Hasil untuk "Otorhinolaryngology"

Vladan Milutinović, Aleksandar Trivić, Ivana Čolović-Čalovski et al.

Jiao Zhang, Minghui Zhao, Wei Shi et al.

Purpose To investigate the perinatal risk factors for conductive hearing loss (CHL) in infancy and develop an initial prediction model to facilitate accurate diagnosis and early detection of CHL. Method This retrospective study utilized data from the Newborn Cohort Study of Hearing Loss (ChiCTR2100049765). Infants who underwent diagnostic audiological assessments at our hospital between January 2003 and June 2024 were included. Data analysis was conducted using R (version 4.4.1) to construct an initial prediction model for CHL in infancy, applying the LASSO regression technique. Results A total of 661 infants (1322 ears) were included, with 1253 ears in the normal hearing group and 69 ears in the CHL group. Statistically significant differences were observed between the groups in the following factors: parent-reported infant response to sound, craniofacial deformities, neonatal hemolysis, jaundice treatment, and neonatal hypoglycemia. A multivariate prediction model and nomogram for CHL in infancy were developed and validated, achieving an accuracy of 92.5% and a specificity of 91.3%. ConclusionsThis study identified key risk factors for CHL in infancy and developed a preliminary predictive model, improving the diagnostic accuracy for CHL. Improved diagnostic precision can decrease misdiagnoses, reduce delays in treatment, and limit unnecessary antimicrobial prescriptions for infants.

Lili Xiao, Jianju Liu, Yi Chen et al.

Abstract Noise-induced hearing loss (NIHL), a common sensory disorder, is traditionally thought to stem primarily from direct damage to sound-sensing hair cells (HCs). Here, we demonstrate that supporting cells (SCs), neighboring cells not previously implicated in NIHL pathogenesis, orchestrate hearing loss and HC degeneration through Gasdermin D (GSDMD) activation. Mechanistically, noise-induced oxidative stress in HCs triggers activation of epidermal growth factor receptor in SCs, leading to extracellular-regulated kinase phosphorylation and caspase-11-dependent cleavage of GSDMD, thereby establishing an HC-to-SC signaling cascade. Furthermore, GSDMD activation in SCs reciprocally exacerbates oxidative injury in HCs, creating a pathogenic positive feedback loop between the two cell types. Our findings uncover a central role for SCs in noise-induced hearing loss and identify GSDMD-mediated intercellular communication as a potential therapeutic target.

Kun Ni, Jia Fang, Wenyan Fan et al.

Abstract The clinical features of neurocristopathy-related hearing loss, and the correlation between these features and patient improvements after cochlear implantation (CI) are unknown. This study enrolled 16 children with sensorineural hearing loss due to four types of neurocristopathies, Waardenburg syndrome (WS), Noonan syndrome (NS), Kabuki syndrome (KS), and CHARGE syndrome (CS), who underwent CI. Neurodevelopmental assessment was conducted using the Gesell Developmental Schedules, ear development was evaluated using temporal bone computed tomography, and the post-CI auditory nerve response was assessed via neural response telemetry. Auditory performance was evaluated using the categories of the auditory performance scale. Genetic features were examined using whole-exome sequencing. WS/NS Groups achieved excellent auditory-speech outcomes (CAP_3 year/SIR_3 year: WS 7.3/4.0 n = 3, NS 8.0/4.0 n = 1), using Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR), with minimal impact from SOX10 (WS) or PTPN11 (NS) mutations on neurodevelopment. CS Group showed poor recovery (CAP_3 year/SIR_3 year: 3.3/1.8 n = 3) due to CHD7-related cochlear nerve dysplasia and central auditory deficits, Gesell_mean showed a significant positive correlation with CAP_1 year (ρ = 0.83 n = 6 p = 0.042), CAP_3 year was significantly correlated with both implantation CI_age_mon and Gesell_mean independently (ρ = 1.0, n = 3, p < 0.001). Non-CS Groups(WS/NS/KS)showed older CI_age_mon predicted higher 1-year SIR (ρ = 0.77 n = 10 p = 0.009), while structural abnormalities (abnormal_sum) trended toward worse 3-year SIR (ρ=-0.79 n = 5). The integration of genetic, ear structure, and neurodevelopmental assessments can assist in clinical decision making for CI.

