Wolf-Dieter Baumgartner, Javier Gavilán, Abdelhamid Benghalem
et al.
Objective: This review aims to analyse the implications of the World Health Organization's 2021 world report on hearing, with a particular focus on the cochlear implant field. The objective is to understand the challenges and opportunities highlighted in the report and propose viable solutions for effective implementation within the cochlear implant community. Methods: Following the release of the World Health Organization's world report on hearing, cochlear implant professionals explored and discussed the implications of the report with examples from various countries to understand the disparities in access, reimbursement policies, and social stigma associated with hearing loss. Results: The world hearing report identifies hearing loss as a major global health issue, with an estimate of 1.5 billion people currently affected and a projected increase to 2.5 billion by 2050. Key challenges in the cochlear implantation field include disparities in access to services, particularly in low- and middle-income countries, lack of reimbursement policies in many regions, and the social stigma surrounding hearing loss. Conclusion: A multi-faced approach is needed to address the rising prevalence of hearing loss and policy makers must prioritize ear and hearing care as a public health concern. Organizations like the HEARRING group can promote education, awareness, and training, and act as advocates for changes in healthcare systems to expand access to hearing care services.
Christian Idel, Jonas Fleckner, Kirstin Plötze-Martin
et al.
Abstract Background Head and neck squamous cell carcinoma (HNSCC) represents a common and heterogeneous malignancy of the oral cavity, pharynx and larynx. Surgery and radio(chemo)therapy are the standard treatment options and also have great influence on the composition of the tumor microenvironment and immune cell functions. However, the impact of radio(chemo)therapy on the distribution and characteristics of circulating monocyte subsets in HNSCC are not fully understood. Methods Expression patterns of adhesion molecules and chemokine receptors CD11a (integrin-α L; LFA-1), CD11b (integrin-α M; Mac-1), CD11c (integrin-α X), CX3CR1 (CX3CL1 receptor) and checkpoint molecule PD-L1 (programmed cell death ligand-1) were investigated upon radio(chemo)therapeutic treatment using flow cytometry. Furthermore, comprehensive analysis of plasma cytokines was performed before and after treatment using ELISA measurements. Results Our data reveal a partial recovery of circulating monocytes in HNSCC patients upon radio(chemo)therapeutic treatment, with differential effects of the individual therapy regimen. PD-L1 expression on non-classical monocytes significantly correlates with the individual plasma levels of chemokine CXCL11 (C-X-C motif chemokine 11). Conclusions Further comprehensive investigations on larger patient cohorts are required to elucidate the meaningfulness of peripheral blood monocyte subsets and chemokine CXCL11 as potential bioliquid indicators in HNSCC with regard to therapy response and the individual immunological situation.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Background: Hearing impairment and tinnitus are common otological manifestations found in the outpatient Department of Otorhinolaryngology. Hearing loss and tinnitus have been documented among coronavirus disease-2019 (COVID-19) patients. However, these clinical manifestations were rarely investigated among pediatric patients with COVID-19 infections. Objective: This study aims to evaluate the prevalence of hearing impairment and tinnitus among children with COVID-19 infection at a teaching hospital. Materials and Methods: This is a prospective and descriptive study where 192 children with COVID-19 infections were evaluated for hearing loss and tinnitus. There were 44 (22.91%) children with COVID-19 infections presenting with hearing loss and tinnitus. All of the children were confirmed as COVID-19 infection with the help of reverse transcription-polymerase chain reaction of the nasopharyngeal swab. Detailed history taking and clinical examination of the ear were done for the assessment of hearing loss and tinnitus and its outcome was analyzed. Results: Out of 44 children, 20 (45.45%) were presented with tinnitus, 16 (36.36%) were presented with hearing loss, and 8 (18.18%) were presented with both hearing loss and tinnitus. Out of 44 pediatric patients with hearing loss and/or tinnitus, 26 (59.09%) were males and 18 (40.90%) were females with a male child to female child ratio of 1.44:1. The mean age of the participants was 9.16 years with an age range from 5 to 18 years. The sporadic type of tinnitus is more common than any other type. Conclusion: This study showed that the presence of subjective neurological features like hearing loss and tinnitus can be found in children with COVID-19 infection. More studies are required to confirm the exact pathophysiology mechanism underlying this subjective symptom in pediatric patients with COVID-19 infection.
Cláudia Santos, Tomás Nunes, Mariana Branco
et al.
Objetivos: Proposta de protocolo de atuação em profissionais portadores de MRSA nasal assintomáticos referenciados a consulta de Otorrinolaringologia.
Desenho de estudo: Revisão da literatura e de normas de atuação clínica e de boas práticas.
