European Archives of Oto-Rhino-Laryngology最新文献

Purpose: To investigate the risk of swallowing disorders and the frequency and intensity of vocal tract symptoms in patients with chronic rhinosinusitis and nasal polyposis (CRSwNP).

Methods: Adult patients diagnosed with CRSwNP presenting to the rhinology clinic of a tertiary referral center between March 2023 and March 2024, were recruited. Patients with acute or recent history of respiratory tract infections, tonsillitis, pharyngitis or otitis, were excluded. The frequency and severity of nasal symptoms and their impact on quality of life was assessed using the Sinonasal Outcome Test (SNOT-22). The Eating Assessment Tool (EAT-10) was used to evaluate the risk of swallowing disorders, and the Vocal Tract Discomfort Scale (VTDS) was used to evaluate the frequency and intensity of vocal tract symptoms.

Results: Twenty-five patients with CRSwNP and 25 controls were recruited for this study. There was a statistically significant difference in the mean EAT-10 score between the study group and control group (3.52 ± 4.68 vs.0.88 ± 1.83; p = 0.013). There was also a statistically significant difference in the mean VTDS score between the study group and control group (12.56 ± 7.9 vs. 4 ± 4.64; p < 0.001). There was a positive moderate correlation between the VTDS score and the SNOT-22 score (r = 0.595; p < 0.001).

Conclusion: The study indicates that patients with CRSwNP have a higher risk for swallowing disorders and are more likely to experience vocal tract symptoms than healthy controls.

Introduction: There are inconsistencies in how different endoscopic procedures to manage Bilateral Vocal Fold Immobility (BVFI) have been described in the literature. This limits our ability to compare functional outcomes. There is no unifying international terminology available that precisely describes the anatomical boundaries and extent of the different types of treatment. A pan-European consensus regarding terminology of different endoscopic surgical procedures to manage BVFI in adults was developed.

Methods: Thirty-one expert laryngologists and phoniatricians of the European Laryngological Society (ELS) or Union of the European Phoniatricians (UEP), participated in a modified Delphi process. They voted on an initial series of 13 proposed statements, including graphical visualization of different endoscopic surgical techniques for BVFI. Statements reaching > 70% of agreement in the first voting round were accepted. In the second voting round, eight revised and newly proposed statements were accepted with an increased threshold of > 80%.

Results: Fourteen statements were anonymously validated through two voting rounds. The following categories of endoscopic arytenoid and vocal fold surgery were defined: total arytenoidectomy, partial arytenoidectomy (subclassified into subtotal, anteromedial, posteromedial and superomedial), posterior cordectomy (subclassified into ligamental, transmuscular and ventriculocordectomy) and transverse cordotomy (subclassified into posterior cordotomy and ventriculocordotomy). The suffixes 'with mucosal preservation', 'with laterofixation' and 'combined procedure' were defined too.

Conclusion: This ELS-UEP consensus on endoscopic arytenoid and vocal fold surgery for BVFI provides a practical nomenclature and classification to improve reporting in literature and clinical practice and to allow comparison of functional outcomes.

Purpose: 'Illness perceptions' refers to the thoughts and ideas a person has about an illness. According to Leventhal's Self-Regulatory Model (SRM), changing the threatening illness perceptions of cochlear implant (CI) recipients can be a further step in optimizing hearing outcomes with the CI. The aims of the present study were to assess users' illness perceptions and to determine whether perceptions change during six months of CI rehabilitation.

Methods: One hundred and thirty-eight participants completed the Brief Illness Perception Questionnaire (Brief IPQ), assessing their illness perceptions on nine scales. Data were collected at a German CI center at first CI fitting and six-month follow-up. After first fitting, participants underwent intensive rehabilitation including auditory training, medical, audiological and psychological treatments.

Results: At both assessments, participants tended to view their hearing impairment as a severe threat. On the Brief IPQ, the 'consequences' assessment improved during CI rehabilitation, which can be explained by the CI-induced hearing improvement. However, 'understanding' and 'identity' assessments worsened. This could be because CI recipients only come to realize the full complexity of their hearing impairment during rehabilitation. The other scales and the total score remained unaffected.

Conclusions: Current practice in CI rehabilitation seems to be insufficient to improve threatening illness perceptions (except for perceived consequences). This may be because standard information often fails to reach the patients. The development and empirical validation of an intervention program to address individual illness perceptions in CI recipients could be helpful in this context. Further research will be needed to confirm the results.

Background: Despite a high prevalence of chronic otitis media and related complications, many African dispensaries and clinics lack microscopes or fiberoptic equipment for examining external ear ducts and tympanic membranes.

Method: An alternative, inexpensive, and readily available device designed for ear wax removal is presented as a clinical ear and anterior nasal cavity examination tool. The device connects to Wi-Fi or cellular networks, providing high-definition images of the ear and anterior nasal cavity through a smartphone interface. Its use, utility, strengths, and limitations are discussed.

Conclusion: This paper describes a novel, cost-effective, and user-friendly device for examining the external ear, tympanic membrane, and anterior nasal cavity of patients throughout humanitarian missions.

Purpose: The aim of this study is to propose a classification for patients with recurrent head and neck squamous cell carcinoma (HNSCC) treated with salvage surgery based on the location of the primary tumor and data commonly found in the pathological report of the resection.

