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Assessing the Complex Impact of Smoking Habits on Allergic Rhinitis: A National Cross-Sectional Study. 评估吸烟习惯对过敏性鼻炎的复杂影响:一项全国横断面研究
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-11-25 DOI: 10.21053/ceo.2024.00202
Jae-Min Shin, Yujin Jeong, Jaehyeong Kim, Juhyun Lee, Tae Hoon Kim

Objectives: Allergic rhinitis (AR) significantly affects quality of life and generates socioeconomic costs. The impact of smoking habits, including the use of conventional cigarettes (CC) and electronic cigarettes (EC), on AR prevalence and management remains controversial. To investigate the association between smoking status (CC and EC use) and AR prevalence and management among Koreans, data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2018) and VIII (2019-2021) were analyzed.

Methods: This cross-sectional study included 22,290 participants aged ≥19 years from the KNHANES. Smoking status was self-reported, and urinary cotinine levels were measured to assess nicotine exposure. Statistical analyses, including logistic regression, were employed to examine the relationships between smoking status, cotinine levels, and AR prevalence and management.

Results: In univariable logistic regression analysis, compared to non-smokers, electronic cigarette (EC) users showed a 35.8% increased risk of allergic rhinitis (AR), while conventional cigarette (CC) users had a 27.7% lower risk. In multivariable logistic regression analysis, CC users demonstrated a 20.3% lower risk, but no significant association was found among EC users. High cotinine levels (>500 ng/ml) were inversely related to AR prevalence. Among heavy CC users with high cotinine levels, a 35% reduced risk of AR was observed, but after adjusting for confounders, the association was no longer significant, suggesting that other variables may mediate this relationship.

Conclusion: Smoking status is associated with the prevalence of allergic rhinitis (AR) in Koreans, and heavy use of conventional cigarettes (CC) shows a negative correlation with AR prevalence.

目的:过敏性鼻炎(AR)严重影响人们的生活质量,并造成社会经济损失。吸烟习惯(包括使用传统香烟(CC)和电子香烟(EC))对过敏性鼻炎发病率和管理的影响仍存在争议。为了研究韩国人的吸烟状况(CC和EC的使用)与AR患病率和管理之间的关系,我们分析了韩国国民健康和营养调查(KNHANES)第七次(2018年)和第八次(2019-2021年)的数据:这项横断面研究纳入了韩国国民健康与营养调查中年龄≥19岁的22290名参与者。吸烟状况由参与者自我报告,尿液中可替宁水平的测量用于评估尼古丁暴露。统计分析(包括逻辑回归)用于研究吸烟状况、可替宁水平、AR患病率和管理之间的关系:在单变量逻辑回归分析中,与非吸烟者相比,电子香烟(EC)使用者患过敏性鼻炎(AR)的风险增加了35.8%,而传统香烟(CC)使用者的风险降低了27.7%。在多变量逻辑回归分析中,CC 用户的风险降低了 20.3%,但在电子烟用户中没有发现明显的关联。可替宁水平过高(>500纳克/毫升)与AR患病率成反比。在可替宁水平较高的重度CC使用者中,观察到AR风险降低了35%,但在调整了混杂因素后,这种关联不再显著,这表明其他变量可能介导了这种关系:结论:吸烟状况与韩国人的过敏性鼻炎(AR)发病率有关,而大量使用传统香烟(CC)与AR发病率呈负相关。
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引用次数: 0
Video Head Impulse Test Coherence Predicts Vertigo Recovery in Sudden Sensorineural Hearing Loss with Vertigo. 视频头脉冲测试相干性可预测突发性感音神经性听力损失伴眩晕患者的眩晕恢复情况。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-11-06 DOI: 10.21053/ceo.2024.00068
Sheng-Chiao Lin, Ming-Yee Lin, Bor-Hwang Kang, Yaoh-Shiang Lin, Yu-Hsi Liu, Chi-Yuan Yin, Po-Shing Lin, Che-Wei Lin

Objective: The labyrinthitis poses inferior quality of life with prolonged vestibular symptoms in patients with sudden sensorineural hearing loss with vertigo (SSNHLV). This study utilized a novel coherence analysis in video head impulse test (vHIT) to investigate vertigo outcomes in SSNHLV patients.

Methods: A retrospective review included 48 SSNHLV patients completing high-dose steroid treatment between December 2016 and April 2023, and 38 healthy volunteers were prospectively enrolled between November 2022 and April 2023 in our academic tertiary referral center. Magnitude-squared wavelet coherence was measured between eye and head velocities in vHIT to represent the degree of correlation across different frequency bands. Vertigo recovery, assessed by visual analog scale equal to zero at 2 weeks and 2 months, was analyzed using a multivariable Cox regression model.

