data from the NCDB. Five machine learning models were combined and achieved an AUC of 0.80 (95% CI: 0.77‐0.83) for mortality prediction and 0.67 (95% CI: 0.65‐0.68) for readmission prediction. SHAP analysis identified sex and urban‐rural index as key predictors of mortality and readmission, respectively. Conclusion Machine learning models can accurately predict mortality and readmission risks, offering insights into the most influential factors. With further validation, these models may enhance clinical decision‐making in postsurgical care for HNSCC patients.

Meng‐Xuan Shi, Lin‐Lin Lan, Pei‐Yun Zhuang

ABSTRACT Objective To explore the specific effects of unilateral injuries to the vagus nerve (VN), recurrent laryngeal nerve (RLN), and superior laryngeal nerve (SLN) on the vocal fold movement characteristics, and investigate the regulation pattern of current intensity on the vocal fold movement after the injuries. Methods Nine Beagle dogs were used to establish right‐sided laryngeal nerve injury models, divided into three groups (VN, RLN, and SLN transection groups, n = 3 per group). The right (injured side) vocal folds served as the experimental group, while the left (healthy side) vocal folds acted as the control group. At 3 months postoperatively, a graded electrical current (1–4 mA, in 1 mA increments) was applied to the distal end of the injured RLN, 2 cm from the vocal fold plane, to stimulate either the healthy (left) or injured (right) RLN. Vocal fold movements were captured using high‐speed laryngoscopy, and the pixel distances and velocities of adductory motions were quantified using PCC3.6 software. Independent samples t‐tests were performed to compare vocal fold movements between the injured (right) and healthy (left) sides within each injury group, as well as bilateral vocal fold movements between the RLN and VN injury groups. Results (1) Healthy‐side RLN stimulation: The amplitude and velocity of vocal fold movements on the injured side were significantly lower than those on the healthy side across all injury groups (p < 0.05). The RLN injury group exhibited higher movement parameters than the VN injury group at all current intensities, with a statistically significant difference at 1 mA (p < 0.05); (2) Injured‐side RLN stimulation: Only the SLN injury group demonstrated bilateral vocal fold movements, with maximal performance observed at 4 mA; (3) Regulation pattern of current intensity: In the VN and RLN injury groups, the parameters reached their maximum at 2 mA. In the SLN injury group, the maximum parameters were delayed until 3 mA (healthy‐side RLN stimulation) or 4 mA (injured‐side RLN stimulation). Conclusions The vocal fold movement regulation pathways partially overlap between RLN and VN injuries. Residual vocal fold motion after SLN injury suggests potential cricothyroid‐arytenoid mechanical coupling or neural compensation mechanisms. An electrical stimulation intensity of 2 mA is optimal for RLN/VN injuries, while 4 mA can activate compensatory pathways in SLN injuries. This study provides experimental evidence for the precise diagnosis of laryngeal nerve injuries and the optimization of electrical stimulation parameters.

Olga Karłowska-Bijak, Grażyna Stryjewska-Makuch, Marta Michalak-Kolarz et al.

<i>Background and Objectives</i>: Tumours of the lacrimal drainage system are rare and most located in the lacrimal sac. The authors of this study aimed to conduct a literature review to find out which malignant tumours most often occurred in the lacrimal sac and what symptoms patients reported in the early stages of the disease. <i>Materials and Methods</i>: The PubMed database was searched for papers published between 2019 and 2024. The inclusion criteria were presence of an abstract, malignant lacrimal sac tumours, papers written in English, studies on humans, and case reports. The exclusion criteria were lack of an abstract, pathologies other than malignant tumours, including benign tumours of the lacrimal drainage system, malignant tumours of a part of the drainage system other than the lacrimal sac, papers in languages other than English, studies not involving humans, and no case report. No gender criterion was used. <i>Results</i>: Based on the data available in the literature, 31 studies were included in the article, describing 34 cases of malignant lacrimal sac tumours. Moreover, a case of a 58-year-old patient diagnosed with non-Hodgkin lymphoma was presented. <i>Conclusions</i>: As a result of the literature analysis, it was impossible to find any symptoms reported by patients with lacrimal sac tumours that would clearly suggest their diagnosis.