Rémy Hamdan, Cyrielle Chea, Maxime Brisson et al.

Neck cellulitis occurs as a result of dental, pharyngeal or ear infections or following trauma, but rarely via a cutaneous entry point. A 34-year-old female patient consulted with a left-sided, painful cervical swelling with limited head rotation and trismus, accompanied by a painful, oozing, retroauricular contact dermatitis (CD). Clinical examination confirmed the left cervical cellulitis with superinfected retroauricular CD. A computed tomography scan of the neck revealed no abscess. Systemic antibiotic therapy against streptococci and staphylococci for 8 days, combined with hygiene care for the CD lesions and the avoidance of glasses with metal frames, resulted in complete recovery without recurrence. Patch tests revealed sensitization to several metals, particularly nickel. Eyeglasses may cause allergic CD, an inflammatory skin disease caused by a delayed-type hypersensitivity reaction. Metal spectacle frames are particularly prone to causing CD, mainly due to the presence of nickel. Because of the skin breakdown it entails, spectacle frames’ CD may lead to skin infections and neck cellulitis. Spectacle frame CD should be investigated in patients presenting with retroauricular eczema. To our knowledge, the case of neck cellulitis induced by spectacle frame-allergic CD has never been reported.

Ziwen Li, Min Li, Sinuo Sun et al.

Background: Previous studies have found that Apolipoprotein E (APOE) plays a crucial role in invasion and migration of papillary thyroid carcinoma (PTC) cells and enhance M2 macrophage polarization. Ferroptosis has been implicated in development of various tumors and their treatment resistance, and studies have shown that APOE is involved in ferroptosis regulation. However, whether APOE promotes PTC progression through ferroptosis modulation remains unclear. This study aims to investigate the ferroptosis-related mechanisms through which APOE facilitates cell invasion, migration, and macrophage polarization in PTC. Methods: The expression levels of APOE, Sodium-dependent cystine/glutamate exchanger (xCT), Glutathione Peroxidase 4 (GPX4), Ferritin Heavy Chain 1 (FTH1), and Fe2+ in PTC tissues were detected using immunohistochemistry, Prussian blue staining, and western blot. The effects and mechanisms of APOE on ferroptosis were further examined through a series of experiments, including immunofluorescence, electron microscopy, RT-qPCR, western blot, and colorimetric assays. Additionally, In vivo experiments were conducted to assess the effect of APOE silencing on ferroptosis. The interaction between ferroptosis and macrophages in regulating PTC cell invasion and migration was validated using assays.co-culture systems, wound healing assays, and Transwell migration assays. Results: In PTC tissues, Fe2+ accumulation was lower than in adjacent normal tissues, while the expression of APOE, xCT, GPX4, and FTH1 was significantly higher compared to adjacent normal tissues. Functional assays demonstrated that APOE inhibited ferroptosis in PTC cells, potentially by regulating ferroptosis through the PI3K/AKT1 pathway and modulating Fe2+ accumulation. Furthermore, APOE enhanced the invasion and migration abilities of PTC cells by promoting M2 macrophage polarization via ferroptosis inhibition. Conclusion: This study reveals that APOE regulates ferroptosis through the PI3K/AKT1 pathway, thereby driving macrophage polarization toward the M2 phenotype, which in turn promotes the invasion and migration of PTC.

Masoud Janipour, Shahin Bastaninejad, Alireza mohebbi et al.

Abstract Background Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. Methods Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. Results Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. Conclusion In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

