Hasil untuk "Otorhinolaryngology"

Balwinder S. Tiwana, Ankita Aggarwal, Sanjeev Bhagat et al.

Abstract Objective Our study aimed to investigate the ototoxicity associated with the iron chelator deferasirox in patients with β‐thalassemia major, who were receiving regular transfusion therapy, along with evaluating the data on audiological tests using appropriate statistical tests. Methods A cross‐sectional observational study was conducted on 100 transfusion‐dependent β‐thalassemia major patients on oral iron chelating agent‐deferasirox. Pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE) was carried out in all patients to assess the auditory side effects of the drug. Data was collected, compiled, and analyzed statistically using appropriate statistical tests. The relationship between ototoxicity and various demographic parameters such as age, sex, hemoglobin (Hb) level, S. ferritin, duration, and dose of chelation therapy was also assessed. Results Sixteen patients had abnormal DPOAE and the number of patients with pure tone average above 25 dB HL which was taken as hearing deficit on PTA was 13. No statistically significant relationship between hearing loss and age, gender, S. ferritin, duration of therapy, cumulative dose, Hb levels were found. Conclusion Despite being a lifesaving drug, the advantages of chelating agent‐Deferasirox must be weighed against its probable ototoxic effects. We could not find a relationship of ototoxicity with variable parameters (age, gender, Hb level, Ferritin level, duration, and cumulative dose of drug), thus future research is encouraged to form a definitive basis.

Sînziana Adina Scărlătescu, Irina-Maria Gheorghiu, Loredana Mitran et al.

Annalisa Pace, Valeria Rossetti, Giannicola Iannella et al.

Acquired atresia of the external auditory canal (EAC) is a rare disease characterized by otorrhea and progressive hearing loss. Clinically, it is differentiated into two stages: the wet stage and the dry stage. The dry stage does not respond to pharmacological treatment and has to be treated surgically. One surgical option is canaloplasty of the EAC with Thiersch graft reconstruction. This study aimed to report the follow-up outcomes (otomicroscopic signs and pure tone audiometry [PTA]) in patients with acquired atresia treated with this technique. Eighteen adult patients surgically treated for acquired atresia of the EAC between 2010 and 2020 were enrolled. All underwent canaloplasty with Thiersch graft reconstruction by one senior surgeon. Otomicroscopy and PTA results were evaluated before and after surgery. Postsurgical follow-up was performed at 1-3-6-12 months and then annually. Presurgical otomicroscopic examination revealed stenosis that occluded more than 75% of the EAC in all patients, and preoperative PTA showed conductive hearing loss in 89% of patients. However, postsurgical otomicroscopic examination showed that 94% of patients had a normal EAC diameter after one year, and only one patient had anterior blunting and recurrent atresia. In addition, postsurgical PTA evidenced a normal range in 89% of patients after one year. In conclusion, acquired atresia of the EAC is a troublesome disease usually associated with hearing loss. Therefore, treatment is chosen to resolve its symptoms. The results demonstrate evidence that canaloplasty with Thirsch graft may be a suitable surgical method considering the lower incidence of recurrence and the excellent hearing outcomes.

Maximilian Rink, Ernst-Michael Jung, Julian Künzel

Metastatic cervical lymph nodes are a frequent finding in head and neck squamous cell carcinoma (HNSCC). If a non-surgical approach is primarily chosen, a therapy response evaluation of the primary tumor and the affected lymph nodes is necessary in the follow-up. Supplementary contrast-enhanced ultrasound (CEUS) can be used to precisely visualize the microcirculation of the target lesion in the neck, whereby malignant and benign findings differ in their uptake behavior. The same applies to many other solid tumors. For various tumor entities, it has already been shown that therapy monitoring is possible through regular contrast-enhanced sonography of the primary tumor or the affected lymph nodes. Thus, in some cases, maybe in the future, a change in therapy strategy can be achieved at an early stage in the case of non-response or, in the case of therapy success, a de-escalation of subsequent (surgical) measures can be achieved. In this paper, a systematic review of the available studies and a discussion of the potential of therapy monitoring by means of CEUS in HNSCC are presented.

Rubens Dantas da Silva Junior, Osmar Clayton Person, Priscila Bogar et al.

Paola Parisi, Mohssen Ansarin, Elisabetta Pennacchioli et al.

Hua Sun, Hua Sun, Ashish Damania et al.

Unified airway disease, including concurrent asthma and chronic rhinosinusitis (CRS), is a common, but poorly understood disorder with no curative treatment options. To establish a murine model of chronic unified eosinophilic airway inflammation, mice were challenged with Aspergillus niger, and sinonasal mucosa and lung tissue were evaluated by immunohistochemistry, flow cytometry, and gene expression. Inhalation of A niger conidia resulted in a Th2-biased lung and sinus inflammation that typifies allergic asthma and CRS. Gene network and pathway analysis correlated with human disease with upregulation of not only the JAK-STAT and helper T-cell pathways, but also less expected pathways governing the spliceosome, osteoclast differentiation, and coagulation pathways. Utilizing a specific inhibitor and gene-deficient mice, we demonstrate that STAT6 is required for mycosis-induced sinus inflammation. These findings confirm the relevance of this new model and portend future studies that further extend our understanding of the immunopathologic basis of airway mycosis and unified airway disease.