Giuseppe De Donato, Emanuela Fuccillo, Alberto Maria Saibene et al.

Yoko Fujimaki, Kenji Kondo, Hironobu Nishijima et al.

Background and aimThe administration of growth and neurotrophic factors has been attempted experimentally as a new therapeutic strategy for severe facial paralysis. Granulocyte colony-stimulating factor (G-CSF) has an effect on the treatment of central nervous system injuries, such as cerebral infarction and spinal cord injury. This study aimed at examining the effects of G-CSF on facial nerve regeneration in rats.MethodsThe left facial nerve of rats was either partially resected (resection group) or severed and sutured (suture group) at the main trunk outside the temporal bone. In each surgical group, saline or G-CSF was administered via the gelatin hydrogel drug delivery system. The suture group was further divided into two subgroups for the late administration of G-CSF (2 weeks after surgical treatment) or immediate administration of G-CSF after surgical treatment. Recovery of the facial nerve was assessed by the evaluation of facial movements (after 12 weeks), complex muscle action potential amplitude measurements (after 2, 4, 8, and 12 weeks), electroneurography values (after 12 weeks), and histological evaluation (comparison of myelinated axon diameters among the groups).ResultsRecovery of the function and morphology of damaged nerves was faster in the suture groups than in the resection group. In the suture groups, recovery was faster for G-CSF-treated rats than for saline-treated rats. Furthermore, recovery was faster in the group that received G-CSF immediately after surgical treatment than in the group that received G-CSF 2 weeks later. However, the group that received G-CSF 2 weeks later also showed faster recovery than did the control group.ConclusionG-CSF effectively promoted nerve regeneration during facial nerve paralysis. Thus, G-CSF may be a potential treatment strategy for injured facial nerves as it has been safely administered in clinical treatments for hematological diseases.

Naema Mohamed Ismail, Salma Badreldin Galal, Reda Mohamed Behairy et al.

Abstract Background The diagnosis of auditory neuropathy spectrum disorder (ANSD) is based on the existence of cochlear microphonics or otoacoustic emissions, as well as aberrant or nonexistent-evoked auditory brainstem responses. The outcomes of cochlear implantation (CI) are thought to be significantly influenced by genetic reasons in ANSD. Objective The purpose of this systematic review was to gather more information regarding the relationship between various genetic variants and the outcomes of cochlear implantation in adult and pediatric patients with ANSD (both syndromic and non-syndromic). Methods Electronic databases “Medline/PubMed, Google Scholar, ScienceDirect, Europe PMC, and Cochrane Library” were searched for this systematic review. For cohort studies, the Newcastle–Ottawa scale (NOS score) was used to assess the quality of the retrieved research. The standardized mean difference produced by the Cohen’s d or Hedges’ g tests was used to assess the effect size measure. Results This comprehensive study showed that OTOF, GJB2, ATPA3, and OPA1 were among the genetic variants with improved CI outcomes. On the other hand, other genetic mutations displayed variable results (TMPRSS3) or worse CI outcomes (PJVK). For OTOF mutations, CI had a moderate effect (Hedges’ g = 0.7), which led to good cochlear implant outcomes. The results of the GJB2 cochlear implant showed a significant effect size when pre- and post-implant assessments were compared. The results of CI for TMPRSS3 mutations were inconsistent, with one study demonstrating a negligible effect (Hedges’ g = 0.2), and another study found a negative impact (Hedges’ g =  − 2.17). Poor CI results were indicated by PJVK mutations impacting CI outcomes. A significant impact was observed when comparing pre- and postimplantation outcomes (Cohen’s d > 1) in cases of ATP1A3 mutations (CAPOS syndrome) and OPA1 mutations. In addition, early implantation produced better results than late implantation in certain genetic variations. Conclusion Some genetic variants, such as OTOF, GJB2, ATPA3, and OPA1, had improved CI outcomes, according to data extraction and synthesis of the systematic review’s findings. Conversely, PJVK displayed worse CI results and inconsistent results for TMPRSS3 genetic mutations.