Results: The VAS among patients with SSNHLV was 5.73 ± 2.45 (mean ± standard deviation). Higher coherent frequencies in the horizontal semicircular canal (SCC), posterior SCC, mean, and minimal coherent frequencies of all three SCCs combined were significantly associated with early complete vertigo remission at two weeks post-treatment. In the multivariate analysis, the minimal coherent frequency among the three SCCs emerged as an independent factor (hazard ratio [HR] 2.040, 95% confidence interval [CI] 1.776-2.304). At two months post-treatment, in addition to the previously significant parameters, vestibulo-ocular reflex (VOR) abnormality in the posterior SCC, gains in the horizontal and posterior SCCs, total and overt saccades in the horizontal SCC, coherent frequency in the anterior SCC, and mean VOR gain of all three SCCs combined were also statistically significantly related to total vertigo relief.

Conclusion: The greater minimal coherent frequency among the three SCCs was a strong factor contributing to earlier relief of vertigo in patients with SSNHLV. Coherence analysis in vHIT may be more sensitive than time series analysis for evaluating vertigo prognosis prediction.

目的:突发性感音神经性听力损失伴眩晕(SSNHLV)患者的迷走神经炎会导致生活质量下降,前庭症状持续时间延长。本研究利用视频头脉冲测试(vHIT)中的新型相干性分析来研究 SSNHLV 患者的眩晕后果:回顾性研究纳入了 2016 年 12 月至 2023 年 4 月期间完成大剂量类固醇治疗的 48 名 SSNHLV 患者,并在 2022 年 11 月至 2023 年 4 月期间在我们的学术三级转诊中心前瞻性地招募了 38 名健康志愿者。测量了vHIT中眼部速度和头部速度之间的幅度平方小波相干性,以表示不同频段之间的相关程度。使用多变量考克斯回归模型对眩晕的恢复情况进行了分析,眩晕的恢复情况是通过视觉模拟量表在2周和2个月时等于零来评估的:结果:SSNHLV 患者的 VAS 为 5.73 ± 2.45(平均值 ± 标准差)。水平半规管(SCC)、后半规管(SCC)较高的相干频率、所有三个SCC的平均相干频率和最小相干频率与治疗后两周的早期完全眩晕缓解显著相关。在多变量分析中,三个 SCC 中的最小相干频率成为一个独立因素(危险比 [HR] 2.040,95% 置信区间 [CI] 1.776-2.304)。在治疗后两个月,除了之前的显著参数外,后SCC的前庭眼反射(VOR)异常、水平和后SCC的增益、水平SCC的总和明显囊视、前SCC的连贯频率以及所有三个SCC的平均VOR增益也与眩晕的完全缓解有显著统计学关系:结论:三个 SCC 的最小相干频率越高,眩晕缓解越早。在评估眩晕预后预测时,vHIT 中的相干分析可能比时间序列分析更敏感。
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引用次数: 0
Long-term Assessment of Speech and Swallowing Function in Laryngopharyngeal Cancer Patients After J-Flap Reconstruction. 喉咽癌患者 J 瓣重建后言语和吞咽功能的长期评估
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-11-04 DOI: 10.21053/ceo.2024.00109
Yi-An Lu, Chung-Kan Tsao, Li-Jen Hsin, Hsiu-Feng Chuang, Tuan-Jen Fang

Background: A novel J-shaped anterolateral thigh (ALT) flap reconstruction technique had been developed to simultaneously restore swallowing and speech functions in patients following total laryngopharyngectomy. This study aimed to assess the outcomes and surgical complications in patients who underwent J-flap reconstruction over time.

Methods: Patients who underwent J-shaped ALT flap phonatory tube reconstruction were enrolled. Surgical morbidities and outcomes were evaluated every 3 months postsurgery for 12 months or death.

Results: Of the 36 patients, 13 underwent circumferential pharyngeal wall resection (circumferential defect group, CD group), and 23 underwent partial resection (partial defect group, PD group). After 12 months, 97% of the patients resumed oral intake without reliance on a nasogastric tube (NG tube), and 50% achieved fluent speech using the reconstructed phonatory tube. The CD group showed a higher rate of delayed healing (30.77% vs. 0%, p=0.005). The PD group exhibited significantly greater percentages of individuals consuming solid food at both the 3- and 12-month intervals than the CD group (81.0% vs. 23.1% and 78.9% vs. 40%, respectively).

Conclusion: : This study examined the evolution of speech and swallowing functions over time following J-flap voice tube reconstruction. Regardless of whether the defect was circumferential or partial, using a J-shaped ALT flap phonatory tube effectively restored both speech and swallowing functions, offering long-lasting benefits.

