Seher Yılmaz, Caner Yatmaz, Furkan Büyükkal
et al.
Background: This study aims to elucidate the potential protective effects of Pycnogenol® against noise-induced hearing (NIHL) loss in a rat model.
Methods: This study employed a randomized controlled design to investigate the potential protective effects of Pycnogenol® against NIHL in a rat model. Twenty-five male Wistar albino rats were randomly assigned to 5 groups (n=5 per group): a control group receiving saline administration, a noise exposure group, a noise+saline receiving group, only Pycnogenol® receiving group, and finally, a Pycnogenol® treatment group receiving daily oral administration of Pycnogenol® at 40 mg/kg/day via gavage for 7 days following noise exposure. All groups were subjected to auditory brainstem response assessments at 4 time points: pre-exposure (baseline), post-exposure day 1, day 7, and day 21. Both noise exposure and the Pycnogenol® treatment groups were exposed to 4 kHz narrowband noise at 120 dB SPL for 4 hours. Following sacrifice, histological and immunohistochemical evaluations were conducted on cochlear tissues. Statistical analyses were performed using SPSS software version 25 to determine significant differences between groups and across time points.
Results: Outcome of this research shows that the auditory brainstem response thresholds and cochlear morphology between the experimental and control groups are significantly different from each other, suggesting that Pycnogenol® may have the potential to prevent NIHL loss in rats.
Conclusion: Pycnogenol® shows potential in protecting against NIHL. However, further research, particularly at the molecular level, is necessary to better understand its therapeutic mechanisms and its specific impact on auditory metabolic processes.
Nur Sabrina Abdul Rahim, Xin-Jie Lim, E-Li Leong
et al.
Abstract Background Previous studies indicated that the SARS-CoV-2 virus and COVID-19 vaccines may contribute to idiopathic sudden sensorineural hearing loss (ISSNHL). This nationwide study sought to evaluate the correlation between COVID-19 infection and vaccination with ISSNHL. Methods This case–control study analysed samples from adults aged 18 years and older who visited the otorhinolaryngology department in 32 government hospitals in Malaysia for pure tone audiometry(PTA) between January 25, 2020 and June 30, 2022. Cases comprised patients diagnosed with ISSNHL, while controls consisted of individuals with normal PTA assessments presenting for other otorhinolaryngology-related symptoms during the same period. Patients with known causes of hearing loss were excluded. Cases and controls were matched in a 1:5 ratio based on age (± 5 years) and index date (± 10 days). The study investigated the association between ISSNHL and both COVID-19 vaccination and COVID-19 infection using conditional logistic regression, with statistical significance set at P < 0.05 for two-sided tests. Results A total of 187 ISSNHL cases and 935 matched controls were included. The mean (SD) age of participants was 42.4 (12.3) years, and 704 (62.7%) were female. Cases had a higher proportion of COVID-19 infections compared to controls [16 (8.6%) vs 44 (4.7%), P = 0.034], while both groups had similar proportions of COVID-19 vaccination [90 (48.1%) vs 415 (44.5%), P = 0.377]. Individuals who tested positive for COVID-19 had a significantly higher likelihood of developing ISSNHL compared to those without COVID-19 infection at the time of diagnosis (aOR:2.49; 95% CI:1.176 – 5.260; P = 0.017). However, there was no statistically significant association between COVID-19 vaccination and ISSNHL. Conclusions This study provides significant insights into the intricate correlation between ISSNHL, COVID-19 infection, and vaccination. The recognized hazard linked to infection emphasizes the significance of monitoring auditory health in COVID-19 patients.