Patrizia Scavone

Tympanic membrane perforation is a very common clinical condition encountered in otological practice; it can result from a large variety of causes such as trauma or infections. Ear buzzing, earache, and hearing loss are the major symptoms of tympanic membrane perforation, which it might also result into middle ear infection (otitis media) and transmissive hearing loss, if not treated in time. Various non-surgical treatments are available to aid tympanic membrane recovery, but to date, there are no efficient topical therapies to improve membrane re-epithelialization. In this article, two cases of persistent tympanic perforation treated with a sterile medical device consisting of Adelmidrol and Trans-traumatic acid are described.

Wai Tsz Chang, Ka Yue Tam, Hung Yao et al.

Endolymphatic sac tumors (ELSTs) are rare, papillary adenomatous tumors that arise from the endothelium of the endolymphatic sac. We demonstrate a difficult case of endolymphatic sac tumor and how it is managed via transcanal endoscopic assisted technique, with discussion of feasibility of transcanal approach to lateral skull base tumor. Keywords: Endolymphatic sac, Lateral skull base, Transcanal endoscopic assisted technique, Transcanal combined endoscopic microscopic approach

F.J. Sanz-Santaeufemia, J.L. Almodóvar Martín, R. Espinosa Góngora et al.

Abscess in the thyroid gland is a rare but severe infectious disease in children. Risk factors include anatomic abnormalities or underlying conditions; either inflammatory (Hashimoto thyroiditis) or postraumatic. Treatment requires endovenous antibiotics and usually children undergo surgery for drainage and eventual reparations of associated malformations. Pathogens vary considerably depending on the main predisposing thyroid illnesses.

Fei Su, Rui Tian, Yi Yang et al.

Staphylococcus epidermidis is one of the most commonly isolated species from human skin and the second leading cause of bloodstream infections. Here, we performed a large-scale comparative study without any pre-assigned reference to identify genomic determinants associated with the diversity and adaptation of S. epidermidis strains to various environments. Pan-genome of S. epidermidis was open with 435 core proteins and had a pan-genome size of 8,034 proteins. Genome-wide phylogenetic tree showed high heterogeneity and suggested that routine whole genome sequencing was a powerful tool for analyzing the complex evolution of S. epidermidis and for investigating the infection sources. Comparative genome analyses demonstrated a range of antimicrobial resistance (AMR) genes, especially those within mobile genetic elements. The complicated host-bacterium and bacterium-bacterium relationships help S. epidermidis to play a vital role in balancing the epithelial microflora. The highly variable and dynamic nature of the S. epidermidis genome may contribute to its success in adapting to broad habitats. Genes related to biofilm formation and cell toxicity were significantly enriched in the blood and skin, demonstrating their potentials in identifying risk genotypes. This study gave a general landscape of S. epidermidis pan-genome and provided valuable insights into mechanisms for genome evolution and lifestyle adaptation of this ecologically flexible species.

Patorn Piromchai, Charoiboon Puvatanond, Virat Kirtsreesakul et al.

Background Nasal irrigation is widely used as an adjunctive treatment for nasal diseases. There is little evidence regarding the efficacy of the devices used in this procedure. The objective of this survey was to evaluate the effectiveness of nasal irrigation devices based on the experiences of patients and physicians. Methods We conducted a multicentre survey study between November 2017 and October 2018. Physician and patient questionnaires were developed based on the available literature and expert opinion. The physician questionnaire was submitted to the Otolaryngology residents and staff of each centre and their network. The physicians were also asked to distribute the patient questionnaire to their patients. Results Information regarding 331 devices used by the patients was collected. The mean age of the patients was 45.46 ± 17.19 years (from 5 to 81). Roughly half were male, and half were female (48.6%: 51.4%). Among the high-pressure devices, we found that the high-pressure large-volume nasal irrigation devices yielded significantly higher symptom scores in seven of 12 domains (p < 0.05). Among the large-volume devices, we found that the large-volume high-pressure nasal irrigation devices received significantly higher symptom scores in 4 of 12 domains (p < 0.05). However, a higher proportion of patients using the large-volume high-pressure devices had retained fluid in the sinuses compared to those using large-volume low-pressure devices (p < 0.001). Conclusions This survey supports the regular use of nasal irrigation, particularly with large-volume high-pressure devices, as an effective treatment for nasal disease. It may be effective at clearing nasal secretion, improve nasal congestion, decrease post-nasal drip, improve sinus pain or headache, improve taste and smell, and improve sleep quality. It could be used by patients with good compliance and minimal side effects.

Vjeran Bogović, Stjepan Grga Milanković, Željko Zubčić et al.

