Clinical Otolaryngology最新文献

英文中文

Internal Maxillary Artery Pretreatment Is Valuable for Bleeding Control for Endonasal Infratemporal Fossa Surgery 颌内动脉预处理对腔内颞下窝手术的出血控制很有价值。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-13 DOI: 10.1111/coa.14228

Lifeng Li, Shangfeng Zhao, Jun Kang, Xiaohong Chen

引用次数: 0

A Systematic Review and Meta-Analysis of the Efficacy of Antimicrobial Chemoprophylaxis for Recurrent Acute Otitis Media in Children 儿童复发性急性中耳炎抗菌药物预防疗效的系统回顾和荟萃分析》（A Systematic Review and Meta-Analysis of the Efficacy of Antimicrobial Chemoprophylaxis for Recurrent Acute Otitis Media in Children）。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-12 DOI: 10.1111/coa.14240

Timothy Davies, Xicheng Peng, Joseph Salem, Zeynep C. Elcioglu, Anna Kremneva, Mei-yin Gruber, Kristijonas Milinis, Michael W. Mather, Jason Powell, Sunil Sharma

Objectives

Acute otitis media (AOM) is a common childhood infection. Recurrent AOM affects a subset of children, resulting in an adverse impact on quality of life, socioeconomic disadvantage, and risk of long-term sequelae. Antimicrobial chemoprophylaxis is used in some settings but is increasingly controversial due to an awareness of adverse long-term effects and contribution to global antibiotic resistance.

Design and Setting

A comprehensive literature search was undertaken using Medline (1946–October 2023) and Embase (1974–October 2023). The primary aim was to assess the efficacy of antimicrobial chemoprophylaxis on AOM episodes in children < 18 years of age. Bias and quality assessment was performed. Dichotomous data were analysed using risk ratio with 95% confidence intervals. Meta-analysis was carried out using random-effects models for pooled analysis, independent of heterogeneity. Heterogeneity was assessed using the I ² statistic.

Main Outcome Measures

The effect of antimicrobial chemoprophylaxis in children with rAOM on the number of individual AOM episodes. Secondary outcomes: assessment of antimicrobial agents and outcomes in children with risk factors.

Results

Assessment of qualitative data was performed on 20 studies (n = 2210). No controlled trials were identified post-multivalent pneumococcal conjugate vaccine (PCV) introduction, restricting current generalisability. Quantitative meta-analysis on nine pre-PCV studies (n = 1087) demonstrated antimicrobial chemoprophylaxis reduced any episode of AOM with a risk ratio 0.59 (95% CI 0.45–0.77).

Conclusion

Families and clinicians must balance marginal short-medium term benefit (based on pre-PCV data), and the potential for adverse effects to that individual, and the societal risk of antimicrobial resistance with prolonged antibiotic use.

目的：急性中耳炎（AOM）是一种常见的儿童感染疾病。反复发作的急性中耳炎会影响一部分儿童，对他们的生活质量、社会经济地位和长期后遗症风险造成不利影响。抗菌药物化学预防在某些情况下被使用，但由于人们意识到其长期不良影响以及对全球抗生素耐药性的影响，抗菌药物化学预防越来越受到争议：利用 Medline（1946 年至 2023 年 10 月）和 Embase（1974 年至 2023 年 10 月）进行了全面的文献检索。主要目的是评估抗菌药物化学预防对2岁儿童AOM发作的疗效：次要结果：评估抗菌药物和存在风险因素的儿童的结果：对 20 项研究（n = 2210）的定性数据进行了评估。在引入多价肺炎球菌结合疫苗 (PCV) 后，未发现任何对照试验，这限制了目前的普遍性。对接种 PCV 前的 9 项研究（n = 1087）进行的定量荟萃分析表明，抗菌药物化学预防可减少 AOM 的发病，风险比为 0.59（95% CI 0.45-0.77）：家庭和临床医生必须平衡短期和中期的边际效益（基于 PCV 前的数据）、对个人的潜在不良影响以及长期使用抗生素产生抗菌素耐药性的社会风险。

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引用次数: 0

Impact of the Prognostic Nutritional Index on the Development of Sialocele or Salivary Fistula, After Parotidectomy 腮腺切除术后预后营养指数对发生涎瘘的影响

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-10 DOI: 10.1111/coa.14244

Zehra Betül Paksoy, Fatma Cemre Sazak Kundi

Purpose

Sialocele or salivary fistula formation is common after parotidectomy. This study aims to evaluate the predictive value of the prognostic nutritional index in the development of salivary fistulas and sialoceles after parotidectomy.