Ahmed Mahmoud, Ali Mahrous, Mahmoud EL-Sobki

Background: Chronic rhinosinusitis [CRS] is a common condition encountered in otorhinolaryngological practice. It shares pathophysiological mechanisms with the severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]. However, the incidence of CRS after COVID-19 and the association between the two conditions is not well investigated.The Aim of the work: The current work aimed to assess the incidence of post-COVID-19 rhinosinusitis.  Patients and Methods: Adult patients [18 years or older] attending our otorhinolaryngological department during a 6-months duration, with a newly confirmed CRS were included. All were evaluated on the clinical, laboratory and radiological basis. Those who had COVID-19 infection prior to the development of CRS were recognized. Their demographic and clinical characteristics were collected in a trial to plot a pattern of CRS after COVID-19. The duration between COVID-19 injury and development of CRS was measured and documented.Results: The incidence of CRS after COVID-19 was 34.0%. Their age ranged 18 and 60 years, the mean ± SD was [38.4±9.89 years], with slight increase of the disease among male patients [58.5%]. Smoking was reported among 25 patients [47.2%] and all of them were males. All patients had nasal discharge and nasal obstruction, facial pain and headache. All patients with post-COVID-19 CRS had an abnormality of smell. Hyposmia was the commonest [reported for 67.9%] followed by anosmia [32.1%]. The bilateral infection was reported among 84.9%. The mean duration rhinosinusitis developed after COVID-19 infection ranged between 34 and 60 days and the mean value was 43.17 ± 7.23 days.Conclusion: The incidence of post-COVID-19 chronic rhinosinusitis was 34.0%. The nasal discharge, nasal obstruction, headache and hyposmia were the commonest clinical manifestations. Thus, a high suspicion of CRS should be kept in mind in patients with recent COVID-19.

Yoshinari Nakamura , Takaomi Kurioka , Hajime Sano et al.

Paris Binos, Theodora Papastefanou, George Psillas

The impact of language input on children’s speech, language, and brain development was borne out of Hart and Risley’s famous “30-million-word gap”. A perspective bolstered by many studies in the last decade relates higher socio-economic status (SES) to better qualitative and quantitative differences in children’s speech. The logic chains found in these studies suggest that literacy development depends on language and brain development. Thus, brain building develops based on environmental experience and language input depends on the brain’s perception of the auditory information. This essay uses the latest published peer-reviewed research to outline the current landscape of the role of SES in the development of speech and language skills among children with hearing loss (HL) who are enrolled in auditory-driven habilitation programs. This essay argues that low SES families may provide sufficient input for their children. The outcome of auditory-driven programs implemented by speech-language pathologists (SLPs) seems to be detached from SES. The role of SES on this developmental trajectory remains unclear, and clinical practice may be related to other validated and robust parameters related to hearing loss.

Tarek Abdel hay Mostafa, Mohammed Osama Tommom, Naglaa Khalil Khalil

Abstract Background The main anesthetic goal in the postoperative period of functional endoscopic sinus surgery (FESS) is early and pain-free recovery, with return of protective airway reflex. The aim of this study is to evaluate the role of dexmedetomidine as an adjuvant to regional blocks in patients undergoing functional endoscopic sinus surgery. Results Group bupivacaine + dexmedetomidine (BD) showed statistically significantly lower postoperative pain measurements than group bupivacaine (B), longer time to the first request of rescue analgesia, less patients needing rescue analgesia, and less rescue morphine analgesic requirements. Other measurements were insignificantly different between both groups. Conclusions Dexmedetomidine can be used as an adjuvant to regional nerve block in patients undergoing functional endoscopic sinus surgery. It effectively prolonged postoperative analgesia, decreased postoperative opioid analgesic requirements, and reduced the number of patients needing rescue analgesia.