The aim of this study was to present the advantages and disadvantages of open approach in rhinoplasty. In it, we also present the development of this technique in Croatia and examine its application in the last five years at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Hospital Centre Osijek. Retrospectively, from January 2008 to August 2012, 400 patients with septal deviation and/or deformities of the nasal pyramid who underwent open rhinoplasty at the Department of Otorhinolaryngology, Head and Neck Surgery of the Clinical Hospital Centre of Osijek, Croatia were identified. The clinical diagnosis was based on a detailed medical history of the patient and nasal endoscopy. The patients were photographed in six projections before and after the surgery, and followed up on two occasions.

Yu L, Li N, Zhang JS et al.

Lei Yu,1 Na Li,1 Jisheng Zhang,2 Yan Jiang1 1Department of Otorhinolaryngology, 2Key Laboratory of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Qingdao University, Qingdao, China Introduction: Epigenetic regulation has been shown to play an important role in the development of inflammatory diseases, including chronic rhinosinusitis and nasal polyps. The latter are characterized by epithelial mis-differentiation and infiltration of inflammatory cytokines. H3K4me3 has been shown to be involved in regulating lineage commitment. However, the underlying mechanisms, especially in human nasal epithelial cells (HNEpC), remain underexplored. The objective of this study was to investigate the role of H3K4me3 in HNEpC differentiation treated with the Th2 cytokine IL-13. Patients and methods: The expression levels of mRNA and proteins were investigated using reverse transcription-polymerase chain reaction (RT-PCR) assays and Western blot in nasal polyp tissues and human nasal epithelial cells respectively. We measured these levels of H3K4me3, MLL1 and targeted genes compared with control subjects.Results: We demonstrate that expression of H3K4me3 and its methyltransferase MLL1 was significantly upregulated in IL-13-treated HNEpC. This elevation was also observed in nasal polyps. Expression of cilia-related transcription factors FOXJ1 and DNAI2 decreased, while goblet cell-derived genes CLCA1 and MUC5a increased upon IL-13 treatment. Mechanistically, knockdown of MLL1 restored expression of these four genes induced by IL-13. Conclusion: These findings suggest that H3K4me3 is a critical regulator in control of nasal epithelial cell differentiation. MLL1 may be a potential therapeutic target for nasal inflammatory diseases. Keywords: IL-13, H3K4me3 modification, nasal epithelial cell, differentiation&nbsp;

Yildiray Yildirim, Taner Kar, Tuncay Topal et al.

Aim. To compare the surgical outcomes of surgery with and without bicanalicular silicon tube intubation for the treatment of patients who have primary uncomplicated nasolacrimal duct obstruction. Methods. This retrospective study is comprised of 113 patients with uncomplicated primary nasolacrimal duct obstruction. There were 2 groups in the study: Group 1 (n=58) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation and Group 2 (n=55) patients underwent transcanalicular diode laser dacryocystorhinostomy surgery without bicanalicular silicon tube intubation. The follow-up period was 18.42±2.8 months for Group 1 and 18.8±2.1 months for Group 2. Results. Success was defined by irrigation of the lacrimal system without regurgitation and by the absence of epiphora. Success rates were 84.4% for Group 1 and 63.6% for Group 2 (P=0.011). Statistically a significant difference was found between the two groups. Conclusion. The results of the study showed that transcanalicular diode laser dacryocystorhinostomy surgery with bicanalicular silicon tube intubation was more successful than the other method of surgery. Consequently, the application of silicone tube intubation in transcanalicular diode laser dacryocystorhinostomy surgery is recommended.

M. Abou-elfadl, S. Lrhazi, M. Mahtar et al.

I. M. Villarreal, M. Pinilla, I. Salas et al.

Priyanka Jain, Shraddha Mukerji

Pediatric head and neck masses are commonly congenital in origin or of infectious etiology. We present a rare case of benign mesenchymoma in close proximity to the submandibular gland in an otherwise asymptomatic child. Computerized tomography (CT) scan of the head and neck area revealed a benign lesion, which was later determined to be a benign mesenchymoma on histopathology. The child did well after surgery without any reported recurrence. We discuss the salient features of a benign mesenchymoma in a child and also discuss relevant imaging and management.

T. Nikolopoulos

Fabio Augusto Rabello, E. Massuda, J. A. D. de Oliveira et al.

PhD, Medicine (Professor, FMRP-USP).Send correspondence to: Miguel Angelo Hyppolito. Av. Bandeirantes, no 3900, 12o andar. Monte Alegre. Ribeirao Preto - SP. Brazil. CEP: 14048-900.Medical School of Ribeirao Preto - University of Sao Paulo - University Hospital (FMRP - USP).FAEPA - HCRP - FMRP-USP.Paper submitted to the BJORL-SGP (Publishing Management System - Brazilian Journal of Otorhinolaryngology) on September 29, 2005;and accepted on October 16, 2012. cod. 1460.