Materiais e Métodos: Pesquisa na PubMed com as palavras-chave: “nasal carriage MRSA”, “MRSA health care workers”, “community MRSA”, “MRSA control strategies”.
Resultados: O rastreio de colonização por MRSA e aplicação de medidas de descolonização em doentes de unidades de saúde tem impacto na diminuição da carga de doença deste microrganismo.
Existem recomendações para rastreio de profissionais de saúde com o intuito de diminuir a transmissão nosocomial de MRSA, apesar da sua aplicação em Portugal ser ainda reduzida.
Conclusões: Devem ser considerados fatores clínicos e do ambiente profissional para abordagem dos profissionais portadores assintomáticos de MRSA no exsudado nasal. As medidas preventivas de contacto e higiene são preferidas à descolonização em assintomáticos.
Abstract Introduction Ear, nose and throat (ENT)pathologies can present with proptosis as the early manifestation. The majority of ENT pathologies present with ocular manifestations, due to close anatomical relationship. Objective To study proptosis in ENT disorders in terms of etiology, pathogenesis, and management. Methods The present article is a prospective study conducted at a tertiary care center, in Telangana, India. Patients presenting with proptosis secondary to ENT disorders were thoroughly evaluated and subjected to surgical exploration after providing a signed informed consent. Results Sixty cases of proptosis secondary to ENT disorders have been reported. The most common cause was sinonasal squamous cell carcinoma followed by juvenile nasopharyngeal angiofibroma and allergic fungal rhinosinusitis. Conclusion Many ENT disorders can present with proptosis. Proptosis needs to be evaluated completely for proper management and to limit the morbidity associated with it.
Afonso Castro, Carlos Nabuco, Rogério Fernandes
et al.
Os tumores do espaço parafaríngeo são raros correspondendo apenas a 0.5% dos tumores de cabeça e pescoço neste espaço. Descrevem-se dois casos clínicos. O primeiro de uma doente de 44 anos, com queixas de abaulamento da parede lateral da faringe. A TAC cervical revelou uma volumosa lesão expansiva, de aspecto heterogéneo e vascularizada, que desviava a carótidas interna e externa. O segundo caso, de uma doente de 57 anos, com queixas de massa cervical à esquerda, de crescimento indolente e indolor. A TAC cervical mostrou uma lesão com epicentro no espaço carotídeo esquerdo, com realce global marcado, de contornos regulares. Em ambos os casos a abordagem cirúrgica via incisão transcervial. O estudo histológico revelou schwanoma do nervo vago no primeiro caso e paraganglioma no segundo. O diagnóstico pode ser difícil, sendo a TC e a RMN exames cruciais no diagnóstico diferencial destes tumores e no seu planeamento cirúrgico.
OBJECTIVES To present the guidelines of the French Society of Otolaryngology-Head and Neck Surgery concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pediatric ENT infections. METHODS Based on a critical analysis of the medical literature up to November 2016, a multidisciplinary workgroup of 11 practitioners wrote clinical practice guidelines. Levels of evidence were classified according to the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system: GRADE A, B, C or "expert opinion". The first version of the text was reworked by the workgroup following comments by the 22 members of the reading group. RESULTS The main recommendations are: NSAIDs are indicated at analgesic doses (e.g. 20-30 mg/kg/day for ibuprofen) in combination with paracetamol (acetaminophen) in uncomplicated pediatric ENT infections (acute otitis media, tonsillitis, upper respiratory infections, and maxillary sinusitis) if: o pain is of medium intensity (visual analogue scale (VAS) score 3-5 or "Evaluation Enfant Douleur" (EVENDOL) child pain score 4-7) and insufficiently relieved by first-line paracetamol (residual VAS≥3 or EVENDOL≥4); o pain is moderate to intense (VAS 5-7 or EVENDOL 7-10). When combined, paracetamol and ibuprofen are ideally taken simultaneously every 6h. It is recommended: (1) o not to prescribe NSAIDs in severe or complicated pediatric ENT infections; (2) o to suspend NSAIDs treatment in case of unusual clinical presentation of the infection (duration or symptoms); (3) o not to prescribe NSAIDs for more than 72h.
Karolina Dżaman, Karolina Zborowska-Piskadło, M. Pietniczka-Załęska
et al.
Marcus Gunn phenomenon (MGP) is a rare form of congenital facial synkinesis known as jaw-winking or pterygoid-levator synkinesis. The MGP is the raising of the affected eyelid is synchronous and proportionate to the opening of the mouth. The etiology is unclear. Most authors claim that a branch of trigeminal nerve has been congenitally misdirected into position of the oculomotor nerve which supplies the levator muscle of the upper lid. The MGP deals with number of problems which have to be manage by ENT doctors, but they are not well‑documented. We describe the first time Marcus Gunn phenomenon associated with an olfactory nerve disturbance. We have especially emphasized laryngological aspect of MGP diagnosis and the need for deeper interdisciplinary diagnostics in each child with olfactory dysfunction.