Ahmad Gaber Abdelraheem, Manar Mahran Sadek*, Nehad Hassan Abdelrahman et al.

Background: Mucoperichondrial flap elevation is the first step in septoplasty operation. MESNA was used in flap elevation to decrease the amount of bleeding, get better surgical field, decrease the operation time and lessen mucosal damage. Objectives: To evaluate the effect of submucosal injection of sodium 2- mercaptoethanesulfonate (MESNA) on the operation time, intra-operative blood loss, integrity of the flap in septoplasty and post operative pain. Patients and methods: It is a case control study that was conducted on 60 patients their ages ranged from 18 years to 43 years, all were underwent septoplasty operation by the same surgeon at Otorhinolaryngology Department, Qena University hospitals, Egypt. Results: Results revealed that the mean time of flap elevation was 6.7±1.8 SD minutes in group A, but was 10.9 ± 2.2 SD minutes in group B which was highly statistical significant with p-value < 0.001.As regard the mean of Intra-operative blood loss it was82 ±15.9 SD ml. in group A, but was 109.7 ± 21.8 SD ml. in group B which was highly statistical significant with p-value < 0.001. Conclusion: Submucosal injection of sodium 2- mercaptoethanesulfonate (MESNA) being more advantageous method that make mucoperichondrial flap elevation is convenient and effective and preserving mucosal integrity in surgical treatment of deviated nasal septum .

Aline Ouriques Freire Fernandes, José Rildo Fernandes de Oliveira Filho

Sue Jean Mun, Young-Seok Choi, Ji Hwan Kim et al.

Objectives In extracorporeal septoplasty (ECS), the entire septal cartilage is harvested, and a neo-L strut is built extracorporeally. Thus, ECS can simultaneously achieve septum straightening and tip projection. This study evaluated the functional and esthetic outcomes of the ECS technique for rhinoplasty in Asian patients. Methods We conducted a retrospective review of 64 patients who underwent rhinoplasty using ECS between January 2016 and March 2018. Subjective patient satisfaction was assessed and objective surgical outcomes were evaluated. Improvement in nasal obstruction was rated using a visual analog scale (VAS). Anthropometric changes were compared between preoperative and postoperative facial photographs. Complications and revisions were also analyzed. Results The participants comprised 64 patients (48 males and 16 females, with a mean age of 29.3 years). The mean operative time was 89.3 minutes. In total, 61 patients were satisfied with the esthetic outcome, and the overall objective rhinoplasty outcome score was 3.45. Preoperative nasal obstruction symptoms (7.9±1.2 on VAS) improved postoperatively (3.1±1.3, P<0.001), and significant improvements were also observed in the nasofrontal angle (152.3° to 148.1°, P<0.001), nasolabial angle (88.8° to 92.0°, P<0.001), and nasal tip projection (0.62 to 0.66, P<0.033). Recurrent deviation of the nasal septum and external nose or tip deprojection did not occur in any patients, and there were no cases of revision during the mean follow-up period of 13.3 months. Conclusion ECS might be an esthetically and functionally satisfactory alternative rhinoplasty technique for Asian patients with a shortage of septal cartilage.

Ana Cristina de Albuquerque Montenegro, Gabrielle Araújo Leite, Natália de Melo Franco et al.