Methods

Patients who underwent parotidectomy at our clinic and were diagnosed with benign salivary gland masses were included in the study. Patients who developed postoperative sialoceles or salivary fistulas were identified. Various factors were assessed, including surgical technique, tumour size, gender, age, prognostic nutritional index, and the volume of the excised mass. Variables associated with sialocele or salivary fistula were later included in a multiple logistic regression model. Possible factors related to the formation of sialocele or salivary fistulas were analysed.

Results

The study comprised 158 patients (95 male and 63 female). The frequency of sialocele or salivary fistula development was 13.9% (n = 22). The multiple logistic regression model found that the prognostic nutritional index(PNI) was linked to the occurrence of sialocele or salivary fistula (ORs = 0.9, 95% CI = [0.9], p = 0.003). Warthin tumour was associated with an elevated risk of sialocele or salivary fistula (ORs = 0.38, 95% CI = [0.184, 0.79], p = 0.009). ROC analysis demonstrated that the PNI had a specificity of 90% and a sensitivity of 68%. No significant associations were observed between the excised tumour size, surgical technique with the development of sialocele or salivary fistula.

Conclusion

Prognostic nutritional index can be utilised as an independent risk factor for the development of sialocele, or salivary fistula.

目的：腮腺切除术后形成涎瘘或唾液瘘很常见。本研究旨在评估预后营养指数对腮腺切除术后发生涎瘘和涎管的预测价值：研究对象包括在本诊所接受腮腺切除术并被诊断为良性唾液腺肿块的患者。确定术后出现涎窦或涎瘘的患者。对各种因素进行了评估，包括手术技术、肿瘤大小、性别、年龄、预后营养指数和切除肿块的体积。与咽峡部瘘或涎瘘相关的变量随后被纳入多元逻辑回归模型。分析了与涎囊或涎瘘形成有关的可能因素：研究共包括 158 名患者（95 名男性和 63 名女性）。涎囊或涎瘘形成的频率为 13.9%（n = 22）。多元逻辑回归模型发现，预后营养指数（PNI）与涎管或涎瘘的发生有关（ORs = 0.9，95% CI = [0.9]，P = 0.003）。疣状肿瘤与咽峡部或涎瘘风险升高有关（ORs = 0.38，95% CI = [0.184，0.79]，p = 0.009）。ROC分析表明，PNI的特异性为90%，灵敏度为68%。切除肿瘤的大小、手术技术与咽峡部瘘管或唾液瘘管的发生无明显关联：预后营养指数可作为发生咽峡炎或涎瘘的独立风险因素。

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引用次数: 0

Additive Effect of Blood and Tissue Eosinophilia on Chronic Rhinosinusitis With Nasal Polyps 血液和组织嗜酸性粒细胞增多对伴有鼻息肉的慢性鼻炎的叠加效应

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-10 DOI: 10.1111/coa.14243

Peipei Yang, Yongcong Shen, Wenqing Wang, Yuhong Wang, Yuhui Fan, Jisheng Liu, Dan Zhang

Purpose

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly heterogeneous disease with varied clinical features and treatment effects. This study aimed to investigate the additive effect of blood and tissue eosinophilia on patients with CRSwNP.

Methods

Based on the blood eosinophil (Beos) count and tissue eosinophil (Teos) count, we divided 144 CRSwNP patients into four groups, analysed their clinical features and histopathologic changes, and investigated their postoperative control.

Results

Patients in the Beos⁺Teos⁺ (blood eosinophil count > 0.3 × 10⁹/L, tissue eosinophil count > 10/HPF) group had a higher incidence of allergic rhinitis (AR) and asthma. Lund-Mackay (LM) scores, hyposmia visual analogue scale (VAS) scores and Global Osteitis Scoring Scale (GOSS) scores were higher in the Beos⁺Teos⁺ group than those in the other groups. Tissue remodelling, such as connective tissue oedema and basement membrane thickening was more severe in the Beos⁺Teos⁺ group compared with other groups. There were more uncontrolled patients after surgery in Beos⁺Teos⁺, Beos⁺Teos⁻ (blood eosinophil count > 0.3 × 10⁹/L, tissue eosinophil count ≤ 10/HPF)and Beos⁻Teos⁺ (blood eosinophil count ≤ 0.3 × 10⁹/L, tissue eosinophil count > 10/HPF)groups compared with the Beos⁻Teos⁻ group.