Our health is highly determined by the diverse microbial community living within our body and upon our skin. Balance among the members of the commensal microbiota is essential for the preservation of health. New generation sequencing is a rapid, sensitive method for determining the whole microbiome without prior hypothesis and also gives information on the resistance and virulence status. Application of this method can help to identify the pathogens contributing to different diseases, and also the protective bacteria inhibiting their growth. Detecting the changes of the microbiome helps to identify new therapeutic targets and establish targeted antibiotic therapy. Broad-spectrum antibiotics also act against the beneficial members of the microbial flora, which may lead to the development of recurrent or chronic disease. Ear, nose and throat infections are the most common infective diseases in humans and the leading cause for antibiotic prescription worldwide. In recent years, many studies using molecular biology methods were performed examining the microbiome of healthy humans and in otorhinolaryngologic diseases. In the present work, the authors review the changes of the microbiological communities in the healthy state and in various pathologic states in the anatomic regions of the ear, nose and throat. Orv Hetil. 2019; 160(39): 1533-1541.
SUMMARY The aim of this study is to compare the changes in impact factors and citation numbers of Open Access (OA) vs subscription-based (SB) journals between 1999 and 2016 and to explore the changing trends in ORL publishing. All data extracted from SCImago Journal and Country ranking (SJR) website have been used as input for statistical analysis. The chi-square test of independency was applied in order to understand whether the ratio of number of OA journals of ORL category have dramatically changed between years 1999 and 2016. Also, the years and impact factors of journals belonging to the OA and SB journals have been graphed separately and the changes of annual SJR ranks of both journal types have been compared using one-way Z-test. There was a significant difference as the proportion of OA Journals were not equal to the proportion of SB Journals throughout the years 1999 and 2016, and it showed the tendency to increase greater compared to SB Journals (p < 0.01). Although the overall level of impact factors of SB journals was generally high, by comparing two regression models, it was obvious that the level of increase of the impact factors of OA journals were significantly higher (p < 0.01). When choosing where to publish, it is important to consider the journal’s visibility, cost of publication, IF or SJR of the journal and speed of publication as well as changing trends in medical publishing nourished by the Web of Science.
J. Nokso-Koivisto, K. Blomgren, L. Aaltonen
et al.
OBJECTIVES Patient injuries in children can have lifelong effects on the patient and a marked impact on the whole family. The aim of this study was to identify the errors and incidents leading to patient injuries in pediatric otorhinolaryngology (ORL) by evaluating accepted patient injury claims. METHODS The records of all accepted patient injury claims in ORL between 2001 and 2011 were searched from the nationwide Patient Insurance Centre registry. Pediatric injuries were reviewed and evaluated in detail, and factors contributing to injury were identified. RESULTS In the 10-year study period, 17 (7.6%) of the 223 patient injuries occurred in children, and of these, 15 (88%) were considered operative care. The median age of the patients was 8 years (range 3-16 years). All operations were performed as daytime elective surgery and by a fully trained specialist in 93% of the cases. One-half of the cases were routine surgeries for common ORL diseases. The most common incidences were incomplete surgery, retained gauze or foreign body, injury to adjacent anatomic structure, and insufficient charts or instructions (each occurred in 3 cases). The most frequent consequence was burn (n = 4). One child died because of post-tonsillectomy hemorrhage. CONCLUSIONS Patient injuries in pediatric ORL are strongly related to surgery. Most injuries occurred after routine operations by a fully trained specialist. Clinicians should be aware of the most likely scenarios resulting in claims.
Denise Maria Zaratini Fernandes, Maria Cecília Marconi Pinheiro Lima
ABSTRACT Objective: to compare the parents and teachers views about the occurrence of deleterious oral habits in preschool children. Methods: a cross - sectional study with a quantitative analysis. Parents and teachers answered a self-administered questionnaire regarding the deleterious habits of preschool children and signed the Informed Consent Term. At the end, 221questionaries were included. The data were submitted to Chi-square test, Fisher exact and McNemar tests. Results: according to the parents, the most frequent habit was the bottle with 52.04%, followed by the pacifier with 24.09%. According to the teachers, the pacifier was the most frequent one, accounting for 20.36% of cases, followed by the use of bottle (7.69%). In the present sample, 90.95% of the children were breastfed. When related to oral habits, it was observed that the longer the breastfeeding time, the lower the use of pacifiers and bottles. By comparing the questionnaires, it was verified that the parents noticed, more frequently, the oral habits than did the teachers. Conclusion: in the group studied, the parents reported more the presence of deleterious oral habits than did the teachers. It is important that parents, and especially teachers, have information about the harm caused by the prolonged presence of such habits, so that they can encourage their interruption, thus, avoiding possible damages to the stomatognathic system and the performance of orofacial functions.