Raid M. Al-Ani, Thamir A Kubaisi

Abstract Background Trichoepithelioma is a rare benign tumor. It could be an inherited or acquired condition. Trichoepithelioma has mostly involved the face with bilateral multiple lesions. Involvement of the auricle by this tumor is extremely rare encountered in clinical practice. Case presentation A 36-year-old female presented to the Dermatology Clinic with painless right auricular papules 4 years ago. Examination revealed multiple non-tender, firm, rounded, dome-shaped, flesh-colored, pink, and shiny papules. There was mild bleeding from the lesions after trivial trauma. There was no family history of similar problem. No abnormality was found on other examinations. An excisional biopsy of one lesion was performed under local anesthesia. The histopathological evaluation confirmed the diagnosis of trichoepithelioma. The lesions under local anesthesia were excised with primary closure of the wound. No recurrence was seen during 2 years of follow-up. Conclusion Only five cases of trichoepitheliomas that affected the auricle were reported in the PubMed database. Four of them are affecting both auricles as well as other parts of the body, particularly the face. The fifth case was with a unilateral single giant auricular lesion. Our case was with non-familial multiple unilateral auricular trichoepitheliomas. The tumors responded well on surgical excision and primary closure.

Shin Hyuk Yoo, Hyo-Yeon Kim, Yoon-Ah Kim et al.

Background and Objectives Turbinoplasty may be an option in patients with persistent symptoms of allergic rhinitis (AR) despite adequate medication. The two most frequently used surgical techniques for turbinoplasty are radiofrequency ablation and microdebriderassisted turbinoplasty. This study compared the outcomes of these two surgical techniques and assessed the long-term treatment effects. Methods This study included patients with AR who underwent turbinoplasty between January 2010 and June 2017. We examined the medication scores, overall treatment satisfaction scores, and medical records. Based on the type of surgery, patients were classified into microdebrider and coblator groups. A telephone survey was conducted to collect data on the 5-year post-treatment efficacy parameters. Scores for allergic symptoms, prescription medicines taken after surgery, and general satisfaction were compared. Results Of the total 241 patients, 192 (79.7%) and 49 (20.3%) underwent microdebrider-assisted turbinoplasty and radiofrequency ablation turbinoplasty, respectively. Both the microdebrider and coblator groups showed remarkable improvements in AR symptoms at the 5-year follow-up (p<0.001). Although the degree of symptom improvement did not differ significantly between the two groups, the coblator group did show significant improvements in medication scores when compared with the microdebrider group (p<0.05), and there were significant differences in postoperative satisfaction scores between the two groups. Conclusion In terms of 5-year postoperative outcomes, radiofrequency-ablation turbinoplasty and microdebrider-assisted turbinoplasty were equally beneficial for reducing nasal symptoms and enhancing medication ratings in patients with AR.

Ruxian Tian, Yumei Li, Chuanliang Jia et al.

ObjectiveWe aim to establish and validate computed tomography (CT)-based radiomics model for predicting TP53 status in patients with laryngeal squamous cell carcinoma (LSCC).MethodsWe divided all patients into a training set 1 (n=66) and a testing set 1 (n=30) to establish and validate radiomics model to predict TP53. Radiomics features were selected by analysis of variance (ANOVA) and the least absolute shrinkage and selection operator (Lasso) regression analysis. Five radiomics models were established by using K-Nearest Neighbor, logistics regressive, linear-support vector machine (SVM), gaussian-SVM, and polynomial-SVM in training set 1. We also divided all patients into a training set 2 and a testing set 2 according to different CT equipment to establish and evaluate the stability of the radiomics models.ResultsAfter ANOVA and subsequent Lasso regression analysis, 22 radiomics features were selected to build the radiomics model in training set 1. The radiomics model based on linear-SVM has the best predictive performance of the five models, and the area under the receiver operating characteristic curve in training set 1 and testing set 1 were 0.831(95% confidence interval [CI] 0.692–0.970) and 0.797(95% CI 0.632–0.957) respectively. The specificity, sensitivity, and accuracy were 0.971(95% CI 0.834–0.999), 0.714(95% CI 0.535–0.848), and 0.843(95% CI 0.657–0.928) in training set 1 and 0.750(95% CI 0.500–0.938), 0.786(95% CI 0.571–1.000), and 0.667(95% CI 0.467–0.720) in testing set 1, respectively. In addition, the radiomics model also achieved stable prediction results even in different CT equipment. Decision curve analysis showed that the radiomics model for predicting TP53 status could benefit LSCC patients.ConclusionWe developed and validated a relatively optimal radiomics model for TP53 status prediction by trying five different machine learning methods in patients with LSCC. It shown great potential of radiomics features for predicting TP53 status preoperatively and guiding clinical treatment.