Conclusions

Eosinophilic inflammation both in blood and tissue was accompanied by more severe clinical features and tissue remodelling. Eosinophilia in blood or tissue indicated poorer disease control after surgery.

目的：慢性鼻炎伴鼻息肉（CRSwNP）是一种高度异质性疾病，其临床特征和治疗效果各不相同。本研究旨在探讨血液和组织嗜酸性粒细胞增多对 CRSwNP 患者的叠加效应：根据血液嗜酸性粒细胞（Beos）计数和组织嗜酸性粒细胞（Teos）计数，我们将 144 例 CRSwNP 患者分为四组，分析他们的临床特征和组织病理学变化，并调查他们的术后控制情况：结果：Beos+Teos+（血液嗜酸性粒细胞计数> 0.3 × 109/L，组织嗜酸性粒细胞计数> 10/HPF）组患者过敏性鼻炎（AR）和哮喘的发病率较高。Beos+Teos+ 组的伦德-马凯（LM）评分、低渗视觉模拟量表（VAS）评分和全球骨炎评分量表（GOSS）评分均高于其他组。与其他组相比，Beos+Teos+组的结缔组织水肿和基底膜增厚等组织重塑更为严重。与 Beos-Teos- 组相比，Beos+Teos+组、Beos+Teos-组（血液中嗜酸性粒细胞计数 > 0.3 × 109/L，组织中嗜酸性粒细胞计数≤ 10/HPF）和 Beos-Teos+ 组（血液中嗜酸性粒细胞计数≤ 0.3 × 109/L，组织中嗜酸性粒细胞计数 > 10/HPF）术后未受控制的患者更多：血液和组织中的嗜酸性粒细胞炎症伴随着更严重的临床特征和组织重塑。血液或组织中的嗜酸性粒细胞增多表明术后疾病控制较差。

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引用次数: 0

In Reference to Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma 关于对难治性声带肉芽肿进行局部类固醇注射的治疗效果。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-08 DOI: 10.1111/coa.14229

Manon Louvrier, Noémie Nemry, Jennifer Aoun, Mejdeddine Al Barajraji, Jerome R. Lechien

引用次数: 0

Feasibility of Indocyanine Green Fluorescence Endoscopic Assisted Resection of Sinonasal Tumours 吲哚青绿荧光内窥镜辅助鼻窦肿瘤切除术的可行性。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-02 DOI: 10.1111/coa.14238

Mohamed Abdelmohsen Alnemr, Johannes A. Rijken, Weibel W. Braunius, Dominique N. V. Donders, Remco de Bree

引用次数: 0

Screening for Psychiatric Disorders in Chronic Rhinosinusitis Patients Waiting for Surgery: A Prospective Cross-Sectional Study 对等待手术的慢性鼻炎患者进行精神障碍筛查：一项前瞻性横断面研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-10-02 DOI: 10.1111/coa.14239

Liang Peng, Hui-Fang Wang, Dong-Fang Wang, Yi-Hui Wen, Hua Zhong, Wei-Ping Wen, Jian Li

Objective

To assess the prevalence of depression, anxiety, insomnia and somatic symptom disorder (SSD) in chronic rhinosinusitis (CRS) patients who were waiting for surgery and to predict these psychiatric disorders using the 22-item Sinonasal Outcome Test (SNOT-22).

Design

A prospective cross-sectional study.

Setting

The rhinology ward at our institution, a tertiary hospital.

Participants

Adult patients (> 18 years) diagnosed with CRS who were admitted to the rhinology ward for endoscopic sinus surgery and were able to understand and complete the study questionnaires.

Main Outcome Measures

Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), Insomnia Severity Index (ISI), Patient Health Questionnaire-15 (PHQ-15) and SNOT-22.