背景:一种新型的 J 形大腿前外侧(ALT)皮瓣重建技术已被开发出来,可同时恢复喉咽全切除术后患者的吞咽和语言功能。本研究旨在评估接受J形皮瓣重建术患者的疗效和手术并发症:方法:研究对象为接受 J 型 ALT 皮瓣发音管重建术的患者。结果:36 名患者中有 13 人接受了 J 形 ALT 皮瓣咽鼓管重建术:36名患者中,13人接受了咽壁环周切除术(环周缺损组,CD组),23人接受了部分切除术(部分缺损组,PD组)。12 个月后,97% 的患者恢复了口腔进食,无需依赖鼻胃管(NG 管),50% 的患者使用重建的发音管实现了流利的语言表达。CD 组的延迟愈合率较高(30.77% 对 0%,P=0.005)。PD组在3个月和12个月期间进食固体食物的比例明显高于CD组(分别为81.0%对23.1%和78.9%对40%):本研究探讨了J-瓣声门导管重建术后语言和吞咽功能随时间的变化情况。无论缺损是环形还是部分缺损,使用J形ALT瓣声门导管都能有效恢复言语和吞咽功能,并带来持久的益处。
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引用次数: 0
Clinical significance of gross extrathyroidal extension to only the strap muscle according to tumor size in differentiated thyroid cancer: a systematic review and metaanalysis. 根据分化型甲状腺癌的肿瘤大小,甲状腺外大面积扩展到带状肌的临床意义:系统综述和荟萃分析。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-10-31 DOI: 10.21053/ceo.2024.00162
Ho-Ryun Won, Hyo-One Son, Sumin Yi, Ji Won Kim, Jae Won Chang, Bon Seok Koo

Objective: The presence of extrathyroidal extension (ETE) in differentiated thyroid cancer (DTC) patients is an important predictor of their prognosis. Therefore, the tumor stage of DTC is divided into extensive ETE and gross ETE only affecting the strap muscle (Gross strap muscles invasion; gSMI). However, insufficient evidence exists regarding the association of gSMI with the prognosis, especially in relation to tumor size.

Methods: Related literature was searched in MEDLINE, Embase, Cochrane Library and KoreaMed. All processes were performed in accordance with PRISMA guidelines, and the process was conducted by two independent reviewers. The meta-analysis was performed using a random-effect model considering the diversity of studies. RoBANS version 2.0, an evaluation tool for non-randomized studies, was used to evaluate the quality of the selected research. Clinical data from observational studies that analyzed the relationship between the degree of ETE and prognosis were collected, and a meta-analysis was performed.

Results: Eighteen observational studies were included in this study. A subgroup analysis was performed for each outcome. The recurrence rate (odds ratio [OR]: 2.498), disease-specific mortality (risk ratio [RR]: 2.984), overall mortality (RR: 1.361) and lymph node (LN) metastasis (OR: 5.355) were significantly higher in patients with gSMI than in those with no ETE. However, in an analysis limited to tumors 4 cm or smaller, no significant difference in prognostic outcomes was seen, except for LN metastasis.

Conclusion: gSMI has a negative impact on the prognosis; however, this correlation diminishes when the tumor size is small. Thus, a more cautious approach is warranted during the treatment process.

目的:分化型甲状腺癌(DTC)患者出现甲状腺外扩展(ETE)是预测其预后的一个重要指标。因此,DTC的肿瘤分期分为广泛ETE和仅影响带状肌的粗大ETE(粗大带状肌侵犯;gSMI)。然而,关于 gSMI 与预后的关系,尤其是与肿瘤大小的关系,目前还没有足够的证据:方法:在 MEDLINE、Embase、Cochrane Library 和 KoreaMed 中检索相关文献。所有过程均按照 PRISMA 指南进行,并由两名独立审稿人进行。考虑到研究的多样性,采用随机效应模型进行了荟萃分析。非随机研究评估工具 RoBANS 2.0 版用于评估所选研究的质量。收集了分析 ETE 程度与预后关系的观察性研究的临床数据,并进行了荟萃分析:本研究共纳入了 18 项观察性研究。对每个结果都进行了分组分析。gSMI患者的复发率(几率比[OR]:2.498)、疾病特异性死亡率(风险比[RR]:2.984)、总死亡率(RR:1.361)和淋巴结(LN)转移率(OR:5.355)均显著高于无ETE患者。结论:gSMI 对预后有负面影响;但当肿瘤较小时,这种相关性会减弱。因此,在治疗过程中应采取更加谨慎的方法。
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引用次数: 0
Therapeutic Effectiveness SNOT 22-based interdose interval adjustment of dupilumab for CRSwNP. 基于疗效 SNOT 22,调整杜必鲁单抗治疗 CRSwNP 的用药间隔。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-10-31 DOI: 10.21053/ceo.2024.00233
So Yeon Yoon, HyunKyung Cha, Seung-No Hong, Min-Suk Yang, Dae Woo Kim

Objectives: This study aims to evaluate whether Sino-nasal Outcome Test (SNOT-22)-based interdose interval adjustment of dupilumab demonstrates enduring efficacy and patient satisfaction in chronic rhinosinusitis with nasal polyps (CRSwNP).

Methods: A retrospective analysis was conducted using planned data collection from 44 patients who received dupilumab and had been followed up for more than 6 months, targeting individuals with CRSwNP based on the EPOS 2020 Criteria. Patients were treated with add-on dupilumab by adjusting the interdose interval based on SNOT-22, which was tapered when subjects with >40 SNOT-22 at pretreatment evaluation were controlled at the level of ≤20 SNOT-22; when subjects with ≤40 SNOT-22 at pretreatment evaluation were controlled at the level of ≥50% improvement. SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire modified from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4) were assessed at each visit.