Norazwani Azwal, Yogeswaran Lokanathan, Mawaddah Azman et al.

Ricardo Melnick, Gabriela Soares Rech, Rafaela Soares Rech et al.

Introduction Cigarettes are the main cause of preventable death in the world, and primary health care services can contribute to the management of this habit. Objective To describe and analyze the factors associated with tobacco cessation in groups of smokers in primary health care. Methods The present is a cross-sectional study conducted in 12 primary health care units from July 2016 to May 2017. We investigated sociodemographic and health variables, as well as smoking characteristics and different interventions for tobacco cessation, with the outcome being studied and analyzed after the fourth group care session. Results We evaluated 329 smokers, of which 182 quit smoking after the fourth interview. Most of the individuals who quit smoking were women (n = 121, 66.5%), with a monthly income of 2 to 5 minimum wages (n = 88, 77.9%). After the multivariable analysis, we observed that tobacco cessation was significantly associated with depression (prevalence ratio [PR] = 1.11; 95% confidence interval [95%CI] = 1.02 to 1.22), as well as with belonging to the groups which used as approaches motivational interviewing (PR = 1.21; 95%CI = 1.13 to 2.01), patches (PR = 1.36; 95%CI = 1.24 to 1.48), and bupropion (PR = 1.16; 95%CI = 1.03 to 1.31). Conclusion Primary health care is the ideal site for the reduction of smoking rates, given that different technologies may be applicable and useful for tobacco cessation. The comprehensiveness and longitudinal care offered in primary care may provide opportunities for health professionals to understand which is the best technology for each health system user, thus contributing to personalized care.

Nuno Daniel Ribeiro Costa, Clara Magalhães, Delfim Duarte et al.

Objectivo: Avaliar as alterações nas imuglobulinas séricas e níveis do sistema complemento em crianças submetidas a adenoamigdalectomia em função do critério cirúrgico. Materiais e Métodos: Um total de 69 crianças programadas para adenoamigdalectomia foram incluídas neste estudo e posteriormente separadas em 3 grupos conforme o critério de indicação cirúrgica (infecioso, obstrutivo e misto). Os níveis de IgA, IgG, IgM, C3 e C4 foram determinados em amostras de sangue recolhidas destes doentes antes e 6 meses depois da cirurgia. Resultados: Os níveis de IgG, IgA e IgM nas crianças submetidas a adenoamigdalectomia apresentaram uma diminuição significativa no período pós-operatório, enquanto os níveis de C3 foram significativamente maiores. Na divisão por critério cirúrgico observou-se uma diminuição significativa da IgA em todos os grupos, enquanto nas crianças operadas por critério obstrutivo registou-se ainda uma diminuição significativa da IgG e aumento de C4. Nas crianças com ambas indicações cirúrgicas foi também observada uma diminuição significativa da IgM. Conclusão: O presente estudo demonstra que a adenoamigdalectomia apresenta um impacto significativo na função imune humoral e que este impacto é variável em função da indicação cirúrgica. No entanto, os valores de imunoglobulinas e de complemento permaneceram dentro dos valores de referência, o que evidencia que este procedimento não compromete a função imune das crianças a médio prazo.

F. Dagna, A. Murri, R. Albera et al.

Presentiamo un caso di posizionamento di impianto cocleare in un uomo di 50 anni che, dopo aver subito tre anni prima un intervento per via retrosigmoidea per un neurinoma dell’acustico in stadio 1, è stato colpito da ipoacusia improvvisa ipsilaterale sviluppando un intenso acufene. Dopo l’attivazione dell’impianto l’acufene è sceso da un grado 4 ad un grado 2 secondo il THI. Sono migliorate le capacità di localizzazione. L’ascolto nel rumore (S/R + 7 dB) con il segnale proveniente dal lato operato è migliorato da 38 a 100%. Abbiamo inoltre verificato un significativo incremento dei punteggi relativi a spazialità e linguaggio del questionario “Speech, spatial and qualities of sounds”. In conclusione l’impianto cocleare è una soluzione praticabile ed efficace in caso di insorgenza di ipoacusia ritardata dopo chirurgia conservativa del neurinoma dell’acustico.