European Archives of Oto-Rhino-Laryngology最新文献

Introduction: Various factors, including an aging population and expanding eligibility criteria, may increase the demand for cochlear implants (CIs), potentially resulting in longer waiting times. In most Dutch CI centers, the time between referral and surgery exceeds 6 months. Clinical experience suggests that during the waiting period for cochlear implantation, hearing and communication difficulties increase. Simultaneously, there is an interest in outcomes more closely aligned with patient values and needs, which resulted in the SMILE (Societal Merit of Interventions on hearing Loss Evaluation) study. This paper presents results on observed changes in societal and participatory outcomes during waiting time in participants with a time to CI surgery exceeding 6 months.

Methods: SMILE is a prospective multi-center study including 232 individuals who were referred for unilateral CI. Continuous and nominal data from multiple questionnaires, sent immediately after referral and shortly before surgery, were analyzed by computing differences, Cohen's D, and odds ratios.

Results: Of the total 232 participants, 102 had a time between inclusion and surgery exceeding 6 months. Of these, 89 had (partially) filled out surveys at both time points. Of all the domain scores 55% did not show differences between timepoints. All Cohen's D estimates were relatively small, ranging from - 0.298 to 0.388 for those outcomes that showed noteworthy changes.

Conclusion: Waiting time from referral to surgery, even though exceeding 6 months, was observed to not seriously affect non-clinically-prioritized patients in an adverse way. Future investigations should identify subgroups on tolerable waiting times regarding short- and long-term outcomes.

Trial registration: Trial registration number at ClinicalTrials.gov: NCT05525221, 25-8-2022.

Purpose: The pathophysiology of COVID-19 remains unclear. Olfactory dysfunction is one of the neurological symptoms of the disease. There is no evidence to evaluate whether there is a morphometric change in the olfactory pathways. This study aimed to examine the effect of COVID-19 on olfactory center sections through morphometric measurements obtained from autopsy cases.

Methods: Our study was conducted on 63 autopsy cases (COVID-19 [n = 37], control (non-COVID) [n = 26]) between the ages of 18-80 years who came to Tokat Forensic Medicine Institute. The anatomical structures of the olfactory tracts were determined on the brains removed during routine autopsy. The dimensions of the structures belonging to the olfactory center sections were measured with a precision digital caliper, weights were measured with a precision digital scale, and volumes were measured with a 0.01 cm³ graduated cylinder. The Archimedes principle method was used for volume calculations.

Results: In the autopsy cases examined, it was found that there was a significant decrease in bilateral olfactory bulb (OB) and olfactory tract (OT) volumes in COVID-19 group (p < 0.001). In addition, OB and OT weights were lighter in COVID-19 group on both sides (p < 0.001). The length, width and depth measurements of the examined anatomical structures were found to be shorter in COVID-19 group (p < 0.01).

Conclusion: Autopsy findings showed damage in olfactory center sections in COVID-19 group. We believe that knowing the OB and OT morphology in particular will make significant contributions to both clinical approaches and future studies in the pathology of infectious diseases.

Purpose: The main objective of this study was to compare laryngeal dystonia (LD) and vocal tremor's (VT) response to botulinum toxin injection.

Methods: Retrospective study including every patient with LD or VT injected with botulinum toxin guided by electromyography, from January 1, 2010, to September 30, 2022, at a tertiary hospital centre. Improvement was assessed with the VHI-10, grade of dysphonia in a visual analogue scale (VAS; 0-10), GRBAS(I) scale (0-3) and maximum phonation time (MPT).

Results: A total of 77 patients were included, 44 patients with LD and 33 with VT. There were no differences between groups on pre-treatment VHI-10, grade of dysphonia in the VAS, MPT and G, R, B, A and I at diagnosis (p > 0.05). S was significantly higher in patients with LD (p < 0.001). After the first injection, both groups showed an increase in the grade of dysphonia on the VAS and a decrease in VHI-10, G, S and I (p < 0.05), with a higher variation in the VAS and S parameters in the LD group compared to VT (p < 0.05). In the 54 patients that performed two or more injections, G, S and I had a higher decrease in patients with LD when compared to patients with VT (p < 0.05).

Conclusion: BTX injection was successful in improving the VHI-10, grade of dysphonia on the VAS and G, S and I in the GRBAS-I scale for both DT and VT. LD seems to have a better response to BTX in comparison to VT.

Purpose: As a common pathogen of rhinosinusitis, the role of Staphylococcus aureus in modulating autophagy through STING activation and Th17 cell differentiation in CRSwNP remains unexplored. This study aims to investigate how S. aureus regulates Th17 cell differentiation and the occurrence and development of autophagy in CRS by inducing STING expression.

Methods: Immunoblotting and flow cytometry were employed to assess the expression levels of STING, RORγt, LC3B, and MUC5AC, as well as Th17 markers in cells. HNECs were co-cultured with S. aureus in vitro to explore its regulatory effects.

Results: STING expression was found to be decreased in CRSwNP tissues, while RORγt, LC3B, and MUC5AC levels were elevated. S. aureus was shown to induce Th17 differentiation via STING regulation. STING activators reduced Th17 inflammation, while autophagy activators increased autophagosomes and MUC5AC levels.

Conclusion: The STING system may play a protective role in the inflammatory response of nasal epithelial cells. S. aureus inhibits STING, not only by promoting the differentiation of pathogenic Th17 cells but also by increasing autophagy levels in nasal epithelial cells. Both mechanisms contribute to the enhanced expression of MUC5AC, facilitating the progression of CRSwNP.