Results: The SNOT-22-based interdose interval adjustment of dupilumab showed sustained improvement in patients' subjective symptoms, satisfaction, and NPS. Mean scores (S.D) of SNOT-22 improved from 46.04 (22.30) to 14.72 (13.66) at 6 months (p=0.000); NPS improved from 3.20 (2.24) to 1.72 (1.46) at 6 months (p=0.000). Satisfaction scores (0-5) were well maintained above 3.5 points for up to 6 months(p=0.166). There was also a significant correlation between the improvement in the nasal symptom domain of SNOT-22 scores and higher satisfaction scores.

Conclusion: Adjusting dupilumab intervals based on SNOT-22 from the start leads to sustained efficacy and patient satisfaction in Korean CRSwNP. This will be of great clinical help in determining the optimal dupilumab interval.

研究目的本研究旨在评估基于SNOT-22结果测试(Sino-nasal Outcome Test)的dupilumab剂量间隔调整是否对伴有鼻息肉的慢性鼻炎(CRSwNP)具有持久疗效和患者满意度:根据EPOS 2020标准,针对CRSwNP患者进行了一项回顾性分析,计划收集44名接受过杜比单抗治疗且随访时间超过6个月的患者的数据。根据SNOT-22调整两次给药的间隔时间,当患者在治疗前评估时SNOT-22大于40,而治疗后SNOT-22控制在≤20的水平时,则减量给药;当患者在治疗前评估时SNOT-22≤40,而治疗后SNOT-22控制在改善≥50%的水平时,则减量给药。每次就诊时评估 SNOT-22、鼻息肉评分(NPS)和根据药物治疗满意度问卷(TSQM v.1.4)修改的主观满意度问卷:结果:基于 SNOT-22 的双鲁单抗剂量间隔调整显示,患者的主观症状、满意度和 NPS 均有持续改善。SNOT-22 的平均得分(S.D)从 46.04(22.30)分改善到 6 个月时的 14.72(13.66)分(P=0.000);NPS 从 3.20(2.24)分改善到 6 个月时的 1.72(1.46)分(P=0.000)。满意度评分(0-5 分)在 6 个月内一直保持在 3.5 分以上(p=0.166)。SNOT-22评分中鼻腔症状领域的改善与较高的满意度评分之间也存在明显的相关性:结论:在韩国 CRSwNP 患者中,从一开始就根据 SNOT-22 调整杜必鲁单抗的间隔时间可获得持续疗效和患者满意度。结论:根据 SNOT-22 从一开始就对韩国 CRSwNP 患者的疗效和满意度进行调整,可使疗效和满意度保持稳定,这对确定杜比鲁单抗的最佳治疗间隔有很大临床帮助。
{"title":"Therapeutic Effectiveness SNOT 22-based interdose interval adjustment of dupilumab for CRSwNP.","authors":"So Yeon Yoon, HyunKyung Cha, Seung-No Hong, Min-Suk Yang, Dae Woo Kim","doi":"10.21053/ceo.2024.00233","DOIUrl":"https://doi.org/10.21053/ceo.2024.00233","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate whether Sino-nasal Outcome Test (SNOT-22)-based interdose interval adjustment of dupilumab demonstrates enduring efficacy and patient satisfaction in chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>A retrospective analysis was conducted using planned data collection from 44 patients who received dupilumab and had been followed up for more than 6 months, targeting individuals with CRSwNP based on the EPOS 2020 Criteria. Patients were treated with add-on dupilumab by adjusting the interdose interval based on SNOT-22, which was tapered when subjects with >40 SNOT-22 at pretreatment evaluation were controlled at the level of ≤20 SNOT-22; when subjects with ≤40 SNOT-22 at pretreatment evaluation were controlled at the level of ≥50% improvement. SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire modified from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4) were assessed at each visit.</p><p><strong>Results: </strong>The SNOT-22-based interdose interval adjustment of dupilumab showed sustained improvement in patients' subjective symptoms, satisfaction, and NPS. Mean scores (S.D) of SNOT-22 improved from 46.04 (22.30) to 14.72 (13.66) at 6 months (p=0.000); NPS improved from 3.20 (2.24) to 1.72 (1.46) at 6 months (p=0.000). Satisfaction scores (0-5) were well maintained above 3.5 points for up to 6 months(p=0.166). There was also a significant correlation between the improvement in the nasal symptom domain of SNOT-22 scores and higher satisfaction scores.</p><p><strong>Conclusion: </strong>Adjusting dupilumab intervals based on SNOT-22 from the start leads to sustained efficacy and patient satisfaction in Korean CRSwNP. This will be of great clinical help in determining the optimal dupilumab interval.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Consensus Statement: Postoperative Management after Balloon Dilation of the Eustachian Tube. 共识声明:咽鼓管球囊扩张术后管理。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-10-31 DOI: 10.21053/ceo.2024.00121
Min Young Kwak, Ho Yun Lee, Soo-Keun Kong, In Seok Moon, Bong Jik Kim, Myung-Whan Suh, Jae Yun Jung, Hong Ju Park, Kyu-Yup Lee, Hyong-Ho Cho, Ryoukichi Ikeda, Jae-Jin Song, Chi-Kyou Lee

Objective: Balloon dilation of Eustachian tube (BDET) has been widely used as a minimally invasive treatment for obstructive Eustachian tube dysfunction (ETD). We used a Delphi consensus methodology to explore recommendations for clinical management of BDET in obstructive ETD.