Methods: Retrospective study of 665 patients with HNSCC treated with a salvage surgery after a local and/or regional recurrence of the tumor.

Results: We propose a new postoperative classification for patients with recurrent HNSCC treated with salvage surgery. PATH classification stratifies patients into 4 stages based on the glottic or non-glottic location of the primary tumor, the local and regional pathologic extension of the tumor, the status of the surgical margins, and the presence of lymph node metastases with extracapsular spread. The PATH classification was more homogeneous in the prognosis of patients included in each of its stages, and it had a better prognostic discrimination capacity between stages than the rpTNM classification. According to the PATH classification, the 5-year disease-specific survival was: PATH I (n = 306) 82.8%; PATH II (n = 119) 47.1%; PATH III (n = 202) 24.4%; PATH IV (n = 38) 3.7%. For the rpTNM classification, the 5-year disease-specific survival was: stage I (n = 119) 85.1%; stage II (n = 134) 68.4%; stage III (n = 111) 59.5%; stage IV (n = 301) 33.3%.

Conclusion: The PATH classification for HNSCC patients with local and/or regional recurrence treated with salvage surgery had a better prognostic capacity than the rpTNM classification.

Level of evidence: Level IV.

Introduction: Hearing impairment concerns a relevant percentage of individuals with Osteogenesis Imperfecta (OI). When looking at the current literature, the percentage of affected individuals with OI varies greatly from 32 to 58% of patients having mild OI and 21% to 27% of patients having moderate to severe OI. Little is known about the German population with OI.

Method: The goal of this study was to detect how many patients with OI, who visited the annual meeting of the German Association for Osteogenesis Imperfecta in 2023, proved to have a hearing impairment. In this prospective, cross-sectional study, each included individual obtained ear microscopy, audiometry, stapedius reflexes, tympanometry, and OAEs. Furthermore, each patient was asked a set of questions concerning the medical history.

Results: Of the included patients, 33% had hearing impairment. A significant difference was found for the mean air-bone gap (ABG) as well as the hearing threshold of the right ears. The difference was found between OI type III and IV (p = 0.0127) for the mean ABG and OI type I and IV (p = 0.0138) as well as III and IV (p = 0.0281) for the hearing threshold. Spearman's rank correlation showed a high correlation between age and hearing threshold. Of the patients between 40 and 50 years old, 56% had hearing loss.

Conclusion: Hearing loss in individuals with OI is still a relevant problem, especially age-related in OI type I. Audiometry should be performed at least when individuals experience subjective hearing loss. The implementation of a screening starting at 40 years should be discussed and studied.

Purpose: This study aimed to investigate correlation between the presence of endolymphatic hydrops(EH) and factors such as causes of hearing loss, patient age, duration of deafness, and results of vestibular function tests.

Methods: We retrospectively reviewed medical charts of 128 ears of cochlear implantees who were not considered relevant to Meniere's disease.

Results: When comparing group with genetic variants of GJB2, SLC26A4, LMX1A and other genetic mutation group, the proportion of vestibular EH and cochlear EH found in group with genetic variants of GJB2, SLC26A4, LMX1A was significantly higher than group with other genetic etiology (p < 0.01) or the group with all the other causes of hearing loss (p < 0.01). The rate of vestibular and cochlear EH detection was higher in younger patients (41.5% and 35.4%) than in older patients (25.4% and 20.6%). A higher ratio of vestibular and cochlear EH was observed in patients with a longer duration of deafness (37.5% and 31.3%) than those with a shorter duration of deafness (29.7% and 25.0%). The group with vestibular EH showed a higher incidence of abnormal findings in the caloric test (42.9%) than the group without vestibular EH (28.2%).

Conclusion: Patients with genetic variants of GJB2, SLC26A4, LMX1A, younger patients, those with longer deaf durations showed a higher prevalence of vestibular and cochlear EH, implying EH appears to be formed as a developmental disorder in association with a certain set of genetic variants, rather than a phenotypic marker as a result of severe to profound hearing loss.

Purpose: Retraction is the removal of published material due to flaws in research that cannot be corrected. Our aim was to perform a systematic review of all retracted literature in Ear Nose and Throat to understand the characteristics of retraction and the citations of retracted literature.

Methods: The Retraction Watch, EMBASE and MEDLINE databases were systematically searched to yield relevant retractions. Two independent authors performed abstract and full-text screening. Non-relevant texts, articles in non-English languages, and articles that were neither published (protocols) or retracted (expression of concern) were excluded.

Results: We found 225 retractions in Ear Nose and Throat literature from 1992 to 2023. The number of retractions increased with time, and the average time-to-retraction was 1 year (range 0-29). Most articles were retracted due to misconduct (72%). In total, 191/225 of retractions were signposted with a retraction notice; 90.6% of notices were linked to the original manuscript; 96.9% specified the reason for retraction and 100% were freely accessible. Publications were cited more after retraction (median 2, range 0-215 vs median 0, range 0-78, Z -1.78, p = 0.075), however this was not significant, and appeared to improve with a shorter retraction time (RS 0.67, p < 0.001).

Conclusion: Retractions, although rare, are increasing across all scientific disciplines. Our data suggests that retractions are both efficiently and transparently publicised in the Ear Nose and Throat Literature. Investigators should be veracious when conducting their own research and regularly appraise manuscripts to ensure that misinformation is not perpetuated, remaining aware that retracted articles continue to be cited.