RESUMO Este artigo apresenta as contribuições do uso de um sistema de Comunicação Aumentativa e Alternativa de alta tecnologia no desenvolvimento das habilidades comunicacionais de uma criança com Transtorno do Espectro do Autismo (TEA). Para isso, foi realizado um estudo de caso com uma criança de 2 anos e 2 meses, durante 24 sessões de terapia, ao longo de oito meses. Como instrumentos de avaliação, foram utilizados o Autism Treatment Evaluation Checklist e o protocolo Avaliação da Comunicação no Transtorno do Espectro do Autismo. Durante as intervenções, utilizou-se o método Desenvolvimento das Habilidades Comunicacionais no Autismo e, como recurso de Comunicação Aumentativa e Alternativa, a prancha de alta tecnologia do aplicativo aBoard. De acordo com os resultados, após as intervenções foram observadas melhoras nos escores dos instrumentos de avaliação, quanto às habilidades de expressão, compreensão e interação social. Além disso, observou-se aumento do vocabulário da criança, com aquisição de novas categorias lexicais; realização de solicitações de objetos fora do alcance visual, utilizando a Comunicação Aumentativa e Alternativa, e melhor comunicação social no contexto familiar e educacional. De acordo com os resultados obtidos, puderam ser observadas as contribuições do uso de um sistema de alta tecnologia assistiva de Comunicação Aumentativa e Alternativa no desenvolvimento das habilidades comunicacionais de uma criança com TEA.

Jinsei Jung

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. 2: 87-88, May 2020 https://doi.org/10.21053/ceo.2019.02117

Sung-Chan Shin, Byung-Joo 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. 4: 324-325, November 2020 https://doi.org/10.21053/ceo.2020.01158

Anu Sharma, J. Kyong

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. 3: 211-212, August 2020 https://doi.org/10.21053/ceo.2020.00500

S. Cho

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. 2: 89-90, May 2020 https://doi.org/10.21053/ceo.2019.02026

H. Çobanoğlu, G. Eskiizmir, M. Gökcan

In otorhinolaryngology-head and neck surgery, there are several routine and surgical procedures applied to the upper airway that generate droplets and/or aerosols. Therefore, otorhinolaryngology-head and neck surgeons are at higher risk of being exposed to viral content. The COVID-19 pandemic has shaken the world with approximately 30 million affected cases and more than 900.000 deaths officially reported in more than 200 countries/regions from March 11th, 2020 to date (September 12th, 2020). All healthcare providers working at the frontlines of the fight against the COVID-19 are at risk of contracting the virus. In this review, we discuss the efficacy of the different types of respiratory protective equipment and remind about the surgery-based respiratory protection strategies in otorhinolaryngology and head and neck surgeries in the light of the latest literature.

Deniz Avcı

Objective: To investigate the relationship between subjective tinnitus and red cell distribution width (RDW), platelet distribution width (PDW), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) levels. Materials and Methods: This retrospective research included a total of 91 patients with subjective tinnitus and a control group of gender- and age-matched 65 healthy volunteers. Ear, nose, throat examination followed by pure tone audiometry, tympanometry, complete blood count, and magnetic resonance imaging of the temporal bone was performed. The clinical features and duration of tinnitus were recorded for each patient. The MPV, NLR, PDW, PLR and RDW levels were compared between tinnitus and control groups. Results: Mean RDW was 15.49+-2.43% in the patient group and 15.42+-2.04% in the control group (p=0.831). Mean PDW was 16.13+-2.51% in the patient group and 15.99+-9.94% in the control group (p=0.901). Mean MPV was 8.95+-0.77 fL in the patient group and 8.55+-0.75 fL in the control group (p=0.002). Mean NLR was 1.89+-0.63 in the patient group and 1.88+-0.75 in the control group (p=0.916). Mean PLR was 113.93+-33.91 in the patient group and 120.90+-33.23 in the control group (p=0.204). Only MPV established a significant difference between tinnitus and control groups. Conclusion: Only MPV was found to have an important role in the clinical prognosis and diagnosis of tinnitus. Elevated MPV indicates a possible role of thrombosis and vascular diseases in the etiology of subjective tinnitus, so increased MPV can be used as a thrombosis marker in subjective tinnitus.