Results

Of the 159 participants recruited, 58 were at risk of depression (defined by PHQ-9 > 4, while 25 with PHQ-9 > 9), 49 were at risk of anxiety (defined by GAD-7 > 4, while 25 with GAD-7 > 9), 81 were at risk of insomnia (defined by ISI > 7, while 51 with ISI > 14) and 69 were at risk of SSD (defined by PHQ-15 > 4, while 24 with PHQ-15 > 9). The SNOT-22 score was closely correlated with the scores of psychometric tests and was an independent predictor of these psychiatric disorders. Patients with a high SNOT-22 score (> 30) are likely to be affected by comorbid psychiatric disorders and should be further evaluated by otolaryngologists.

Conclusion

Depression, anxiety, insomnia and SSD are prevalent in CRS patients. Otolaryngologists should have a low threshold to ask the patient about psychiatric symptoms, especially for patients with an SNOT-22 score > 30.

目的评估等待手术的慢性鼻窦炎（CRS）患者中抑郁、焦虑、失眠和躯体症状障碍（SSD）的患病率，并使用22项鼻窦结果测试（SNOT-22）预测这些精神障碍：前瞻性横断面研究：参与者：成年患者（18 岁以上）：主要结果测量指标：患者健康问卷-9（Patient Health Questionnaire-9）：患者健康问卷-9（PHQ-9）、广泛性焦虑症-7（GAD-7）、失眠严重程度指数（ISI）、患者健康问卷-15（PHQ-15）和SNOT-22：在招募的 159 名参与者中，58 人有抑郁风险（PHQ-9 > 4，25 人 PHQ-9 > 9），49 人有焦虑风险（GAD-7 > 4，25 人 GAD-7 > 9），81 人有失眠风险（ISI > 7，51 人 ISI > 14），69 人有 SSD 风险（PHQ-15 > 4，24 人 PHQ-15 > 9）。SNOT-22 评分与心理测试评分密切相关，是这些精神障碍的独立预测指标。SNOT-22得分较高（大于30分）的患者很可能合并有精神疾病，应由耳鼻喉科医生进行进一步评估：结论：抑郁、焦虑、失眠和 SSD 在 CRS 患者中很普遍。结论：抑郁、焦虑、失眠和 SSD 在 CRS 患者中普遍存在，耳鼻喉科医生在询问患者精神症状时应降低门槛，尤其是 SNOT-22 评分大于 30 分的患者。

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引用次数: 0

Cochlear Synaptopathy Evaluation With Electrocochleography in Patients With Hearing Difficulty in Noise Despite Normal Hearing Levels 用电耳蜗造影术评估听力水平正常但在噪音中听力困难的患者的耳蜗突触病。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-09-30 DOI: 10.1111/coa.14235

Murat Yaşar, Fatih Öner, Fatma Atalay, Sezai Sacid Anbar

Objective

This study examined patients with normal hearing thresholds who had trouble understanding speech in noise. We used electrocochleography (ECochG) to detect and compare SP/AP amplitude area ratios, a potential indicator of cochlear synaptopathy, and investigate speech perception disorder in noise.

Methods

The study included 68 people aged between 18 and 65 years, 35 patients and 33 healthy volunteers, who applied to the otorhinolaryngology clinic between November 2023 and March 2024 with a 2-month history of difficulty understanding speech in noisy environments. Everyone was given a tiptrode electrode ECochG test, and the results were compared between groups. An ECochG test was recorded with tiptrode electrodes and was performed on all participants, and the results were compared between groups.

Results

In the ECochG test, the summation potential/action potential (SP/AP) amplitude and area ratios of patients who had difficulty understanding speech in a noisy environment were statistically higher than those of the control group.

Conclusion

ECochG testing may provide additional evidence to evaluate auditory nerve pathways.

研究目的本研究对听阈正常但在噪声中理解言语有困难的患者进行了调查。我们使用耳蜗电图（ECochG）检测和比较 SP/AP 振幅面积比（耳蜗突触病的潜在指标），并研究噪声中的言语感知障碍：研究对象包括 68 名年龄在 18 岁至 65 岁之间的人，其中 35 名是患者，33 名是健康志愿者，他们于 2023 年 11 月至 2024 年 3 月期间到耳鼻喉科门诊就诊，有 2 个月的嘈杂环境中言语理解困难病史。每个人都接受了尖端电极心电图测试，并对各组结果进行了比较。用尖端电极记录所有参与者的心电图测试，并比较各组之间的结果：结果：在心电图测试中，在嘈杂环境中理解语言有困难的患者的总和电位/动作电位（SP/AP）振幅和面积比在统计学上高于对照组：结论：心电图测试可为评估听觉神经通路提供更多证据。