Background and aimClassical music students, as a key group of professional ear users (PEUs), rely heavily on their auditory perception, making ear health critical to their education and careers. However, significant gaps in their knowledge of hearing health and protection have been previously identified, while data on non-noise-related risk factors and broader aspects of ear health remain scarce. This study aimed to evaluate classical music students’ knowledge of ear health, including ear anatomy, common ear disorders, and non-noise-related risk factors such as ototoxic medications and cardiovascular risk factors, as well as attitudes toward specialized ear health care. The goal was to inform the development of tailored educational programs and evaluate the need for specialized ear health care in performing arts medicine.MethodsA questionnaire specifically designed for the purpose of the present study (Professional Ear User Questionnaire) was distributed to classical music students at music schools in Switzerland and Germany, as well as to medical and general students at a Swiss university. Statistical analyses, including Fisher’s exact test and principal component analysis, explored response patterns and identified factors influencing ear health knowledge and behavior.ResultsData were collected from 209 music students and two control groups of 65 medical students and 40 general students. Significant gaps in ear health knowledge were identified, with only 37.8% familiar with common ear disorders. A total of 52.4% rarely or never used hearing protection, despite 84.4% expressing concerns about potential hearing deterioration. Many were unaware of non-noise-related risk factors, such as ototoxic medications. Only 27.4% knew of an ear specialist for PEUs, yet 72.1% preferred a hearing exam at a specialized clinic.ConclusionThe study highlights the need for comprehensive ear health education tailored to the unique needs of classical music students and other PEUs. Educational programs should cover both noise and non-noise-related risk factors and promote early hearing protection. The preference for specialized care underscores the importance of establishing dedicated ear health clinics for PEUs. Collaborations between (university) music schools, healthcare providers, and policymakers is crucial to protect the ear health of music students, musicians, and other PEUs, ensuring their ability to perform without preventable ear disorders.
George S. Bebawy, Aman M. Patel, David Herz
et al.
ABSTRACT Objective To analyze Medicare reimbursement and utilization trends of Zenker's diverticulectomy from 2000 to 2024. Study Design Retrospective cross‐sectional study. Setting Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule (2000–2024) and Part B Medicare Fee‐For‐Service National Summary Data (2000–2022). Methods Utilization and payment trends for open (Current Procedural Terminology [CPT] code 43130) and endoscopic (CPT code 43180, introduced in 2015) repair of Zenker's diverticulum were analyzed, with reimbursement rates adjusted for inflation using the Consumer Price Index (CPI). Linear regression analysis was performed to assess the relationship between reimbursement rates and time. Results From 2000 to 2022, the total number of Zenker's diverticulectomy procedures decreased by 14.8% (1775–1513), with a 72.1% decrease (1775–495) for open approach. There was a 22.5% increase (831–1018) in endoscopic approach from 2015 to 2022. By 2022, endoscopic procedures accounted for 67.3% of all Zenker's diverticulectomies, compared to 32.7% for the open approach. From 2000 to 2024, inflation‐adjusted reimbursement for open procedures declined by 49.96% ($1586.26–$670.41), with an annual decrease of 2.08%. Endoscopic procedures, tracked separately from 2015 to 2024, saw a 29.32% decline ($773.24–$547.13) and an annual decrease of 3.26%. Unadjusted reimbursement for both approaches combined declined by an average of 0.88% per year, while inflation‐adjusted rates decreased by 3.45% annually (p < 0.001). Conclusion There has been a downward trend in the Medicare reimbursement of Zenker's diverticulectomy, with an average adjusted decline of 3.45% annually. This trend raises concerns about the sustainability of such specialized procedures, potentially limiting access for elderly patients reliant on Medicare coverage. Level of Evidence 4.
In order to study the interaction between the human body, clothing, and environment in a low-temperature environment, a three-dimensional human thermoregulation model was established based on real human body scanning images. The human body was divided into 12 parts by dividing the body into core, equivalent, skin, and clothing layers. Further computational fluid mechanics (CFD) numerical simulation was carried out to realize the measurement and calculation of human physiological parameters, such as human skin temperature, core temperature, and average temperature of the garment surface, in a low-temperature environment. The clothing surface heat transfer, clothing surface average temperature, human skin surface heat transfer, and local skin temperature change rule were explored with the external environmental temperature to establish a basis for the study of the human body’s heat transfer characteristics in a low-temperature environment. To verify the accuracy of the developed numerical model of the human body, the simulated values of the human body model were compared with the experimental measurements of the human local skin temperature and the simulated values in the literature. The results show that the maximum relative error between the local skin temperature of the human numerical model and the experimental measurements of the human body is 3.43%, and the human numerical model has a high degree of accuracy.