Procedure: A Delphi panel of 26 expert physicians of otology participated in two rounds of anonymous, iterative questionnaires. Consensus is defined as ≥ 70% of panelists agree with recommendation and disagreement as < 70% agree. The responses from the Delphi study were analyzed using both the content validity ratio and Kendall's coefficient of concordance.

Results: The panel finally evaluated 26 topics, agreed 9 and did not reach consensus on 17 topics after 2 rounds. Although no consensus was reached on the postoperative follow-up period, a period of 12 months was most adopted. The Valsalva maneuver and questionnaire responses showed the highest agreement as postoperative assessment tools after BDET.

Conclusion: Consensus was reached on some of the recommendations for the management of BEDT in obstructive ETD. The resultant agreement will provide directions for future research to describe standard postoperative management of BDET.

目的:咽鼓管球囊扩张术(BDET)作为一种微创治疗方法,已被广泛应用于阻塞性咽鼓管功能障碍(ETD)的治疗。我们采用德尔菲共识法探讨了阻塞性咽鼓管功能障碍 BDET 的临床管理建议:由 26 位耳科专家组成的德尔菲小组参与了两轮匿名反复问卷调查。共识的定义是≥70%的专家小组成员同意建议,不同意的定义是<70%的专家小组成员同意建议。德尔菲研究采用内容效度比和肯德尔一致系数对回答进行了分析:经过两轮讨论,小组最终对 26 个主题进行了评估,同意 9 个主题,未就 17 个主题达成共识。虽然对术后随访期未达成共识,但大多数人都认为随访期为 12 个月。作为 BDET 术后评估工具,Valsalva 动作和问卷回答的一致性最高:结论:就阻塞性 ETD 的 BEDT 管理建议达成了共识。结论:就阻塞性 ETD 的 BEDT 管理的一些建议达成了共识,这些共识将为今后描述 BDET 术后标准管理的研究提供方向。
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引用次数: 0
Measurement of microplastic release after use of polypropylene nasal irrigation bottles. 测量使用聚丙烯鼻腔冲洗瓶后的微塑料释放量。
IF 3 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-09-10 DOI: 10.21053/ceo.2024.00182
Kyung Soo Kim,Hyun Jin Min
ObjectivesMicroplastics from plastic materials can affect human health. This study aimed to assess their presence in nasal irrigation fluids obtained from reused bottles based on usage duration.MethodsReadily available nasal irrigation bottles made of polypropylene were purchased. Unused irrigation bottles served as controls. Bottles mimicking 1-, 3-, and 6-month reuse were prepared as test samples. Nasal irrigation fluid samples (n=12) were collected from each set of irrigation bottles: three from new control bottles and nine from bottles mimicking 1-, 3-, and 6-month reuse. Raman spectroscopy was employed to detect microplastics in the nasal irrigation samples; the results were compared according to the bottle use duration.ResultsAn average of 33.00±20.42 (ea/300 mL) microplastic particles was detected in the nasal irrigation fluid from the control bottles relative to an average of 68.66±30.07, 261.66±20.59, and 204.33±52.16 (ea/300 mL) from bottles used for 1, 3, and 6 months, respectively. The majority of the detected microplastics were 10-100 μm in size and fragmentshaped in form. The predominant microplastic was polypropylene, indicating direct release from irrigation bottles.ConclusionWe found microplastics in nasal irrigation fluids, likely originating from the repeated use of nasal irrigation bottles. The quantity of microplastics was notably elevated in the samples obtained from bottles simulating 3 months of use compared to those in the control samples. Thus, we propose developing guidelines regulating the duration of nasal irrigation bottle usage to mitigate microplastic infiltration into the body through the sinonasal cavity.
目的 塑料材料中的微塑料会影响人体健康。本研究旨在根据使用时间的长短,评估从重复使用的瓶子中获得的鼻腔冲洗液中是否含有微塑料。未使用过的冲洗瓶作为对照。模拟重复使用 1 个月、3 个月和 6 个月的瓶子作为测试样本。从每组灌流瓶中收集鼻腔灌流液样本(n=12):3 份来自新的对照瓶,9 份来自模拟重复使用 1、3 和 6 个月的瓶子。结果 在对照瓶的鼻腔灌洗液中平均检测到 33.00±20.42(ea/300 mL)个微塑料颗粒,而在使用 1、3 和 6 个月的瓶子中平均分别检测到 68.66±30.07、261.66±20.59 和 204.33±52.16(ea/300 mL)个微塑料颗粒。检测到的大多数微塑料大小为 10-100 μm,呈碎片状。结论我们在鼻腔冲洗液中发现了微塑料,很可能是反复使用鼻腔冲洗瓶造成的。与对照样本相比,从模拟使用 3 个月的瓶子中提取的样本中的微塑料数量明显增加。因此,我们建议制定规范鼻腔冲洗瓶使用时间的指南,以减少微塑料通过鼻窦腔渗入人体。
{"title":"Measurement of microplastic release after use of polypropylene nasal irrigation bottles.","authors":"Kyung Soo Kim,Hyun Jin Min","doi":"10.21053/ceo.2024.00182","DOIUrl":"https://doi.org/10.21053/ceo.2024.00182","url":null,"abstract":"ObjectivesMicroplastics from plastic materials can affect human health. This study aimed to assess their presence in nasal irrigation fluids obtained from reused bottles based on usage duration.MethodsReadily available nasal irrigation bottles made of polypropylene were purchased. Unused irrigation bottles served as controls. Bottles mimicking 1-, 3-, and 6-month reuse were prepared as test samples. Nasal irrigation fluid samples (n=12) were collected from each set of irrigation bottles: three from new control bottles and nine from bottles mimicking 1-, 3-, and 6-month reuse. Raman spectroscopy was employed to detect microplastics in the nasal irrigation samples; the results were compared according to the bottle use duration.ResultsAn average of 33.00±20.42 (ea/300 mL) microplastic particles was detected in the nasal irrigation fluid from the control bottles relative to an average of 68.66±30.07, 261.66±20.59, and 204.33±52.16 (ea/300 mL) from bottles used for 1, 3, and 6 months, respectively. The majority of the detected microplastics were 10-100 μm in size and fragmentshaped in form. The predominant microplastic was polypropylene, indicating direct release from irrigation bottles.ConclusionWe found microplastics in nasal irrigation fluids, likely originating from the repeated use of nasal irrigation bottles. The quantity of microplastics was notably elevated in the samples obtained from bottles simulating 3 months of use compared to those in the control samples. Thus, we propose developing guidelines regulating the duration of nasal irrigation bottle usage to mitigate microplastic infiltration into the body through the sinonasal cavity.","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":"16 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142218326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical efficacy study of position-responding mandibular advancement device in patients with obstructive sleep apnea. 阻塞性睡眠呼吸暂停患者使用位置反应下颌前突矫正器的临床疗效研究。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-29 DOI: 10.21053/ceo.2024.00124
Sung-Woon On, Dong-Kyu Kim, Min Hyuk Lee, Ji Hae Lee, Kyung Chul Lee, Soo-Hwan Byun, Seok Jin Hong