Introduction: Mixed neuroendocrine and non-neuroendocrine neoplasms (MiNENs) refer to a heterogenous group of rare neoplasms which is usually composed of a neuroendocrine population which is either well differentiated and more frequently poorly differentiated along with a non-neuroendocrine component, each of the above accounting for at least 30% of the tumour population. It is most commonly seen in the gastro-entero-pancreatic tract. MiNENs have an aggressive behaviour due to its high grade neuroendocrine component and have poor prognosis. This is the first case reported in literature of a MiNEN in the oropharynx.

Case report: 69 year old male patient with no co morbidities presented to the outpatient department with complains of odynophagia for 1 month. He had history of neoadjuvant chemotherapy followed by transoral robotic surgery (TORS) with right selective neck dissection (SND) done in 2019 for carcinoma base of tongue. On flexible laryngoscopy, an ulcerative lesion was noted over the left base of tongue. Although PET scan done showed no significant abnormalities. Biopsy from the lesion showed features of poorly differentiated carcinoma along with morphological features of poorly differentiated neuroendocrine carcinoma (small cell carcinoma). He was planned for upfront surgery (TORS with left SND). Post operatively recovery was uneventful and patient was on ryles tube feed for 12 days. Final histopathology report showed features of mixed neuroendocrine non neuroendocrine neoplasm. He has been on follow up for 1 year with no features of recurrence.

Conclusion: MiNEN is an aggressive tumour which has poor prognosis and is most commonly located in the gastrointestinal tract. This is the first case reported in oropharynx who has been successfully treated and has been on follow up.

Background: This study investigates the relationship between the recurrence of Chronic Otitis Media with Otorrhea (ChOLE) and patient-related factors, surgical procedures, and elements. It involved 190 patients and aimed to identify significant relationships between demographics, condition severity, surgical approaches, comorbidities, problem classification, hygiene practices, and education level. Statistical analyses, including Chi-Square tests, were used to determine these connections.

Methodology: Data from 190 patients were meticulously reviewed, leading to significant discoveries. Statistical techniques, particularly Chi-Square tests, were employed to comprehend the links between ChOLE recurrence and diverse patient-related factors.

Results: The examination yielded crucial insights, revealing significant correlations between ChOLE recurrence and comorbidities, education level, complications, problem classification, and hygiene habits. These findings were confirmed with a confidence level of 95%. Moreover, specific relationships were observed between recurrence and surgical procedures, geographic location, and condition severity.

Conclusion: This study highlights the significance of factors like comorbidities, education level, complications, problem classification, and hygiene practices in predicting ChOLE recurrence. It also reveals notable associations with surgical techniques, patient location, and condition severity. Understanding these factors is vital for assessing recurrence risk, improving patient care, and developing personalized treatments. These findings advance our understanding of ChOLE recurrence, enabling more targeted interventions for this common ear condition.

Aim: The purpose of this study was to evaluate the effect of menstrual cycle phases on the vestibular system in healthy adult women.

Materials and methods: A total of 40 healthy adult women aged 18-40 years without hearing or balance complaints were included in the study. The participants were administered the Vestibular Evoked Myogenic Potentials (VEMP) test, the Video Head Impulse Test (vHIT), the Dizziness Handicap Inventory (DHI), and the Hospital Anxiety and Depression Scale (HADS). Participants' pre- and post-menstrual test results were compared.

Results: Cervical VEMP (cVEMP) and ocular VEMP (cVEMP) N1, P1 latency measurements and vHIT results of the participants before and after menstruation were not statistically significantly different (p > 0.05). A statistically significant difference was found in the participants' DHI and HADS scores before and after menstruation (p < 0.05).

Conclusion: It was observed that symptoms such as dizziness and anxiety, which are more common in the premenstrual period, were reflected in our subjective tests but not in our objective tests and clinic. This study will provide a benchmark for comparison in future studies of hormonal changes in menstrual cycle phases.

Background: Currently, there is a debate around the use of biological agents in the treatment of chronic sinusitis with nasal polyps. Therefore, this study's purpose was to assess the effectiveness of various biologics in the treatment of chronic rhinosinusitis with nasal polyps.

Methods: A systematic and manual search was conducted for all relevant studies from inception to December 20, 2023. Two independent authors carried out the search, screening, assessment, and data extraction. Network meta-analysis was conducted using STATA 14 software.

Results: Our analysis includes a comprehensive set of 19 studies. These studies compared the efficacy of four distinct biologic treatments. The results of reticulated Meta-analysis showed that Dupilumab (MD = - 1.85, 95% CI: - 2.47, - 1.24), Omalizumab (MD = - 1.30, 95% CI: - 1.90, - 0.70), Benralizumab (MD = - 0.84, 95% CI: - 1.66, - 0.03) and Mepolizumab (MD = - 1.48, 95% CI: - 2.22, - 0.74) were superior to placebo from the nasal polyp score(NPS), Dupilumab (MD = - 12.56, 95% CI: - 22.49,- 2.63) was superior to placebo from the Sino-Nasal Outcome Test-22(SNOT-22)score, and Dupilumab (MD = - 0.84, 95% CI: - 1.08, - 0.59) and Omalizumab (RR = - 0.51, 95% CI: - 0.83, - 0.19) were superior to placebo from the nasal congestion severity(NCS). In terms of cumulative sorting under the surface of the curve (SUCRA) values, Dupilumab was the best performer in the NPS (0.92), SNOT-22 score (0.70), and NCS (0.93); Four different biologics outperformed placebo in the NPS, SNOT-22 score, and NCS.

Conclusion: In patients with CRSwNP, based on the efficacy (NPS, (SNOT-22) score, NCS) and, dupilumab is the most efficacious for CRSwNP.