Bikram Choudhury, Palak Gupta, Saptarshi Mandal
et al.
Introduction Fat grafts have been in used since 1962 for small central perforations, with a success rate ranging from 86 to 100%. Platelet-rich plasma (PRP) containing platelet concentrations greater than 1 million platelets/μL assist the healing process by various means. Current data suggests improved healing when tympanoplasty is performed using temporalis fascia grafts if PRP is added during surgery.
Background: Tonsillar Lymphangiomatous Polyp (TLP) is a rare hamartomatous lesion composed of lymphangiectasia fibro-lipomatous elements. Its stromal framework includes adipose tissue with dilated lymphatic ducts and lymphoid tissue. Despite its rarity, TLP can be challenging to classify due to its unique clinical and pathological characteristics. In this context, we present a comprehensive examination of a TLP patient and documented TLP cases.
Case presentation: A 27-year-old man was referred to the Kurdistan Otolaryngology Clinic due to persistent snoring, difficulty swallowing, and a foreign body sensation in his throat. A pedunculated mass was found on the superior pole of the right tonsil. He underwent a bilateral tonsillectomy, and the pathological examination revealed lymphangiomatous polyps. The patient had no postoperative bleeding and showed no recurrence after a year.
Discussion: The head and neck region is the most common area for lymphatic lesions, particularly lymphangiomas. While tonsillar lymphangiomatous tumors are rare, identifying them in this area can be challenging. Tonsillar lymphangiomatous polyps are benign tumors that can sometimes be misdiagnosed as malignant neoplasms. Common clinical presentations of lymphangiomatous polyps included dysphagia, dyspnea, and a sensation of having a foreign body in the throat. Surgical removal through tonsillectomy is the established treatment approach, with no documented instances of post-surgery recurrence.
Conclusion: We studied a Tonsillar Lymphangiomatous Polyp (TLP) case and provided a comprehensive understanding of its clinical, histopathological, and immunohistochemical attributes. Accurate diagnosis requires histological evaluation, and the recommended treatment involves complete removal of the tonsils.
Background: Chronic rhinosinusitis is classified into eosinophilic chronic rhinosinusitis (ECRS) and non-eosinophilic chronic rhinosinusitis (NECRS). ECRS is a refractory allergic disease involving a variety of immune and epithelial cells. S100A8 is a damage-associated molecular pattern that is closely related to allergic inflammation. However, the pathological implications of S100A8 in ECRS have not been clarified. Methods: We evaluated the role of S100A8 in the pathogenesis of ECRS. Gene expression profiles of nasal polyps obtained from patients with ECRS or NECRS were evaluated using RNA sequencing. Results: S100A8 was identified as a significantly upregulated gene in nasal polyps associated with ECRS. Immunohistochemistry consistently revealed intense S100A8 staining in nasal polyps from patients with ECRS. Human nasal epithelial cells expressed the receptor for advanced glycation end products and Toll-like receptor 4. Recombinant S100A8 protein induced interleukin-1β secretion in human nasal epithelial cells. Conclusions: Our data demonstrate that S100A8 results in production of interleukin-1β in the nasal epithelium, which may be involved in the pathogenesis of ECRS.
Rhinoscleroma is a rare, disfiguring granulomatous inflammatory lesion caused by Klebsiella rhinoscleromatis. This condition is commonly encountered in otorhinolaryngology practice and its presentation to an ophthalmologist seldom occurs. Ocular involvement occurs as an extension from nasal cavity. The management has been challenging with higher recurrence even after debridement. This report illustrates such a case of rhinoscleroma which has presented initially as nasal polyposis and later with orbital extension due to loss of follow-up. This was confirmed with histopathology as rhinoscleroma and management was done accordingly.