Objectives: Although mandibular advancement device (MAD) treatment is effective in patients with obstructive sleep apnea (OSA), there are still some concerns about its potential therapeutic and side effects. Thus, we developed a novel MAD that auto-titrates depending on its position in patients with OSA. Therefore, we conducted a clinical trial to determine the efficacy of an auto-titrating mandibular advancement device (AMAD) for treating OSA.

Methods: Fourteen patients with OSA were enrolled in this study. Polysomnography (PSG) was conducted at the start of the clinical trial, and PSG with AMAD in situ was performed after three months of treatment.

Results: The mean Epworth Sleepiness Scale (ESS) and STOP-Bang scores were 8.21 ± 4.21 and 5.00 ± 1.00, respectively. After 3 months of treating AMAD, STOP-Bang scores improved to 3.75 ± 1.06; however, there was no significant change in ESS scores. Additionally, we found statistically significant improvements in several respiratory parameters in the PSG data after AMAD treatment. The AHI (32.85 ± 21.71 to 12.93 ± 10.70), supine AHI (45.91 ± 23.58 to 15.59 ± 12.76), lateral AHI (13.94 ± 10.95 to .49 ± 7.40), lowest O2 saturation (79.71 ± 6.22 to 84.00 ± 5.71), total arousal number (191.14 ± 112.07 to 86.57 ± 48.80), and arousal index (33.76 ± 21.00 to 15.05 ± 8.42) were recorded. However, there were no significant changes in total sleep time, sleep efficiency, or mean oxygen saturation. Additionally, we did not observe any major side effects during treatment, specifically related to tooth or jaw pain.

Conclusion: Our clinical trial revealed that AMAD improved PSG parameters and reduced the incidence of common side effects. Therefore, AMAD may be an effective alternative treatment for OSA.