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引用次数: 0

Paediatric Laryngeal Ultrasound: A Retrospective Cohort Study in Aotearoa New Zealand and an International Survey 儿科喉部超声波：新西兰奥特亚罗瓦的回顾性队列研究和一项国际调查。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-09-30 DOI: 10.1111/coa.14237

Silvia Giovanna Marinone Lares, Georgia Mackay, Sita Tarini Clark, Jeyasakthy Saniasiaya, Craig McCaffer

Objective

Vocal fold immobility (VFI) is a cause of significant morbidity and mortality in the paediatric population. Laryngoscopy is the current first-line investigation for patients with suspected VFI. Laryngeal ultrasound (LUS) has recently emerged as an alternative method of identifying VFI. Compared to laryngoscopy, LUS is less invasive, does not require anaesthesia, and can be performed by non-otolaryngologists. The objectives of this study are to evaluate LUS as a diagnostic method for the identification of VFI in a cohort of paediatric patients in Aotearoa New Zealand (NZ) and to estimate the frequency of use of LUS in the paediatric population by clinicians around the world.

Methods

A retrospective, single-centre cohort study was performed on all paediatric patients who had undergone laryngoscopy and LUS at Starship Children's Health in Auckland, NZ, between 2020 and 2023. An eight-question survey was also developed and distributed to better understand clinicians' use of LUS in their clinical practice to diagnose paediatric VFI globally.

Results

Twenty-nine paediatric patients met the inclusion criteria. LUS demonstrated good sensitivity (80.95%) for detecting VFI and increased to 93.33% for the detection of unilateral VFI. Of the 87 respondents to the survey, 41.38% utilise LUS in their clinical practice in the paediatric population. The main barriers to implementation of LUS as identified by non-users were lack of equipment, expertise, and training.

Conclusions

These findings support the use of LUS as an accurate diagnostic tool for the detection of unilateral VFI. Further studies in non-surgical populations and in patients with bilateral VFI, as well as standardised guidelines for LUS technique and reporting, are required.

目的：声带不动（VFI）是导致儿科重大疾病和死亡的原因之一。喉镜检查是目前对疑似 VFI 患者进行检查的一线方法。喉超声（LUS）是最近出现的一种识别 VFI 的替代方法。与喉内镜检查相比，喉超声检查创伤更小，不需要麻醉，非耳鼻喉科医生也能操作。本研究的目的是评估 LUS 作为一种诊断方法在新西兰奥特亚罗瓦（Aotearoa New Zealand，NZ）一组儿科患者中对 VFI 的识别效果，并估计世界各地临床医生在儿科人群中使用 LUS 的频率：一项回顾性单中心队列研究针对 2020 年至 2023 年期间在新西兰奥克兰 Starship Children's Health 接受喉镜检查和 LUS 的所有儿科患者。为了更好地了解临床医生在临床实践中使用 LUS 诊断全球儿科 VFI 的情况，研究人员还编制并分发了一份包含八个问题的调查问卷：结果：29 名儿科患者符合纳入标准。LUS 检测 VFI 的灵敏度良好（80.95%），检测单侧 VFI 的灵敏度提高到 93.33%。在接受调查的 87 位受访者中，41.38% 在儿科临床实践中使用 LUS。未使用 LUS 的受访者认为，使用 LUS 的主要障碍是缺乏设备、专业知识和培训：这些研究结果支持使用 LUS 作为检测单侧 VFI 的准确诊断工具。需要对非手术人群和双侧 VFI 患者进行进一步研究，并制定 LUS 技术和报告的标准化指南。

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引用次数: 0

Fiberoptic Bronchoscope Guided Assessment of Vocal Cord Function Using Bailey's Manoeuvre With an I-Gel Supraglottic Airway Device in Patients Undergoing Thyroid Surgery: An Initial Exploratory Prospective Study 使用 I-Gel 声门上气道装置在纤维支气管镜引导下评估甲状腺手术患者的声带功能：一项初步探索性前瞻性研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology

Pub Date : 2024-09-30 DOI: 10.1111/coa.14227

Ashwini Reddy, Nidhi Singh, Narender Kaloria, Shiv Lal Soni, Ajay Singh, Naveen Banavathu Naik, Priya Thappa, Naresh Panda

引用次数: 0

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