Objective. Previous studies have yielded conflicting results regarding the association of coronavirus disease 2019 (COVID-19) with allergic rhinitis (AR). Data on AR prevalence in COVID-19 patients are limited. Consequently, whether AR is a harmful or protective factor for COVID-19 patients remains controversial. Therefore, we analyzed the relationship between COVID-19 and AR. Methods. We systematically searched PubMed, Embase, Cochrane, and Web of Science databases for studies published between January 1, 2020 and January 11, 2022. We included studies reporting the epidemiological and clinical characteristics of COVID-19 and its incidence in patients with AR. We excluded letters, case reports, literature review articles, non-English language article, and non-full-text articles. The raw data from these studies were pooled into a meta-analysis. Results. We analyzed the results of nine studies. The prevalence of AR in patients with COVID-19 was 0.13 (95% confidence interval [CI] 0.04–0.25), with an overall I2 of 99.77%, P=0.24. COVID-19 patients with AR are less prone to severe disease (odds ratio [OR] = 0.79, 95% CI, 0.52–1.18, P=0.25) and hospitalization (OR = 0.23, 95%CI, 0.02–2.67, P≤0.0001) than patients without AR. Conclusion. Our data suggest that allergic rhinitis is a protective factor in patients with COVID-19.
Abstract Objective Childhood obstructive sleep apnea hypopnea syndrome (OSAHS) is a common clinical disease that can cause serious complications if not treated in time. Adenoidectomy with or without tonsillectomy is the most important first line surgical treatment of obstructive sleep apnea in children. The aim of this study was to compare the differences between these two surgical procedures for adenoidectomy in terms of operation time, intraoperative blood loss, proportion of patients experiencing postoperative delayed hemorrhage, and incidence of adverse events. Study Design Retrospective analysis. Methods We performed a retrospective systematic analysis of patient data using the in‐house electronic patient records and considered a 2‐year period from 2016 to 2017. In total, 468 patients who underwent adenoidectomy under nasal endoscopy with coblation or microdebrider were identified. Results The coblation adenoidectomy technique was associated with significantly reduced blood loss and operation time. However, incidence of fever, neck pain, and halitosis were significantly lower in the microdebrider adenoidectomy group (p < .01). The difference in the postoperative primary and secondary hemorrhage between the two groups was not statistically significant (p > .05). Conclusion Coblation adenoidectomy had a significantly higher incidence of adverse events such as halitosis, neck pain, and fever. Therefore, otorhinolaryngologists should consider the differences in adverse events when selecting use of coblation adenoidectomy for pediatric patients. Level of Evidence IV
Aysegul Unuvar, Levent Aydemir, Mehmet Barburoglu
et al.
Objective: The bleeding phenotype of patients with inherited FVII deficiency is variable, and epistaxis is one of the most frequent symptoms. Interestingly, the bleeding risk does not correlate with the level of FVII activity. The severity of FVII deficiency and the type of surgery are not determinants of the optimal management of surgery, the doses and the duration of rFVIIa therapy are widely variable. The aim of this study is to present our successful experience in a 16-year-old boy with inherited FVII deficiency and a huge nasopharyngeal angiofibroma with a very high risk of bleeding Case report: The patient was referred with recurrent epistaxis in the last 6 months and he was diagnosed as an inherited FVII deficiency (FVIIC:29%, FVII inhibitor negative with positive family history). Tranexamic acid (10days) and rFVIIa (2doses) were used with success in the management of this surgery. Since this surgery may cause life-threatening bleeding, endovascular particle embolization was done to the important vessels feeding the mass one day before surgery without rFVIIa support. No bleeding or thrombosis were observed in our patient. Conclusion: In conclusion, a life-threatening major surgery was successfully done for a patient with inherited FVII deficiency and a huge angiofibroma. However, perioperative management of patients with FVII deficiency still remains a major challenge and clinical trials are needed to provide evidence-based optimal management of surgeries. And, angiofibroma should be thought in the differential diagnosis of epistaxis.