目的:虽然下颌前突矫正器(MAD)对阻塞性睡眠呼吸暂停(OSA)患者的治疗效果显著,但其潜在的治疗效果和副作用仍令人担忧。因此,我们开发了一种新型下颌前突装置,可根据 OSA 患者的位置自动调整。因此,我们进行了一项临床试验,以确定自动滴定下颌前突装置(AMAD)治疗 OSA 的疗效:本研究共纳入了 14 名 OSA 患者。临床试验开始时进行多导睡眠图(PSG)检查,治疗三个月后在原位安装 AMAD 的情况下进行多导睡眠图检查:结果:埃普沃斯嗜睡量表(ESS)和 STOP-Bang 评分的平均值分别为 8.21 ± 4.21 和 5.00 ± 1.00。治疗 AMAD 3 个月后,STOP-Bang 评分提高到 3.75 ± 1.06,但 ESS 评分没有显著变化。此外,我们还发现,在 AMAD 治疗后,PSG 数据中的几个呼吸参数有了统计学意义上的明显改善。AHI(32.85 ± 21.71 到 12.93 ± 10.70)、仰卧 AHI(45.91 ± 23.58 到 15.59 ± 12.76)、侧卧 AHI(13.94 ± 10.95 到 .49 ± 7.40)、最低氧气饱和度(79.71±6.22至84.00±5.71)、总唤醒数(191.14±112.07至86.57±48.80)和唤醒指数(33.76±21.00至15.05±8.42)。然而,总睡眠时间、睡眠效率和平均血氧饱和度均无明显变化。此外,我们在治疗过程中没有观察到任何重大副作用,特别是与牙齿或下巴疼痛有关的副作用:我们的临床试验显示,AMAD 改善了 PSG 参数,降低了常见副作用的发生率。因此,AMAD 可能是治疗 OSA 的有效替代疗法。
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引用次数: 0
Microbiome and mycobiome analyses in continuous positive airway pressure devices. 持续气道正压装置中的微生物组和霉菌生物组分析。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-13 DOI: 10.21053/ceo.2024.00167
Hyun Jin Min, Bo-Yun Choi, Woo Jun Sul, Hyung-Ju Cho

Objectives: Microorganisms are likely present in continuous positive airway pressure (CPAP) devices used daily. Considering the potential risk of infections among CPAP device users, here we aimed to compare the microbiomes in CPAP devices with those in nasal mucosal samples obtained from corresponding individuals using these devices.

Methods: We conducted a prospective cohort study at tertiary medical institutes. Samples were collected from the tubes and filters of CPAP devices and the nasal mucosa of corresponding individuals using these devices. Microbiomes and mycobiomes were analyzed using 16S ribosomal RNA and internal transcribed spacer region sequencing. Results were compared according to the sampling site and usage duration for each patient.

Results: Overall, 27 paired human nasal mucosa and CPAP samples were analyzed. Bacteria were present in 7 of 27 tubes (29.6%) and 22 of 27 filters (81.5%). Fungi were present in 2 of the 27 tubes (7.4%) and 16 of the 27 filters (59.3%). Actinobacteria and Firmicutes were the predominant phyla among all samples. Fungi were not detected in any of the nasal mucosal samples. However, Basidiomycota and Ascomycota were predominant in the CPAP filters and tube samples. No significant associations were identified among the results according to sampling site and usage duration.

Conclusion: Bacteria or fungi can be detected to some extent in CPAP samples even if the CPAP usage period is short. The association between respiratory infections and these microbiomes or mycobiomes was not investigated. Further research might be required to determine the risk posed by CPAP devices as a microbial contamination source.

目的:日常使用的持续气道正压(CPAP)装置中可能存在微生物。考虑到 CPAP 设备使用者的潜在感染风险,我们在此旨在比较 CPAP 设备中的微生物群与从使用这些设备的相应个体中获得的鼻粘膜样本中的微生物群:方法:我们在三级医疗机构开展了一项前瞻性队列研究。方法:我们在三级医疗机构开展了一项前瞻性队列研究,从 CPAP 设备的管道和过滤器以及使用这些设备的相应患者的鼻腔粘膜中采集样本。使用 16S 核糖体 RNA 和内部转录间隔区测序分析微生物组和霉菌生物组。根据每位患者的采样部位和使用时间对结果进行比较:结果:共分析了 27 份成对的人类鼻粘膜和 CPAP 样本。27 个管道中有 7 个存在细菌(29.6%),27 个过滤器中有 22 个存在细菌(81.5%)。真菌存在于 27 个试管中的 2 个(7.4%)和 27 个过滤器中的 16 个(59.3%)。放线菌和真菌是所有样本中的主要菌门。在所有鼻粘膜样本中均未检测到真菌。不过,在 CPAP 过滤器和管道样本中,主要是基枝菌纲和子囊菌纲。根据采样部位和使用时间的不同,结果之间没有发现明显的关联:结论:即使使用 CPAP 的时间较短,也能在 CPAP 样本中检测到一定程度的细菌或真菌。呼吸道感染与这些微生物群或真菌生物群之间的关系尚未得到研究。要确定 CPAP 设备作为微生物污染源所带来的风险,可能还需要进一步的研究。
{"title":"Microbiome and mycobiome analyses in continuous positive airway pressure devices.","authors":"Hyun Jin Min, Bo-Yun Choi, Woo Jun Sul, Hyung-Ju Cho","doi":"10.21053/ceo.2024.00167","DOIUrl":"10.21053/ceo.2024.00167","url":null,"abstract":"<p><strong>Objectives: </strong>Microorganisms are likely present in continuous positive airway pressure (CPAP) devices used daily. Considering the potential risk of infections among CPAP device users, here we aimed to compare the microbiomes in CPAP devices with those in nasal mucosal samples obtained from corresponding individuals using these devices.</p><p><strong>Methods: </strong>We conducted a prospective cohort study at tertiary medical institutes. Samples were collected from the tubes and filters of CPAP devices and the nasal mucosa of corresponding individuals using these devices. Microbiomes and mycobiomes were analyzed using 16S ribosomal RNA and internal transcribed spacer region sequencing. Results were compared according to the sampling site and usage duration for each patient.</p><p><strong>Results: </strong>Overall, 27 paired human nasal mucosa and CPAP samples were analyzed. Bacteria were present in 7 of 27 tubes (29.6%) and 22 of 27 filters (81.5%). Fungi were present in 2 of the 27 tubes (7.4%) and 16 of the 27 filters (59.3%). Actinobacteria and Firmicutes were the predominant phyla among all samples. Fungi were not detected in any of the nasal mucosal samples. However, Basidiomycota and Ascomycota were predominant in the CPAP filters and tube samples. No significant associations were identified among the results according to sampling site and usage duration.</p><p><strong>Conclusion: </strong>Bacteria or fungi can be detected to some extent in CPAP samples even if the CPAP usage period is short. The association between respiratory infections and these microbiomes or mycobiomes was not investigated. Further research might be required to determine the risk posed by CPAP devices as a microbial contamination source.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Surgical and Regenerative Treatment Options for Empty Nose Syndrome: A Systematic Review. 空鼻综合征的手术和再生治疗方案:系统综述。
IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI: 10.21053/ceo.2023.00038
Do Hyun Kim, Mohammed Abdullah Basurrah, Soo Whan Kim, Sung Won Kim