Objective To assess the experience on using direct observation of procedural skills (DOPS) by trainees and trainers and to evaluate its use during the training process of Otorhinolaryngology (ORL) residency. Methods This study was designed as a prospective educational research. For the quantitative assessment, the "construct validity" of the assessment tool was examined. For the qualitative assessment, the trainees and trainers' experiences regarding the use of DOPS in training process were investigated. Results A total of 55 DOPS assessment forms were filled during the study. The mean observation time was 7.14±4.83 (range: 1-20) minutes, and the mean feedback time was 2.11±2.01 (range: 0.5-10) minutes. A significant difference was detected between the first year trainees and the older ones, whereas no significant difference was observed between the third, fourth, and fifth year trainees. A statistically significant, positive correlation was found between the years of education and the average score. According to the results of the qualitative assessment, the trainees stated that they realized their technical inadequacy in some procedures and it helped them to improve their skills during their residency training. The trainers confirmed that they gave feedback after each assessment. Both the trainers and trainees suggested that specific guidelines should be prepared for every procedure. Conclusion DOPS is a useful, valid, and fair tool for assessing Otorhinolaryngology trainees. The data obtained from the DOPS forms can be used for demonstrating the success of a training clinic and to evaluate the training program.
Objectives: To provide an up-to-date review of honey’s effectiveness and potential applications in otorhinolaryngology. Methods: A literature search of the online databases PubMed, EMBASE, and Cochrane Central Register of Controlled Trials was conducted. Results: Sixty-three studies were identified within head and neck surgery (n = 23, 36%); pediatric otolaryngology (n = 18, 29%); rhinology, sinus, and skull base surgery (n = 11, 17%); otology (n = 6, 10%), facial plastic and reconstructive surgery (n = 3, 5%); and laryngology (n = 2, 3%). Studies included 6 meta-analyses, 44 randomized control trials, 5 case reports, and 8 animal models or in vitro studies. Of 55 clinical studies, 50 reported Level 1 evidence (prospective randomized control trials), and 5 reported Level 4 evidence (case series). The evidence level by subspecialty was: head and neck surgery (Level 1 n = 23), pediatrics (Level 1 n = 18), rhinology (Level 1 n = 7, level 4 n = 1), otology (Level 1 n = 1, Level 4 n = 3), facial plastics and reconstructive surgery (Level 4 n = 1), and laryngology (Level 1 n = 2). Conclusions: Honey can be used for a variety of otolaryngology conditions. The highest quality meta-analyses support oral honey for prevention and treatment of oral mucositis in cancer patients, cough associated with upper respiratory infection in children, and pain control after tonsillectomy. Further research will likely justify broader applications.
BACKGROUND Otorhinolaryngology has an extensive history that spans nearly five millennia, and the history of women as medical and surgical practitioners stretches back to at least 3500 BC. OBJECTIVES To explore the history of women in ENT from ancient to modern times, and discover their fascinating role in this field over the years. METHOD A literature review was conducted using Google Scholar and PubMed. RESULTS In ancient and medieval times, there were female doctors accomplished in areas pertaining to ENT. In the nineteenth and twentieth centuries, inspirational women pioneers paved the way for modern female ENT surgeons. This led to a rapid increase in the representation of female otorhinolaryngologists in clinical practice and authorship over the last fifty years. CONCLUSION The contribution of women to otorhinolaryngology has evolved since ancient times and the greatest advancement has occurred within the last two hundred years.
SUMMARY Emerging and re-emerging infectious disease in otorhinolaryngology (ENT) are an area of growing epidemiological and clinical interest. The aim of this section is to comprehensively report on the epidemiology of key infectious disease in otorhinolaryngology, reporting on their burden at the national and international level, expanding of the need of promoting and implementing preventive interventions, and the rationale of applying evidence-based, effective and cost- effective diagnostic, curative and preventive approaches. In particular, we focus on i) ENT viral infections (HIV, Epstein-Barr virus, Human Papilloma virus), retrieving the available evidence on their oncogenic potential; ii) typical and atypical mycobacteria infections; iii) non-specific granulomatous lymphadenopathy; iv) emerging paediatric ENT infectious diseases and the prevention of their complications; v) the growing burden of antimicrobial resistance in ENT and the strategies for its control in different clinical settings. We conclude by outlining knowledge gaps and action needed in ENT infectious diseases research and clinical practice and we make references to economic analysis in the field of ENT infectious diseases prevention and care.