Jervell and Lange-Nielsen syndrome (JLNS) is a rare but severe autosomal recessive disease characterized by profound congenital deafness and a prolonged QTc interval (greater than 500 milliseconds) in the ECG waveforms. The prevalence of JLNS is about 1/1000000 to 1/200000 around the world. However, exceed 25% of JLNS patients suffered sudden cardiac death with kinds of triggers containing anesthesia. Approximately 90% of JLNS cases are caused by KCNQ1 gene mutations. Here, using next-generation sequencing (NGS), we identified a compound heterozygosity for two mutations c.1741A>T (novel) and c.477+5G>A (known) in KCNQ1 gene as the possible pathogenic cause of JLNS, which suggested a high risk of cardiac events in a deaf child. The hearing of this patient improved significantly with the help of cochlear implantation (CI). But life-threatening arrhythmias occurred with a trigger of anesthesia after the end of the CI surgery. Our findings extend the KCNQ1 gene mutation spectrum and contribute to the management of deaf children diagnosed with JLNS for otolaryngologists (especially cochlear implant teams).
Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan, University of Milan, Milan, Italy, Department of Otorhinolaryngology – Head and Neck Surgery, University of Genoa, Genoa, Italy, Department of Otorhinolaryngology – Head and Neck Surgery, University Hospital Leuven, Leuven, Belgium, 4 Section Head and Neck Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
Mohd Shaiful Nizam Mamat Nasir, Suhaimi Yusof, Irfan Mohamad
Nasal foreign bodies are a common occurrence in children and are relatively easy to be removed in an outpatient setting.
Depending on the type and location, special precaution needs to be taken especially in cases involving a battery or an
impacted foreign body in the nostril. Although the removal procedure usually can be safely conducted in a clinic, general
anaesthesia is sometimes required, especially if the foreign body is corrosive or the child is uncooperative to prevent further
complications either from the procedure or the foreign body itself. We present a case of a 2-year-old boy, who presented with
persistent nasal discharge of 2 week-duration. A rare type of foreign body which is a metal spring, was found in the right
nostril. The spring was successfully removed under general anaesthesia without any local complications.
a Medical University Prof. Dr. P. Stoyanov, Department of Neurosurgery and Ear, Nose and Trought Diseases, Division of Otorhinolaryngology, Varna, Bulgaria b Medical University Prof. Dr. P. Stoyanov, Department of Pathology, Varna, Bulgaria c DRK Krankenhaus Altenkirchen-Hachenburg, Altenkirchen, Germany d Queens Medical Centre, University Hospital, Combined Head and Neck Oncology Clinic, Nottingham, United Kingdom
Altair Cadrobbi Pupo, Giovana Targino Esturaro, Luisa Barzaghi
et al.
RESUMO Objetivo Analisar o desempenho fonológico e do vocabulário de crianças com perda auditiva unilateral. Métodos Participaram do estudo 12 crianças com perda auditiva unilateral, seis delas com perda condutiva por malformação congênita de orelha e seis com perda sensorioneural congênita ou adquirida no primeiro ano de vida, de qualquer grau, configuração, em qualquer ouvido e sem outro comprometimento associado, na faixa etária entre 3 anos e 7 meses e 7 anos e 8 meses. Foram aplicadas as provas de fonologia e vocabulário do “Teste de Linguagem Infantil – ABFW”. Resultados Trinta e três por cento das crianças apresentaram desempenho diferente do esperado para a faixa etária, no que concerne ao desenvolvimento fonológico (2 crianças) e lexical (2 crianças). Na prova de fonologia, 1 criança com perda sensorioneural apresentou processos produtivos não esperados para a faixa etária (simplificações das líquidas e ensurdecimento de fricativas) e baixos índices de acertos no inventário fonético. Uma criança com perda auditiva condutiva por malformação congênita de orelha apresentou plosivação de fricativas, simplificação de líquidas e resultado limítrofe, na análise do inventário fonético (75%). Na prova de vocabulário, 2 crianças com perda sensorioneural apresentaram médias percentuais de Designação Verbal Usual abaixo das esperadas para as idades, nos diversos campos conceituais. Não houve diferença entre os grupos sensorioneural e condutivo nas provas de fonologia e de vocabulário. Conclusão Crianças com perda auditiva unilateral apresentam risco para o desenvolvimento de linguagem. Destaca-se a importância do acompanhamento de linguagem e audição neste grupo, uma vez que o monitoramento pode propiciar intervenções oportunas e eficazes, prevenindo possíveis alterações da linguagem e dificuldades escolares.