Objectives: Patients with empty nose syndrome typically experience paradoxical nasal congestion, nasal dryness, epistaxis, and suffocation. Conservative management is generally preferred for empty nose syndrome. However, some patients continue to experience persistent symptoms. When symptoms do not resolve, surgical options are considered. Therefore, we reviewed the surgical and regenerative treatment options for empty nose syndrome.

Methods: PubMed, Embase, Scopus, Cochrane Register of Controlled Trials, and Google Scholar were searched from the earliest date provided in the database until December 2022. This review included studies that assessed treatment outcomes using patient symptom scores, including the Sino-Nasal Outcome Test (SNOT-20, -22, and -25) and the Empty Nose Syndrome 6-Item Questionnaire, supplemented by various clinical examinations.

Results: Twenty-eight studies were analyzed. Various materials were utilized, including submucosal injectable materials, allografts/xenografts/cadaveric implants, autologous implants, and synthetic implants. The polyethylene implant was the most commonly used (23.3%), followed by autologous, homologous, or cadaveric costal cartilage (20%). The anterior-inferior lateral nasal wall was the most frequent site of administration. Most studies indicated that surgical intervention led to significant improvements in clinical outcomes, as evidenced by endoscopic exams, acoustic rhinometry, and computed tomography scans, along with patient-reported enhancements in nasal symptoms, psychological well-being, and overall health-related quality of life. However, several studies found no improvement in certain psychological-related questionnaires or saccharin transit times. The average follow-up duration was 12.0 months (range, 2.0-27.6 months). Only two studies reported postoperative adverse effects.

Conclusion: Several surgical options and recent tissue regeneration techniques have demonstrated efficacy in treating empty nose syndrome. However, more detailed investigations involving a larger number of participants and a randomized control study are necessary to establish a standardized treatment protocol for patients with empty nose syndrome.

目的:空鼻综合征患者通常患有矛盾性鼻塞、鼻腔干燥、鼻衄和窒息。保守治疗是空鼻综合征的一般选择。然而,也有一些患者会持续抱怨症状。如果症状持续存在,就需要考虑手术治疗。因此,我们回顾了空鼻综合征的手术和再生治疗方案:方法:我们检索了 PubMed、Embase、Scopus、Cochrane Controlled Trials Register 和 Google Scholar,检索时间从数据库提供的最早日期开始,直至 2022 年 12 月。在这些研究中,治疗效果是通过患者症状评分来衡量的,如中国-鼻结果测试(SNOT-20、22和25)、空鼻综合征6项问卷(ENS6Q)以及各种临床检查:结果:分析了 28 项研究。结果:分析了 28 项研究,使用了粘膜下注射材料、同种异体移植/异种移植/卡达维植入物、自体植入物和合成植入物。其中,聚乙烯植入物最常用(23.3%),其次是自体、同种或尸体肋软骨(20%)。最常见的植入部位是鼻腔前内侧外侧壁。大多数研究显示,手术干预能显著改善内窥镜检查、声学鼻测量和 CT 等临床结果,以及患者的鼻部症状、心理或整体健康相关生活质量问卷调查报告。不过,有几项研究并未证实某些心理相关问卷或糖精转运时间的改善效果。平均随访时间为 12.0(2.0-27.6)个月。只有两项研究报告了术后不良反应:结论:几种手术方案和最新的组织再生技术在治疗空鼻综合征方面显示出了积极的疗效。然而,还需要进行更多的详细调查和随机对照研究,以制定治疗空鼻症患者的标准化方案。
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引用次数: 0
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Clinical and Experimental Otorhinolaryngology
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